Nonfatal overdose-related ED visits are and Nonfatal overdose-related IP hospitalizations are drug overdoses defined by any mention of the following diagnosis codes in the discharge paperwork, and do not result in death. Note than one overdose event may include more than one code, indicating multiple drug types suspected or identified thus, counts are not mutually exclusive. For T36.9, T37.9, T39.9, T41.4, T42.7, T43.9, T45.9, T47.9, and T49.9, a 5th character of the following—and for all other codes a 6th character of the following—is required:
1: Accidental (unintentional)
2: Intentional self-harm
3: Assault or
4: Undetermined intent.
Note: 5th or 6th characters of 5 (denoting adverse effect) or 6 (denoting underdosing) are excluded from overdose-related counts.
A 7th character of A indicates an initial encounter for active treatment.
Any Drug
T36–T50: Poisoning by drugs, medicaments, and biological substances
Any Opioid
T40.0X: Poisoning by opium
T40.1X: Poisoning by heroin
T40.2X: Poisoning by other opioids
T40.3X: Poisoning by methadone
T40.4X: Poisoning by synthetic narcotics
T40.60: Poisoning by unspecified narcotics
T40.69: Poisoning by other narcotics
Heroin
T40.1X: Poisoning by heroin
Non-Heroin Opioid
T40.0X: Poisoning by opium
T40.2X: Poisoning by other opioids
T40.3X: Poisoning by methadone
T40.4X: Poisoning by synthetic narcotics
T40.60: Poisoning by unspecified narcotics
T40.69: Poisoning by other narcotics
Stimulant
T40.5X: Poisoning by cocaine
T43.60: Poisoning by unspecified psychostimulants
T43.61: Poisoning by caffeine
T43.62: Poisoning by amphetamines
T43.63: Poisoning by methylphenidate
T43.64: Poisoning by ecstasy and
T43.69: Poisoning by other psychostimulants
Cocaine
T40.5X: Poisoning by cocaine
Non-Cocaine Stimulant
T43.60: Poisoning by unspecified psychostimulants
T43.61: Poisoning by caffeine
T43.62: Poisoning by amphetamines
T43.63: Poisoning by methylphenidate
T43.64: Poisoning by ecstasy and
T43.69: Poisoning by other psychostimulants
Overdose Fatalities:
Death certificate ICD-10 codes are scanned to identify overdose fatalities of Kentucky residents. A drug overdose death is defined as an event that includes an underlying cause of death code falling within the following ranges: X40–X44, X60–X64, X85, or Y10–Y14. Note than one overdose event may be coded with multiple codes, indicating multiple drug types found; thus, counts are not mutually exclusive. Drug overdose deaths are identified by drug type using the following ICD-10 codes:
Any Opioid
T40.0: Poisoning by opium
T40.1: Poisoning by heroin
T40.2: Poisoning by other opioids
T40.3: Poisoning by methadone
T40.4: Poisoning by synthetic narcotics
T40.6: Poisoning by unspecified or other narcotics
Heroin
T40.1: Poisoning by heroin
Non-Heroin Opioid
T40.0: Poisoning by opium
T40.2: Poisoning by other opioids
T40.3: Poisoning by methadone
T40.4: Poisoning by synthetic narcotics
T40.60: Poisoning by unspecified narcotics
T40.69: Poisoning by other narcotics
Stimulant
T40.5: Poisoning by cocaine
T43.60: Poisoning by unspecified psychostimulants
T43.61: Poisoning by caffeine
T43.62: Poisoning by amphetamines
T43.63: Poisoning by methylphenidate
T43.64: Poisoning by ecstasy
T43.69: Poisoning by other psychostimulants
Cocaine
T40.5: Poisoning by cocaine
Non-Cocaine Stimulant
T43.60: Poisoning by unspecified psychostimulants
T43.61: Poisoning by caffeine
T43.62: Poisoning by amphetamines
T43.63: Poisoning by methylphenidate
T43.64: Poisoning by ecstasy
T43.69: Poisoning by other psychostimulants
Substance Use Disorder Diagnosis:
This indicator is meant to capture ED visits or inpatient hospitalizations with a substance use disorder diagnosis (any time the code is used for billing and not necessarily the initial diagnosis) in any diagnosis field. Note that alcohol-related disorders, nicotine dependence, and inhalant-related disorders are excluded. ED or inpatient hospitalization records are scanned for the following ICD-10-CM codes:
