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Missing ICD-9/10 codes

Vocabulary Users
#1

Hi all,

In working on an i2b2 ontology, we recently came across a number of ICD-9 and ICD-10 codes that seem to be “missing” from our vendor’s crosswalk between interface terminology and reference terminology.

Looking into this further, we also found that many (but not all!) of these codes are “missing” from the CONCEPT table in the CDM as well. For example, ICD-9 codes 044 and 320.4 aren’t there (and don’t seem to be in Athena either), but K07 does exist in Athena.

They all seem to be well-covered by other codes: for example, ICD-9 code 320.4 (“Tuberculous meningitis”) is also covered by ICD-9 013.00. Likewise, ICD-10 code K07 (dentofacial anomalies) is also covered by M26.

While trying to get to the bottom of this, I came across the concept of the “dagger-and-asterix” coding convention in ICD-9/10. Many or most of these seem to fall into this category - conditions where two codes exist, one for the etiology and one for the manifestation. But some don’t.

This isn’t posing any grave issue for us - it’s not like we have anything in our source systems that needs to be mapped from these codes. But I am curious about it. Is there anyone out there with more familiarity with ICD-9/10 who can shed some light on this issue? I’m including some (but not all) of the codes below for reference.

ICD-10

A16 - Respiratory tuberculosis, not confirmed bacteriologically or histologically

B21 - Human Immunodeficiency Virus [HIV] disease resulting in malignant neoplasms
B22 - Human immunodeficiency virus [HIV] disease resulting in other specified diseases
B23 - Human Immunodeficiency Virus [HIV] disease resulting in other conditions
B24 - Unspecified Human Immunodeficiency Virus [HIV] disease

C97 - Malignant neoplasms of independent primary multiple sites

E14 - Unspecified diabetes mellitus
E90 - Nutritional and metabolic disorders in diseases classified elsewhere

F00 - Dementia in Alzheimer’s disease (G30.-+)
F38 - Other mood [affective] disorders
F61 - Mixed and other personality disorders
F62 - Enduring personality changes, not attributable to brain damage and disease
F83 - Mixed specific developmental disorders
F92 - Mixed disorders of conduct and emotions

G22 - Parkinsonism in diseases classified elsewhere

H06 - Disorders of lacrimal system and orbit in diseases classified elsewhere
H13 - Disorders of conjunctiva in diseases classified elsewhere
H19 - Disorders of sclera and cornea in diseases classified elsewhere
H45 - Disorders of vitreous body and globe in diseases classified elsewhere
H48 - Disorders of optic [2nd] nerve and visual pathways in diseases classified elsewhere
H58 - Other disorders of eye and adnexa in diseases classified elsewhere

I84 - Haemorrhoids

J46 - Status asthmaticus

K07 - Dentofacial anomalies [including malocclusion]
K93 - Disorders of other digestive organs in diseases classified elsewhere

M03 - Postinfective and reactive arthropathies in diseases classified elsewhere
M68 - Disorders of synovium and tendon in diseases classified elsewhere
M82 - Osteoporosis in diseases classified elsewhere

O05 - other abortion
O06 - unspecified abortion
O81 - single delivery by forceps and vacuum extractor
O83 - other assisted single delivery
O84 - multiple delivery
O95 - obstetric death of unspecified cause
O96 - Death from any obstetric cause occurring more than 42 days but less than one year after delivery
O97 - Death from sequelae of direct obstetric causes

P20 - Intrauterine hypoxia
P21 - Birth asphyxia
P75 - Meconium ileus (E84.1+)

R02 - Gangrene, not elsewhere classified
R95 - Sudden infant death syndrome
R96 - Other sudden death, cause unknown

ICD-9

042.0 HIV INFECTION WITH CERTAIN SPECIFIED INFECTIONS
042.1 HIV INFECTION CAUSING OTHER SPECIFIED INFECTIONS
042.2 HIV INFECTION WITH SPECIFIED MALIGNANT NEOPLASMS
042.9 ACQUIRED IMMUNODEFICIENCY SYNDROME WITH OR WITHOUT OTHER CONDITIONS
043 HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION CAUSING OTHER
SPECIFIED CONDITIONS
043.0 HIV INFECTION CAUSING LYMPHADENOPATHY (785.6)
043.1 HIV INFECTION CAUSING SPECIFIED DISEASES OF THE CENTRAL NERVOUS SYSTEM
043.2 HIV INFECTION CAUSING OTHER DISORDERS INVOLVING THE IMMUNE MECHANISM
043.3 HIV INFECTION CAUSING OTHER SPECIFIED CONDITIONS
043.9 ACQUIRED IMMUNODEFICIENCY SYNDROME-RELATED COMPLEX WITH OR WITHOUT
OTHER CONDITIONS
044 OTHER HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION
044.0 HIV INFECTION CAUSING SPECIFIED ACUTE INFECTIONS
044.9 HIV INFECTION NOT OTHERWISE SPECIFIED (WITH OR WITHOUT OTHER
044.9 CONDITIONS NOT CLASSIFIABLE TO 042, 043, 044.0)

320.4 TUBERCULOUS MENINGITIS
321.5 MENINGITIS DUE TO MUMPS VIRUS
321.6 MENINGITIS DUE TO LYMPHOCYTIC CHORIOMENINGITIS VIRUS
321.7 MENINGITIS DUE TO OTHER AND UNSPECIFIED VIRUSES
323.3 ARTHROPOD-BORNE VIRAL ENCEPHALITIS

350.0 POST-HERPETIC TRIGEMINAL NEURALGIA

370.1 DENDRITIC KERATITIS

425.6 CARDIOMYOPATHY IN CHAGAS’S DISEASE

484.0 MEASLES

730.4 TUBERCULOSIS OF SPINE
730.5 TUBERCULOSIS OF LIMB BONES
730.6 TUBERCULOSIS OF OTHER BONES

777.0 MECONIUM ILEUS

#2

@esholle:

Not sure I can reproduce your problem:

  • 044 is not a valid ICD9CM code. It just doesn’t exist. Not sure where your source data got that from.
  • 320.4 doesn’t exist, either. As you said, there are 013 “Tuberculosis of meninges and central nervous system”, 013.0 “Tuberculous meningitis” and 013.00 “Tuberculous meningitis, unspecified”.
  • None of the other ICD9 codes you listed exist.
  • K07 is a so-called Hierarchical Term. It exists only in ICD10 (the international version from the WHO). It cannot be used for billing. ICD10CM (the much larger American version) doesn’t have it. It has so-called 3-character non-billing codes. But K07 isn’t one of them, even though it has 3 characters.
  • All the other ICD10 codes you listed exist fall into the same category. They are ICD10 Hierarchy Terms, but don’t belong into ICD10CM.

Are you sure these codes are derived from billing information? Where is your reference table derived from, which apparently has all those codes?

#3

Thanks, @Christian_Reich. That does seem to cover it. Some of these old ICD-9 codes also seem to have been retired ages ago - for example, I found a reference to 044 in this ancient set of coding guidelines from the CDC - apparently it was replaced by 042 some time ago. We have some reference to these in old, old billing data, but I think it may have been mistakenly entered or abstracted from paper bills. As I said, not a big deal (not even a problem, really) - I was just curious.

#4

@esholle:

Ah. That’s possible. If you have those old ones (beyond the ones you gave us), bring them on. With an end date, if possible. If not, the last time you observed them in the data. We add them in. We want to support old deprecated codes. Thanks, man.

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