ICD10 Guideline for drugs and substances: Difference between revisions
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**Psychoactive drugs/substances/agents -- these are substances of abuse, not pharmaceuticals. Includes: alcohol, opioids, sedative/hypnotics, cocaine, stimulants (including methamphetamine), hallucinogens (including hallucinogenic mushrooms), solvents + a wastebasket of "NOS" | **Psychoactive drugs/substances/agents -- these are substances of abuse, not pharmaceuticals. Includes: alcohol, opioids, sedative/hypnotics, cocaine, stimulants (including methamphetamine), hallucinogens (including hallucinogenic mushrooms), solvents + a wastebasket of "NOS" | ||
**Drugs/biologics -- these are specific pharmaceutical agents + wastebaskets of "NOS" | **Drugs/biologics -- these are specific pharmaceutical agents + wastebaskets of "NOS" | ||
**Non-medicinal | **Non-medicinal substances -- these are toxins/poisons, including toxic alcohols( methanol, ethylene glycol, isopropyl alcohol), organic solvents, acids, metals, carbon monoxide, gases/fumes/vapors, pesticides, food poisoning, cyanide, venom from animals + a wastebasket of "NOS" | ||
=== Categories of medical problem and the agents to which they can be used: === | === Categories of medical problem and the agents to which they can be used: === | ||
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|searchlabel= Drug/substance '''withdrawal'''... | |searchlabel= Drug/substance '''withdrawal'''... | ||
}} | }} | ||
*{{#ask: [[Has ICD10Dx::~*"used appropriately, adverse effect (reaction, allergy, hypersensitivity)"]] | *{{#ask: [[Has ICD10Dx::~*"used appropriately, adverse effect (reaction, allergy, hypersensitivity)"]] | ||
|limit=0 | |limit=0 | ||
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**Includes: reaction, allergy, or hypersensitivity to the drug | **Includes: reaction, allergy, or hypersensitivity to the drug | ||
*overdose/poisoning" and "poisoning/toxic effect" | *The final two categories are: "overdose/poisoning" and "poisoning/toxic effect" | ||
**overdose/poisoning is the term used in application to | *They seem similar, but they don't overlap because they apply to different agents. | ||
**poisoning/toxic effect is the term used in application to | **overdose/poisoning is the term used in application to drugs/biologics | ||
**poisoning/toxic effect is the term used in application to nonmedicinal substances | |||
*{{#ask: [[Has ICD10Dx::~*"overdose/poisoning"]] | |||
|limit=0 | |limit=0 | ||
|format=broadtable | |format=broadtable | ||
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|searchlabel= Drug/substance '''overdose/poisoning'''... | |searchlabel= Drug/substance '''overdose/poisoning'''... | ||
}} | }} | ||
{{Discuss | who = Tina | | |||
*AG ISSUE -- Tina I've tried here to clarify the apparent confusion between "intoxication, acute" vs. "overdose/poisoning. We need 2 separate lists for these, so need to make the 2nd of them which includes the 14 items T51.0 to T65.9 }} | |||
=== To Clarify How Agent Type and Medical Problems Mix & Match === | === To Clarify How Agent Type and Medical Problems Mix & Match === | ||
*Regarding confusion between '''intoxication, acute''' vs. either '''overdose/poisoning''' or '''poisoning/toxic effect" | |||
**Acute intoxication indicates just that. Being drunk is a good example of acute ethanol intoxication. These generally require just observation, not treatment. | |||
**On the other hand, an overdose, poisoning or toxic effect indicates that the patient either has a medical consequence, or is at high risk of getting one -- so that some medical treatment is given. These treatments might include: activated charcoal, gastric lavage or dialysis; use of an antidote or neutralizing agent; life support if the overdose caused shock or respiratory failure; or others. | |||
**But clearly there can be some overlap. A common example is the drunk person who is felt in the ED to be "not protecting their airway" and so is intubated for this rationale. Because it is so difficult to judge the "need" for such things, the rule we will use to distinguish between them is to use '''intoxication, acute''' if no treatment is given, and to use '''overdose/poisoning''' or '''poisoning/toxic effect" if treatment is given. | |||
*Regarding confusion between '''intoxication, acute''' vs. '''overdose/poisoning''' | |||
**Acute intoxication indicates just that. Being drunk is a good example of acute | |||
**On the other hand, an overdose | |||
**But clearly there can be some overlap. A common example is the drunk person who is felt in the ED to be "not protecting their airway" and so is intubated for this rationale. Because it is so difficult to judge the "need" for such things, the rule we will use to distinguish between them is to use '''intoxication, acute''' if no treatment is given, and to use '''overdose/poisoning''' if treatment is given. | |||
*Regarding confusion between '''withdrawal''' vs. '''chronic abuse/dependence/addiction''' | *Regarding confusion between '''withdrawal''' vs. '''chronic abuse/dependence/addiction''' | ||
**Withdrawal refers to the presence of withdrawal symptoms or signs. | **Withdrawal refers to the presence of withdrawal symptoms or signs. | ||
| Line 84: | Line 77: | ||
*Regarding confusion between '''used appropriately, adverse effect (reaction, allergy, hypersensitivity)''' vs. '''intoxication, acute''' | *Regarding confusion between '''used appropriately, adverse effect (reaction, allergy, hypersensitivity)''' vs. '''intoxication, acute''' | ||