Any Opioid
F11: Opioid-related disorders
F12: Cannabis-related disorders
F13: Sedative-, hypnotic-, or anxiolytic-related disorders
F14: Cocaine-related disorders
F15: Other stimulant-related disorders
F16: Hallucinogen-related disorders
F19: Other psychoactive substance-related disorders
Infectious Disease Involvement:
Hepatitis A
B15.0: Hepatitis A with hepatic coma
B15.9: Hepatitis A without hepatic coma
Hepatitis C
B17.10: Acute hepatitis C without hepatic coma
B17.11: Acute hepatitis C with hepatic coma
B18.2: Chronic viral hepatitis C
B19.20: Unspecified viral hepatitis C without hepatic coma
B19.21: Unspecified viral hepatitis C with hepatic coma
Z22.52: Carrier of viral hepatitis C
Human Immunodeficiency Virus (HIV) Disease
B20: HIV disease
Z21: Asymptomatic HIV infection status
Endocarditis
B37.6: Candidal endocarditis
I33.0: Acute and subacute infective endocarditis
I33.9: Acute and subacute infective endocarditis, unspecified
I38: Endocarditis, valve unspecified
I39: Endocarditis and heart valve disorders in diseases classified elsewhere
A32.82: Listerial endocarditis
Hepatitis A with Drug-Related Comorbidity
Any ICD-10-CM code found in Drug(s) with Potential for Abuse and Dependence AND one or more of the ICD-10-CM codes found in Hepatitis A
Hepatitis C with Drug-Related Comorbidity
Any ICD-10-CM code found in Drug(s) with Potential for Abuse and Dependence AND one or more of the ICD-10-CM codes found in Hepatitis C
Human Immunodeficiency Virus with Drug-Related Comorbidity
Any ICD-10-CM code found in Drug(s) with Potential for Abuse and Dependence AND one or more of the ICD-10-CM codes found in Human Immunodeficiency Virus Disease
Endocarditis with Drug-Related Comorbidity
Any ICD-10-CM code found in Drug(s) with Potential for Abuse and Dependence AND one or more of the ICD-10-CM codes found in Endocarditis
Co-Occurring Drug-Related Diagnosis: Drug(s) with Potential for Abuse and Dependence:
This dashboard uses definitions developed by the Council of State and Territorial Epidemiologists’ (CSTE) Indicator 7. (see below for codes). Both emergency department and inpatient regular expressions take an “any mention” approach by searching for the presence of the following codes in any diagnostic category:
F11.1–F11.9: Opioid-related disorders
F12.1–F12.9: Cannabis-related disorders
F13.1–F13.9: Sedative-, hypnotic-, or anxiolytic-related disorders
F14.1–F14.9: Cocaine-related disorders
F15.1–15.9: Other stimulant-related disorders
F16.1–F16.9: Hallucinogen-related disorders
F19.1–F19.9: Other psychoactive substance-related disorders
O99.32: Drug use complicating pregnancy, childbirth, and the puerperium
P04.4: Newborn suspected to be affected by maternal use of drugs of addiction
P96.1: Neonatal withdrawal symptoms from maternal use of drugs of addiction
T40.0–T40.9: Poisoning by narcotics and hallucinogens
T42.3: Poisoning by barbiturates
T42.4: Poisoning by benzodiazepines
T42.6: Poisoning by other antiepileptic and sedative-hypnotic drugs
T42.7: Poisoning by unspecified antiepileptic and sedative-hypnotic drugs
T43.6: Poisoning by psychostimulants
For all T codes, adverse effects, underdosing, and encounters due to sequela are excluded.
Inpatient Hospitalizations:
Also see Infectious Disease Involvement, the contents of which are indicators in both ED and inpatient data.
Neonatal Abstinence Syndrome (NAS) Birth
Both codes must be present for an inpatient hospitalization to be counted. Also note that neonates are grouped by their year of birth, not discharge (unlike with other ED and inpatient indicators). For example, an infant born with NAS at the end of 2019, but discharged in the first quarter of 2020, will be included in the 2019 count.
P96.1: Neonatal withdrawal symptoms from maternal use of drugs of addiction AND Z38: Live-born infant according to place of birth and type of delivery