2e - Volume 1

Tabular List, 2022

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention

National Center for Health Statistics

INTRODUCTION

A classification of diseases may be defined as a system of categories to which morbid entities are assigned according to established criteria. There are many possible axes of classification and the one selected will depend upon the use to be made of the statistics to be compiled. A statistical classification of diseases must encompass the entire range of morbid conditions within a manageable number of categories.

The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems is the latest in a series that was formalized in 1893 as the Bertillon Classification or International List of Causes of Death. A complete review of the historical background to the classification is given in Part 2a Instruction Manual (NCHS). While the title has been amended to make clearer the content and purpose and to reflect the progressive extension of the scope of the classification beyond diseases and injuries, the familiar abbreviation "ICD" has been retained. In the updated classification, conditions have been grouped in a way that was felt to be most suitable for general epidemiological purposes and the evaluation of health care.

Work on the Tenth Revision of the ICD started in September 1983 when a Preparatory Meeting on ICD-10 was convened in Geneva. The programme of work was guided by regular meetings of Heads of WHO Collaborating Centres for Classification of Diseases. Policy guidance was provided by a number of special meetings including those of the Expert Committee on the International Classification of Disease -Tenth Revision, held in 1984 and 1987.

In addition to the technical contributions provided by many specialist groups and individual experts, a large number of comments and suggestions were received from WHO Member States and Regional Offices as a result of the global circulation of draft proposals for revision in 1984 and 1986. From the comments received, it was clear that many users wished the ICD to encompass types of data other than the "diagnostic information" (in the broadest sense of the term) that it has always covered. In order to accommodate the perceived needs of these users, the concept arose of a "family" of classifications centred on the traditional ICD with its familiar form and structure. The ICD itself would thus meet the requirement for diagnostic information for general purposes, while a variety of other classifications would be used in conjunction with it and would deal either with different approaches to the same information or with different information (notably medical and surgical procedures and disablement).

Following suggestions at the time of development of the Ninth Revision of the classification that a different basic structure might better serve the needs of the many and varied users, several alternative models were evaluated. It became clear, however, that the traditional single-variable-axis design of 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 Tenth 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.

Content of the three volumes of ICD-10

The presentation of the classification has been changed and there are now three volumes:

Volume 1. Tabular List. This contains the report of the International Conference for the Tenth Revision, the classification itself at the three-and four-character levels, the classification of the morphology of neoplasms, special tabulation lists for mortality and morbidity, definitions, and the nomenclature regulations.

Part 2a. Instruction Manual. This brings together the notes on certification and classification formerly included in Volume 1 with a good deal of new background and instructional matter and guidance on the use of Volume 1, on tabulations, and on planning for the use of ICD, which was seen as lacking in earlier revisions. It also includes the historical material formerly presented in the introduction to Volume 1.

Volume 3. Alphabetical Index. This presents the index itself with an introduction and expanded instructions on its use.

                                                           * * *

The classification was approved by the International Conference for the Tenth Revision of the International Classification of Diseases in 1989 and adopted by the Forty-third World Health Assembly in the following resolution:

The Forty-third World Health Assembly,

Having considered the report of the International Conference for the Tenth Revision of the International Classification of Diseases;

1.   ADOPTS the following, recommended by the Conference:

(1)   the detailed list of three-character categories and optional four-character subcategories with the Short Tabulation Lists for Mortality and Morbidity, constituting the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems, due to come into effect on 1 January 1993;

(2)   the definitions, standards and reporting requirements related to maternal, fetal, perinatal, neonatal and infant mortality;

(3)   the rules and instructions for underlying cause coding for mortality and main condition coding for morbidity;

2.   REQUESTS the Director-General to issue the Manual of the International Statistical Classification of Diseases and Related Health Problems;

3.   ENDORSES the recommendations of the Conference concerning:

(1)   the concept and implementation of the family of disease and health-related classifications, with the International Statistical Classification of Diseases and Related Health Problems as the core classification surrounded by a number of related and supplementary classifications and the International Nomenclature of Diseases;

(2)   the establishment of an updating process within the ten-year revision cycle.

Acknowledgements

The periodic revision of the ICD has, since the Sixth Revision in 1948, been coordinated by the World Health Organization. As the use of the classification has increased, so, understandably, has the desire among its users to contribute to the revision process. The Tenth Revision is the product of a vast amount of international activity, cooperation and compromise. WHO acknowledges with gratitude the contributions of the international and national specialist groups and individuals in numerous many countries.

WHO Collaborating Centres for Classification of Diseases

Nine WHO Collaborating Centres for Classification of Diseases have been established to assist countries with problems encountered in the development and use of health-related classifications and, in particular, in the use of the ICD.

It is important that countries bring to the attention of the respective Centre any significant problems they might encounter in the use of the ICD and especially when a new disease for which the ICD does not provide a suitable classification is encountered frequently. Until now the ICD has not been updated between revisions but it has been proposed that, through the Centres, a mechanism will be introduced to provide suitable codes for new diseases where necessary.

In addition to the official WHO Collaborating Centres, there are a number of national reference centres and individual users should first consult these, or their appropriate national office, when they encounter problems.

There are three Centres for English-language users. Communications should be addressed to the Head, WHO Collaborating Centre for Classification of Diseases at:

          Australian Institute of Health

          GPO Box 570

          Canberra ACT 2601,

          Australia

          Office of Population and Censuses and Surveys

          St. Catherine's House

          Kingsway 10

          London WC2B 6JP

          England

          National Center for Health Statistics

          3311 Toledo Road

          Hyattsville, MD 27703

          United States of America

The other six centres, each based on an individual language or group of languages, are located in the following institutions:

          Peking Union Medical College Hospital

          Chinese Academy of Medical Sciences

          Beijing 100730

          China (for Chinese)

          INSERM

          44 Chemin de Ronde

          F-78110 Le Vesinet

          France (for French)

          Department of Social Medicine

          University Hospital

          S-751 85 Uppsala

          Sweden (for the Nordic countries)

          Faculdade de Saude Publica/Universidade de Sao Paulo

          Avenida Dr Arnaldo 715,

          01246-904 Sao Paulo, SP

          Brazil (for Portuguese)

          The N.A. Semasko Institute,

          U1. Obuha 12

          Moscow B-20

          Russian Federation Republic (for Russian)

          Centro Venezolano de Clasificacion de Enfermedades

          Edificio Sur, 9^o Piso

          M.S.A.S.,

          Centro Simon Bolivar,

          P.O. Box 6653

          Caracas

          Venezuela (for Spanish)

Report of the International Conference for the Tenth Revision of the International Classification of Diseases

The International Conference for the Tenth Revision of the International Classification of Diseases was convened by the World Health Organization at WHO headquarters in Geneva from 26 September to 2 October 1989. The Conference was attended by delegates from 43 Member States:

Angola                             Luxembourg

Australia                          Madagascar

Bahamas                            Mali

Belgium                            Malta

Brazil                             Mozambique

Bulgaria                           Netherlands

Burundi                            Niger

Canada                             Portugal

China                              Republic of Korea

Cuba                               Senegal

Cyprus                             Singapore

Denmark                            Spain

Finland                            Sweden

France                             Switzerland

German Democratic Republic         Thailand

Germany, Federal Republic of       Uganda

Hungary                            Union of Soviet Socialist Republics

India                              United Arab Emirates

Indonesia                          United Kingdom of Great Britain

Israel                                  and Northern Ireland

Japan                              United States of America

Kuwait                             Venezuela

The United Nations, the International Labour Organisation and the WHO Regional Offices sent representatives to participate in the Conference, as did the Council for International Organizations of Medical Sciences, and twelve other nongovernmental organizations 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 J.-P. 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 Tenth 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 R.H.C. Wells, Australia (Chairman)

Dr H. Bay-Nielsen, Denmark (Vice-Chairman)

Dr R. Braun, German Democratic Republic (Vice-Chairman)

Mr R.A. 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 J.-P. Jardel, Assistant Director-General, WHO, Geneva, Switzerland

Dr H.R. Hapsara, Director, Division of Epidemiological Surveillance and Health Situation and Trend Assessment, WHO, Geneva, Switzerland

Dr J.-C. Alary, Chief Medical Officer, Development of Epidemiological and Health Statistical Services, WHO, Geneva, Switzerland

Dr G.R. Bramer, 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. Janisch, German Democratic Republic (Temporary Adviser)

Mr T. Kruse, Denmark (Temporary Adviser)

Dr K. Kupka, France (Temporary Adviser)

Dr J. Leowski, Poland (Temporary Adviser)

Ms R.M. Loy, United Kingdom of Great Britain and Northern Ireland (Temporary Adviser)

Mr R.H. Seeman, United States of America (Temporary Adviser)

The secretariat of the Conference was assisted by representatives of other relevant technical units of WHO headquarters.

The Conference adopted an agenda dealing with the proposed content of the chapters of the Tenth Revision, and material to be incorporated in the published manual; the process for its introduction; and the family of classifications and related matters.

1.   History and development of uses of the International Classification of Diseases (ICD)

The Conference was reminded of the impressive history of a statistical classification which dated back to the eighteenth century. While early revisions of the classification had been concerned only with causes of death, its scope had been extended at the Sixth Revision in 1948 to include non-fatal diseases. This extension had continued through the Ninth Revision, with certain innovations being made to meet the statistical needs of widely differing organizations. In addition, at the International Conference for the Ninth Revision (Geneva, 1975) (1), recommendations had been made and approved for the publication for trial purposes of supplementary classifications of procedures in medicine and of impairments, disabilities, and handicaps.

2.   Review of activities in the preparation of proposals for the Tenth Revision of the ICD

The proposals before the Conference were the product of a vast amount of activity at WHO headquarters and around the world. The programme of work had been guided by regular meetings of the heads of WHO Collaborating Centres for Classification of Diseases. Policy guidance had been provided by a number of special meetings and by the Expert Committee on the International Classification of Diseases - Tenth Revision, which met in 1984 (2) and 1987 (3) to make decisions on the direction the work should take and the form of the final proposals.

Extensive preparatory activity had been devoted to a radical review of the suitability of the structure of the ICD, essentially a statistical classification of diseases and other health problems, to serve a wide variety of needs for mortality and health-care data. Ways of stabilizing the coding system to minimize disruption at successive revisions had been investigated, as had the possibility of providing a better balance between the content of the different chapters of the ICD.

Even with a new structure, it was plain that one classification could not cope with the extremes of the requirements. The concept had therefore been developed of a "family" of classifications, 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 Tenth 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.

3.   General characteristics and content of the proposed Tenth Revision of the ICD

The main innovation in the proposals for the Tenth Revision was the use of an alphanumeric coding scheme of one letter followed by three numbers at the four-character level. This had the effect of more than doubling the size of the coding frame in comparison with the Ninth Revision and enabled the vast majority of chapters to be assigned a unique letter or group of letters, each capable of providing 100 three-character categories. Of the 26 available letters, 25 had been used, the letter U being left vacant for future additions and changes and for possible interim classifications to solve difficulties arising at the national and international level between revisions.

As a matter of policy, some three-character categories had been left vacant for future expansion and revision, the number varying according to the chapters: those with a primarily anatomical axis of classification had fewer vacant categories as it was considered that future changes in their content would be more limited in nature.

The Ninth Revision contained 17 chapters plus two supplementary classifications: the Supplementary Classification of External Causes of Injury and Poisoning (the E code) and the Supplementary Classification of Factors Influencing Health Status and Contact with Health Services (the V code). As recommended by the Preparatory Meeting on the Tenth Revision (Geneva, 1983) (4) and endorsed by subsequent meetings, these two chapters were no longer considered to be supplementary but were included as a part of the core classification.

The order of entry of chapters in the proposals for the Tenth Revision had originally been the same as in the Ninth Revision; however, to make effective use of the available space, disorders of the immune mechanism were later included with diseases of the blood and blood-forming organs, whereas in the Ninth Revision they had been included with endocrine, nutritional and metabolic diseases. The new chapter on "Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism" now followed the "Neoplasms" chapter, with which it shared the letter D.

During the elaboration of early drafts of the chapter on "Diseases of the nervous system and sense organs", it had soon become clear that it would not be possible to accommodate all the required detail under one letter in 100 three-character categories. It had been decided, therefore, to create three separate chapters - "Diseases of the nervous system" having the letter G, and the two chapters on "Diseases of the eye and adnexa" and on "Diseases of the ear and mastoid process" sharing the letter H.

Also, the chapters on "Diseases of the genitourinary system", on "Pregnancy, childbirth and the puerperium", on "Certain conditions originating in the perinatal period, and on "Congenital malformations, deformations and chromosomal abnormalities" had been brought together as contiguous chapters XIV to XVII.

With the inclusion of the former supplementary classifications as part of the core classification and the creation of two new chapters, the total number of chapters in the proposal for the Tenth Revision had become 21. The titles of some chapters had been amended to give a better indication of their content.

Where radical changes to the ICD had been proposed, field-testing had been appropriate. This had been the case for the following chapters:

V.       Mental and behavioural disorders

XIX.    Injury, poisoning and certain other consequences of external causes

XX.     External causes of morbidity and mortality

Chapter II, "Neoplasms", had also been subject to some field-testing, although the changes in its content had been of a minor nature.

Some new features of the proposals for the Tenth Revision were as follows:

•   The exclusion notes at the beginning of each chapter had been expanded to explain the relative hierarchy of chapters, and to make it clear that the "special group" chapters had priority of assignment over the organ or system chapters and that, among the special group chapters, those on "Pregnancy, childbirth and the puerperium" and on "Certain conditions originating in the perinatal period" had priority over the others.

•   Also, at the beginning of each chapter an overview was given of the blocks of three-character categories and, where relevant, the asterisk categories; this had been done to clarify the structure of the chapters and to facilitate the use of the asterisk categories.

•   The notes in the tabular list applied to all uses of the classification; if a note was appropriate only to morbidity or only to mortality, it was included in the special notes accompanying either the morbidity coding rules or the mortality coding rules.

•   The Ninth Revision had identified a certain number of conditions as being drug-induced; this approach had been continued in drawing up the proposals for the Tenth Revision and many such conditions were now separately identified.

An important innovation was the creation towards the end of certain chapters of categories for postprocedural disorders. These identified important conditions that constituted a medical care problem in their own right and included such examples as endocrine and metabolic diseases following ablation of an organ and other specific conditions such as postgastrectomy dumping syndrome. Postprocedural conditions that were not specific to a particular body system, including immediate complications such as air embolism and postoperative shock, continued to be classified in the chapter on "Injury, poisoning and certain other consequences of external causes".

Another change was that in the Ninth Revision, the four-digit titles had often had to be read in conjunction with the three-digit titles to ascertain the full meaning and intent of the subcategory, whereas in the draft presented to the Conference the titles were almost invariably complete and could stand alone.

The dual classification scheme for etiology and manifestation, known as the dagger and asterisk system, introduced in the Ninth Revision, had been the 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 Tenth 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 Tenth 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.

4.   Standards and definitions related to maternal and child health

The Conference considered with interest the recommended definitions, standards and reporting requirements for the Tenth Revision with regard to maternal mortality and to fetal, perinatal, neonatal and infant mortality. These recommendations were the outcome of a series of special meetings and consultations and were directed towards improving the comparability of data.

The Conference agreed that it was desirable to retain the definitions of live birth and fetal death as they appeared in the Ninth Revision.

After some discussion, the Conference set up a working party on the subject of maternal mortality and, on the basis of its recommendations, also agreed to retain the definition of maternal death as it appeared in the Ninth Revision.

In order to improve the quality of maternal mortality data and provide alternative methods of collecting data on deaths during pregnancy or related to it, as well as to encourage the recording of deaths from obstetric causes occurring more than 42 days following termination of pregnancy, two additional definitions, for "pregnancy-related deaths" and "late maternal deaths", were formulated by the working party.

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 Part 2a Instruction Manual (NCHS)].

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 Tenth Revision of the ICD, of definitions, standards and reporting requirements related to maternal mortality and to fetal, perinatal, neonatal and infant mortality.

5. Coding and selection rules and tabulation lists

5.1 Coding and selection rules for 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 Tenth Revision [by those contained in Part 2a Instruction Manual (NCHS)].

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 Tenth 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 Tenth Revision should contain any particular rules or methods of analysis to be followed.

In considering the international form of medical certificate of cause of death, the Expert Committee had recognized that the situation of an aging population with a greater proportion of deaths involving multiple disease processes, and the effects of associated therapeutic interventions, tended to increase the number of possible statements between the underlying cause and the direct cause of death: this meant that an increasing number of conditions were being entered on death certificates in many countries. This led the Committee to recommend the inclusion of an additional line (d) in Part I of the certificate.

The Conference therefore

RECOMMENDED that, where a need has been identified, countries consider the possibility of including an additional line (d) in Part I of the medical certificate of cause of death.

5.2 Coding and selection rules for morbidity

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 Tenth 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 Tenth 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 Part 2a Instruction Manual (NCHS).]

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.

The Conference agreed that extensive notes and examples should be added to provide further assistance.

5.3 Lists for tabulation of mortality and morbidity

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 five 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 five 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.

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 Tenth Revision by appropriate explanations and instructions on their use.

In the 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 Tenth 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.

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.

After studies and discussions in cooperation with the various Collaborating Centres, a concept of a family of classifications had been elaborated and subsequently revised by the Expert Committee in 1987, which had recommended the scheme shown opposite.

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 Tenth 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.

Family of disease and health-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 Tenth Revision.

6.2 Specialty-based adaptations

The Conference was informed about plans for the development of adaptations of the Tenth 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 Tenth 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 the topography and morphology of neoplasms. The morphology codes of the ICD-O, which had evolved over a long period of time, had been revised and extensively field-tested. The topography codes of the second edition would be based on categories C00-C80 in the Tenth Revision and publication would, therefore, await World Health Assembly approval of the Tenth Revision.

There was agreement on the value of an adaptation in the area of general medical practice and the Conference was informed about the willingness of groups working in this area to collaborate with WHO. In respect of other specialty-based adaptations, which were likely to become more numerous, the recommended role of WHO as a clearing-house was considered to be extremely important.

6.3 Information support to primary health care

In accordance with the recommendations of the 1975 Revision Conference, a working group had been convened by the WHO Regional Office for South-East Asia in Delhi in 1976. It had drawn up a detailed list of symptom associations, and from this, two short lists were derived, one for causes of death and one for reasons for contact with health services. Field trials of this system had been carried out in countries of the Region and the results used to revise the list of symptom associations and the reporting forms. This revised version had been published by WHO in 1978 in the booklet Lay reporting of health information (5).

The Global Strategy for Health for All by the Year 2000, launched in 1978, had raised a number of challenges for the development of information systems in Member States. At the International Conference on Health Statistics for the Year 2000 (Bellagio, Italy, 1982) (6), the integration of "lay reporting" information with other information generated and used for health management purposes had been identified as a major problem inhibiting the wider implementation of lay reporting schemes. The Consultation on Primary Care Classifications (Geneva, 1985) (7) had stressed the need for an approach that could unify information support, health service management and community services through information based on lay reporting in the expanded sense of community-based information.

The Conference was informed about the experience of countries in developing and applying community-based health information that covered health problems and needs, related risk factors and resources. It supported the concept of developing non-conventional methods at the community level as a method of filling information gaps in individual countries and strengthening their information systems. It was stressed that, for both developed and developing countries, such methods or systems should be developed locally and that, because of factors such as morbidity patterns as well as language and cultural variations, transfer to other areas or countries should not be attempted.

6.4 Impairments, disabilities and handicaps

The International Classification of Impairments, Disabilities, and Handicaps (ICIDH) (8) had been published by WHO in English in 1980 for trial purposes, in accordance with the recommendations of the 1975 Revision Conference and resolution WHA29.35 (9) of the 1976 World Health Assembly. Since that time, research and development on the classification had followed a number of paths.

The major definitions of the three elements - impairment, disability and handicap - had undoubtedly been instrumental in changing attitudes to disablement. The definition of impairment, an area where there was considerable overlap with the terms included in the ICD, had been widely accepted. The definition of disability broadly matched the field of action of rehabilitation professionals and groups, although there was felt to be a need for more attention in the associated code to the gradation of severity, which was often a predictor of handicap. There had also been increasing requests to revise the definition of handicap so as to put more emphasis on the effect of interaction with the environment.

The rapid evolution of ideas and practices in the management of disablement had ruled out the production of a revised ICIDH in time to be submitted to the Conference. It was stated that the publication of a new version was unlikely before implementation of the Tenth Revision.

6.5 Procedures in medicine

The International Classification of Procedures in Medicine (ICPM) (10) had been published by WHO in 1978 for trial purposes, in accordance with the recommendations of the 1975 Revision Conference and resolution WHA29.35 (9) of the 1976 World Health Assembly. The classification had been adopted by a few countries and was used as a basis for national classifications of surgical operations by a number of other countries.

The Heads of WHO Collaborating Centres for Classification of Diseases had recognized that the process of drafting proposals, obtaining comments, redrafting and soliciting further comments, which WHO necessarily had to go through before finalization and publication, was inappropriate in such a rapidly advancing field as that of procedures. The Centre Heads had therefore recommended that there should be no revision of the ICPM in conjunction with the Tenth Revision of ICD.

In 1987 the Expert Committee had asked that WHO consider updating for the Tenth Revision at least the outline of Chapter 5, “Surgical procedures", of the trial ICPM. In response to this request and the needs expressed by a number of countries, an attempt had been made by the Secretariat to prepare a tabulation list for procedures.

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 Tenth Revision.

6.6 International Nomenclature of Diseases

Since 1970 the Council for International Organizations of Medical Sciences (CIOMS) had been involved in the preparation of an International Nomenclature of Diseases (IND) which would serve as a complement to the ICD.

The main purpose of the IND was to provide a single recommended name for every disease entity. The main criteria for selection of that name were that it should be specific, unambiguous, as self-descriptive and simple as possible, and based on cause wherever feasible. Each disease or syndrome for which a name was recommended was defined as unambiguously, and yet briefly, as possible. A list of synonyms was appended to each definition.

At the time of the Conference, volumes had been published on diseases of the lower respiratory tract, infectious diseases (viral, bacterial and parasitic diseases and mycoses) and cardiac and vascular diseases, and work was under way on volumes for the digestive system, female genital system, urinary and male genital system, metabolic and endocrine diseases, blood and blood-forming organs, immunological system, musculoskeletal system and nervous system. Subjects proposed for future volumes included psychiatric diseases, as well as diseases of the skin, ear, nose and throat, and eye and adnexa.

The Conference recognized that an authoritative, up-to-date and international nomenclature of diseases was important in developing the ICD and improving the comparability of health information. The Conference therefore

RECOMMENDED that WHO and CIOMS be encouraged to explore cost-efficient ways to achieve the timely completion and maintenance of such a nomenclature.

7. Implementation of the Tenth Revision of the ICD

The Conference was informed of WHO's intention to publish the detailed four-character version of the Tenth Revision in three volumes: one containing the Tabular List, a second containing all related definitions, standards, rules and instructions, and a third containing the Alphabetical Index.

The Conference was further informed that a three-character version of the Tenth 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 Tenth 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 Tenth 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 Tenth 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 Tenth Revision, and the reverse, should be available before the implementation of the Tenth Revision.

As the development activities that had been endorsed by the Expert Committee were on schedule, the Conference

RECOMMENDED that the Tenth Revision of the International Classification of Diseases should come into effect as from 1 January 1993.

8. Future revision of the ICD

The Conference discussed the difficulties experienced during the extended period of use of the Ninth Revision, related to the emergence of new diseases and the lack of an updating mechanism to accommodate them.

Various suggestions for mechanisms to overcome these difficulties and avoid similar problems with respect to the Tenth Revision were discussed. There was a clear feeling that there was a need for ongoing information exchange to standardize the use of the Tenth Revision between countries, but that any changes introduced during its "lifetime" should be considered very carefully in relation 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.

9. Adoption of the Tenth Revision of the ICD

The Conference made the following recommendation:

Having considered the proposals prepared by the Organization on the basis of the recommendations of the Expert Committee on the International Classification of Diseases - Tenth Revision,

Recognizing the need for a few further minor modifications to reflect the comments on points of detail submitted by Member States during the Conference,

RECOMMENDED that the proposed revised chapters, with their three-character categories and four-character subcategories and the Short Tabulation Lists for Morbidity and Mortality, constitute the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems.

References

1.     International Classification of Diseases, 1975 Revision, Volume 1. Geneva, World           Health Organization, 1977, pp. xiii-xxiv.

2.     Report of the Expert Committee on the International Classification of Diseases-10^th 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-10^th 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.     Lay reporting of health information. Geneva, World Health Organization, 1978.

6.     International Conference on Health Statistics for the Year 2000. Budapest, Statistical Publishing House, 1984.

7.     Report of the Consultation on Primary Care Classifications. Geneva, World Health Organization, 1985 (unpublished document DES/PHC/85.7).

