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Medical utilization surrounding initial opioid-related diagnoses by coding method.

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|February 15, 2020
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Coding methods for opioid-related disorder (ORD) diagnoses in administrative claims impact medical utilization. Buprenorphine for medication-assisted treatment (BUP-MAT) coding shows lower costs and utilization than F11 codes.

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Area of Science:

  • Health Services Research
  • Medical Informatics
  • Public Health

Background:

  • Opioid-related disorder (ORD) is a significant public health issue.
  • Accurate coding of initial ORD diagnoses in administrative claims is crucial for understanding healthcare utilization.
  • Different coding methods may reflect varying patient acuity and treatment pathways.

Purpose of the Study:

  • To identify methods for coding initial opioid-related disorder (ORD) diagnoses in administrative claims.
  • To determine if coding methods correlate with acute medical utilization patterns.

Main Methods:

  • Retrospective analysis of commercial claims data (Blue Health Intelligence).
  • Included members with continuous coverage around initial ORD diagnosis (Oct 2015-Mar 2016).
  • Identified initial ORD using ICD-10-CM F11 codes or buprenorphine for medication-assisted treatment (BUP-MAT). Analyzed costs, opioid agonist prescriptions (OAP), inpatient/ED visits, and long-term opiate use codes (Z79.891).

Main Results:

  • 6426 initial ORD diagnoses identified: F11.20 (65.2%), F11.x (28.7%), BUP-MAT (6.1%).
  • BUP-MAT coding showed lower costs ($2054 PMPM) compared to F11 codes ($5053-$6597 PMPM) in the diagnosis month.
  • Members coded with F11.x had higher inpatient (30.9%) and ED (26.8%) visit rates than F11.20 and BUP-MAT.

Conclusions:

  • Medical utilization patterns for patients with opioid-related disorder (ORD) vary significantly based on the administrative claims coding method.
  • Coding initial ORD using buprenorphine for medication-assisted treatment (BUP-MAT) is associated with lower healthcare costs and utilization compared to F11 codes.