ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 0259

JIA Diagnoses and Trends from 2006-2019: Has the U.S. ICD-9-to-ICD-10 Transition Created Coding Artifacts?

Daniel Horton1, Lauren Parlett2, Cecilia Huang3, Stephen Crystal4, Amy Davidow5, Tobias Gerhard6, Carlos Rose7, Kevin Haynes2 and Brian Strom8, 1Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 2HealthCore, Wilmington, DE, 3Rutgers Institute for Health, New Brunswick, NJ, 4Rutgers School of Social Work, New Brunswick, NJ, 5Rutgers School of Public Health, New Brunswick, NJ, 6Ernst Mario School of Pharmacy, New Brunswick, NJ, 7Thomas Jefferson University, Wilmington, DE, 8Rutgers Biomedical and Health Sciences, Newark, NJ

Meeting: ACR Convergence 2021

Keywords: Administrative Data, Epidemiology, Juvenile idiopathic arthritis, Pediatric rheumatology, Statistical methods

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Saturday, November 6, 2021

Title: Pediatric Rheumatology – Clinical Poster I: JIA (0241–0265)

Session Type: Poster Session A

Session Time: 8:30AM-10:30AM

Background/Purpose: JIA is the most common rheumatic disease of childhood, but recent data on diagnostic trends in the US are lacking. Furthermore, the impact of the ICD-9/ICD-10 transition on the rates of JIA diagnoses is unclear. We sought to characterize recent trends in JIA claims, including changes related to the US International ICD-9/ICD-10 transition in late 2015.

Methods: We studied JIA diagnoses within administrative claims data on commercially insured children under age 18 from 14 geographically diverse US states in the HealthCore Integrated Research Database (2006-2019). JIA diagnoses were defined by claims with diagnostic codes (ICD-9 696.0, 714, or 720; ICD-10 L40.5, M05, M06, M08, or M45), requiring at least 1 inpatient claim or 2 outpatient claims between 8 and 52 weeks apart. Incident diagnoses were defined as having at least 6 months of baseline data without previous JIA claim; prevalent diagnoses could have occurred at any time. Incidence and prevalence of JIA were calculated quarterly 2006-2019, excluding 6 months before and 6 months after the ICD-9/10 transition to limit transitional coding errors. Trends and changes in level around the ICD-9/10 transition were analyzed by single-group interrupted time-series using ordinary least-squares segmented regression.

Results: Of 26.5 million children identified, 22,158 had claims for JIA by ICD-9 or ICD-10 code in any setting (0.084%). Over half of children diagnosed with JIA were 12-17 years old, and approximately 2/3 were female (Table). ICD-9-based incident and prevalent diagnoses of JIA steadily increased in both outpatient and inpatient settings (Figure). Rates of JIA, both incident and prevalent, dropped abruptly in both outpatient and inpatient settings at the time of the ICD-9/10 transition (Figure). In outpatient settings, ICD-10-based incident JIA diagnoses have declined since then, whereas prevalent JIA diagnoses have remained stable (Figure). There have been modest, but not statistically significant, declines in ICD-10-based diagnoses from inpatient settings (Figure). Rates of recorded conventional and biologic DMARD use were higher among children diagnosed by ICD-10 code than children diagnosed by ICD-9 code (Table).

Conclusion: Among commercially insured children, apparent incident and prevalent rates of claims for JIA declined abruptly with the US transition from ICD-9 to ICD-10, likely reflecting an artifact of changes in the sensitivity and specificity of coding practices. The higher prevalence of DMARD use by children diagnosed with JIA in the ICD-10 era could suggest greater diagnostic specificity, but the uncertain validity of both ICD-9 and ICD-10 claims warrants further research. New JIA diagnoses appeared to rise until 2015 and fall since 2016; more work is needed to establish to what extent these trends reflect temporal changes in coding practices versus true changes in JIA epidemiology.

JIA diagnosis trends ACR abstract.001.jpeg”

Figure. Trends and changes in ICD-9 and ICD_10 claims for JIA in commercial administrative claims data, 2006_2019. Graphs show yearly rates of JIA diagnoses per 100,000 children in commercial claims data based on ICD-9 codes (2006_2015) or ICD_10 codes (2016_2019). Diagnoses reflected ≥2 outpatient claims 8-52 weeks apart (A and B) or ≥1 inpatient claim (C and D). Incident JIA diagnoses (A and C) required ≥6 months of JIA-free baseline time; prevalent JIA diagnoses (B and D) could have occurred at any time. Trends and changes in level before and after the ICD-9/10 transition were estimated using segmented regression from interrupted time-series.


Disclosures: D. Horton, Danisco USA Inc., 5; L. Parlett, None; C. Huang, None; S. Crystal, None; A. Davidow, None; T. Gerhard, Intracellular Therapies, 2, Eisai, 2, Alkermes, 2; C. Rose, None; K. Haynes, HealthCore, 3; B. Strom, University Hospital, Newark, 4, Robert Wood Johnson University Hospital, 4, Robert Wood Johnson Barnabas Health, 4, Lundbeck, 2, Johnson and Johnson Consumer Products, 2, Consumer Healthcare Products Association, 2, Pharmacosmos, 2.

To cite this abstract in AMA style:

Horton D, Parlett L, Huang C, Crystal S, Davidow A, Gerhard T, Rose C, Haynes K, Strom B. JIA Diagnoses and Trends from 2006-2019: Has the U.S. ICD-9-to-ICD-10 Transition Created Coding Artifacts? [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/jia-diagnoses-and-trends-from-2006-2019-has-the-u-s-icd-9-to-icd-10-transition-created-coding-artifacts/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/jia-diagnoses-and-trends-from-2006-2019-has-the-u-s-icd-9-to-icd-10-transition-created-coding-artifacts/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology