ICD10
ICD10
ICD10
ICD-10 statistical
classification
of diseases and
related health
problems
10th revision
Volume 1
Tabular list
Fifth edition
2016
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Printed in France
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the classification, and other aspects of its structure that gave emphasis to
conditions that were frequent, costly or otherwise of public health importance,
had withstood the test of time and that many users would be unhappy with any
of the models that had been proposed as a possible replacement.
Consequently, as study of the 10th revision will show, the traditional ICD
structure has been retained but an alphanumeric coding scheme replaces the
previous numeric one. This provides a larger coding frame and leaves room for
future revision without disruption of the numbering system, as has occurred at
previous revisions.
In order to make optimum use of the available space, certain disorders of the
immune mechanism are included with diseases of the blood and blood-forming
organs (Chapter III). New chapters have been created for diseases of the eye and
adnexa, and diseases of the ear and mastoid process. The former supplementary
classifications of external causes and of factors influencing health status and
contact with health services now form part of the main classification.
The dagger and asterisk system of dual classification for certain diagnostic
statements, introduced in the ninth revision, has been retained and extended,
with the asterisk axis being contained in homogeneous categories at the three-
character level.
The periodic revision of the ICD has, since the sixth revision in 1948, been
coordinated by the World Health Organization (WHO). As the use of the
classification has increased, so, understandably, has the desire among its users
to contribute to the revision process. The 10th revision is the product of a
vast amount of international activity, cooperation and compromise, and WHO
acknowledges with gratitude the contributions of the international and national
specialist groups and individuals in numerous many countries.
WHO gratefully acknowledges the important technical contribution of the
WHO Collaborating Centre for the Family of International Classifications
which is located at the Deutsches Institut für Medizinische Dokumentation und
Information (DIMDI) in Cologne, Germany, and, in particular, that of the Head
of the Centre Michael Schopen, in the updating of the texts and the preparation
of the electronic files that were used for this version of ICD-10.
The official updates to the published volumes of ICD-10 are available as annual
lists of changes on the WHO website for classifications.
http://www.who.int/classifications
These updates are approved annually at the meeting of the WHO Network for
the Family of International Classifications.
The lists indicate the sources of the recommendations and implementation
dates.
The date of approval has been indicated for all changes except the corrigenda.
Training
The official self-learning training of ICD-10 and an online support forum can
be accessed at
http://www.who.int/classifications/icd/implementation/
A version for offline use is available for download at
http://apps.who.int/classifications/apps/icd/ClassificationDownload/
DLArea/OfflineTrainingPackage.zip
and as a CD-ROM upon request.
INSERM-CépiDc
80 Rue du Général Leclerc
94270 Le Kremlin-Bicêtre Cedex, France
ICD Office
Policy Planning Division
Statistics and Information Department
Minister’s Secretariat,
Ministry of Health, Labour and Welfare
1-2-2 Kasumigaseki, Chiyodaku, Tokyo, Japan
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-- Kuwait -- Venezuela
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The United Nations, the International Labour Organization and the WHO
regional offices sent representatives to participate in the conference, as did
the Council for International Organizations of Medical Sciences, and 12 other
nongovernmental organizations (NGOs) concerned with cancer registration,
the deaf, epidemiology, family medicine, gynaecology and obstetrics,
hypertension, health records, preventive and social medicine, neurology,
psychiatry, rehabilitation and sexually transmitted diseases.
The Conference was opened by Dr JP Jardel, Assistant Director-General, on
behalf of the Director-General. Dr Jardel spoke of the extensive consultations
and preparatory work that had gone into the revision proposals and had
necessitated a longer than usual interval between revisions. He noted that the
10th revision would have a new title, International statistical classification
of diseases and related health problems, to emphasize its statistical purpose
and reflect the widening of its scope. The convenient abbreviation ICD would,
however, be retained. He also mentioned the new alphanumeric coding scheme,
which had made it possible to provide a better balance between the content of
the chapters and to leave room for future additions and changes, as well as
the intention to produce an ICD manual of three-character categories with an
alphabetical index for use where the more complex, detailed four-character
version would be inappropriate.
The Conference elected the following officers:
Dr RHC Wells, Australia (Chairman)
Dr H Bay-Nielsen, Denmark (Vice-Chairman)
Dr R Braun, German Democratic Republic (Vice-Chairman)
Mr RA Israel, United States of America (Vice-Chairman)
Dr R Laurenti, Brazil (Vice-Chairman)
Dr P Maguin, France (Rapporteur)
Ms E Taylor, Canada (Rapporteur).
The secretariat of the conference was as follows:
Dr JP Jardel, Assistant Director-General, WHO, Geneva, Switzerland
Dr HR Hapsara, Director, Division of Epidemiological Surveillance and
Health Situation and Trend Assessment, WHO, Geneva, Switzerland
Dr JC Alary, Chief Medical Officer, Development of Epidemiological and
Health Statistical Services, WHO, Geneva, Switzerland
Dr GR Brämer, Medical Officer, Development of Epidemiological and Health
Statistical Services, WHO, Geneva, Switzerland (Secretary)
Mr A L’Hours, Technical Officer, Development of Epidemiological and Health
Statistical Services, WHO, Geneva, Switzerland
Professor W Jänisch, German
Democratic Republic (Temporary Adviser)
Mr T Kruse, Denmark (Temporary Adviser)
Dr K Kupka, France (Temporary Adviser)
Dr J Leowski, Poland (Temporary Adviser)
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Even with a new structure, it was plain that one classification could not cope with
the extremes of the requirements. The concept of a ‘family’ of classifications
had therefore been developed, with the main ICD as the core, covering the
centre ground of needs for traditional mortality and morbidity statistics, while
needs for more detailed, less detailed or different classifications and associated
matters would be dealt with by other members of the family.
Several alternative models for the structure of the ICD had been investigated
by the collaborating centres, but it had been found that each had unsatisfactory
features and none had sufficient advantages over the existing structure to
justify replacing it. Special meetings held to evaluate the ninth revision had
confirmed that, although some potential users found the existing structure of
the ICD unsuitable, there was a large body of satisfied users who considered it
had many inherent strengths, whatever its apparent inconsistencies, and wished
it to continue in its existing form.
Various schemes involving alphanumeric notation had been examined, with
a view to producing a coding frame that would give a better balance to the
chapters and allow sufficient space for future additions and changes without
disrupting the codes.
Decisions made on these matters had paved the way for the preparation of
successive drafts of chapter proposals for the 10th revision. These had twice
been circulated to Member States for comment, as well as being reviewed by
other interested bodies, meetings of centre heads, and the expert committee. A
large number of international professional specialist associations, individual
specialists and experts, other WHO headquarters units and regional offices had
given advice and guidance to the WHO unit responsible for the ICD, and to the
collaborating centres, on the preparation of the proposals and the associated
material placed before the conference. WHO gratefully acknowledged this
assistance.
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subject of a certain amount of criticism. This related mainly to the fact that
the classification frequently contained a mixture of manifestation and other
information at the three- and four-digit levels, with the same diagnostic labels
sometimes appearing under both axes. Also, many considered the system to be
insufficiently comprehensive. To overcome these problems, in the draft for the
10th revision, the asterisk information was contained in 82 homogeneous three-
character categories for optional use. This approach enabled those diagnostic
statements containing information about both a generalized underlying disease
process and a manifestation or complication in a particular organ or site to
receive two codes, allowing retrieval or tabulation according to either axis.
These characteristics of the proposed 10th revision were accepted by the
conference.
Each of the chapters was introduced to the conference, with a presentation on
changes introduced since the ninth revision and some background information
about certain innovations. Some issues related to changes in chapter structure
and content were discussed by the conference and agreement reached on
follow-up and modification by the secretariat.
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The conference
RECOMMENDED that countries consider the inclusion on death certificates
of questions regarding current pregnancy and pregnancy within one year
preceding death.
The conference agreed that, since the number of live births was more universally
available than the number of total births (live births plus fetal deaths), it should
be used as the denominator in the ratios related to maternal mortality [as
contained in Volume 2].
With respect to perinatal, neonatal and infant mortality, it was strongly
advised that published rates based on birth cohorts should be so identified and
differentiated.
The conference confirmed the practice of expressing age in completed units of
time and thus designating the first day of life as day zero.
The conference
RECOMMENDED the inclusion, in the manual of the 10th revision of the
ICD, of definitions, standards and reporting requirements related to maternal
mortality and to fetal, perinatal, neonatal and infant mortality.
The conference was informed about a process for review of the selection and
modification rules for underlying cause of death and the associated notes, as
they appeared in the ninth revision, which had resulted in several recommended
changes in the rules and extensive changes to the notes.
The conference
RECOMMENDED that the rules for selection of cause of death for primary
mortality tabulation, as they appear in the ninth revision, be replaced in the
10th revision [by those contained in Volume 2].
The conference was further informed that additional notes for use in underlying
cause coding and the interpretation of entries of causes of death had been drafted
and were being reviewed. As these notes were intended to improve consistency
in coding, the conference agreed that they would also be incorporated in the
10th revision.
The conference noted the continued use of multiple-condition coding and
analysis in relation to causes of death. It expressed encouragement for such
activities, but did not recommend that the 10th revision should contain any
particular rules or methods of analysis to be followed.
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For the first time, the ninth revision contained guidance on recording and
coding for morbidity and specifically for the selection of a single condition
for presentation of morbidity statistics. Experience gained in the use of the
definitions and rules in the ninth revision had proved their usefulness and
generated requests for their clarification, for further elaboration regarding the
recording of diagnostic information by health-care practitioners, and for more
guidance on dealing with specific problem situations.
The conference endorsed the recommendations of the 1975 Revision Conference
about the condition to be selected for single-condition analysis of episodes of
health care, and its view that, where practicable, multiple-condition coding and
analysis should be undertaken to supplement routine statistics. It stressed that
the 10th revision should make it clear that much of the guidance was applicable
only when the tabulation of a ‘main condition’ for an episode was appropriate
and when the concept of an ‘episode’ per se was relevant to the way in which
data collection was organized.
The conference accordingly
RECOMMENDED that additional guidance on the recording and coding of
morbidity should be included in the 10th Revision, and that the definitions
of “main condition” and “other conditions” should be incorporated, together
with the modified rules for dealing with obviously incorrectly reported “main
condition”. [These are included in Volume 2.]
The conference also
RECOMMENDED that where the “main condition” is subject to the dual
classification system provided in the ICD, both the dagger and asterisk codes
should be recorded, to permit alternative tabulation by either.
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The conference agreed that extensive notes and examples should be added to
provide further assistance.
The conference was informed about difficulties that had arisen in the use of the
Basic tabulation list based on the ninth revision and about the activities that had
been undertaken, particularly by WHO, to develop new lists for the tabulation
and publication of mortality data. In this process it had become apparent that, in
many countries, mortality up to the age of 5 years was a more robust indicator
than infant mortality, and that it would therefore be preferable to have a list that
included infant deaths and deaths of children up to the age of 5 years, rather than
a list for infants only.
Two versions of the general mortality list and of the infant and child mortality
list had been prepared for consideration by the conference, with the second
version including chapter titles and residual items for chapters as necessary.
As some concerns were expressed regarding the mortality lists as presented,
a small working party was convened to consider the possible inclusion of
some additional items. The report of the working party was accepted by the
Conference and is reflected in the mortality lists (see Special tabulation list for
mortality and morbidity, p. 1043).
On the topic of lists for the tabulation of morbidity, the conference reviewed
both a proposed tabulation list and a model publication list based on chapter
titles, with selected items included as examples under each title. Considerable
concern was expressed about the applicability of such lists to all morbidity in
the broadest sense. There was general agreement that the lists as presented were
probably more suited to inpatient morbidity, and it was felt that further efforts
should be made to develop lists suitable for other morbidity applications, and
also that both mortality and morbidity tabulation lists should be accompanied
in the 10th revision by appropriate explanations and instructions on their use.
In light of the concerns raised in the conference and the conclusions of the
working party, the conference agreed that the tabulation and publication lists
should appear in the 10th revision, while an effort should be made to establish
clearer, more descriptive titles for these lists. It was also agreed that, to
facilitate the alternative tabulation of asterisk categories, a second version of
the morbidity tabulation list should be developed, which included the asterisk
categories.
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6. Family of classifications
6.1. Concept of the family of classifications
During the preparation of the ninth revision it had already been realized that the
ICD alone could not cover all the information required and that only a ‘family’ of
disease and health-related classifications would meet the different requirements
in public health. Since the late 1970s, therefore, various possible solutions had
been envisaged, one of which called for a core classification (ICD) with a series
of modules, some hierarchically related and others of a supplementary nature.
INTERNATIONAL STATISTICAL
CLASSIFICATION OF
DISEASES AND RELATED
HEALTH PROBLEMS
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The conference
RECOMMENDED that the concept of the family of disease and health-
related classifications should be followed up by WHO.
In order to maintain the integrity of the ICD itself and this family concept, the
conference
RECOMMENDED that, in the interests of international comparability, no
changes should be made to the content (as indicated by the titles) of the three-
character categories and four-character sub-categories of the 10th revision
in the preparation of translations or adaptations, except as authorized by
WHO. The Secretariat of WHO is responsible for the ICD and acts as central
clearing-house for any publication (except national statistical publications)
or translation to be derived from it. WHO should be promptly notified about
the intention to produce translations and adaptations or other ICD-related
classifications.
The conference viewed with interest a presentation of the use and linkage of
different members of the ICD family in the medicosocial and multidimensional
assessment of the elderly in relation not only to health but also to activities of
daily living as well as the social and physical environment. It was demonstrated
that effective information could be obtained through use of the ICD and the
International classification of impairments, disabilities, and handicaps (ICIDH),
and especially through use of the codes from the proposed Chapter XXI of the
10th revision.
The conference was informed about plans for the development of adaptations
of the 10th revision in the mental health programme area. Clinical guidelines
would accompany a version intended for use by clinicians working in the field
of psychiatry; research criteria would be proposed for use in investigations of
mental health problems; and multi-axial presentations for use in dealing with
childhood disorders and for the classification of adult problems would be
developed, as well as a version for use by general practitioners. Compilations
of ICD codes relevant to psychiatry and to neurology would also be produced,
along the lines of previous publications on this subject.
The Conference also heard about the methods used to ensure that the basic
structure and function of the ICD were preserved in the initial development of
the application for medical specialists in dentistry and stomatology (ICD-DA)
and was informed that a new revision of the ICD-DA linked to the 10th revision
was in the final stages of preparation.
A presentation was given on the International classification of diseases for
oncology (ICD-O), second edition, a multi-axial classification including both
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This list had been presented to the centre heads at their 1989 meeting and
it had been agreed that it could serve as a guide for national presentation
or publication of statistics on surgical procedures and could also facilitate
intercountry comparisons. The aim of the list was to identify procedures and
groups of procedures and define them as a basis for the development of national
classifications, thereby improving the comparability of such classifications.
The conference agreed that such a list was of value and that work should
continue on its development, even though any publication would follow the
implementation of the 10th revision.
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The conference was further informed that a three-character version of the 10th
revision would be published as a single volume which would contain, in the
tabular list, all inclusion and exclusion notes. It would also contain all related
definitions, standards, rules and instructions and a shortened alphabetical index.
Member States intending to produce national language versions of the 10th
revision should notify WHO of their intentions. Copies of the drafts of the ICD
at the three- and four-character levels would be made available from WHO
both in printed form and on electronic media.
With respect to the physical appearance of the pages and type formats for both
the tabular list and the alphabetical index, the conference was assured that
recommendations from the centre heads and complaints from coders would be
considered, and every attempt made to improve those aspects as compared with
the ninth revision.
As with the ninth revision, it was intended to develop materials for the
reorientation of trained coders, with the help of the collaborating centres. The
actual training courses would be the responsibility of the WHO regional offices
and individual countries. They would be carried out from late 1991 to the end
of 1992, to finish before the implementation of the 10th revision.
Materials for the basic training of new users of the ICD would also be developed
by WHO; it was not, however, planned to begin courses before 1993.
As noted above, WHO would be prepared to provide the 10th revision (both
the tabular list and the alphabetical index) on electronic media. In future, with
the assistance of the collaborating centres, other software might also be made
available. A key for conversion from the ninth to the 10th revision, and the
reverse, should be available before the implementation of the 10th revision.
As the development activities that had been endorsed by the expert committee
were on schedule, the conference
RECOMMENDED that the 10th revision of the International classification
of diseases should come into effect as from 1 January 1993.
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to their impact on analyses and trends. There was discussion on the type of
forum in which such changes and the potential for use of the vacant letter ‘U’
in new or temporary code assignments could be discussed. It was agreed that it
would not be feasible to hold revision conferences more frequently than every
10 years.
On the basis of the needs expressed, and the fact that it would be inappropriate
to attempt to determine or define the exact process to be used, the conference
RECOMMENDED that the next International revision conference should
take place in ten years’ time, and that WHO should endorse the concept of
an updating process between revisions and give consideration as to how an
effective updating mechanism could be put in place.
References
1. International classification of diseases, 1975 revision, Volume 1. Geneva:
World Health Organization; 1977, xiii–xxiv.
2. Report of the expert committee on the international classification of diseases
– 10th revision: first meeting. Geneva: World Health Organization; 1984
(unpublished document DES/EC/ICD-10/84.34).
3. Report of the expert committee on the international classification of diseases
– 10th revision: second meeting. Geneva: World Health Organization; 1987
(unpublished document WHO/DES/EC/ICD-10/87.38).
4. Report of the preparatory meeting on ICD-10. Geneva: World Health
Organization; 1983 (unpublished document DES/ICD-10/83.19).
5. International classification of impairments, disabilities and handicaps.
Geneva, World Health Organization, 1980.
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Chapter I
Certain infectious and parasitic diseases
(A00–B99)
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34
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Helminthiases (B65–B83)
B65 Schistosomiasis [bilharziasis]
B66 Other fluke infections
B67 Echinococcosis
B68 Taeniasis
B69 Cysticercosis
B70 Diphyllobothriasis and sparganosis
B71 Other cestode infections
B72 Dracunculiasis
B73 Onchocerciasis
B74 Filariasis
B75 Trichinellosis
B76 Hookworm diseases
B77 Ascariasis
B78 Strongyloidiasis
B79 Trichuriasis
B80 Enterobiasis
B81 Other intestinal helminthiases, not elsewhere classified
B82 Unspecified intestinal parasitism
B83 Other helminthiases
Pediculosis, acariasis and other infestations (B85–B89)
B85 Pediculosis and phthiriasis
B86 Scabies
B87 Myiasis
B88 Other infestations
B89 Unspecified parasitic disease
Sequelae of infectious and parasitic diseases (B90–B94)
B90 Sequelae of tuberculosis
B91 Sequelae of poliomyelitis
B92 Sequelae of leprosy
B94 Sequelae of other and unspecified infectious and parasitic diseases
Bacterial, viral and other infectious agents (B95–B98)
B95 Streptococcus and Staphylococcus as the cause of diseases classified
to other chapters
B96 Other specified bacterial agents as the cause of diseases classified
to other chapters
B97 Viral agents as the cause of diseases classified to other chapters
B98 Other specified infectious agents as the cause of diseases classified
to other chapters
Other infectious diseases (B99)
B99 Other and unspecified infectious diseases
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Chapter II
Neoplasms
(C00–D48)
38
39
40
41
Chapter III
Diseases of the blood and blood-forming organs and certain
disorders involving the immune mechanism
(D50–D89)
42
Chapter IV
Endocrine, nutritional and metabolic diseases
(E00–E90)
43
44
Chapter V
Mental and behavioural disorders
(F00–F99)
45
46
47
Chapter VI
Diseases of the nervous system
(G00–G99)
48
49
Chapter VII
Diseases of the eye and adnexa
(H00–H59)
50
Chapter VIII
Diseases of the ear and mastoid process
(H60–H95)
51
Chapter IX
Diseases of the circulatory system
(I00–I99)
52
53
54
Chapter X
Diseases of the respiratory system
(J00–J99)
55
56
Chapter XI
Diseases of the digestive system
(K00–K93)
58
Chapter XII
Diseases of the skin and subcutaneous tissue
(L00–L99)
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60
Chapter XIII
Diseases of the musculoskeletal system and connective tissue
(M00–M99)
Arthropathies (M00–M25)
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M33 Dermatopolymyositis
M34 Systemic sclerosis
M35 Other systemic involvement of connective tissue
M36* Systemic disorders of connective tissue in diseases classified elsewhere
Dorsopathies (M40–M54)
62
Chapter XIV
Diseases of the genitourinary system
(N00–N99)
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64
65
Chapter XV
Pregnancy, childbirth and the puerperium
(O00–O99)
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67
Chapter XVI
Certain conditions originating in the perinatal period
(P00–P96)
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69
Chapter XVII
Congenital malformations, deformations and chromosomal
abnormalities
(Q00–Q99)
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Chapter XVIII
Symptoms, signs and abnormal clinical and laboratory
findings, not elsewhere classified
(R00–R99)
Symptoms and signs involving the circulatory and respiratory systems (R00–R09)
R00 Abnormalities of heart beat
R01 Cardiac murmurs and other cardiac sounds
R02 Gangrene, not elsewhere classified
R03 Abnormal blood-pressure reading, without diagnosis
R04 Haemorrhage from respiratory passages
R05 Cough
R06 Abnormalities of breathing
R07 Pain in throat and chest
R09 Other symptoms and signs involving the circulatory and respiratory
systems
Symptoms and signs involving the digestive system and abdomen (R10–R19)
R10 Abdominal and pelvic pain
R11 Nausea and vomiting
R12 Heartburn
R13 Dysphagia
R14 Flatulence and related conditions
R15 Faecal incontinence
R16 Hepatomegaly and splenomegaly, not elsewhere classified
R17 Unspecified jaundice
R18 Ascites
R19 Other symptoms and signs involving the digestive system and abdomen
Symptoms and signs involving the skin and subcutaneous tissue (R20–R23)
R20 Disturbances of skin sensation
R21 Rash and other nonspecific skin eruption
R22 Localized swelling, mass and lump of skin and subcutaneous tissue
R23 Other skin changes
Symptoms and signs involving the nervous and musculoskeletal systems
(R25–R29)
R25 Abnormal involuntary movements
R26 Abnormalities of gait and mobility
R27 Other lack of coordination
R29 Other symptoms and signs involving the nervous and musculoskeletal
systems
Symptoms and signs involving the urinary system (R30–R39)
R30 Pain associated with micturition
R31 Unspecified haematuria
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Chapter XIX
Injury, poisoning and certain other consequences
of external causes
(S00–T98)
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76
77
78
79
T48 Poisoning by agents primarily acting on smooth and skeletal muscles and
the respiratory system
T49 Poisoning by topical agents primarily affecting skin and mucous membrane
and by ophthalmological, otorhinolaryngological and dental drugs
T50 Poisoning by diuretics and other and unspecified drugs, medicaments and
biological substances
Toxic effects of substances chiefly nonmedicinal as to source (T51–T65)
T51 Toxic effect of alcohol
T52 Toxic effect of organic solvents
T53 Toxic effect of halogen derivatives of aliphatic and aromatic hydrocarbons
T54 Toxic effect of corrosive substances
T55 Toxic effect of soaps and detergents
T56 Toxic effect of metals
T57 Toxic effect of other inorganic substances
T58 Toxic effect of carbon monoxide
T59 Toxic effect of other gases, fumes and vapours
T60 Toxic effect of pesticides
T61 Toxic effect of noxious substances eaten as seafood
T62 Toxic effect of other noxious substances eaten as food
T63 Toxic effect of contact with venomous animals
T64 Toxic effect of aflatoxin and other mycotoxin food contaminants
T65 Toxic effect of other and unspecified substances
Other and unspecified effects of external causes (T66–T78)
T66 Unspecified effects of radiation
T67 Effects of heat and light
T68 Hypothermia
T69 Other effects of reduced temperature
T70 Effects of air pressure and water pressure
T71 Asphyxiation
T73 Effects of other deprivation
T74 Maltreatment syndromes
T75 Effects of other external causes
T78 Adverse effects, not elsewhere classified
Certain early complications of trauma (T79)
T79 Certain early complications of trauma, not elsewhere classified
Complications of surgical and medical care, not elsewhere classified (T80–T88)
T80 Complications following infusion, transfusion and therapeutic injection
T81 Complications of procedures, not elsewhere classified
T82 Complications of cardiac and vascular prosthetic devices, implants and grafts
T83 Complications of genitourinary prosthetic devices, implants and grafts
T84 Complications of internal orthopaedic prosthetic devices, implants and grafts
T85 Complications of other internal prosthetic devices, implants and grafts
80
Chapter XX
External causes of morbidity and mortality
(V01–Y98)
Accidents (V01–X59)
81
82
83
V75 Bus occupant injured in collision with railway train or railway vehicle
V76 Bus occupant injured in collision with other nonmotor vehicle
V77 Bus occupant injured in collision with fixed or stationary object
V78 Bus occupant injured in noncollision transport accident
V79 Bus occupant injured in other and unspecified transport accidents
Other land transport accidents (V80–V89)
V80 Animal-rider or occupant of animal-drawn vehicle injured in transport
accident
V81 Occupant of railway train or railway vehicle injured in transport accident
V82 Occupant of streetcar injured in transport accident
V83 Occupant of special vehicle mainly used on industrial premises injured in
transport accident
V84 Occupant of special vehicle mainly used in agriculture injured in transport
accident
V85 Occupant of special construction vehicle injured in transport accident
V86 Occupant of special all-terrain or other motor vehicle designed primarily
for off-road use, injured in transport accident
V87 Traffic accident of specified type but victim’s mode of transport unknown
V88 Nontraffic accident of specified type but victim’s mode of transport
unknown
V89 Motor- or nonmotor-vehicle accident, type of vehicle unspecified
Water transport accidents (V90–V94)
V90 Accident to watercraft causing drowning and submersion
V91 Accident to watercraft causing other injury
V92 Water-transport-related drowning and submersion without accident to
watercraft
V93 Accident on board watercraft without accident to watercraft, not causing
drowning and submersion
V94 Other and unspecified water transport accidents
Air and space transport accidents (V95–V97)
V95 Accident to powered aircraft causing injury to occupant
V96 Accident to nonpowered aircraft causing injury to occupant
V97 Other specified air transport accidents
Other and unspecified transport accidents (V98–V99)
V98 Other specified transport accidents
V99 Unspecified transport accident
Other external causes of accidental injury (W00–X59)
Falls (W00–W19)
W00 Fall on same level involving ice and snow
W01 Fall on same level from slipping, tripping and stumbling
W02 Fall involving ice-skates, skis, roller-skates or skateboards
84
W03 Other fall on same level due to collision with, or pushing by,
another person
W04 Fall while being carried or supported by other persons
W05 Fall involving wheelchair
W06 Fall involving bed
W07 Fall involving chair
W08 Fall involving other furniture
W09 Fall involving playground equipment
W10 Fall on and from stairs and steps
W11 Fall on and from ladder
W12 Fall on and from scaffolding
W13 Fall from, out of or through building or structure
W14 Fall from tree
W15 Fall from cliff
W16 Diving or jumping into water causing injury other than drowning or
submersion
W17 Other fall from one level to another
W18 Other fall on same level
W19 Unspecified fall
Exposure to inanimate mechanical forces (W20–W49)
W20 Struck by thrown, projected or falling object
W21 Striking against or struck by sports equipment
W22 Striking against or struck by other objects
W23 Caught, crushed, jammed or pinched in or between objects
W24 Contact with lifting and transmission devices, not elsewhere classified
W25 Contact with sharp glass
W26 Contact with other sharp objects
W27 Contact with nonpowered hand tool
W28 Contact with powered lawnmower
W29 Contact with other powered hand tools and household machinery
W30 Contact with agricultural machinery
W31 Contact with other and unspecified machinery
W32 Handgun discharge
W33 Rifle, shotgun and larger firearm discharge
W34 Discharge from other and unspecified firearms
W35 Explosion and rupture of boiler
W36 Explosion and rupture of gas cylinder
W37 Explosion and rupture of pressurized tyre, pipe or hose
W38 Explosion and rupture of other specified pressurized devices
W39 Discharge of firework
W40 Explosion of other materials
W41 Exposure to high-pressure jet
W42 Exposure to noise
W43 Exposure to vibration
W44 Foreign body entering into or through eye or natural orifice
W45 Foreign body or object entering through skin
W46 Contact with hypodermic needle
W49 Exposure to other and unspecified inanimate mechanical forces
85
86
87
88
89
90
91
Surgical and other medical procedures as the cause of abnormal reaction of the
patient, or of later complication, without mention of misadventure at the time of the
procedure (Y83–Y84)
Y83 Surgical operation and other surgical procedures as the cause of abnormal
reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure
Y84 Other medical procedures as the cause of abnormal reaction of the patient,
or of later complication, without mention of misadventure at the time of
the procedure
Sequelae of external causes of morbidity and mortality (Y85–Y89)
Y85 Sequelae of transport accidents
Y86 Sequelae of other accidents
Y87 Sequelae of intentional self-harm, assault and events of undetermined intent
Y88 Sequelae with surgical and medical care as external cause
Y89 Sequelae of other external causes
Supplementary factors related to causes of morbidity and mortality classified
elsewhere (Y90–Y98)
Y90 Evidence of alcohol involvement determined by blood alcohol level
Y91 Evidence of alcohol involvement determined by level of intoxication
Y95 Nosocomial condition
Y96 Work-related condition
Y97 Environmental-pollution-related condition
Y98 Lifestyle-related condition
Chapter XXI
Factors influencing health status and contact with health
services
(Z00–Z99)
92
93
94
Chapter XXII
Codes for special purposes
(U00–U99)
95
99
A00 Cholera
A00.0 Cholera due to Vibrio cholerae 01, biovar cholerae
Classical cholera
A00.1 Cholera due to Vibrio cholerae 01, biovar eltor
Cholera eltor
A00.9 Cholera, unspecified
100
A03 Shigellosis
A03.0 Shigellosis due to Shigella dysenteriae
Group A shigellosis [Shiga–Kruse dysentery]
A03.1 Shigellosis due to Shigella flexneri
Group B shigellosis
A03.2 Shigellosis due to Shigella boydii
Group C shigellosis
A03.3 Shigellosis due to Shigella sonnei
Group D shigellosis
A03.8 Other shigellosis
A03.9 Shigellosis, unspecified
Bacillary dysentery NOS
101
A06 Amoebiasis
Incl.: infection due to Entamoeba histolytica
Excl.: other protozoal intestinal diseases (A07.-)
A06.0 Acute amoebic dysentery
Acute amoebiasis
Intestinal amoebiasis NOS
A06.1 Chronic intestinal amoebiasis
A06.2 Amoebic nondysenteric colitis
A06.3 Amoeboma of intestine
Amoeboma NOS
A06.4† Amoebic liver abscess (K77.0*)
Hepatic amoebiasis
A06.5† Amoebic lung abscess (J99.8*)
Amoebic abscess of lung (and liver)
A06.6† Amoebic brain abscess (G07*)
Amoebic abscess of brain (and liver)(and lung)
A06.7 Cutaneous amoebiasis
A06.8 Amoebic infection of other sites
Amoebic:
• appendicitis
• balanitis† (N51.2*)
A06.9 Amoebiasis, unspecified
102
103
104
Tuberculosis
(A15–A19)
Incl.: infections due to Mycobacterium tuberculosis and Mycobacterium bovis
Excl.: congenital tuberculosis (P37.0)
human immunodeficieny [HIV] disease resulting in tuberculosis (B20.0)
pneumoconiosis associated with tuberculosis (J65)
sequelae of tuberculosis (B90.-) silicotuberculosis (J65)
105
106
107
108
109
A20 Plague
Incl.: infection due to Yersinia pestis
A20.0 Bubonic plague
A20.1 Cellulocutaneous plague
A20.2 Pneumonic plague
A20.3 Plague meningitis
A20.7 Septicaemic plague
A20.8 Other forms of plague
Abortive plague
Asymptomatic plague
Pestis minor
A20.9 Plague, unspecified
A21 Tularaemia
Incl.: deer-fly fever
infection due to Francisella tularensis
rabbit fever
A21.0 Ulceroglandular tularaemia
A21.1 Oculoglandular tularaemia
Ophthalmic tularaemia
A21.2 Pulmonary tularaemia
A21.3 Gastrointestinal tularaemia
Abdominal tularaemia
110
A22 Anthrax
Incl.: infection due to Bacillus anthracis
A22.0 Cutaneous anthrax
Malignant:
• carbuncle
• pustule
A22.1 Pulmonary anthrax
Inhalation anthrax
Ragpicker’s disease
Woolsorter’s disease
A22.2 Gastrointestinal anthrax
A22.7 Anthrax sepsis
A22.8 Other forms of anthrax
Anthrax meningitis† (G01*)
A22.9 Anthrax, unspecified
A23 Brucellosis
Incl.: fever:
• Malta
• Mediterranean
• undulant
A23.0 Brucellosis due to Brucella melitensis
A23.1 Brucellosis due to Brucella abortus
A23.2 Brucellosis due to Brucella suis
A23.3 Brucellosis due to Brucella canis
A23.8 Other brucellosis
A23.9 Brucellosis, unspecified
111
A26 Erysipeloid
A26.0 Cutaneous erysipeloid
Erythema migrans
A26.7 Erysipelothrix sepsis
A26.8 Other forms of erysipeloid
A26.9 Erysipeloid, unspecified
A27 Leptospirosis
A27.0 Leptospirosis icterohaemorrhagica
Leptospirosis due to Leptospira interrogans serovar icterohaemorrhagiae
A27.8 Other forms of leptospirosis
A27.9 Leptospirosis, unspecified
112
113
A32 Listeriosis
Incl.: listerial foodborne infection
Excl.: neonatal (disseminated) listeriosis (P37.2)
A32.0 Cutaneous listeriosis
A32.1† Listerial meningitis and meningoencephalitis
Listerial:
• meningitis (G01*)
• meningoencephalitis (G05.0*)
A32.7 Listerial sepsis
A32.8 Other forms of listeriosis
Listerial:
• cerebral arteritis† (I68.1*)
• endocarditis† (I39.8*)
Oculoglandular listeriosis
A32.9 Listeriosis, unspecified
A36 Diphtheria
A36.0 Pharyngeal diphtheria
Diphtheritic membranous angina
Tonsillar diphtheria
A36.1 Nasopharyngeal diphtheria
A36.2 Laryngeal diphtheria
Diphtheritic laryngotracheitis
A36.3 Cutaneous diphtheria
Excl.: erythrasma (L08.1)
A36.8 Other diphtheria
Diphtheritic:
• conjunctivitis† (H13.1*)
• myocarditis† (I41.0*)
• polyneuritis† (G63.0*)
A36.9 Diphtheria, unspecified
114
115
A42 Actinomycosis
Excl.: actinomycetoma (B47.1)
A42.0 Pulmonary actinomycosis
A42.1 Abdominal actinomycosis
A42.2 Cervicofacial actinomycosis
A42.7 Actinomycotic sepsis
A42.8 Other forms of actinomycosis
A42.9 Actinomycosis, unspecified
A43 Nocardiosis
A43.0 Pulmonary nocardiosis
A43.1 Cutaneous nocardiosis
A43.8 Other forms of nocardiosis
A43.9 Nocardiosis, unspecified
A44 Bartonellosis
A44.0 Systemic bartonellosis
Oroya fever
A44.1 Cutaneous and mucocutaneous bartonellosis
Verruga peruana
A44.8 Other forms of bartonellosis
A44.9 Bartonellosis, unspecified
117
A46 Erysipelas
Excl.: postpartum or puerperal erysipelas (O86.8)
118
120
121
122
123
A57 Chancroid
Incl.: ulcus molle
A59 Trichomoniasis
Excl.: intestinal trichomoniasis (A07.8)
A59.0 Urogenital trichomoniasis
Leukorrhoea (vaginalis)
due to Trichomonas (vaginalis)
Prostatitis† (N51.0*)
A59.8 Trichomoniasis of other sites
A59.9 Trichomoniasis, unspecified
124
A66 Yaws
Incl.: bouba
framboesia (tropica)
pian
A66.0 Initial lesions of yaws
Chancre of yaws
Framboesia, initial or primary
Initial framboesial ulcer
Mother yaw
A66.1 Multiple papillomata and wet crab yaws
Framboesioma
Pianoma
Plantar or palmar papilloma of yaws
A66.2 Other early skin lesions of yaws
Cutaneous yaws, less than five years after infection
Early yaws (cutaneous)(macular)(maculopapular)(micropapular)(papular)
Framboeside of early yaws
A66.3 Hyperkeratosis of yaws
Ghoul hand
Hyperkeratosis, palmar or plantar (early)(late) due to yaws
Worm-eaten soles
A66.4 Gummata and ulcers of yaws
Gummatous framboeside
Nodular late yaws (ulcerated)
A66.5 Gangosa
Rhinopharyngitis mutilans
125
126
A71 Trachoma
Excl.: sequelae of trachoma (B94.0)
A71.0 Initial stage of trachoma
Trachoma dubium
127
Rickettsioses
(A75–A79)
128
A78 Q fever
Incl.: infection due to Coxiella burnetii
Nine Mile fever
quadrilateral fever
129
A82 Rabies
A82.0 Sylvatic rabies
A82.1 Urban rabies
A82.9 Rabies, unspecified
130
131
132
133
A97 Dengue
Dengue is a viral disease transmitted by the bite of a mosquito infected by
dengue viruses. It is one disease entity with different clinical presentations
and often with unpredictable clinical evolution and outcome. Most
patients recover following a self-limiting non-severe clinical course like
nausea, vomiting, rash, aches and pains, but a small proportion progress
to severe disease, mostly characterized by plasma leakage with or without
haemorrhage, although severe haemorrhages or severe organ impairment
can occur, with or without dengue shock.
A97.0 Dengue without warning signs
Incl.: dengue haemorrhagic fever grades 1 and 2
dengue haemorrhagic fever without warning signs
A97.1 Dengue with warning signs
Clinical warning signs are: abdominal pain or tenderness, mucosal
bleeding, lethargy and/or restlessness, rapid decrease in platelet count,
increase in haematocrit. Other signs can include: persistent vomiting,
visible fluid accumulation, liver enlargement more than 2 cm.
