TY - JOUR T1 - Descriptive exploration of overdose codes in hospital and emergency department discharge data to inform development of drug overdose morbidity surveillance indicator definitions in ICD-10-CM JF - Injury Prevention JO - Inj Prev SP - i27 LP - i34 DO - 10.1136/injuryprev-2019-043520 VL - 27 IS - Suppl 1 AU - Leigh M Tyndall Snow AU - Katelyn E Hall AU - Cody Custis AU - Allison L Rosenthal AU - Emilia Pasalic AU - Sarah Nechuta AU - James W Davis AU - Bretta Jane Jacquemin AU - Sherani R Jagroep AU - Peter Rock AU - Elyse Contreras AU - Barbara A Gabella AU - Katherine A James Y1 - 2021/03/01 UR - http://injuryprevention.bmj.com/content/27/Suppl_1/i27.abstract N2 - Background In October 2015, discharge data coding in the USA shifted to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), necessitating new indicator definitions for drug overdose morbidity. Amid the drug overdose crisis, characterising discharge records that have ICD-10-CM drug overdose codes can inform the development of standardised drug overdose morbidity indicator definitions for epidemiological surveillance.Methods Eight states submitted aggregated data involving hospital and emergency department (ED) discharge records with ICD-10-CM codes starting with T36–T50, for visits occurring from October 2015 to December 2016. Frequencies were calculated for (1) the position within the diagnosis billing fields where the drug overdose code occurred; (2) primary diagnosis code grouped by ICD-10-CM chapter; (3) encounter types; and (4) intents, underdosing and adverse effects.Results Among all records with a drug overdose code, the primary diagnosis field captured 70.6% of hospitalisations (median=69.5%, range=66.2%–76.8%) and 79.9% of ED visits (median=80.7%; range=69.8%–88.0%) on average across participating states. The most frequent primary diagnosis chapters included injury and mental disorder chapters. Among visits with codes for drug overdose initial encounters, subsequent encounters and sequelae, on average 94.6% of hospitalisation records (median=98.3%; range=68.8%–98.8%) and 95.5% of ED records (median=99.5%; range=79.2%–99.8%), represented initial encounters. Among records with drug overdose of any intent, adverse effect and underdosing codes, adverse effects comprised an average of 74.9% of hospitalisation records (median=76.3%; range=57.6%–81.1%) and 50.8% of ED records (median=48.9%; range=42.3%–66.8%), while unintentional intent comprised an average of 11.1% of hospitalisation records (median=11.0%; range=8.3%–14.5%) and 28.2% of ED records (median=25.6%; range=20.8%–40.7%).Conclusion Results highlight considerations for adapting and standardising drug overdose indicator definitions in ICD-10-CM. ER -