ICD-9-CM to ICD-10-CM transition

Hi All,

Here at Public Health — Seattle & King County we are starting to use our Medicaid claims data to look at time trends. One of the barriers to doing this is the switch from ICD-9-CM to ICD-10-CM.

We began with the General Equivalence Mappings (GEMS) that were generated from CMS, but found those problematic as we noted a number of large bumps that appear to be due to newer conditions being added to ICD-10-CM. For example, asthma, as defined in the Clinical Classification Software (CCS), includes chronic obstructive pulmonary disease in the ICD-10-CM definition. That means we see a spike in cases, starting in Q4 2015.

We are aware of some work at the Council of State and Territorial Epidemiologists (CSTE) around falls, alcohol and other drugs, and opioids. However, we haven't seen any work yet focused on chronic disease (diabetes, asthma, CVD, etc) definitions.

I wanted to see if anyone in this group has any experience in tracking chronic conditions across the ICD switch. If not, perhaps this could be the focus of a call in the coming months.

Thanks,
Alastair