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Condition Name: Meningococcal Disease CSTE Committee Name: Infectious CSTE Position Statement Title and Code: Public Health Reporting and National Notification for Meningococcal Disease Revision Date; Author(s): September 2013; Ted Klein and Gib Parrish Technical Implementation Guide Contents Table 1. SNOMED CT, LOINC, and ICD text and codes for Meningococcal Disease related clinical criteria Table 1a. Singly-encoded clinical criteria for reporting and defining a case of Meningococcal Disease expressed as standard SNOMED CT codes Table 1b. Dual-coded clinical criteria for reporting and defining a case of Meningococcal Disease expressed as standard clinical LOINC codes for the observable entities and standard SNOMED CT or ICD codes for the observations Table 1c. Clinical criteria for reporting and defining a case of Meningococcal Disease that are based on radiologic or other diagnostic procedures and expressed as dual-coded items with codes from a standard terminology for the observable entities and standard SNOMED CT codes for the observations Table 1d. Clinical criteria for reporting and defining a case of Meningococcal Disease that are composed of complex clinical statements and expressed as post-coordinated expressions using the SNOMED CT grammar for combining SNOMED CT concepts for complex observations Table 2. Laboratory criteria for reporting and defining a case of Meningococcal Disease expressed as standard LOINC and SNOMED CT codes Table 3. ICD-9-CM text and codes for Meningococcal Disease related clinical criteria Table 4. ICD-10-CM text and codes for Meningococcal Disease related clinical criteria Appendix 1. Additional terms that may be of interest Notes on Coding: 1. 2. 3. The clinical and laboratory criteria listed in the tables below are derived from Sections VI and VII and Tables VI-B and VII-B of the CSTE Position Statement for the public health reporting and national notification of this condition. Clinical criteria that provide supporting—but not sufficient—evidence for reporting or classifying a condition are usually not condition-specific (e.g., pneumonia, meningitis, pulmonary fibrosis). Criteria that provide sufficient evidence are usually condition-specific (e.g., Hemophilus influenzae pneumonia, Meningococcal meningitis, silicotic fibrosis). Refer to Tables VI-B and VII-B in the condition's position statement for how specific clinical criteria are designated (e.g., sufficient, necessary, corroborative). All tables below with clinical criteria contain a coding match flag to indicate how closely the terminology concept (text and code) matches the clinical criterion. The coding match flag is located in the rightmost column of each table and is assigned one of the following values, depending on the match between the clinical criterion and the terminology text: Exact: The terminology concept is an exact match to the concept expressed by the clinical criterion. Narrower: The terminology concept is narrower than the concept expressed by the clinical criterion. Broader: The terminology concept is broader than the concept expressed by the clinical criterion. Inexact: The terminology concept is related to the concept expressed by the clinical criterion, but may be narrower in some respects and broader in others. No decent match: The clinical criterion cannot be expressed in the terminology with any fidelity. Page 1 of 9 Table 1a. Singly-encoded clinical criteria for reporting and defining a case of Meningococcal Disease expressed as standard SNOMED CT codes Clinical criterion Text basis for coding (preferred term from code system) Code Coding granularity match to criterion Petechial Rash Petechiae 271813007 Broader Petechial Rash Petechiae of skin 423716004 Broader Purpura Purpura 423902002 Exact Purpura fulminans Purpura fulminans 13507004 Exact Sepsis Septicemia 105592009 Exact Death Death 419620001 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal infectious disease 23511006 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcemia 4089001 Exact Healthcare record contains a diagnosis of meningococcal disease acute meningococcemia 186365005 Exact Healthcare record contains a diagnosis of meningococcal disease chronic meningococcemia 240426001 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal arthropathy 9467007 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal carditis 