ICD-10-CM linking

Use InferICD10CM to detect possible medical conditions as entities and link them to codes from the 2024 version of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). The ICD-10-CM is provided by the US Centers for Disease Control and Prevention (CDC).

When medical conditions are detected, InferICD10CM returns the matching ICD-10-CM codes and descriptions. The detected conditions are listed in descending order of confidence. The scores indicate the confidence in the accuracy of the entities matched to the concepts found in the text. Related information such as family history, signs, symptoms, and negation are recognized as traits. Additional information such as anatomical designations and acuity are listed as attributes.

InferICD10CM is well-suited for the following scenarios:

• Assisting the professional medical coding of patient records

• Clinical studies and trials

• Integration with a medical software system

• Early detection and diagnosis

• Population health management

ICD-10-CM category

InferICD10CM detects entities in the MEDICAL_CONDITION category. Additional related information is also detected and linked as attributes or traits.

ICD-10-CM types

InferICD10CM detects entities of the types DX_NAME and TIME_EXPRESSION.

ICD-10-CM traits

InferICD10CM detects the following contextual information as traits:

• DIAGNOSIS: An identification of a medical condition that is determined by evaluation of the symptoms.

• HYPOTHETICAL: An indication that a medical condition is expressed as a hypothesis.

• LOW_CONFIDENCE: An indication that a medical condition is expressed as having high uncertainty. This is not directly related to the confidence scores provided.

• NEGATION: An indication that a medical condition is not present.

• PERTAINS_TO_FAMILY: An indication that a medical condition is relevant to the patient’s family, not the patient.

• SIGN: A medical condition that is reported by the physician.

• SYMPTOM: A medical condition that is reported by the patient.

ICD-10-CM attributes

InferICD10CM detects the following contextual information as attributes:

• DIRECTION: Directional terms. For example, left, right, medial, lateral, upper, lower, posterior, anterior, distal, proximal, contralateral, bilateral, ipsilateral, dorsal, or ventral.

• SYSTEM_ORGAN_SITE: Anatomical location.

• ACUITY: Determination of a disease instance, such as chronic, acute, sudden, persistent, or gradual. This only applies to the MEDICAL_CONDITION type.

• QUALITY: Any descriptive term of the medical condition, such as stage or grade.

Time expression category

The TIME_EXPRESSION category detects entities related to time. This includes entities such as dates, and time expressions such as "three days ago," "today," "currently," "day of admission," "last month," or "16 days." Results in this category are only returned if they are associated with an entity. For example, the expression, "Yesterday, the patient was diagnosed with influenza" would return Yesterday as a TIME_EXPRESSION entity that overlaps with the DX_NAME entity, "influenza." However, "yesterday" would not be recognized as an entity in the expression, "yesterday, the patient walked their dog."

Types

The recognized type of TIME_EXPRESSION is TIME_TO_DX_NAME: the date that a medical condition occurred. The attribute for this type is DX_NAME.

Relationship type

The RELATIONSHIP_TYPE refers to the relationship between an entity and an attribute. The recognized RELATIONSHIP_TYPE is OVERLAP– the TIME_EXPRESSION concurs with the entity detected.

Input and response examples

Note

For specific API input and response syntax, see InferICD10CM in the Amazon Comprehend Medical API Reference.

The following example input text shows how the InferICD10CM operation works. To view all input text, scroll over the Copy button.

"The patient is a 71-year-old female patient of Dr. X. The patient presented to the emergency room last evening with approximately 7 to 8 day history of abdominal pain which has been persistent. She has had no nausea and vomiting, but has had persistent associated anorexia. She is passing flatus, but had some obstipation symptoms with the last bowel movement two days ago. She denies any bright red blood per rectum and no history of recent melena. Her last colonoscopy was approximately 5 years ago with Dr. Y. She has had no definite fevers or chills and no history of jaundice. The patient denies any significant recent weight loss."

The InferICD10CM operation returns the following output in JSON format (abbreviated for brevity).

{
    "Entities": [
        {
            "Id": 1,
            "Text": "abdominal pain",
            "Category": "MEDICAL_CONDITION",
            "Type": "DX_NAME",
            "Score": Float,
            "BeginOffset": 153,
            "EndOffset": 167,
            "Attributes": [
                {
                    "Type": "ACUITY",
                    "Score": Float,
                    "RelationshipScore": Float,
                    "Id": 2,
                    "BeginOffset": 183,
                    "EndOffset": 193,
                    "Text": "persistent",
                    "Traits": []
                }
            ],
            "Traits": [
                {
                    "Name": "SYMPTOM",
                    "Score": Float
                }
            ],
            "ICD10CMConcepts": [
                {
                    "Description": "Unspecified abdominal pain",
                    "Code": "R10.9",
                    "Score": Float
                },
                {
                    "Description": "Epigastric pain",
                    "Code": "R10.13",
                    "Score": Float
                },
                {
                    "Description": "Lower abdominal pain, unspecified",
                    "Code": "R10.30",
                    "Score": Float
                },
                {
                    "Description": "Generalized abdominal pain",
                    "Code": "R10.84",
                    "Score": Float
                },
                {
                    "Description": "Upper abdominal pain, unspecified",
                    "Code": "R10.10",
                    "Score": Float
                }
            ]
        }
...
    "ModelVersion": "2.7.0.20231001"
}

InferICD10CM also recognizes when an entity is negated in text. For instance, if a patient is not experiencing a symptom, both the symptom and negation are identified as traits and listed with a confidence score. Based on the input for the previous example, the symptom Nausea will be listed under NEGATION because the patient isn't experiencing nausea.

{
    "Id": 3,
    "Text": "nausea",
    "Category": "MEDICAL_CONDITION",
    "Type": "DX_NAME",
    "Score": Float,
    "BeginOffset": 210,
    "EndOffset": 216,
    "Attributes": [],
    "Traits": [
        {
            "Name": "SYMPTOM",
            "Score": Float
        },
        {
            "Name": "NEGATION",
            "Score": Float
        }
    ],
    "ICD10CMConcepts": [
        {
            "Description": "Nausea with vomiting, unspecified",
            "Code": "R11.2",
            "Score": Float
        },
        {
            "Description": "Nausea",
            "Code": "R11.0",
            "Score": Float
        }
    ]
}