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SNOMED CT to ICD-10 Maps
Other and Unspecified
Overview
▪ A feature of the ICD-10
classification, that distinguishes it
from a terminology like SNOMED
CT, is the presence of codes for
the ‘other specified’ and
‘unspecified’ form of a disorder
▪ These are usually, but not
always.8 and .9 (see example
D39), at four character level in a
category
▪ The use of these categories
means that ICD-10 can be
described as ‘exhaustive’ in that
every diagnosis can be classified
Example D39
NEC
▪ NEC stands for Not
Elsewhere Classified
‘Not Elsewhere
Classified’ indicates that specified
variants or types of the disease
are classified elsewhere, and that
where appropriate, a more
precise term should be looked for
▪ If the specific diagnostic term
cannot be found then the NEC
code can be used, indicating
that the specific condition does
not have a unique code
elsewhere in the Classification.
In other words, it cannot be
coded in another place
Other specified in use
D39.7 shown below is a grouped
code which includes neoplasm of
uncertain or unknown behaviour of
any specific anatomical area of
female genital organs, other than
Uterus, Ovary or Placenta. For
example fallopian tube, or vulva,
would be coded here because they
do not have a specific fourth
character of their own
▪ The ‘other’ category (.7 here
but usually .8) is also known
as the residual (and
sometimes ‘bucket’) category
and immediately follows the
specific codes/categories to
which it pertains.
SNOMED CT to ICD-10 Map Example
This slide shows an example of a SNOMED CT concept and its ICD-10 map
based on what has been explained previously (see slides 2 and 4)
94837001|Neoplasm of uncertain behavior of female genital organ
(disorder)|
ICD-10 Index
Neoplasm
- genital organ or tract
- - female NEC
D39.9
- - - specified site NEC D39.7
NEC in the Tabular list
▪ NEC Not Elsewhere
Classified
▪ If you see this phrase or its
abbreviation used in a code
title or in an inclusion or
exclusion note, it alerts you to
consult the Index or the
inclusion and exclusion notes
because other conditions
which include the same terms
are to be found classified
elsewhere, often in other
chapters of the ICD.
▪ The exclusion notes will help you
find alternative codes for various
types of oedema. The fourth
character categories in R60.- are
only used if you cannot find a
more specific code for the case of
oedema.
SNOMED CT to ICD-10 Map Example
ICD-10 Index
Edema, edematous
- heat T67.7
.9 in the Index, Volume 3
▪ A term without any essential
modifiers is usually the
unspecified form of the
condition
▪ When mapping a concept for a
diagnosis, problem or reason
for an encounter that has no
modifiers it is said to be
unspecified or unqualified or
NOS (not otherwise
specified).
▪ NOS (not otherwise specified)
is the equivalent of unspecified
i.e. usually the .9.
▪ In the index the code
assignment is most often that
which directly follows the lead
term or the ‘unmodified’ term.
The abbreviation NOS is found
in the Tabular List not the
Index.
SNOMED CT to ICD-10 Map Examples
129103003|Endometriosis (disorder)|
61640006|Endometriosis of cervix (disorder)|
- parent Endometriosis of uterus (disorder)
ICD-10 Index
▪ Endometriosis N80.9
- uterus N80.0
Unspecified terms in Volume 1
▪ Unspecified or NOS indicates
where a disease/injury belongs
if it is not qualified or if you
have no further information to
allow you to use a specific
three- or four-character code
for a disease.
Deficiency, deficient
- vitamin (multiple) E56.9
- - B NEC (complex) E53.9
▪ ‘Vitamin B deficiency, unspecified’
means use E53.9 if you do not
have any more information other
than there is a deficiency of
Vitamin B.
193188009 Polyneuropathy due to vitamin B deficiency
▪ In this case, the vitamin is known
to be B but is unspecified as no
further information is available.
Index:
Polyneuropathy (peripheral) G62.9
-- in (due to)
- - lack of vitamin NEC E56.9† G63.4*
Axis of classification
▪ In ICD-10 anatomy is
the primary axis of classification
and codes are based on the
anatomical systems.
BUT
▪ ICD-10 is a variable or multi-axial
classification
Other examples of axes used are:
• Etiology or cause of disease
(certain infectious and
parasitic diseases)
• Type of disease
(cardiac arrhythmia)
• Morphology or structure
and form of an organism
(leukaemia)
▪ The use of assorted axes of
classification is necessary to
meet the needs of a varied
groups of users in classifying
diseases, injuries and other
reasons for health services
being provided in a wide array
of healthcare settings.
▪ A combination of multiple and
varied axes are used in
classifying some diseases
within the same chapter.
Example types of axis of classification
When coding injuries, the first axis
of classification is the body region
affected (such as head, neck,
thorax, etc.)
The second axis of classification
of injuries is the specific type of
injury (such as superficial, open
wound, fracture, dislocation and
sprain, injuries to nerves, blood
vessels, muscle and tendon
damage, crushing injuries,
traumatic amputation, other or
unspecified injuries, etc.)
▪ S50 Example
SNOMED CT to ICD-10 Map Example
211251003|Abrasion, elbow area (disorder)|
ICD-10 Index
Abrasion — see also Injury, superficial T14.0
Injury — see also specified injury type T14.9
- superficial (for contusions, see first
Contusion)
- - elbow S50.9
Example of axis of classification
▪ The meaning of ‘other’ (and thus .8) is determined by the
preceding codes/categories to which it pertains as
‘other’.
S60 Superficial injury of wrist and hand
S61 Open wound of wrist and hand
S62 Fracture at wrist and hand level
S63 Dislocation, sprain and strain of joints and ligaments at wrist and hand level
S64 Injury of nerves at wrist and hand level
S65 Injury of blood vessels at wrist and hand level
S66 Injury of muscle and tendon at wrist and hand level
S67 Crushing injury of wrist and hand
S68 Traumatic amputation of wrist and hand
S69 Other and unspecified injuries of wrist and hand
S69.7 Multiple injuries of wrist and hand
S69.8 Other specified injuries of wrist and hand
S69.9 Unspecified injury of wrist and hand
SNOMED CT to ICD-10 Map Example
438480008|Injury of nail bed of
finger (disorder)|
ICD-10 Index
Injury
- finger (nail) S69.9