Appendix F
Diagnostic Codes Used to Define Health Outcomes
The committee examined the mortality and morbidity experience of Project SHAD (Shipboard Hazard and Defense) veterans and the comparison population using data on cause of death and diagnosis coded in accordance with the International Classification of Diseases (ICD). This appendix provides the ICD codes that correspond to the categories of cause of death or diagnosis used in presenting the results of the analyses. Table F-1 presents the codes for the outcome categories for the analyses that tested the committee’s literature-based hypotheses regarding exposure to substances used in some SHAD tests. Table F-2 and Table F-3 provide the codes that correspond to the categories used in the exploratory analyses of mortality and morbidity.
TABLE F-1 International Classification of Disease Codes Used to Define Health Outcomes Examined for Possible Association with Exposure to Specified Substances Used in SHAD Tests
| Exposure and Health Outcome | ICD-9 Codes (2011 version) | ICD-10 Codes (2011 version) | ||||||
| Betapropiolactone | ||||||||
| Cancer (malignant neoplasms), any |
140.x-209.x Malignant neoplasms 230.x-234.x Carcinoma in situ V10.xx Personal history of malignant neoplasm |
C00-C97 Malignant neoplasms C7A.x Malignant neuroendocrine tumors C7B.x Secondary neuroendocrine tumors D00-D09 In situ neoplasms Z85 Personal history of malignant neoplasm |
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| Coxiella burnetii | ||||||||
| Endocarditis |
421.x Acute and subacute endocarditis 424.9x Endocarditis, valve unspecified 424.99 Other endocarditis, valve unspecified |
I33 Acute and subacute endocarditis I38 Endocarditis, valve unspecified I39 Endocarditis and heart valve disorders in diseases classified elsewhere |
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| Fatigue syndrome |
300.5 Neurasthenia |
F48 Other nonpsychotic mental |
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| Exposure and Health Outcome | ICD-9 Codes (2011 version) | ICD-10 Codes (2011 version) | ||||||
|
780.71 Chronic fatigue syndrome 780.79 Other malaise and fatigue |
disorders F48.8 Other specified neurotic disorders R53.1 Weakness R53.8 Other malaise and fatigue R53.82 Chronic fatigue, unspecified R53.81 Other malaise R53.83 other fatigue |
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| Chronic hepatitis |
571.4x Chronic hepatitis (includes 571.40, 571.41, 571.49) 571.42 Autoimmune hepatitis 573.3 Hepatitis, unspecified |
K73.x Chronic hepatitis, not elsewhere classified K75.4 Autoimmune hepatitis K75.9 Inflammatory liver disease, unspecified (Hepatitis nos) |
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| Osteomyelitis |
730.1xx Chronic osteomyelitis 730.2xx Unspecified osteomyelitis 730.9xx Unspecified infection of bone |
M86.6x Other chronic osteomyelitis, unspecified site M86.9 Osteomyelitis, unspecified M86.3x Chronic multifocal osteomyelitis M86.4x Chronic osteomyelitis with draining sinus M86.5x Other chronic hematogenous osteomyelitis M86.8x Other osteomyelitis |
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| Vascular infection | 447.6 Arteritis, unspecified | I77.6 Arteritis, unspecified | ||||||
| Escherichia coli | ||||||||
|
Irritable bowel syndrome |
555.x Regional enteritis (Crohn’s) 556.x Ulcerative enterocolitis 558.x Other and unspecified noninfectious gastroenteritis and colitis 564.1 Irritable bowel syndrome |
K50.x Crohn’s disease [regional enteritis] K51.x Ulcerative colitis K52.x Other noninfective gastroenteritis and colitis K58.x Irritable bowel syndrome |
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| Sarin | ||||||||
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Neurological effects: Central nervous system |
290.xx Dementias 323.7x Toxic encephalitis, myelitis, and encephalomyelitis 323.8x Other causes of encephalitis, myelitis, and encephalomyelitis 327.xx Organic sleep disorders 331.xx Other cerebral degenerations (e.g., Alzheimer’s disease, frontotemporal dementia, senile degeneration of brain) 332.x Parkinson’s disease 333.0 Other degenerative diseases of |
