Developmental-Behavioral Pediatricians' Diagnosis and Coding of Overweight and Obesity in Children with Autism Spectrum Disorder

J Dev Behav Pediatr. 2020 May;41(4):258-264. doi: 10.1097/DBP.0000000000000783.

Abstract

Objective: The prevalence of obesity in autism spectrum disorder (ASD) is high, and managing obesity in children with ASD can be challenging. The study's objective was to examine developmental-behavioral pediatricians' (DBPs) coding practices for overweight/obesity in children with ASD and patient characteristics associated with coding.

Methods: We analyzed the clinical data on children with ASD with at least 1 visit at one of 3 developmental-behavioral pediatrics network sites between January 2010 and December 2011. Weight status was calculated using body mass index z-scores. For children meeting the criteria for overweight/obesity, we assessed the frequency of weight-related ICD-9 diagnosis codes at DBP visits, used multivariable logistic regression to determine characteristics associated with the presence of these codes, and examined the prevalence of weight-related codes relative to other diagnosis codes.

Results: The sample included 4542 children, ages 2 to 19 years. 15.5% of children met the criteria for overweight, 14.7% for obesity, and 6.3% for severe obesity. Of children meeting the criteria for overweight/obesity/severe obesity, 7.5% had a weight-related code documented at their visits. Children with obesity or severe obesity and older children had higher odds of having a weight-related code. Compared with not being on medications, atypical antipsychotics use was significantly associated with increased odds of having a weight-related code. Of 3802 unique ICD-9 diagnosis codes documented at any visit during the study period, only 4% were related to weight.

Conclusion: Few children meeting the criteria for overweight/obesity had documented weight-related codes. Weight-related coding was more likely for children with obesity, who were older, and those taking atypical antipsychotics.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antipsychotic Agents / therapeutic use
  • Autism Spectrum Disorder / diagnosis*
  • Autism Spectrum Disorder / drug therapy
  • Autism Spectrum Disorder / epidemiology*
  • Child
  • Child, Preschool
  • Clinical Coding
  • Comorbidity
  • Female
  • Humans
  • International Classification of Diseases
  • Male
  • Overweight / diagnosis*
  • Overweight / epidemiology*
  • Pediatric Obesity / diagnosis
  • Pediatric Obesity / epidemiology
  • Pediatricians / statistics & numerical data
  • Young Adult

Substances

  • Antipsychotic Agents