Table 2.
Adult Populations with Encounter (Outpatient or Inpatient) During ICD-9-CM Period (10/14–09/15) Compared to ICD-10-CM Period (1/16–12/16) by Pain Condition Diagnostic Cluster
| KPNW Population | Group Health Population | VHA Population | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ICD-9-CM Total N=351,778 | ICD-10-CM Total N=368,947 | Absolute Difference | % Change | ICD-9-CM Total N=286,861 | ICD-10-CM Total N=261,972 | Absolute Difference | % Change | ICD-9-CM Total N=515,541 | ICD-10-CM Total N=563,426 | Absolute Difference | % Change | |||||||
| N | % | N | % | N | % | N | % | N | % | N | % | |||||||
| 1. Back pain | 57,446 | 16.3 | 62,367 | 16.9 | 0.6 | 3.7% | 60,930 | 21.2 | 53,315 | 20.4 | −0.8 | −3.8% | 169,908 | 33.0 | 178,310 | 31.7 | 1.3 | −3.9% |
| 2. Neck pain | 22,254 | 6.3 | 24,670 | 6.7 | 0.4 | 6.3% | 32,697 | 11.4 | 28,388 | 10.8 | −0.6 | −5.3% | 47,157 | 9.2 | 47,116 | 8.4 | 0.8 | −8.7% |
| 3. Limb/extremity pain, joint pain and non-systemic, non-inflammatory arthritic disorders | 114,304 | 32.5 | 119,399 | 32.4 | −0.1 | −0.3% | 97,553 | 34 | 88,776 | 33.9 | −0.1 | −0.3% | 201,381 | 39.1 | 209,259 | 37.1 | 2.0 | −5.1% |
| Carpal tunnel | 4,905 | 1.4 | 4,849 | 1.3 | −0.1 | 3,605 | 1.3 | 3,134 | 1.2 | −0.1 | 10,941 | 2.1 | 10,925 | 1.9 | 0.2 | |||
| Gout and other crystal arthropathies | 5,148 | 1.5 | 6,381 | 1.7 | 0.2 | 6,545 | 2.3 | 5,825 | 2.2 | −0.1 | 11,653 | 2.3 | 12,846 | 2.3 | 0.0 | |||
| Joint pain | 80,326 | 22.8 | 75,549 | 20.5 | −2.3 | 67,056 | 23. 4 | 57,854 | 22.1 | −1.3 | 156,840 | 30.4 | 154,097 | 27.4 | 3.0 | |||
| Limb/extremity pain | 47,704 | 13.6 | 52,827 | 14.3 | 0.7 | 45,186 | 15.8 | 41,601 | 15.9 | 0.1 | 53,844 | 10.4 | 66,894 | 11.9 | −1.5 | |||
| Neuropathic arthropathy | 169 | 0.1 | 126 | 0.0 | −0.02 | 182 | 0.06 | 125 | 0.05 | −0.01 | 38 | 0.01 | 41 | 0.01 | 0.0 | |||
| Osteoarthritis | 19,923 | 5.7 | 28,898 | 7.8 | 2.1 | 31,085 | 10.8 | 30,924 | 11.8 | 1 | 39,801 | 7.7 | 35,720 | 6.3 | 1.4 | |||
| Other non-systemic, non-inflammatory arthritic disorders | 17 | 0.00 | 251 | 0.1 | 0.1 | 51 | 0.02 | 293 | 0.1 | 0.08 | 147 | 0.03 | 4,436 | 0.8 | −0.8 | |||
