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CDC Stimulants v3

Definition Purpose: To assist state, local, tribal, territorial, and federal public health practitioners in monitoring emergency department visits for suspected stimulant overdoses.

New or Revised Definition: Revision in CDC Stimulants v3

Version Date: v3 was edited on October 25, 2022

Justification for New Version: Revisions in version 3 include the addition of ICD-10-CM codes T43.651A, and
T43.654A - Poisoning by methamphetamines

Development Methods: CDC scientists started developing the definition using guidance from the Council of State and Territorial Epidemiologists (CSTE) and the Substance Abuse and Mental Health Services Administration (SAMHSA). First, International Classification of Diseases, 10th Revision (ICD-10-CM), and 9th Revision (ICD-9-CM) Clinical Modification, and Systematized Nomenclature of Medicine code (SNOMED) diagnosis codes indicating an acute stimulant poisoning were identified; this was followed by overdose terms. Finally, the team identified stimulant drug terms indicating that a stimulant was involved in the overdose.

Definition Fields & Structure: The Chief Complaint Discharge Diagnosis (CCDD) field is used to query both the diagnosis codes and chief complaint free text with exclusions (as necessary). If a diagnosis code indicating an unintentional or undetermined intent stimulant poisoning is present, the ED visit is automatically included in the syndrome definition. If there is no diagnosis code present for stimulant poisoning, the visit is only captured if it includes two components and no exclusion terms: 1) chief complaint text indicating an overdose or poisoning and 2) chief complaint text indicating stimulant involvement. The list of exclusions is only applied to the chief complaint
text when the automatic inclusion criteria are not met.

For Consideration: With the separate opioid query, CDC identified several non-poisoning ICD-10-CM codes for inclusion in the syndrome definition (e.g., F11 codes indicating opioid abuse, dependence, or use). CDC also explored the inclusion of the stimulant abuse, dependence, or use F codes (i.e., F14 and F15) in this stimulant definition. However, our analysis showed that these codes were not identifying acute overdose visits and instead were being coded correctly as stimulant abuse. The team attempted to identify most drug
names used for stimulants; however, it’s likely that some additional drug names and slang terms will be
added to a future version of the definition.

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