33618002 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal endocarditis 34845009 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal myocarditis 91468009 Exact Healthcare record contains a diagnosis of meningococcal disease acute myocarditis - meningococcal 194950003 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal encephalitis 18071005 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal eye disease 240427005 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal conjunctivitis 94151004 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal optic neuritis 73431005 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal meningitis 192644005 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal cerebrospinal fever 203182008 Exact Healthcare record contains a diagnosis of meningococcal meningitis with Exact Page 2 of 9 314130008 meningococcal disease meningococcal septicemia Healthcare record contains a diagnosis of meningococcal disease meningococcal meningitis with acute meningococcal septicemia 313437008 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal pericarditis 66704002 Exact Healthcare record contains a diagnosis of meningococcal disease acute meningococcal pericarditis 194906004 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal pharyngitis 232402006 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal pneumonia 233608005 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal rash 238425003 Exact 36102002 Exact Healthcare record contains a diagnosis of Waterhouse-Friderichsen meningococcal disease syndrome SNOMED CT code system OID = 2.16.840.1.113883.6.96 Table 1b. Dual-coded clinical criteria for reporting and defining a case of Meningococcal Disease expressed as standard clinical LOINC codes for the observable entities and standard SNOMED CT or ICD codes for the observations Clinical criterion Text for Observable LOINC Observabl Entity (LOINC) e Entity Code Text for Observation (from code system) Observatio Code n code System Coding granularity match to criterion death certificate lists Cause of death [US 69453-9 meningococcal disease standard certificate as a cause of death or a of death] significant condition contributing to death * 23511006 SNOMED meningococcal CT infectious disease (disorder) Exact death certificate lists Cause of death [US 69453-9 meningococcal disease standard certificate as a cause of death or a of death] significant condition contributing to death * 322.9 Meningitis of unspecified cause; Meningitis, unspecified Exact death certificate lists Cause of death [US 69453-9 meningococcal disease standard certificate as a cause of death or a of death] significant condition contributing to death * Meningitis, unspecified death certificate lists Death cause other meningococcal disease significant 69441-4 G03.9 ICD-9-CM ICD-10-CM Exact 23511006 SNOMED meningococcal CT infectious disease Page 3 of 9 Exact as a cause of death or a conditions [US significant condition standard certificate contributing to death * of death] (disorder) death certificate lists meningococcal disease as a cause of death or a significant condition contributing to death * Death cause other significant conditions [US standard certificate of death] 69441-4 322.9 Meningitis of unspecified cause; Meningitis, unspecified death certificate lists meningococcal disease as a cause of death or a significant condition contributing to death * Death cause other significant conditions [US standard certificate of death] 69441-4 Meningitis, unspecified G03.9 ICD-9-CM Exact ICD-10-CM Exact SNOMED CT code system OID = 2.16.840.1.113883.6.96 LOINC code system OID = 2.16.840.1.113883.6.1 ICD-9-CM Diagnosis code system OID = 2.16.840.1.113883.6.103 ICD-10-CM Diagnosis code system OID = 2.16.840.1.113883.6.90 * Note that the International Classification of Diseases (ICD9 and ICD10) is the international standard for classifying and reporting the cause of death. Table 1c. Clinical criteria for reporting and defining a case of Meningococcal Disease that are based on radiologic or other diagnostic procedures and expressed as dual-coded items with codes from a standard terminology for the observable entities and standard SNOMED CT codes for the observations There exist no radiologic or other non-laboratory diagnostic Clinical Criteria for reporting a case of meningococcal disease as of this release. Table 1d. Clinical criteria for reporting