8.     International Classification of Impairments, Disabilities, and Handicaps. Geneva, World Health Organization, 1980.

9.     WHO Official Records, No. 233, 1976, p. 18.

10.   International Classification of Procedures in Medicine. Geneva, World Health Organization, 1978.

LIST OF THREE-CHARACTER CATEGORIES

Chapter I - Certain infectious and parasitic diseases (A00-B99)

Intestinal infectious diseases (A00-A09)

A00    Cholera

A01    Typhoid and paratyphoid fevers

A02    Other salmonella infections

A03    Shigellosis

A04    Other bacterial intestinal infections

A05    Other bacterial foodborne intoxications

A06    Amoebiasis

A07    Other protozoal intestinal diseases

A08    Viral and other specified intestinal infections

A09    Other gastroenteritis and colitis of infectious and unspecified origin

Tuberculosis (A15-A19)

A15    Respiratory tuberculosis, bacteriologically and histologically confirmed

A16    Respiratory tuberculosis, not confirmed bacteriologically or histologically

A17†  Tuberculosis of nervous system

A18    Tuberculosis of other organs

A19    Miliary tuberculosis

Certain zoonotic bacterial diseases (A20-A28)

A20    Plague

A21    Tularaemia

A22    Anthrax

A23    Brucellosis

A24    Glanders and melioidosis

A25    Rat-bite fevers

A26    Erysipeloid

A27    Leptospirosis

A28    Other zoonotic bacterial diseases, not elsewhere classified

Other bacterial diseases (A30-A49)

A30    Leprosy [Hansen disease]

A31    Infection due to other mycobacteria

A32    Listeriosis

A33    Tetanus neonatorum

A34    Obstetrical tetanus

A35    Other tetanus

A36    Diphtheria

A37    Whooping cough

A38    Scarlet fever

A39    Meningococcal infection

A40    Streptococcal septicaemia

A41    Other septicaemia

A42    Actinomycosis

A43    Nocardiosis

A44    Bartonellosis

A46    Erysipelas

A48    Other bacterial diseases, not elsewhere classified

A49    Bacterial infection of unspecified site

Infections with a predominantly sexual mode of transmission (A50-A64)

A50    Congenital syphilis

A51    Early syphilis

A52    Late syphilis

A53    Other and unspecified syphilis

A54    Gonococcal infection

A55    Chlamydial lymphogranuloma (venereum)

A56    Other sexually transmitted chlamydial diseases

A57    Chancroid

A58    Granuloma inguinale

A59    Trichomoniasis

A60    Anogenital herpesviral [herpes simplex] infections

A63    Other predominantly sexually transmitted diseases, not elsewhere classified

A64    Unspecified sexually transmitted disease

Other spirochaetal diseases (A65-A69)

A65    Nonvenereal syphilis

A66    Yaws

A67    Pinta [carate]

A68    Relapsing fevers

A69    Other spirochaetal infections

Other diseases caused by chlamydiae (A70-A74)

A70    Chlamydia psittaci infection

A71    Trachoma

A74    Other diseases caused by chlamydiae

Rickettsioses (A75-A79)

A75    Typhus fever

A77    Spotted fever [tick-borne rickettsioses]

A78    Q fever

A79    Other rickettsioses

Viral infections of the central nervous system (A80-A89)

A80    Acute poliomyelitis

A81    Atypical virus infections of central nervous system

A82    Rabies

A83    Mosquito-borne viral encephalitis

A84    Tick-borne viral encephalitis

A85    Other viral encephalitis, not elsewhere classified

A86    Unspecified viral encephalitis

A87    Viral meningitis

A88    Other viral infections of the central nervous system, not elsewhere classified

A89    Unspecified viral infection of the central nervous system

Arthropod-borne viral fevers and viral haemorrhagic fevers (A90-A99)

A90    Dengue fever [classical dengue]

A91    Dengue haemorrhagic fever

A92    Other mosquito-borne viral fevers

A93    Other arthropod-borne viral fevers, not elsewhere classified

A94    Unspecified arthropod-borne viral fever

A95    Yellow fever

A96    Arenaviral haemorrhagic fever

A98    Other viral haemorrhagic fevers, not elsewhere classified

A99    Unspecified viral haemorrhagic fever

Viral infections characterized by skin and mucous membrane lesions (B00-B09)

B00    Herpesviral [herpes simplex] infections

B01    Varicella [chickenpox]

B02    Zoster [herpes zoster]

B03    Smallpox

B04    Monkeypox

B05    Measles

B06    Rubella [German measles]

B07    Viral warts

B08    Other viral infections characterized by skin and mucous membrane lesions, not elsewhere classified

B09    Unspecified viral infection characterized by skin and mucous membrane lesions

Viral hepatitis (B15-B19)

B15    Acute hepatitis A

B16    Acute hepatitis B

B17    Other acute viral hepatitis

B18    Chronic viral hepatitis

B19    Unspecified viral hepatitis

Human immunodeficiency virus [HIV] disease (B20-B24)

B20    Human immunodeficiency virus [HIV] disease with infectious and parasitic diseases

B21    Human immunodeficiency virus [HIV] disease with malignant neoplasms

B22    Human immunodeficiency virus [HIV] disease with other specified diseases

B23    Human immunodeficiency virus [HIV] disease with other conditions

B24    Unspecified human immunodeficiency virus [HIV] disease

Other viral diseases (B25-B34)

B25    Cytomegaloviral disease

B26    Mumps

B27    Infectious mononucleosis

B30    Viral conjunctivitis

B33    Other viral diseases, not elsewhere classified

B34    Viral infection of unspecified site

Mycoses (B35-B49)

B35    Dermatophytosis

B36    Other superficial mycoses

B37    Candidiasis

B38    Coccidioidomycosis

B39    Histoplasmosis

B40    Blastomycosis

B41    Paracoccidioidomycosis

B42    Sporotrichosis

B43    Chromomycosis and phaeomycotic abscess

B44    Aspergillosis

B45    Cryptococcosis

B46    Zygomycosis

B47    Mycetoma

B48    Other mycoses, not elsewhere classified

B49    Unspecified mycosis

Protozoal diseases (B50-B64)

B50    Plasmodium falciparum malaria

B51    Plasmodium vivax malaria

B52    Plasmodium malariae malaria

B53    Other parasitologically confirmed malaria

B54    Unspecified malaria

B55    Leishmaniasis

B56    African trypanosomiasis

B57    Chagas disease

B58    Toxoplasmosis

B59    Pneumocystosis

B60    Other protozoal diseases, not elsewhere classified

B64    Unspecified protozoal disease

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-B97)

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

Other infectious diseases (B99)

B99    Other and unspecified infectious diseases

Chapter II - Neoplasms (C00-D48)

Malignant neoplasms (C00-C97)

Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)

C00    Malignant neoplasm of lip

C01    Malignant neoplasm of base of tongue

C02    Malignant neoplasm of other and unspecified parts of tongue

C03    Malignant neoplasm of gum

C04    Malignant neoplasm of floor of mouth

C05    Malignant neoplasm of palate

C06    Malignant neoplasm of other and unspecified parts of mouth

C07    Malignant neoplasm of parotid gland

C08    Malignant neoplasm of other and unspecified major salivary glands

C09    Malignant neoplasm of tonsil

C10    Malignant neoplasm of oropharynx

C11    Malignant neoplasm of nasopharynx

C12    Malignant neoplasm of pyriform sinus

C13    Malignant neoplasm of hypopharynx

C14    Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx

Malignant neoplasms of digestive organs (C15-C26)

C15    Malignant neoplasm of oesophagus

C16    Malignant neoplasm of stomach

C17    Malignant neoplasm of small intestine

C18    Malignant neoplasm of colon

C19    Malignant neoplasm of rectosigmoid junction

C20    Malignant neoplasm of rectum

C21    Malignant neoplasm of anus and anal canal

C22    Malignant neoplasm of liver and intrahepatic bile ducts

C23    Malignant neoplasm of gallbladder

C24    Malignant neoplasm of other and unspecified parts of biliary tract

C25    Malignant neoplasm of pancreas

C26    Malignant neoplasm of other and ill-defined digestive organs

Malignant neoplasms of respiratory and intrathoracic organs (C30-C39)

C30    Malignant neoplasm of nasal cavity and middle ear

C31    Malignant neoplasm of accessory sinuses

C32    Malignant neoplasm of larynx

C33    Malignant neoplasm of trachea

C34    Malignant neoplasm of bronchus and lung

C37    Malignant neoplasm of thymus

C38    Malignant neoplasm of heart, mediastinum and pleura

C39    Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs

Malignant neoplasms of bone and articular cartilage (C40-C41)

C40    Malignant neoplasm of bone and articular cartilage of limbs

C41    Malignant neoplasm of bone and articular cartilage of other and unspecified sites

Melanoma and other malignant neoplasms of skin (C43-C44)

C43    Malignant melanoma of skin

C44    Other malignant neoplasms of skin

Malignant neoplasms of mesothelial and soft tissue (C45-C49)

C45    Mesothelioma

C46    Kaposi sarcoma

C47    Malignant neoplasm of peripheral nerves and autonomic nervous system

C48    Malignant neoplasm of retroperitoneum and peritoneum

C49    Malignant neoplasm of other connective and soft tissue

Malignant neoplasm of breast (C50)

C50    Malignant neoplasm of breast

Malignant neoplasms of female genital organs (C51-C58)

C51    Malignant neoplasm of vulva

C52    Malignant neoplasm of vagina

C53    Malignant neoplasm of cervix uteri

C54    Malignant neoplasm of corpus uteri

C55    Malignant neoplasm of uterus, part unspecified

C56    Malignant neoplasm of ovary

C57    Malignant neoplasm of other and unspecified female genital organs

C58    Malignant neoplasm of placenta

Malignant neoplasms of male genital organs (C60-C63)

C60    Malignant neoplasm of penis

C61    Malignant neoplasm of prostate

C62    Malignant neoplasm of testis

C63    Malignant neoplasm of other and unspecified male genital organs

Malignant neoplasms of urinary tract (C64-C68)

C64    Malignant neoplasm of kidney, except renal pelvis

C65    Malignant neoplasm of renal pelvis

C66    Malignant neoplasm of ureter

C67    Malignant neoplasm of bladder

C68    Malignant neoplasm of other and unspecified urinary organs

Malignant neoplasms of eye, brain and other parts of central nervous system (C69-C72)

C69    Malignant neoplasm of eye and adnexa

C70    Malignant neoplasm of meninges

C71    Malignant neoplasm of brain

C72    Malignant neoplasm of spinal cord, cranial nerves and other parts of central nervous system

Malignant neoplasms of thyroid and other endocrine glands (C73-C75)

C73    Malignant neoplasm of thyroid gland

C74    Malignant neoplasm of adrenal gland

C75    Malignant neoplasm of other endocrine glands and related structures

Malignant neoplasms of ill-defined, secondary and unspecified sites (C76-C80)

C76    Malignant neoplasm of other and ill-defined sites

C77    Secondary and unspecified malignant neoplasm of lymph nodes

C78    Secondary malignant neoplasm of respiratory and digestive organs

C79    Secondary malignant neoplasm of other sites

C80 Malignant neoplasm without specification of site

Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96)

C81    Hodgkin disease

C82    Follicular [nodular] non-Hodgkin lymphoma

C83    Diffuse non-Hodgkin lymphoma

C84    Peripheral and cutaneous T-cell lymphomas

C85    Other and unspecified types of non-Hodgkin lymphoma

C88    Malignant immunoproliferative diseases

C90    Multiple myeloma and malignant plasma cell neoplasms

C91    Lymphoid leukaemia

C92    Myeloid leukaemia

C93    Monocytic leukaemia

C94    Other leukaemias of specified cell type

C95    Leukaemia of unspecified cell type

C96    Other and unspecified malignant neoplasms of lymphoid, haematopoietic and related tissue

Malignant neoplasms of independent (primary) multiple sites (C97)

C97    Malignant neoplasms of independent (primary) multiple sites

In situ neoplasms (D00-D09)

D00    Carcinoma in situ of oral cavity, oesophagus and stomach

D01    Carcinoma in situ of other and unspecified digestive organs

D02    Carcinoma in situ of middle ear and respiratory system

D03    Melanoma in situ

D04    Carcinoma in situ of skin

D05    Carcinoma in situ of breast

D06    Carcinoma in situ of cervix uteri

D07    Carcinoma in situ of other and unspecified genital organs

D09    Carcinoma in situ of other and unspecified sites

Benign neoplasms (D10-D36)

D10    Benign neoplasm of mouth and pharynx

D11    Benign neoplasm of major salivary glands

D12    Benign neoplasm of colon, rectum, anus and anal canal

D13    Benign neoplasm of other and ill-defined parts of digestive system

D14    Benign neoplasm of middle ear and respiratory system

D15    Benign neoplasm of other and unspecified intrathoracic organs

D16    Benign neoplasm of bone and articular cartilage

D17    Benign lipomatous neoplasm

D18    Haemangioma and lymphangioma, any site

D19    Benign neoplasm of mesothelial tissue

D20    Benign neoplasm of soft tissue of retroperitoneum and peritoneum

D21    Other benign neoplasms of connective and other soft tissue

D22    Melanocytic naevi

D23    Other benign neoplasms of skin

D24    Benign neoplasm of breast

D25    Leiomyoma of uterus

D26    Other benign neoplasms of uterus

D27    Benign neoplasm of ovary

D28    Benign neoplasm of other and unspecified female genital organs

D29    Benign neoplasm of male genital organs

D30    Benign neoplasm of urinary organs

D31    Benign neoplasm of eye and adnexa

D32    Benign neoplasm of meninges

D33    Benign neoplasm of brain and other parts of central nervous system

D34    Benign neoplasm of thyroid gland

D35    Benign neoplasm of other and unspecified endocrine glands

D36    Benign neoplasm of other and unspecified sites

Neoplasms of uncertain or unknown behaviour (D37-D48)

D37    Neoplasm of uncertain or unknown behaviour of oral cavity and digestive organs

D38    Neoplasm of uncertain or unknown behaviour of middle ear and respiratory and intrathoracic organs

D39    Neoplasm of uncertain or unknown behaviour of female genital organs

D40    Neoplasm of uncertain or unknown behaviour of male genital organs

D41    Neoplasm of uncertain or unknown behaviour of urinary organs

D42    Neoplasm of uncertain or unknown behaviour of meninges

D43    Neoplasm of uncertain or unknown behaviour of brain and central nervous system

D44    Neoplasm of uncertain or unknown behaviour of endocrine glands

D45    Polycythaemia vera

D46    Myelodysplastic syndromes

D47    Other neoplasms of uncertain or unknown behaviour of lymphoid, haematopoietic and related tissue

D48    Neoplasm of uncertain or unknown behaviour of other and unspecified sites

Chapter III - Diseases of blood and blood-forming organs and certain disorders involving the immune mechanisms (D50-D89)

Nutritional anaemias (D50-D53)

D50    Iron deficiency anaemia

D51    Vitamin B₁₂ deficiency anaemia

D52    Folate deficiency anaemia

D53    Other nutritional anaemias

Haemolytic anaemias (D55-D59)

D55    Anaemia due to enzyme disorders

D56    Thalassaemia

D57    Sickle-cell disorders

D58    Other hereditary haemolytic anaemias

D59    Acquired haemolytic anaemia

Aplastic and other anaemias (D60-D64)

D60    Acquired pure red cell aplasia [erythroblastopenia]

D61    Other aplastic anaemias

D62    Acute posthaemorrhagic anaemia

D63*  Anaemia in chronic diseases classified elsewhere

D64    Other anaemias

Coagulation defects, purpura and other haemorrhagic conditions (D65-D69)

D65    Disseminated intravascular coagulation [defibrination syndrome]

D66    Hereditary factor VIII deficiency

D67    Hereditary factor IX deficiency

D68    Other coagulation defects

D69    Purpura and other haemorrhagic conditions

Other diseases of blood and blood-forming organs (D70-D77)

D70    Agranulocytosis

D71    Functional disorders of polymorphonuclear neutrophils

D72    Other disorders of white blood cells

D73    Diseases of spleen

D74    Methaemoglobinaemia

D75    Other diseases of blood and blood-forming organs

D76    Certain diseases involving lymphoreticular tissue and reticulohistiocytic system

D77*  Other disorders of blood and blood-forming organs in diseases classified elsewhere

Certain disorders involving the immune mechanism (D80-D89)

D80    Immunodeficiency with predominantly antibody defects

D81    Combined immunodeficiencies

D82    Immunodeficiency associated with other major defects

D83    Common variable immunodeficiency

D84    Other immunodeficiencies

D86    Sarcoidosis

D89    Other disorders involving the immune mechanism, not elsewhere classified

Chapter IV - Endocrine, nutritional and metabolic diseases (E00-E90)

Disorders of thyroid gland (E00-E07)

E00    Congenital iodine-deficiency syndrome

E01    Iodine-deficiency-related thyroid disorders and allied conditions

E02    Subclinical iodine-deficiency hypothyroidism

E03    Other hypothyroidism

E04    Other nontoxic goitre

E05    Thyrotoxicosis [hyperthyroidism]

E06    Thyroiditis

E07    Other disorders of thyroid

Diabetes mellitus (E10-E14)

E10    Type 1 diabetes mellitus

E11    Type 2 diabetes mellitus

E12    Malnutrition-related diabetes mellitus

E13    Other specified diabetes mellitus

E14    Unspecified diabetes mellitus

Other disorders of glucose regulation and pancreatic internal secretion (E15-E16)

E15    Nondiabetic hypoglycaemic coma

E16    Other disorders of pancreatic internal secretion

Disorders of other endocrine glands (E20-E35)

E20    Hypoparathyroidism

E21    Hyperparathyroidism and other disorders of parathyroid gland

E22    Hyperfunction of pituitary gland

E23    Hypofunction and other disorders of pituitary gland

E24    Cushing syndrome

E25    Adrenogenital disorders

E26    Hyperaldosteronism

E27    Other disorders of adrenal gland

E28    Ovarian dysfunction

E29    Testicular dysfunction

E30    Disorders of puberty, not elsewhere classified

E31    Polyglandular dysfunction

E32    Diseases of thymus

E34    Other endocrine disorders

E35*  Disorders of endocrine glands in diseases classified elsewhere

Malnutrition (E40-E46)

E40    Kwashiorkor

E41    Nutritional marasmus

E42    Marasmic kwashiorkor

E43    Unspecified severe protein-energy malnutrition

E44    Protein-energy malnutrition of moderate and mild degree

E45    Retarded development following protein-energy malnutrition

E46    Unspecified protein-energy malnutrition

Other nutritional deficiencies (E50-E64)

E50    Vitamin A deficiency

E51    Thiamine deficiency

E52    Niacin deficiency [pellagra]

E53    Deficiency of other B group vitamins

E54    Ascorbic acid deficiency

E55    Vitamin D deficiency

E56    Other vitamin deficiencies

E58    Dietary calcium deficiency

E59    Dietary selenium deficiency

E60    Dietary zinc deficiency

E61    Deficiency of other nutrient elements

E63    Other nutritional deficiencies

E64    Sequelae of malnutrition and other nutritional deficiencies

Obesity and other hyperalimentation (E65-E68)

E65    Localized adiposity

E66    Obesity

E67    Other hyperalimentation

E68    Sequelae of hyperalimentation

Metabolic disorders (E70-E90)

E70    Disorders of aromatic amino-acid metabolism

E71    Disorders of branched-chain amino-acid metabolism and fatty-acid metabolism

E72    Other disorders of amino-acid metabolism

E73    Lactose intolerance

E74    Other disorders of carbohydrate metabolism

E75    Disorders of sphingolipid metabolism and other lipid storage disorders

E76    Disorders of glycosaminoglycan metabolism

E77    Disorders of glycoprotein metabolism

E78    Disorders of lipoprotein metabolism and other lipidaemias

E79    Disorders of purine and pyrimidine metabolism

E80    Disorders of porphyrin and bilirubin metabolism

E83    Disorders of mineral metabolism

E84    Cystic fibrosis

E85    Amyloidosis

E86    Volume depletion

E87    Other disorders of fluid, electrolyte and acid-base balance

E88    Other metabolic disorders

E89    Postprocedural endocrine and metabolic disorders, not elsewhere classified

E90*  Nutritional and metabolic disorders in diseases classified elsewhere

Chapter V - Mental, behavioural disorders (F00-F99)

Organic, including symptomatic, mental disorders (F00-F09)

F00*   Dementia in Alzheimer disease

F01    Vascular dementia

F02*   Dementia in other diseases classified elsewhere

F03    Unspecified dementia

F04    Organic amnesic syndrome, not induced by alcohol and other psychoactive substances

F05    Delirium, not induced by alcohol and other psychoactive substances

F06    Other mental disorders due to brain damage and dysfunction and to physical disease

F07    Personality and behavioural disorders due to brain disease, damage and dysfunction

F09    Unspecified organic or symptomatic mental disorder

Mental and behavioural disorders due to psychoactive substance use (F10-F19)

F10    Mental and behavioural disorders due to use of alcohol

F11    Mental and behavioural disorders due to use of opioids

F12    Mental and behavioural disorders due to use of cannabinoids

F13    Mental and behavioural disorders due to use of sedatives or hypnotics

F14    Mental and behavioural disorders due to use of cocaine

F15    Mental and behavioural disorders due to use of other stimulants, including caffeine

F16    Mental and behavioural disorders due to use of hallucinogens

F17    Mental and behavioural disorders due to use of tobacco

F18    Mental and behavioural disorders due to use of volatile solvents

F19    Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances

Schizophrenia, schizotypal and delusional disorders (F20-F29)

F20    Schizophrenia

F21    Schizotypal disorder

F22    Persistent delusional disorders

F23    Acute and transient psychotic disorders

F24    Induced delusional disorder

F25    Schizoaffective disorders

F28    Other nonorganic psychotic disorders

F29    Unspecified nonorganic psychosis

Mood [affective] disorders (F30-F39)

F30    Manic episode

F31    Bipolar affective disorder

F32    Depressive episodes

F33    Recurrent depressive disorder

F34    Persistent mood [affective] disorders

F38    Other mood [affective] disorders

F39    Unspecified mood [affective] disorder

Neurotic, stress-related and somatoform disorders (F40-F48)

F40    Phobic anxiety disorders

F41    Other anxiety disorders

F42    Obsessive-compulsive disorder

F43    Reaction to severe stress, and adjustment disorders

F44    Dissociative [conversion] disorders

F45    Somatoform disorders

F48    Other neurotic disorders

Behavioural syndromes associated with physiological disturbances and physical factors (F50-F59)

F50    Eating disorders

F51    Nonorganic sleep disorders

F52    Sexual dysfunction, not caused by organic disorder or disease

F53    Mental and behavioural disorders associated with the puerperium, not elsewhere classified

F54    Psychological and behavioural factors associated with disorders or diseases classified elsewhere

F55    Abuse of non-dependence-producing substances

F59    Unspecified behavioural syndromes associated with physiological disturbances and physical factors

Disorders of adult personality and behaviour (F60-F69)

F60    Specific personality disorders

F61    Mixed and other personality disorders

F62    Enduring personality changes, not attributable to brain damage and disease

F63    Habit and impulse disorders

F64    Gender identity disorders

F65    Disorders of sexual preference

F66    Psychological and behavioural disorders associated with sexual development and orientation

F68    Other disorders of adult personality and behaviour

F69    Unspecified disorder of adult personality and behaviour

Mental retardation (F70-F79)

F70    Mild mental retardation

F71    Moderate mental retardation

F72    Severe mental retardation

F73    Profound mental retardation

F78    Other mental retardation

F79    Unspecified mental retardation

Disorders of psychological development (F80-F89)

F80    Specific developmental disorders of speech and language

F81    Specific developmental disorders of scholastic skills

F82    Specific developmental disorder of motor function

F83    Mixed specific developmental disorders

F84    Pervasive developmental disorders

F88    Other disorders of psychological development

F89    Unspecified disorder of psychological development

Behavioural and emotional disorders with onset usually occurring in childhood and adolescence (F90-F98)

F90    Hyperkinetic disorders

F91    Conduct disorders

F92    Mixed disorders of conduct and emotions

F93    Emotional disorders with onset specific to childhood

F94    Disorders of social functioning with onset specific to childhood and adolescence

F95    Tic disorders

F98    Other behavioural and emotional disorders with onset usually occurring in childhood and adolescence

Unspecified mental disorder (F99)

F99    Mental disorder, not otherwise specified

Chapter VI - Diseases of the nervous system (G00-G99)

Inflammatory diseases of the central nervous system (G00-G09)

G00    Bacterial meningitis, not elsewhere classified

G01*  Meningitis in bacterial diseases classified elsewhere

G02*  Meningitis in other infectious and parasitic diseases classified elsewhere

G03    Meningitis due to other and unspecified causes

G04    Encephalitis, myelitis and encephalomyelitis

G05*  Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere

G06    Intracranial and intraspinal abscess and granuloma

G07*  Intracranial and intraspinal abscess and granuloma in diseases classified elsewhere

