Non-standard ICD10 Diagnoses

See also: Non-standard CCI Procedure

The following non-standard ICD10 Diagnoses we customized/added have been added to encode specific diagnostic details that ICD10 doesn't account for. Pages would generally be added to this page using Template:ICD10 nonstandard code.

ICD10 CA specific Codes

• Note that for ICD10 (unlike ICD9) different countries do some customization. In general here we're using the ICD-10-CA (Canadian) version but in some cases we have borrowed codes that are from the US customization.

ICD10	description	reason for using non-standard code
C7A.0	Malignant carcinoid tumor	there is no Canadian code for carcinoid tumor and so we used this US code; this is also the reason why this code has a letter in it.
J45.91	Status asthmaticus	Status Asthmaticus is coded as J46 in the International version of ICD10 but we chose to code it as this code.
U82.1	Resistance to antimicrobials, methicillin (anti-staph penicillins)	Antimicrobial resistance is not coded in standard ICD10.
U82.20	Resistance to carbapenem antibiotics	Antimicrobial resistance is not coded in standard ICD10.
U82.3	Resistance to antimicrobials, extended spectrum beta lactamase (ESBL)	Antimicrobial resistance is not coded in standard ICD10.
U82.8	Resistance to antimicrobials, antibiotic, resistance to other beta lactams	Antimicrobial resistance is not coded in standard ICD10.
U83.9	Resistance to antimicrobials, miscellaneous antibacterial antibiotics	Antimicrobial resistance is not coded in standard ICD10.
U84.0	Resistance to antimicrobials, antiparasitic drug	Antimicrobial resistance is not coded in standard ICD10.
U84.1	Resistance to antimicrobials, antifungal drug	Antimicrobial resistance is not coded in standard ICD10.
U84.2	Resistance to antimicrobials, antiviral agent	Antimicrobial resistance is not coded in standard ICD10.
U84.3	Resistance to antimicrobials, classic anti-mycobacterial agent	Antimicrobial resistance is not coded in standard ICD10.
U84.9	Resistance to antimicrobials, drug NOS	Antimicrobial resistance is not coded in standard ICD10.
U85.1	Asystole	Asystole is not coded in standard ICD10.
U85.2	Pulseless Electrical Activity (PEA)	Pulseless Electrical Activity (PEA) is not coded in standard ICD10.
Z95.811	Heart assist device, has one	We needed to be able to collect LVADs and standard ICD10 doesn't have a code for this.

ICD10 CM specific Codes

These are codes that follow the American ICD10 CM listing and are different from the WHO listing.

ICD10	description	reason for using non-standard code
J84.89	Bronchiolitis obliterans organizing pneumonia (BOOP, cryptogenic organizing pneumonia (COP))	There is no specific code for BOOP in the CA version.

Codes our program added

• U00-U49 - Provisional codes for temporary assignment by World Health Organization of new diseases of uncertain etiology
• U50-U99 - Provisional codes for research and temporary assignment in Canada

List of our Custom Codes

ICD10	description	reason for using non-standard code
0	No Dx Entered	This is the default code that shows up in an ICD10 diagnosis when a new record is entered. The entry should always be replaced with an actual diagnosis by the time a record is finalized. Cross check Query check_ICD10_unfilled will give an error for the record if this entry is present.
00	Not an Infection (ICD10 pathogen alternative)	This is a possible entry as an ICD10 pathogen. It isn't an actual ICD10 code, but it is used in our database to prevent someone from forgetting to combine a pathogen with a diagnoses requiring pathogens.
000	No Comorbidities (ICD10 code)	This code is entered as a Comorbid Diagnosis for patients who have no comorbidities so that we can cross-check that the entry was not simply forgotten.
U04	SARS (severe acute respiratory syndrome)	This is a special purpose code currently assigned by the WHO for SARS.
U14.68	Diabetes mellitus acute complication: Non-ketotic hyperosmolar state	In ICD10 proper, this code would be grouped together with Diabetes mellitus chronic complication NOS which is less specific than we want, or with Diabetic coma which would miss cases that are not severe enough to cause coma, so we added this code.
U22.11	Stenotrophomonas species	We needed to some track pathogens that do not have a specific ICD10 code.
U22.12	Citrobacter species	We needed to some track pathogens that do not have a specific ICD10 code.
U22.13	Enterobacter species	We needed to some track pathogens that do not have a specific ICD10 code.
U22.14	Acinetobacter species	We needed to some track pathogens that do not have a specific ICD10 code.
U22.9	Infectious organism, unknown	We needed to track some pathogens that do not have a specific ICD10 code.