| 4. Fibromyalgia | 10,574 | 3.0 | 11,474 | 3.1 | 0.1 | 3.3% | 8,918 | 3.1 | 8,444 | 3.2 | 0.1 | 3.2% | 8,982 | 1.7 | 10,246 | 1.8 | −0.1 | 5.9% |
| 5. Headache | 24,074 | 6.8 | 26,900 | 7.3 | 0.5 | 7.4% | 22,419 | 7.8 | 19,277 | 7.4 | −0.4 | −5.1% | 70,695 | 13.7 | 71,426 | 12.7 | 1.0 | −7.3% |
| 6. Orofacial, ear, and temporomandibular disorder pain | 4,655 | 1.3 | 2,987 | 0.8 | −0.5 | −38.5% | 4,363 | 1.5 | 3,135 | 1.2 | −0.3 | −20.0% | 4,766 | 0.9 | 3,828 | 0.7 | 0.2 | −22.2% |
| 7. Abdominal and bowel pain | 36,421 | 10.4 | 45,059 | 12. 2 | 1.8 | 17.3% | 37,339 | 13 | 34,100 | 13 | 0 | 0.0% | 41,243 | 8.0 | 42,806 | 7.6 | 0.4 | −5.0% |
| General abdominal pain | 27,886 | 7.9 | 34,540 | 9.4 | 1.5 | 30,099 | 10.5 | 27,361 | 10.4 | −0.1 | 22,104 | 4.3 | 22,821 | 4.1 | 0.2 | |||
| Hernia | 4,929 | 1.4 | 6,761 | 1.8 | 0.4 | 5,876 | 2.1 | 5,441 | 2.1 | 0 | 9,317 | 1.8 | 8,179 | 1.5 | 0.3 | |||
| Irritable Bowel Syndrome | 3,927 | 1.1 | 4,744 | 1.3 | 0.2 | 3,086 | 1.1 | 2,807 | 1.1 | 0 | 8,275 | 1.6 | 10,207 | 1.8 | −0.2 | |||
| Kidney/gallstones | 3,964 | 1.1 | 5,259 | 1.4 | 0.3 | 5,667 | 2.0 | 5,101 | 2.0 | 0 | 7,215 | 1.4 | 7,402 | 1.3 | 0.1 | |||
| 8. Urogenital, pelvic and menstrual pain | 14,345 | 4.1 | 14,048 | 3.8 | −0.3 | −7.3% | 11,397 | 4.0 | 8,259 | 3.2 | −0.8 | −20.0% | 10,591 | 2.1 | 9,806 | 1.7 | 0.4 | −19.0% |
| Cystitis and bladder disorders | 266 | 0.1 | 292 | 0.1 | 0.0 | 170 | 0.06 | 137 | 0.05 | −0.01 | 196 | 0.04 | 224 | 0.04 | 0.0 | |||
| Endometriosis | 618 | 0.2 | 852 | 0.2 | 0.0 | 746 | 0.3 | 654 | 0.3 | 0 | 828 | 0.2 | 857 | 0.2 | 0.0 | |||
| Menstrual pain | 3,008 | 0.9 | 3,044 | 0.8 | −0.1 | 2,372 | 0.8 | 1,881 | 0.7 | −0.1 | 1,910 | 0.4 | 1,824 | 0.3 | 0.1 | |||
| Other disorders of female reproductive system | 7,913 | 2.3 | 7,644 | 2.1 | −0.2 | 6,481 | 2.3 | 4,506 | 1.7 | −0.6 | 2,319 | 0.5 | 3,445 | 0.6 | −0.1 | |||
| Other disorders of male reproductive system | 1,890 | 0.5 | 1,401 | 0.4 | −0.1 | 1,461 | 0.5 | 891 | 0.3 | −0.2 | 4,517 | 0.9 | 2,803 | 0.5 | 0.4 | |||
| Prostatitis | 1,057 | 0.3 | 1,160 | 0.3 | 0.0 | 782 | 0.3 | 647 | 0.3 | 0 | 1,242 | 0.2 | 1,233 | 0.2 | 0.0 | |||
| Urinary calculus | 494 | 0.1 | 610 | 0.2 | 0.1 | 347 | 0.1 | 302 | 0.1 | 0 | 403 | 0.1 | 327 | 0.06 | 0.0 | |||
