(P69) USE OF ICD-10 Z BEHAVIORAL CODES IN STI MANAGEMENT AMONG ADMINISTRATIVE CLAIMS DATA, 2022

Background:
International Classification of Diseases version 10 adds a set of codes referred to as Z-codes which allow for collection of information on social determinants and health behaviors. Healthy People 2030 goals indicate that social and behavioral factors affect the spread of sexually transmitted infections (STI). Therefore, these analyses sought to identify the use of ICD Z health behavior codes related to STI management in a large administrative claims dataset.

Methods:
Using 2022 Marketscan Commercial Claims and Encounters data, a convenience sample of more than 50 million privately and publicly insured individuals receiving care each year, we searched for three ICD codes identifying elevated risk behaviors with opposite-sex (Z72.51), same-sex (Z72.52) or opposite and same-sex (Z72.53) partners among visits that had either an STI test or diagnosis. These STI visits were stratified by sex and by age.

Results:
Among 12,629,299 STI visits in 2022, 49,684 visits contained the codes of Z72.51, Z72.52, or Z72.53. The incidence of these codes among STI visits were 2.79% for Z72.51, .52% for Z72.52, and .09% for Z72.53. A greater proportion of visits containing Z72.51 were associated with female patients than with male patients (61.6% v. 38.4%, p < .05). A greater proportion of visits with Z72.52 were associated with male patients compared to female patients (96.8% v. 3.1%, p < .05). A greater proportion of visits with Z72.53 were associated with male patients compared to female patients (67.5% v. 32.5%, p < .05).

Conclusion:
These analyses suggest that ICD Z health behavior codes are seldom used for most visits associated with STI management and that differences in use of these codes exist between male and female patients, which could indicate gaps in care or risk assessment. Increasing usage of these codes, as well as refining theses codes for less stigmatizing and more detailed risk information, would be useful.