Development of an algorithm to identify serious opioid toxicity in children

Table 8 ICD9-CM diagnosis codes for opioid respiratory or CNS symptoms

	Code	Diagnosis
A. Respiratory depression^a in the absence of known causes^b
1.	518.0	Pulmonary collapse
2.	518.81	Acute respiratory failure
3.	518.82	Other pulmonary insufficiency, not elsewhere classified
4.	518.84	Acute and chronic respiratory failure
B. Central nervous system^c
5.	780.0	Alteration of consciousness
6.	780.01	Coma
7.	780.02	Transient alteration of awareness
8.	780.09	Other alteration of consciousness
9.	780.1	Hallucinations
10.	780.97	Altered mental state
11.	781.3	Lack of coordination

^aDoes not include pneumonia (486), chronic airway obstruction (496), shortness of breath (786.05,786.09), or painful respiration (786.52). Based on the preliminary analysis, also does not include symptoms: 786.00 respiratory abnormality, unspecified, 786.03 apnea, 799.0 asphyxia and hypoxemia, 799.01 asphyxia, 799.02 hypoxemia, 799.1 respiratory arrest. Pilot indicated very low PPV for these latter codes.
^bFor the day the prescription was filled or the preceding 6 days, no encounter with a diagnosis of pneumonia or other respiratory infections, pleural effusion, pneumothorax; or a procedure for thoracentesis or thoracostomy.
^cDoes not include dizziness (780.4) or abnormal gait (781.2).