Stream: implementers
Topic: icd-9 codes
Josh Mandel (Feb 01 2017 at 22:14):
Can someone help me understand when to choose http://hl7.org/fhir/sid/icd-9-cm over http://hl7.org/fhir/sid/icd-9-cm/diagnosis when coding a diagnosis? https://www.hl7.org/fhir/terminologies-systems.html isn't totally helping me.
Josh Mandel (Feb 02 2017 at 16:36):
Is it a mistake for the spec to define http://hl7.org/fhir/sid/icd-9-cm when the more-specific "diagnosis" and "procedure" systems are defined?
Grahame Grieve (Feb 06 2017 at 03:55):
my understanding is that there are 3 different code systems at play here, the actual ICD-9 system, and then 2 additional code systems that are helpfully called 'ICD-9' but actually aren't at all. @Rob Hausam please comment
Rob Hausam (Feb 06 2017 at 04:34):
It is a little complicated, and, at least, as Josh said, I don't think we're explaining it very well in FHIR. So, as briefly as I can, this is what it is (at least my take). ICD-9-CM is published in 3 volumes. The first two volumes are for diagnosis, with volume 1 being the tabular representation (the actual code system section for diagnosis) and volume 2 being the alpha index (both assisting in navigation and providing some guidance/rules for coding - including at least some of the cases where multiple codes are required). The diagnosis codes were used for both provider and facility (hospital) billing in the US (now superceded by ICD-10-CM). Volume 3 is the ICD-9-CM procedure codes, including both the tabular representation and alpha index, which were used only for hospital (facility) procedure billing in the US (provider procedure billing uses CPT). In my opinion, ICD-9-CM is a single code system (at least the codes are unique across all 3 volumes), but which has this primary division of diagnosis and procedure - and that is what we see with the URL's that have been defined. Probably what we really should have, though, is the single URL for the code system ( http://hl7.org/fhir/sid/icd-9-cm), with the diagnosis and procedure codes sections both defined as value sets (which don't seem to exist at present in FHIR).
Grahame Grieve (Feb 06 2017 at 06:29):
that wasn't my understanding. Can you create a task to fix this ASAP, and we need to create a 'how to use ICD-9' page - thanks @Rob Hausam
Rob Hausam (Feb 06 2017 at 06:46):
Grahame Grieve (Feb 06 2017 at 06:50):
thanks. Could Vocab accelerate this?
Grahame Grieve (Feb 06 2017 at 06:51):
or could we handle it as a technical correction?
Rob Hausam (Feb 06 2017 at 06:55):
I'm thinking a technical correction is appropriate - except for the "how to" page. I'm pretty sure that won't be controversial. I will get some other Vocab co-chair opinion. Russ and I were discussing setting up an additional call for FHIR items, as there isn't one scheduled for this week.
Grahame Grieve (Feb 06 2017 at 06:56):
k thanks
Josh Mandel (Feb 06 2017 at 16:41):
Thanks @Rob Hausam and @Grahame Grieve — this is a huge help!
Last updated: Apr 12 2022 at 19:14 UTC