F00.x Dementia in Alzheimer’s disease F01.xx Vascular dementia F03.xx Unspecified dementia G92 Toxic encephalopathy G04.8x Other encephalitis, myelitis and encephalomyelitis G47.xx Sleep disorders (organic) G30.x Alzheimer’s disease G31.xx Other degenerative diseases of nervous system, not elsewhere classified G20 Parkinson’s disease |
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| Exposure and Health Outcome | ICD-9 Codes (2011 version) | ICD-10 Codes (2011 version) | ||||||
|
the basal ganglia 333.1 Essential and other specified forms of tremor 333.2 Myoclonus 333.3 Tics of organic origin 333.7 Acquired torsion dystonia 333.8 Fragments of torsion dystonia 333.9 Other and unspecified extrapyramidal diseases and abnormal movement disorder 334.2 Primary cerebellar degeneration 334.3 Other cerebellar ataxia 334.4 Cerebellar ataxia in diseases classified elsewhere 334.8 Other spinocerebellar diseases 334.9 Spinocerebellar disease, unspecified 335.2x Motor neuron disease (e.g., ALS) 336.x Other diseases of spinal cord 337.xx Disorders of the autonomic nervous system 338.0 Central pain syndrome 338.29 Other chronic pain 338.4 Chronic pain syndrome 339.xx Other Headache Syndromes 340 Multiple sclerosis 341.xx Other demyelinating diseases of central nervous system 342.xx Hemiplegia and hemiparesis 344.xx Other paralytic syndromes 345.xx Epilepsy and recurrent seizures (excluding 345.6 Infantile spasms) 346.xx Migraine 347.xx Cataplexy and narcolepsy 348.2 Benign intracranial hypertension 348.4 Compression of brain 348.5 Cerebral edema 348.8x Other conditions of brain 348.9 Unspecified condition of brain 349.2 Disorders of meninges, not elsewhere classified 349.8x Other specified disorders of nervous system 349.9 Unspecified disorders of nervous system 781.xx Symptoms involving nervous |
G23.x Other degenerative diseases of basal ganglia G25.0 Essential tremor G25.2 Other specified forms of tremor G25.3 Myoclonus G25.6x Drug induced tics and other tics of organic origin G25.8x Other specified extrapyramidal and movement disorders G25.9 Extrapyramidal and movement disorder, unspecified G24.2x-G24.9x Dystonias G80.3 Athetoid cerebral palsy G11.2 Late-onset cerebellar ataxia G32.81 Cerebellar ataxia in diseases classified elsewhere (Not including hereditary diseases G11.3, G11.8, G11.9) G12.2x Motor Neuron disease G12.8 Other spinal muscular atrophies and related syndromes G12.9 Spinal muscular atrophy, unspecified G95.xx Other diseases of spinal cord G90.xx Disorders of autonomic nervous system G89.0 Central pain syndrome G89.29 Other chronic pain G89.4 Chronic pain syndrome G44.xxx Other headache syndromes G35 Multiple sclerosis G36.x Other acute disseminated demyelination G37.x Other demyelinating diseases of central nervous system G81.xx Hemiplegia G82.xx Paraplegia (paraparesis) and quadriplegia (quadriparesis) G83.xx Other paralytic syndromes G40.xx Epilepsy G43.xxx Migraine G93.2 Benign intracranial hypertension G93.5 Compression of brain G93.6 Cerebral edema G93.8xx Other specified disorders of brain G93.9 Disorder of brain, unspecified G96.1x Disorders of meninges, not |
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| Exposure and Health Outcome | ICD-9 Codes (2011 version) | ICD-10 Codes (2011 version) | ||||||
|
and musculoskeletal systems 784.0 Headache 780.96 Generalized pain 794.0x Nonspecific abnormal results of function study of brain and central nervous system 799.5 Signs and symptoms involving cognition |
otherwise classified G96.8 Other specified disorders of central nervous system G96.9 Disorder of central nervous system, unspecified G92 Toxic encephalopathy G98.x Other disorders of nervous system not elsewhere classified R25.xxx-R29.xxx Symptoms and signs involving the nervous and musculoskeletal systems R51 Headache R52 Pain, not elsewhere classified R94.0x Abnormal findings of function studies of central nervous system R41.xx Other symptoms and signs involving cognitive functions and awareness R43.x Disturbances of smell and taste |
