Stream: terminology
Topic: Display texts for 5-digit ICD-10 codes
Morten Ernebjerg (Dec 20 2021 at 07:38):
I need to encode smt. with the ICD-10 code M41.86. That is the code M41.8 "Other forms of scoliosis", extended with the supplementary subclassification digit 6 "Lumbar region" (cf. section on Dorsopathies(M40-M54) in the ICD-10 browser). However, the browser does not offer a display text for this particular combination and I'm not of official rules for generating display strings for 5-digit codes from the 4-digit ones (for now, I put "Other forms of scoliosis, lumbar region"). Are there such rules for official lists of display texts for 5-digit codes?
Robert McClure (Dec 20 2021 at 15:32):
As long as your locally generated text is consistent with the meaning of the concept, you can use your own local text as the description for the concept. Particularly true when it is a valid code but there is no defined description by the code system, like this. I don't know if there is an official syntax for this from WHO, but yours looks fine.
Rob Hausam (Dec 20 2021 at 17:41):
@Morten Ernebjerg I agree with Rob M. But I will add that if ICD-10 (WHO or a national variant?) does (now, or possibly in the future) provide a mechanism for generating a "standard" description for the codes with the additional digits, then all Coding instances should be using those descriptions for 'display'.
Morten Ernebjerg (Dec 21 2021 at 10:37):
Sounds good, thanks Rob & Rob!
Morten Ernebjerg (Dec 21 2021 at 12:16):
Actually, one follow-up question. Running the latests JAR validator on this example, it throws a validation error saying that the code M41.86 is invalid (using the general ICD-10 URL, http://hl7.org/fhir/sid/icd-10):
Error @ Condition.code.coding[0] (line 23, col21):
The code "M41.86" is not valid in the system http://hl7.org/fhir/sid/icd-10;
The code provided (http://hl7.org/fhir/sid/icd-10#M41.86) is not valid in the value set 'All codes known to the system' (from http://tx.fhir.org/r4) for 'http://hl7.org/fhir/sid/icd-10#M41.86'
Is that a limitation of the term server or is this actually an invalid code for this ICD-10 URL?
Rob Hausam (Dec 21 2021 at 14:21):
@Morten Ernebjerg M41.86 is a valid ICD-10-CM (US) code, but it is not in the "base" WHO version of ICD-10 (according to the ICD-10 browser). So the error message is correct.
Morten Ernebjerg (Dec 21 2021 at 14:52):
Ah, OK. But how is one then supposed to use the supplementary subclassification listed in the browser in the section on dorsopathies and referred to in the section on M41 (when writing codes in the base ICD-10 version)? Looking at section of 2.4.6 of the ICD-10 instruction manual linked from the browser, it says
The fifth and subsequent character levels are usually subclassifications along a
different axis from the fourth character. They are found in:
Chapter XIII – subdivisions by anatomical site
and chapter XIII (M00-M99) is where M41.8 is at home. I thought that meant adding a fifth character is valid.
Rob Hausam (Dec 21 2021 at 15:12):
@Morten Ernebjerg Yes, you have a good point on that. My assumption was that the browser included the complete contents, but according to the manual it seems that it probably does not. These "supplementary classifications" can be a real pain (I've run into this a lot in working with ICD-9-CM and ICD-10-CM). So if this "new" interpretation based on the documentation in the manual is correct, then the issue becomes that we need to obtain a new source file for ICD-10 that is actually complete. I have that available and I've used it for ICD-10-CM, but at the moment I don't know where else to look for it for the "base" ICD-10 from WHO.
Morten Ernebjerg (Dec 22 2021 at 11:37):
OK, thanks for the update @Rob Hausam. If I know that M41.86 is indeed a valid code, the validation error in itself is actually not an issue for me (does not break any builds etc.).
Last updated: Apr 12 2022 at 19:14 UTC