| Vulvodynia | 307 | 0.1 | 332 | 0.1 | 0.0 | 91 | 0.03 | 88 | 0.03 | 0 | 28 | 0.01 | 55 | 0.01 | 0.0 | |||
| 9. Musculoskeletal chest pain | 21,861 | 6.2 | 26,125 | 7.1 | 0.9 | 14.5% | 25,536 | 8.9 | 23,380 | 8.9 | 0 | 0.0% | 20,298 | 3.9 | 22,613 | 4.0 | −0.1 | 2.6% |
| 10. Neuropathy | 19,807 | 5.6 | 19,342 | 5.2 | −0.4 | −7.1% | 17,977 | 6.3 | 17,203 | 6.6 | 0.3 | 4.8% | 11,527 | 2.2 | 11,226 | 2.0 | 0.2 | −9.1% |
| Diabetic neuropathy | 10,737 | 3.1 | 9,567 | 2.6 | −0.5 | 9,863 | 3.4 | 9,115 | 3.5 | 0.1 | 1,932 | 0.4 | 3,559 | 0.6 | −0.2 | |||
| Neuropathy without mention of diabetes | 10,450 | 3.0 | 10,744 | 2.9 | −0.1 | 9,610 | 3.4 | 9,195 | 3.5 | 0.1 | 10,127 | 2.0 | 7,822 | 1.4 | 0.6 | |||
| Optic neuropathy | 279 | 0.1 | 324 | 0.1 | 0.0 | 197 | 0.07 | 213 | 0.08 | 0.01 | 135 | 0.03 | 349 | 0.06 | 0.0 | |||
| 11. Systemic disorders or diseases causing pain | 5,278 | 1.5 | 5,833 | 1.6 | 0.1 | 6.7% | 5,168 | 1.8 | 4,356 | 1.7 | −0.1 | −5.6% | 4,372 | 0.9 | 3,628 | 0.6 | 0.3 | −33.3% |
| Complex Regional Pain Syndrome | 133 | 0.04 | 221 | 0.1 | 0.02 | 92 | 0.03 | 167 | 0.06 | 0.03 | 183 | 0.04 | 495 | 0.09 | −0.1 | |||
| Lyme disease | 19 | 0.01 | 19 | 0.0 | 0.00 | 37 | 0.01 | 25 | 0.01 | 0 | 254 | 0.05 | 252 | 0.04 | 0.0 | |||
| Other inflammatory arthropathies | 1,407 | 0.4 | 1,597 | 0.4 | 0.0 | 1,289 | 0.5 | 1,276 | 0.5 | 0 | 333 | 0.06 | 392 | 0.07 | 0.0 | |||
| Other systemic disorders | 1 | 0.0 | 5 | 0.0 | 0.0 | 461 | 0.2 | 73 | 0.03 | −0.2 | 1,526 | 0.3 | 57 | 0.01 | 0.3 | |||
| Rheumatoid Arthritis | 3,395 | 1.0 | 3,608 | 1.0 | 0.0 | 2,917 | 1.0 | 2,460 | 0.9 | −0.1 | 1,432 | 0.3 | 1,670 | 0.3 | 0.0 | |||
| Sickle Cell Disease | 99 | 0.03 | 162 | 0.0 | 0.01 | 145 | 0.05 | 127 | 0.05 | 0 | 376 | 0.07 | 335 | 0.06 | 0.0 | |||
| Systemic lupus erythematosus | 366 | 0.1 | 423 | 0.1 | 0.0 | 475 | 0.2 | 407 | 0.2 | 0 | 383 | 0.07 | 552 | 0.1 | 0.0 | |||
| 12. Other painful conditions | 25,308 | 7.2 | 30,277 | 8.2 | 1.0 | 13.9% | 25,491 | 8.9 | 31,337 | 12 | 3.1 | 34.8% | 41,546 | 8.1 | 54,615 | 9.7 | −1.6 | 19.8% |
| Acquired deformities (excluding back conditions) | 5,124 | 1.5 | 6,445 | 1.8 | 0.3 | 7,170 | 2.5 | 6,981 | 2.7 | 0.2 | 16,804 | 3.3 | 13,382 | 2.4 | 0.9 | |||