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|
Neurological effects: Peripheral nervous system |
350.x Trigeminal nerve disorders 351.x Facial nerve disorders 352.x Disorders of other cranial nerves 353.x Nerve root and plexus disorders 354.x Mononeuritis of upper limb and mononeuritis multiplex 355.x Mononeuritis of lower limb and unspecified site 357.7 Polyneuropathy due to other toxic agents 357.9 Unspecified inflammatory and toxic neuropathy 358.xx Myoneural disorders 359.3 Periodic paralysis 359.4 Toxic myopathy 359.9 Myopathy, unspecified 781.xx Symptoms involving nervous and musculoskeletal systems 794.1x Nonspecific abnormal results of function study of peripheral nervous system 357.8x Other inflammatory and toxic neuropathy 359.5 Myopathy in endocrine diseases classified elsewhere 359.6 Symptomatic inflammatory myopathy in diseases classified |
G50.x Disorders of trigeminal nerve G51.x Facial nerve disorders G52.x Disorders of other cranial nerves G54.x Nerve root and plexus disorders G55 Nerve root and plexus compressions in diseases classified elsewhere G56.xx Mononeuropathies of upper limb G57.xx Mononeuropathies of lower limb G58.x Other mononeuropathies G62.2 Polyneuropathy due to other toxic agents G61.9 Inflammatory polyneuropathy, unspecified G70.xx Myasthenia gravis and other myoneural disorders G72.3 Periodic paralysis G72.2 Myopathy due to other toxic agents G72.9 Myopathy, unspecified R25.xx-R29.xx Symptoms and signs involving the nervous and musculoskeletal systems R94.1xx Abnormal results of function studies of peripheral nervous system G61.8x Other inflammatory |
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| Exposure and Health Outcome | ICD-9 Codes (2011 version) | ICD-10 Codes (2011 version) | ||||||
|
elsewhere 359.7x Inflammatory and immune myopathies, not elsewhere classified |
polyneuropathies G62.8 Other specified polyneuropathies G72.4x Inflammatory myopathy, not elsewhere classified G64 Other disorders of peripheral nervous system |
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|
Neurological effects: Hearing loss |
389.xx Hearing loss 385.0x Tympanosclerosis 385.1x Adhesive middle ear disease 385.2x Other acquired abnormality of ear ossicles 387.x Otosclerosis 388.xx Other disorders of ear |
H90.xx Conductive and sensorineural hearing loss H91.xx Other hearing loss H74.0x Tympanosclerosis H74.1x Adhesive middle ear disease H74.3x Other acquired abnormalities of ear ossicles H80.xx Otosclerosis H93.xxx-H94.xxx Other disorders of ear |
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|
Psychological symptoms |
293.xx Transient mental disorders due to conditions classified elsewhere 294.xx Persistent mental disorders due to conditions classified elsewhere 295.xx Schizophrenic disorders 296.xx Episodic mood disorders 297.x Delusional disorders 298.x Other nonorganic psychoses 300.xx Anxiety, dissociative and somatoform disorders 301.xx Personality disorders 303.xx Alcohol dependence syndrome 304.xx Drug dependence 305.xx Nondependent abuse of drugs 306.xx Physiological malfunction arising from mental factors 307.xx Special symptoms or syndromes not elsewhere classified (e.g., sleep, eating, tics) 309.xx Adjustment reaction 311 Depressive disorder, not elsewhere classified 312.xx Disturbance of conduct not elsewhere classified 316 Psychic factors associated with diseases classified elsewhere 797 Senility without mention of psychosis 799.2x Nervousness 799.3 Debility, unspecified 799.5 Signs and symptoms involving |
F02.8 Dementia in other specified diseases classified elsewhere F03 Unspecified dementia F04 Organic amnesic syndrome, not induced by alcohol and other psychoactive substances F05 Delirium not induced by alcohol and other psychoactive substances F06 Other mental disorders due to brain damage and dysfunction and to physical disease F07 Personality and behavioral disorders due to brain disease, damage, and dysfunction F09 Unspecified organic or symptomatic mental disorder F10-F19 Mental and behavioral disorders due to psychoactive substance use F20-F29 Schizophrenia, schizotypal and delusional disorders F30-39 Mood [affective] disorders F40-48 Neurotic, stress-related and somatoform disorders F50-59 Behavioral syndromes associated with physiological disturbances and physical factors F60 Specific personality disorders F61 Mixed and other personality disorders R54 Senility (without mention of |