G08    Intracranial and intraspinal phlebitis and thrombophlebitis

G09    Sequelae of inflammatory diseases of central nervous system

Systemic atrophies primarily affecting the central nervous system (G10-G14)

G10    Huntington disease

G11    Hereditary ataxia

G12    Spinal muscular atrophy and related syndromes

G13*  Systemic atrophies primarily affecting central nervous system in diseases classified elsewhere

G14    Postpolio syndrome

Extrapyramidal and movement disorders (G20-G26)

G20    Parkinson disease

G21    Secondary parkinsonism

G22*  Parkinsonism in diseases classified elsewhere

G23    Other degenerative diseases of the basal ganglia

G24    Dystonia

G25    Other extrapyramidal and movement disorders

G26*  Extrapyramidal and movement disorders in diseases classified elsewhere

Other degenerative diseases of the nervous system (G30-G32)

G30    Alzheimer disease

G31    Other degenerative diseases of nervous system, not elsewhere classified

G32*  Other degenerative disorders of nervous system in diseases classified elsewhere

Demyelinating diseases of the central nervous system (G35-G37)

G35    Multiple sclerosis

G36    Other acute disseminated demyelination

G37    Other demyelinating diseases of central nervous system

Episodic and paroxysmal disorders (G40-G47)

G40    Epilepsy

G41    Status epilepticus

G43    Migraine

G44    Other headache syndromes

G45    Transient cerebral ischaemic attacks and related syndromes

G46*  Vascular syndromes of brain in cerebrovascular diseases

G47    Sleep disorders

Nerve, nerve root and plexus disorders (G50-G59)

G50    Disorders of trigeminal nerve

G51    Facial nerve disorders

G52    Disorders of other cranial nerves

G53*  Cranial nerve disorders in diseases classified elsewhere

G54    Nerve root and plexus disorders

G55*  Nerve root and plexus compressions in diseases classified elsewhere

G56    Mononeuropathies of upper limb

G57    Mononeuropathies of lower limb

G58    Other mononeuropathies

G59*  Mononeuropathy in diseases classified elsewhere

Polyneuropathies and other disorders of the peripheral nervous system (G60-G64)

G60    Hereditary and idiopathic neuropathy

G61    Inflammatory polyneuropathy

G62    Other polyneuropathies

G63*  Polyneuropathy in diseases classified elsewhere

G64    Other disorders of peripheral nervous system

Diseases of myoneural junction and muscle (G70-G73)

G70    Myasthenia gravis and other myoneural disorders

G71    Primary disorders of muscles

G72    Other myopathies

G73*  Disorders of myoneural junction and muscle in diseases classified elsewhere

Cerebral palsy and other paralytic syndromes (G80-G83)

G80    Cerebral palsy

G81    Hemiplegia

G82    Paraplegia and tetraplegia

G83    Other paralytic syndromes

Other disorders of the nervous system (G90-G99)

G90    Disorders of autonomic nervous system

G91    Hydrocephalus

G92    Toxic encephalopathy

G93    Other disorders of brain

G94*  Other disorders of brain in diseases classified elsewhere

G95    Other diseases of spinal cord

G96    Other disorders of central nervous system

G97    Postprocedural disorders of nervous system, not elsewhere classified

G98    Other disorders of nervous system, not elsewhere classified

G99*  Other disorders of nervous system in diseases classified elsewhere

Chapter VII - Diseases of the eye and adnexa (H00-H59)

Disorders of eyelid, lacrimal system and orbit (H00-H06)

H00    Hordeolum and chalazion

H01    Other inflammation of eyelid

H02    Other disorders of eyelid

H03*  Disorders of eyelid in diseases classified elsewhere

H04    Disorders of lacrimal system

H05    Disorders of orbit

H06*  Disorders of lacrimal system and orbit in diseases classified elsewhere

Disorders of conjunctiva (H10-H13)

H10    Conjunctivitis

H11    Other disorders of conjunctiva

H13*  Disorders of conjunctiva in diseases classified elsewhere

Disorders of sclera, cornea, iris and ciliary body (H15-H22)

H15    Disorders of sclera

H16    Keratitis

H17    Corneal scars and opacities

H18    Other disorders of cornea

H19*  Disorders of sclera and cornea in diseases classified elsewhere

H20    Iridocyclitis

H21    Other disorders of iris and ciliary body

H22*  Disorders of iris and ciliary body in diseases classified elsewhere

Disorders of lens (H25-H28)

H25    Senile cataract

H26    Other cataract

H27    Other disorders of lens

H28*  Cataract and other disorders of lens in diseases classified elsewhere

Disorders of choroid and retina (H30-H36)

H30    Chorioretinal inflammation

H31    Other disorders of choroid

H32*  Chorioretinal disorders in diseases classified elsewhere

H33    Retinal detachments and breaks

H34    Retinal vascular occlusions

H35    Other retinal disorders

H36*  Retinal disorders in diseases classified elsewhere

Glaucoma (H40-H42)

H40    Glaucoma

H42*  Glaucoma in diseases classified elsewhere

Disorders of vitreous body and globe (H43-H45)

H43    Disorders of vitreous body

H44    Disorders of globe

H45*  Disorders of vitreous body and globe in diseases classified elsewhere

Disorders of optic nerve and visual pathways (H46-H48)

H46    Optic neuritis

H47    Other disorders of optic [2nd] nerve and visual pathways

H48*  Disorders of optic [2nd] nerve and visual pathways in diseases classified elsewhere

Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)

H49    Paralytic strabismus

H50    Other strabismus

H51    Other disorders of binocular movement

H52    Disorders of refraction and accommodation

Visual disturbances and blindness (H53-H54)

H53    Visual disturbances

H54    Visual impairment including blindness (binocular or monocular)

Other disorders of eye and adnexa (H55-H59)

H55    Nystagmus and other irregular eye movements

H57    Other disorders of eye and adnexa

H58*  Other disorders of eye and adnexa in diseases classified elsewhere

H59    Postprocedural disorders of eye and adnexa, not elsewhere classified

Chapter VIII - Diseases of the ear and mastoid process (H60-H95)

Diseases of external ear (H60-H62)

H60    Otitis externa

H61    Other disorders of external ear

H62*  Disorders of external ear in diseases classified elsewhere

Diseases of middle ear and mastoid (H65-H75)

H65    Nonsuppurative otitis media

H66    Suppurative and unspecified otitis media

H67*  Otitis media in diseases classified elsewhere

H68    Eustachian salpingitis and obstruction

H69    Other disorders of Eustachian tube

H70    Mastoiditis and related conditions

H71    Cholesteatoma of middle ear

H72    Perforation of tympanic membrane

H73    Other disorders of tympanic membrane

H74    Other disorders of middle ear and mastoid

H75*  Other disorders of middle ear and mastoid in diseases classified elsewhere

Diseases of inner ear (H80-H83)

H80    Otosclerosis

H81    Disorders of vestibular function

H82*  Vertiginous syndromes in diseases classified elsewhere

H83    Other diseases of inner ear

Other disorders of ear (H90-H95)

H90    Conductive and sensorineural hearing loss

H91    Other hearing loss

H92    Otalgia and effusion of ear

H93    Other disorders of ear, not elsewhere classified

H94*  Other disorders of ear in diseases classified elsewhere

H95    Postprocedural disorders of ear and mastoid process, not elsewhere classified

Chapter IX - Diseases of the circulatory system (I00-I99)

Acute rheumatic fever (I00-I02)

I00     Rheumatic fever without mention of heart involvement

I01     Rheumatic fever with heart involvement

I02     Rheumatic chorea

Chronic rheumatic heart diseases (I05-I09)

I05     Rheumatic mitral valve diseases

I06     Rheumatic aortic valve diseases

I07     Rheumatic tricuspid valve diseases

I08     Multiple valve diseases

I09     Other rheumatic heart diseases

Hypertensive diseases (I10-I15)

I10     Essential (primary) hypertension

I11     Hypertensive heart disease

I12     Hypertensive renal disease

I13     Hypertensive heart and renal disease

I15     Secondary hypertension

Ischaemic heart diseases (I20-I25)

I20     Angina pectoris

I21     Acute myocardial infarction

I22     Subsequent myocardial infarction

I23     Certain current complications following acute myocardial infarction

I24     Other acute ischaemic heart diseases

I25     Chronic ischaemic heart disease

Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)

I26     Pulmonary embolism

I27     Other pulmonary heart diseases

I28     Other diseases of pulmonary vessels

Other forms of heart disease (I30-I52)

I30     Acute pericarditis

I31     Other diseases of pericardium

I32*   Pericarditis in diseases classified elsewhere

I33     Acute and subacute endocarditis

I34     Nonrheumatic mitral valve disorders

I35     Nonrheumatic aortic valve disorders

I36     Nonrheumatic tricuspid valve disorders

I37     Pulmonary valve disorders

I38     Endocarditis, valve unspecified

I39*   Endocarditis and heart valve disorders in diseases classified elsewhere

I40     Acute myocarditis

I41*   Myocarditis in diseases classified elsewhere

I42     Cardiomyopathy

I43*   Cardiomyopathy in diseases classified elsewhere

I44     Atrioventricular and left bundle-branch block

I45     Other conduction disorders

I46     Cardiac arrest

I47     Paroxysmal tachycardia

I48     Atrial fibrillation and flutter

I49     Other cardiac arrhythmias

I50     Heart failure

I51     Complications and ill-defined descriptions of heart disease

I52*   Other heart disorders in diseases classified elsewhere

Cerebrovascular diseases (I60-I69)

I60     Subarachnoid haemorrhage

I61     Intracerebral haemorrhage

I62     Other nontraumatic intracranial haemorrhage

I63     Cerebral infarction

I64     Stroke, not specified as haemorrhage or infarction

I65     Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction

I66     Occlusion and stenosis of cerebral arteries, not resulting in cerebral infarction

I67     Other cerebrovascular diseases

I68*   Cerebrovascular disorders in diseases classified elsewhere

I69     Sequelae of cerebrovascular disease

Diseases of arteries, arterioles and capillaries (I70-I79)

I70     Atherosclerosis

I71     Aortic aneurysm and dissection

I72     Other aneurysm and dissection

I73     Other peripheral vascular diseases

I74     Arterial embolism and thrombosis

I77     Other disorders of arteries and arterioles

I78     Diseases of capillaries

I79*   Disorders of arteries, arterioles and capillaries in diseases classified elsewhere

Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)

I80     Phlebitis and thrombophlebitis

I81     Portal vein thrombosis

I82     Other venous embolism and thrombosis

I83     Varicose veins of lower extremities

I84     Haemorrhoids

I85     Oesophageal varices

I86     Varicose veins of other sites

I87     Other disorders of veins

I88     Nonspecific lymphadenitis

I89     Other noninfective disorders of lymphatic vessels and lymph nodes

Other and unspecified disorders of the circulatory system (I95-I99)

I95     Hypotension

I97     Postprocedural disorders of circulatory system, not elsewhere classified

I98*   Other disorders of circulatory system in diseases classified elsewhere

I99     Other and unspecified disorders of circulatory system

Chapter X - Diseases of the respiratory system (J00-J99)

Acute upper respiratory infections (J00-J06)

J00     Acute nasopharyngitis [common cold]

J01     Acute sinusitis

J02     Acute pharyngitis

J03     Acute tonsillitis

J04     Acute laryngitis and tracheitis

J05     Acute obstructive laryngitis [croup] and epiglottitis

J06     Acute upper respiratory infections of multiple or unspecified sites

Influenza and pneumonia (J09-J18)

J09     Influenza due to identified zoonotic or pandemic influenza virus

J10     Influenza due to identified seasonal influenza virus

J11     Influenza, virus not identified

J12     Viral pneumonia, not elsewhere classified

J13     Pneumonia due to Streptococcus pneumoniae

J14     Pneumonia due to Haemophilus influenzae

J15     Bacterial pneumonia, not elsewhere classified

J16     Pneumonia due to other infectious organisms, not elsewhere classified

J17*   Pneumonia in diseases classified elsewhere

J18     Pneumonia, organism unspecified

Other acute lower respiratory infections (J20-J22)

J20     Acute bronchitis

J21     Acute bronchiolitis

J22     Unspecified acute lower respiratory infection

Other diseases of upper respiratory tract (J30-J39)

J30     Vasomotor and allergic rhinitis

J31     Chronic rhinitis, nasopharyngitis and pharyngitis

J32     Chronic sinusitis

J33     Nasal polyp

J34     Other disorders of nose and nasal sinuses

J35     Chronic diseases of tonsils and adenoids

J36     Peritonsillar abscess

J37     Chronic laryngitis and laryngotracheitis

J38     Diseases of vocal cords and larynx, not elsewhere classified

J39     Other diseases of upper respiratory tract

Chronic lower respiratory diseases (J40-J47)

J40     Bronchitis, not specified as acute or chronic

J41     Simple and mucopurulent chronic bronchitis

J42     Unspecified chronic bronchitis

J43     Emphysema

J44     Other chronic obstructive pulmonary disease

J45     Asthma

J46     Status asthmaticus

J47     Bronchiectasis

Lung diseases due to external agents (J60-J70)

J60     Coalworker pneumoconiosis

J61     Pneumoconiosis due to asbestos and other mineral fibres

J62     Pneumoconiosis due to dust containing silica

J63     Pneumoconiosis due to other inorganic dusts

J64     Unspecified pneumoconiosis

J65     Pneumoconiosis associated with tuberculosis

J66     Airway disease due to specific organic dust

J67     Hypersensitivity pneumonitis due to organic dust

J68     Respiratory conditions due to inhalation of chemicals, gases, fumes and vapours

J69     Pneumonitis due to solids and liquids

J70     Respiratory conditions due to other external agents

Other respiratory diseases principally affecting the interstitium (J80-J84)

J80     Adult respiratory distress syndrome

J81     Pulmonary oedema

J82     Pulmonary eosinophilia, not elsewhere classified

J84     Other interstitial pulmonary diseases

Suppurative and necrotic conditions of lower respiratory tract (J85-J86)

J85     Abscess of lung and mediastinum

J86     Pyothorax

Other diseases of pleura (J90-J94)

J90     Pleural effusion, not elsewhere classified

J91*   Pleural effusion in conditions classified elsewhere

J92     Pleural plaque

J93     Pneumothorax

J94     Other pleural conditions

Other diseases of the respiratory system (J95-J99)

J95     Postprocedural respiratory disorders, not elsewhere classified

J96     Respiratory failure, not elsewhere classified

J98     Other respiratory disorders

J99*   Respiratory disorders in diseases classified elsewhere

Chapter XI - Diseases of the digestive system (K00-K93)

Diseases of oral cavity, salivary glands and jaws (K00-K14)

K00    Disorders of tooth development and eruption

K01    Embedded and impacted teeth

K02    Dental caries

K03    Other diseases of hard tissues of teeth

K04    Diseases of pulp and periapical tissues

K05    Gingivitis and periodontal diseases

K06    Other disorders of gingiva and edentulous alveolar ridge

K07    Dentofacial anomalies [including malocclusion]

K08    Other disorders of teeth and supporting structures

K09    Cysts of oral region, not elsewhere classified

K10    Other diseases of jaws

K11    Diseases of salivary glands

K12    Stomatitis and related lesions

K13    Other diseases of lip and oral mucosa

K14    Diseases of tongue

Diseases of oesophagus, stomach and duodenum (K20-K31)

K20    Oesophagitis

K21    Gastro-oesophageal reflux disease

K22    Other diseases of oesophagus

K23*  Disorders of oesophagus in diseases classified elsewhere

K25    Gastric ulcer

K26    Duodenal ulcer

K27    Peptic ulcer, site unspecified

K28    Gastrojejunal ulcer

K29    Gastritis and duodenitis

K30    Functional dyspepsia

K31    Other diseases of stomach and duodenum

Diseases of appendix (K35-K38)

K35    Acute appendicitis

K36    Other appendicitis

K37    Unspecified appendicitis

K38    Other diseases of appendix

Hernia (K40-K46)

K40    Inguinal hernia

K41    Femoral hernia

K42    Umbilical hernia

K43    Ventral hernia

K44    Diaphragmatic hernia

K45    Other abdominal hernia

K46    Unspecified hernia of abdominal cavity

Noninfective enteritis and colitis (K50-K52)

K50    Crohn disease [regional enteritis]

K51    Ulcerative colitis

K52    Other noninfective gastroenteritis and colitis

Other diseases of intestines (K55-K63)

K55    Vascular disorders of intestine

K56    Paralytic ileus and intestinal obstruction without hernia

K57    Diverticular disease of intestine

K58    Irritable bowel syndrome

K59    Other functional intestinal disorders

K60    Fissure and fistula of anal and rectal regions

K61    Abscess of anal and rectal regions

K62    Other diseases of anus and rectum

K63    Other diseases of intestine

Diseases of peritoneum (K65-K67)

K65    Peritonitis

K66    Other disorders of peritoneum

K67*  Disorders of peritoneum in infectious diseases classified elsewhere

Diseases of liver (K70-K77)

K70    Alcoholic liver disease

K71    Toxic liver disease

K72    Hepatic failure, not elsewhere classified

K73    Chronic hepatitis, not elsewhere classified

K74    Fibrosis and cirrhosis of liver

K75    Other inflammatory liver diseases

K76    Other diseases of liver

K77*  Liver disorders in diseases classified elsewhere

Disorders of gallbladder, biliary tract and pancreas (K80-K87)

K80    Cholelithiasis

K81    Cholecystitis

K82    Other diseases of gallbladder

K83    Other diseases of biliary tract

K85    Acute pancreatitis

K86    Other diseases of pancreas

K87*  Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere

Other diseases of the digestive system (K90-K93)

K90    Intestinal malabsorption

K91    Postprocedural disorders of digestive system, not elsewhere classified

K92    Other diseases of digestive system

K93*  Disorders of other digestive organs in diseases classified elsewhere

Chapter XII - Diseases of the skin and subcutaneous tissue (L00-L99)

Infections of the skin and subcutaneous tissue (L00-L08)

L00    Staphylococcal scalded skin syndrome

L01    Impetigo

L02    Cutaneous abscess, furuncle and carbuncle

L03    Cellulitis

L04    Acute lymphadenitis

L05    Pilonidal cyst

L08    Other local infections of skin and subcutaneous tissue

Bullous disorders (L10-L14)

L10    Pemphigus

L11    Other acantholytic disorders

L12    Pemphigoid

L13    Other bullous disorders

L14*   Bullous disorders in diseases classified elsewhere

Dermatitis and eczema (L20-L30)

L20    Atopic dermatitis

L21    Seborrhoeic dermatitis

L22    Diaper [napkin] dermatitis

L23    Allergic contact dermatitis

L24    Irritant contact dermatitis

L25    Unspecified contact dermatitis

L26    Exfoliative dermatitis

L27    Dermatitis due to substances taken internally

L28    Lichen simplex chronicus and prurigo

L29    Pruritus

L30    Other dermatitis

Papulosquamous disorders (L40-L45)

L40    Psoriasis

L41    Parapsoriasis

L42    Pityriasis rosea

L43    Lichen planus

L44    Other papulosquamous disorders

L45*   Papulosquamous disorders in diseases classified elsewhere

Urticaria and erythema (L50-L54)

L50    Urticaria

L51    Erythema multiforme

L52    Erythema nodosum

L53    Other erythematous conditions

L54*   Erythema in diseases classified elsewhere

Radiation-related disorders of the skin and subcutaneous tissue (L55-L59)

L55    Sunburn

L56    Other acute skin changes due to ultraviolet radiation

L57    Skin changes due to chronic exposure to nonionizing radiation

L58    Radiodermatitis

L59    Other disorders of skin and subcutaneous tissue related to radiation

Disorders of skin appendages (L60-L75)

L60    Nail disorders

L62*   Nail disorders in diseases classified elsewhere

L63    Alopecia areata

L64    Androgenic alopecia

L65    Other nonscarring hair loss

L66    Cicatricial alopecia [scarring hair loss]

L67    Hair colour and hair shaft abnormalities

L68    Hypertrichosis

L70    Acne

L71    Rosacea

L72    Follicular cysts of skin and subcutaneous tissue

L73    Other follicular disorders

L74    Eccrine sweat disorders

L75    Apocrine sweat disorders

Other disorders of the skin and subcutaneous tissue (L80-L99)

L80    Vitiligo

L81    Other disorders of pigmentation

L82    Seborrhoeic keratosis

L83    Acanthosis nigricans

L84    Corns and callosities

L85    Other epidermal thickening

L86*   Keratoderma in diseases classified elsewhere

L87    Transepidermal elimination disorders

L88    Pyoderma gangrenosum

L89    Decubitus ulcer and pressure area

L90    Atrophic disorders of skin

L91    Hypertrophic disorders of skin

L92    Granulomatous disorders of skin and subcutaneous tissue

L93    Lupus erythematosus

L94    Other localized connective tissue disorders

L95    Vasculitis limited to skin, not elsewhere classified

L97    Ulcer of lower limb, not elsewhere classified

L98    Other disorders of skin and subcutaneous tissue, not elsewhere classified

L99*   Other disorders of skin and subcutaneous tissue in diseases classified elsewhere

Chapter XIII - Diseases of the musculoskeletal system and connective tissue (M00-M99)

Arthropathies (M00-M25)

Infectious arthropathies (M00-M03)

M00    Pyogenic arthritis

M01*  Direct infections of joint in infectious and parasitic diseases classified elsewhere

M02    Reactive arthropathies

M03*  Postinfective and reactive arthropathies in diseases classified elsewhere

Inflammatory polyarthropathies (M05-M14)

M05    Seropositive rheumatoid arthritis

M06    Other rheumatoid arthritis

M07*  Psoriatic and enteropathic arthropathies

M08    Juvenile arthritis

M09*  Juvenile arthritis in diseases classified elsewhere

M10    Gout

M11    Other crystal arthropathies

M12    Other specific arthropathies

M13    Other arthritis

M14*  Arthropathies in other diseases classified elsewhere

Arthrosis (M15-M19)

M15    Polyarthrosis

M16    Coxarthrosis [arthrosis of hip]

M17    Gonarthrosis [arthrosis of knee]

M18    Arthrosis of first carpometacarpal joint

M19    Other arthrosis

Other joint disorders (M20-M25)

M20    Acquired deformities of fingers and toes

M21    Other acquired deformities of limbs

M22    Disorders of patella

M23    Internal derangement of knee

M24    Other specific joint derangements

M25    Other joint disorders, not elsewhere classified

Systemic connective tissue disorders (M30-M36)

M30    Polyarteritis nodosa and related conditions

M31    Other necrotizing vasculopathies

M32    Systemic lupus erythematosus

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)

Deforming dorsopathies (M40-M43)

M40    Kyphosis and lordosis

M41    Scoliosis

M42    Spinal osteochondrosis

M43    Other deforming dorsopathies

Spondylopathies (M45-M49)

M45    Ankylosing spondylitis

M46    Other inflammatory spondylopathies

M47    Spondylosis

M48    Other spondylopathies

M49*  Spondylopathies in diseases classified elsewhere

Other dorsopathies (M50-M54)

M50    Cervical disc disorders

M51    Other intervertebral disc disorders

M53    Other dorsopathies, not elsewhere classified

M54    Dorsalgia

Soft tissue disorders (M60-M79)

Disorders of muscles (M60-M63)

M60    Myositis

M61    Calcification and ossification of muscle

M62    Other disorders of muscle

M63*  Disorders of muscle in diseases classified elsewhere

Disorders of synovium and tendon (M65-M68)

M65    Synovitis and tenosynovitis

M66    Spontaneous rupture of synovium and tendon

M67    Other disorders of synovium and tendon

M68*  Disorders of synovium and tendon in diseases classified elsewhere

Other soft tissue disorders (M70-M79)

M70    Soft tissue disorders related to use, overuse and pressure

M71    Other bursopathies

M72    Fibroblastic disorders

M73*  Soft tissue disorders in diseases classifed elsewhere

M75    Shoulder lesions

M76    Enthesopathies of lower limb, excluding foot

M77    Other enthesopathies

M79    Other soft tissue disorders, not elsewhere classified

Osteopathies and chondropathies (M80-M94)

Disorders of bone density and structure (M80-M85)

M80    Osteoporosis with pathological fracture

M81    Osteoporosis without pathological fracture

M82*  Osteoporosis in diseases classified elsewhere

M83    Adult osteomalacia

M84    Disorders of continuity of bone

M85    Other disorders of bone density and structure

Other osteopathies (M86-M90)

M86    Osteomyelitis

M87    Osteonecrosis

M88    Paget disease of bone [osteitis deformans]

M89    Other disorders of bone

M90*  Osteopathies in diseases classified elsewhere

Chondropathies (M91-M94)

M91    Juvenile osteochondrosis of hip and pelvis

M92    Other juvenile osteochondrosis

M93    Other osteochondropathies

M94    Other disorders of cartilage

Other disorders of the musculoskeletal system and connective tissue (M95-M99)