Incl.: dengue haemorrhagic fever with warning signs
134
135
136
B03 Smallpox1
B04 Monkeypox
In 1980, the 33rd World Health Assembly declared that smallpox had been eradicated. The classification is
1
137
B05 Measles
Incl.: morbilli
Excl.: subacute sclerosing panencephalitis (A81.1)
B05.0† Measles complicated by encephalitis (G05.1*)
Postmeasles encephalitis
B05.1† Measles complicated by meningitis (G02.0*)
Postmeasles meningitis
B05.2† Measles complicated by pneumonia (J17.1*)
Postmeasles pneumonia
B05.3† Measles complicated by otitis media (H67.1*)
Postmeasles otitis media
B05.4 Measles with intestinal complications
B05.8 Measles with other complications
Measles keratitis and keratoconjunctivitis† (H19.2*)
B05.9 Measles without complication
Measles NOS
138
139
Viral hepatitis
(B15–B19)
Use additional code (Chapter XX), if desired, to identify drug, if post-transfusion
hepatitis.
Excl.: cytomegaloviral hepatitis (B25.1)
herpesviral [herpes simplex] hepatitis (B00.8)
sequelae of viral hepatitis (B94.2)
140
141
142
B26 Mumps
Incl.: parotitis:
• epidemic
• infectious
B26.0† Mumps orchitis (N51.1*)
B26.1† Mumps meningitis (G02.0*)
B26.2† Mumps encephalitis (G05.1*)
B26.3† Mumps pancreatitis (K87.1*)
B26.8 Mumps with other complications
Mumps:
• arthritis† (M01.5*)
• myocarditis† (I41.1*)
• nephritis† (N08.0*)
• polyneuropathy† (G63.0*)
B26.9 Mumps without complication
Mumps:
• NOS
• parotitis NOS
143
144
Mycoses
(B35–B49)
Excl.: hypersensitivity pneumonitis due to organic dust (J67.-)
mycosis fungoides (C84.0)
B35 Dermatophytosis
Incl.: favus
infections due to species of Epidermophyton, Microsporum and
Trichophyton tinea, any type except those in B36.-
B35.0 Tinea barbae and tinea capitis
Beard ringworm
Kerion
Scalp ringworm
Sycosis, mycotic
B35.1 Tinea unguium
Dermatophytic onychia
Dermatophytosis of nail
Onychomycosis
Ringworm of nails
B35.2 Tinea manuum
Dermatophytosis of hand
Hand ringworm
B35.3 Tinea pedis
Athlete’s foot
Dermatophytosis of foot
Foot ringworm
B35.4 Tinea corporis
Ringworm of the body
B35.5 Tinea imbricata
Tokelau
B35.6 Tinea inguinalis [Tinea cruris]
Dhobi itch
Groin ringworm
Jock itch
145
B37 Candidiasis
Incl.: candidosis
moniliasis
Excl.: neonatal candidiasis (P37.5)
B37.0 Candidal stomatitis
Oral thrush
B37.1 Pulmonary candidiasis
B37.2 Candidiasis of skin and nail
Candidal:
• onychia
• paronychia
Excl.: diaper [napkin] dermatitis (L22)
B37.3† Candidiasis of vulva and vagina (N77.1*)
Candidal vulvovaginitis
Monilial vulvovaginitis
Vaginal thrush
146
B38 Coccidioidomycosis
B38.0 Acute pulmonary coccidioidomycosis
B38.1 Chronic pulmonary coccidioidomycosis
B38.2 Pulmonary coccidioidomycosis, unspecified
B38.3 Cutaneous coccidioidomycosis
B38.4† Coccidioidomycosis meningitis (G02.1*)
B38.7 Disseminated coccidioidomycosis
Generalized coccidioidomycosis
B38.8 Other forms of coccidioidomycosis
B38.9 Coccidioidomycosis, unspecified
B39 Histoplasmosis
B39.0 Acute pulmonary histoplasmosis capsulati
B39.1 Chronic pulmonary histoplasmosis capsulati
B39.2 Pulmonary histoplasmosis capsulati, unspecified
B39.3 Disseminated histoplasmosis capsulati
Generalized histoplasmosis capsulati
B39.4 Histoplasmosis capsulati, unspecified
American histoplasmosis
B39.5 Histoplasmosis duboisii
African histoplasmosis
B39.9 Histoplasmosis, unspecified
147
B40 Blastomycosis
Excl.: Brazilian blastomycosis (B41.-)
keloidal blastomycosis (B48.0)
B40.0 Acute pulmonary blastomycosis
B40.1 Chronic pulmonary blastomycosis
B40.2 Pulmonary blastomycosis, unspecified
B40.3 Cutaneous blastomycosis
B40.7 Disseminated blastomycosis
Generalized blastomycosis
B40.8 Other forms of blastomycosis
B40.9 Blastomycosis, unspecified
B41 Paracoccidioidomycosis
Incl.: Brazilian blastomycosis
Lutz disease
B41.0 Pulmonary paracoccidioidomycosis
B41.7 Disseminated paracoccidioidomycosis
Generalized paracoccidioidomycosis
B41.8 Other forms of paracoccidioidomycosis
B41.9 Paracoccidioidomycosis, unspecified
B42 Sporotrichosis
B42.0† Pulmonary sporotrichosis (J99.8*)
B42.1 Lymphocutaneous sporotrichosis
B42.7 Disseminated sporotrichosis
Generalized sporotrichosis
B42.8 Other forms of sporotrichosis
B42.9 Sporotrichosis, unspecified
148
B44 Aspergillosis
Incl.: aspergilloma
B44.0 Invasive pulmonary aspergillosis
B44.1 Other pulmonary aspergillosis
B44.2 Tonsillar aspergillosis
B44.7 Disseminated aspergillosis
Generalized aspergillosis
B44.8 Other forms of aspergillosis
B44.9 Aspergillosis, unspecified
B45 Cryptococcosis
B45.0 Pulmonary cryptococcosis
B45.1 Cerebral cryptococcosis
Cryptococcal meningitis† (G02.1*)
Cryptococcosis meningocerebralis
B45.2 Cutaneous cryptococcosis
B45.3 Osseous cryptococcosis
B45.7 Disseminated cryptococcosis
Generalized cryptococcosis
B45.8 Other forms of cryptococcosis
B45.9 Cryptococcosis, unspecified
B46 Zygomycosis
B46.0 Pulmonary mucormycosis
B46.1 Rhinocerebral mucormycosis
B46.2 Gastrointestinal mucormycosis
B46.3 Cutaneous mucormycosis
Subcutaneous mucormycosis
B46.4 Disseminated mucormycosis
Generalized mucormycosis
B46.5 Mucormycosis, unspecified
B46.8 Other zygomycoses
Entomophthoromycosis
B46.9 Zygomycosis, unspecified
Phycomycosis NOS
149
B47 Mycetoma
B47.0 Eumycetoma
Madura foot, mycotic
Maduromycosis
B47.1 Actinomycetoma
B47.9 Mycetoma, unspecified
Madura foot NOS
Protozoal diseases
(B50–B64)
Excl.: amoebiasis (A06.-)
other protozoal intestinal diseases (A07.-)
150
151
B55 Leishmaniasis
B55.0 Visceral leishmaniasis
Kala-azar
Post-kala-azar dermal leishmaniasis
B55.1 Cutaneous leishmaniasis
B55.2 Mucocutaneous leishmaniasis
B55.9 Leishmaniasis, unspecified
152
B58 Toxoplasmosis
Incl.: infection due to Toxoplasma gondii
Excl.: congenital toxoplasmosis (P37.1)
B58.0† Toxoplasma oculopathy
Toxoplasma chorioretinitis (H32.0*)
B58.1† Toxoplasma hepatitis (K77.0*)
B58.2† Toxoplasma meningoencephalitis (G05.2*)
B58.3† Pulmonary toxoplasmosis (J17.3*)
B58.8 Toxoplasmosis with other organ involvement
Toxoplasma:
• myocarditis† (I41.2*)
• myositis† (M63.1*)
B58.9 Toxoplasmosis, unspecified
153
Helminthiases
(B65–B83)
154
B66.4 Paragonimiasis
Infection due to Paragonimus species
Lung fluke disease
Pulmonary distomiasis
B66.5 Fasciolopsiasis
Infection due to Fasciolopsis buski
Intestinal distomiasis
B66.8 Other specified fluke infections
Echinostomiasis
Heterophyiasis
Metagonimiasis
Nanophyetiasis
Watsoniasis
B66.9 Fluke infection, unspecified
B67 Echinococcosis
Incl.: hydatidosis
B67.0 Echinococcus granulosus infection of liver
B67.1 Echinococcus granulosus infection of lung
B67.2 Echinococcus granulosus infection of bone
B67.3 Echinococcus granulosus infection, other and multiple sites
B67.4 Echinococcus granulosus infection, unspecified
Dog tapeworm (infection)
B67.5 Echinococcus multilocularis infection of liver
B67.6 Echinococcus multilocularis infection, other and multiple sites
B67.7 Echinococcus multilocularis infection, unspecified
B67.8 Echinococcosis, unspecified, of liver
B67.9 Echinococcosis, other and unspecified
Echinococcosis NOS
B68 Taeniasis
Excl.: cysticercosis (B69.-)
B68.0 Taenia solium taeniasis
Pork tapeworm (infection)
B68.1 Taenia saginata taeniasis
Beef tapeworm (infection)
Infection due to adult tapeworm Taenia saginata
B68.9 Taeniasis, unspecified
155
B69 Cysticercosis
Incl.: cysticerciasis infection due to larval form of Taenia solium
B69.0 Cysticercosis of central nervous system
B69.1 Cysticercosis of eye
B69.8 Cysticercosis of other sites
B69.9 Cysticercosis, unspecified
B72 Dracunculiasis
Incl.: Guinea worm infection
infection due to Dracunculus medinensis
B73 Onchocerciasis
Incl.: Onchocerca volvulus infection
onchocercosis
river blindness
B74 Filariasis
Excl.: onchocerciasis (B73)
tropical (pulmonary) eosinophilia NOS (J82)
156
B75 Trichinellosis
Incl.: infection due to Trichinella species
trichiniasis
B77 Ascariasis
Incl.: ascaridiasis
roundworm infection
B77.0 Ascariasis with intestinal complications
B77.8 Ascariasis with other complications
B77.9 Ascariasis, unspecified
157
B78 Strongyloidiasis
Excl.: trichostrongyliasis (B81.2)
B78.0 Intestinal strongyloidiasis
B78.1 Cutaneous strongyloidiasis
B78.7 Disseminated strongyloidiasis
B78.9 Strongyloidiasis, unspecified
B79 Trichuriasis
Incl.: trichocephaliasis
whipworm (disease)(infection)
B80 Enterobiasis
Incl.: oxyuriasis
pinworm infection
threadworm infection
158
159
B86 Scabies
Incl.: sarcoptic itch
B87 Myiasis
Incl.: infestation by larvae of flies
B87.0 Cutaneous myiasis
Creeping myiasis
B87.1 Wound myiasis
Traumatic myiasis
B87.2 Ocular myiasis
B87.3 Nasopharyngeal myiasis
Laryngeal myiasis
B87.4 Aural myiasis
B87.8 Myiasis of other sites
Genitourinary myiasis
Intestinal myiasis
B87.9 Myiasis, unspecified
160
161
162
163
CHAPTER II
(C00–D48)
Notes
2. Functional activity
All neoplasms are classified in this chapter, whether they are functionally active or
not. An additional code from Chapter IV may be used, if desired, to identify functional
activity associated with any neoplasm. For example, catecholamine-producing malignant
phaeochromocytoma of adrenal gland should be coded to C74 with additional code
E27.5; basophil adenoma of pituitary gland with Cushing syndrome should be coded to
D35.2 with additional code E24.0.
165
3. Morphology
There are a number of major morphological (histological) groups of malignant
neoplasms: carcinomas including squamous (cell) and adenocarcinomas; sarcomas;
other soft tissue tumours including mesotheliomas; lymphomas (Hodgkin and non-
Hodgkin); leukaemia; other specified and site-specific types; and unspecified cancers.
Cancer is a generic term and may be used for any of the above groups, although it
is rarely applied to the malignant neoplasms of lymphatic, haematopoietic and related
tissue. ‘Carcinoma’ is sometimes used incorrectly as a synonym for ‘cancer’.
In Chapter II, neoplasms are classified predominantly by site within broad groupings
for behaviour. In a few exceptional cases, morphology is indicated in the category and
subcategory titles.
For those wishing to identify the histological type of neoplasm, the list of morphology
codes of ICD-O is available for separate download online. The list formerly included in
ICD-10 was outdated because it was derived from the second edition of the International
classification of diseases for oncology (ICD-O). ICD-O is a dual-axis classification
providing independent coding systems for topography and morphology. Morphology
codes have six digits: the first four digits identify the histological type; the fifth digit
is the behaviour code (malignant primary, malignant secondary (metastatic), in situ,
benign, uncertain whether malignant or benign); and the sixth digit is a grading code
(differentiation) for solid tumours, and is also used as a special code for lymphomas and
leukaemias.
The ICD-O lists can be downloaded from the classification website of WHO
(www.who.int/classifications).
166
167
Malignant neoplasms
(C00–C97)
Use additional code (U85), if desired, to identify resistance, non-responsiveness and
refractive properties of the neoplasm to antineoplastic drugs.
168
169
170
171
172
173
174
175
176
C26.1 Spleen
Excl.: follicular lymphoma (C82.-)
Hodgkin lymphoma (C81.-)
mature T/NK-cell lymphomas (C84.-)
non-follicular lymphoma (C83.-)
non-Hodgkin lymphoma, other and unspecified types (C85.-)
C26.8 Overlapping lesion of digestive system
[See note 5 at the beginning of this chapter]
Malignant neoplasm of digestive organs whose point of origin cannot be
classified to any one of the categories C15–C26.1
Excl.: cardio-oesophageal junction (C16.0)
C26.9 Ill-defined sites within the digestive system
Alimentary canal or tract NOS
Gastrointestinal tract NOS
177
178
179
180
181
C45 Mesothelioma
C45.0 Mesothelioma of pleura
Excl.: other malignant neoplasms of pleura (C38.4)
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
199
200
201
202
In situ neoplasms
(D00–D09)
Note: Many in situ neoplasms are regarded as being located within a continuum of
morphological change between dysplasia and invasive cancer. For example,
for cervical intraepithelial neoplasia (CIN), three grades are recognized, the
third of which (CIN III) includes both severe dysplasia and carcinoma in
situ. This system of grading has been extended to other organs, such as
vulva and vagina. Descriptions of grade III intraepithelial neoplasia, with
or without mention of severe dysplasia, are assigned to this section; grades
I and II are classified as dysplasia of the organ system involved and should
be coded to the relevant body system chapter.
Incl.: Bowen disease
erythroplasia
Queyrat erythroplasia
203
204
205
206
207
Benign neoplasms
(D10–D36)
208
209
D13.4 Liver
Intrahepatic bile ducts
D13.5 Extrahepatic bile ducts
D13.6 Pancreas
Excl.: endocrine pancreas (D13.7)
D13.7 Endocrine pancreas
Islet cell tumour
Islets of Langerhans
D13.9 Ill-defined sites within the digestive system
Digestive system NOS
Intestine NOS
Spleen
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D30.3 Bladder
Orifice of bladder:
• urethral
• ureteric
D30.4 Urethra
Excl.: urethral orifice of bladder (D30.3)
D30.7 Other urinary organs
Paraurethral glands
D30.9 Urinary organ, unspecified
Urinary system NOS
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CHAPTER III
(D50–D89)
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Nutritional anaemias
(D50–D53)
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Haemolytic anaemias
(D55–D59)
D56 Thalassaemia
D56.0 Alpha thalassaemia
Excl.: hydrops fetalis due to haemolytic disease (P56.-)
D56.1 Beta thalassaemia
Cooley anaemia
Severe beta thalassaemia
Thalassaemia:
• intermedia
• major
D56.2 Delta-beta thalassaemia
D56.3 Thalassaemia trait
D56.4 Hereditary persistence of fetal haemoglobin [HPFH]
D56.8 Other thalassaemias
D56.9 Thalassaemia, unspecified
Mediterranean anaemia (with other haemoglobinopathy)
Thalassaemia (minor)(mixed)(with other haemoglobinopathy)
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D70 Agranulocytosis
Incl.: agranulocytic angina
infantile genetic agranulocytosis
Kostmann disease
Neutropenia:
• NOS
• congenital
• cyclic
• drug-induced
• periodic
• splenic (primary)
• toxic
neutropenic splenomegaly
Werner–Schultz disease
Use additional external cause code (Chapter XX), if desired, to identify
drug, if drug-induced.
Excl.: transient neonatal neutropenia (P61.5)
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D74 Methaemoglobinaemia
D74.0 Congenital methaemoglobinaemia
Congenital NADH-methaemoglobin reductase deficiency
Haemoglobin-M [Hb-M] disease
Methaemoglobinaemia, hereditary
D74.8 Other methaemoglobinaemias
Acquired methaemoglobinaemia (with sulfhaemoglobinaemia)
Toxic methaemoglobinaemia
Use additional external cause code (Chapter XX), if desired, to identify cause.
D74.9 Methaemoglobinaemia, unspecified
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D86 Sarcoidosis
D86.0 Sarcoidosis of lung
D86.1 Sarcoidosis of lymph nodes
D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes
D86.3 Sarcoidosis of skin
D86.8 Sarcoidosis of other and combined sites
Iridocyclitis in sarcoidosis† (H22.1*)
Multiple cranial nerve palsies in sarcoidosis† (G53.2*)
Sarcoid:
• arthropathy† (M14.8*)
• myocarditis† (I41.8*)
• myositis† (M63.3*)
Uveoparotid fever [Heerfordt’s]
D86.9 Sarcoidosis, unspecified
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Note: All neoplasms, whether functionally active or not, are classified in Chapter
II. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16–E31, E34.-)
may be used, if desired, as additional codes to indicate either functional
activity by neoplasms and ectopic endocrine tissue or hyperfunction and
CHAPTER IV
hypofunction of endocrine glands associated with neoplasms and other
conditions classified elsewhere.
Excl.: complications of pregnancy, childbirth and the puerperium (O00–O99)
symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified (R00–R99)
transitory endocrine and metabolic disorders specific to fetus and newborn
(P70–P74)
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E06 Thyroiditis
Excl.: postpartum thyroiditis (O90.5)
E06.0 Acute thyroiditis
Abscess of thyroid
Thyroiditis:
• pyogenic
• suppurative
Use additional code (B95–B98), if desired, to identify infectious agent.
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Diabetes mellitus
(E10–E14)
Use additional external cause code (Chapter XX), if desired, to identify drug, if
drug-induced.
