From the Guidelines
There is no specific ICD-10-CM code for polypharmacy.
Definition and Criteria
- Polypharmacy is often defined as taking 3 to 5 or more medications by persons older than 18 years of age, as stated by the Centers for Medicare and Medicaid Services (CMS) 1.
- However, this definition is considered lacking in utility for older adults being treated for multiple diseases.
Prevalence and Risks
- A population-based survey showed that 37.1% of men and 36% of women between 75 and 85 years of age took 5 or more prescription medications 1.
- The average number of prescribed medications rose from 6.4 to 6.9 between 1999 and 2009, with a corresponding increase in annual costs per beneficiary 1.
- Higher numbers of medications correlate with increased risk of drug-related problems, with patients taking 5 medications averaging 1 significant drug problem 1.
From the Research
ICD Code for Polypharmacy
- There is no direct ICD code for polypharmacy, as it is a term used to describe the use of multiple medications by a patient, rather than a specific medical condition 2, 3, 4.
- However, ICD codes can be used to identify patients with polypharmacy, such as those with multiple prescriptions for central nervous system (CNS)-acting medications 4.
- ICD-9-CM codes have been used to define polypharmacy in some studies, such as those with five or more active prescriptions at the time of diagnosis 3, 4.
- The validity of ICD codes in identifying illicit drug use target conditions, including polypharmacy, has been evaluated in some studies, with varying results 5.
Limitations of ICD Codes for Polypharmacy
- ICD codes may not accurately capture the complexity of polypharmacy, as they do not account for specific comorbidities or medication interactions 2.
- The use of ICD codes to identify polypharmacy may be limited by variations in coding practices and the lack of a standardized definition of polypharmacy 2, 3.
- Further research is needed to evaluate the validity and reliability of ICD codes in identifying polypharmacy and associated adverse outcomes 3, 4, 5.