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Published on: September 20, 2018
Migrating existing clinical content from ICD-9 to SNOMED
Prakash M Nadkarni1, Jonathan A Darer
1Yale University School of Medicine, USA. Prakash.Nadkarni@yale.edu
Journal of the American Medical Informatics Association : JAMIA
|September 8, 2010
Summary
Mapping legacy ICD-9-CM data to SNOMED presents challenges, including deprecated codes and the need for compositional approaches. The NLM clinical core subset requires augmentation for comprehensive coverage.
Area of Science:
- Medical Informatics
- Health Data Standards
- Clinical Terminology
Background:
- Legacy health data encoded with International Classification of Disease, 9th edition, Clinical Modification (ICD-9-CM) requires mapping to modern terminologies like Systematic Nomenclature of Medicine (SNOMED) for interoperability.
- Existing mapping strategies face challenges due to the nature of ICD-9-CM codes, often created by non-taxonomists.
Purpose of the Study:
- To identify challenges in mapping ICD-9-CM legacy data to SNOMED using compositional approaches.
- To evaluate the coverage of the US National Library of Medicine's (NLM) SNOMED clinical core subset for this mapping task.
Main Methods:
- Selected ICD-CM codes occurring at least 100 times in organizational data from 2008.
- Manually mapped remaining codes with software assistance after excluding those with pre-existing UMLS mappings.
Main Results:
- 35.7% of codes required manual mapping, with many being deprecated or composite.
- Composite concepts necessitated operators (disjunction, set-difference) not currently defined in SNOMED.
- The NLM clinical core subset contained only 47% of necessary concepts, and SNOMED searches demanded extensive synonymy knowledge.
Conclusions:
- Strategies for legacy ICD data must account for non-taxonomist-generated codes.
- The NLM SNOMED core subset may need expansion, particularly in qualifiers, body structures, substances, and organisms.
- Concept-matching software requires query expansion, benefiting from a large, non-redundant SNOMED subset.
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