Non-standard ICD10 Diagnoses

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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

These are codes that follow the Canadian CIHI listing and are different from the WHO listing.

ICD10descriptionreason for using non-standard code
C7A.0Malignant carcinoid tumorthere 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.
J45.91Status asthmaticusStatus Asthmaticus is coded as J46 in the International version of ICD10 but we chose to code it as this code.
U82.1Resistance to antimicrobials, methicillin (anti-staph penicillins)Antimicrobial resistance is not coded in standard ICD10.
U82.3Resistance to antimicrobials, extended spectrum beta lactamase (ESBL)Antimicrobial resistance is not coded in standard ICD10.
U82.8Resistance to antimicrobials, antibiotic, resistance to other beta lactamsAntimicrobial resistance is not coded in standard ICD10.
U83.0Resistance to antimicrobials, vancomycinAntimicrobial resistance is not coded in standard ICD10.
U83.9Resistance to antimicrobials, miscellaneous antibacterial antibioticsAntimicrobial resistance is not coded in standard ICD10.
U84.0Resistance to antimicrobials, antiparasitic drugAntimicrobial resistance is not coded in standard ICD10.
U84.1Resistance to antimicrobials, antifungal drugAntimicrobial resistance is not coded in standard ICD10.
U84.2Resistance to antimicrobials, antiviral agentAntimicrobial resistance is not coded in standard ICD10.
U84.3Resistance to antimicrobials, anti-mycobacterial agentAntimicrobial resistance is not coded in standard ICD10.
U84.9Resistance to antimicrobials, drug NOSAntimicrobial resistance is not coded in standard ICD10.
Z95.811Heart assist device, has oneWe 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.

ICD10descriptionreason for using non-standard code
J84.89Bronchiolitis obliterans organizing pneumonia (BOOP, cryptogenic organizing pneumonia (COP))There is no specific code for BOOP in the CA version.

Codes our program added

Our choice of codes

As per [1]:

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

We are going to stick out extra codes into the WHO range, anticipating that it is more likely that we would want to adopt all-Canada temp codes than WHO temp codes.

List of our Custom Codes

ICD10descriptionreason for using non-standard code
0No Dx EnteredThis 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 Check fundamentals for ICD10 will give an error for the record if this entry is present.
00Not 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.
000No 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.
U04SARS (severe acute respiratory syndrome)This is a special purpose code currently assigned by the WHO for SARS.
U14.68Diabetes mellitus acute complication: Non-ketotic hyperosmolar stateIn 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.
U22.11Stenotrophomonas speciesWe needed to some track pathogens that do not have a specific ICD10 code.
U22.12Citrobacter speciesWe needed to some track pathogens that do not have a specific ICD10 code.
U22.13Enterobacter speciesWe needed to some track pathogens that do not have a specific ICD10 code.
U22.14Acinetobacter speciesWe needed to some track pathogens that do not have a specific ICD10 code.
U22.9Infectious organism, unknownWe needed to some track 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_codedescription
U04SARS (severe acute respiratory syndrome)
U14.68Diabetes mellitus acute complication: Non-ketotic hyperosmolar state
U22.11Stenotrophomonas species
U22.12Citrobacter species
U22.13Enterobacter species
U22.14Acinetobacter species
U22.8Other type of infectious organism, NOS
U22.9Infectious organism, unknown
U82.1Resistance to antimicrobials, methicillin (anti-staph penicillins)
U82.3Resistance to antimicrobials, extended spectrum beta lactamase (ESBL)
U82.8Resistance to antimicrobials, antibiotic, resistance to other beta lactams
U83.0Resistance to antimicrobials, vancomycin
U83.9Resistance to antimicrobials, miscellaneous antibacterial antibiotics
U84.0Resistance to antimicrobials, antiparasitic drug
U84.1Resistance to antimicrobials, antifungal drug
U84.2Resistance to antimicrobials, antiviral agent
U84.3Resistance to antimicrobials, anti-mycobacterial agent
U84.9Resistance to antimicrobials, drug NOS

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.

Swiss Army Knife.svg

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.
  • SMW


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