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| Exposure and Health Outcome | ICD-9 Codes (2011 version) | ICD-10 Codes (2011 version) | ||||||
|
cognition 308.x Acute reaction to stress |
psychosis) R45.0 Nervousness R53 Malaise and fatigue R41 Other symptoms and signs involving cognitive functions and awareness |
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| Staphylococcal enterotoxin type B | ||||||||
|
Asthma |
493 Asthma (includes 493.x, 493.xx) |
J45.xx Asthma |
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|
Graves’ disease |
242.xx Thyrotoxicosis with or without goiter |
E05.xx Thyrotoxicosis (includes Graves’ disease) |
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|
Multiple sclerosis |
340 Multiple sclerosis |
G35 Multiple sclerosis |
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|
Rheumatoid arthritis: Broad definition |
714.0 Rheumatoid arthritis 714.1 Felty’s syndrome 714.2 Other rheumatoid arthritis with visceral or systemic involvement 715.xx Osteoarthrosis and allied disorders 720.0 Ankylosing spondylitis 721.x Spondylosis |
M05.xxx Rheumatoid arthritis with rheumatoid factor M06.xx Other rheumatoid arthritis M15.xxx Polyosteoarthritis M16.xxx Osteoarthritis of hip M17.xxx Osteoarthritis of knee M18.xxx Osteoarthritis of first carpometacarpal joint M19.xxx Other and unspecified osteoarthritis M45.xxx Ankylosing spondylitis M47.xxx Spondylosis M48.xxx Other spondylopathies |
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|
Rheumatoid arthritis: Narrow definition |
714.0 Rheumatoid arthritis 714.1 Felty’s syndrome 714.2 Other rheumatoid arthritis with visceral or systemic involvement 720.0 Ankylosing spondylitis |
M05.xxx Rheumatoid arthritis with rheumatoid factor M06.xxx Other rheumatoid arthritis M45.xxx Ankylosing spondylitis |
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| Zinc cadmium sulfide | ||||||||
|
Lung cancer |
162.2, 162.3, 162.4, 162.5, 162.8, 162.9 Malignant neoplasm of bronchus or lung (excluding 162.0 Malignant neoplasm of trachea) 231.2 Carcinoma in situ of respiratory system V10.11 personal history of malignant neoplasm of bronchus or lung |
C34.xx Malignant neoplasm of bronchus and lung D02.20 Carcinoma in situ of bronchus and lung Z85.11x Personal history of malignant neoplasm of trachea, bronchus and lung |
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Chronic kidney disease: Broad definition |
403.xx (includes stages I-IV) 404.xx Hypertensive heart and chronic kidney disease, stage V or ESRD |
I12 xx (includes I12.9 stage I-IV) I13xx Hypertensive heart and chronic kidney disease or end stage renal |
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| Exposure and Health Outcome | ICD-9 Codes (2011 version) | ICD-10 Codes (2011 version) | ||||||
|
440.1 Atherosclerosis of renal artery 442.1 Aneurysm of renal artery 572.4 Hepatorenal syndrome 580.xx Acute glomerulonephritis 581.xx Nephrotic syndrome 582.xx Chronic glomerulonephritis 583.xx Nephritis and nephropathy not specified as acute or chronic 584.x Acute kidney failure) 585.x Chronic kidney disease 586 Renal failure, unspecified 587 Renal sclerosis, unspecified 588.xx Disorders resulting from impaired renal function 591 Hydronephrosis 794.4 Nonspecific abnormal results of kidney function study 249.4x Secondary diabetes mellitus with renal manifestations 250.4x Diabetes with renal manifestations 271.4 Renal glycosuria 274.10 Gout nephropathy 283.11 Hemolytic uremic syndrome 589.x Small kidney of unknown origin |