The following fourth-character subdivisions are for use with categories E10–E14:
.0 With coma
Diabetic:
• coma with or without ketoacidosis
• hyperosmolar coma
• hypoglycaemic coma
Hyperglycaemic coma NOS
.1 With ketoacidosis
Diabetic:
• acidosis without mention of coma
• ketoacidosis
.2† With renal complications
Diabetic nephropathy (N08.3*)
Intracapillary glomerulonephrosis (N08.3*)
Kimmelstiel–Wilson syndrome (N08.3*)
.3† With ophthalmic complications
Diabetic:
• cataract (H28.0*)
• retinopathy (H36.0*)
.4† With neurological complications
Diabetic:
• amyotrophy (G73.0*)
• autonomic neuropathy (G99.0*)
• mononeuropathy (G59.0*)
• polyneuropathy (G63.2*)
–– autonomic (G99.0*)
.5 With peripheral circulatory complications
Diabetic:
• gangrene
• peripheral angiopathy† (I79.2*)
• ulcer
.6 With other specified complications
Diabetic arthropathy† (M14.2*)
Neuropathic diabetic arthropathy† (M14.6*)
.7 With multiple complications
.8 With unspecified complications
.9 Without complications
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E20 Hypoparathyroidism
Excl.: DiGeorge syndrome (D82.1)
postprocedural hypoparathyroidism (E89.2)
tetany NOS (R29.0)
transitory neonatal hypoparathyroidism (P71.4)
E20.0 Idiopathic hypoparathyroidism
E20.1 Pseudohypoparathyroidism
E20.8 Other hypoparathyroidism
E20.9 Hypoparathyroidism, unspecified
Parathyroid tetany
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E26 Hyperaldosteronism
E26.0 Primary hyperaldosteronism
Conn syndrome
Primary aldosteronism due to adrenal hyperplasia (bilateral)
E26.1 Secondary hyperaldosteronism
E26.8 Other hyperaldosteronism
Bartter syndrome
E26.9 Hyperaldosteronism, unspecified
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Malnutrition
(E40–E46)
Note: The degree of malnutrition is usually measured in terms of weight, expressed
in standard deviations from the mean of the relevant reference population.
When one or more previous measurements are available, lack of weight
gain in children, or evidence of weight loss in children or adults, is usually
indicative of malnutrition. When only one measurement is available, the
diagnosis is based on probabilities and is not definitive without other clinical
or laboratory tests. In the exceptional circumstances that no measurement of
weight is available, reliance should be placed on clinical evidence.
If an observed weight is below the mean value of the reference population,
there is a high probability of severe malnutrition if there is an observed value
situated 3 or more standard deviations below the mean value of the reference
population; a high probability of moderate malnutrition for an observed
value located between 2 and less than 3 standard deviations below this mean;
and a high probability of mild malnutrition for an observed value located
between 1 and less than 2 standard deviations below this mean.
Excl.: intestinal malabsorption (K90.-)
nutritional anaemias (D50–D53)
sequelae of protein-energy malnutrition (E64.0)
slim disease (B22.2)
starvation (T73.0)
E40 Kwashiorkor
Severe malnutrition with nutritional oedema with dyspigmentation of skin and hair.
Excl.: marasmic kwashiorkor (E42)
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E66 Obesity
Excl.: adiposogenital dystrophy (E23.6)
lipomatosis:
• NOS (E88.2)
• dolorosa [Dercum] (E88.2)
Prader–Willi syndrome (Q87.1)
E66.0 Obesity due to excess calories
E66.1 Drug-induced obesity
Use additional external cause code (Chapter XX), if desired, to identify drug.
E66.2 Extreme obesity with alveolar hypoventilation
Obesity hypoventilation syndrome (OHS)
Pickwickian syndrome
E66.8 Other obesity
Morbid obesity
E66.9 Obesity, unspecified
Simple obesity NOS
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Metabolic disorders
(E70–E90)
Excl.: androgen resistance syndrome (E34.5)
congenital adrenal hyperplasia (E25.0)
Ehlers–Danlos syndrome (Q79.6)
haemolytic anaemias due to enzyme disorders (D55.-)
Marfan syndrome (Q87.4)
5-alpha-reductase deficiency (E29.1)
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E85 Amyloidosis
Excl.: Alzheimer disease (G30.-)
E85.0 Non-neuropathic heredofamilial amyloidosis
Familial Mediterranean fever
Hereditary amyloid nephropathy
E85.1 Neuropathic heredofamilial amyloidosis
Amyloid polyneuropathy (Portuguese)
E85.2 Heredofamilial amyloidosis, unspecified
E85.3 Secondary systemic amyloidosis
Haemodialysis-associated amyloidosis
E85.4 Organ-limited amyloidosis
Localized amyloidosis
E85.8 Other amyloidosis
E85.9 Amyloidosis, unspecified
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CHAPTER V
physical factors
F60–F69 Disorders of adult personality and behaviour
F70–F79 Mental retardation
F80–F89 Disorders of psychological development
F90–F98 Behavioural and emotional disorders with onset usually occurring in
childhood and adolescence
F99 Unspecified mental disorder
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.1 Harmful use
A pattern of psychoactive substance use that is causing damage to health. The
damage may be physical (as in cases of hepatitis from the self-administration of
injected psychoactive substances) or mental (e.g. episodes of depressive disorder
secondary to heavy consumption of alcohol).
Psychoactive substance abuse
.2 Dependence syndrome
A cluster of behavioural, cognitive and physiological phenomena that develop after
repeated substance use and that typically include a strong desire to take the drug,
difficulties in controlling its use, persisting in its use despite harmful consequences,
a higher priority given to drug use than to other activities and obligations, increased
tolerance, and sometimes a physical withdrawal state.
The dependence syndrome may be present for a specific psychoactive substance
(e.g. tobacco, alcohol or diazepam), for a class of substances (e.g. opioid drugs) or
for a wider range of pharmacologically different psychoactive substances.
Chronic alcoholism
Dipsomania
Drug addiction
.3 Withdrawal state
A group of symptoms of variable clustering and severity, occurring on absolute or
relative withdrawal of a psychoactive substance after persistent use of that substance.
The onset and course of the withdrawal state are time-limited and are related to the
type of psychoactive substance and dose being used immediately before cessation or
reduction of use. The withdrawal state may be complicated by convulsions.
.4 Withdrawal state with delirium
A condition where the withdrawal state as defined in the common fourth character
.3 is complicated by delirium as defined in F05.-. Convulsions may also occur.
When organic factors are also considered to play a role in the etiology, the condition
should be classified to F05.8.
Delirium tremens (alcohol-induced)
.5 Psychotic disorder
A cluster of psychotic phenomena that occur during or following psychoactive
substance use but that are not explained on the basis of acute intoxication alone
and do not form part of a withdrawal state. The disorder is characterized by
hallucinations (typically auditory, but often in more than one sensory modality),
perceptual distortions, delusions (often of a paranoid or persecutory nature),
psychomotor disturbances (excitement or stupor) and an abnormal affect, which
may range from intense fear to ecstasy. The sensorium is usually clear but some
degree of clouding of consciousness, though not severe confusion, may be present.
Alcoholic:
• hallucinosis
• jealousy
• paranoia
• psychosis NOS
Excl.: alcohol- or other psychoactive-substance-induced residual and late-
onset psychotic disorder (F10–F19 with common fourth character .7)
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.6 Amnesic syndrome
A syndrome associated with chronic prominent impairment of recent and
remote memory. Immediate recall is usually preserved and recent memory is
characteristically more disturbed than remote memory. Disturbances of time
sense and ordering of events are usually evident, as are difficulties in learning
new material. Confabulation may be marked but is not invariably present. Other
cognitive functions are usually relatively well preserved and amnesic defects are
out of proportion to other disturbances.
Amnestic disorder, alcohol- or drug-induced
Korsakov psychosis or syndrome, alcohol- or other psychoactive
substance-induced or unspecified
Use additional code, (E51.2†, G32.8*), if desired, when associated with
Wernicke disease or syndrome.
Excl.: nonalcoholic Korsakov psychosis or syndrome (F04)
.7 Residual and late-onset psychotic disorder
A disorder in which alcohol- or psychoactive-substance-induced changes of
cognition, affect, personality, or behaviour persist beyond the period during which
a direct psychoactive-substance-related effect might reasonably be assumed to
be operating. Onset of the disorder should be directly related to the use of the
psychoactive substance. Cases in which initial onset of the state occurs later than
episode(s) of such substance use should be coded here only where clear and strong
evidence is available to attribute the state to the residual effect of the psychoactive
substance. Flashbacks may be distinguished from psychotic state partly by their
episodic nature, frequently of very short duration, and by their duplication of
previous alcohol- or other psychoactive-substance-related experiences.
Alcoholic dementia NOS
Chronic alcoholic brain syndrome
Dementia and other milder forms of persisting impairment of cognitive
functions
Flashbacks
Late-onset psychoactive substance-induced psychotic disorder
Posthallucinogen perception disorder
Residual:
• affective disorder
• disorder of personality and behaviour
Excl.: alcohol- or psychoactive-substance-induced:
• Korsakov syndrome (F10–F19 with common fourth character .6)
• psychotic state (F10–F19 with common fourth character .5)
.8 Other mental and behavioural disorders
.9 Unspecified mental and behavioural disorder
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F20 Schizophrenia
The schizophrenic disorders are characterized in general by fundamental
and characteristic distortions of thinking and perception, and affects that are
inappropriate or blunted. Clear consciousness and intellectual capacity are usually
maintained, although certain cognitive deficits may evolve in the course of time.
The most important psychopathological phenomena include thought echo; thought
insertion or withdrawal; thought broadcasting; delusional perception and delusions
of control; influence or passivity; hallucinatory voices commenting or discussing
the patient in the third person; thought disorders; and negative symptoms.
The course of schizophrenic disorders can be either continuous, or episodic with
progressive or stable deficit, or there can be one or more episodes with complete
or incomplete remission. The diagnosis of schizophrenia should not be made
in the presence of extensive depressive or manic symptoms unless it is clear
that schizophrenic symptoms antedate the affective disturbance. Nor should
schizophrenia be diagnosed in the presence of overt brain disease or during states
of drug intoxication or withdrawal. Similar disorders developing in the presence of
epilepsy or other brain disease should be classified under F06.2, and those induced
by psychoactive substances under F10–F19 with common fourth character .5.
Excl.: schizophrenia:
• acute (undifferentiated) (F23.2)
• cyclic (F25.2)
schizophrenic reaction (F23.2)
schizotypal disorder (F21)
F20.0 Paranoid schizophrenia
Paranoid schizophrenia is dominated by relatively stable, often paranoid delusions,
usually accompanied by hallucinations, particularly of the auditory variety, and
perceptual disturbances. Disturbances of affect, volition and speech, and catatonic
symptoms, are either absent or relatively inconspicuous.
Paraphrenic schizophrenia
Excl.: involutional paranoid state (F22.8)
paranoia (F22.0)
F20.1 Hebephrenic schizophrenia
A form of schizophrenia in which affective changes are prominent, delusions and
hallucinations fleeting and fragmentary, behaviour irresponsible and unpredictable,
and mannerisms common. The mood is shallow and inappropriate, thought is
disorganized, and speech is incoherent. There is a tendency to social isolation.
Usually the prognosis is poor because of the rapid development of ‘negative’
symptoms, particularly flattening of affect and loss of volition. Hebephrenia should
normally be diagnosed only in adolescents or young adults.
Disorganized schizophrenia
Hebephrenia
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the stressful stimulus or event, and disappear within two to three days (often within
hours). Partial or complete amnesia (F44.0) for the episode may be present. If the
symptoms persist, a change in diagnosis should be considered.
Acute:
• crisis reaction
• reaction to stress
Combat fatigue
Crisis state
Psychic shock
F43.1 Post-traumatic stress disorder
Arises as a delayed or protracted response to a stressful event or situation (of
either brief or long duration) of an exceptionally threatening or catastrophic
nature, which is likely to cause pervasive distress in almost anyone. Predisposing
factors, such as personality traits (e.g. compulsive, asthenic) or previous history
of neurotic illness, may lower the threshold for the development of the syndrome
or aggravate its course, but they are neither necessary nor sufficient to explain its
occurrence. Typical features include episodes of repeated reliving of the trauma
in intrusive memories (‘flashbacks’), dreams or nightmares, occurring against
the persisting background of a sense of ‘numbness’ and emotional blunting,
detachment from other people, unresponsiveness to surroundings, anhedonia, and
avoidance of activities and situations reminiscent of the trauma. There is usually a
state of autonomic hyperarousal with hypervigilance, an enhanced startle reaction,
and insomnia. Anxiety and depression are commonly associated with the above
symptoms and signs, and suicidal ideation is not infrequent. The onset follows
the trauma with a latency period that may range from a few weeks to months. The
course is fluctuating but recovery can be expected in the majority of cases. In a
small proportion of cases, the condition may follow a chronic course over many
years, with eventual transition to an enduring personality change (F62.0).
Traumatic neurosis
F43.2 Adjustment disorders
States of subjective distress and emotional disturbance, usually interfering with social
functioning and performance, arising in the period of adaptation to a significant life
change or a stressful life event. The stressor may have affected the integrity of an
individual’s social network (bereavement, separation experiences) or the wider system
of social supports and values (migration, refugee status), or represented a major
developmental transition or crisis (going to school, becoming a parent, failure to attain
a cherished personal goal, retirement). Individual predisposition or vulnerability plays
an important role in the risk of occurrence and the shaping of the manifestations of
adjustment disorders, but it is nevertheless assumed that the condition would not
have arisen without the stressor. The manifestations vary and include depressed
mood, anxiety or worry (or mixture of these) and a feeling of inability to cope, plan
ahead or continue in the present situation, as well as some degree of disability in
the performance of daily routine. Conduct disorders may be an associated feature,
particularly in adolescents. The predominant feature may be a brief or prolonged
depressive reaction, or a disturbance of other emotions and conduct.
Culture shock
Grief reaction
Hospitalism in children
Excl.: separation anxiety disorder of childhood (F93.0)
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disruption of social, interpersonal and family behaviour. Short-lived (less than two
years) and less striking symptom patterns should be classified under undifferentiated
somatoform disorder (F45.1).
Briquet disorder
Multiple psychosomatic disorder
Excl.: malingering [conscious simulation] (Z76.5)
F45.1 Undifferentiated somatoform disorder
When somatoform complaints are multiple, varying and persistent, but the complete
and typical clinical picture of somatization disorder is not fulfilled, the diagnosis of
undifferentiated somatoform disorder should be considered.
Undifferentiated psychosomatic disorder
F45.2 Hypochondriacal disorder
The essential feature is a persistent preoccupation with the possibility of having
one or more serious and progressive physical disorders. Patients manifest persistent
somatic complaints or a persistent preoccupation with their physical appearance.
Normal or commonplace sensations and appearances are often interpreted by
patients as abnormal and distressing, and attention is usually focused upon only
one or two organs or systems of the body. Marked depression and anxiety are often
present, and may justify additional diagnoses.
Body dysmorphic disorder
Dysmorphophobia (nondelusional)
Hypochondriacal neurosis
Hypochondriasis
Nosophobia
Excl.: delusional dysmorphophobia (F22.8)
fixed delusions about bodily functions or shape (F22.-)
F45.3 Somatoform autonomic dysfunction
Symptoms are presented by the patient as if they were due to a physical disorder
of a system or organ that is largely or completely under autonomic innervation and
control, i.e. the cardiovascular, gastrointestinal, respiratory and urogenital systems.
The symptoms are usually of two types, neither of which indicates a physical
disorder of the organ or system concerned. First, there are complaints based upon
objective signs of autonomic arousal, such as palpitations, sweating, flushing,
tremor and expression of fear and distress about the possibility of a physical
disorder. Second, there are subjective complaints of a nonspecific or changing
nature, such as fleeting aches and pains, sensations of burning, heaviness, tightness
and feelings of being bloated or distended, which are referred by the patient to a
specific organ or system.
Cardiac neurosis
Da Costa syndrome
Gastric neurosis
Neurocirculatory asthenia
Psychogenic forms of:
• aerophagy
• cough
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• diarrhoea
• dyspepsia
• dysuria
• flatulence
• hiccough
• hyperventilation
• increased frequency of micturition
• irritable bowel syndrome
• pylorospasm
Excl.: psychological and behavioural factors associated with disorders or
diseases classified elsewhere (F54)
F45.4 Persistent somatoform pain disorder
The predominant complaint is of persistent, severe and distressing pain, which
cannot be explained fully by a physiological process or a physical disorder, and
which occurs in association with emotional conflict or psychosocial problems that
are sufficient to allow the conclusion that they are the main causative influences.
The result is usually a marked increase in support and attention, either personal or
medical. Pain presumed to be of psychogenic origin occurring during the course of
depressive disorders or schizophrenia should not be included here.
Psychalgia
Psychogenic:
• backache
• headache
Somatoform pain disorder
Excl.: backache NOS (M54.9)
pain:
• NOS (R52.9)
• acute (R52.0)
• chronic (R52.2)
• intractable (R52.1)
tension headache (G44.2)
F45.8 Other somatoform disorders
Any other disorders of sensation, function and behaviour, not due to physical
disorders, that are not mediated through the autonomic nervous system, that are
limited to specific systems or parts of the body and that are closely associated in
time with stressful events or problems.
Psychogenic:
• dysmenorrhoea
• dysphagia, including ‘globus hystericus’
• pruritus
• torticollis
Teeth-grinding
F45.9 Somatoform disorder, unspecified
Psychosomatic disorder NOS
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F65.5 Sadomasochism
A preference for sexual activity that involves the infliction of pain or humiliation, or
bondage. If the subject prefers to be the recipient of such stimulation, this is called
masochism; if the provider, sadism. Often an individual obtains sexual excitement
from both sadistic and masochistic activities.
Masochism
Sadism
F65.6 Multiple disorders of sexual preference
Sometimes more than one abnormal sexual preference occurs in one person and
there is none of first rank. The most common combination is fetishism, transvestism
and sadomasochism.
F65.8 Other disorders of sexual preference
A variety of other patterns of sexual preference and activity, including making
obscene telephone calls, rubbing up against people for sexual stimulation in
crowded public places, sexual activity with animals, and use of strangulation or
anoxia for intensifying sexual excitement.
Frotteurism
Necrophilia
F65.9 Disorder of sexual preference, unspecified
Sexual deviation NOS
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Mental retardation
(F70–F79)
A condition of arrested or incomplete development of the mind, which is especially characterized
by impairment of skills manifested during the developmental period, skills which contribute to the
overall level of intelligence, i.e. cognitive, language, motor and social abilities. Retardation can
occur with or without any other mental or physical condition.
Degrees of mental retardation are conventionally estimated by standardized intelligence tests.
These can be supplemented by scales assessing social adaptation in a given environment. These
measures provide an approximate indication of the degree of mental retardation. The diagnosis
will also depend on the overall assessment of intellectual functioning by a skilled diagnostician.
Intellectual abilities and social adaptation may change over time, and, however poor, may
improve as a result of training and rehabilitation. Diagnosis should be based on the current levels
of functioning.
Use additional code, if desired, to identify associated conditions such as autism, other
developmental disorders, epilepsy, conduct disorders or severe physical handicap.
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The following fourth-character subdivisions are for use with categories F70–F79 to
identify the extent of impairment of behaviour:
.0 With the statement of no, or minimal, impairment of behaviour
.1 Significant impairment of behaviour requiring attention or treatment
.8 Other impairments of behaviour
.9 Without mention of impairment of behaviour
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Examples of the behaviours on which the diagnosis is based include excessive levels
of fighting or bullying, cruelty to other people or animals, severe destructiveness
to property, fire-setting, stealing, repeated lying, truancy from school and running
away from home, unusually frequent and severe temper tantrums, and disobedience.
Any one of these behaviours, if marked, is sufficient for the diagnosis, but isolated
dissocial acts are not.
