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Relationships between increasing outpatient encounters for neurological disorders and introductions of associated diagnostic codes, active duty military service members, 1998-2010.

Previous surveillance summaries of administrative data have indicated increases in the incidence and health care burdens of neurological disorders among active component U.S. military members during the last decade. Seventy-eight percent of the increase in average annual numbers of neurological disorders-related outpatient encounters during 2005-2010 is attributable to new diagnostic codes for three common conditions--sleep disorders, pain, and headache. The new codes were added to the International Classification of Diseases as "diseases of the nervous system" between 2005 and 2008. The pre-existing codes for these conditions are in most cases not classified as neurological. Visits for "organic sleep disorders" in particular represented nearly one-half of all outpatient encounters for neurological disorders in 2010. The use of the new diagnostic codes by healthcare providers can mask trends of the "true incidence" of illnesses and injuries and should be considered when interpreting surveillance analyses.