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ICD Dagger/Asterisk Convention

ICD Dagger/Asterisk Convention. Summary of recent work. Procedure. Download from ClaML Expansion of aetiology (dagger) and manifestation (asterisk) ICD-10 combinations using Access Excel sheet with over 1200 “new titles”. Procedure. Number of asterisk codes = 83.

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ICD Dagger/Asterisk Convention

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  1. ICD Dagger/Asterisk Convention Summary of recent work

  2. Procedure • Download from ClaML • Expansion of aetiology (dagger) and manifestation (asterisk) ICD-10 combinations using Access • Excel sheet with over 1200 “new titles”

  3. Procedure

  4. Number of asterisk codes = 83

  5. Number of asterisk codes = 83

  6. Manifestation Types • Generic • Specific • One to one • One to multiple • Multiple to one

  7. Generic Manifestation • “xxx in diseases classified elsewhere” Examples: G94* Other disorders of brain in diseases classified elsewhere J17* Pneumonia in diseases classified elsewhere • Added to Chapter 99IC • A Supplementary manifestations

  8. Specific Manifestation • Specific condition named in code Examples: M07.1*Arthritis mutilans (L40.5†) H19.1* Herpesviral keratitis and keratoconjunctivitis (B00.5†) • Three scenarios resulted from expansion ..........

  9. Dagger + asterisk = New title • Added as a new class under the dagger code • Assigned an additional parent to indicate location of the concept in the asterisk chapter

  10. Dagger + asterisk = New title • Example • A new title ‘Tuberculosis of thyroid gland’ has been added under category A18.8. The new title came from A18.8 Tuberculosis of other specified organs and E35.0 Disorders of thyroid gland in diseases classified elsewhere • It has also been given an additional parent of E00-E35

  11. Dagger + asterisk = Asterisk title • Made a child of the dagger code • Assigned an additional parent to indicate location of the concept in the asterisk chapter

  12. Dagger + asterisk = Asterisk title Example: • The new title is ‘Tuberculous peritonitis’ which is the exact match to the title of K67.3. K67.3 has been given the parent of A18.3 Tuberculosis of intestines, peritoneum and mesenteric glands • An additional parent was assigned to indicate location of the concept in the asterisk chapter (LA Peritonitis)

  13. Dagger + asterisk = Dagger title • Assigned an additional parent to indicate location of the concept in the asterisk chapter

  14. Dagger + asterisk = Dagger title Example: • The new title is ‘Amoebic lung abscess’ which is the exact match to the title of A06.5 • A06.5 has been given an additional parent of J95-J99 to indicate location of the concept in the asterisk chapter

  15. Further review • Manifestations referring to broad ranges (blocks, categories, chapters)removed • Kept the three character code as a supplementary code • Most of the new titles have been kept for review by appropriate TAG/WG

  16. Issues • Expansion – many ‘new titles’ • Not all commonly occurring conditions • ?? Clinical correct • ?? Necessary • Overburdening of classification • Alternatively use a multiple coding convention

  17. Overburdening

  18. Issues • Inconsistency in new revisions by various TAG/WGs • Retirement of asterisk codes • Kept asterisk codes as asterisk codes • Kept asterisk codes as single codes • Need a consistent decision

  19. Issues • Linearization • By tradition aetiology • Manifestation TAGs claiming main • Most TAG/WGs have not addresses this

  20. Linearization issues

  21. ICD-10-CM • Has removed dagger/asterisk codes • Use of ‘code first underlying disease’ • Pre-coordinated term added as an inclusion to the aetiology • Assign pre-coordinated term its own code usually at 5th character

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