Excl.: mood [affective] (F30–F39)
pervasive developmental disorders (F84.-)
schizophrenia (F20.-)
when associated with:
• emotional disorders (F92.-)
• hyperkinetic disorders (F90.1)
F91.0 Conduct disorder confined to the family context
Conduct disorder involving dissocial or aggressive behaviour (and not merely
oppositional, defiant, disruptive behaviour), in which the abnormal behaviour is
entirely, or almost entirely, confined to the home and to interactions with members
of the nuclear family or immediate household. The disorder requires that the overall
criteria for F91.- be met; even severely disturbed parent–child relationships are not
of themselves sufficient for diagnosis.
F91.1 Unsocialized conduct disorder
Disorder characterized by the combination of persistent dissocial or aggressive
behaviour (meeting the overall criteria for F91.- and not merely comprising
oppositional, defiant, disruptive behaviour) with significant pervasive abnormalities
in the individual’s relationships with other children.
Conduct disorder, solitary aggressive type
Unsocialized aggressive disorder
F91.2 Socialized conduct disorder
Disorder involving persistent dissocial or aggressive behaviour (meeting the overall
criteria for F91.- and not merely comprising oppositional, defiant, disruptive behaviour)
occurring in individuals who are generally well integrated into their peer group.
Conduct disorder, group type
Group delinquency
Offences in the context of gang membership
Stealing in company with others
Truancy from school
F91.3 Oppositional defiant disorder
Conduct disorder, usually occurring in younger children, primarily characterized by
markedly defiant, disobedient, disruptive behaviour that does not include delinquent
acts or the more extreme forms of aggressive or dissocial behaviour. The disorder
requires that the overall criteria for F91.- be met; even severely mischievous or naughty
behaviour is not in itself sufficient for diagnosis. Caution should be employed before
using this category, especially with older children, because clinically significant
conduct disorder will usually be accompanied by dissocial or aggressive behaviour
that goes beyond mere defiance, disobedience or disruptiveness.
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CHAPTER VI
G40–G47 Episodic and paroxysmal disorders
G50–G59 Nerve, nerve root and plexus disorders
G60–G64 Polyneuropathies and other disorders of the peripheral nervous system
G70–G73 Diseases of myoneural junction and muscle
G80–G83 Cerebral palsy and other paralytic syndromes
G90–G99 Other disorders of the nervous system
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G24 Dystonia
Incl.: dyskinesia
Excl.: athetoid cerebral palsy (G80.3)
G24.0 Drug-induced dystonia
Use additional external cause code (Chapter XX), if desired, to identify drug.
G24.1 Idiopathic familial dystonia
Idiopathic dystonia NOS
G24.2 Idiopathic nonfamilial dystonia
G24.3 Spasmodic torticollis
Excl.: torticollis NOS (M43.6)
G24.4 Idiopathic orofacial dystonia
Orofacial dyskinesia
G24.5 Blepharospasm
G24.8 Other dystonia
G24.9 Dystonia, unspecified
Dyskinesia NOS
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G40 Epilepsy
Excl.: Landau–Kleffner syndrome (F80.3)
seizure (convulsive) NOS (R56.8)
status epilepticus (G41.-)
Todd paralysis (G83.8)
G40.0 Localization-related (focal)(partial) idiopathic epilepsy and
epileptic syndromes with seizures of localized onset
Benign childhood epilepsy with centrotemporal EEG spikes
Childhood epilepsy with occipital EEG paroxysms
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G43 Migraine
Use additional external cause code (Chapter XX), if desired, to identify
drug, if drug-induced.
Excl.: headache NOS (R51)
G43.0 Migraine without aura [common migraine]
G43.1 Migraine with aura [classical migraine]
Migraine:
• aura without headache
• basilar
• equivalents
• familial hemiplegic
• with:
–– acute-onset aura
–– prolonged aura
–– typical aura
G43.2 Status migrainosus
G43.3 Complicated migraine
G43.8 Other migraine
Ophthalmoplegic migraine
Retinal migraine
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362
363
364
365
366
367
368
369
370
371
372
G81 Hemiplegia
Note: For primary coding, this category is to be used only when hemiplegia
(complete) (incomplete) is reported without further specification, or
is stated to be old or longstanding but of unspecified cause. The
category is also for use in multiple coding to identify these types of
hemiplegia resulting from any cause.
Excl.: congenital cerebral palsy (G80.-)
G81.0 Flaccid hemiplegia
G81.1 Spastic hemiplegia
G81.9 Hemiplegia, unspecified
373
374
G91 Hydrocephalus
Incl.: acquired hydrocephalus
Excl.: hydrocephalus:
• acquired, of newborn (P91.7)
• congenital (Q03.-)
• due to congenital toxoplasmosis (P37.1)
G91.0 Communicating hydrocephalus
G91.1 Obstructive hydrocephalus
G91.2 Normal-pressure hydrocephalus
G91.3 Post-traumatic hydrocephalus, unspecified
G91.8 Other hydrocephalus
G91.9 Hydrocephalus, unspecified
375
376
377
378
CHAPTER VII
H53–H54 Visual disturbances and blindness
H55–H59 Other disorders of eye and adnexa
379
380
381
382
Disorders of conjunctiva
(H10–H13)
H10 Conjunctivitis
Excl.: keratoconjunctivitis (H16.2)
H10.0 Mucopurulent conjunctivitis
H10.1 Acute atopic conjunctivitis
H10.2 Other acute conjunctivitis
H10.3 Acute conjunctivitis, unspecified
Excl.: ophthalmia neonatorum NOS (P39.1)
H10.4 Chronic conjunctivitis
H10.5 Blepharoconjunctivitis
H10.8 Other conjunctivitis
H10.9 Conjunctivitis, unspecified
383
384
H16 Keratitis
H16.0 Corneal ulcer
Ulcer:
• corneal:
–– NOS
–– central
–– marginal
–– perforated
–– ring
–– with hypopyon
• Mooren
H16.1 Other superficial keratitis without conjunctivitis
Keratitis:
• areolar
• filamentary
• nummular
• stellate
• striate
• superficial punctate
Photokeratitis
Snow blindness
H16.2 Keratoconjunctivitis
Keratoconjunctivitis:
• NOS
• exposure
• neurotrophic
• phlyctenular
Ophthalmia nodosa
Superficial keratitis with conjunctivitis
H16.3 Interstitial and deep keratitis
H16.4 Corneal neovascularization
Ghost vessels (corneal)
Pannus (corneal)
H16.8 Other keratitis
H16.9 Keratitis, unspecified
385
386
H20 Iridocyclitis
H20.0 Acute and subacute iridocyclitis
Anterior uveitis
Cyclitis acute, recurrent or subacute of cornea
Iritis
H20.1 Chronic iridocyclitis
H20.2 Lens-induced iridocyclitis
H20.8 Other iridocyclitis
H20.9 Iridocyclitis, unspecified
387
388
Disorders of lens
(H25–H28)
389
390
391
392
394
Glaucoma
(H40–H42)
H40 Glaucoma
Excl.: absolute glaucoma (H44.5)
congenital glaucoma (Q15.0)
traumatic glaucoma due to birth injury (P15.3)
H40.0 Glaucoma suspect
Ocular hypertension
H40.1 Primary open-angle glaucoma
Glaucoma (primary)(residual stage):
• capsular with pseudoexfoliation of lens
• chronic simple
• low-tension
• pigmentary
H40.2 Primary angle-closure glaucoma
Angle-closure glaucoma (primary)(residual stage):
• acute
• chronic
• intermittent
H40.3 Glaucoma secondary to eye trauma
Use additional code, if desired, to identify cause.
H40.4 Glaucoma secondary to eye inflammation
Use additional code, if desired, to identify cause.
H40.5 Glaucoma secondary to other eye disorders
Use additional code, if desired, to identify cause.
H40.6 Glaucoma secondary to drugs
Use additional external cause code (Chapter XX), if desired, to identify drug.
H40.8 Other glaucoma
H40.9 Glaucoma, unspecified
395
396
397
398
399
H50.5 Heterophoria
Alternating hyperphoria
Esophoria
Exophoria
H50.6 Mechanical strabismus
Brown’s sheath syndrome
Strabismus due to adhesions
Traumatic limitation of duction of eye muscle
H50.8 Other specified strabismus
Duane syndrome
H50.9 Strabismus, unspecified
400
401
402
Presenting distance
Category
visual acuity
Equal to or better
Worse than: than:
6/60 3/60
2 Severe visual
1/10 (0.1) 1/20 (0.05)
impairment
20/200 20/400
3/60 1/60*
3 Blindness 1/20 (0.05) 1/50 (0.02)
20/400 5/300 (20/1200)
1/60*
4 Blindness 1/50 (0.02) light perception
5/300 (20/1200)
9 Undetermined or unspecified
403
404
405
CHAPTER VIII
407
408
409
411
412
413
H80 Otosclerosis
Incl.: otospongiosis
H80.0 Otosclerosis involving oval window, nonobliterative
H80.1 Otosclerosis involving oval window, obliterative
H80.2 Cochlear otosclerosis
Otosclerosis involving:
• otic capsule
• round window
H80.8 Other otosclerosis
H80.9 Otosclerosis, unspecified
414
415
416
417
419
420
422
Hypertensive diseases
(I10–I15)
Excl.: complicating pregnancy, childbirth and the puerperium
(O10–O11, O13–O16)
involving coronary vessels (I20–I25)
neonatal hypertension (P29.2)
pulmonary hypertension (I27.0)
423
424
425
426
427
428
429
430
431
432
433
I42 Cardiomyopathy
Excl.: cardiomyopathy complicating:
• pregnancy (O99.4)
• puerperium (O90.3)
ischaemic cardiomyopathy (I25.5)
I42.0 Dilated cardiomyopathy
Congestive cardiomyopathy
I42.1 Obstructive hypertrophic cardiomyopathy
Hypertrophic subaortic stenosis
434
435
436
437
438
439
Cerebrovascular diseases
(I60–I69)
Incl.: with mention of hypertension (conditions in I10 and I15.-)
Use additional code, if desired, to identify presence of hypertension.
Excl.: transient cerebral ischaemic attacks and related syndromes (G45.-)
traumatic intracranial haemorrhage (S06.-)
vascular dementia (F01.-)
440
441
442
443
444
I70 Atherosclerosis
Incl.: arteriolosclerosis
arteriosclerosis
arteriosclerotic vascular disease
atheroma
degeneration:
• arterial
• arteriovascular
• vascular
endarteritis deformans or obliterans
senile:
• arteritis
• endarteritis
Excl.: cerebral (I67.2)
coronary (I25.1)
mesenteric (K55.1)
pulmonary (I27.0)
The following supplementary classification to indicate the presence
or absence of gangrene is provided for optional use with appropriate
subcategories in I70.
0 without gangrene
1 with gangrene
I70.0 Atherosclerosis of aorta
I70.1 Atherosclerosis of renal artery
Goldblatt kidney
Excl.: atherosclerosis of renal arterioles (I12.-)
I70.2 Atherosclerosis of arteries of extremities
Atherosclerotic gangrene
Mönckeberg (medial) sclerosis
I70.8 Atherosclerosis of other arteries
I70.9 Generalized and unspecified atherosclerosis
445
446
447
449
450
451
452
453
I95 Hypotension
Excl.: cardiovascular collapse (R57.9)
maternal hypotension syndrome (O26.5)
nonspecific low blood pressure reading NOS (R03.1)
I95.0 Idiopathic hypotension
I95.1 Orthostatic hypotension
Hypotension, postural
Excl.: neurogenic orthostatic hypotension [Shy–Drager] (G23.8)
I95.2 Hypotension due to drugs
Use additional external cause code (Chapter XX), if desired, to identify drug.
I95.8 Other hypotension
Chronic hypotension
I95.9 Hypotension, unspecified
454
455
Note: When a respiratory condition is described as occurring in more than one site
and is not specifically indexed, it should be classified to the lower anatomic
site (e.g. tracheobronchitis to bronchitis in J40).
Excl.: certain conditions originating in the perinatal period (P00–P96)
certain infectious and parasitic diseases (A00–B99)
complications of pregnancy, childbirth and the puerperium (O00–O99)
congenital malformations, deformations and chromosomal abnormalities
(Q00–Q99)
endocrine, nutritional and metabolic diseases (E00–E90)
injury, poisoning and certain other consequences of external causes
(S00–T98)
neoplasms (C00–D48)
symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified (R00–R99)
457
458
459
460
461
462
463
464
465
466
467
468
469
471
472
J43 Emphysema
Excl.: emphysema:
• compensatory (J98.3)
• due to inhalation of chemicals, gases, fumes or vapours (J68.4)
• interstitial (J98.2)
• interstitial:
–– neonatal (P25.0)
• mediastinal (J98.2)
• surgical (subcutaneous) (T81.8)
• traumatic subcutaneous (T79.7)
• with chronic (obstructive) bronchitis (J44.-)
emphysematous (obstructive) bronchitis (J44.-)
J43.0 MacLeod’s syndrome
Unilateral:
• emphysema
• transparency of lung
J43.1 Panlobular emphysema
Panacinar emphysema
J43.2 Centrilobular emphysema
J43.8 Other emphysema
473
474
J45 Asthma
Excl.: acute severe asthma (J46)
chronic asthmatic (obstructive) bronchitis (J44.-)
chronic obstructive asthma (J44.-)
eosinophilic asthma (J82)
lung diseases due to external agents (J60–J70)
status asthmaticus (J46)
J45.0 Predominantly allergic asthma
Allergic:
• bronchitis NOS
• rhinitis with asthma
Atopic asthma
Extrinsic allergic asthma
Hay fever with asthma
J45.1 Nonallergic asthma
Idiosyncratic asthma
Intrinsic nonallergic asthma
J45.8 Mixed asthma
Combination of conditions listed in J45.0 and J45.1
J45.9 Asthma, unspecified
Asthmatic bronchitis NOS
Late-onset asthma
J47 Bronchiectasis
Incl.: bronchiolectasis
Excl.: congenital bronchiectasis (Q33.4)
tuberculous bronchiectasis (current disease) (A15–A16)
475
476
477
478
479
480
J86 Pyothorax
Incl.: abscess of:
• pleura
• thorax
empyema
pyopneumothorax
Use additional code (B95–B98), if desired, to identify infectious agent.
Excl.: due to tuberculosis (A15–A16)
J86.0 Pyothorax with fistula
J86.9 Pyothorax without fistula
481
J93 Pneumothorax
Excl.: pneumothorax:
• congenital or perinatal (P25.1)
• traumatic (S27.0)
• tuberculous (current disease) (A15–A16)
pyopneumothorax (J86.-)
J93.0 Spontaneous tension pneumothorax
J93.1 Other spontaneous pneumothorax
J93.8 Other pneumothorax
J93.9 Pneumothorax, unspecified
482
483
484
485
487
CHAPTER XI
488
Dilaceration of tooth
Enamel hypoplasia (neonatal)(postnatal)(prenatal)
Regional odontodysplasia
Turner tooth
Excl.: Hutchinson teeth and mulberry molars in congenital syphilis (A50.5)
mottled teeth (K00.3)
K00.5 Hereditary disturbances in tooth structure, not elsewhere
classified
Amelogenesis
Dentinogenesis imperfecta
Odontogenesis
Dentinal dysplasia
Shell teeth
K00.6 Disturbances in tooth eruption
Dentia praecox
Natal
tooth
Neonatal
Premature:
• eruption of tooth
• shedding of primary [deciduous] tooth
Retained [persistent] primary tooth
K00.7 Teething syndrome
K00.8 Other disorders of tooth development
Colour changes during tooth formation
Intrinsic staining of teeth NOS
K00.9 Disorder of tooth development, unspecified
Disorder of odontogenesis NOS
489
490
491
492
K05.4 Periodontosis
Juvenile periodontosis
K05.5 Other periodontal diseases
K05.6 Periodontal disease, unspecified
493
494
495
496
K11.5 Sialolithiasis
Calculus
of salivary gland or duct
Stone
K11.6 Mucocele of salivary gland
Mucous:
• extravasation cyst of salivary gland
• retention cyst
Ranula
K11.7 Disturbances of salivary secretion
Hypoptyalism
Ptyalism
Xerostomia
Excl.: dry mouth NOS (R68.2)
K11.8 Other diseases of salivary glands
Benign lymphoepithelial lesion of salivary gland
Mikulicz disease
Necrotizing sialometaplasia
Sialectasia
Stenosis
of salivary gland
Stricture
Excl.: sicca syndrome [Sjögren] (M35.0)
K11.9 Disease of salivary gland, unspecified
Sialoadenopathy NOS
497
498
including tongue
Erythroplakia
of oral epithelium, including tongue
Leukoedema
Leukokeratosis nicotina palati
Smoker’s palate
Excl.: hairy leukoplakia (K13.3)
K13.3 Hairy leukoplakia
K13.4 Granuloma and granuloma-like lesions of oral mucosa
Eosinophilic granuloma
Granuloma pyogenicum of oral mucosa
Verrucous xanthoma
K13.5 Oral submucous fibrosis
Submucous fibrosis of tongue
K13.6 Irritative hyperplasia of oral mucosa
Excl.: irritative hyperplasia of edentulous ridge [denture hyperplasia]
(K06.2)
K13.7 Other and unspecified lesions of oral mucosa
Focal oral mucinosis
499
Atrophic glossitis
K14.5 Plicated tongue
Fissured
Furrowed tongue
Scrotal
Excl.: fissured tongue, congenital (Q38.3)
K14.6 Glossodynia
Glossopyrosis
Painful tongue
K14.8 Other diseases of tongue
Atrophy
Crenated
(of) tongue
Enlargement
Hypertrophy
K14.9 Disease of tongue, unspecified
Glossopathy NOS
500
K20 Oesophagitis
Incl.: abscess of oesophagus
oesophagitis:
• NOS
• chemical
• peptic
Use additional external cause code (Chapter XX), if desired, to identify cause.
Excl.: erosion of oesophagus (K22.1)
reflux oesophagitis (K21.0)
with gastro-oesophageal reflux disease (K21.0)
501
502
503
504
Diseases of appendix
(K35–K38)
505
Hernia
(K40–K46)
Note: Hernia with both gangrene and obstruction is classified to hernia with
gangrene.
Incl.: hernia:
• acquired
• congenital [except diaphragmatic or hiatus]
• recurrent
506
507
508
509
510
511
512
513
514
515
516
517
518
Diseases of peritoneum
(K65–K67)
K65 Peritonitis
Excl.: peritonitis:
• aseptic (T81.6)
• benign paroxysmal (E85.0)
• chemical (T81.6)
• due to talc or other foreign substance (T81.6)
• neonatal (P78.0–P78.1)
• pelvic, female (N73.3–N73.5)
• periodic familial (E85.0)
• puerperal (O85)
• with or following:
–– abortion or ectopic or molar pregnancy (O00–O07, O08.0)
–– appendicitis (K35.-)
–– diverticular disease of intestine (K57.-)
K65.0 Acute peritonitis
Abscess (of):
• abdominopelvic
• mesenteric
• omentum
• peritoneum
• retrocaecal
• retroperitoneal
• subdiaphragmatic
• subhepatic
• subphrenic
Peritonitis (acute):
• generalized
• pelvic, male
• subphrenic
• suppurative
Use additional code (B95–B98), if desired, to identify infectious agent.