disease (includes stage I-IV and V) I70.1 Atherosclerosis of renal artery I72.2 Aneurysm of renal artery K76.7 Hepatorenal syndrome N00-N06, N08 Glomerular diseases (excluding N07 hereditary nephropathy, nos) N17 Acute renal failure N18 Chronic kidney disease N19 Unspecified kidney failure N26 Unspecified contracted kidney N25 Disorders resulting from impaired renal tubular function N13.1, 13.2, 13.3 Hydronephrosis R94.4 Abnormal results of kidney function studies E08.22, E09.22, E10.22, E11.22 E13.22 diabetic chronic kidney disease M10.3x Gout due to renal impairment, unspecified site D59.3 Hemolytic-uremic syndrome N27 Small kidney of unknown cause |
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|
Chronic kidney disease: Narrow definition |
440.1 Atherosclerosis of renal artery 581.xx Nephrotic syndrome 582.xx Chronic glomerulonephritis 583.xx Nephritis and nephropathy not specified as acute or chronic 585.x Chronic kidney disease 586 Renal failure, unspecified 587 Renal sclerosis, unspecified 588.xx Disorders resulting from impaired renal function 794.4 Nonspecific abnormal results of kidney function study 580.xx Acute glomerulonephritis 584.x Acute kidney failure 589.x Small kidney of unknown origin |
I70.1 Atherosclerosis of renal artery N04 Nephrotic syndrome N03 Chronic nephritic syndrome N05 Unspecified nephritic syndrome N18 Chronic kidney disease N19 Unspecified kidney failure N26 Unspecified contracted kidney N25 Disorders resulting from impaired renal tubular function R94.4 Abnormal results of kidney function studies N00 Acute nephritic syndrome N17 Acute Renal failure N27 Small kidney of unknown cause |
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NOTE: An x in a code indicates that all versions of the code category preceding the x are included. For example, a code shown as 123.x indicates that the category includes instances of outcomes coded as 123.0, 123.1, . . ., or 123.9. An xx entry indicates a two-digit range of codes (e.g., 123.00, 123.01, etc.).
TABLE F-2 Broad Categories of Underlying Cause of Death and the Corresponding Codes from the International Classification of Diseases
| Cause of Death | ICD-9 (2011 ICD-9 CM) | ICD-10 Codes | ||||||
|
Cancer (malignant neoplasms), any |
140-209, V10 | C00-C97, Z85 | ||||||
|
Cardiovascular disease [Circulatory disease] |
390-459 | I00-I99 | ||||||
|
Ischemic heart disease |
410-414 | I20-I25 | ||||||
|
Other heart disease |
390-409, 415-459 | I00-I19, I26-I99 | ||||||
|
Respiratory disease |
460-519 | J00-J99 | ||||||
|
Endocrine and metabolic diseases |
240-279 | E00-E90 | ||||||
|
Infectious diseases |
001-139 | A00-B99 | ||||||
|
Injury/external causes |
800-959, E codes 800-999 | S00-T98, V01-X84 | ||||||
|
Neurocognitive problems |
290-319, 320-327 | F00-F99, G00-G09 | ||||||
TABLE F-3 Broad Categories of Diagnoses Received from Inpatient or Outpatient Medical Care and the Corresponding Codes from the International Classification of Diseases, Ninth Revision
| Diagnostic Categories | ICD-9 (2011 ICD-9 CM) | |||||||
|
Infectious diseases |
001-139 | |||||||
|
Cancer (neoplasms, including malignant, benign, in situ) |
140-209, 210-229, 230-234, 235-238, 239-239, V10.xx | |||||||
|
Endocrine and metabolic diseases |
240-279 | |||||||
|
Diseases of the blood and blood-forming organs |
280-289 | |||||||
|
Mental disorders |
290-319 | |||||||
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Nervous system and sense organs |
320-389 | |||||||
|
Circulatory disease |
390-459 | |||||||
|
Ischemic heart disease |
410-414 | |||||||
|
Other heart disease |
390-409, 415-459 | |||||||
|
Respiratory disease |
460-519 | |||||||
|
Digestive disease |
520-579 | |||||||
|
Genitourinary disease |
580-629 | |||||||
|
Skin disease |
680-709 | |||||||
|
Musculoskeletal disease |
710-739 | |||||||
|
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified |
780-799 | |||||||
|
Injury |
800-959, E codes 800-999 | |||||||
|
Neurocognitive problems |
290-319, 320-327 | |||||||
NOTES: Claims criteria: At least 1 inpatient, or 2 HOP or Carrier claims with diagnosis codes during the 1-year period; codes have to be on 2 different days. HHA = home health agency; HOP = hospital outpatient.
