{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T22:53:38Z","timestamp":1768776818959,"version":"3.49.0"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["1I01HX002324-01A2"],"award-info":[{"award-number":["1I01HX002324-01A2"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["HCoE Research and Evaluation Center Grant, Prosthetics and Rehabilitation-001"],"award-info":[{"award-number":["HCoE Research and Evaluation Center Grant, Prosthetics and Rehabilitation-001"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Understand the continuity and changes in headache not-otherwise-specified (NOS), migraine, and post-traumatic headache (PTH) diagnoses after the transition from ICD-9-CM to ICD-10-CM in the Veterans Health Administration (VHA).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Background<\/jats:title>\n<jats:p>Headache is one of the most commonly diagnosed chronic conditions managed within primary and specialty care clinics. The VHA transitioned from ICD-9-CM to ICD-10-CM on October-1-2015. The effect transitioning on coding of specific headache diagnoses is unknown. Accuracy of headache diagnosis is important since different headache types respond to different treatments.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We mapped headache diagnoses from ICD-9-CM (FY 2014\/2015) onto ICD-10-CM (FY 2016\/2017) and computed coding proportions two years before\/after the transition in VHA. We used queries to determine the change in transition pathways. We report the odds of ICD-10-CM coding associated with ICD-9-CM controlling for provider type, and patient age, sex, and race\/ethnicity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Only 37%, 58% and 34% of patients with ICD-9-CM coding of NOS, migraine, and PTH respectively had an ICD-10-CM headache diagnosis. Of those with an ICD-10-CM diagnosis, 73\u201379% had a single headache diagnosis. The odds ratios for receiving the same code in both ICD-9-CM and ICD-10-CM after adjustment for ICD-9-CM and ICD-10-CM headache comorbidities and sociodemographic factors were high (range 6\u201326) and statistically significant. Specifically, 75% of patients with headache NOS had received one headache diagnoses (Adjusted headache NOS-ICD-9-CM OR for headache NOS-ICD-10-CM = 6.1, 95% CI 5.89\u20136.32. 79% of migraineurs had one headache diagnoses, mostly migraine (Adjusted migraine-ICD-9-CM OR for migraine-ICD-10-CM = 26.43, 95% CI 25.51\u201327.38). The same held true for PTH (Adjusted PTH-ICD-9-CM OR for PTH-ICD-10-CM = 22.92, 95% CI: 18.97\u201327.68). These strong associations remained after adjustment for specialist care in ICD-10-CM follow-up period.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>The majority of people with ICD-9-CM headache diagnoses did not have an ICD-10-CM headache diagnosis. However, a given diagnosis in ICD-9-CM by a primary care provider (PCP) was significantly predictive of its assignment in ICD-10-CM as was seeing either a neurologist or physiatrist (compared to a generalist) for an ICD-10-CM headache diagnosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>When a veteran had a specific diagnosis in ICD-9-CM, the odds of being coded with the same diagnosis in ICD-10-CM were significantly higher. Specialist visit during the ICD-10-CM period was independently associated with all three ICD-10-CM headaches.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0279163","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T18:21:37Z","timestamp":1672856497000},"page":"e0279163","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Understanding headache classification coding within the veterans health administration using ICD-9-CM and ICD-10-CM in fiscal years 2014\u20132017"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4664-3143","authenticated-orcid":true,"given":"Samah Jamal","family":"Fodeh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda T.","family":"Fenton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rixin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Skanderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamada","family":"Altalib","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deena","family":"Kuruvilla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Schindler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Haskell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Brandt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason J.","family":"Sico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,1,4]]},"reference":[{"key":"pone.0279163.ref001","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1111\/head.13281","article-title":"The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies","volume":"58","author":"R. Burch","year":"2018","journal-title":"Headache"},{"key":"pone.0279163.ref002","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1046\/j.1526-4610.2001.041007646.x","article-title":"Prevalence and Burden of Migraine in the United States: Data From the American Migraine Study II","volume":"41","author":"R. B. Lipton","year":"2001","journal-title":"Headache: The Journal of Head and Face Pain"},{"key":"pone.0279163.ref003","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/S0140-6736(16)31460-X","article-title":"\"Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"N. J. Kassebaum","year":"2016","journal-title":"The Lancet"},{"key":"pone.0279163.ref004","first-page":"563","article-title":"\"The impact of chronic migraine: The Chronic Migraine Epidemiology and Outcomes (CaMEO) Study methods and baseline results,\" Cephalalgia: an international journal of headache","volume":"35","author":"A. M. Adams","year":"2015"},{"key":"pone.0279163.ref005","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1212\/01.wnl.0000252808.97649.21","article-title":"Migraine prevalence, disease burden, and the need for preventive therapy","volume":"68","author":"R. B. Lipton","year":"2007","journal-title":"Neurology"},{"key":"pone.0279163.ref006","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1111\/head.12154","article-title":"Examination