Question

We have been asked by a client to incorporate ICD-9 codes into a system.

I'm looking for a good resource to get a complete listing of codes and descriptions that will end up in a SQL database.

Unfortunately a web service is out of the question as a fair amount of the time folks will be off line using the application.

I've found http://icd9cm.chrisendres.com/ and http://www.icd9data.com/ but neither offer downloads/exports of the data that I could find.

I also found http://www.cms.hhs.gov/MinimumDataSets20/07_RAVENSoftware.asp which has a database of the ICD-9 codes but they are not in the correct format and I'm not 100% sure how to properly convert (It shows the code 5566 which is really 556.6 but I can't find a rule as to how/when to convert the code to include a decimal)

I'm tagging this with medical and data since I'm not 100% sure where it should really be tagged...any help there would also be appreciated.

Was it helpful?

Solution

I ran into this same issue a while back and ended up building my own solution from scratch. Recently, I put up an open API for the codes for others to use: http://aqua.io/codes/icd9/documentation

You can just download all codes in JSON (http://api.aqua.io/codes/beta/icd9.json) or pull an individual code (http://api.aqua.io/codes/beta/icd9/250-1.json). Pulling a single code not only gives you the ICD-10 "crosswalk" (equivalents), but also some extra goodies, like relevant Wikipedia links.

OTHER TIPS

Just wanted to chime in on how to correct the code decimal places. First, there are four broad points to consider:

  1. Standard codes have Decimal place XXX.XX
  2. Some Codes Do not have trailing decimal places
  3. V Codes also follow the XXX.XX format --> V54.31
  4. E Codes follow XXXX.X --> E850.9

Thus the general logic of how to fix the errors is

If first character = E:
    If 5th character = '':
        Ignore
    Else replace XXXXX with XXXX.X                
Else If 4th-5th Char is not '':                      (XXXX or XXXXX)
    replace XXXXX with XXX + . + remainder           (XXX.XX or XXX.X)
(All remaining are XXX)

I implemented this with two SQL Update statements:
Number 1, for Non E-codes:

USE MainDb;
UPDATE "dbo"."icd9cm_diagnosis_codes" 
    SET "DIAGNOSIS CODE" = SUBSTRING("DIAGNOSIS CODE",1,3)+'.'+SUBSTRING("DIAGNOSIS CODE",4,5)
FROM "dbo"."icd9cm_diagnosis_codes"
WHERE 
    SUBSTRING("DIAGNOSIS CODE",4,5) != ''
    AND
    LEFT("DIAGNOSIS CODE",1) != 'E'

Number 2 - For E Codes:

UPDATE "dbo"."icd9cm_diagnosis_codes" 
    SET "DIAGNOSIS CODE" = SUBSTRING("DIAGNOSIS CODE",1,4)+'.'+SUBSTRING("DIAGNOSIS CODE",5,5)
FROM "dbo"."icd9_Diagnosis_table"
WHERE
    LEFT("DIAGNOSIS CODE",1) = 'E'
    AND
    SUBSTRING("DIAGNOSIS CODE",5,5) != ''

Seemed to do the trick for me (Using SQL Server 2008).

I finally found the following:

"The field for the ICD-9-CM Principal and Other Diagnosis Codes is six characters in length, with the decimal point implied between the third and fourth digit for all diagnosis codes other than the V codes. The decimal is implied for V codes between the second and third digit."

So I was able to get a hold of a complete ICD-9 list and reformat as required.

You might find that the ICD-9 codes follow the following format:

  • All codes are 6 characters long
  • The decimal point comes between the 3rd and 4th characters
  • If the code starts with a V character the decimal point comes between the 2nd and 3rd characters

Check this out: http://en.wikipedia.org/wiki/List_of_ICD-9_codes

I struggled with this issue myself for a long time as well. The best resource I have been able to find for these are the zip files here:

https://www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp

It's unfortunate because they (oddly) are missing the decimal places, but as several other posters have pointed out, adding them is fairly easy since the rules are known. I was able to use a regular expression based "find and replace" in my text editor to add them. One thing to watch out for if you go that route is that you can end up with codes that have a trailing "." but no zero after it. That's not valid, so you might need to go through and do another find/replace to clean those up.

The annoying thing about the data files in the link above is that there is no relationship to categories. Which you might need depending on your application. I ended up taking one of the RTF-based category files I found online and re-formatting it to get the ranges of each category. That was still doable in a text editor with some creative regular expressions.

I was able to use the helpful answers here an create a groovy script to decimalize the code and combine long and short descriptions into a tab separated list. In case this helps anyone, I'm including my code here:

import org.apache.log4j.BasicConfigurator
import org.apache.log4j.Level
import org.apache.log4j.Logger

import java.util.regex.Matcher
import java.util.regex.Pattern

Logger log = Logger.getRootLogger()
BasicConfigurator.configure();
Logger.getRootLogger().setLevel(Level.INFO);

Map shortDescMap = [:]
new File('CMS31_DESC_SHORT_DX.txt').eachLine {String l ->
    int split = l.indexOf(' ')
    String code = l[0..split].trim()
    String desc = l[split+1..-1].trim()
    shortDescMap.put(code, desc)
}
int shortLenCheck = 40      // arbitrary lengths, but provide some sanity checking...
int longLenCheck = 300
File longDescFile = new File('CMS31_DESC_LONG_DX.txt')
Map cmsRows = [:]
Pattern p = Pattern.compile(/^(\w*)\s+(.*)$/)
new File('parsedICD9.csv').withWriter { out ->
    out.write('ICD9 Code\tShort Description\tLong Description\n')
    longDescFile.eachLine {String row ->
        Matcher m = row =~ p
        if (m.matches()) {
            String code = m.group(1)
            String shortDescription = shortDescMap.get(code)
            String longDescription = m.group(2)
            if(shortDescription.size() > shortLenCheck){
                log.info("Not short? $shortDescription")
            }
            if(longDescription.size() > longLenCheck){
                log.info("${longDescription.size()} == Too long? $longDescription")
            }
            log.debug("Match 1:${code} -- 2:${longDescription} -- orig:$row")

            if (code.startsWith('V')) {
                if (code.size() > 3) {
                    code = code[0..2] + '.' + code[3..-1]
                }
                log.info("Code: $code")

            } else if (code.startsWith('E')) {
                if (code.size() > 4) {
                    code = code[0..3] + '.' + code[4..-1]
                }
                log.info("Code: $code")
            } else if (code.size() > 3) {
                code = code[0..2] + '.' + code[3..-1]
            }
            if (code) {
                cmsRows.put(code, ['longDesc': longDescription])
            }
            out.write("$code\t$shortDescription\t$longDescription\n")
        } else {
            log.warn "No match for row: $row"
        }
    }
}

I hope this helps someone.

Sean

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