M95    Other acquired deformities of musculoskeletal system

M96    Postprocedural muscoloskeletal disorders, not elsewhere classified

M99    Biomechanical lesions, not elsewhere classified

Chapter XIV - Diseases of the genitourinary system (N00-N99)

Glomerular diseases (N00-N08)

N00    Acute nephritic syndrome

N01    Rapidly progressive nephritic syndrome

N02    Recurrent and persistent haematuria

N03    Chronic nephritic syndrome

N04    Nephrotic syndrome

N05    Unspecified nephritic syndrome

N06    Isolated proteinuria with specified morphological lesion

N07    Hereditary nephropathy, not elsewhere classified

N08*  Glomerular disorders in diseases classified elsewhere

Renal tubulo-interstitial diseases (N10-N16)

N10    Acute tubulo-interstitial nephritis

N11    Chronic tubulo-interstitial nephritis

N12    Tubulo-interstitial nephritis, not specified as acute or chronic

N13    Obstructive and reflux uropathy

N14    Drug- and heavy-metal-induced tubulo-interstitial and tubular conditions

N15    Other renal tubulo-interstitial diseases

N16*  Renal tubulo-interstitial disorders in diseases classified elsewhere

Renal failure (N17-N19)

N17    Acute renal failure

N18    Chronic kidney disease

N19    Unspecified kidney failure

Urolithiasis (N20-N23)

N20    Calculus of kidney and ureter

N21    Calculus of lower urinary tract

N22*  Calculus of urinary tract in diseases classified elsewhere

N23    Unspecified renal colic

Other disorders of kidney and ureter (N25-N29)

N25    Disorders resulting from impaired renal tubular function

N26    Unspecified contracted kidney

N27    Small kidney of unknown cause

N28    Other disorders of kidney and ureter, not elsewhere classified

N29*  Other disorders of kidney and ureter in diseases classified elsewhere

Other diseases of urinary system (N30-N39)

N30    Cystitis

N31    Neuromuscular dysfunction of bladder, not elsewhere classified

N32    Other disorders of bladder

N33*  Bladder disorders in diseases classified elsewhere

N34    Urethritis and urethral syndrome

N35    Urethral stricture

N36    Other disorders of urethra

N37*  Urethral disorders in diseases classified elsewhere

N39    Other disorders of urinary system

Diseases of male genital organs (N40-N51)

N40    Hyperplasia of prostate

N41    Inflammatory diseases of prostate

N42    Other disorders of prostate

N43    Hydrocele and spermatocele

N44    Torsion of testis

N45    Orchitis and epididymitis

N46    Male infertility

N47    Redundant prepuce, phimosis and paraphimosis

N48    Other disorders of penis

N49    Inflammatory disorders of male genital organs, not elsewhere classified

N50    Other disorders of male genital organs

N51*  Disorders of male genital organs in diseases classified elsewhere

Disorders of breast (N60-N64)

N60    Benign mammary dysplasia

N61    Inflammatory disorders of breast

N62    Hypertrophy of breast

N63    Unspecified lump in breast

N64    Other disorders of breast

Inflammatory diseases of female pelvic organs (N70-N77)

N70    Salpingitis and oophoritis

N71    Inflammatory disease of uterus, except cervix

N72    Inflammatory disease of cervix uteri

N73    Other female pelvic inflammatory diseases

N74*  Female pelvic inflammatory disorders in diseases classified elsewhere

N75    Diseases of Bartholin gland

N76    Other inflammation of vagina and vulva

N77*  Vulvovaginal ulceration and inflammation in diseases classified elsewhere

Noninflammatory disorders of female genital tract (N80-N98)

N80    Endometriosis

N81    Female genital prolapse

N82    Fistulae involving female genital tract

N83    Noninflammatory disorders of ovary, fallopian tube and broad ligament

N84    Polyp of female genital tract

N85    Other noninflammatory disorders of uterus, except cervix

N86    Erosion and ectropion of cervix uteri

N87    Dysplasia of cervix uteri

N88    Other noninflammatory disorders of cervix uteri

N89    Other noninflammatory disorders of vagina

N90    Other noninflammatory disorders of vulva and perineum

N91    Absent, scanty and rare menstruation

N92    Excessive, frequent and irregular menstruation

N93    Other abnormal uterine and vaginal bleeding

N94    Pain and other conditions associated with female genital organs and menstrual cycle

N95    Menopausal and other perimenopausal disorders

N96    Habitual aborter

N97    Female infertility

N98    Complications associated with artificial fertilization

Other disorders of the genitourinary tract (N99)

N99    Postprocedural disorders of the genitourinary system, not elsewhere classified

Chapter XV - Pregnancy, childbirth and the puerperium (O00-O99)

Pregnancy with abortive outcome (O00-O08)

O00    Ectopic pregnancy

O01    Hydatidiform mole

O02    Other abnormal products of conception

O03    Spontaneous abortion

O04    Medical abortion

O05    Other abortion

O06    Unspecified abortion

O07    Failed attempted abortion

O08    Complications following abortion and ectopic and molar pregnancy

Oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16)

O10    Pre-existing hypertension complicating pregnancy, childbirth and the puerperium

O11    Pre-existing hypertensive disorder with superimposed proteinuria

O12    Gestational [pregnancy-induced] oedema and proteinuria without hypertension

O13    Gestational [pregnancy-induced] hypertension without significant proteinuria

O14    Gestational [pregnancy-induced] hypertension with significant proteinuria

O15    Eclampsia

O16    Unspecified maternal hypertension

Other maternal disorders predominantly related to pregnancy (O20-O29)

O20    Haemorrhage in early pregnancy

O21    Excessive vomiting in pregnancy

O22    Venous complications in pregnancy

O23    Infections of genitourinary tract in pregnancy

O24    Diabetes mellitus in pregnancy

O25    Malnutrition in pregnancy

O26    Maternal care for other conditions predominantly related to pregnancy

O28    Abnormal findings on antenatal screening of mother

O29    Complications of anaesthesia during pregnancy

Maternal care related to fetus and amniotic cavity and possible delivery problems (O30-O48)

O30    Multiple gestation

O31    Complications specific to multiple gestation

O32    Maternal care for known or suspected malpresentation of fetus

O33    Maternal care for known or suspected disproportion

O34    Maternal care for known or suspected abnormality of pelvic organs

O35    Maternal care for known or suspected fetal abnormality and damage

O36    Maternal care for other known or suspected fetal problems

O40    Polyhydramnios

O41    Other disorders of amniotic fluid and membranes

O42    Premature rupture of membranes

O43    Placental disorders

O44    Placenta praevia

O45    Premature separation of placenta [abruptio placentae]

O46    Antepartum haemorrhage, not elsewhere classified

O47    False labour

O48    Prolonged pregnancy

Complications of labour and delivery (O60-O75)

O60    Preterm labour

O61    Failed induction of labour

O62    Abnormalities of forces of labour

O63    Long labour

O64    Obstructed labour due to malposition and malpresentation of fetus

O65    Obstructed labour due to maternal pelvic abnormality

O66    Other obstructed labour

O67    Labour and delivery complicated by intrapartum haemorrhage, not elsewhere classified

O68    Labour and delivery complicated by fetal stress [distress]

O69    Labour and delivery complicated by umbilical cord complications

O70    Perineal laceration during delivery

O71    Other obstetric trauma

O72    Postpartum haemorrhage

O73    Retained placenta and membranes, without haemorrhage

O74    Complications of anaesthesia during labour and delivery

O75    Other complications of labour and delivery, not elsewhere classified

Delivery (O80-O84)

O80    Single spontaneous delivery

O81    Single delivery by forceps and vacuum extractor

O82    Single delivery by caesarean section

O83    Other assisted single delivery

O84    Multiple delivery

Complications predominantly related to the puerperium (O85-O92)

O85    Puerperal sepsis

O86    Other puerperal infections

O87    Venous complications in the puerperium

O88    Obstetric embolism

O89    Complications of anaesthesia during the puerperium

O90    Complications of the puerperium, not elsewhere classified

O91    Infections of breast associated with childbirth

O92    Other disorders of breast and lactation associated with childbirth

Other obstetric conditions, not elsewhere classified (O94-O99)

O94    Sequelae of complication of pregnancy, childbirth and the puerperium

O95    Obstetric death of unspecified cause

O96    Death from any obstetric cause occurring more than 42 days but less than one year after delivery

O97    Death from sequelae of obstetric causes

O98    Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

O99    Other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium

Chapter XVI - Certain conditions originating in the perinatal period (P00-P96)

Fetus and newborn affected by maternal factors and by complications of pregnancy, labour and delivery (P00-P04)

P00    Fetus and newborn affected by maternal conditions that may be unrelated to present pregnancy

P01    Fetus and newborn affected by maternal complications of pregnancy

P02    Fetus and newborn affected by complications of placenta, cord and membranes

P03    Fetus and newborn affected by other complications of labour and delivery

P04    Fetus and newborn affected by noxious influences transmitted via placenta or breast milk

Disorders related to length of gestation and fetal growth (P05-P08)

P05    Slow fetal growth and fetal malnutrition

P07    Disorders related to short gestation and low birth weight, not elsewhere classified

P08    Disorders related to long gestation and high birth weight

Birth trauma (P10-P15)

P10    Intracranial laceration and haemorrhage due to birth injury

P11    Other birth injuries to central nervous system

P12    Birth injury to scalp

P13    Birth injury to skeleton

P14    Birth injury to peripheral nervous system

P15    Other birth injuries

Respiratory and cardiovascular disorders specific to the perinatal period (P20-P29)

P20    Intrauterine hypoxia

P21    Birth asphyxia

P22    Respiratory distress of newborn

P23    Congenital pneumonia

P24    Neonatal aspiration syndromes

P25    Interstitial emphysema and related conditions originating in the perinatal period

P26    Pulmonary haemorrhage originating in the perinatal period

P27    Chronic respiratory disease originating in the perinatal period

P28    Other respiratory conditions originating in the perinatal period

P29    Cardiovascular disorders originating in the perinatal period

Infections specific to the perinatal period (P35-P39)

P35    Congenital viral diseases

P36    Bacterial sepsis of newborn

P37    Other congenital infectious and parasitic diseases

P38    Omphalitis of newborn with or without mild haemorrhage

P39    Other infections specific to the perinatal period

Haemorrhagic and haematological disorders of fetus and newborn (P50-P61)

P50    Fetal blood loss

P51    Umbilical haemorrhage of newborn

P52    Intracranial nontraumatic haemorrhage of fetus and newborn

P53    Haemorrhagic disease of fetus and newborn

P54    Other neonatal haemorrhages

P55    Haemolytic disease of fetus and newborn

P56    Hydrops fetalis due to haemolytic disease

P57    Kernicterus

P58    Neonatal jaundice due to other excessive haemolysis

P59    Neonatal jaundice from other and unspecified causes

P60    Disseminated intravascular coagulation of fetus and newborn

P61    Other perinatal haematological disorders

Transitory endocrine and metabolic disorders specific to fetus and newborn (P70-P74)

P70    Transitory disorders of carbohydrate metabolism specific to fetus and newborn

P71    Transitory neonatal disorders of calcium and magnesium metabolism

P72    Other transitory neonatal endocrine disorders

P74    Other transitory neonatal electrolyte and metabolic disturbances

Digestive system disorders of fetus and newborn (P75-P78)

P75*  Meconium ileus

P76    Other intestinal obstruction of newborn

P77    Necrotizing enterocolitis of fetus and newborn

P78    Other perinatal digestive system disorders

Conditions involving the integument and temperature regulation of fetus and newborn (P80-P83)

P80    Hypothermia of newborn

P81    Other disturbances of temperature regulation of newborn

P83    Other conditions of integument specific to fetus and newborn

Other disorders originating in the perinatal period (P90-P96)

P90    Convulsions of newborn

P91    Other disturbances of cerebral status of newborn

P92    Feeding problems of newborn

P93    Reactions and intoxications due to drugs administered to fetus and newborn

P94    Disorders of muscle tone of newborn

P95    Fetal death of unspecified cause

P96    Other conditions originating in the perinatal period

Chapter XVII - Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)

Congenital malformations of the nervous system (Q00-Q07)

Q00    Anencephaly and similar malformations

Q01    Encephalocele

Q02    Microcephaly

Q03    Congenital hydrocephalus

Q04    Other congenital malformations of brain

Q05    Spina bifida

Q06    Other congenital malformations of spinal cord

Q07    Other congenital malformations of nervous system

Congenital malformations of eye, ear, face and neck (Q10-Q18)

Q10    Congenital malformations of eyelid, lacrimal apparatus and orbit

Q11    Anophthalmos, microphthalmos and macrophthalmos

Q12    Congenital lens malformations

Q13    Congenital malformations of anterior segment of eye

Q14    Congenital malformations of posterior segment of eye

Q15    Other congenital malformations of eye

Q16    Congenital malformations of ear causing impairment of hearing

Q17    Other congenital malformations of ear

Q18    Other congenital malformations of face and neck

Congenital malformations of the circulatory system (Q20-Q28)

Q20    Congenital malformations of cardiac chambers and connections

Q21    Congenital malformations of cardiac septa

Q22    Congenital malformations of pulmonary and tricuspid valves

Q23    Congenital malformations of aortic and mitral valves

Q24    Other congenital malformations of the heart

Q25    Congenital malformations of great arteries

Q26    Congenital malformations of great veins

Q27    Other congenital malformations of peripheral vascular system

Q28    Other congenital malformations of circulatory system

Congenital malformations of the respiratory system (Q30-Q34)

Q30    Congenital malformations of nose

Q31    Congenital malformations of larynx

Q32    Congenital malformations of trachea and bronchus

Q33    Congenital malformations of lung

Q34    Other congenital malformations of respiratory system

Cleft lip and cleft palate (Q35-Q37)

Q35    Cleft palate

Q36    Cleft lip

Q37    Cleft palate with cleft lip

Other congenital malformations of the digestive system (Q38-Q45)

Q38    Other congenital malformations of tongue, mouth and pharynx

Q39    Congenital malformations of oesophagus

Q40    Other congenital malformations of upper alimentary tract

Q41    Congenital absence, atresia and stenosis of small intestine

Q42    Congenital absence, atresia and stenosis of large intestine

Q43    Other congenital malformations of intestine

Q44    Congenital malformations of gallbladder, bile ducts and liver

Q45    Other congenital malformations of digestive system

Congenital malformations of genital organs (Q50-Q56)

Q50    Congenital malformations of ovaries, fallopian tubes and broad ligaments

Q51    Congenital malformations of uterus and cervix

Q52    Other congenital malformations of female genitalia

Q53    Undescended testicle

Q54    Hypospadias

Q55    Other congenital malformations of male genital organs

Q56    Indeterminate sex and pseudohermaphroditism

Congenital malformations of the urinary system (Q60-Q64)

Q60    Renal agenesis and other reduction defects of kidney

Q61    Cystic kidney disease

Q62    Congenital obstructive defects of renal pelvis and congenital malformations of ureter

Q63    Other congenital malformations of kidney

Q64    Other congenital malformations of urinary system

Congenital malformations and deformations of the musculoskeletal system (Q65-Q79)

Q65    Congenital deformities of hip

Q66    Congenital deformities of feet

Q67    Congenital musculoskeletal deformities of head, face, spine and chest

Q68    Other congenital musculoskeletal deformities

Q69    Polydactyly

Q70    Syndactyly

Q71    Reduction defects of upper limb

Q72    Reduction defects of lower limb

Q73    Reduction defects of unspecified limb

Q74    Other congenital malformations of limb(s)

Q75    Other congenital malformations of skull and face bones

Q76    Congenital malformations of spine and bony thorax

Q77    Osteochondrodysplasia with defects of growth of tubular bones and spine

Q78    Other osteochondrodysplasias

Q79    Congenital malformations of the musculoskeletal system, not elsewhere classified

Other congenital malformations (Q80-Q89)

Q80    Congenital ichthyosis

Q81    Epidermolysis bullosa

Q82    Other congenital malformations of skin

Q83    Congenital malformations of breast

Q84    Other congenital malformations of integument

Q85    Phakomatoses, not elsewhere classified

Q86    Congenital malformation syndromes due to known exogenous causes, not elsewhere classified

Q87    Other specified congenital malformation syndromes affecting multiple systems

Q89    Other congenital malformations, not elsewhere classified

Chromosomal abnormalities, not elsewhere classified (Q90-Q99)

Q90    Down syndrome

Q91    Edward syndrome and Patau syndrome

Q92    Other trisomies and partial trisomies of the autosomes, not elsewhere classified

Q93    Monosomies and deletions from the autosomes, not elsewhere classified

Q95    Balanced rearrangements and structural markers, not elsewhere classified

Q96    Turner syndrome

Q97    Other sex chromosome abnormalities, female phenotype, not elsewhere classified

Q98    Other sex chromosome abnormalities, male phenotype, not elsewhere classified

Q99    Other chromosome abnormalities, not elsewhere classified

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

R32    Unspecified urinary incontinence

R33    Retention of urine

R34    Anuria and oliguria

R35    Polyuria

R36    Urethral discharge

R39    Other symptoms and signs involving the urinary system

Symptoms and signs involving cognition, perception, emotional state and behaviour (R40-R46)

R40    Somnolence, stupor and coma

R41    Other symptoms and signs involving cognitive functions and awareness

R42    Dizziness and giddiness

R43    Disturbances of smell and taste

R44    Other symptoms and signs involving general sensations and perceptions

R45    Symptoms and signs involving emotional state

R46    Symptoms and signs involving appearance and behaviour

Symptoms and signs involving speech and voice (R47-R49)

R47    Speech disturbances, not elsewhere classified

R48    Dyslexia and other symbolic dysfunctions, not elsewhere classified

R49    Voice disturbances

General symptoms and signs (R50-R69)

R50    Fever of other and unknown origin

R51    Headache

R52    Pain, not elsewhere classified

R53    Malaise and fatigue

R54    Senility

R55    Syncope and collapse

R56    Convulsions, not elsewhere classified

R57    Shock, not elsewhere classified

R58    Haemorrhage, not elsewhere classified

R59    Enlarged lymph nodes

R60    Oedema, not elsewhere classified

R61    Hyperhidrosis

R62    Lack of expected normal physiological development

R63    Symptoms and signs concerning food and fluid intake

R64    Cachexia

R68    Other general symptoms and signs

R69    Unknown and unspecified causes of morbidity

Abnormal findings on examination of blood, without diagnosis (R70-R79)

R70    Elevated erythrocyte sedimentation rate and abnormality of plasma viscosity

R71    Abnormality of red blood cells

R72    Abnormality of white blood cells, not elsewhere classified

R73    Elevated blood glucose level

R74    Abnormal serum enzyme levels

R75    Laboratory evidence of human immunodeficiency virus [HIV]

R76    Other abnormal immunological findings in serum

R77    Other abnormalities of plasma proteins

R78    Findings of drugs and other substances, not normally found in blood

R79    Other abnormal findings of blood chemistry

Abnormal findings on examination of urine, without diagnosis (R80-R82)

R80    Isolated proteinuria

R81    Glycosuria

R82    Other abnormal findings in urine

Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89)

R83    Abnormal findings in cerebrospinal fluid

R84    Abnormal findings in specimens from respiratory organs and thorax

R85    Abnormal findings in specimens from digestive organs and abdominal cavity

R86    Abnormal findings in specimens from male genital organs

R87    Abnormal findings in specimens from female genital organs

R89    Abnormal findings in specimens from other organs, systems and tissues

Abnormal findings on diagnostic imaging and in function studies, without diagnosis (R90-R94)

R90    Abnormal findings on diagnostic imaging of central nervous system

R91    Abnormal findings on diagnostic imaging of lung

R92    Abnormal findings on diagnostic imaging of breast

R93    Abnormal findings on diagnostic imaging of other body structures

R94    Abnormal results of function studies

Ill-defined and unknown causes of mortality (R95-R99)

R95    Sudden infant death syndrome

R96    Other sudden death, cause unknown

R98    Unattended death

R99    Other ill-defined and unspecified causes of mortality

Chapter XIX - Injury, poisoning and certain other consequences of external causes (S00-T98)

Injuries to the head (S00-S09)

S00    Superficial injury of head

S01    Open wound of head

S02    Fracture of skull and facial bones

S03    Dislocation, sprain and strain of joints and ligaments of head

S04    Injury of cranial nerves

S05    Injury of eye and orbit

S06    Intracranial injury

S07    Crushing injury of head

S08    Traumatic amputation of part of head

S09    Other and unspecified injuries of head

Injuries to the neck (S10-S19)

S10    Superficial injury of neck

S11    Open wound of neck

S12    Fracture of neck

S13    Dislocation, sprain and strain of joints and ligaments at neck level

S14    Injury of nerves and spinal cord at neck level

S15    Injury of blood vessels at neck level

S16    Injury of muscle and tendon at neck level

S17    Crushing injury of neck

S18    Traumatic amputation at neck level

S19    Other and unspecified injuries of neck

Injuries to the thorax (S20-S29)

S20    Superficial injury of thorax

S21    Open wound of thorax

S22    Fracture of rib(s), sternum and thoracic spine

S23    Dislocation, sprain and strain of joints and ligaments of thorax

S24    Injury of nerves and spinal cord at thorax level

S25    Injury of blood vessels of thorax

S26    Injury of heart

S27    Injury of other and unspecified intrathoracic organs

S28    Crushing injury of thorax and traumatic amputation of part of thorax

S29    Other and unspecified injuries of thorax

Injuries to the abdomen, lower back, lumbar spine and pelvis (S30-S39)

S30    Superficial injury of abdomen, lower back and pelvis

S31    Open wound of abdomen, lower back and pelvis

S32    Fracture of lumbar spine and pelvis

S33    Dislocation, sprain and strain of joints and ligaments of lumbar spine and pelvis

S34    Injury of nerves and lumbar spinal cord at abdomen, lower back and pelvis level

S35    Injury of blood vessels at abdomen, lower back and pelvis level

S36    Injury of intra-abdominal organs

S37    Injury of urinary and pelvic organs

S38    Crushing injury and traumatic amputation of part of abdomen, lower back and pelvis

S39    Other and unspecified injuries of abdomen, lower back and pelvis

Injuries to the shoulder and upper arm (S40-S49)

S40    Superficial injury of shoulder and upper arm

S41    Open wound of shoulder and upper arm

S42    Fracture of shoulder and upper arm

S43    Dislocation, sprain and strain of joints and ligaments of shoulder girdle

S44    Injury of nerves at shoulder and upper arm level

S45    Injury of blood vessels at shoulder and upper arm level

S46    Injury of muscle and tendon at shoulder and upper arm level

S47    Crushing injury of shoulder and upper arm

S48    Traumatic amputation of shoulder and upper arm

S49    Other and unspecified injuries of shoulder and upper arm

Injuries to the elbow and forearm (S50-S59)

S50    Superficial injury of forearm

S51    Open wound of forearm

S52    Fracture of forearm

S53    Dislocation, sprain and strain of joints and ligaments of elbow

S54    Injury of nerves at forearm level

S55    Injury of blood vessels at forearm level

S56    Injury of muscle and tendon at forearm level

S57    Crushing injury of forearm

S58    Traumatic amputation of forearm

S59    Other and unspecified injuries of forearm

Injuries to the wrist and hand (S60-S69)

S60    Superficial injury of wrist and hand

S61    Open wound of wrist and hand

S62    Fracture at wrist and hand level

S63    Dislocation, sprain and strain of joints and ligaments at wrist and hand level

S64    Injury of nerves at wrist and hand level

S65    Injury of blood vessels at wrist and hand level

S66    Injury of muscle and tendon at wrist and hand level

S67    Crushing injury of wrist and hand

S68    Traumatic amputation of wrist and hand

S69    Other and unspecified injuries of wrist and hand

Injuries to the hip and thigh (S70-S79)

S70    Superficial injury of hip and thigh

S71    Open wound of hip and thigh

S72    Fracture of femur

S73    Dislocation, sprain and strain of joint and ligaments of hip

S74    Injury of nerves at hip and thigh level

S75    Injury of blood vessels at hip and thigh level

S76    Injury of muscle and tendon at hip and thigh level

S77    Crushing injury of hip and thigh

S78    Traumatic amputation of hip and thigh

S79    Other and unspecified injuries of hip and thigh

Injuries to the knee and lower leg (S80-S89)

S80    Superficial injury of lower leg

S81    Open wound of lower leg

S82    Fracture of lower leg, including ankle

S83    Dislocation, sprain and strain of joints and ligaments of knee

S84    Injury of nerves at lower leg level

S85    Injury of blood vessels at lower leg level

S86    Injury of muscle and tendon at lower leg level

S87    Crushing injury of lower leg

S88    Traumatic amputation of lower leg

S89    Other and unspecified injuries of lower leg

Injuries to the ankle and foot (S90-S99)