and defining a case of Meningococcal Disease that are composed of complex clinical statements and expressed as post-coordinated expressions using the SNOMED CT grammar for combining SNOMED CT concepts for complex observations Clinical criterion Death Text basis for coding Post-coordinated Expression Coding granularity match to criterion Death associated with meningococcal disease 419620001 | death | : 47429007 | associated with SNOMED CT | = 23511006 | meningococcal infectious disease | SNOMED CT code system OID = 2.16.840.1.113883.6.96 Table 2. Laboratory criteria for reporting and defining a case of Meningococcal Disease expressed as standard LOINC and SNOMED CT codes Page 4 of 9 Laboratory criterion Text basis for coding Test code Test code system name Text basis for result code Result code Result code system name Isolation of Neisseria meningitidis from a normally sterile site N men XXX Ql Cult 16134- LOINC 9 Positive 10828004 SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site N men Islt Cult 44093- LOINC 3 Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria Plr Aerobe 17279- LOINC Cult 1 Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria Bld Aerobe Cult 17928- LOINC 3 Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria XXX Anaerobe+Aerobe Cult 21020- LOINC 3 Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria Islt Aerobe 32367- LOINC Cult 5 Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria Aspirate Aerobe Cult 597-5 LOINC Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria Fld Aerobe 610-6 Cult LOINC Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria XXX Aerobe Cult 634-6 LOINC Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria CSF Cult 606-4 LOINC Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria Bld Cult 600-7 LOINC Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria Snv Cult 621-3 LOINC Neisseria 17872004 meningitidis SNOMED CT Isolation of Neisseria meningitidis from a normally sterile site Bacteria Plr Cult 618-9 LOINC Neisseria 17872004 meningitidis SNOMED CT Evidence of N. meningitidis DNA using a validated polymerase chain reaction (PCR), obtained from a normally sterile site N men DNA XXX Ql PCR 49671- LOINC 1 Positive SNOMED CT Page 5 of 9 10828004 N. meningitidis antigen identified by immunohistochemistry (IHC) on formalin-fixed tissue No code N. meningitidis antigen identified in CSF by latex agglutination N men Ag CSF LA- 17324- LOINC aCnc 5 N. meningitidis antigen identified in CSF by latex agglutination N men A+C+W135+Y Ag CSF Ql LA 19133- LOINC 8 Positive 10828004 SNOMED CT N. meningitidis antigen identified in CSF by latex agglutination N men B+E coli K1 19134- LOINC Ag CSF Ql LA 6 Positive 10828004 SNOMED CT N. meningitidis antigen identified in CSF by latex agglutination N men A Ag CSF Ql LA 6494-9 LOINC Positive 10828004 SNOMED CT N. meningitidis antigen identified in CSF by latex agglutination N men B Ag CSF Ql LA 6498-0 LOINC Positive 10828004 SNOMED CT N. meningitidis antigen identified in CSF by latex agglutination N men C Ag CSF Ql LA 6500-3 LOINC Positive 10828004 SNOMED CT N. meningitidis antigen identified in CSF by latex agglutination N men Y Ag CSF Ql LA 6505-2 LOINC Positive 10828004 SNOMED CT N. meningitidis antigen identified in CSF by latex agglutination N men W135 Ag CSF Ql LA 6507-8 LOINC Positive 10828004 SNOMED CT Gram negative diplococci in CSF Gram Stn CSF 14357- LOINC 8 Gramnegative diplococcus 83410001 SNOMED CT Gram negative diplococci in CSF Gram Stn Fld 27112- LOINC 2 Gramnegative diplococcus 83410001 SNOMED CT Gram negative diplococci in CSF Gram Stn XXX 664-3 LOINC Gramnegative diplococcus 83410001 SNOMED CT Gram negative diplococci in peripheral blood smear Gram Stn Fld 27112- LOINC 2 Gramnegative diplococcus 83410001 SNOMED CT Gram negative diplococci in peripheral blood smear Gram Stn XXX 664-3 Gramnegative diplococcus 83410001 SNOMED CT LOINC Quantitative value LOINC code system OID = 2.16.840.1.113883.6.1 SNOMED CT code system OID = 2.16.840.1.113883.6.96 Table 3. ICD-9-CM text and codes for Meningococcal Disease related clinical criteria Page 6 of 9 Clinical Criterion text Text Basis for Coding (ICD-9-CM Text) ICD-9-CM code Coding granularity match to criterion Petechial Rash spontaneous ecchymoses 782.7 Inexact Purpura fulminans Defibrination syndrome (including Purpura: fibrinolytic, fulminans) 286.6 Broader Purpura other nonthrombocytopenic