More specific mapping of ICD10CM code C83.19 to SNOMED concept referring to Mantle Cell Lymphoma

[conovermitch]

The ICD-10-CM code C83.19 "Mantle cell lymphoma, extranodal and solid organ sites" (see details below) should have a more specific mapping that refers to a SNOMED concept referring to mantle cell lymphoma. Currently, this ICD-10-CM code maps to the standard SNOMED concept for "Malignant lymphoma of extranodal AND/OR solid organ site" (ConceptId=440058, ConceptCode=93199007). We identified this mapping issue while developing a phenotype for Mantle Cell Lymphoma. The clinical expert we were working with felt confident that this re-mapping was necessary; however, we defer to the expertise of the vocabulary team.

Details describing the ICD-10-CM source code that needs to be remapped: ConceptName = Mantle cell lymphoma, extranodal and solid organ sites DomainId = Condition ConceptClassId = 5-char billing code VocabularyId = ICD10CM ConcepId = 45590943 ConceptCode = C83.19

Details describing the SNOMED source code that this should be mapped to: ConceptName = Mantle cell lymphoma Domain Id = Condition Concept Class Id = Clinical Finding Vocabulary Id = SNOMED Concept Id = 40481901 Concept Code = 443487006

If I can provide any additional details to clarify the issue please let me know (Mitch Conover, email: mconove1@its.jnj.com)

Thank you!

[cgreich]

@conovermitch:

Not sure I follow. The current mapping is exactly as you want it: https://athena.ohdsi.org/search-terms/terms/1567653. Do you have an obsolete vocabulary version?

Of course, the generic mantle cell lymphoma concept is a compromise, because you are losing the "extranodal and solid organ sites". The problem is that this is a conglomerate of any site that is not a lymph node. We have them all listed individually, but not as a combo. Difficult problem to solve. We could add an interim concept between the SNOMED mantle cell and the all the itsy-bitsy ICDOs, but do we really want to go into ontology generation and maintenance, particularly in cancer?

[ericaVoss]

Vocab Version = v5.0 17-JUN-21

This source code: C83.19-"Mantle cell lymphoma, extranodal and solid organ sites"

Maps to this target: 440058-Malignant lymphoma of extranodal AND/OR solid organ site

This target's parent is a: 432571-118600007 Malignant lymphoma

I think what Mitch is saying is this source code should connect in at a lower level than the generic "Malignant lymphoma of extranodal AND/OR solid organ site"

[conovermitch]

@cgreich My sincere apologies for the delay in response to this and letting this fall through the cracks. I looked at the link you posted (Link: https://athena.ohdsi.org/search-terms/terms/1567653). If I'm not mistaken, that link reflects the mapping of the ICD10 source-code C83.1 which does correctly map to "Mantle cell lymphoma" (conceptId = 40481901). However, the more specific ICD10 source-code C83.19 maps to "Malignant lymphoma of extranodal AND/OR solid organ site" (conceptId = 440058). When I look at C83.19 (Link: https://athena.ohdsi.org/search-terms/terms/45590943), I can see that there is a relationship reflected that says "Is a: Mantle Cell Lymphoma" which seems correct (as shown in the screen-grab below). However, my interpretation of what I'm seeing in Athena is that there is no hierarchical relationship between "Malignant lymphoma of extranodal AND/OR solid organ site" (conceptId = 440058) and "Mantle cell lymphoma" (conceptId = 40481901). Neither one contains the other as a descendant. Apologies if I'm mistaken.

(

[pbr6cornell]

bumping this thread again. Latest vocabulary still observes the same issue. ICD10CM C83.19 'Mantle cell lymphoma, extranodal and solid organ sites' is mapped more broadly, but I'd agree should be mapped more narrowly to 'Mantel cell lymphoma'.

https://athena.ohdsi.org/search-terms/terms/45590943

I'll also note, the ICD9CM code with the similar text label as the ICD10CM code, 200.40 , 'Mantle cell lymphoma, unspecified site, extranodal and solid organ sites' , does map to Mantel cell lymphoma. https://athena.ohdsi.org/search-terms/terms/44829826

(I'm wondering if there's a potential test that could be considered for finding vocabulary inconsistencies more broadly: if two source vocabularies have similar string - here, modulo the 'unspecified site' qualifier, then should map to the same standard. @aostropolets @cgreich )

[dimshitc]

@pbr6cornell I like the idea of if two source vocabularies have similar string - here, modulo the 'unspecified site' qualifier, then should map to the same standard. in case of ICD9CM and ICD10CM we can determine the matching source concepts using ICD9CM to ICD10CM crosswalk (provided by the CDC if I'm not mistaken), they are not 100% equivalent, but can make a good place the manual review should be focused on.

[mik-ohdsi]

@irinazherko - highlighting this for a possible QC activity

[pbr6cornell]

@aostropolets , in the Feb2024 release, ICD10CM C83.19 'Mantle cell lymphoma, extranodal and solid organ sites' (ID = 45590943) appears to still map to 'Malignant lymphoma of extranodal AND/OR solid organ site' (ID = 440058), and we believe it should map to 'Mantle cell lymphoma' (ID = 40481901), Would this be a candidate for a community contribution?

@dimshitc , this source code is used in our Mantle Cell Lymphoma phenotype, and currently because of the mappings, we have to look for source code, but if this is updated in Aug2024 release, then I'd anticipate your cohort version checker would flag this as improved.

[dimshitc]

https://github.com/OHDSI/Vocabulary-v5.0/issues/979 The whole C83.1* section is included in this community contribution. I'll double check the mapping of the C83.19 later.

On Sat, 4 May 2024 at 15:27, Patrick Ryan @.***> wrote:

@aostropolets https://github.com/aostropolets , in the Feb2024 release, ICD10CM C83.19 'Mantle cell lymphoma, extranodal and solid organ sites' (ID = 45590943) appears to still map to 'Malignant lymphoma of extranodal AND/OR solid organ site' (ID = 440058), and we believe it should map to 'Mantle cell lymphoma' (ID = 40481901), Would this be a candidate for a community contribution?

@dimshitc https://github.com/dimshitc , this source code is used in our Mantle Cell Lymphoma phenotype, and currently because of the mappings, we have to look for source code, but if this is updated in Aug2024 release, then I'd anticipate your cohort version checker would flag this as improved.

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[pbr6cornell]

@dimshitc that's awesome, thanks for being on top of it already!

[dimshitc]

You're welcome, @pbr6cornell! Yes, C83.19 is mapped to the 'Mantle cell lymphoma' in that community contribution request