S90    Superficial injury of ankle and foot

S91    Open wound of ankle and foot

S92    Fracture of foot, except ankle

S93    Dislocation, sprain and strain of joints and ligaments at ankle and foot level

S94    Injury of nerves at ankle and foot level

S95    Injury of blood vessels at ankle and foot level

S96    Injury of muscle and tendon at ankle and foot level

S97    Crushing injuries of ankle and foot

S98    Traumatic amputation of ankle and foot

S99    Other and unspecified injuries of ankle and foot

Injuries involving multiple body regions (T00-T07)

T00    Superficial injuries involving multiple body regions

T01    Open wounds involving multiple body regions

T02    Fractures involving multiple body regions

T03    Dislocations, sprains and strains involving multiple body regions

T04    Crushing injuries involving multiple body regions

T05    Traumatic amputations involving multiple body regions

T06    Other injuries involving multiple body regions, not elsewhere classified

T07    Unspecified multiple injuries

Injuries to unspecified part of trunk, limb or body region (T08-T14)

T08    Fracture of spine, level unspecified

T09    Other injuries of spine and trunk, level unspecified

T10    Fracture of upper limb, level unspecified

T11    Other injuries of upper limb, level unspecified

T12    Fracture of lower limb, level unspecified

T13    Other injuries of lower limb, level unspecified

T14    Injury of unspecified of body

Effects of foreign body entering through natural orifice (T15-T19)

T15    Foreign body on external eye

T16    Foreign body in ear

T17    Foreign body in respiratory tract

T18    Foreign body in alimentary tract

T19    Foreign body in genitourinary tract

Burns and corrosions (T20-T32)

Burns and corrosions of external body surface, specified by site (T20-T25)

T20    Burn and corrosion of head and neck

T21    Burn and corrosion of trunk

T22    Burn and corrosion of shoulder and upper limb, except wrist and hand

T23    Burn and corrosion of wrist and hand

T24    Burn and corrosion of hip and lower limb, except ankle and foot

T25    Burn and corrosion of ankle and foot

Burns and corrosions confined to eye and internal organs (T26-T28)

T26    Burn and corrosion confined to eye and adnexa

T27    Burn and corrosion of respiratory tract

T28    Burn and corrosion of other internal organs

Burns and corrosions of multiple and unspecified body regions (T29-T32)

T29    Burns and corrosions of multiple body regions

T30    Burn and corrosion, body region unspecified

T31    Burns classified according to extent of body surface involved

T32    Corrosions classified according to extent of body surface involved

Frostbite (T33-T35)

T33    Superficial frostbite

T34    Frostbite with tissue necrosis

T35    Frostbite involving multiple body regions and unspecified frostbite

Poisoning by drugs, medicaments and biological substances (T36-T50)

T36    Poisoning by systemic antibiotics

T37    Poisoning by other systemic anti-infectives and antiparasitics

T38    Poisoning by hormones and their synthetic substitutes and antagonists, not elsewhere classified

T39    Poisoning by nonopioid analgesics, antipyretics and antirheumatics

T40    Poisoning by narcotics and psychodysleptics [hallucinogens]

T41    Poisoning by anaesthetics and therapeutic gases

T42    Poisoning by antiepileptic, sedative-hypnotic and antiparkinsonism drugs

T43    Poisoning by psychotropic drugs, not elsewhere classified

T44    Poisoning by drugs primarily affecting the autonomic nervous system

T45    Poisoning by primarily systemic and haematological agents, not elsewhere classified

T46    Poisoning by agents primarily affecting the cardiovascular system

T47    Poisoning by agents primarily affecting the gastrointestinal system

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 devices, implants and grafts

T84    Complications of internal orthopaedic prosthetic devices, implants and grafts

T85    Complications of other internal prosthetic devices, implants and grafts

T86    Failure and rejection of transplanted organs and tissues

T87    Complications peculiar to reattachment and amputation

T88    Other complications of surgical and medical care, not elsewhere classified

Sequelae of injuries, of poisoning and of other consequences of external causes (T90-T98)

T90    Sequelae of injuries of head

T91    Sequelae of injuries of neck and trunk

T92    Sequelae of injuries of upper limb

T93    Sequelae of injuries of lower limb

T94    Sequelae of injuries involving multiple and unspecified body regions

T95    Sequelae of burns, corrosions and frostbite

T96    Sequelae of poisoning by drugs, medicaments and biological substances

T97    Sequelae of toxic effects of substances chiefly nonmedicinal as to source

T98    Sequelae of other and unspecified effects of external causes

Chapter XX - External causes of morbidity and mortality (V01-Y98)

Transport accidents (VO1-V99)

Pedestrian injured in transport accident (V01-V09)

V01    Pedestrian injured in collision with pedal cycle

V02    Pedestrian injured in collision with two- or three-wheeled motor vehicle

V03    Pedestrian injured in collision with car, pick-up truck or van

V04    Pedestrian injured in collision with heavy transport vehicle or bus

V05    Pedestrian injured in collision with railway train or railway vehicle

V06    Pedestrian injured in collision with other nonmotor vehicle

V09    Pedestrian injured in other and unspecified transport accidents

Pedal cyclist injured in transport accident (Vl0-Vl9)

V10    Pedal cyclist injured in collision with pedestrian or animal

V11    Pedal cyclist injured in collision with other pedal cycle

V12    Pedal cyclist injured in collision with two-or three-wheeled motor vehicle

V13    Pedal cyclist injured in collision with car, pick-up truck or van

V14    Pedal cyclist injured in collision with heavy transport vehicle or bus

V15    Pedal cyclist injured in collision with railway train or railway vehicle

V16    Pedal cyclist injured in collision with other nonmotor vehicle

V17    Pedal cyclist injured in collision with fixed or stationary object

V18    Pedal cyclist injured in noncollision transport accident

V19    Pedal cyclist injured in other and unspecified transport accidents

Motorcycle rider injured in transport accident (V20-V29)

V20    Motorcyle rider injured in collision with pedestrian or animal

V21    Motorcyle rider injured in collision with pedal cycle

V22    Motorcyle rider injured in collision with two-or three-wheeled motor vehicle

V23    Motorcyle rider injured in collision with car, pick-up truck or van

V24    Motorcyle rider injured in collision with heavy transport vehicle or bus

V25    Motorcyle rider injured in collision with railway train or railway vehicle

V26    Motorcyle rider injured in collision with other nonmotor vehicle

V27    Motorcyle rider injured in collision with fixed or stationary object

V28    Motorcyle rider injured in noncollision transport accident

V29    Motorcyle rider injured in other and unspecified transport accidents

Occupant of three-wheeled motor vehicle injured in transport accident (V30-V39)

V30    Occupant of three-wheeled motor vehicle injured in collision with pedestrian or animal

V31    Occupant of three-wheeled motor vehicle injured in collision with pedal cycle

V32    Occupant of three-wheeled motor vehicle injured in collision with two-or three-wheeled motor vehicle

V33    Occupant of three-wheeled motor vehicle injured in collision with car, pick-up truck or van

V34    Occupant of three-wheeled motor vehicle injured in collision with heavy transport vehicle or bus

V35    Occupant of three-wheeled motor vehicle injured in collision with railway train or railway vehicle

V36    Occupant of three-wheeled motor vehicle injured in collision with other nonmotor vehicle

V37    Occupant of three-wheeled motor vehicle injured in collision with fixed or stationary object

V38    Occupant of three-wheeled motor vehicle injured in noncollision transport accident

V39    Occupant of three-wheeled motor vehicle injured in other and unspecified transport accidents

Car occupant injured in transport accident (V40-V49)

V40    Car occupant injured in collision with pedestrian or animal

V41    Car occupant injured in collision with pedal cycle

V42    Car occupant injured in collision with two-or three-wheeled motor vehicle

V43    Car occupant injured in collision with car, pick-up truck or van

V44    Car occupant injured in collision with heavy transport vehicle or bus

V45    Car occupant injured in collision with railway train or railway vehicle

V46    Car occupant injured in collision with other nonmotor vehicle

V47    Car occupant injured in collision with fixed or stationary object

V48    Car occupant injured in noncollision transport accident

V49    Car occupant injured in other and unspecified transport accidents

Occupant of pick-up truck or van injured in transport accident (V50-V59)

V50    Occupant of pick-up truck or van injured in collision with pedestrian or animal

V51    Occupant of pick-up truck or van injured in collision with pedal cycle

V52    Occupant of pick-up truck or van injured in collision with two-or three-wheeled motor vehicle

V53    Occupant of pick-up truck or van injured in collision with car, pick-up truck or van

V54    Occupant of pick-up truck or van injured in collision with heavy transport vehicle or bus

V55    Occupant of pick-up truck or van injured in collision with railway train or railway vehicle

V56    Occupant of pick-up truck or van injured in collision with other nonmotor vehicle

V57    Occupant of pick-up truck or van injured in collision with fixed or stationary object

V58    Occupant of pick-up truck or van injured in noncollision transport accident

V59    Occupant of pick-up truck or van injured in other and unspecified transport accidents

Occupant of heavy transport vehicle injured in transport accident (V60-V69)

V60    Occupant of heavy transport vehicle injured in collision with pedestrian or animal

V61    Occupant of heavy transport vehicle injured in collision with pedal cycle

V62    Occupant of heavy transport vehicle injured in collision with two-or three-wheeled motor vehicle

V63    Occupant of heavy transport vehicle injured in collision with car, pick-up truck or van

V64    Occupant of heavy transport vehicle injured in collision with heavy transport vehicle or bus

V65    Occupant of heavy transport vehicle injured in collision with railway train or railway vehicle

V66    Occupant of heavy transport vehicle injured in collision with other nonmotor vehicle

V67    Occupant of heavy transport vehicle injured in collision with fixed or stationary object

V68    Occupant of heavy transport vehicle injured in noncollision transport accident

V69    Occupant of heavy transport vehicle injured in other and unspecified transport accidents

Bus occupant injured in transport accident (V70-V79)

V70    Bus occupant injured in collision with pedestrian or animal

V71    Bus occupant injured in collision with pedal cycle

V72    Bus occupant injured in collision with two-or three-wheeled motor vehicle

V73    Bus occupant injured in collision with car, pick-up truck or van

V74    Bus occupant injured in collision with heavy transport vehicle or bus

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 vehicles 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

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 knife, sword or dagger

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 tire, 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

Exposure to animate mechanical forces (W50-W64)

W50   Hit, struck, kicked, twisted, bitten or scratched by another person

W51   Striking against or bumped into by another person

W52   Crushed, pushed and stepped on by crowd or human stampede

W53   Bitten by rat

W54   Bitten or struck by dog

W55   Bitten or struck by other mammals

W56   Contact with marine animal

W57   Bitten or stung by nonvenomous insects and other nonvenomous arthropods

W58   Bitten or struck by crocodile or alligator

W59   Bitten or crushed by other reptiles

W60   Contact with plant thorns and spines and sharp leaves

W64   Exposure to other and unspecified animate mechanical forces

Accidental drowning and submersion (W65-W74)

W65   Drowning and submersion while in bath-tub

W66   Drowning and submersion following fall into bath-tub

W67   Drowning and submersion while in swimming-pool

W68   Drowning and submersion following fall into swimming-pool

W69   Drowning and submersion while in natural water

W70   Drowning and submersion following fall into natural water

W73   Other specified drowning and submersion

W74   Unspecified drowning and submersion

Other accidental threats to breathing (W75-W84)

W75   Accidental suffocation and strangulation in bed

W76   Other accidental hanging and strangulation

W77   Threat to breathing due to cave-in, falling earth and other substances

W78   Inhalation of gastric contents

W79   Inhalation and ingestion of food causing obstruction of respiratory tract

W80   Inhalation and ingestion of other objects causing obstruction of respiratory tract

W81   Confined to or trapped in a low oxygen-environment

W83   Other specified threats to breathing

W84   Unspecified threat to breathing

Exposure to electric current, radiation and extreme ambient air temperature and pressure (W85-W99)

W85   Exposure to electric transmission lines

W86   Exposure to other specified electric current

W87   Exposure to unspecified electric current

W88   Exposure to ionizing radiation

W89   Exposure to man-made visible and ultraviolet light

W90   Exposure to other nonionizing radiation

W91   Exposure to unspecified type of radiation

W92   Exposure to excessive heat of man-made origin

W93   Exposure to excessive cold of man-made origin

W94   Exposure to high and low air pressure and changes in air pressure

W99   Exposure to other and unspecified man-made environmental factors

Exposure to smoke, fire and flames (X00-X09)

X00    Exposure to uncontrolled fire in building or structure

X01    Exposure to uncontrolled fire, not in building or structure

X02    Exposure to controlled fire in building or structure

X03    Exposure to controlled fire, not in building or structure

X04    Exposure to ignition of highly flammable material

X05    Exposure to ignition or melting of nightwear

X06    Exposure to ignition or melting of other clothing and apparel

X08    Exposure to other specified smoke, fire and flames

X09    Exposure to unspecified smoke, fire and flames

Contact with heat and hot substances (X10-X19)

X10    Contact with hot drinks, food, fats and cooking oils

X11    Contact with hot tap-water

X12    Contact with other hot fluids

X13    Contact with steam and hot vapours

X14    Contact with hot air and gases

X15    Contact with hot household appliances

X16    Contact with hot heating appliances, radiators and pipes

X17    Contact with hot engines, machinery and tools

X18    Contact with other hot metals

X19    Contact with other and unspecified heat and hot substances

Contact with venomous animals and plants (X20-X29)

X20    Contact with venomous snakes and lizards

X21    Contact with venomous spiders

X22    Contact with scorpions

X23    Contact with hornets, wasps and bees

X24    Contact with centipedes and venomous millipedes (tropical)

X25    Contact with other venomous arthropods

X26    Contact with venomous marine animals and plants

X27    Contact with other specified venomous animals

X28    Contact with other specified venomous plants

X29    Contact with unspecified venomous animal or plant

Exposure to forces of nature (X30-X39)

X30    Exposure to excessive natural heat

X31    Exposure to excessive natural cold

X32    Exposure to sunlight

X33    Victim of lightning

X34    Victim of earthquake

X35    Victim of volcanic eruption

X36    Victim of avalanche, landslide and other earth movements

X37    Victim of cataclysmic storm

X38    Victim of flood

X39    Exposure to other and unspecified forces of nature

Accidental poisoning by and exposure to noxious substances (X40-X49)

X40    Accidental poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics

X41    Accidental poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, not elsewhere classified

X42    Accidental poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified

X43    Accidental poisoning by and exposure to other drugs acting on the autonomic nervous system

X44    Accidental poisoning by and exposure to other and unspecified drugs, medicaments and biological substances

X45    Accidental poisoning by and exposure to alcohol

X46    Accidental poisoning by and exposure to organic solvents and halogenated hydrocarbons and their vapours

X47    Accidental poisoning by and exposure to other gases and vapours

X48    Accidental poisoning by and exposure to pesticides

X49    Accidental poisoning by and exposure to other and unspecified chemicals and noxious substances

Overexertion, travel and privation (X50-X57)

X50    Overexertion and strenuous or repetitive movements

X51    Travel and motion

X52    Prolonged stay in weightless environment

X53    Lack of food

X54    Lack of water

X57    Unspecified privation

Accidental exposure to other and unspecified factors (X58-X59)

X58    Exposure to other specified factors

X59    Exposure to unspecified factor

Intentional self-harm (X60-X84)

X60    Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics

X61    Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, not elsewhere classified

X62    Intentional self-poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified

X63    Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system

X64    Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substances

X65    Intentional self-poisoning by and exposure to alcohol

X66    Intentional self-poisoning by and exposure to organic solvents and halogenated hydrocarbons and their vapours

X67    Intentional self-poisoning by and exposure to other gases and vapours

X68    Intentional self-poisoning by and exposure to pesticides

X69    Intentional self-poisoning by and exposure to other and unspecified chemicals and noxious substances

X70    Intentional self-harm by hanging, strangulation and suffocation

X71    Intentional self-harm by drowning and submersion

X72    Intentional self-harm by handgun discharge

X73    Intentional self-harm by rifle, shotgun and larger firearm discharge

X74    Intentional self-harm by other and unspecified firearm discharge

X75    Intentional self-harm by explosive material

X76    Intentional self-harm by smoke, fire and flames

X77    Intentional self-harm by steam, hot vapours and hot objects

X78    Intentional self-harm by sharp object

X79    Intentional self-harm by blunt object

X80    Intentional self-harm by jumping from a high place

X81    Intentional self-harm by jumping or lying before moving object

X82    Intentional self-harm by crashing of motor vehicle

X83    Intentional self-harm by other specified means

X84    Intentional self-harm by unspecified means

Assault (X85-Y09)

X85    Assault by drugs, medicaments and biological substances

X86    Assault by corrosive substance

X87    Assault by pesticides

X88    Assault by gases and vapours

X89    Assault by other specified chemicals and noxious substances

X90    Assault by unspecified chemical or noxious substance

X91    Assault by hanging, strangulation and suffocation

X92    Assault by drowning and submersion

X93    Assault by handgun discharge

X94    Assault by rifle, shotgun and larger firearm discharge

X95    Assault by other and unspecified firearm discharge

X96    Assault by explosive material

X97    Assault by fire and flames

X98    Assault by steam, hot vapours and hot objects

X99    Assault by sharp object

Y00    Assault by blunt object

Y01    Assault by pushing from high place

Y02    Assault by pushing or placing victim before moving object

Y03    Assault by crashing of motor vehicle

Y04    Assault by bodily force

Y05    Sexual assault by bodily force

Y06    Neglect and abandonment

Y07    Other maltreatment syndromes

Y08    Assault by other specified means

Y09    Assault by unspecified means

Event of undetermined intent (Y10-Y34)

Y10    Poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics, undetermined intent

Y11    Poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, not elsewhere classified, undetermined intent

Y12    Poisoning by and exposure to narcotics and psychodysleptics [hallucinogens], not elsewhere classified, undetermined intent

Y13    Poisoning by and exposure to other drugs acting on the autonomic nervous system, undetermined intent

Y14    Poisoning by and exposure to other and unspecified drugs, medicaments and biological substances, undetermined intent

Y15    Poisoning by and exposure to alcohol, undetermined intent

Y16    Poisoning by and exposure to organic solvents and halogenated hydrocarbons and their vapours, undetermined intent

Y17    Poisoning by and exposure to other gases and vapours, undetermined intent

Y18    Poisoning by and exposure to pesticides, undetermined intent

Y19    Poisoning by and exposure to other and unspecified chemicals and noxious substances, undetermined intent

Y20    Hanging, strangulation and suffocation, undetermined intent

Y21    Drowning and submersion, undetermined intent

Y22    Handgun discharge, undetermined intent

Y23    Rifle, shotgun and larger firearm discharge, undetermined intent

Y24    Other and unspecified firearm discharge, undetermined intent

Y25    Contact with explosive material, undetermined intent

Y26    Exposure to smoke, fire and flames, undetermined intent

Y27    Contact with steam, hot vapours and hot objects, undetermined intent

Y28    Contact with sharp object, undetermined intent

Y29    Contact with blunt object, undetermined intent

Y30    Falling, jumping or pushed from a high place, undetermined intent

Y31    Falling, lying or running before or into moving object, undetermined intent

Y32    Crashing of motor vehicle, undetermined intent

Y33    Other specified events, undetermined intent

Y34    Unspecified event, undetermined intent

Legal intervention and operations of war (Y35-Y36)

Y35    Legal intervention

Y36    Operations of war

Complications of medical and surgical care (Y40-Y84)

Drugs, medicaments and biological substances causing adverse effects in therapeutic use (Y40-Y59)

Y40    Systemic antibiotics

Y41    Other systemic anti-infectives and antiparasitics

Y42    Hormones, and their synthetic substitutes and antagonists, not elsewhere classified

Y43    Primarily systemic agents

Y44    Agents primarily affecting blood constituents

Y45    Analgesics, antipyretics and anti-inflammatory drugs

Y46    Antiepileptics and antiparkinsonism drugs

Y47    Sedatives, hypnotics and antianxiety drugs

Y48    Anaesthetics and therapeutic gases

Y49    Psychotropic drugs, not elsewhere classified

Y50    Central nervous system stimulants, not elsewhere classified

Y51    Drugs primarily affecting the autonomic nervous system

Y52    Agents primarily affecting the cardiovascular system

Y53    Agents primarily affecting the gastrointestinal system

Y54    Agents primarily affecting water-balance and mineral and uric acid metabolism

Y55    Agents primarily acting on smooth and skeletal muscles and the respiratory system

Y56    Topical agents primarily affecting skin and mucous membrane and ophthalmological, otorhinolaryngological and dental drugs

Y57    Other and unspecified drugs and medicaments

Y58    Bacterial vaccines

Y59    Other and unspecified vaccines and biological substances

Misadventures to patients during surgical and medical care (Y60-Y69)

Y60    Unintentional cut, puncture, perforation or haemorrhage during surgical and medical care

Y61    Foreign object accidentally left in body during surgical and medical care

Y62    Failure of sterile precautions during surgical and medical care

Y63    Failure in dosage during surgical and medical care

Y64    Contaminated medical or biological substances

Y65    Other misadventures during surgical and medical care

Y66    Nonadministration of surgical and medical care

Y69    Unspecified misadventure during surgical and medical care

Medical devices associated with adverse incidents in diagnostic and therapeutic use (Y70-Y82)

Y70    Anaesthesiology devices associated with adverse incidents

Y71    Cardiovascular devices associated with adverse incidents

Y72    Otorhinolaryngological devices associated with adverse incidents

Y73    Gastroenterology and urology devices associated with adverse incidents

Y74    General hospital and personal-use devices associated with adverse incidents

Y75    Neurological devices associated with adverse incidents

Y76    Obstetric and gynaecological devices associated with adverse incidents

Y77    Ophthalmic devices associated with adverse incidents

Y78    Radiological devices associated with adverse incidents

Y79    Orthopaedic devices associated with adverse incidents

Y80    Physical medicine devices associated with adverse incidents

Y81    General-and plastic-surgery devices associated with adverse incidents

Y82    Other and unspecified medical devices associated with adverse incidents

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 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 of 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)

Persons encountering health services for examination and investigation (Z00-Z13)

^[i]Z00    General examination and investigation of persons without complaint and reported diagnosis

^[i]Z01   Other special examinations and investigations of persons without complaint and reported diagnosis

^[i]Z02   Examination and encounter for administrative purposes

^[i]Z03   Medical observation and evaluation for suspected diseases and conditions, ruled out

^[i]Z04   Examination and observation for other reasons

^[i]Z08   Follow-up examination after treatment for malignant neoplasms

^[i]Z09  Follow-up examination after treatment for conditions other than malignant neoplasms

^[i]Z10  Routine general health check-up of defined subpopulation

^[i]Z11   Special screening examination for infectious and parasitic diseases

^[i]Z12   Special screening examination for neoplasms

^[i]Z13   Special screening examination for other diseases and disorders

Persons with potential health hazards related to communicable diseases (Z20-Z29)

^[i]Z20  Contact with and exposure to communicable diseases

^[i]Z21  Asymptomatic human immunodeficiency virus [HIV] infection status

^[i]Z22  Carrier of infectious disease

^[i]Z23  Need for immunization against single bacterial diseases

^[i]Z24  Need for immunization against certain single viral diseases

^[i]Z25 Need for immunization against other single viral diseases

^[i]Z26 Need for immunization against other single infectious diseases

^[i]Z27  Need for immunization against combinations of infectious diseases

^[i]Z28  Immunization not carried out

^[i]Z29  Need for other prophylactic measures

Persons encountering health services in circumstances related to reproduction (Z30-Z39)

^[i]Z30 Contraceptive management

^[i]Z31 Procreative management

^[i]Z32 Pregnancy examination and test

^[i]Z33 Pregnant state, incidental

^[i]Z34 Supervision of normal pregnancy

^[i]Z35 Supervision of high-risk pregnancy

^[i]Z36          Antenatal screening

^[i]Z37 Outcome of delivery

^[i]Z38 Liveborn infants according to place of birth

^[i]Z39 Postpartum care and examination

Persons encountering health services for specific procedures and health care (Z40-Z54)

^[i]Z40 Prophylactic surgery

^[i]Z41          Procedures for purposes other than remedying health state

^[i]Z42         Follow-up care involving plastic surgery

^[i]Z43 Attention to artificial openings

^[i]Z44         Fitting and adjustment of external prosthetic device

^[i]Z45         Adjustment and management of implanted device

^[i]Z46         Fitting and adjustment of other devices

^[i]Z47         Other orthopaedic follow-up care

^[i]Z48   Other surgical follow-up care

^[i]Z49  Care involving dialysis

^[i]Z50  Care involving use of rehabilitation procedures

^[i]Z51  Other medical care

^[i]Z52 Donors of organs and tissues

^[i]Z53  Persons encountering health services for specific procedures, not carried out

^[i]Z54 Convalescence

Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65)

