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Source concepts which map to ICD-10 chapters with dagger and asterisk conventions will often be mapped to two target classification codes. The asterisk classification will be the second target record (mapGroup=2). The asterisk code will have applied advice of THIS CODE MAY BE USED IN THE PRIMARY POSITION WHEN THE MANIFESTATION IS THE PRIMARY FOCUS OF CARE.

Exemplar: Dagger & Asterisk: #1

111900000 |Pneumonia in aspergillosis (disorder)| maps to B44.1 Other pulmonary aspergillosis (dagger code) and J17.2 Pneumonia in mycoses (asterisk code):

  • B44.1 "Other pulmonary aspergillosis" mapGroup 1, mapCategoryId="Properly classified", mapRule=TRUE, mapAdvice="ALWAYS B44.1", Map Target = "B44.1"
  • J17.2 "Pneumonia in mycoses" mapGroup 2, mapCategoryId="Properly classified",mapRule=TRUE, mapAdvice= "ALWAYS J17.2" and "THIS CODE MAY BE USED IN THE PRIMARY POSITION WHEN THE MANIFESTATION IS THE PRIMARY FOCUS OF CARE" Map Target = "J17.2"

Exemplar: Dagger & Asterisk: #2

20735004 |Syphilitic aortitis (disorder)| maps to A52.0, Cardiovascular syphilis and I79.1, Aortitis in diseases classified elsewhere:

  • A52.0 "Cardiovascular syphilis" mapGroup 1, MapPriority 2, mapCategoryId="Properly classified", mapRule=TRUE, mapAdvice="ALWAYS A52.0", Map Target = "A52.0"
  • I79.1 "Aortitis in disease classified elsewhere" mapGroup 2, mapCategoryId="Properly classified", mapRule=TRUE, mapAdvice="ALWAYS I79.1" and "THIS CODE MAY BE USED IN THE PRIMARY POSITION WHEN THE MANIFESTATION IS THE PRIMARY FOCUS OF CARE" Map Target = "I79.1"

Exemplar: Dagger & Asterisk: #4

307726001 |Anemia in ovarian carcinoma (disorder)| maps to C56, Malignant neoplasm of ovary, and D63.0, Anemia in neoplastic disease:

  • C56 "Malignant neoplasm of ovary" (mapGroup 1, mapCategoryId="Properly classified", mapRule=TRUE. mapAdvice is "POSSIBLE REQUIREMENT FOR MORPHOLOGY CODE" and MAPPED FOLLOWING WHO GUIDANCE" Map Target = "C56"
  • D63.0 "Anemia in neoplastic disease" (mapGroup 2, mapCategoryId="Properly classified", mapRule=TRUE, mapAdvice= "ALWAYS D63.0" and "THIS CODE MAY BE USED IN THE PRIMARY POSITION WHEN THE MANIFESTATION IS THE PRIMARY FOCUS OF CARE", Map Target = "D63.0")


Dagger codes identified during tabular review which do not have a corresponding asterisk are called "virtual dagger" references. These do not require second target addition.

There may be instances where only an asterisk is provided in a map because the dagger information is unavailable in the SNOMED CT concept.  In this instance, mapAdvice THIS MAP REQUIRES A DAGGER CODE AS WELL AS AN ASTERISK CODE is appended to the map to communicate to the end user the need to add an additional corresponding code. 


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