of unmet treatment needs among persons with episodic migraine: results of the American Migraine Prevalence and Prevention (AMPP) Study,","volume":"53","author":"R. B. Lipton","year":"2013","journal-title":"Headache"},{"key":"pone.0279163.ref007","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1111\/head.12878","article-title":"A Comparison of the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study and American Migraine Prevalence and Prevention (AMPP) Study: Demographics and Headache-Related Disability","volume":"56","author":"R. B. Lipton","year":"2016","journal-title":"Headache"},{"key":"pone.0279163.ref008","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1055\/s-0038-1646946","article-title":"The Global Burden of Headache","volume":"38","author":"D. Saylor","year":"2018","journal-title":"Semin Neurol"},{"key":"pone.0279163.ref009","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/0333102417738202","article-title":"Headache classification committee of the international headache society (ihs) the international classification of headache disorders","volume":"38","author":"M. Arnold","year":"2018","journal-title":"Cephalalgia"},{"key":"pone.0279163.ref010","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1468-2982.2007.01288.x","article-title":"The Global Burden of Headache: A Documentation of Headache Prevalence and Disability Worldwide","volume":"27","author":"L. Stovner","year":"2007","journal-title":"Cephalalgia: an international journal of headache"},{"key":"pone.0279163.ref011","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/0333102416631959","article-title":"Increase in migraine diagnoses and guideline-concordant treatment in veterans, 2004\u20132012","volume":"37","author":"H. H. Altalib","year":"2017","journal-title":"Cephalalgia"},{"key":"pone.0279163.ref012","unstructured":"(05\/04\/2020). Centers for Medicare and Medicaid Services Available: https:\/\/www.cms.gov\/medicare\/coding\/icd10\/downloads\/icd-10_gem_fact_sheet.pdf"},{"key":"pone.0279163.ref013","unstructured":"(05\/04\/2020). ICD10:Version 2019. Available: https:\/\/icd.who.int\/browse10\/2019\/en"},{"key":"pone.0279163.ref014","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.amjmed.2017.09.005","article-title":"Headache","volume":"131","author":"W. J. M. Paul Rizzoli","year":"2018","journal-title":"The American Journal of Medicine"},{"key":"pone.0279163.ref015","unstructured":"(9\/10\/2022). IHS Classification ICHD-3. Available: https:\/\/ichd-3.org\/how-to-use-the-classification\/"},{"key":"pone.0279163.ref016","first-page":"887","volume-title":"International classification of headache disorders-ICHD-4 alpha","author":"P. J. Goadsby","year":"2020"},{"key":"pone.0279163.ref017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s10194-019-1072-2","article-title":"ICHD-3 is significantly more specific than ICHD-3 beta for diagnosis of migraine with aura and with typical aura","volume":"21","author":"C. H. G\u00f6bel","year":"2020","journal-title":"The journal of headache and pain"},{"key":"pone.0279163.ref018","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1111\/head.12189","article-title":"The international classification of headache disorders, (ICHD III)\u2013changes and challenges","volume":"53","author":"M. Levin","year":"2013","journal-title":"Headache: The Journal of Head and Face Pain"},{"key":"pone.0279163.ref019","unstructured":"(05\/04\/2020). American Academy of Neurology. Available: aan.com"},{"key":"pone.0279163.ref020","unstructured":"(05\/04\/2020). American Headache Society. Available: https:\/\/americanheadachesociety.org\/"},{"key":"pone.0279163.ref021","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1186\/s12913-017-2504-9","article-title":"Comparing chronic condition rates using ICD-9 and ICD-10 in VA patients FY2014\u20132016","volume":"17","author":"J. Yoon","year":"2017","journal-title":"BMC Health Services Research"},{"key":"pone.0279163.ref022","first-page":"S28","article-title":"Symptom-based clinical profiles in the classification of post-traumatic headache","volume":"91","author":"A. H. Ahn","year":"2018","journal-title":"Neurology"},{"key":"pone.0279163.ref023","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s11940-011-0157-2","article-title":"Posttraumatic headache in military personnel and veterans of the Iraq and Afghanistan conflicts","volume":"14","author":"B. J. Theeler","year":"2012","journal-title":"Current treatment options in neurology"},{"key":"pone.0279163.ref024","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1212\/WNL.0000000000012261","article-title":"Factors associated with, and mitigation strategies for, health care disparities faced by patients with headache disorders","volume":"97","author":"J. Kiarashi","year":"2021","journal-title":"Neurology"},{"key":"pone.0279163.ref025","doi-asserted-by":"crossref","first-page":"2268","DOI":"10.1212\/WNL.0000000000004025","article-title":"Racial disparities in neurologic health care access and utilization in the United States","volume":"88","author":"A. Saadi","year":"2017","journal-title":"Neurology"},{"key":"pone.0279163.ref026","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/S1474-4422(18)30143-1","article-title":"How do we fix the shortage of neurologists?","volume":"17","author":"A. Burton","year":"2018","journal-title":"The Lancet Neurology"},{"key":"pone.0279163.ref027","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1212\/WNL.0b013e31829d8783","article-title":"The Workforce Task Force report: clinical implications for neurology","volume":"81","author":"W. D. Freeman","year":"2013","journal-title":"Neurology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0279163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T18:21:48Z","timestamp":1672856508000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0279163"}},"subtitle":[],"editor":[{"given":"Peyman","family":"Rezaei-Hachesu","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,1,4]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0279163","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,4]]}}}