^[i]Z55 Problems related to education and literacy

^[i]Z56 Problems related to employment and unemployment

^[i]Z57 Occupational exposure to risk-factors

^[i]Z58    Problems related to physical environment

^[i]Z59   Problems related to housing and economic circumstances

^[i]Z60   Problems related to social environment

^[i]Z61   Problems related to negative life events in childhood

^[i]Z62  Other problems related to upbringing

^[i]Z63   Other problems related to primary support group, including family circumstances

^[i]Z64  Problems related to certain psychosocial circumstances

^[i]Z65  Problems related to other psychosocial circumstances

Persons encountering health services in other circumstances (Z70-Z76)

^[i]Z70  Counselling related to sexual attitude, behaviour and orientation

^[i]Z71  Persons encountering health services for other counselling and medical advice, not elsewhere classified

^[i]Z72   Problems related to lifestyle

^[i]Z73  Problems related to life-management difficulty

^[i]Z74  Problems related to care-provider dependency

^[i]Z75  Problems related to medical facilities and other health care

^[i]Z76 Persons encountering health services in other circumstances

Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z80-Z99)

^[i]Z80  Family history of malignant neoplasm

^[i]Z81 Family history of mental and behavioural disorders

^[i]Z82 Family history of certain disabilities and chronic diseases leading to disablement

^[i]Z83 Family history of other specific disorders

^[i]Z84 Family history of other conditions

^[i]Z85  Personal history of malignant neoplasm

^[i]Z86 Personal history of certain other diseases

^[i]Z87 Personal history of other diseases and conditions

^[i]Z88 Personal history of allergy to drugs, medicaments and biological substances

^[i]Z89 Acquired absence of limb

^[i]Z90 Acquired absence of organs, not elsewhere classified

^[i]Z91 Personal history of risk-factors, not elsewhere classified

^[i]Z92          Personal history of medical treatment

^[i]Z93         Artificial opening status

^[i]Z94 Transplanted organ and tissue status

^[i]Z95 Presence of cardiac and vascular implants and grafts

^[i]Z96 Presence of other functional implants

^[i]Z97          Presence of other devices

^[i]Z98         Other postsurgical states

^[i]Z99         Dependence on enabling machines and devices, not elsewhere classified

TABULAR LIST OF INCLUSIONS AND FOUR-CHARACTER SUBCATEGORIES

CHAPTER I - Certain infectious and parasitic diseases (A00-B99)

Includes:    diseases generally recognized as communicable or transmissible

Excludes:    carrier or suspected carrier of infectious disease (^[i]Z22.-)

certain localized infections - see body system-related chapters

infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium [except obstetrical tetanus] (O98-)

infectious and parasitic diseases specific to the perinatal period [except tetanus neonatorum, whooping cough, congenital syphilis, perinatal gonococcal infection and perinatal human immunodeficiency virus [HIV] disease] (P35-P39)

influenza and other acute respiratory infections (J00-J22)

This chapter contains the following blocks:

A00-A09       Intestinal infectious diseases

A15-A19       Tuberculosis

A20-A28       Certain zoonotic bacterial diseases

A30-A49       Other bacterial diseases

A50-A64       Infections with a predominantly sexual mode of transmission

A65-A69       Other spirochaetal diseases

A70-A74       Other diseases caused by chlamydiae

A75-A79       Rickettsioses

A80-A89       Viral infections of the central nervous system

A90-A99       Arthropod-borne viral fevers and viral haemorrhagic fevers

B00-B09       Viral infections characterized by skin and mucous membrane lesions

B15-B19       Viral hepatitis

B20-B24       Human immunodeficiency virus [HIV] disease

B25-B34       Other viral diseases

B35-B49       Mycoses

B50-B64       Protozoal diseases

B65-B83       Helminthiases

B85-B89       Pediculosis, acariasis and other infestations

B90-B94       Sequelae of infectious and parasitic diseases

B95-B97       Bacterial, viral and other infectious agents

B99              Other infectious diseases

Intestinal infectious diseases (A00-A09)

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

A01  Typhoid and paratyphoid fevers

A01.0   Typhoid fever

Infection due to Salmonella typhi

A01.1   Paratyphoid fever A

A01.2   Paratyphoid fever B

A01.3   Paratyphoid fever C

A01.4   Paratyphoid fever, unspecified

Infection due to Salmonella paratyphi NOS

A02  Other salmonella infections

Includes:    infection or foodborne intoxication due to any Salmonella species other than S. typhi and S. paratyphi

A02.0   Salmonella enteritis

Salmonellosis

A02.1   Salmonella septicaemia

A02.2   Localized salmonella infections

Salmonella:

• arthritis† (M01.3*)

• meningitis† (G01*)

• osteomyelitis† (M90.2*)

• pneumonia† (J17.0*)

• renal tubulo-interstitial disease† (N16.0*)

A02.8   Other specified salmonella infections

A02.9   Salmonella infection, unspecified

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

A04  Other bacterial intestinal infections

Excludes:    foodborne intoxications, elsewhere classified tuberculous enteritis (A18.3)

A04.0   Enteropathogenic Escherichia coli infection

A04.1   Enterotoxigenic Escherichia coli infection

A04.2   Enteroinvasive Escherichia coli infection

A04.3   Enterohaemorrhagic Escherichia coli infection

A04.4   Other intestinal Escherichia coli infections

Escherichia coli enteritis NOS

A04.5   Campylobacter enteritis

A04.6   Enteritis due to Yersinia enterocolitica

Excludes:    extraintestinal yersiniosis (A28.2)

A04.7   Enterocolitis due to Clostridium difficile

Foodborne intoxication by Clostridium difficile

Pseudomembranous colitis

A04.8   Other specified bacterial intestinal infections

A04.9   Bacterial intestinal infection, unspecified

Bacterial enteritis NOS

A05  Other bacterial foodborne intoxications, not elsewhere classified

Excludes:    Clostridium difficile foodborne intoxication and infection (A04.7)

Escherichia coli infection (A04.0-A04.4)

listeriosis (A32-)

salmonella foodborne intoxication and infection (A02-)

toxic effect of noxious foodstuffs (T61-T62)

A05.0   Foodborne staphylococcal intoxication

A05.1   Botulism

Classical foodborne intoxication due to Clostridium botulinum

A05.2   Foodborne Clostridium perfringens [Clostridium welchii] intoxication

Enteritis necroticans

Pig-bel

A05.3   Foodborne Vibrio parahaemolyticus intoxication

A05.4   Foodborne Bacillus cereus intoxication

A05.8   Other specified bacterial foodborne intoxications

A05.9   Bacterial foodborne intoxication, unspecified

A06  Amoebiasis

Includes:    infection due to Entamoeba histolytica

Excludes:    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

Hepatic amoebiasis

A06.5† Amoebic lung abscess

Amoebic abscess of lung (and liver) (J99.8*)

Amoebic abscess of lung (and liver) with pneumonia (J17.3*)

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

A07  Other protozoal intestinal diseases

A07.0   Balantidiasis

Balantidial dysentery

A07.1   Giardiasis [lambliasis]

A07.2   Cryptosporidiosis

A07.3   Isosporiasis

Infection due to Isospora belli and Isospora hominis

Intestinal coccidiosis

Isosporosis

A07.8   Other specified protozoal intestinal diseases

Intestinal trichomoniasis

Sarcocystosis

Sarcosporidiosis

A07.9   Protozoal intestinal disease, unspecified

Flagellate diarrhoea

Protozoal:

• colitis

• diarrhoea

• dysentery

A08  Viral and other specified intestinal infections

Excludes:    influenza with involvement of gastrointestinal tract (J09, J10.8, J11.8)

A08.0   Rotaviral enteritis

A08.1   Acute gastroenteropathy due to Norovirus

Noroviral enteritis

Small round structured virus enteritis

A08.2   Adenoviral enteritis

A08.3   Other viral enteritis

A08.4   Viral intestinal infection, unspecified

Viral:

• enteritis NOS

• gastroenteritis NOS

• gastroenteropathy NOS

A08.5   Other specified intestinal infections

A09  Other gastroenteritis and colitis of infectious and unspecified origin

Excludes:    due to bacterial, protozoal, viral and other specified infectious agents (A00-A08)

noninfective (see noninfectious) diarrhoea (K52.9)

• neonatal (P78.3)

A09.0   Other and unspecified gastroenteritis and colitis of infectious origin

Catarrh, enteric or intestinal

Diarrhoea:

• acute bloody

• acute haemorrhagic

• acute watery

• dysenteric

• epidemic

Infectious or septic:

• colitis           

• enteritis            NOS haemorrhagic

• gastroenteritis   

Infectious (neonatal) diarrhoea NOS

A09.9   Gastroenteritis and colitis of unspecified origin

Excludes:    indeterminate colitis (K52.3)

Tuberculosis (A15-A19)

Includes:    infections due to Mycobacterium tuberculosis and Mycobacterium bovis

Excludes:    congenital tuberculosis (P37.0)

human immunodeficiency [HIV] disease resulting in tuberculosis (B20.0)

pneumoconiosis associated with tuberculosis (J65)

sequelae of tuberculosis (B90-)

silicotuberculosis (J65)

A15  Respiratory tuberculosis, bacteriologically and histologically confirmed

A15.0   Tuberculosis of lung, confirmed by sputum microscopy with or without culture

Tuberculosis of lung, bacteriologically confirmed

Tuberculous:

• bronchiectasis     

• fibrosis of lung      confirmed bacteriologically with or

• pneumonia              without culture

• pneumothorax       

Excludes:    confirmed by culture only (A15.1)

A15.1   Tuberculosis of lung, confirmed by culture only

Conditions listed in A15.0, confirmed by culture only

A15.2   Tuberculosis of lung, confirmed histologically

Conditions listed in A15.0, confirmed histologically

A15.3   Tuberculosis of lung, confirmed by unspecified means

Conditions listed in A15.0, confirmed but unspecified whether bacteriologically or histologically

A15.4   Tuberculosis of intrathoracic lymph nodes, confirmed bacteriologically and histologically

Tuberculosis of lymph nodes:

• hilar              

• mediastinal           confirmed bacteriologically and

• tracheobronchial       histologically

Excludes:    specified as primary (A15.7)

A15.5   Tuberculosis of larynx, trachea and bronchus, confirmed bacteriologically and histologically

Tuberculosis of:

• bronchus   

• glottis       confirmed bacteriologically and

• larynx         histologically

• trachea    

A15.6   Tuberculous pleurisy, confirmed bacteriologically and histologically

  Tuberculosis of pleura    confirmed bacteriologically and

  Tuberculous empyema         histologically

Excludes:   in primary respiratory tuberculosis, confirmed bacteriologically and histologically (A15.7)

A15.7   Primary respiratory tuberculosis, confirmed bacteriologically and histologically

A15.8   Other respiratory tuberculosis, confirmed bacteriologically and histologically

  Mediastinal tuberculosis      

  Nasopharyngeal tuberculosis      confirmed bacteriologically and

  Tuberculosis of:                  histologically

• nose                        

• sinus [any nasal]           

A15.9   Respiratory tuberculosis unspecified, confirmed bacteriologically and histologically

A16  Respiratory tuberculosis, not confirmed bacteriologically or histologically

Includes:    5^TH DIGIT TO IDENTIFY TUBERCULOSIS NOT QUALIFIED AS RESPIRATORY OR PULMONARY

A16.0   Tuberculosis of lung, bacteriologically and histologically negative

Tuberculous:

• bronchiectasis     

• fibrosis of lung      bacteriologically and histologically

• pneumonia              negative

• pneumothorax       

A16.1   Tuberculosis of lung, bacteriological and histological examination not done

Conditions listed in A16.0, bacteriological and histological examination not done

A16.2   Tuberculosis of lung, without mention of bacteriological or histological confirmation

  Tuberculosis of lung   

  Tuberculous:           

• bronchiectasis          NOS (without mention of bacteriological

• fibrosis of lung         or histological confirmation)

• pneumonia            

• pneumothorax         

A16.3   Tuberculosis of intrathoracic lymph nodes, without mention of bacteriological or histological confirmation

Tuberculosis of lymph nodes:

• hilar              

• intrathoracic         NOS (without mention of bacteriological

• mediastinal            or histological confirmation)

• tracheobronchial   

Excludes:    when specified as primary (A16.7)

A16.4   Tuberculosis of larynx, trachea and bronchus, without mention of bacteriological or histological confirmation

Tuberculosis of:

• bronchus   

• glottis       NOS (without mention of bacteriological

• larynx         or histological confirmation)

• trachea    

A16.5   Tuberculous pleurisy, without mention of bacteriological or histological confirmation

  Tuberculosis of pleura   

  Tuberculous:                NOS (without mention of bacteriological

• empyema                    or histological confirmation)

• pleurisy               

Excludes:    in primary respiratory tuberculosis (A16.7)

A16.7   Primary respiratory tuberculosis without mention of bacteriological or histological confirmation

Primary:

• respiratory tuberculosis NOS

• tuberculous complex

A16.8   Other respiratory tuberculosis, without mention of bacteriological or histological confirmation

  Mediastinal tuberculosis      

  Nasopharyngeal tuberculosis      NOS (without mention of bacteriological

  Tuberculosis of:                  or histological confirmation)

• nose                        

• sinus [any nasal]           

A16.9   Respiratory tuberculosis unspecified, without mention of bacteriological or histological confirmation

Respiratory tuberculosis NOS

Tuberculosis NOS

A16.90 Tuberculosis NOS

A17  Tuberculosis of nervous system

A17.0† Tuberculous meningitis (G01*)

Tuberculosis of meninges (cerebral) (spinal)

Tuberculous leptomeningitis

A17.1† Meningeal tuberculoma (G07*)

Tuberculoma of meninges

A17.8† Other tuberculosis of nervous system

Tuberculoma Tuberculosis

of

brain (G07*) spinal cord (G07*)

Tuberculous:

• abscess of brain (G07*)

• meningoencephalitis (G05.0*)

• myelitis (G05.0*)

• polyneuropathy (G63.0*)

A17.9† Tuberculosis of nervous system, unspecified (G99.8*)

A18  Tuberculosis of other organs

A18.0† Tuberculosis of bones and joints

Tuberculosis of:

• hip (M01.1*)

• knee (M01.1*)

• vertebral column (M49.0*)

Tuberculous:

• arthritis (M01.1*)

• mastoiditis (H75.0*)

• necrosis of bone (M90.0*)

• osteitis (M90.0*)

• osteomyelitis (M90.0*)

• synovitis (M68.0*)

• tenosynovitis (M68.0*)

A18.1   Tuberculosis of genitourinary system

Tuberculosis of:

• bladder† (N33.0*)

• cervix† (N74.0*)

• kidney† (N29.1*)

• male genital organs† (N51*)

• ureter† (N29.1*)

Tuberculous female pelvic inflammatory disease† (N74.1*)

A18.2   Tuberculous peripheral lymphadenopathy

Tuberculous adenitis

Excludes:    tuberculosis of lymph nodes:

• intrathoracic (A15.4, A16.3)

• mesenteric and retroperitoneal (A18.3)

tuberculous tracheobronchial adenopathy (A15.4, A16.3)

A18.3   Tuberculosis of intestines, peritoneum and mesenteric glands

Tuberculosis (of):

• anus and rectum† (K93.0*)

• intestine (large) (small)† (K93.0*)

• retroperitoneal (lymph nodes)

Tuberculous:

• ascites

• enteritis† (K93.0*)

• peritonitis† (K67.3*)

A18.4   Tuberculosis of skin and subcutaneous tissue

Erythema induratum, tuberculous

Lupus:

• exedens

• vulgaris

• NOS

• of eyelid† (H03.1*)

Scrofuloderma

Excludes:    lupus erythematosus (L93-)

• systemic (M32-)

A18.5   Tuberculosis of eye

Tuberculous:

• chorioretinitis† (H32.0*)

• episcleritis† (H19.0*)

• interstitial keratitis† (H19.2*)

• iridocyclitis† (H22.0*)

• keratoconjunctivitis (interstitial) (phlyctenular)† (H19.2*)

Excludes:    lupus vulgaris of eyelid (A18.4)

A18.6   Tuberculosis of ear

Tuberculous otitis media† (H67.0*)

Excludes:    tuberculous mastoiditis (A18.0†)

A18.7† Tuberculosis of adrenal glands (E35.1*)

Addison disease, tuberculous

A18.8   Tuberculosis of other specified organs

Tuberculosis of:

• endocardium† (I39.8*)

• myocardium† (I41.0*)

• oesophagus† (K23.0*)

• pericardium† (I32.0*)

• thyroid gland† (E35.0*)

Tuberculous cerebral arteritis† (I68.1*)

A19  Miliary tuberculosis

Includes:    tuberculosis:

• disseminated

• generalized

tuberculous polyserositis

A19.0   Acute miliary tuberculosis of a single specified site

A19.1   Acute miliary tuberculosis of multiple sites

A19.2   Acute miliary tuberculosis, unspecified

A19.8   Other miliary tuberculosis

A19.9   Miliary tuberculosis, unspecified

Certain zoonotic bacterial diseases (A20-A28)

A20  Plague

Includes:    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

Includes:    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

A21.7   Generalized tularaemia

A21.8   Other forms of tularaemia

A21.9   Tularaemia, unspecified

A22  Anthrax

Includes:    infection due to Bacillus anthracis

A22.0   Cutaneous anthrax

Malignant:

• carbuncle

• pustule

A22.1   Pulmonary anthrax

Inhalation anthrax

Ragpicker disease

Woolsorter disease

A22.2   Gastrointestinal anthrax

A22.7   Anthrax septicaemia

A22.8   Other forms of anthrax

Anthrax meningitis† (G01*)

A22.9   Anthrax, unspecified

A23  Brucellosis

Includes:    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

A24  Glanders and melioidosis

A24.0   Glanders

Infection due to Burkholderia mallei

Infection due to Pseudomonas mallei

Malleus

A24.1   Acute and fulminating melioidosis

Melioidosis:

• pneumonia

• sepsis

• septicaemia

A24.2   Subacute and chronic melioidosis

A24.3   Other melioidosis

A24.4   Melioidosis, unspecified

Infection due to Burkholderia pseudomallei NOS

Infection due to Pseudomonas pseudomallei NOS

Whitmore disease

A25  Rat-bite fevers

A25.0   Spirillosis

Sodoku

A25.1   Streptobacillosis

Epidemic arthritic erythema

Haverhill fever

Streptobacillary rat-bite fever

A25.9   Rat-bite fever, unspecified

A26  Erysipeloid

A26.0   Cutaneous erysipeloid

Erythema migrans

A26.7   Erysipelothrix septicaemia

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

A28  Other zoonotic bacterial diseases, not elsewhere classified

A28.0   Pasteurellosis

A28.1   Cat-scratch disease

Cat-scratch fever

A28.2   Extraintestinal yersiniosis

Excludes:    enteritis due to Yersinia enterocolitica (A04.6)

plague (A20-)

A28.8   Other specified zoonotic bacterial diseases, not elsewhere classified

A28.9   Zoonotic bacterial disease, unspecified

Other bacterial diseases (A30-A49)

A30  Leprosy [Hansen disease]

Includes:    infection due to Mycobacterium leprae

Excludes:    sequelae of leprosy (B92)

A30.0   Indeterminate leprosy

I leprosy

A30.1   Tuberculoid leprosy

TT leprosy

A30.2   Borderline tuberculoid leprosy

BT leprosy

A30.3   Borderline leprosy

BB leprosy

A30.4   Borderline lepromatous leprosy

BL leprosy

A30.5   Lepromatous leprosy

LL leprosy

A30.8   Other forms of leprosy

A30.9   Leprosy, unspecified

A31  Infection due to other mycobacteria

Excludes:    leprosy (A30-)

tuberculosis (A15-A19)

A31.0   Pulmonary mycobacterial infection

Infection due to Mycobacterium:

• avium

• intracellulare [Battey bacillus]

• kansasii

A31.1   Cutaneous mycobacterial infection

Buruli ulcer

Infection due to Mycobacterium:

• marinum

• ulcerans

A31.8   Other mycobacterial infections

A31.9   Mycobacterial infection, unspecified

Atypical mycobacterium infection NOS

Mycobacteriosis NOS

A32  Listeriosis

Includes:    listerial foodborne infection

Excludes:    neonatal (disseminated) listeriosis (P37.2)

A32.0   Cutaneous listeriosis

A32.1† Listerial meningitis and meningoencephalitis

Listerial:

• meningitis (G01*)

• meningoencephalitis (G05.0*)

A32.7   Listerial septicaemia

A32.8   Other forms of listeriosis

Listerial:

• cerebral arteritis† (I68.1*)

• endocarditis† (I39.8*)

Oculoglandular listeriosis

A32.9   Listeriosis, unspecified

A33  Tetanus neonatorum

A34  Obstetrical tetanus

A35  Other tetanus

Tetanus NOS

Excludes:    tetanus:

• neonatorum (A33)

• obstetrical (A34)

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

Excludes:    erythrasma (L08.1)

A36.8   Other diphtheria

Diphtheritic:

• conjunctivitis† (H13.1*)

• myocarditis† (I41.0*)

• polyneuritis† (G63.0*)

A36.9   Diphtheria, unspecified

A37  Whooping cough

A37.0   Whooping cough due to Bordetella pertussis

A37.1   Whooping cough due to Bordetella parapertussis

A37.8   Whooping cough due to other Bordetella species

A37.9   Whooping cough, unspecified

A38  Scarlet fever

Scarlatina

Excludes:    streptococcal sore throat (J02.0)

A39  Meningococcal infection

A39.0† Meningococcal meningitis (G01*)

A39.1† Waterhouse-Friderichsen syndrome (E35.1*)

Meningococcal haemorrhagic adrenalitis

Meningococcic adrenal syndrome

A39.2   Acute meningococcaemia

A39.3   Chronic meningococcaemia

A39.4   Meningococcaemia, unspecified

Meningococcal bacteraemia NOS

A39.5† Meningococcal heart disease

Meningococcal:

• carditis NOS (I52.0*)

• endocarditis (I39.8*)

• myocarditis (I41.0*)

• pericarditis (I32.0*)

A39.8   Other meningococcal infections

Meningococcal:

• arthritis† (M01.0*)

• conjunctivitis† (H13.1*)

• encephalitis† (G05.0*)

• retrobulbar neuritis† (H48.1*)

Postmeningococcal arthritis† (M03.0*)

A39.9   Meningococcal infection, unspecified

Meningococcal disease NOS

A40  Streptococcal septicaemia

Excludes:    during labour (O75.3)

following:

• abortion or ectopic or molar pregnancy (O03-O07, O08.0)

• immunization (T88.0)

• infusion, transfusion or therapeutic injection (T80.2)

neonatal (P36.0-P36.1)

postprocedural (T81.4)

puerperal (O85)

A40.0   Septicaemia due to streptococcus, group A

A40.1   Septicaemia due to streptococcus, group B

A40.2   Septicaemia due to streptococcus, group D and enterococcus

A40.3   Septicaemia due to Streptococcus pneumoniae

Pneumococcal septicaemia

A40.8   Other streptococcal septicaemia

A40.9   Streptococcal septicaemia, unspecified

A41  Other septicaemia

Excludes:    bacteraemia NOS (A49.9)

during labour (O75.3)

following:

• abortion or ectopic or molar pregnancy (O03-O07, O08.0)

• immunization (T88.0)

• infusion, transfusion or therapeutic injection (T80.2)

septicaemia (due to) (in):

• actinomycotic (A42.7)

• anthrax (A22.7)

• candidal (B37.7)

• Erysipelothrix (A26.7)

• extraintestinal yersiniosis (A28.2)

• gonococcal (A54.8)

• herpesviral (B00.7)

• listerial (A32.7)

• meningococcal (A39.2-A39.4)

• neonatal (P36-)

• postprocedural (T81.4)

• puerperal (O85)

• streptococcal (A40-)

• tularaemia (A21.7)

septicaemic:

• melioidosis (A24.1)

• plague (A20.7)

toxic shock syndrome (A48.3)

A41.0   Septicaemia due to Staphylococcus aureus

A41.1   Septicaemia due to other specified staphylococcus

Septicaemia due to coagulase-negative staphylococcus

A41.2   Septicaemia due to unspecified staphylococcus

A41.3   Septicaemia due to Haemophilus influenzae

A41.4   Septicaemia due to anaerobes

Excludes:    gas gangrene (A48.0)

A41.5   Septicaemia due to other Gram-negative organisms

Gram-negative septicaemia NOS

A41.8   Other specified septicaemia

A41.9   Septicaemia, unspecified

Septic shock

A42  Actinomycosis

Excludes:    actinomycetoma (B47.1)

A42.0   Pulmonary actinomycosis

A42.1   Abdominal actinomycosis

A42.2   Cervicofacial actinomycosis

A42.7   Actinomycotic septicaemia

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

A46  Erysipelas

Excludes:    postpartum or puerperal erysipelas (O86.8)

A48  Other bacterial diseases, not elsewhere classified

Excludes:    actinomycetoma (B47.1)

A48.0   Gas gangrene

Clostridial:

• cellulitis

• myonecrosis

A48.1   Legionnaires disease

A48.2   Nonpneumonic Legionnaires disease [Pontiac fever]

A48.3   Toxic shock syndrome

Excludes:    endotoxic shock NOS (R57.8)

septicaemia NOS (A41.9)

A48.4   Brazilian purpuric fever

Systemic Haemophilus aegyptius infection

A48.8   Other specified bacterial diseases

A49  Bacterial infection of unspecified site

Excludes:    bacterial agents as the cause of diseases classified to other chapters (B95-B96)

chlamydial infection NOS (A74.9)

meningococcal infection NOS (A39.9)

rickettsial infection NOS (A79.9)

spirochaetal infection NOS (A69.9)

A49.0   Staphylococcal infection, unspecified site

A49.1   Streptococcal infection, unspecified site

A49.2   Haemophilus influenzae infection, unspecified site

A49.3   Mycoplasma infection, unspecified site

A49.8   Other bacterial infections of unspecified site

A49.9   Bacterial infection, unspecified

Bacteraemia NOS

Infections with a predominantly sexual mode of transmission (A50-A64)

Excludes:    human immunodeficiency virus [HIV] disease (B20-B24)

nonspecific and nongonococcal urethritis (N34.1)

Reiter disease (M02.3)

A50  Congenital syphilis

A50.0   Early congenital syphilis, symptomatic

Any congenital syphilitic condition specified as early or manifest less than two years after birth.

