Jeff Stark, MD: The Importance of ICD-10 Codes for nr-ax-SpA

The ICD-10 Coordination and Maintenance committee recently made public that non-radiographical axial spondyloarthritis (nr-ax-SpA) will be formally indexed to ICD-10 subcategory M46.8.

HCPLive® had a chance to speak to Jeff Stark, MD, Head of US Medical Immunology at UCB, about the importance of the decision.

“The fact that we haven’t had these diagnostic codes up until this point in time is a significant shortcoming,” Stark said.

The administrative systems supporting clinical practice tend to lag behind clinical and scientific understanding. Despite nr-ax-SpA being recognized by the medical community for more than a decade, the disease has not been captured or documented in the coding manual.

Manual modification exists to bring it up to date with current clinical knowledge of the disease, which constitutes 50% of the larger axial spondyloarthritis spectrum. The community is familiar with ankylosing spondyloarthritis, which has been captured in the system for many years. But the other half of the disease state umbrella has been missing.

“That led to several deficiencies in our ability to capture, document, and characterize these patients,” he said.

Because nr-ax-SpA was missing from the ICD-10 coding manual, it resulted in the community using codes that were inaccurate or less specific that they viewed as the best fit. However, the codes were actually not the correct or most accurate ones being used to characterize such patients.

The data captured in real-world databases like electronic health records were also inaccurate, making it more difficult to study patients with the disease. Patients are typically identified in databases by their diagnosis or ICD-10 codes.

Most importantly, these patients typically go through years of misdiagnoses and cannot have their official diagnosis recorded. With the new update, they will be able to feel verified in their disease diagnosis.