**These 2 codes can be used together, if a pharmaceutical is used in the correct dose, and that leads nonetheless to acute intoxication. | **These 2 codes can be used together, if a pharmaceutical is used in the correct dose, and that leads nonetheless to acute intoxication. | ||
{{Discuss | who = Allan | question = This is an evil twin of [[Overdose vs used appropriately/adverse effect]]. This seems to be the healthier twin, though, so maybe it's the one we should keep, evil or otherwise. We'd need to reconcile the two and make sure the links are fixed. Allan, if you can make sure all the content of [[Overdose vs used appropriately/adverse effect|the twin]] is present in here and let me know then I will fix the links at the same time as linking all the other diagnoses to this page via [[Template:ICD10 Guideline drugs and substances]].Ttenbergen 12:32, 2018 June 19 (CDT)}} | {{Discuss | who = Allan | question = This is an evil twin of [[Overdose vs used appropriately/adverse effect]]. This seems to be the healthier twin, though, so maybe it's the one we should keep, evil or otherwise. We'd need to reconcile the two and make sure the links are fixed. Allan, if you can make sure all the content of [[Overdose vs used appropriately/adverse effect|the twin]] is present in here and let me know then I will fix the links at the same time as linking all the other diagnoses to this page via [[Template:ICD10 Guideline drugs and substances]].Ttenbergen 12:32, 2018 June 19 (CDT)}} | ||
[[Category: ICD10 Coding Guidelines]] | [[Category: ICD10 Coding Guidelines]] | ||
Revision as of 08:51, 13 September 2018
| This page contains an ICD10 Coding Guideline for ICD10 collection. See ICD10 coding guidelines for similar pages. |
Coding in ICD10 of Issues Related to Drugs and Substances
Introduction
- This is a bit confusing because there are TWO OVERLAPPING DIMENSIONS to these ICD10 codes
- (1) The type of agent/substance
- (2) The category of problem related to the agent/substance
- Not all categories of problems relate to all types of agents/substances
Regarding the type of agent/substance
- The categories included are:
- Psychoactive drugs/substances/agents -- these are substances of abuse, not pharmaceuticals. Includes: alcohol, opioids, sedative/hypnotics, cocaine, stimulants (including methamphetamine), hallucinogens (including hallucinogenic mushrooms), solvents + a wastebasket of "NOS"
- Drugs/biologics -- these are specific pharmaceutical agents + wastebaskets of "NOS"
- Non-medicinal substances -- these are toxins/poisons, including toxic alcohols( methanol, ethylene glycol, isopropyl alcohol), organic solvents, acids, metals, carbon monoxide, gases/fumes/vapors, pesticides, food poisoning, cyanide, venom from animals + a wastebasket of "NOS"
Categories of medical problem and the agents to which they can be used:
|
|
|
- Drug/substance withdrawal...
- Drug/substance used appropriately, adverse effect (reaction, allergy, hypersensitivity)...
- Includes: reaction, allergy, or hypersensitivity to the drug
- The final two categories are: "overdose/poisoning" and "poisoning/toxic effect"
- They seem similar, but they don't overlap because they apply to different agents.
- overdose/poisoning is the term used in application to drugs/biologics
- poisoning/toxic effect is the term used in application to nonmedicinal substances
|
|
To Clarify How Agent Type and Medical Problems Mix & Match
- Regarding confusion between intoxication, acute vs. either overdose/poisoning or poisoning/toxic effect"
- Acute intoxication indicates just that. Being drunk is a good example of acute ethanol intoxication. These generally require just observation, not treatment.
- On the other hand, an overdose, poisoning or toxic effect indicates that the patient either has a medical consequence, or is at high risk of getting one -- so that some medical treatment is given. These treatments might include: activated charcoal, gastric lavage or dialysis; use of an antidote or neutralizing agent; life support if the overdose caused shock or respiratory failure; or others.
- But clearly there can be some overlap. A common example is the drunk person who is felt in the ED to be "not protecting their airway" and so is intubated for this rationale. Because it is so difficult to judge the "need" for such things, the rule we will use to distinguish between them is to use intoxication, acute if no treatment is given, and to use overdose/poisoning or poisoning/toxic effect" if treatment is given.
- Regarding confusion between withdrawal vs. chronic abuse/dependence/addiction
- Withdrawal refers to the presence of withdrawal symptoms or signs.
- Chronic abuse/dependence/addiction does not necessarily indicate that anything acute is currently occurring.
- These 2 codes can be used together, if appropriate.
- Regarding confusion between used appropriately, adverse effect (reaction, allergy, hypersensitivity) vs. overdose/poisoning
- The difference here is that used appropriately refers to use of a pharmaceutical used in the correct dose. While if that drug is given or taken in excess amount, an overdose/poisoning can occur.
- Regarding confusion between used appropriately, adverse effect (reaction, allergy, hypersensitivity) vs. intoxication, acute
- These 2 codes can be used together, if a pharmaceutical is used in the correct dose, and that leads nonetheless to acute intoxication.
|
|
This is an evil twin of Overdose vs used appropriately/adverse effect. This seems to be the healthier twin, though, so maybe it's the one we should keep, evil or otherwise. We'd need to reconcile the two and make sure the links are fixed. Allan, if you can make sure all the content of the twin is present in here and let me know then I will fix the links at the same time as linking all the other diagnoses to this page via Template:ICD10 Guideline drugs and substances.Ttenbergen 12:32, 2018 June 19 (CDT) |