Pneumoconiosis ICD-CM Diagnosis Codes on Medicare Claims for Federal Black Lung Program Beneficiaries

Details

• Personal Author:
  Casey M ; Kurth L
• Description:
  Respiratory disease (e.g., silicosis, chronic obstructive pulmonary disease) prevalence can be estimated using health insurance information, such as U.S. Centers for Medicare & Medicaid Services (CMS) claims data. In previous surveillance studies, cases of respiratory disease were defined by the presence of specific International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis code(s) on health insurance claims. Defining respiratory disease cases without clinical information may lead to misclassification of disease status. To further explore this issue, the current study applies ICD-CM diagnosis-based case definitions to a subset of Federal Black Lung Benefits Program (FBLP) beneficiaries within Medicare data to determine the proportion with diagnosis codes for coal workers' pneumoconiosis (CWP), pneumoconiosis, and other respiratory diseases. The FBLP originally provided financial compensation and medical benefits to qualifying coal miners with total disability due to pneumoconiosis. Because coal mine dust exposure can cause disabling respiratory impairment in the absence of radiographic evidence of pneumoconiosis, FBLP eligibility was extended to miners with totally disabling respiratory impairment as a result of their coal mine employment. CMS Medicare data include claims for Medicare beneficiaries also in the FBLP. When a healthcare claim for these Medicare beneficiaries is related to their disabling lung disease, the FBLP (not Medicare) has primary responsibility for claim payment. [Description provided by NIOSH]
• Subjects:
  Coal Coal Mining Delivery Of Health Care Economics Lung Lung Diseases Mining Occupational Health Pneumoconiosis Respiratory System Respiratory Tract Diseases Safety

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• Keywords:
  Author Keywords: Lung Disease Black Lung Disease Black Lung Disease Benefits Coal Miners Coal Workers Pneumoconiosis Coal Workers Pneumoconiosis Benefits Compensation Costs Disease Incidence Economic Impact Health Care Lung Disease Medical Care Medical Records Medical Services Medical Treatment Surveillance Workers Compensation

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• ISSN:
  2329-6933
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division ; NPPTL - National Personal Protective Technology Laboratory
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  17
• Issue:
  7
• NIOSHTIC Number:
  nn:20059287
• Citation:
  Ann Am Thorac Soc 2020 Jul; 17(7):904-906
• Contact Point Address:
  Laura Kurth, Senior Service Fellow, Respiratory Health Division, NIOSH/CDC 1095 Willowdale Road, MS HG912, Morgantown, WV 26505
• Email:
  LKurth@cdc.gov
• Federal Fiscal Year:
  2020
• NORA Priority Area:
  Mining
• Peer Reviewed:
  True
• Source Full Name:
  Annals of the American Thoracic Society
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:611a7425990845068ba1400fe52be76edfc3de5fa28de102cdea4d33724436da685ad7b8ea026d63b55987ad2e6cdc0cc7016e4fe295f366017fc455316bce05
• Download URL:
  https://stacks.cdc.gov/view/cdc/223564/cdc_223564_DS1.pdf
• File Type:
  [PDF - 509.38 KB ]