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Non Standard IC9CM Procedures Mapping to Different Domains

Vocabulary Users
#1

While culling our diagnosis table for procedures we found that some of the mappings via Concept Relationship map to concepts that are in a different domain than their source concept. Any help would be greatly appreciated.

Source
C1 - Standard = Non Standard
C1 - Vocabulary ID = ICD9CM
C1 - Domain = Procedures
Destination (Via Concept Relation and ‘Map To’)
C2 - Standard = Standard
C2 - Vocabulary ID =SNOMED
C2 - Domain = Condition - This is problematic.

#2

So, you are saying that there are ICD9CM codes that are in the procedure domain, but are non-standard; however, when you map to a standard code it is in a different domain from procedure? Could you provide an specific example?

#3

@cukarthik:

Tons of them. It’s silly to assume that because ICD means classification of disease that it contains only diseases:

V76.43 Screening for malignant neoplasms of skin
V26.0 Tuboplasty or vasoplasty after previous sterilization
V50.41 Prophylactic breast removal
V72.81 Pre-operative cardiovascular examination

But even outside the V codes:

629.32 Exposure of implanted vaginal mesh and other prosthetic materials into vagina
794.6 Nonspecific abnormal results of other endocrine function study
995.24 Failed moderate sedation during procedure
998.4 Foreign body accidentally left during a procedure

So, it’s all good. We map to the right Concept, and if the concept is in another domain than Condition - so be it.

#4

@Christian_Reich and @cukarthik

  • I see ICD codes that are indeed procedures but map to SNOMED and
    are then reclassified as a Condition. (see below)
  • Should we always lets the mapped concept (Concept 2) determine the finally destination of a fact/clinical record?

See here

#5

@dblatt

You got it. That’s how it works.

Imagine the opposite. Say, you are in Australia putting a study together on stillbirth or mastectomy. You would have to somehow guess where these Conditions and Procedures sit, and if you have a US-based database some Procedures sit in the Condition table and the other way around, because the coding scheme of the source data had it upside down. It’s impossible. So, the vocabulary team sets the domain_id of each concept, and that defines which table it should go. That way, all stillbirths are in Condition, and all mastectomies are in Procedure, where they belong.

#6

Thank you @Christian_Reich

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