519
520
Diseases of liver
(K70–K77)
Excl.: haemochromatosis (E83.1)
jaundice NOS (R17)
Reye syndrome (G93.7)
viral hepatitis (B15–B19)
Wilson disease (E83.0)
521
522
523
524
K80 Cholelithiasis
K80.0 Calculus of gallbladder with acute cholecystitis
Any condition listed in K80.2 with acute cholecystitis
K80.1 Calculus of gallbladder with other cholecystitis
Any condition listed in K80.2 with cholecystitis (chronic)
Cholecystitis with cholelithiasis NOS
525
K81 Cholecystitis
Excl.: with cholelithiasis (K80.-)
K81.0 Acute cholecystitis
Abscess of gallbladder
Angiocholecystitis
Cholecystitis:
• emphysematous (acute)
without calculus
• gangrenous
• suppurative
Empyema of gallbladder
Gangrene of gallbladder
K81.1 Chronic cholecystitis
K81.8 Other cholecystitis
K81.9 Cholecystitis, unspecified
526
527
528
529
530
531
533
L01 Impetigo
Excl.: impetigo herpetiformis (L40.1)
pemphigus neonatorum (L00)
L01.0 Impetigo [any organism][any site]
Bockhart impetigo
L01.1 Impetiginization of other dermatoses
534
535
L03 Cellulitis
Incl.: acute lymphangitis
Excl.: cellulitis of:
• anal and rectal regions (K61.-)
• external auditory canal (H60.1)
• external genital organs:
–– female (N76.4)
–– male (N48.2, N49.-)
• eyelid (H00.0)
• lacrimal apparatus (H04.3)
• mouth (K12.2)
• nose (J34.0)
eosinophilic cellulitis [Wells] (L98.3)
febrile neutrophilic dermatosis [Sweet] (L98.2)
lymphangitis (chronic)(subacute) (I89.1)
L03.0 Cellulitis of finger and toe
Infection of nail
Onychia
Paronychia
Perionychia
L03.1 Cellulitis of other parts of limb
Axilla
Hip
Shoulder
L03.2 Cellulitis of face
L03.3 Cellulitis of trunk
Abdominal wall
Back [any part]
Chest wall
Groin
Perineum
Umbilicus
Excl.: omphalitis of newborn (P38)
L03.8 Cellulitis of other sites
Head [any part, except face]
Scalp
L03.9 Cellulitis, unspecified
536
537
Bullous disorders
(L10–L14)
Excl.: benign familial pemphigus [Hailey–Hailey] (Q82.8)
staphylococcal scalded skin syndrome (L00)
toxic epidermal necrolysis [Lyell] (L51.2)
L10 Pemphigus
Excl.: pemphigus neonatorum (L00)
L10.0 Pemphigus vulgaris
L10.1 Pemphigus vegetans
L10.2 Pemphigus foliaceus
L10.3 Brazilian pemphigus [fogo selvagem]
L10.4 Pemphigus erythematosus
Senear–Usher syndrome
L10.5 Drug-induced pemphigus
Use additional external cause code (Chapter XX), if desired, to identify drug.
L10.8 Other pemphigus
L10.9 Pemphigus, unspecified
L12 Pemphigoid
Excl.: herpes gestationis (O26.4)
impetigo herpetiformis (L40.1)
L12.0 Bullous pemphigoid
L12.1 Cicatricial pemphigoid
Benign mucous membrane pemphigoid
L12.2 Chronic bullous disease of childhood
Juvenile dermatitis herpetiformis
L12.3 Acquired epidermolysis bullosa
Excl.: epidermolysis bullosa (congenital) (Q81.-)
L12.8 Other pemphigoid
L12.9 Pemphigoid, unspecified
538
539
540
541
542
L29 Pruritus
Excl.: neurotic excoriation (L98.1)
psychogenic pruritus (F45.8)
L29.0 Pruritus ani
L29.1 Pruritus scroti
L29.2 Pruritus vulvae
L29.3 Anogenital pruritus, unspecified
L29.8 Other pruritus
L29.9 Pruritus, unspecified
Itch NOS
543
Papulosquamous disorders
(L40–L45)
L40 Psoriasis
L40.0 Psoriasis vulgaris
Nummular psoriasis
Plaque psoriasis
L40.1 Generalized pustular psoriasis
Impetigo herpetiformis
Von Zumbusch’s disease
L40.2 Acrodermatitis continua
L40.3 Pustulosis palmaris et plantaris
L40.4 Guttate psoriasis
L40.5† Arthropathic psoriasis (M07.0–M07.3*, M09.0*)
L40.8 Other psoriasis
Flexural psoriasis
L40.9 Psoriasis, unspecified
544
L41 Parapsoriasis
Excl.: poikiloderma vasculare atrophicans (L94.5)
L41.0 Pityriasis lichenoides et varioliformis acuta
Mucha–Habermann disease
L41.1 Pityriasis lichenoides chronica
L41.3 Small plaque parapsoriasis
L41.4 Large plaque parapsoriasis
L41.5 Retiform parapsoriasis
L41.8 Other parapsoriasis
L41.9 Parapsoriasis, unspecified
545
L50 Urticaria
Excl.: allergic contact dermatitis (L23.-)
angioneurotic oedema (T78.3)
hereditary angio-oedema (D84.1)
Quincke oedema (T78.3)
urticaria:
• giant (T78.3)
• neonatorum (P83.8)
• papulosa (L28.2)
• pigmentosa (Q82.2)
• serum (T80.6)
• solar (L56.3)
L50.0 Allergic urticaria
L50.1 Idiopathic urticaria
L50.2 Urticaria due to cold and heat
L50.3 Dermatographic urticaria
L50.4 Vibratory urticaria
L50.5 Cholinergic urticaria
L50.6 Contact urticaria
L50.8 Other urticaria
Urticaria:
• chronic
• recurrent periodic
L50.9 Urticaria, unspecified
546
L55 Sunburn
L55.0 Sunburn of first degree
L55.1 Sunburn of second degree
L55.2 Sunburn of third degree
L55.8 Other sunburn
L55.9 Sunburn, unspecified
547
L58 Radiodermatitis
L58.0 Acute radiodermatitis
L58.1 Chronic radiodermatitis
L58.9 Radiodermatitis, unspecified
548
549
550
L68 Hypertrichosis
Incl.: excess hair
Excl.: congenital hypertrichosis (Q84.2)
persistent lanugo (Q84.2)
L68.0 Hirsutism
Use additional external cause code (Chapter XX), if desired, to identify
drug, if drug-induced.
L68.1 Acquired hypertrichosis lanuginosa
Use additional external cause code (Chapter XX), if desired, to identify
drug, if drug-induced.
L68.2 Localized hypertrichosis
L68.3 Polytrichia
L68.8 Other hypertrichosis
L68.9 Hypertrichosis, unspecified
L70 Acne
Excl.: acne keloid (L73.0)
L70.0 Acne vulgaris
L70.1 Acne conglobata
L70.2 Acne varioliformis
Acne necrotica miliaris
L70.3 Acne tropica
L70.4 Infantile acne
L70.5 Acné excoriée
Acné excoriée des jeunes filles
L70.8 Other acne
L70.9 Acne, unspecified
L71 Rosacea
L71.0 Perioral dermatitis
Use additional external cause code (Chapter XX), if desired, to identify
drug, if drug-induced.
L71.1 Rhinophyma
L71.8 Other rosacea
L71.9 Rosacea, unspecified
551
552
L80 Vitiligo
553
554
555
556
557
558
559
CHAPTER XIII
Diseases of the musculoskeletal system
and connective tissue
(M00–M99)
561
562
6 Lower leg
fibula
knee joint
tibia
7 Ankle and foot
metatarsus
tarsus
toes
ankle joint
other joints in foot
8 Other
head
neck
ribs
skull
trunk
vertebral column
9 Site unspecified
563
Arthropathies
(M00–M25)
Incl.: disorders affecting predominantly peripheral (limb) joints
Infectious arthropathies
(M00–M03)
564
565
Inflammatory polyarthropathies
(M05–M14)
566
567
M10 Gout
[See site code at the beginning of this chapter]
M10.0 Idiopathic gout
Gouty bursitis
Primary gout
Urate tophus of heart† (I43.8*)
M10.1 Lead-induced gout
M10.2 Drug-induced gout
Use additional external cause code (Chapter XX), if desired, to identify drug.
M10.3 Gout due to impairment of renal function
Use additional code, if desired, to identify impairment of kidney disease
(N17–N19)
M10.4 Other secondary gout
M10.9 Gout, unspecified
568
569
Arthrosis
(M15–M19)
Note: In this block, the term osteoarthritis is used as a synonym for arthrosis or
osteoarthrosis. The term primary has been used with its customary clinical
meaning of no underlying or determining condition identified.
Excl.: osteoarthritis of spine (M47.-)
M15 Polyarthrosis
Incl.: arthrosis with mention of more than one site
Excl.: bilateral involvement of single joint (M16–M19)
M15.0 Primary generalized (osteo)arthrosis
M15.1 Heberden nodes (with arthropathy)
M15.2 Bouchard nodes (with arthropathy)
M15.3 Secondary multiple arthrosis
Post-traumatic polyarthrosis
M15.4 Erosive (osteo)arthrosis
570
571
572
573
574
0 multiple sites
1 Anterior cruciate ligament or anterior horn of medial meniscus
2 Posterior cruciate ligament or posterior horn of medial meniscus
3 Medial collateral ligament or other and unspecified medial meniscus
4 Lateral collateral ligament or anterior horn of lateral meniscus
5 Posterior horn of lateral meniscus
6 Other and unspecified lateral meniscus
7 Capsular ligament
9 Unspecified ligament or unspecified meniscus
M23.0 Cystic meniscus
M23.1 Discoid meniscus (congenital)
M23.2 Derangement of meniscus due to old tear or injury
Old bucket-handle tear
M23.3 Other meniscus derangements
Degenerate
Detached meniscus
Retained
M23.4 Loose body in knee
M23.5 Chronic instability of knee
M23.6 Other spontaneous disruption of ligament(s) of knee
M23.8 Other internal derangements of knee
Laxity of ligament of knee
Snapping knee
M23.9 Internal derangement of knee, unspecified
576
577
M33 Dermatopolymyositis
M33.0 Juvenile dermatomyositis
M33.1 Other dermatomyositis
M33.2 Polymyositis
M33.9 Dermatopolymyositis, unspecified
578
579
Dorsopathies
(M40–M54)
The following supplementary subclassification to indicate the site of involvement is
provided for optional use with appropriate categories in the block on dorsopathies,
except categories M50 and M51; see also note at the beginning of this chapter.
580
7 Lumbosacral region
8 Sacral and sacrococcygeal region
9 Site unspecified
Deforming dorsopathies
(M40–M43)
M41 Scoliosis
[See site code before M40]
Incl.: kyphoscoliosis
Excl.: congenital scoliosis:
• NOS (Q67.5)
• due to bony malformation (Q76.3)
• postural (Q67.5)
kyphoscoliotic heart disease (I27.1)
postprocedural (M96.-)
M41.0 Infantile idiopathic scoliosis
M41.1 Juvenile idiopathic scoliosis
Adolescent scoliosis
M41.2 Other idiopathic scoliosis
M41.3 Thoracogenic scoliosis
581
582
M43.6 Torticollis
Excl.: torticollis:
• congenital (sternomastoid) (Q68.0)
• current injury – see injury of spine by body region
• due to birth injury (P15.2)
• psychogenic (F45.8)
• spasmodic (G24.3)
M43.8 Other specified deforming dorsopathies
Excl.: kyphosis and lordosis (M40.-)
scoliosis (M41.-)
M43.9 Deforming dorsopathy, unspecified
Curvature of spine NOS
Spondylopathies
(M45–M49)
M47 Spondylosis
[See site code before M40]
Incl.: arthrosis or osteoarthritis of spine
degeneration of facet joints
583
584
Other dorsopathies
(M50–M54)
Excl.: current injury – see injury of spine by body region
discitis NOS (M46.4)
585
M54 Dorsalgia
[See site code before M40]
Excl.: psychogenic dorsalgia (F45.4)
M54.0 Panniculitis affecting regions of neck and back
Excl.: panniculitis:
• NOS (M79.3)
• lupus (L93.2)
• relapsing [Weber-Christian] (M35.6)
M54.1 Radiculopathy
Neuritis or radiculitis:
• brachial NOS
• lumbar NOS
• lumbosacral NOS
• thoracic NOS
Radiculitis NOS
Excl.: neuralgia and neuritis NOS (M79.2)
radiculopathy with:
• cervical disc disorder (M50.1)
• lumbar and other intervertebral disc disorder (M51.1)
• spondylosis (M47.2)
586
M54.2 Cervicalgia
Excl.: cervicalgia due to intervertebral cervical disc disorder (M50.-)
M54.3 Sciatica
Excl.: lesion of sciatic nerve (G57.0)
sciatica:
• due to intervertebral disc disorder (M51.1)
• with lumbago (M54.4)
M54.4 Lumbago with sciatica
Excl.: due to intervertebral disc disorder (M51.1)
M54.5 Low back pain
Loin pain
Low back strain
Lumbago NOS
Excl.: lumbago:
• due to intervertebral disc displacement (M51.2)
• with sciatica (M54.4)
M54.6 Pain in thoracic spine
Excl.: pain due to intervertebral disc disorder (M51.-)
M54.8 Other dorsalgia
M54.9 Dorsalgia, unspecified
Backache NOS
Disorders of muscles
(M60–M63)
Excl.: dermatopolymyositis (M33.-)
muscular dystrophies and myopathies (G71–G72)
myopathy in:
• amyloidosis (E85.-)
• polyarteritis nodosa (M30.0)
• rheumatoid arthritis (M05.3)
• scleroderma (M34.-)
• Sjögren syndrome (M35.0)
• systemic lupus erythematosus (M32.-)
587
M60 Myositis
[See site code at the beginning of this chapter]
M60.0 Infective myositis
Tropical pyomyositis
Use additional code (B95–B98), if desired, to identify infectious agent.
M60.1 Interstitial myositis
M60.2 Foreign body granuloma of soft tissue, not elsewhere classified
Excl.: foreign body granuloma of skin and subcutaneous tissue (L92.3)
M60.8 Other myositis
M60.9 Myositis, unspecified
588
589
590
591
592
593
596
597
Other osteopathies
(M86–M90)
Excl.: postprocedural osteopathies (M96.-)
M86 Osteomyelitis
[See site code at the beginning of this chapter]
Use additional code (B95–B98), if desired, to identify infectious agent.
Excl.: osteomyelitis (of):
• due to Salmonella (A01–A02)
• jaw (K10.2)
• vertebra (M46.2)
M86.0 Acute haematogenous osteomyelitis
M86.1 Other acute osteomyelitis
M86.2 Subacute osteomyelitis
M86.3 Chronic multifocal osteomyelitis
M86.4 Chronic osteomyelitis with draining sinus
M86.5 Other chronic haematogenous osteomyelitis
M86.6 Other chronic osteomyelitis
M86.8 Other osteomyelitis
Brodie’s abscess
M86.9 Osteomyelitis, unspecified
Infection of bone NOS
Periostitis without mention of osteomyelitis
M87 Osteonecrosis
[See site code at the beginning of this chapter]
Incl.: avascular necrosis of bone
Excl.: osteochondropathies (M91–M93)
osteonecrosis of jaw (drug-induced) (radiation induced) (K10.2)
599
600
Chondropathies
(M91–M94)
Excl.: postprocedural chondropathies (M96.-)
601
M91.3 Pseudocoxalgia
M91.8 Other juvenile osteochondrosis of hip and pelvis
Juvenile osteochondrosis after reduction of congenital dislocation of hip
M91.9 Juvenile osteochondrosis of hip and pelvis, unspecified
602
603
604
605
606
CHAPTER XIV
injury, poisoning and certain other consequences of external causes
(S00–T98)
neoplasms (C00–D48)
symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified (R00–R99)
607
Glomerular diseases
(N00–N08)
Use additional code, if desired, to identify associated chronic kidney disease (N18.-) .
Use additional code, if desired, to identify external cause (Chapter XX) or presence of
renal failure, acute (N17.-) or unspecified, (N19).
Excl.: hypertensive renal disease (I12.-)
The following fourth-character subdivisions classify morphological changes and are for
use with categories N00–N07. Subdivisions .0–.8 should not normally be used unless
these have been specifically identified (e.g. by renal biopsy or autopsy). The three-
character categories relate to clinical syndromes.
.0 Minor glomerular abnormality
Minimal change lesion
.1 Focal and segmental glomerular lesions
Focal and segmental:
••hyalinosis
••sclerosis
Focal glomerulonephritis
.2 Diffuse membranous glomerulonephritis
.3 Diffuse mesangial proliferative glomerulonephritis
.4 Diffuse endocapillary proliferative glomerulonephritis
.5 Diffuse mesangiocapillary glomerulonephritis
Membranoproliferative glomerulonephritis, types 1 and 3, or NOS
.6 Dense deposit disease
Membranoproliferative glomerulonephritis, type 2
.7 Diffuse crescentic glomerulonephritis
Extracapillary glomerulonephritis
.8 Other
Proliferative glomerulonephritis NOS
.9 Unspecified
608
609
610
611
612
613
614
Renal failure
(N17–N19)
Use additional external cause code (Chapter XX), if desired, to identify external agent.
Excl.: congenital renal failure (P96.0)
drug- and heavy-metal-induced tubulo-interstitial and tubular conditions
(N14.-)
extrarenal uraemia (R39.2)
haemolytic-uraemic syndrome (D59.3)
hepatorenal syndrome (K76.7)
hepatorenal syndrome:
• postpartum (O90.4)
prerenal uraemia (R39.2)
renal failure:
• complicating abortion or ectopic or molar pregnancy (O00–O07, O08.4)
• following labour and delivery (O90.4)
• postprocedural (N99.0)
615
616
Urolithiasis
(N20–N23)
617
618
619
N30 Cystitis
Use additional code, if desired, to identify infectious agent (B95–B98) or
responsible external agent (Chapter XX).
Excl.: prostatocystitis (N41.3)
N30.0 Acute cystitis
Excl.: irradiation cystitis (N30.4)
trigonitis (N30.3)
N30.1 Interstitial cystitis (chronic)
N30.2 Other chronic cystitis
N30.3 Trigonitis
Urethrotrigonitis
N30.4 Irradiation cystitis
N30.8 Other cystitis
Abscess of bladder
N30.9 Cystitis, unspecified
620
621
622
623
624
625
N48.3 Priapism
Painful erection
N48.4 Impotence of organic origin
Use additional code, if desired, to identify cause.