purpuras 287.2 Broader Sepsis unspecified septicemia 038.9 Broader Sepsis Sepsis 995.91 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal meningitis 036.0 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal encephalitis 036.1 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcemia 036.2 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal carditis, unspecified 036.40 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal pericarditis 036.41 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal endocarditis 036.42 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal myocarditis 036.43 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal optic neuritis 036.81 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcal arthropathy 036.82 Exact Healthcare record contains a diagnosis of meningococcal disease Other specified meningococcal infections, Other 036.89 Exact Healthcare record contains a diagnosis of meningococcal disease meningococcemia 036.9 Exact 322.9 Exact Healthcare record contains a Meningitis of unspecified cause; diagnosis of meningococcal disease Meningitis, unspecified ICD-9-CM Diagnosis code system OID = 2.16.840.1.113883.6.103 Table 4. ICD-10-CM text and codes for Meningococcal Disease related clinical criteria Clinical Criterion text Text Basis for Coding (ICD-10-CM text) ICD-10-CM code Coding granularity match to criterion Petechial Rash Petechia, petechiae R23.3 Broader Purpura Other nonthrombocytopenic purpura D69.2 Narrower Page 7 of 9 Purpura fulminans Disseminated intravascular coagulation [defibrination syndrome] (including purpura fulminans) D65 Broader Sepsis Sepsis (generalized) (unspecified organism) A41.9 Narrower Healthcare record contains a diagnosis of meningococcal disease Acute meningococcemia A39.2 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal myocarditis A39.52 Exact Healthcare record contains a diagnosis of meningococcal disease Chronic meningococcemia A39.3 Exact Healthcare record contains a diagnosis of meningococcal disease Meningitis, unspecified G03.9 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal arthritis A39.83 Exact Healthcare record contains a diagnosis of meningococcal disease Postmeningococcal arthritis A39.84 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal carditis, unspecified A39.50 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal encephalitis A39.81 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal endocarditis A39.51 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal infection, unspecified A39.9 Exact Healthcare record contains a diagnosis of meningococcal disease Other meningococcal infections A39.89 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal meningitis A39.0 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcal myocarditis A39.52 Exact Healthcare record contains a diagnosis of meningococcal disease Meningococcemia, unspecified A39.4 Exact A39.53 Exact Healthcare record contains a Meningococcal pericarditis diagnosis of meningococcal disease ICD-10-CM Diagnosis code system OID = 2.16.840.1.113883.6.90 SNOMED CT code system OID = 2.16.840.1.113883.6.96 Appendix 1. Additional terms that may be of interest Suggested New Criterion Text Basis for Coding (Code System preferred term) Code Code System Coding Name granularity match to criterion Peripheral Gangrene gangrene 785.4 ICD-9-CM Broader Peripheral Gangrene Peripheral Gangrene 195301007 SNOMED Exact Page 8 of 9 CT Pericarditis acute pericarditis unspecified 420.90 ICD-9-CM Narrower Pericarditis Pericarditis 3238004 SNOMED CT Exact Fever fever and other physiologic disturbances of temperature regulation 780.6 ICD-9-CM Exact Fever Fever, unspecified 780.60 ICD-9-CM Exact Fever Fever 386661006 SNOMED CT Exact Fever Fever, unspecified R50.9 ICD-10-CM Exact Pleural Effusion unspecified pleural effusion 511.9 ICD-9-CM Exact Pleural Effusion Pleural Effusion 60046008 SNOMED CT Exact Septic Arthritis pyogenic arthritis site unspecified 711.00 ICD-9-CM Broader Septic Arthritis Pyogenic arthritis, unspecified M00.9 ICD-10-CM Exact Septic Arthritis Suppurative arthritis 372939007 SNOMED CT Exact Meningitis Meningitis 7180009 SNOMED CT Exact ICD-9-CM Diagnosis code system OID = 2.16.840.1.113883.6.103 ICD-10-CM Diagnosis code system OID = 2.16.840.1.113883.6.90 SNOMED CT code system OID = 2.16.840.1.113883.6.96 Page 9 of 9
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