| Cancer-related pain | 501 | 0.1 | 599 | 0.2 | 0.1 | 464 | 0.2 | 460 | 0.2 | 0 | 78 | 0.02 | 103 | 0.02 | 0.0 | |||
| General pain | 17,055 | 4.9 | 20,295 | 5.5 | 0.6 | 14,203 | 5.0 | 21,141 | 8.1 | 3.1 | 23,337 | 4.5 | 37,580 | 6.7 | −2.2 | |||
| Post-operative pain | 791 | 0.2 | 1,478 | 0.4 | 0.2 | 3,522 | 1.2 | 3,383 | 1.3 | 0.1 | 704 | 0.1 | 1,355 | 0.2 | −0.1 | |||
| Post-trauma pain | 10 | 0.0 | 35 | 0.0 | 0.0 | 242 | 0.08 | 243 | 0.09 | 0.01 | 512 | 0.1 | 1,711 | 0.3 | −0.2 | |||
| Restless legs syndrome (RLS) | 3,235 | 0.9 | 3,576 | 1.0 | 0.1 | 2,328 | 0.8 | 2,316 | 0.9 | 0.1 | 1,753 | 0.3 | 3,503 | 0.6 | −0.3 | |||
| Spinal cord injury | 18 | 0.01 | 39 | 0.0 | 0.0 | 66 | 0.02 | 73 | 0.03 | 0.01 | 236 | 0.05 | 197 | 0.03 | 0.0 | |||
| Bone infections | 335 | 0.1 | 485 | 0.1 | 0.0 | 556 | 0.2 | 601 | 0.2 | 0 | 384 | 0.07 | 428 | 0.08 | 0.0 | |||
| Infectious arthritic diseases | 83 | 0.02 | 113 | 0.0 | 0.01 | 144 | 0.05 | 141 | 0.05 | 0 | 160 | 0.03 | 305 | 0.05 | 0.0 | |||
| All people with encounters with pain diagnosis in clusters 1–12 | 197,909 | 56.3 | 208,750 | 56.6 | 0.3 | 0.5% | 166,263 | 58.0 | 151,505 | 57.8 | −0.2 | −0.3% | 329,558 | 63.9 | 355,797 | 63.1 | 0.8 | −1.3% |
| 13. Fractures, contusions, sprains and strains | 27,199 | 7.7 | 37,738 | 10.2 | 2.5 | 32.5% | 38,929 | 13.6 | 38,445 | 14.7 | 1.1 | 8.1% | 40,951 | 7.9 | 33,019 | 5.9 | 2.0 | −25.3% |
| Contusions | 7,464 | 2.1 | 9,669 | 2.6 | 0.5 | 11,677 | 4.1 | 10,813 | 4.1 | 0 | 5,280 | 1.0 | 5,337 | 1.0 | 0.0 | |||
| Fractures | 6,168 | 1.8 | 8,948 | 2.4 | 0.6 | 9,933 | 3.5 | 8,790 | 3.4 | −0.1 | 9,490 | 1.8 | 7,376 | 1.3 | 0.5 | |||
| General injury | 1,088 | 0.3 | 5,588 | 1.5 | 1.2 | 3,892 | 1.4 | 6,961 | 2.7 | 1.3 | 2,811 | 0.6 | 1,715 | 0.3 | 0.3 | |||
| Joint injury | 3,329 | 1.0 | 3,947 | 1.1 | 0.1 | 8,068 | 2.8 | 7,617 | 2.9 | 0.1 | 14,385 | 2.8 | 9,754 | 1.7 | 1.1 | |||
| Sprains and strains | 12,200 | 3.5 | 16,161 | 4.4 | 0.9 | 16,125 | 5.6 | 15,287 | 5.8 | 0.2 | 14,424 | 2.8 | 12,435 | 2.2 | 0.6 | |||
| All people with health care encounters with any pain condition diagnosis | 203,077 | 57.7 | 215,857 | 58.5 | 0.8 | 1.3% | 171,039 | 59.6 | 157,055 | 60.0 | 0.3 | 0.5% | 335,388 | 0.7 | 360,335 | 0.6 | 0.01 | −1.7% |