Early congenital syphilis:

• cutaneous

• mucocutaneous

• visceral

Early congenital syphilitic:

• laryngitis

• oculopathy

• osteochondropathy

• pharyngitis

• pneumonia

• rhinitis

A50.1   Early congenital syphilis, latent

Congenital syphilis without clinical manifestations, with positive serological reaction and negative spinal fluid test, less than two years after birth.

A50.2   Early congenital syphilis, unspecified

Congenital syphilis NOS less than two years after birth.

A50.3   Late congenital syphilitic oculopathy

Late congenital syphilitic interstitial keratitis† (H19.2*)

Late congenital syphilitic oculopathy NEC† (H58.8*)

Excludes:    Hutchinson triad (A50.5)

A50.4   Late congenital neurosyphilis [juvenile neurosyphilis]

Dementia paralytica juvenilis

Juvenile:

• general paresis

• tabes dorsalis

• taboparetic neurosyphilis

Late congenital syphilitic:

• encephalitis† (G05.0*)

• meningitis† (G01*)

• polyneuropathy† (G63.0*)

Use additional code, if desired, to identify any associated mental disorder.

Excludes:    Hutchinson triad (A50.5)

A50.5   Other late congenital syphilis, symptomatic

Any congenital syphilitic condition specified as late or manifest two years or more after birth.

Clutton joints† (M03.1*)

Hutchinson:

• teeth

• triad

Late congenital:

• cardiovascular syphilis† (I98.0*)

• syphilitic:

• arthropathy† (M03.1*)

• osteochondropathy† (M90.2*)

Syphilitic saddle nose

A50.6   Late congenital syphilis, latent

Congenital syphilis without clinical manifestations, with positive serological reaction and negative spinal fluid test, two years or more after birth.

A50.7   Late congenital syphilis, unspecified

Congenital syphilis NOS two years or more after birth.

A50.9   Congenital syphilis, unspecified

A51  Early syphilis

A51.0   Primary genital syphilis

Syphilitic chancre NOS

A51.1   Primary anal syphilis

A51.2   Primary syphilis of other sites

A51.3   Secondary syphilis of skin and mucous membranes

Condyloma latum

Syphilitic:

• alopecia† (L99.8*)

• leukoderma† (L99.8*)

• mucous patch

A51.4   Other secondary syphilis

Secondary syphilitic:

• female pelvic inflammatory disease† (N74.2*)

• iridocyclitis† (H22.0*)

• lymphadenopathy

• meningitis† (G01*)

• myositis† (M63.0*)

• oculopathy NEC† (H58.8*)

• periostitis† (M90.1*)

A51.5   Early syphilis, latent

Syphilis (acquired) without clinical manifestations, with positive serological reaction and negative spinal fluid test, less than two years after infection.

A51.9   Early syphilis, unspecified

A52  Late syphilis

A52.0† Cardiovascular syphilis

Cardiovascular syphilis NOS (I98.0*)

Syphilitic:

• aneurysm of aorta (I79.0*)

• aortic incompetence (I39.1*)

• aortitis (I79.1*)

• arteritis, cerebral (I68.1*)

• endocarditis NOS (I39.8*)

• myocarditis (I41.0*)

• pericarditis (I32.0*)

• pulmonary regurgitation (I39.3*)

A52.1   Symptomatic neurosyphilis

Charcot arthropathy† (M14.6*)

Late syphilitic:

• acoustic neuritis† (H94.0*)

• encephalitis† (G05.0*)

• meningitis† (G01*)

• optic atrophy† (H48.0*)

• polyneuropathy† (G63.0*)

• retrobulbar neuritis† (H48.1*)

Syphilitic parkinsonism† (G22*)

Tabes dorsalis

A52.2   Asymptomatic neurosyphilis

A52.3   Neurosyphilis, unspecified

  Gumma (syphilitic)   

  Syphilis (late)         of central nervous system NOS

  Syphiloma            

A52.7   Other symptomatic late syphilis

Glomerular disease in syphilis† (N08.0*)

Gumma (syphilitic)any sites, except those late or tertiary syphilis classified to A52.0-A52.3

Late syphilitic:

• bursitis† (M73.1*)

• chorioretinitis† (H32.0*)

• episcleritis† (H19.0*)

• female pelvic inflammatory disease† (N74.2*)

• leukoderma† (L99.8*)

• oculopathy NEC† (H58.8*)

• peritonitis† (K67.2*)

Syphilis [stage unspecified] of:

• bone† (M90.2*)

• liver† (K77.0*)

• lung† (J99.8*)

• muscle† (M63.0*)

• synovium† (M68.0*)

A52.8   Late syphilis, latent

Syphilis (acquired) without clinical manifestations, with positive serological reaction and negative spinal fluid test, two years or more after infection.

A52.9   Late syphilis, unspecified

A53  Other and unspecified syphilis

A53.0   Latent syphilis, unspecified as early or late

Latent syphilis NOS

Positive serological reaction for syphilis

A53.9   Syphilis, unspecified

Infection due to Treponema pallidum NOS

Syphilis (acquired) NOS

Excludes:    syphilis NOS causing death under two years of age (A50.2)

A54  Gonococcal infection

A54.0   Gonococcal infection of lower genitourinary tract without periurethral or accessory gland abscess

Gonococcal:

• cervicitis NOS

• cystitis NOS

• urethritis NOS

• vulvovaginitis NOS

Excludes:    with:

• genitourinary gland abscess (A54.1)

• periurethral abscess (A54.1)

A54.1   Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess

Gonococcal Bartholin gland abscess

A54.2   Gonococcal pelviperitonitis and other gonococcal genitourinary infections

Gonococcal:

• epididymitis† (N51.1*)

• female pelvic inflammatory disease† (N74.3*)

• orchitis† (N51.1*)

• prostatitis† (N51.0*)

Excludes:    gonococcal peritonitis (A54.8)

A54.3   Gonococcal infection of eye

Gonococcal:

• conjunctivitis† (H13.1*)

• iridocyclitis† (H22.0*)

Ophthalmia neonatorum due to gonococcus

A54.4† Gonococcal infection of musculoskeletal system

Gonococcal:

• arthritis (M01.3*)

• bursitis (M73.0*)

• osteomyelitis (M90.2*)

• synovitis (M68.0*)

• tenosynovitis (M68.0*)

A54.5   Gonococcal pharyngitis

A54.6   Gonococcal infection of anus and rectum

A54.8   Other gonococcal infections

Gonococcal:

• brain abscess† (G07*)

• endocarditis† (I39.8*)

• meningitis† (G01*)

• myocarditis† (I41.0*)

• pericarditis† (I32.0*)

• peritonitis† (K67.1*)

• pneumonia† (J17.0*)

• septicaemia

• skin lesions

Excludes:    gonococcal pelviperitonitis (A54.2)

A54.9   Gonococcal infection, unspecified

A55  Chlamydial lymphogranuloma (venereum)

Climatic or tropical bubo

Durand-Nicolas-Favre disease

Esthiomene

Lymphogranuloma inguinale

A56  Other sexually transmitted chlamydial diseases

Includes:    sexually transmitted diseases due to Chlamydia trachomatis

Excludes:    chlamydial:

• lymphogranuloma (A55)

• neonatal:

• conjunctivitis (P39.1)

• pneumonia (P23.1)

conditions classified to A74-

A56.0   Chlamydial infection of lower genitourinary tract

Chlamydial:

• cervicitis

• cystitis

• urethritis

• vulvovaginitis

A56.1   Chlamydial infection of pelviperitoneum and other genitourinary organs

Chlamydial:

• epididymitis† (N51.1*)

• female pelvic inflammatory disease† (N74.4*)

• orchitis† (N51.1*)

A56.2   Chlamydial infection of genitourinary tract, unspecified

A56.3   Chlamydial infection of anus and rectum

A56.4   Chlamydial infection of pharynx

A56.8   Sexually transmitted chlamydial infection of other sites

A57  Chancroid

Ulcus molle

A58  Granuloma inguinale

Donovanosis

A59  Trichomoniasis

Excludes:    intestinal trichomoniasis (A07.8)

A59.0   Urogenital trichomoniasis

  Leukorrhoea (vaginalis)      Leukorrhoea (vaginalis)

  Prostatitis† (N51.0*)        Prostatitis† (N51.0*)

A59.8   Trichomoniasis of other sites

A59.9   Trichomoniasis, unspecified

A60  Anogenital herpesviral [herpes simplex] infection

A60.0   Herpesviral infection of genitalia and urogenital tract

Herpesviral infection of genital tract:

• female† (N77.0-N77.1*)

• male† (N51*)

A60.1   Herpesviral infection of perianal skin and rectum

A60.9   Anogenital herpesviral infection, unspecified

A63  Other predominantly sexually transmitted diseases, not elsewhere classified

Excludes:    molluscum contagiosum (B08.1)

papilloma of cervix (D26.0)

A63.0   Anogenital (venereal) warts

A63.8   Other specified predominantly sexually transmitted diseases

A64  Unspecified sexually transmitted disease

Venereal disease NOS

Other spirochaetal diseases (A65-A69)

Excludes:    leptospirosis (A27-)

syphilis (A50-A53)

A65  Nonvenereal syphilis

Bejel

Endemic syphilis

Njovera

A66  Yaws

Includes:    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

A66.6   Bone and joint lesions of yaws

  Ganglion                     

  Hydrarthrosis                

  Osteitis                        of yaws (early) (late)

  Periostitis (hypertrophic)   

Goundou                             

Gumma, bone                            of yaws (late)

Gummatous osteitis or periostitis   

A66.7   Other manifestations of yaws

Juxta-articular nodules of yaws

Mucosal yaws

A66.8   Latent yaws

Yaws without clinical manifestations, with positive serology

A66.9   Yaws, unspecified

A67  Pinta [carate]

A67.0   Primary lesions of pinta

  Chancre (primary)   

  Papule (primary)       of pinta [carate]

A67.1   Intermediate lesions of pinta

  Erythematous plaques   

  Hyperchromic lesions   

  Hyperkeratosis            of pinta [carate]

  Pintids                

A67.2   Late lesions of pinta

  Cardiovascular lesions† (I98.1*)   

  Skin lesions:                      

• achromic                            of pinta [carate]

• cicatricial                      

• dyschromic                       

A67.3   Mixed lesions of pinta

Achromic with hyperchromic skin lesions of pinta [carate]

A67.9   Pinta, unspecified

A68  Relapsing fevers

Includes:    recurrent fever

Excludes:    Lyme disease (A69.2)

A68.0   Louse-borne relapsing fever

Relapsing fever due to Borrelia recurrentis

A68.1   Tick-borne relapsing fever

Relapsing fever due to any Borrelia species other than Borrelia recurrentis

A68.9   Relapsing fever, unspecified

A69  Other spirochaetal infections

A69.0   Necrotizing ulcerative stomatitis

Cancrum oris

Fusospirochaetal gangrene

Noma

Stomatitis gangrenosa

A69.1   Other Vincent infections

Fusospirochaetal pharyngitis

Necrotizing ulcerative (acute):

• gingivitis

• gingivostomatitis

Spirochaetal stomatitis

Trench mouth

Vincent:

• angina

• gingivitis

A69.2   Lyme disease

Erythema chronicum migrans due to Borrelia burgdorferi

A69.8   Other specified spirochaetal infections

A69.9   Spirochaetal infection, unspecified

Other diseases caused by chlamydiae (A70-A74)

A70  Chlamydia psittaci

Ornithosis

Parrot fever

Psittacosis

A71  Trachoma

Excludes:    sequelae of trachoma (B94.0)

A71.0   Initial stage of trachoma

Trachoma dubium

A71.1   Active stage of trachoma

Granular conjunctivitis (trachomatous)

Trachomatous:

• follicular conjunctivitis

• pannus

A71.9   Trachoma, unspecified

A74  Other diseases caused by chlamydiae

Excludes:    chlamydial pneumonia (J16.0)

neonatal chlamydial:

• conjunctivitis (P39.1)

• pneumonia (P23.1)

sexually transmitted chlamydial diseases (A55-A56)

A74.0† Chlamydial conjunctivitis (H13.1*)

Paratrachoma

A74.8   Other chlamydial diseases

Chlamydial peritonitis† (K67.0*)

A74.9   Chlamydial infection, unspecified

Chlamydiosis NOS

Rickettsioses (A75-A79)

A75  Typhus fever

Excludes:    rickettsiosis due to Neorickettsia sennetsu [Ehrlichia sennetsu](A79.8)

A75.0   Epidemic louse-borne typhus fever due to Rickettsia prowazekii

Classical typhus (fever)

Epidemic (louse-borne) typhus

A75.1   Recrudescent typhus [Brill disease]

Brill-Zinsser disease

A75.2   Typhus fever due to Rickettsia typhi

Murine (flea-borne) typhus

A75.3   Typhus fever due to Rickettsia tsutsugamushi

Scrub (mite-borne) typhus

Tsutsugamushi fever

A75.9   Typhus fever, unspecified

Typhus (fever) NOS

A77  Spotted fever [tick-borne rickettsioses]

A77.0   Spotted fever due to Rickettsia rickettsii

Rocky Mountain spotted fever

Sao Paulo fever

A77.1   Spotted fever due to Rickettsia conorii

African tick typhus

Boutonneuse fever

India tick typhus

Kenya tick typhus

Marseilles fever

Mediterranean tick fever

A77.2   Spotted fever due to Rickettsia sibirica

North Asian tick fever

Siberian tick typhus

A77.3   Spotted fever due to Rickettsia australis

Queensland tick typhus

A77.8   Other spotted fevers

A77.9   Spotted fever, unspecified

Tick-borne typhus NOS

A78  Q fever

Infection due to Coxiella burnetii

Nine Mile fever

Quadrilateral fever

A79  Other rickettsioses

A79.0   Trench fever

Quintan fever

Wolhynian fever

A79.1   Rickettsialpox due to Rickettsia akari

Kew Garden fever

Vesicular rickettsiosis

A79.8   Other specified rickettsioses

Rickettsiosis due to Neorickettsia sennetsu [Ehrlichia sennetsu]

A79.9   Rickettsiosis, unspecified

Rickettsial infection NOS

Viral infections of the central nervous system (A80-A89)

Excludes:    sequelae of:

• poliomyelitis (B91)

• viral encephalitis (B94.1)

A80  Acute poliomyelitis

A80.0   Acute paralytic poliomyelitis, vaccine-associated

A80.1   Acute paralytic poliomyelitis, wild virus, imported

A80.2   Acute paralytic poliomyelitis, wild virus, indigenous

A80.3   Acute paralytic poliomyelitis, other and unspecified

A80.4   Acute nonparalytic poliomyelitis

A80.9   Acute poliomyelitis, unspecified

A81  Atypical virus infections of central nervous system

Includes:    prion diseases of the central nervous system

A81.0   Creutzfeldt-Jakob disease

Subacute spongiform encephalopathy

A81.1   Subacute sclerosing panencephalitis

Dawson inclusion body encephalitis

Van Bogaert sclerosing leukoencephalopathy

A81.2   Progressive multifocal leukoencephalopathy

Multifocal leukoencephalopathy NOS

A81.8   Other atypical virus infections of central nervous system

Kuru

A81.9   Atypical virus infection of central nervous system, unspecified

Prion disease of central nervous system NOS

A82  Rabies

A82.0   Sylvatic rabies

A82.1   Urban rabies

A82.9   Rabies, unspecified

A83  Mosquito-borne viral encephalitis

Includes:    mosquito-borne viral meningoencephalitis

Excludes:    Venezuelan equine encephalitis (A92.2)

A83.0   Japanese encephalitis

A83.1   Western equine encephalitis

A83.2   Eastern equine encephalitis

A83.3   St Louis encephalitis

A83.4   Australian encephalitis

Kunjin virus disease

A83.5   California encephalitis

California meningoencephalitis

La Crosse encephalitis

A83.6   Rocio virus disease

A83.8   Other mosquito-borne viral encephalitis

A83.9   Mosquito-borne viral encephalitis, unspecified

A84  Tick-borne viral encephalitis

Includes:    tick-borne viral meningoencephalitis

A84.0   Far Eastern tick-borne encephalitis [Russian spring-summer encephalitis]

A84.1   Central European tick-borne encephalitis

A84.8   Other tick-borne viral encephalitis

Louping ill

Powassan virus disease

A84.9   Tick-borne viral encephalitis, unspecified

A85  Other viral encephalitis, not elsewhere classified

Includes:    specified viral:

• encephalomyelitis NEC

• meningoencephalitis NEC

Excludes:    myalgic encephalomyelitis (G93.3)

encephalitis due to:

• herpesvirus [herpes simplex] (B00.4)

• measles virus (B05.0)

• mumps virus (B26.2)

• poliomyelitis virus (A80-)

• zoster (B02.0)

lymphocytic choriomeningitis (A87.2)

A85.0† Enteroviral encephalitis (G05.1*)

Enteroviral encephalomyelitis

A85.1† Adenoviral encephalitis (G05.1*)

Adenoviral meningoencephalitis

A85.2   Arthropod-borne viral encephalitis, unspecified

A85.8   Other specified viral encephalitis

Encephalitis lethargica

Von Economo-Cruchet disease

A86  Unspecified viral encephalitis

Viral:

• encephalomyelitis NOS

• meningoencephalitis NOS

A87  Viral meningitis

Excludes:    meningitis due to:

• herpesvirus [herpes simplex] (B00.3)

• measles virus (B05.1)

• mumps virus (B26.1)

• poliomyelitis virus (A80-)

• zoster (B02.1)

A87.0† Enteroviral meningitis (G02.0*)

Coxsackievirus meningitis

Echovirus meningitis

A87.1† Adenoviral meningitis (G02.0*)

A87.2   Lymphocytic choriomeningitis

Lymphocytic meningoencephalitis

A87.8   Other viral meningitis

A87.9   Viral meningitis, unspecified

A88  Other viral infections of central nervous system, not elsewhere classified

Excludes:    viral:

• encephalitis NOS (A86)

• meningitis NOS (A87.9)

A88.0   Enteroviral exanthematous fever [Boston exanthem]

A88.1   Epidemic vertigo

A88.8   Other specified viral infections of central nervous system

A89  Unspecified viral infection of central nervous system

Arthropod-borne viral fevers and viral haemorrhagic fevers (A90-A99)

A90  Dengue fever [classical dengue]

Excludes:    dengue haemorrhagic fever (A91)

A91  Dengue haemorrhagic fever

A92  Other mosquito-borne viral fevers

Excludes:    Ross River disease (B33.1)

A92.0   Chikungunya virus disease

Chikungunya (haemorrhagic) fever

A92.1   O'nyong-nyong fever

A92.2   Venezuelan equine fever

Venezuelan equine:

• encephalitis

• encephalomyelitis virus disease

A92.3   West Nile virus infection

West Nile fever

A92.4   Rift Valley fever

A92.8   Other specified mosquito-borne viral fevers

A92.9   Mosquito-borne viral fever, unspecified

A93  Other arthropod-borne viral fevers, not elsewhere classified

A93.0   Oropouche virus disease

Oropouche fever

A93.1   Sandfly fever

Pappataci fever

Phlebotomus fever

A93.2   Colorado tick fever

A93.8   Other specified arthropod-borne viral fevers

Piry virus disease

Vesicular stomatitis virus disease [Indiana fever]

A94  Unspecified arthropod-borne viral fever

Arboviral fever NOS

Arbovirus infection NOS

A95  Yellow fever

A95.0   Sylvatic yellow fever

Jungle yellow fever

A95.1   Urban yellow fever

A95.9   Yellow fever, unspecified

A96  Arenaviral haemorrhagic fever

A96.0   Junin haemorrhagic fever

Argentinian haemorrhagic fever

A96.1   Machupo haemorrhagic fever

Bolivian haemorrhagic fever

A96.2   Lassa fever

A96.8   Other arenaviral haemorrhagic fevers

A96.9   Arenaviral haemorrhagic fever, unspecified

A98  Other viral haemorrhagic fevers, not elsewhere classified

Excludes:    chikungunya haemorrhagic fever (A92.0)

dengue haemorrhagic fever (A91)

A98.0   Crimean-Congo haemorrhagic fever

Central Asian haemorrhagic fever

A98.1   Omsk haemorrhagic fever

A98.2   Kyasanur Forest disease

A98.3   Marburg virus disease

A98.4   Ebola virus disease

A98.5   Haemorrhagic fever with renal syndrome

Haemorrhagic fever:

• epidemic

• Korean

• Russian

Hantaan virus disease

Hantavirus disease with renal manifestations

Nephropathia epidemica

Excludes:    hantavirus (cardio)-pulmonary syndrome (B33.4† J17.1*)

A98.8   Other specified viral haemorrhagic fevers

A99  Unspecified viral haemorrhagic fever

Viral infections characterized by skin and mucous membrane lesions (B00-B09)

B00  Herpesviral [herpes simplex] infections

Excludes:    anogenital herpesviral infection (A60-)

congenital herpesviral infection (P35.2)

gammaherpesviral mononucleosis (B27.0)

herpangina (B08.5)

B00.0   Eczema herpeticum

Kaposi varicelliform eruption

B00.1   Herpesviral vesicular dermatitis

Herpes simplex:

• facialis

• labialis

Vesicular dermatitis of:

• ear      • ear

• lip      • lip

B00.2   Herpesviral gingivostomatitis and pharyngotonsillitis

Herpesviral pharyngitis

B00.3† Herpesviral meningitis (G02.0*)

B00.4† Herpesviral encephalitis (G05.1*)

Herpesviral meningoencephalitis

Simian B disease

B00.5   Herpesviral ocular disease

Herpesviral:

• conjunctivitis† (H13.1*)

• dermatitis of eyelid† (H03.1*)

• iridocyclitis† (H22.0*)

• iritis† (H22.0*)

• keratitis† (H19.1*)

• keratoconjunctivitis† (H19.1*)

• uveitis, anterior† (H22.0*)

B00.7   Disseminated herpesviral disease

Herpesviral septicaemia

B00.8   Other forms of herpesviral infection

Herpesviral:

• hepatitis† (K77.0*)

• whitlow† (L99.8*)

B00.9   Herpesviral infection, unspecified

Herpes simplex infection NOS

B01  Varicella [chickenpox]

B01.0† Varicella meningitis (G02.0*)

B01.1† Varicella encephalitis (G05.1*)

Postchickenpox encephalitis

Varicella encephalomyelitis

B01.2† Varicella pneumonia (J17.1*)

B01.8   Varicella with other complications

B01.9   Varicella without complication

Varicella NOS

B02  Zoster [herpes zoster]

Includes:    shingles

zona

B02.0† Zoster encephalitis (G05.1*)

Zoster meningoencephalitis

B02.1† Zoster meningitis (G02.0*)

B02.2† Zoster with other nervous system involvement

Postherpetic:

• geniculate ganglionitis (G53.0*)

• polyneuropathy (G63.0*)

• trigeminal neuralgia (G53.0*)

B02.3   Zoster ocular disease

Zoster:

• blepharitis† (H03.1*)

• conjunctivitis† (H13.1*)

• iridocyclitis† (H22.0*)

• iritis† (H22.0*)

• keratitis† (H19.2*)

• keratoconjunctivitis† (H19.2*)

• scleritis† (H19.0*)

B02.7   Disseminated zoster

B02.8   Zoster with other complications

B02.9   Zoster without complication

Zoster NOS

B03  Smallpox

B04  Monkeypox

B05  Measles

Includes:    morbilli

Excludes:    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

B06  Rubella [German measles]

Excludes:    congenital rubella (P35.0)

B06.0† Rubella with neurological complications

Rubella:

• encephalitis (G05.1*)

• meningitis (G02.0*)

• meningoencephalitis (G05.1*)

B06.8   Rubella with other complications

Rubella:

• arthritis† (M01.4*)

• pneumonia† (J17.1*)

B06.9   Rubella without complication

Rubella NOS

B07  Viral warts

Verruca:

• simplex

• vulgaris

Excludes:    anogenital (venereal) warts (A63.0)

papilloma of:

• bladder (D41.4)

• cervix (D26.0)

• larynx (D14.1)

B08  Other viral infections characterized by skin and mucous membrane lesions, not elsewhere classified

Excludes:    vesicular stomatitis virus disease (A93.8)

B08.0   Other orthopoxvirus infections

Cowpox

Orf virus disease

Pseudocowpox [milker node]

Vaccinia

Excludes:    monkeypox (B04)

B08.1   Molluscum contagiosum

B08.2   Exanthema subitum [sixth disease]

B08.3   Erythema infectiosum [fifth disease]

B08.4   Enteroviral vesicular stomatitis with exanthem

Hand, foot and mouth disease

B08.5   Enteroviral vesicular pharyngitis

Herpangina

B08.8   Other specified viral infections characterized by skin and mucous membrane lesions

Enteroviral lymphonodular pharyngitis

Foot-and-mouth disease

Tanapox virus disease

Yaba pox virus disease

B09  Unspecified viral infection characterized by skin and mucous membrane lesions

Viral:

• enanthema NOS

• exanthema NOS

Viral hepatitis (B15-B19)

Excludes:    cytomegaloviral hepatitis (B25.1)

herpesviral [herpes simplex] hepatitis (B00.8)

sequelae of viral hepatitis (B94.2)

Use additional code (Chapter XX), if desired, to identify drug, if post-transfusion hepatitis.