Total List of codes in the contingency range

These should all be already addressed above, think of this as a contingency check in case we forgot to specifically address one.

ICD10_code	description
U04	SARS (severe acute respiratory syndrome)
U07.1	COVID-19 (SARS-COV-2)
U07.4	Post COVID-19 condition
U07.5	Past history of Covid-19 infection
U14.68	Diabetes mellitus acute complication: Non-ketotic hyperosmolar state
U22.11	Stenotrophomonas species
U22.12	Citrobacter species
U22.13	Enterobacter species
U22.14	Acinetobacter species
U22.8	Other type of infectious organism, NOS
U22.9	Infectious organism, unknown
U82.1	Resistance to antimicrobials, methicillin (anti-staph penicillins)
U82.20	Resistance to carbapenem antibiotics
U82.3	Resistance to antimicrobials, extended spectrum beta lactamase (ESBL)
U82.8	Resistance to antimicrobials, antibiotic, resistance to other beta lactams
U83.0	Resistance to antimicrobials, vancomycin
U83.9	Resistance to antimicrobials, miscellaneous antibacterial antibiotics
U84.0	Resistance to antimicrobials, antiparasitic drug
U84.1	Resistance to antimicrobials, antifungal drug
U84.2	Resistance to antimicrobials, antiviral agent
U84.3	Resistance to antimicrobials, classic anti-mycobacterial agent
U84.9	Resistance to antimicrobials, drug NOS
U85.1	Asystole
U85.2	Pulseless Electrical Activity (PEA)

Effect on other systems that use ranges of codes in definitions

APACHE Acute Dxs in ICD10 codes, APACHE Comorbidities in ICD10 codes, Charlson Comorbidities in ICD10 codes and ICD10 blocks rely on ranges of codes. Some of the diagnoses listed above might be coded instead of other diagnoses that would have been in the relevant ranges, and therefore prevent inclusion in one of these schemes. Here are our considerations of them.

• Bronchiolitis obliterans organizing pneumonia (BOOP, cryptogenic organizing pneumonia (COP)) (J84.89)
• SARS (severe acute respiratory syndrome) (U04)

Dx grouping With our addition of codes, collectors may use one of our codes rather than the closest standard ICD10 code. In that case, the dx would not show up in the range. How should we address this? The most likely candidates above seem Bronchiolitis obliterans organizing pneumonia (BOOP, cryptogenic organizing pneumonia (COP)) and SARS (severe acute respiratory syndrome) AG REPLY -- for this nonstd BOOP code, there are no existing issues regarding any of the comorbid groups (e.g. Charlson) Allan, could you confirm that that this is what we found when we looked into BOOP. AG REPLY --- so far Tina the only 2 U-codes that would ever be a primary dx are U04 and U14.68 -- which belong respectively to ICD10 chapters J and E. But whenever we add a new U-code we need to remember to decide which chapter (if any) it needs to be included under. Tina to add to template. I can't add this to the template, this is not how templates work, they won't warn me as I start a new dx page. We'd need to remember this some other way. And I just saw other dxs that might fit in here: Diabetes mellitus acute complication: Non-ketotic hyperosmolar state, Asystole, Pulseless Electrical Activity (PEA) Actually, neither BOOP nor SARS would currently be captured by our APACHE Acute Dxs in ICD10 codes filter - they likely should be. So this is still an issue and we would miss them if we did something similar. How do we fix it for the Apache codes and prevent this problem going fwd? Ttenbergen 15:22, 2022 June 30 (CDT) Discussed at JALT, Allan will review. Ttenbergen 10:32, 2022 August 24 (CDT) Allan sent an email 2022-10-02 that provides a new inclusion list for some of these. Nothing for APACHE or Charlson Comos, but additions for APACHE Acute Dxs in ICD10 codes. Tina needs to process the additions into S ICD10 APACHE Dx patterns table. Ttenbergen 16:54, 2022 October 27 (CDT) Additionally, Tina will provide Allan the filter info as it's stored in Access so that future updates aren't confusing. Ttenbergen 17:00, 2022 October 27 (CDT) Additionally we need some way to make sure we consider this when we add dxs. Ttenbergen 17:00, 2022 October 27 (CDT) figured out that the structure of APACHE Acute Dxs in ICD10 codes is way different than I had thought and that my current implementation can't accommodate it, reviewing with Julie. Ttenbergen 23:09, 2022 October 27 (CDT)

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