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Italian ICD9

Ran into an interesting case today, in EHDEN we have an Italian DP who uses ICD9. And was surprised that these codes weren’t getting picked up when using ICD9CM:

'043.11', -- COVID-19 conclamata, virus identificato
‘043.21', -- COVID-19 paucisintomatica, virus identificato
'043.31', -- COVID-19 asintomatica, virus identificato
'480.41', -- Polmonite in COVID-19, virus identificato
'518.91', -- Sindrome da distress respiratorio (ARDS) in COVID-19, virus identificato
'519.71' -- Altra infezione delle vie respiratorie in COVID-19, virus identificato

I was wondering are our ICD9 Vocabularies essentially static at this point? Also, do we know that some countries are updating/using ICD9?

Tagging @Christian_Reich , @mik

@ericaVoss: We have ICD9CM, the American version. Because at the time of inception of OMOP, that was the going diagnosis coding scheme in the US. When OHDSI came along, most other countries already had ditched their ICD9 versions. Turns out there are pockets in Italy and Canada still going strong. Obviously, ICD9CM did not have any Covid-19 codes.

Bottom line: We would have to bring it in. Shouldn’t be a big deal, really, and the mappings from the few new codes could be added manually. Just drop a Github issue.

Italy has added codes, but is in general still using ICD9CM 2007…

So, for CoViD we seem to have:
• 480.41 Lungenentzündung bei COVID-19, Virus nachgewiesen;
• 480.42 Lungenentzündung bei COVID-19, Virus nicht nachgewiesen;
• 519.71 Andere Infektionen der Atemwege bei COVID-19, Virus nachgewiesen;
• 519.72 Andere Infektionen der Atemwege bei COVID-19, Virus nicht nachgewiesen;
• 518.91 Atemnotsyndrom (ARDS) bei COVID-19, Virus nachgewiesen;
• 518.92 Atemnotsyndrom (ARDS) in COVID-19, Virus nicht nachgewiesen;
• 043.11 Bestätigte COVID-19- Infektion, Virus nachgewiesen;
• 043.12 Bestätigte COVID-19- Infektion, Virus nicht nachgewiesen;
• 043.21 COVID-19 geringfügige Symptome, Virus nachgewiesen;
• 043.22 COVID-19 geringfügige Symptome, Virus nicht nachgewiesen;
• 043.31 COVID-19 asymptomatisch, Virus nachgewiesen;
• 043.32 COVID-19 asymptomatisch, Virus nicht nachgewiesen.

or in Italian:
• 480.41 Polmonite in COVID-19, virus identificato;
• 480.42 Polmonite in COVID-19, virus non identificato;
• 519.71 Altra infezione delle vie respiratorie in COVID-19, virus identificato;
• 519.72 Altra infezione delle vie respiratorie in COVID-19, virus non identificato;
• 518.91 Sindrome da distress respiratorio (ARDS) in COVID-19, virus identificato;
• 518.92 Sindrome da distress respiratorio (ARDS) in COVID-19, virus non identificato;
• 043.11 COVID-19 conclamata, virus identificato;
• 043.12 COVID-19 conclamata, virus non identificato;
• 043.21 COVID-19 paucisintomatica, virus identificato;
• 043.22 COVID-19 paucisintomatica, virus non identificato;
• 043.31 COVID-19 asintomatica, virus identificato;
• 043.32 COVID-19 asintomatica, virus non identificato.

Did we check with other Italian contributors, such as @MatteoGabetta and how they approach this?

Is there a trusted source that holds additions to the Italian ICD9, an ICD9IM, so to speak? Which also leads me to the statement that we cannot really just add those codes to ICD9CM, as they are most probably an Italian invention. We would have to create a copy of ICD9CM and give it a new name. ICD10 has no official Italian version yet that is in use, as far as I know and maybe Italy would transition to ICD11 right away and skip ICD10.

Maybe it would be the best to create mappings for the above codes once for all Italian data partners and maintain them locally.

We’re checking with our Italian data partners about the presence of such codes in their hospital discharge systems (ICD9 is used throughout Italy for this purpose).
I agree with the need of creating an ad hoc mapping which could be adopted by all Italian data partners.

BTW, the OHDSI Europe - Italian chapter the group is about to be launched and we will try to meet before the EU symposium: this could be an interesting topic to be discussed there.



Looks like:

  • The Italians use a version of ICD-9, with the last release in 2007 (which they now added the Covid-19 codes).
  • They call it ICD-9-CM, just like the Americans.

I would not assume that they are identical based on the naming. Instead, we should obtain that vocabulary, compare and assess what effort it would take to map it to SNOMED.


@MatteoGabetta - can you extract a delta to ICD9CM that would illustrate the additions that go beyond the COVID codes listed above to the (sort of unofficial) version of the Italian ICD9?
We can then decide if this warrants an actual addition to the OHDSI vocabularies or should be handled locally / regionally.