The invisible cost of pain management by the current International Classification of Diseases coding system: a study in a tertiary care inpatient setting
Issued Date
2023-09-01
Resource Type
eISSN
18726623
Scopus ID
2-s2.0-85168315978
Pubmed ID
37027141
Journal Title
Pain
Volume
164
Issue
9
Start Page
2009
End Page
2015
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pain Vol.164 No.9 (2023) , 2009-2015
Suggested Citation
Eiamtanasate S. The invisible cost of pain management by the current International Classification of Diseases coding system: a study in a tertiary care inpatient setting. Pain Vol.164 No.9 (2023) , 2009-2015. 2015. doi:10.1097/j.pain.0000000000002899 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/88863
Title
The invisible cost of pain management by the current International Classification of Diseases coding system: a study in a tertiary care inpatient setting
Author(s)
Other Contributor(s)
Abstract
ABSTRACT: The International Classification of Diseases ( ICD ) is applied worldwide for public health data collection among other use cases. However, the current version of the ICD ( ICD-10 ), to which the reimbursement system is linked in many countries, does not represent chronic pain properly. This study aims to compare the ICD-10 with the ICD-11 in hospitalized patients in terms of specificity, clinical utility, and reimbursement for pain management. The medical records of hospitalized patients consulted for pain management at Siriraj Hospital, Thailand, were reviewed, and all pain-related diagnoses were coded into ICD-10 and ICD-11 . The data of 397 patients showed unspecified pain was coded 78% in the ICD-10 and only 0.5% in the ICD-11 version. The difference gap in the proportion of unspecified pain between the 2 versions is wider than in the outpatient setting. The 3 most common codes for ICD-10 were other chronic pain, low back pain, and pain in limb. The 3 most common codes for ICD-11 were chronic cancer pain, chronic peripheral neuropathic pain, and chronic secondary musculoskeletal pain. As in many other countries, no pain-related ICD-10 codes were coded for routine reimbursement. The simulated reimbursement fee remained the same when adding 397 pain-related codings, even if the cost of pain management, such as cost of labor, existed. Compared with the ICD-10 version, the ICD-11 is more specific and makes pain diagnoses more visible. Thus, shifting from ICD-10 to ICD-11 has the potential to improve both the quality of care and the reimbursement for pain management.