Impact of the Transition From International Classification of Diseases, 9th Revision, Clinical Modification to International Classification of Diseases, 10th Revision, Clinical Modification on Measuring Rates of Child and Adolescent Self-Harm in Nine Health Systems
Recommended Citation
Ryan TC, Angerhofer JE, Stewart C, Rossom RC, Harry ML, Ahmedani BK, Lynch FL, Beck A, Owen-Smith A, Daida YG, Coleman KJ, Penfold RB. Impact of the Transition from ICD9-CM to ICD10-CM on Measuring Rates of Child and Adolescent Self-harm in Nine Health Systems. Acad Pediatr. 2026;26(7):103327.
Document Type
Article
Publication Date
4-17-2026
Publication Title
Acad Pediatr
Keywords
Humans, Child, Self-Injurious Behavior, Adolescent, International Classification of Diseases, Interrupted Time Series Analysis, Female, Male, United States, Prevalence
Abstract
OBJECTIVE: We sought to evaluate changes in the prevalence of self-harm coding among children and adolescents following the transition from International Classification of Diseases, 9th revision, clinical modification (ICD9-CM) to International Classification of Diseases, 10th revision, clinical modification (ICD10-CM).
METHODS: We performed interrupted time series (ITS) analyses on monthly rates of medically attended deliberate self-harm in the 15 months prior to and 15 months following the transition to ICD10 in October 2015 across 9 health systems. Separate models were estimated for youths aged 6 to 11 years and youths aged 12 to 17 years. Segmented regression models with autocorrelation terms were used to estimate discontinuities and changes in trends pre- and post-October 2015.
RESULTS: There was a 0.18 per 100,000 youths per month (slope change) in the 6 to 11 age group. There was an immediate 38.5 per 100,000 youths change in medically attended deliberate self-harm and a sustained 6.5 per 100,000 per month (slope) change in the 12 to 17 age group.
CONCLUSIONS: The transition to ICD10 was associated with significant changes in monthly rates of medically attended deliberate self-harm in children and adolescents. These results present challenges for interpreting long-term trends in medically attended deliberate self-harm rates and evaluating the effects of contemporaneous efforts to reduce self-harm.
Medical Subject Headings
Humans; Child; Self-Injurious Behavior; Adolescent; International Classification of Diseases; Interrupted Time Series Analysis; Female; Male; United States; Prevalence
PubMed ID
42002139
ePublication
ePub ahead of print
Volume
26
Issue
7
First Page
103327
Last Page
103327
