Executive Summary
This proposal seeks to advocate for the establishment of specific ICD-10 codes for osteoporosis induced by the use of certain medications. Recognizing medication-related osteoporosis in the ICD-10 coding system would significantly enhance the ability of healthcare providers to diagnose, manage, and prevent this condition. It would also facilitate better patient education, research, and policy-making regarding bone health and the side effects of long-term medication use.
Background
Osteoporosis is a condition characterized by weakened bones, increasing the risk of fractures. While several factors contribute to osteoporosis, certain medications have been identified as potential risks for diminishing bone density. Notably, glucocorticoids, proton pump inhibitors (PPIs), anticonvulsants, and some treatments for breast cancer and prostate cancer are linked to an increased risk of osteoporosis. Despite this knowledge, medication-related osteoporosis is often underdiagnosed until a fracture occurs, suggesting a gap in proactive management and prevention.
Proposal Details
1. Creation of ICD-10 Codes: We propose introducing new ICD-10 codes within the existing osteoporosis section, specifically dedicated to medication-related osteoporosis. These codes would differentiate osteoporosis by the class of medication causing it, for example:
· MO01: Osteoporosis Due to Glucocorticoids
· MO02: Osteoporosis Due to Proton Pump Inhibitors
· MO03: Osteoporosis Due to Anticonvulsants
· MO04: Osteoporosis Due to Endocrine Therapy (Breast/Prostate Cancer)
1. Clinical Guidelines and Recommendations: Accompanying the new codes, we recommend the development and dissemination of clinical guidelines for the prevention, screening, and management of medication-related osteoporosis. These guidelines should include recommendations on baseline and periodic bone density testing, calcium and vitamin D supplementation, lifestyle modifications, and alternative medication considerations where feasible.
2. Educational Initiatives: Implement educational programs targeting healthcare providers, patients, and caregivers to increase awareness about the risk of medication-related osteoporosis and strategies for prevention and management. This could include informational brochures, online resources, and continuing medical education courses.
3. Research and Surveillance: Encourage and support research focused on understanding the epidemiology of medication-related osteoporosis, evaluating the effectiveness of various management strategies, and developing new treatments to mitigate bone loss associated with medication use.
Benefits
· Enhanced Patient Management: Specific ICD-10 codes would enable healthcare providers to more accurately diagnose and manage osteoporosis related to medication use, potentially preventing fractures and other complications.
· Improved Monitoring and Reporting: The introduction of these codes would facilitate better tracking of the prevalence and outcomes associated with medication-related osteoporosis, informing public health strategies and research.
· Increased Awareness: Focused educational efforts would raise awareness among both healthcare professionals and patients about the risks of certain medications to bone health, leading to more proactive management strategies.
Conclusion:
Introducing ICD-10 codes for medication-related osteoporosis is a necessary step towards improving patient outcomes, enhancing clinical practices, and expanding our understanding of the relationship between medications and bone health. By recognizing the impact of certain drugs on osteoporosis risk, healthcare providers can take steps to mitigate this risk, ultimately reducing the incidence of fractures and improving the quality of life for patients on long-term medication therapies. We strongly advocate for the adoption of these proposed codes by the relevant healthcare coding authorities.
References
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Guan, H. (2023). Medication-related osteonecrosis of the jaw. Radiopaedia.Org. https://doi.org/10.53347/rid-164428
Nicolatou-Galitis, O., Schiødt, M., Mendes, R. A., Ripamonti, C., Hope, S., Drudge-Coates, L., Niepel, D., & Van den Wyngaert, T. (2019). Medication-related osteonecrosis of the jaw: Definition and best practice for prevention, diagnosis, and treatment. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 127(2), 117–135. https://doi.org/10.1016/j.oooo.2018.09.008
Supanumpar, N., Pisarnturakit, P. P., Charatcharoenwitthaya, N., & Subbalekha, K. (2024). Physicians’ awareness of medication-related osteonecrosis of the jaw in patients with osteoporosis. PLOS ONE, 19(1). https://doi.org/10.1371/journal.pone.0297500
Yeam, C. T., Chia, S., Tan, H. C., Kwan, Y. H., Fong, W., & Seng, J. J. (2018). A systematic review of factors affecting medication adherence among patients with osteoporosis. Osteoporosis International, 29(12), 2623–2637. https://doi.org/10.1007/s00198-018-4759-3
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