Identification of Substance-Exposed Newborns and Neonatal Abstinence Syndrome Using ICD-10-CM — 15 Hospitals, Massachusetts, 2017

Goyal, Sonal; Saunders, K.C.; Moore, Chiara S; Fillo, Katherine T; Ko, Jean Y.; Manning, Susan E.; Shapiro-Mendoza, Carrie K.; Gupta, Munish; Romero, Lisa; Coy, Kelsey; McDow, Kendra B.; Keaton, Amelia A.; Sinatra, Jennifer; Jones, Katarina; Alpren, Charles; Barfield, Wanda D.; Diop, Hafsatou

doi:10.15585/mmwr.mm6929a2

Cited by 20 publications

(21 citation statements)

References 5 publications

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“…CSTE’s standardized definition might help clarify which infants should be reported for future surveillance efforts. Previous studies have found that use of P96.1 to identify infants with NAS can yield high PPV ( 4 , 7 , 8 ), and a combination of P96.1 or P04.49 improves sensitivity but decreases PPV ( 5 ). Second, in this investigation, infants with more severe signs and symptoms of NAS were more likely to be assigned P96.1.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, in this investigation, this strategy relied on reviewing medical records of a selected group of infants with diagnosis codes indicative of prenatal substance exposure or a NAS symptom, and not only NAS diagnosis codes. Additional work is needed to identify the optimal subset of codes to identify possible infants with NAS ( 5 , 7 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of neonatal abstinence syndrome (NAS), a withdrawal syndrome associated with prenatal opioid or other substance exposure ( 1 ), has increased as part of the U.S. opioid crisis ( 2 ). No national NAS surveillance system exists ( 3 ), and data about the accuracy of state-based surveillance are limited ( 4 , 5 ). In February 2018, the Pennsylvania Department of Health began surveillance for opioid-related NAS in birthing facilities and pediatric hospitals * ( 6 ).…”

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confidence: 99%

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Assessment of Neonatal Abstinence Syndrome Surveillance — Pennsylvania, 2019

Krause¹,

Gruber²,

Ailes³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Assessment of Neonatal Abstinence Syndrome Surveillance — Pennsylvania, 2019

Krause¹,

Gruber²,

Ailes³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

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“…During 2017, the NAS rate among publicly insured (Medicaid) infants (5.0 per 1,000 live births) was notably higher than among privately insured infants (0.7 per 1,000 live births) (IDPH, 2019). This data must be examined cautiously as there is evidence to support variability in testing related to race and insurance state (Goyal et al, 2020). The highest NAS rate in Illinois was among residents of urban counties outside the Chicago metropolitan area, and among residents of rural counties.…”

Section: Opioid Use and Nas In Illinoismentioning

confidence: 99%

The interaction of neonatal abstinence syndrome and opioid use disorder treatment availability for women insured by medicaid

Reising

Horne

Bennett

2020

Public Health Nursing

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Objective: This paper will discuss the process of mapping opioid use disorder (OUD) treatment resources for pregnant women and discuss the intersection between treatment resources and rates of neonatal abstinence syndrome (NAS). Design: A resource manual was developed through a systematic process with stakeholders across Illinois. Resources were mapped by county and overlaid with county rates of NAS, using hospital discharge data. Results: Across Illinois, 89 treatment resources were identified for pregnant women insured by Medicaid. Resources were concentrated in 36% of Illinois' counties. Counties with limited treatment resources generally had high rates of NAS. Sixty-six percent of NAS cases among rural Illinois residents had no OUD treatment resources in their county. Rural counties had less access to medication-assisted treatment (MAT), the standard of care for treatment of OUD, compared with other counties across the state. Conclusions: Efforts to increase OUD treatment options for pregnant women insured by Medicaid should concentrate on geographic areas with limited access and high need. K E Y W O R D S access to health care, community assessment, medication-assisted treatment, neonatal abstinence syndrome, opioid use disorder, pregnancy, substance use disorder How to cite this article: Reising VA, Horne A, Bennett AC. The interaction of neonatal abstinence syndrome and opioid use disorder treatment availability for women insured by medicaid.

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“…Hospital discharge and administrative data remain the most common data sources for surveillance of these conditions across US jurisdictions 4,5 and have been validated for NAS. 6,7 On October 1, 2015, the transition to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) expanded coding specificity (Table 1), including the introduction of codes to identify long-term (current) use of opioid analgesics and unspecified opioid use. In previous work, researchers documented that the ICD-10-CM transition was associated with increased opioid-related diagnoses in hospital discharges.…”

mentioning

confidence: 99%

Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses: Analysis of ICD-10-CM Transition, 2013–2017

Hirai

Owens

et al. 2021

Hospital Pediatrics

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BACKGROUND AND OBJECTIVES: Hospital discharge records remain a common data source for tracking the opioid crisis among pregnant women and infants. The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) transition from the International Classification of Diseases, Ninth Revision, Clinical Modification may have affected surveillance. Our aim was to evaluate this transition on rates of neonatal abstinence syndrome (NAS), maternal opioid use disorder (OUD), and opioid-related diagnoses (OUD with ICD-10-CM codes for long-term use of opioid analgesics and unspecified opioid use).METHODS: Data from the 2013-2017 Healthcare Cost and Utilization Project's National Inpatient Sample were used to conduct, interrupted time series analysis and log-binomial segmented regression to assess whether quarterly rates differed across the transition.RESULTS: From 2013 to 2017, an estimated 18.8 million birth and delivery hospitalizations were represented. The ICD-10-CM transition was not associated with NAS rates (rate ratio [RR]: 0.99; 95% confidence interval [CI]: 0.90-1.08; P = .79) but was associated with 11% lower OUD rates (RR: 0.89; 95% CI: 0.80-0.98; P = .02) and a decrease in the quarterly trend (RR: 0.98; 95% CI: 0.96-1.00; P = .04). The transition was not associated with maternal OUD plus long-term use rates (RR: 0.98; 95% CI: 0.89-1.09; P = .76) but was associated with a 20% overall increase in opioid-related diagnosis rates including long-term and unspecified use (RR: 1.20; 95% CI: 1.09-1.32; P < .001). CONCLUSIONS:The ICD-10-CM transition did not appear to affect NAS. However, coding of maternal OUD alone may not capture the same population across the transition, which confounds the interpretation of trend data spanning this time period.

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Identification of Substance-Exposed Newborns and Neonatal Abstinence Syndrome Using ICD-10-CM — 15 Hospitals, Massachusetts, 2017

Cited by 20 publications

References 5 publications

Assessment of Neonatal Abstinence Syndrome Surveillance — Pennsylvania, 2019

Assessment of Neonatal Abstinence Syndrome Surveillance — Pennsylvania, 2019

The interaction of neonatal abstinence syndrome and opioid use disorder treatment availability for women insured by medicaid

Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses: Analysis of ICD-10-CM Transition, 2013–2017

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