Hedegaard Holly, Schoenbaum Michael, Claassen Cynthia, Crosby Alex, Holland Kristin, Proescholdbell Scott
Natl Health Stat Report. 2018 Feb(108):1-19.
Suicide and intentional self-harm are among the leading causes of death in the United States. To study this public health issue, epidemiologists and researchers often analyze data coded using the International Classification of Diseases (ICD). Prior to October 1, 2015, health care organizations and providers used the clinical modification of the Ninth Revision of ICD (ICD-9-CM) to report medical information in electronic claims data. The transition in October 2015 to use of the clinical modification of the Tenth Revision of ICD (ICD-10-CM) resulted in the need to update methods and selection criteria previously developed for ICD-9-CM coded data. This report provides guidance on the use of ICD-10-CM codes to identify cases of nonfatal suicide attempts and intentional self-harm in ICD-10-CM coded data sets. ICD-10-CM codes for nonfatal suicide attempts and intentional self-harm include: X71-X83, intentional self-harm due to drowning and submersion, firearms, explosive or thermal material, sharp or blunt objects, jumping from a high place, jumping or lying in front of a moving object, crashing of motor vehicle, and other specified means; T36-T50 with a 6th character of 2 (except for T36.9, T37.9, T39.9, T41.4, T42.7, T43.9, T45.9, T47.9, and T49.9, which are included if the 5th character is 2), intentional self-harm due to drug poisoning (overdose); T51-T65 with a 6th character of 2 (except for T51.9, T52.9, T53.9, T54.9, T56.9, T57.9, T58.0, T58.1, T58.9, T59.9, T60.9, T61.0, T61.1, T61.9, T62.9, T63.9, T64.0, T64.8, and T65.9, which are included if the 5th character is 2), intentional self-harm due to toxic effects of nonmedicinal substances; T71 with a 6th character of 2, intentional self-harm due to asphyxiation, suffocation, strangulation; and T14.91, Suicide attempt. Issues to consider when selecting records for nonfatal suicide attempts and intentional self-harm from ICD-10-CM coded administrative data sets are also discussed.
自杀和故意自伤是美国主要的死亡原因之一。为研究这一公共卫生问题，流行病学家和研究人员经常分析使用国际疾病分类（ICD）编码的数据。在2015年10月1日之前，医疗保健机构和提供者使用ICD第九版临床修订本（ICD-9-CM）在电子理赔数据中报告医疗信息。2015年10月向ICD第十版临床修订本（ICD-10-CM）的转换导致需要更新先前为ICD-9-CM编码数据开发的方法和选择标准。本报告提供了关于在ICD-10-CM编码数据集中使用ICD-10-CM编码识别非致命自杀未遂和故意自伤病例的指导。非致命自杀未遂和故意自伤的ICD-10-CM编码包括：X71-X83，因溺水和浸没、火器、爆炸或热材料、锐器或钝器、从高处跳下、跳到或躺在移动物体前、机动车碰撞及其他特定方式导致的故意自伤；T36-T50，第六位数字为2（T36.9、T37.9、T39.9、T41.4、T42.7、T43.9、T45.9、T47.9和T49.9除外，若第五位数字为2则包括在内），因药物中毒（过量）导致的故意自伤；T51-T65，第六位数字为2（T51.9、T52.9、T53.9、T54.9、T56.9、T57.9、T58.0、T58.1、T58.9、T59.9、T60.9、T61.0、T61.1、T61.9、T62.9、T63.9、T64.0、T64.8和T65.9除外，若第五位数字为2则包括在内），因非药用物质的毒性作用导致的故意自伤；T71，第六位数字为2，因窒息、闷死、勒死导致的故意自伤；以及T14.91，自杀未遂。还讨论了从ICD-10-CM编码的行政数据集中选择非致命自杀未遂和故意自伤记录时需考虑的问题。