Excl.: psychogenic impotence (F52.2)
N48.5 Ulcer of penis
N48.6 Induratio penis plastica
Peyronie disease
Plastic induration of penis
N48.8 Other specified disorders of penis
Atrophy
Hypertrophy of corpus cavernosum and penis
Thrombosis
N48.9 Disorder of penis, unspecified
626
627
Disorders of breast
(N60–N64)
Excl.: disorders of breast associated with childbirth (O91–O92)
628
630
631
N80 Endometriosis
N80.0 Endometriosis of uterus
Adenomyosis
N80.1 Endometriosis of ovary
N80.2 Endometriosis of fallopian tube
N80.3 Endometriosis of pelvic peritoneum
N80.4 Endometriosis of rectovaginal septum and vagina
N80.5 Endometriosis of intestine
N80.6 Endometriosis in cutaneous scar
N80.8 Other endometriosis
Endometriosis of thorax
N80.9 Endometriosis, unspecified
632
633
634
635
636
637
638
639
640
641
642
The codes included in this chapter are to be used for conditions related to or aggravated
by the pregnancy, childbirth or by the puerperium (maternal causes or obstetric causes)
Excl.: Certain diseases or injuries complicating pregnancy, childbirth and the
CHAPTER XV
puerperium classified elsewhere:
• external causes (for mortality) (V01–Y89)
• injury, poisoning and certain other consequences of external cause (S00–
T88.1, T88.6–T98)
• mental and behavioural disorders associated with the puerperium (F53.-)
• obstetrical tetanus (A34)
• postpartum necrosis of pituitary gland (E23.0)
• puerperal osteomalacia (M83.0)
supervision of:
• high-risk pregnancy (Z35.-)
• normal pregnancy (Z34.-)
643
644
645
646
647
648
649
O14 Pre-eclampsia
Excl.: superimposed pre-eclampsia (O11)
O14.0 Mild to moderate pre-eclampsia
O14.1 Severe pre-eclampsia
O14.2 HELLP syndrome
Combination of haemolysis, elevated liver enzymes and low platelet count
O14.9 Pre-eclampsia, unspecified
O15 Eclampsia
Incl.: convulsions following conditions in O10–O14 and O16
eclampsia with pregnancy-induced or pre-existing hypertension
O15.0 Eclampsia in pregnancy
O15.1 Eclampsia in labour
O15.2 Eclampsia in the puerperium
O15.9 Eclampsia, unspecified as to time period
Eclampsia NOS
650
651
652
653
654
655
656
657
658
659
O40 Polyhydramnios
Incl.: Hydramnios
660
661
662
663
664
665
667
668
669
670
Delivery
(O80–O84)
Note: For use of these categories, reference should be made to the mortality and
morbidity coding rules and guidelines in Volume 2.
671
672
673
674
675
676
677
678
679
680
Incl.: conditions that have their origin in the perinatal period even though death
or morbidity occurs later
Excl.: congenital malformations, deformations and chromosomal abnormalities
(Q00–Q99)
endocrine, nutritional and metabolic diseases (E00–E90)
injury, poisoning and certain other consequences of external causes
(S00–T98)
neoplasms (C00–D48)
tetanus neonatorum (A33)
CHAPTER XVI
This chapter contains the following blocks:
P00–P04 Fetus and newborn affected by maternal factors and by complications of
pregnancy, labour and delivery
P05–P08 Disorders related to length of gestation and fetal growth
P10–P15 Birth trauma
P20–P29 Respiratory and cardiovascular disorders specific to the perinatal period
P35–P39 Infections specific to the perinatal period
P50–P61 Haemorrhagic and haematological disorders of fetus and newborn
P70–P74 Transitory endocrine and metabolic disorders specific to fetus and newborn
P75–P78 Digestive system disorders of fetus and newborn
P80–P83 Conditions involving the integument and temperature regulation of fetus
and newborn
P90–P96 Other disorders originating in the perinatal period
681
682
683
684
685
686
687
Birth trauma
(P10–P15)
688
689
690
691
692
693
694
695
696
697
698
P57 Kernicterus
P57.0 Kernicterus due to isoimmunization
P57.8 Other specified kernicterus
Excl.: Crigler–Najjar syndrome (E80.5)
P57.9 Kernicterus, unspecified
699
700
701
702
703
704
705
706
CHAPTER XVII
707
Q01 Encephalocele
Incl.: encephalomyelocele
hydroencephalocele
hydromeningocele, cranial
meningocele, cerebral
meningoencephalocele
Excl.: Meckel–Gruber syndrome (Q61.9)
Q01.0 Frontal encephalocele
Q01.1 Nasofrontal encephalocele
Q01.2 Occipital encephalocele
Q01.8 Encephalocele of other sites
Q01.9 Encephalocele, unspecified
Q02 Microcephaly
Incl.: hydromicrocephaly
micrencephalon
Excl.: Meckel–Gruber syndrome (Q61.9)
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
Q54 Hypospadias
Excl.: epispadias (Q64.0)
Q54.0 Hypospadias, balanic
Hypospadias:
• coronal
• glandular
Q54.1 Hypospadias, penile
Q54.2 Hypospadias, penoscrotal
Q54.3 Hypospadias, perineal
Q54.4 Congenital chordee
Q54.8 Other hypospadias
Q54.9 Hypospadias, unspecified
733
734
735
736
737
738
739
Q69 Polydactyly
Q69.0 Accessory finger(s)
Q69.1 Accessory thumb(s)
Q69.2 Accessory toe(s)
Accessory hallux
Q69.9 Polydactyly, unspecified
Supernumerary digit(s) NOS
Q70 Syndactyly
Q70.0 Fused fingers
Complex syndactyly of fingers with synostosis
Q70.1 Webbed fingers
Simple syndactyly of fingers without synostosis
Q70.2 Fused toes
Complex syndactyly of toes with synostosis
Q70.3 Webbed toes
Simple syndactyly of toes without synostosis
Q70.4 Polysyndactyly
Q70.9 Syndactyly, unspecified
Symphalangy NOS
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
This chapter includes symptoms, signs, abnormal results of clinical or other investigative
procedures, and ill-defined conditions regarding which no diagnosis classifiable
elsewhere is recorded.
Signs and symptoms that point rather definitely to a given diagnosis have been assigned
to a category in other chapters of the classification. In general, categories in this chapter
include the less well-defined conditions and symptoms that, without the necessary
study of the case to establish a final diagnosis, point perhaps equally to two or more
diseases or to two or more systems of the body. Practically all categories in the chapter
could be designated ‘not otherwise specified’, ‘unknown etiology’ or ‘transient’. The
Alphabetical index should be consulted to determine which symptoms and signs are to
be allocated here and which to other chapters. The residual subcategories, numbered .8,
are generally provided for other relevant symptoms that cannot be allocated elsewhere
in the classification.
The conditions and signs or symptoms included in categories R00–R99 consist of:
a) cases for which no more specific diagnosis can be made even after all the facts
bearing on the case have been investigated;
CHAPTER XVIII
b) signs or symptoms existing at the time of initial encounter that proved to be transient
and whose causes could not be determined;
c) provisional diagnoses in a patient who failed to return for further investigation or care;
d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
e) cases in which a more precise diagnosis was not available for any other reason;
f) certain symptoms, for which supplementary information is provided, that represent
important problems in medical care in their own right.
Excl.: abnormal findings on antenatal screening of mother (O28.-)
certain conditions originating in the perinatal period (P00–P96)
757
R40–R46 Symptoms and signs involving cognition, perception, emotional state and
behaviour
R47–R49 Symptoms and signs involving speech and voice
R50–R69 General symptoms and signs
R70–R79 Abnormal findings on examination of blood, without diagnosis
R80–R82 Abnormal findings on examination of urine, without diagnosis
R83–R89 Abnormal findings on examination of other body fluids, substances and
tissues, without diagnosis
R90–R94 Abnormal findings on diagnostic imaging and in function studies,
without diagnosis
R95–R99 Ill-defined and unknown causes of mortality
758
R00.2 Palpitations
Awareness of heart beat
R00.8 Other and unspecified abnormalities of heart beat
R05 Cough
Excl.: cough with haemorrhage (R04.2)
psychogenic cough (F45.3)
760
R06.0 Dyspnoea
Orthopnoea
Shortness of breath
Excl.: transient tachypnoea of newborn (P22.1)
R06.1 Stridor
Excl.: congenital laryngeal stridor (P28.8)
laryngismus (stridulus) (J38.5)
R06.2 Wheezing
R06.3 Periodic breathing
Cheyne–Stokes breathing
R06.4 Hyperventilation
Excl.: psychogenic hyperventilation (F45.3)
R06.5 Mouth breathing
Snoring
Excl.: dry mouth NOS (R68.2)
R06.6 Hiccough
Excl.: psychogenic hiccough (F45.3)
R06.7 Sneezing
R06.8 Other and unspecified abnormalities of breathing
Apnoea NOS
Breath-holding (spells)
Choking sensation
Sighing
Excl.: apnoea (of):
• newborn (P28.4)
• sleep (G47.3)
• sleep:
–– newborn (primary) (P28.3)
761
762
R12 Heartburn
Excl.: dyspepsia
• NOS (R10.1)
• functional (K30)
R13 Dysphagia
Incl.: difficulty in swallowing
R18 Ascites
Incl.: fluid in peritoneal cavity
765
766
767
R26.3 Immobility
Bedfast
Chairfast
R26.8 Other and unspecified abnormalities of gait and mobility
Unsteadiness on feet NOS
768
R35 Polyuria
Incl.: frequency of micturition
nocturia
Excl.: psychogenic polyuria (F45.3)
769
770
771
772
773
R51 Headache
Incl.: Facial pain NOS
Excl.: atypical facial pain (G50.1)
migraine and other headache syndromes (G43–G44)
trigeminal neuralgia (G50.0)
774
Excl.: debility:
• congenital (P96.9)
• senile (R54)
exhaustion and fatigue (due to)(in):
• combat (F43.0)
• excessive exertion (T73.3)
• exposure (T73.2)
• heat (T67.-)
• neurasthenia (F48.0)
• pregnancy (O26.8)
• senile asthenia (R54)
fatigue syndrome (F48.0)
fatigue syndrome:
• postviral (G93.3)
R54 Senility
Incl.: old age
without mention of psychosis
senescence
senile:
• asthenia
• debility
Excl.: senile psychosis (F03)
775
776
R61 Hyperhidrosis
R61.0 Localized hyperhidrosis
R61.1 Generalized hyperhidrosis
777
778
R64 Cachexia
Excl.: HIV disease resulting in wasting syndrome (B22.2)
malignant cachexia (C80.-)
nutritional marasmus (E41)
779
780
781
782
783
R81 Glycosuria
Excl.: renal glycosuria (E74.8)
784
785
786
787
788
789
790
T33–T35 Frostbite
T36–T50 Poisoning by drugs, medicaments and biological substances
T51–T65 Toxic effects of substances chiefly nonmedicinal as to source
T66–T78 Other and unspecified effects of external causes
T79 Certain early complications of trauma
T80–T88 Complications of surgical and medical care, not elsewhere classified
T90–T98 Sequelae of injuries, of poisoning and of other consequences of
external causes
791
The chapter uses the S-section for coding different types of injuries related to single
body regions and the T-section to cover injuries to multiple or unspecified body regions,
as well as poisoning and certain other consequences of external causes.
Where multiple sites of injury are specified in the titles, the word ‘with’ indicates
involvement of both sites, and the word ‘and’ indicates involvement of either or both sites.
The principle of multiple coding of injuries should be followed wherever possible.
Combination categories for multiple injuries are provided for use when there is
insufficient detail as to the nature of the individual conditions, or for primary tabulation
purposes when it is more convenient to record a single code; otherwise, the component
injuries should be coded separately. Reference should also be made to the morbidity or
mortality coding rules and guidelines in Volume 2.
The blocks of the S-section as well as T00–T14 and T90–T98 contain injuries at the
three-character level classified by type as follows:
Superficial injury including:
•• abrasion
•• blister (nonthermal)
•• contusion, including bruise and haematoma
•• injury from superficial foreign body (splinter) without major open wound
•• insect bite (nonvenomous)
Open wound including:
•• animal bite
•• cut
•• laceration
•• puncture wound:
––NOS
––with (penetrating) foreign body
792
Fracture including:
fracture
closed:
• comminuted
• depressed
• elevated
• fissured
• greenstick
with or without delayed healing
• impacted
• linear
• simple
• slipped epiphysis
• spiral
•• dislocated
•• displaced
fracture
open:
• compound
• infected
with or without delayed healing
• missile
• puncture
• with foreign body
Excl.: fracture:
• pathological (M84.4)
• with osteoporosis (M80.-)
• stress (M84.3)
malunion of fracture (M84.0)
nonunion of fracture [pseudoarthrosis] (M84.1)
Dislocation, sprain and strain including:
avulsion
laceration
sprain
strain cartilage
traumatic: of joint (capsule)
• haemarthrosis ligament
• rupture
• subluxation
• tear
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
824
825
826
827
828
829
830
831
832
833
834
836
837
838
839
840
841
842
T09.4 Injury of unspecified nerve, spinal nerve root and plexus of trunk
T09.5 Injury of unspecified muscle and tendon of trunk
T09.6 Traumatic amputation of trunk, level unspecified
T09.8 Other specified injuries of trunk, level unspecified
T09.9 Unspecified injury of trunk, level unspecified
843
844
845
846
847
848
849
850
T24 Burn and corrosion of hip and lower limb, except ankle
and foot
Incl.: leg [any part, except ankle and foot alone]
Excl.: burn and corrosion of ankle and foot alone (T25.-)
T24.0 Burn of unspecified degree of hip and lower limb, except ankle
and foot
T24.1 Burn of first degree of hip and lower limb, except ankle and foot
T24.2 Burn of second degree of hip and lower limb, except ankle
and foot
851
T24.3 Burn of third degree of hip and lower limb, except ankle and foot
T24.4 Corrosion of unspecified degree of hip and lower limb, except
ankle and foot
T24.5 Corrosion of first degree of hip and lower limb, except ankle
and foot
T24.6 Corrosion of second degree of hip and lower limb, except
ankle and foot
T24.7 Corrosion of third degree of hip and lower limb, except ankle
and foot
852
853
854
Frostbite
(T33–T35)
Excl.: hypothermia and other effects of reduced temperature (T68–T69)
855
856
857
T36.3 Macrolides
T36.4 Tetracyclines
T36.5 Aminoglycosides
Streptomycin
T36.6 Rifamycins
T36.7 Antifungal antibiotics, systemically used
T36.8 Other systemic antibiotics
T36.9 Systemic antibiotic, unspecified
858
859
860
861
862
863
864
865
866
867
868
869
870
871
T68 Hypothermia
Incl.: accidental hypothermia
Excl.: frostbite (T33–T35)
hypothermia (of):
• following anaesthesia (T88.5)
• newborn (P80.-)
• not associated with low environmental temperature (R68.0)
872
Trench foot
T69.1 Chilblains
T69.8 Other specified effects of reduced temperature
T69.9 Effect of reduced temperature, unspecified
T71 Asphyxiation
Incl.: suffocation (by strangulation)
systemic oxygen deficiency due to:
• low oxygen content in ambient air
• mechanical threat to breathing
Excl.: anoxia due to high altitude (T70.2)
asphyxia from:
• carbon monoxide (T58)
• inhalation of food or foreign body (T17.-)
• other gases, fumes and vapours (T59.-)
respiratory distress:
• syndrome in adult (J80)
• in newborn (P22.-)
873
874
875
876
877
878
879
880
882
884
885
886
887
888
889
890
891
892
893
894
1 Residential institution
Children’s home
Dormitory
Home for the sick
Hospice
Military camp
Nursing home
Old people’s home
Orphanage
Pensioner’s home
Prison
Reform school
2 School, other institution and public administrative area
Building (including adjacent grounds) used by the general public or by a
particular group of the public such as:
••assembly hall
••campus
••church
••cinema
••clubhouse
••college
••court-house
••dancehall
••day nursery
••gallery
895
••hospital
••institute for higher education
••kindergarten
••library
••movie-house
••museum
••music-hall
••opera-house
••post office
••public hall
••school (private)(public)(state)
••theatre
••university
••youth centre
Excl.: building under construction (6)
residential institution (1)
sports and athletics area (3)
896
897
898
Activity code
The following categories are provided to be used as separate variables in addition to
categories V01–Y34, to indicate the activity of the injured person at the time the event
occurred. This supplementary classification should not be confused with, or be used
instead of, the recommended categories provided to indicate the place of occurrence of
events classifiable to W00–Y34.
0 While engaged in sports activity
Physical exercise with a described functional element, such as:
••golf
••jogging
••riding
••school athletics
••skiing
••swimming
••trekking
••water-skiing
1 While engaged in leisure activity
Hobby activities
Leisure-time activities with an entertainment element such as going to the cinema,
to a dance or to a party
Participation in sessions and activities of voluntary organizations
Excl.: sports activities (0)
2 While working for income
Paid work (manual)(professional)
Transportation (time) to and from such activities
Work for salary, bonus and other types of income
3 While engaged in other types of work
Domestic duties such as:
••caring for children and relatives
••cleaning
••cooking
••gardening
••household maintenance
Duties for which one would not normally gain an income
Learning activities, e.g. attending school session or lesson
Undergoing education
4 While resting, sleeping, eating or engaging in other vital activities
Personal hygiene
8 While engaged in other specified activities
9 During unspecified activity
899
Accidents
(V01–X59)
Transport accidents
(V01–V99)
900
d) A nontraffic accident is any vehicle accident that occurs entirely in any place other
than a public highway.
e) A pedestrian is any person involved in an accident who was not at the time of the
accident riding in or on a motor vehicle, railway train, streetcar or animal-drawn or
other vehicle, or on a pedal cycle or animal.
Incl.: person:
• changing tyre of vehicle
• making adjustment to motor of vehicle
• on foot
user of a pedestrian conveyance such as:
• baby carriage
• ice-skates
• perambulator
• push-cart
• push-chair
• roller-skates
• scooter
• skateboard
• skis
• sled
• wheelchair (powered)
f) A driver is an occupant of a transport vehicle who is operating or intending to
operate it.
g) A passenger is any occupant of a transport vehicle other than the driver.
Excl.: person travelling on outside of vehicle – see definition (h)
h) A person on outside of vehicle is any person being transported by a vehicle but not
occupying the space normally reserved for the driver or passengers, or the space
intended for the transport of property.
Incl.: person (travelling on):
• bodywork
• bumper [fender]
• hanging on outside
• roof (rack)
• running-board
• step
i) A pedal cycle is any land transport vehicle operated solely by pedals.
Incl.: bicycle
tricycle
Excl.: motorized bicycle – see definition (k)
j) A pedal cyclist is any person riding on a pedal cycle or in a sidecar or trailer attached
to such a vehicle.
901
k) A motorcycle is a two-wheeled motor vehicle with one or two riding saddles and
sometimes with a third wheel for the support of a sidecar. The sidecar is considered
part of the motorcycle.
Incl.: moped
motor scooter
motorcycle:
• NOS
• combination
• with sidecar
motorized bicycle
speed-limited motor-driven cycle
Excl.: motor-driven tricycle – see definition (m)
l) A motorcycle rider is any person riding on a motorcycle or in a sidecar or trailer
attached to such a vehicle.
m) A three-wheeled motor vehicle is a motorized tricycle designed primarily for on-
road use.
Incl.: motor-driven tricycle
motorized rickshaw
three-wheeled motor car
Excl.: motorcycle with sidecar – see definition (k)
special all-terrain vehicle – see definition (x)
n) A car [automobile] is a four-wheeled motor vehicle designed primarily for carrying
up to 10 persons. A trailer or caravan being towed by a car is considered a part of
the car.
Incl.: minibus
o) A motor vehicle or vehicle may refer to various transport vehicles. The local usage
of the terms should be established to determine the appropriate code. If the terms
are used ambiguously, use the code for ‘unspecified’. A trailer or caravan being
towed by a vehicle is considered a part of the vehicle.
p) A pick-up truck or van is a four- or six-wheeled motor vehicle designed primarily
for carrying property, weighing less than the local limit for classification as a heavy
goods vehicle, and not requiring a special driver’s licence.
q) A heavy transport vehicle is a motor vehicle designed primarily for carrying
property, meeting local criteria for classification as a heavy goods vehicle in terms
of kerbside weight (usually above 3500 kg), and requiring a special driver’s licence.
r) A bus is a motor vehicle designed or adapted primarily for carrying more than 10
persons, and requiring a special driver’s licence.
Incl.: coach
902
s) A railway train or railway vehicle is any device, with or without cars coupled to it,
designed for traffic on a railway.
Incl.: interurban:
• electric car (operated chiefly on its own right-of-way, not open
• streetcar to other traffic)
railway train, any power [diesel][electric][steam]:
• funicular
• monorail or two-rail
• subterranean or elevated
other vehicle designed to run on a railway track
Excl.: interurban electric cars [streetcars] specified to be operating on a right-of-
way that forms part of the public street or highway – see definition (t)
t) A streetcar is a device designed and used primarily for transporting persons within
a municipality, running on rails, usually subject to normal traffic control signals,
and operated principally on a right-of-way that forms part of the roadway. A trailer
being towed by a streetcar is considered a part of the streetcar.
Incl.: interurban electric car or streetcar, when specified to be operating on a
street or public highway
tram (car)
trolley (car)
u) A special vehicle mainly used on industrial premises is a motor vehicle designed
primarily for use within the buildings and premises of industrial or commercial
establishments.
Incl.: battery-powered:
• airport passenger vehicle
• truck (baggage)(mail)
coal-car in mine
forklift (truck)
logging car
self-propelled truck, industrial
station baggage truck (powered)
tram, truck or tub (powered) in mine or quarry
v) A special vehicle mainly used in agriculture is a motor vehicle designed specifically
for use in farming and agriculture (horticulture), for example to work the land, tend
and harvest crops and transport materials on the farm.
Incl.: combine harvester
self-propelled farm machinery
tractor (and trailer)
903
w) A special construction vehicle is a motor vehicle designed specifically for use in the
construction (and demolition) of roads, buildings and other structures.
Incl.: bulldozer
digger
dumper truck
earth-leveller
mechanical shovel
road-roller
x) A special all-terrain vehicle is a motor vehicle of special design to enable it
to negotiate rough or soft terrain or snow. Examples of special design are high
construction, special wheels and tyres, tracks, and support on a cushion of air.
Incl.: hovercraft on land or swamp
snowmobile
Excl.: hovercraft on open water – see definition (y)
y) A watercraft is any device for transporting passengers or goods on water.
Incl.: hovercraft NOS
z) An aircraft is any device for transporting passengers or goods in the air.
904
3. Where transport accident descriptions do not specify the victim as being a vehicle
occupant and the victim is described as:
animal being ridden
animal-drawn vehicle
bicycle
bulldozer
bus
crushed car
dragged motorcycle
hit motorized tricycle
injured by any vehicle including
killed pick-up (truck)
knocked down recreational vehicle
run over streetcar
tractor
train
tram
truck
van
4. Where transport accident descriptions do not indicate the victim’s role, such as:
aeroplane
bicycle
boat
bulldozer
bus
car
motorcycle
motorized tricycle accident
pick-up (truck) collision
NOS
recreational vehicle crash
spacecraft wreck
streetcar
tractor
train
tram
truck
van
watercraft
905
If more than one vehicle is mentioned, do not make any assumption as to which
vehicle was occupied by the victim unless the vehicles are the same. Instead, code
to the appropriate categories V87–V88, V90–V94, V95–V97, taking into account
the order of precedence given in note 2 above.
5. Where a transport accident, such as:
vehicle (motor)(nonmotor):
• failing to make curve
• going out of control (due to):
–– burst tyre [blowout]
–– driver falling asleep
–– driver inattention
–– excessive speed
failure of mechanical part
resulted in a subsequent collision, classify the accident as a collision. If an
accident other than a collision resulted, classify it as a noncollision accident,
according to the vehicle type involved.
6. Where a transport accident involving a vehicle in motion, such as:
accidental poisoning from exhaust gas generated by
breakage of any part of
explosion of any part of
fall, jump or being accidentally pushed from vehicle
fire starting in in motion
hit by object thrown into or onto
injured by being thrown against some part of, or object in
injury from moving part of
object falling in or on
906
907
908
909
910
The following fourth-character subdivisions are for use with categories V20–V28:
.0 Driver injured in nontraffic accident
.1 Passenger injured in nontraffic accident
.2 Unspecified motorcycle rider injured in nontraffic accident
.3 Person injured while boarding or alighting
.4 Driver injured in traffic accident
.5 Passenger injured in traffic accident
.9 Unspecified motorcycle rider injured in traffic accident
911
912
913
914
The following fourth-character subdivisions are for use with categories V40–V48:
.0 Driver injured in nontraffic accident
.1 Passenger injured in nontraffic accident
.2 Person on outside of vehicle injured in nontraffic accident
.3 Unspecified car occupant injured in nontraffic accident
.4 Person injured while boarding or alighting
.5 Driver injured in traffic accident
.6 Passenger injured in traffic accident
.7 Person on outside of vehicle injured in traffic accident
.9 Unspecified car occupant injured in traffic accident
915
916
The following fourth-character subdivisions are for use with categories V50–V58:
.0 Driver injured in nontraffic accident
.1 Passenger injured in nontraffic accident
.2 Person on outside of vehicle injured in nontraffic accident
.3 Unspecified occupant of pick-up truck or van injured in nontraffic accident
.4 Person injured while boarding or alighting
.5 Driver injured in traffic accident
.6 Passenger injured in traffic accident
.7 Person on outside of vehicle injured in traffic accident
.9 Unspecified occupant of pick-up truck or van injured in traffic accident
917
918
The following fourth-character subdivisions are for use with categories V60–V68:
.0 Driver injured in nontraffic accident
.1 Passenger injured in nontraffic accident
.2 Person on outside of vehicle injured in nontraffic accident
.3 Unspecified occupant of heavy transport vehicle injured in nontraffic accident
919
920
921
The following fourth-character subdivisions are for use with categories V70–V78:
.0 Driver injured in nontraffic accident
.1 Passenger injured in nontraffic accident
.2 Person on outside of vehicle injured in nontraffic accident
.3 Unspecified bus occupant injured in nontraffic accident
.4 Person injured while boarding or alighting
.5 Driver injured in traffic accident
.6 Passenger injured in traffic accident
.7 Person on outside of vehicle injured in traffic accident
.9 Unspecified bus occupant injured in traffic accident
922
923
924
925
926
927
928
929
930
The following fourth-character subdivisions are for use with categories V90–V94:
.0 Merchant ship
.1 Passenger ship
Ferry-boat
Liner
.2 Fishing boat
.3 Other powered watercraft
Hovercraft (on open water)
Jet skis
.4 Sailboat
Yacht
.5 Canoe or kayak
.6 Inflatable craft (nonpowered)
.7 Water-skis
.8 Other unpowered watercraft
Surf-board
Windsurfer
.9 Unspecified watercraft
Boat NOS
Ship NOS
Watercraft NOS
931
932
933
934
Falls
(W00–W19)
[See at the beginning of this chapter for the classification of the place of occurrence and
activity]
Excl.: assault (Y01–Y02)
fall (in)(from):
• animal (V80.-)
• burning building (X00)
• into fire (X00–X04, X08–X09)
• into water (with drowning or submersion) (W65–W74)
• machinery (in operation) (W28–W31)
• repeated falls not resulting from accident (R29.6)
• transport vehicle (V01–V99)
intentional self-harm (X80–X81)
935
936
938
939
940
941
• factory
• grain store
• munitions
explosive gas
942
W60 Contact with plant thorns and spines and sharp leaves
943
944
• mother’s body
• pillow
945
946
947
X10 Contact with hot drinks, food, fats and cooking oils
949
950
951
956
957
Intentional self-harm
(X60–X84)
[See at the beginning of this chapter for the classification of the place of occurrence and activity]
Incl.: purposely self-inflicted poisoning or injury
suicide (attempted)
958
960
961
Assault
(X85–Y09)
[See at the beginning of this chapter for the classification of the place of occurrence and activity]
Incl.: homicide
injuries inflicted by another person with intent to injure or kill,
by any means
Excl.: injuries due to:
• legal intervention (Y35.-)
• operations of war (Y36.-)
962
963
964
965
967
968
969
970
971
Y40.4 Tetracyclines
Y40.5 Aminoglycosides
Streptomycin
Y40.6 Rifamycins
Y40.7 Antifungal antibiotics, systemically used
Y40.8 Other systemic antibiotics
Y40.9 Systemic antibiotic, unspecified
972
973
974
975
976
977
978
Y55.3 Antitussives
Y55.4 Expectorants
Y55.5 Anti-common-cold drugs
Y55.6 Antiasthmatics, not elsewhere classified
Aminophylline
Salbutamol
Theobromine
Theophylline
Excl.: beta-adrenoreceptor agonists (Y51.5)
anterior pituitary [adenohypophyseal] hormones (Y42.8)
Y55.7 Other and unspecified agents primarily acting on the
respiratory system
979
981
982
983
984
986
987
988
Note: This chapter should not be used for international comparison or for primary
mortality coding.
Categories Z00–Z99 are provided for occasions when circumstances other
than a disease, injury or external cause classifiable to categories A00–Y89
are recorded as ‘diagnoses’ or ‘problems’. This can arise in two main ways:
a) When a person who may or may not be sick encounters the health
services for some specific purpose, such as to receive limited care or
service for a current condition, to donate an organ or tissue, to receive
prophylactic vaccination or to discuss a problem which is in itself not a
disease or injury.
b) When some circumstance or problem is present which influences the
person’s health status but is not in itself a current illness or injury. Such
factors may be elicited during population surveys, when the person may
or may not be currently sick, or be recorded as an additional factor to
be borne in mind when the person is receiving care for some illness or
injury.
989
990
991
992
993
994
995
996
997
998
999
1000
1001
1002
1003
1004
1005
1006
1007
1008
Z54 Convalescence
Z54.0 Convalescence following surgery
Z54.1 Convalescence following radiotherapy
Z54.2 Convalescence following chemotherapy
Z54.3 Convalescence following psychotherapy
Z54.4 Convalescence following treatment of fracture
Z54.7 Convalescence following combined treatment
Convalescence following any combination of treatments
classified to Z54.0–Z54.4
Z54.8 Convalescence following other treatment
Z54.9 Convalescence following unspecified treatment
1009
1010
1011
1012
1013
1014
1015
1016
1017
1018
1019
1020
1021
1022
1023
1024
1025
1026
1027
1028
1029
1030
1031
1032
CHAPTER XXII
1033
1034
1035
1036
Morphology of neoplasms
The morphology of neoplasms is coded using the International classification of diseases
for oncology (ICD-O). Its morphology list was formerly included in ICD-10, but became
outdated soon, owing to the updates of ICD-O. As a result, it was decided to discontinue
the inclusion of ICD-O codes in ICD-10 from 2016. Interested users can download the
ICD-O lists from the classification website of WHO (www.who.int/classifications).
ICD-O is used mostly in tumour or cancer registries for coding the site (topography) and
the histology (morphology) of neoplasms, usually obtained from a pathology report.
ICD-O is a multi-axial classification of the site, morphology, behaviour and grading of
neoplasms.
The topography axis uses the ICD-10 classification of malignant neoplasms (except those
categories that relate to secondary neoplasms and to specified morphological types of
tumours) for all types of tumours, thereby providing greater site detail for non-malignant
tumours than is provided in ICD-10. In contrast to ICD-10, ICD-O includes topography
for sites of haematopoietic and reticuloendothelial tumours.
The morphology axis provides five-digit codes ranging from M-8000/0 to M-9989/3. The
first four digits indicate the specific histological term. The fifth digit after the slash (/) is
the behaviour code, which indicates whether a tumour is malignant, benign, in situ or
uncertain (whether benign or malignant).
A separate one-digit code is also provided for histologic grading (differentiation).
The one-digit behaviour code is as follows:
/0 Benign
/1 Uncertain whether benign or malignant
1
Borderline malignancy
Low malignant potential
1
/2 Intraepithelial
Noninfiltrating
Noninvasive
/3 Malignant, primary site
/6 Malignant, metastatic site
Malignant, secondary site
/9 Malignant, uncertain whether primary or metastatic site
1
Except cystadenomas of ovary in M844–M849, which are considered to be malignant.
1039
In ICD-O, the morphology code numbers include the behaviour code appropriate to the
histological type of neoplasm.
The following table shows the correspondence between the behaviour code and the
different sections of Chapter II:
Behaviour Chapter II
code categories
/0 Benign neoplasms D10–D36
/1 Neoplasms of uncertain and unknown behaviour D37–D48
/2 In situ neoplasms D00–D09
/3 Malignant neoplasms, stated or
presumed to be primary C00–C76, C80–C97
/6 Malignant neoplasms, stated or
presumed to be secondary C77–C79
The ICD-O behaviour digit /9 is not applicable in the ICD context, since all malignant
neoplasms are presumed to be primary (/3) or secondary (/6), according to other
information on the medical record.
Only the first-listed term of the full ICD-O morphology nomenclature appears against
each code number in the list given here.
Some types of neoplasm are specific to certain sites or types of tissue. For example,
nephroblastoma, by definition, always arises in the kidney; hepatocellular carcinoma
is always primary in the liver; and basal cell carcinoma usually arises in the skin. For
such terms, the appropriate site code has been added in parentheses in ICD-O. The
appropriate fourth character for the reported site should be used. The ICD-O site codes
assigned to the morphologic terms can be used when the site of the neoplasm is not
given in the diagnosis. In ICD-O, site codes have not been assigned to many of the
morphology terms because the histologic types can arise in more than one organ or type
of tissue.
For further detail about the coding of morphology refer to ICD-O.
1040
Note: These lists were adopted by the World Health Assembly in 1990 for the
tabulation of data. They are described, and their use is explained, in Volume
2, the Instruction manual.
1043
1044
1045
1046
1047
1048
1049
1050
1051
1052
1053
1054
1055
1056
1057
1058
1059
1060
1061
1062
1063
Note: These definitions have been adopted by the World Health Assembly
(resolutions WHA20.19 and WHA43.24) under Article 23 of the
Constitution of the World Health Organization.
1. Causes of death
The causes of death to be entered on the medical certificate of cause of death
are all those diseases, morbid conditions or injuries that either resulted in or
contributed to death and the circumstances of the accident or violence that
resulted in any such injuries.
1067
3.8. Pre-term
Less than 37 completed weeks (less than 259 days) of gestation
3.9. Term
From 37 completed weeks to less than 42 completed weeks (259 to 293 days) of
gestation
3.10. Post-term
42 completed weeks or more (294 days or more) of gestation
1068
Notes on definitions
i. For live births, birth weight should preferably be measured within the first
hour of life before significant postnatal weight loss has occurred. While
statistical tabulations include 500g groupings for birth weight, weights
should not be recorded in those groupings. The actual weight should be
recorded to the degree of accuracy to which it is measured.
ii. The definitions of ‘low’, ‘very low’, and ‘extremely low’ birth weight do not
constitute mutually exclusive categories. Below the set limits, they are all-
inclusive and therefore overlap (i.e. ‘low’ includes ‘very low’ and ‘extremely
low’, while ‘very low’ includes ‘extremely low’).
iii. Gestational age is frequently a source of confusion when calculations are
based on menstrual dates. For the purposes of calculation of gestational age
from the date of the first day of the last normal menstrual period and the
date of delivery, it should be borne in mind that the first day is day 0 and not
day 1; days 0–6 therefore correspond to ‘completed week 0’, days 7–13 to
‘completed week 1’, and the 40th week of actual gestation is synonymous
with ‘completed week 39’. Where the date of the last normal menstrual
period is not available, gestational age should be based on the best clinical
estimate. In order to avoid misunderstanding, tabulations should indicate
both weeks and days.
iv. Age at death during the first day of life (day 0) should be recorded in units of
completed minutes or hours of life. For the second (day 1), third (day 2) and
through 27 completed days of life, age at death should be recorded in days.
1069
1070
Article 1
Members of the World Health Organization for whom these Regulations
shall come into force under Article 7 below shall be referred to hereinafter as
Members.
Article 2
Members compiling mortality and morbidity statistics shall do so in accordance
with the current revision of the International Statistical Classification of
Diseases, Injuries and Causes of Death as adopted from time to time by the
World Health Assembly. This Classification may be cited as the International
Classification of Diseases.
Article 3
In compiling and publishing mortality and morbidity statistics, Members shall
comply as far as possible with recommendations made by the World Health
Assembly as to classification, coding procedure, age-grouping, territorial areas
to be identified, and other relevant definitions and standards.
Article 4
Members shall compile and publish annually for each calendar year statistics
of causes of death for the metropolitan (home) territory as a whole or for such
part thereof as information is available, and shall indicate the area covered by
the statistics.
1073
Article 5
Members shall adopt a form of medical certificate of cause of death that provides
for the statement of the morbid conditions or injuries resulting in or contributing
to death, with a clear indication of the underlying cause.
Article 6
Each member shall, under Article 64 of the Constitution, provide the Organization
on request with statistics prepared in accordance with these Regulations and not
communicated under Article 63 of the Constitution.
Article 7
1. These Regulations shall come into force on the first day of January 1968.
2. Upon their entry into force these Regulations shall, subject to the exceptions
hereinafter provided, replace as between the Members bound by these
Regulations and as between these Members and the Organization, the provisions
of the Nomenclature Regulations 1948 and subsequent revisions thereof.
3. Any revisions of the International Classification of Diseases adopted by the
World Health Assembly pursuant to Article 2 of these Regulations shall enter
into force on such date as is prescribed by the World Health Assembly and shall,
subject to the exceptions hereinafter provided, replace any earlier classifications.
Article 8
1. The period provided in execution of Article 22 of the Constitution of the
Organization for rejection or reservation shall be six months from the date of the
notification by the Director-General of the adoption of these Regulations by the
World Health Assembly. Any rejection or reservation received by the Director-
General after the expiry of this period shall have no effect.
2. The provisions of paragraph 1 of this Article shall likewise apply in respect of
any subsequent revision of the International Classification of Diseases adopted
by the World Health Assembly pursuant to Article 2 of these Regulations.
Article 9
A rejection, or the whole or part of any reservation, whether to these Regulations
or to the International Classification of Diseases or any revision thereof, may at
any time be withdrawn by notifying the Director-General.
1074
Article 10
The Director-General shall notify all Members of the adoption of these
Regulations, of the adoption of any revision of the International Classification
of Diseases as well as of any notification received by him under Articles 8 and 9.
Article 11
The original texts of these Regulations shall be deposited in the Archives of
the Organization. Certified true copies shall be sent by the Director-General
to all Members. Upon the entry into force of these Regulations, certified true
copies shall be delivered by the Director-General to the Secretary-General of
the United Nations for registration in cccordance with Article 102 of the Charter
of the United Nations.
In faith whereof, we have set our hands at Geneva this twenty-second day of
May 1967.
1075