B15  Acute hepatitis A

B15.0   Hepatitis A with hepatic coma

B15.9   Hepatitis A without hepatic coma

Hepatitis A (acute)(viral) NOS

B16  Acute hepatitis B

B16.0   Acute hepatitis B with delta-agent (coinfection) with hepatic coma

B16.1   Acute hepatitis B with delta-agent (coinfection) without hepatic coma

B16.2   Acute hepatitis B without delta-agent with hepatic coma

B16.9   Acute hepatitis B without delta-agent and without hepatic coma

Hepatitis B (acute)(viral) NOS

B17  Other acute viral hepatitis

B17.0   Acute delta-(super) infection of hepatitis B carrier

B17.1   Acute hepatitis C

B17.2   Acute hepatitis E

B17.8   Other specified acute viral hepatitis

Hepatitis non-A non-B (acute)(viral) NEC

B17.9   Acute viral hepatitis, unspecified

Acute hepatitis NOS

Acute infectious hepatitis NOS

B18  Chronic viral hepatitis

B18.0   Chronic viral hepatitis B with delta-agent

B18.1   Chronic viral hepatitis B without delta-agent

Chronic (viral) hepatitis B

B18.2   Chronic viral hepatitis C

B18.8   Other chronic viral hepatitis

B18.9   Chronic viral hepatitis, unspecified

B19  Unspecified viral hepatitis

B19.0   Unspecified viral hepatitis with hepatic coma

B19.9   Unspecified viral hepatitis without hepatic coma

Viral hepatitis NOS

Human immunodeficiency virus [HIV] disease (B20-B24)

Excludes:    asymptomatic human immunodeficiency virus [HIV] infection status (^[i]Z21)

complicating pregnancy, childbirth and the puerperium (O98.7)

B20  Human immunodeficiency virus [HIV] disease with infectious and parasitic diseases

Excludes:    acute HIV infection syndrome (B23.0)

B20.0   HIV disease with mycobacterial infection

HIV disease with tuberculosis

B20.1   HIV disease with other bacterial infections

B20.2   HIV disease with cytomegaloviral disease

B20.3   HIV disease with other viral infections

B20.4   HIV disease with candidiasis

B20.5   HIV disease with other mycoses

B20.6   HIV disease with Pneumocystis jirovecii pneumonia

HIV disease resulting in Pneumocystis carinii pneumonia

B20.7   HIV disease with multiple infections

B20.8   HIV disease with other infectious and parasitic diseases

B20.9   HIV disease with unspecified infectious or parasitic disease

HIV disease with infection NOS

B21  Human immunodeficiency virus [HIV] disease with malignant neoplasms

B21.0   HIV disease with Kaposi sarcoma

B21.1   HIV disease with Burkitt lymphoma

B21.2   HIV disease with other types of non-Hodgkin lymphoma

B21.3   HIV disease with other malignant neoplasms of lymphoid, haematopoietic and related tissue

B21.7   HIV disease with multiple malignant neoplasms

B21.8   HIV disease with other malignant neoplasms

B21.9   HIV disease with unspecified malignant neoplasm

B22  Human immunodeficiency virus [HIV] disease with other specified diseases

B22.0   HIV disease with encephalopathy

HIV dementia

B22.1   HIV disease with lymphoid interstitial pneumonitis

B22.2   HIV disease with wasting syndrome

HIV disease with failure to thrive

Slim disease

B22.7   HIV disease with multiple diseases classified elsewhere

Note:          For use of this category, reference should be made to the morbidity coding rules and guidelines in Volume 2 or mortality coding rules and guidelines in Part 2a Instruction Manual (NCHS).

B23  Human immunodeficiency virus [HIV] disease with other conditions

B23.0   Acute HIV infection syndrome

B23.1   HIV disease with (persistent) generalized lymphadenopathy

B23.2   HIV disease with haematological and immunological abnormalities, not elsewhere classified

B23.8   HIV disease with other specified conditions

B24  Unspecified human immunodeficiency virus [HIV] disease

Acquired immunodeficiency syndrome [AIDS] NOS

AIDS-related complex [ARC] NOS

Other viral diseases (B25-B34)

B25  Cytomegaloviral disease

Excludes:    congenital cytomegalovirus infection (P35.1)

cytomegaloviral mononucleosis (B27.1)

B25.0† Cytomegaloviral pneumonitis (J17.1*)

B25.1† Cytomegaloviral hepatitis (K77.0*)

B25.2† Cytomegaloviral pancreatitis (K87.1*)

B25.8   Other cytomegaloviral diseases

B25.9   Cytomegaloviral disease, unspecified

B26  Mumps

Includes:    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

B27  Infectious mononucleosis

Includes:    glandular fever

monocytic angina

Pfeiffer disease

B27.0   Gammaherpesviral mononucleosis

Mononucleosis due to Epstein-Barr virus

B27.1   Cytomegaloviral mononucleosis

B27.8   Other infectious mononucleosis

B27.9   Infectious mononucleosis, unspecified

B30  Viral conjunctivitis

Excludes:    ocular disease:

• herpesviral [herpes simplex] (B00.5)

• zoster (B02.3)

B30.0† Keratoconjunctivitis due to adenovirus (H19.2*)

Epidemic keratoconjunctivitis

Shipyard eye

B30.1† Conjunctivitis due to adenovirus (H13.1*)

Acute adenoviral follicular conjunctivitis

Swimming-pool conjunctivitis

B30.2   Viral pharyngoconjunctivitis

B30.3† Acute epidemic haemorrhagic conjunctivitis (enteroviral) (H13.1*)

Conjunctivitis due to:

• coxsackievirus 24

• enterovirus 70

Haemorrhagic conjunctivitis (acute)(epidemic)

B30.8† Other viral conjunctivitis (H13.1*)

Newcastle conjunctivitis

B30.9   Viral conjunctivitis, unspecified

B33  Other viral diseases, not elsewhere classified

B33.0   Epidemic myalgia

Bornholm disease

B33.1   Ross River disease

Epidemic polyarthritis and exanthema

Ross River fever

B33.2   Viral carditis

B33.3   Retrovirus infections, not elsewhere classified

Retrovirus infection NOS

B33.4†    Hantavirus (cardio)-pulmonary syndrome [HPS] [HCPS] (J17.1*)

Hantavirus disease with pulmonary manifestations

Sin Nombre virus disease

Use additional code (N17.9), if desired, to identify any renal failure associated with HPS caused by the Andes, Bayou and Black Creek Canal hantavirus aetiologies.

Excludes:    haemorrhagic fever with renal manifestations (A98.5† N08.0*)

B33.8   Other specified viral diseases

B34  Viral infection of unspecified site

Excludes:    cytomegaloviral disease NOS (B25.9)

herpesvirus [herpes simplex] infection NOS (B00.9)

retrovirus infection NOS (B33.3)

viral agents as the cause of diseases classified to other chapters (B97-)

B34.0   Adenovirus infection, unspecified site

B34.1   Enterovirus infection, unspecified site

Coxsackievirus infection NOS

Echovirus infection NOS

B34.2   Coronavirus infection, unspecified site

B34.3   Parvovirus infection, unspecified site

B34.4   Papovavirus infection, unspecified site

B34.8   Other viral infections of unspecified site

B34.9   Viral infection, unspecified

Viraemia NOS

Mycoses (B35-B49)

Excludes:    hypersensitivity pneumonitis due to organic dust (J67-)

mycosis fungoides (C84.0)

B35  Dermatophytosis

Includes:    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 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

B35.8   Other dermatophytoses

Dermatophytosis:

• disseminated

• granulomatous

B35.9   Dermatophytosis, unspecified

Ringworm NOS

B36  Other superficial mycoses

B36.0   Pityriasis versicolor

Tinea:

• flava

• versicolor

B36.1   Tinea nigra

Keratomycosis nigricans palmaris

Microsporosis nigra

Pityriasis nigra

B36.2   White piedra

Tinea blanca

B36.3   Black piedra

B36.8   Other specified superficial mycoses

B36.9   Superficial mycosis, unspecified

B37  Candidiasis

Includes:    candidosis

moniliasis

Excludes:    neonatal candidiasis (P37.5)

B37.0   Candidal stomatitis

Oral thrush

B37.1   Pulmonary candidiasis

B37.2   Candidiasis of skin and nail

Candidal:

• onychia

• paronychia

Excludes:    diaper [napkin] dermatitis (L22)

B37.3† Candidiasis of vulva and vagina (N77.1*)

Candidal vulvovaginitis

Monilial vulvovaginitis

Vaginal thrush

B37.4   Candidiasis of other urogenital sites

Candidal:

• balanitis† (N51.2*)

• urethritis† (N37.0*)

B37.5† Candidal meningitis (G02.1*)

B37.6† Candidal endocarditis (I39.8*)

B37.7   Candidal septicaemia

B37.8   Candidiasis of other sites

Candidal:

• cheilitis

• enteritis

B37.9   Candidiasis, unspecified

Thrush NOS

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

B40  Blastomycosis

Excludes:    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

Includes:    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

B43  Chromomycosis and phaeomycotic abscess

B43.0   Cutaneous chromomycosis

Dermatitis verrucosa

B43.1   Phaeomycotic brain abscess

Cerebral chromomycosis

B43.2   Subcutaneous phaeomycotic abscess and cyst

B43.8   Other forms of chromomycosis

B43.9   Chromomycosis, unspecified

B44  Aspergillosis

Includes:    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

B47  Mycetoma

B47.0   Eumycetoma

Madura foot, mycotic

Maduromycosis

B47.1   Actinomycetoma

B47.9   Mycetoma, unspecified

Madura foot NOS

B48  Other mycoses, not elsewhere classified

B48.0   Lobomycosis

Keloidal blastomycosis

Lobo disease

B48.1   Rhinosporidiosis

B48.2   Allescheriasis

Infection due to Pseudallescheria boydii

Excludes:    eumycetoma (B47.0)

B48.3   Geotrichosis

Geotrichum stomatitis

B48.4   Penicillosis

B48.7   Opportunistic mycoses

Mycoses caused by fungi of low virulence that can establish an infection only as a consequence of factors such as the presence of debilitating disease or the administration of immunosuppressive and other therapeutic agents or radiation therapy. Most of the causal fungi are normally saprophytic in soil and decaying vegetation.

B48.8   Other specified mycoses

Adiaspiromycosis

B49  Unspecified mycosis

Fungaemia NOS

Protozoal diseases (B50-B64)

Excludes:    amoebiasis (A06-)

other protozoal intestinal diseases (A07-)

B50  Plasmodium falciparum

Includes:    mixed infections of Plasmodium falciparum with any other Pasmodium species

B50.0   Plasmodium falciparum malaria with cerebral complications

Cerebral malaria NOS

B50.8   Other severe and complicated Plasmodium falciparum malaria

Severe or complicated Plasmodium falciparum malaria NOS

B50.9   Plasmodium falciparum malaria, unspecified

B51  Plasmodium vivax

Includes:    mixed infections of Plasmodium vivax with other Plasmodium species, except Plasmodium falciparum

Excludes:    mixed with Plasmodium falciparum (B50-)

B51.0   Plasmodium vivax malaria with rupture of spleen

B51.8   Plasmodium vivax malaria with other complications

B51.9   Plasmodium vivax malaria without complication

Plasmodium vivax malaria NOS

B52  Plasmodium malariae

Includes:    mixed infections of Plasmodium malariae with other Plasmodium species, except Plasmodium falciparum and Plasmodium vivax

Excludes:    when mixed with Plasmodium:

• falciparum (B50-)

• vivax (B51-)

B52.0   Plasmodium malariae malaria with nephropathy

B52.8   Plasmodium malariae malaria with other complications

B52.9   Plasmodium malariae malaria without complication

Plasmodium malariae malaria NOS

B53  Other parasitologically confirmed malaria

B53.0   Plasmodium ovale malaria

Excludes:    when mixed with Plasmodium:

• falciparum (B50-)

• malariae (B52-)

• vivax (B51-)

B53.1   Malaria due to simian plasmodia

Excludes:    when mixed with Plasmodium:

• falciparum (B50-)

• malariae (B52-)

• ovale (B53.0)

• vivax (B51-)

B53.8   Other parasitologically confirmed malaria, not elsewhere classified

Parasitologically confirmed malaria NOS

B54  Unspecified malaria

Clinically diagnosed malaria without parasitological confirmation

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

B56  African trypanosomiasis

B56.0   Gambiense trypanosomiasis

Infection due to Trypanosoma brucei gambiense

West African sleeping sickness

B56.1   Rhodesiense trypanosomiasis

East African sleeping sickness

Infection due to Trypanosoma brucei rhodesiense

B56.9   African trypanosomiasis, unspecified

Sleeping sickness NOS

Trypanosomiasis NOS, in places where African trypanosomiasis is prevalent

B57  Chagas disease

Includes:    American trypanosomiasis

infection due to Trypanosoma cruzi

B57.0† Acute Chagas disease with heart involvement (I41.2*, I98.1*)

Acute Chagas disease with:

• cardiovascular involvement NEC (I98.1*)

• myocarditis (I41.2*)

B57.1   Acute Chagas disease without heart involvement

Acute Chagas disease NOS

B57.2   Chagas disease (chronic) with heart involvement

American trypanosomiasis NOS

Chagas disease (chronic) (with):

• NOS

• cardiovascular involvement NEC† (I98.1*)

• myocarditis† (I41.2*)

Trypanosomiasis NOS, in places where Chagas disease is prevalent

B57.3   Chagas disease (chronic) with digestive system involvement

B57.4   Chagas disease (chronic) with nervous system involvement

B57.5   Chagas disease (chronic) with other organ involvement

B58  Toxoplasmosis

Includes:    infection due to Toxoplasma gondii

Excludes:    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

B59  Pneumocystosis (J17.3*)

Pneumonia due to:

• Pneumocystis carinii

• Pneumocystis jirovecii

B60  Other protozoal diseases, not elsewhere classified

Excludes:    cryptosporidiosis (A07.2)

intestinal microsporidiosis (A07.8)

isosporiasis (A07.3)

B60.0   Babesiosis

Piroplasmosis

B60.1   Acanthamoebiasis

Conjunctivitis due to Acanthamoeba† (H13.1*)

Keratoconjunctivitis due to Acanthamoeba† (H19.2*)

B60.2   Naegleriasis

Primary amoebic meningoencephalitis† (G05.2*)

B60.8   Other specified protozoal diseases

Microsporidiosis

B64  Unspecified protozoal disease

Helminthiases (B65-B83)

B65  Schistosomiasis [bilharziasis]

Includes:    snail fever

B65.0   Schistosomiasis due to Schistosoma haematobium [urinary schistosomiasis]

B65.1   Schistosomiasis due to Schistosoma mansoni [intestinal schistosomiasis]

B65.2   Schistosomiasis due to Schistosoma japonicum

Asiatic schistosomiasis

B65.3   Cercarial dermatitis

Swimmer itch

B65.8   Other schistosomiases

Infection due to Schistosoma:

• intercalatum

• mattheei

• mekongi

B65.9   Schistosomiasis, unspecified

B66  Other fluke infections

B66.0   Opisthorchiasis

Infection due to:

• cat liver fluke

• Opisthorchis (felineus) (viverrini)

B66.1   Clonorchiasis

Chinese liver fluke disease

Infection due to Clonorchis sinensis

Oriental liver fluke disease

B66.2   Dicrocoeliasis

Infection due to Dicrocoelium dendriticum

Lancet fluke infection

B66.3   Fascioliasis

Infection due to Fasciola:

• gigantica

• hepatica

• indica

Sheep liver fluke disease

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

Includes:    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

Excludes:    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

B69  Cysticercosis

Includes:    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

B70  Diphyllobothriasis and sparganosis

B70.0   Diphyllobothriasis

Diphyllobothrium (adult) (latum) (pacificum) infection

Fish tapeworm (infection)

Excludes:    larval diphyllobothriasis (B70.1)

B70.1   Sparganosis

Infection due to:

• Sparganum (mansoni) (proliferum)

• Spirometra larvae

Larval diphyllobothriasis

Spirometrosis

B71  Other cestode infections

B71.0   Hymenolepiasis

Dwarf tapeworm (infection)

Rat tapeworm (infection)

B71.1   Dipylidiasis

B71.8   Other specified cestode infections

Coenurosis

B71.9   Cestode infection, unspecified

Tapeworm (infection) NOS

B72  Dracunculiasis

Guinea worm infection

Infection due to Dracunculus medinensis

B73  Onchocerciasis

Onchocerca volvulus infection

Onchocercosis

River blindness

B74  Filariasis

Excludes:    onchocerciasis (B73)

tropical (pulmonary) eosinophilia NOS (J82)

B74.0   Filariasis due to Wuchereria bancrofti

Bancroftian:

• elephantiasis

• filariasis

B74.1   Filariasis due to Brugia malayi

B74.2   Filariasis due to Brugia timori

B74.3   Loiasis

Calabar swelling

Eyeworm disease of Africa

Loa loa infection

B74.4   Mansonelliasis

Infection due to Mansonella:

• ozzardi

• perstans

• streptocerca

B74.8   Other filariases

Dirofilariasis

B74.9   Filariasis, unspecified

B75  Trichinellosis

Infection due to Trichinella species

Trichiniasis

B76  Hookworm diseases

Includes:    uncinariasis

B76.0   Ancylostomiasis

Infection due to Ancylostoma species

B76.1   Necatoriasis

Infection due to Necator americanus

B76.8   Other hookworm diseases

B76.9   Hookworm disease, unspecified

Cutaneous larva migrans NOS

B77  Ascariasis

Includes:    ascaridiasis

roundworm infection

B77.0   Ascariasis with intestinal complications

B77.8   Ascariasis with other complications

B77.9   Ascariasis, unspecified

B78  Strongyloidiasis

Excludes:    trichostrongyliasis (B81.2)

B78.0   Intestinal strongyloidiasis

B78.1   Cutaneous strongyloidiasis

B78.7   Disseminated strongyloidiasis

B78.9   Strongyloidiasis, unspecified

B79  Trichuriasis

Trichocephaliasis

Whipworm (disease) (infection)

B80  Enterobiasis

Oxyuriasis

Pinworm infection

Threadworm infection

B81  Other intestinal helminthiases, not elsewhere classified

Excludes:    angiostrongyliasis due to:

• Angiostrongylus cantonensis (B83.2)

• Parastrongylus cantonensis (B83.2)

B81.0   Anisakiasis

Infection due to Anisakis larvae

B81.1   Intestinal capillariasis

Capillariasis NOS

Infection due to Capillaria philippinensis

Excludes:    hepatic capillariasis (B83.8)

B81.2   Trichostrongyliasis

B81.3   Intestinal angiostrongyliasis

Angiostrongyliasis due to:

• Angiostrongylus costaricensis

• Parastrongylus costaricensis

B81.4   Mixed intestinal helminthiases

Infection due to intestinal helminths classifiable to more than one of the categories B65.0-B81.3 and B81.8

Mixed helminthiasis NOS

B81.8   Other specified intestinal helminthiases

Infection due to:

• Oesophagostomum species [oesophagostomiasis]

• Ternidens deminutus [ternidensiasis]

• Ternidens diminutus [ternidensiasis]

B82  Unspecified intestinal parasitism

B82.0   Intestinal helminthiasis, unspecified

B82.9   Intestinal parasitism, unspecified

B83  Other helminthiases

Excludes:    capillariasis:

• NOS (B81.1)

• intestinal (B81.1)

B83.0   Visceral larva migrans

Toxocariasis

B83.1   Gnathostomiasis

Wandering swelling

B83.2   Angiostrongyliasis due to Parastrongylus cantonensis

Angiostrongyliasis due to Angiostrongylus cantonensis

Eosinophilic meningoencephalitis† (G05.2*)

Excludes:    intestinal angiostrongyliasis (B81.3)

B83.3   Syngamiasis

Syngamosis

B83.4   Internal hirudiniasis

Excludes:    external hirudiniasis (B88.3)

B83.8   Other specified helminthiases

Acanthocephaliasis

Gongylonemiasis

Hepatic capillariasis

Metastrongyliasis

Thelaziasis

B83.9   Helminthiasis, unspecified

Worms NOS

Excludes:    intestinal helminthiasis NOS (B82.0)

Pediculosis, acariasis and other infestations (B85-B89)

B85  Pediculosis and phthiriasis

B85.0   Pediculosis due to Pediculus humanus capitis

Head-louse infestation

B85.1   Pediculosis due to Pediculus humanus corporis

Body-louse infestation

B85.2   Pediculosis, unspecified

B85.3   Phthiriasis

Infestation by:

• crab-louse

• Phthirus pubis

B85.4   Mixed pediculosis and phthiriasis

Infestation classifiable to more than one of the categories B85.0-B85.3

B86  Scabies

Sarcoptic itch

B87  Myiasis

Includes:    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

B88  Other infestations

B88.0   Other acariasis

Acarine dermatitis

Dermatitis due to:

• Demodex species

• Dermanyssus gallinae

• Liponyssoides sanguineus

Trombiculosis

Excludes:    scabies (B86)

B88.1   Tungiasis [sandflea infestation]

B88.2   Other arthropod infestations

Scarabiasis

B88.3   External hirudiniasis

Leech infestation NOS

Excludes:    internal hirudiniasis (B83.4)

B88.8   Other specified infestations

Ichthyoparasitism due to Vandellia cirrhosa

Linguatulosis

Porocephaliasis

B88.9   Infestation, unspecified

Infestation (skin) NOS

Infestation by mites NOS

Skin parasites NOS

B89  Unspecified parasitic disease

Sequelae of infectious and parasitic diseases (B90-B94)

Note:          Categories B90-B94 are to be used to indicate conditions in categories A00-B89 as the cause of sequelae, which are themselves classified elsewhere. The "sequelae" include conditions specified as such; they also include late effects of diseases classifiable to the above categories if there is evidence that the disease itself is no longer present. For use of these categories, reference should be made to the morbidity coding rules and guidelines in Volume 2 or mortality coding rules and guidelines in Part 2a Instruction Manual (NCHS).

Not to be used for chronic infections. Code current infections to chronic or active infectious disease as appropriate.

B90  Sequelae of tuberculosis

B90.0   Sequelae of central nervous system tuberculosis

B90.1   Sequelae of genitourinary tuberculosis

B90.2   Sequelae of tuberculosis of bones and joints

B90.8   Sequelae of tuberculosis of other organs

B90.9   Sequelae of respiratory and unspecified tuberculosis

Sequelae of tuberculosis NOS

B91  Sequelae of poliomyelitis

Excludes:    postpolio syndrome (G14)

B92  Sequelae of leprosy

B94  Sequelae of other and unspecified infectious and parasitic diseases

B94.0   Sequelae of trachoma

B94.1   Sequelae of viral encephalitis

B94.2   Sequelae of viral hepatitis

B94.8   Sequelae of other specified infectious and parasitic diseases

B94.9   Sequelae of unspecified infectious or parasitic disease

Bacterial, viral and other infectious agents (B95-B97)

Note:          These categories should never be used in primary coding. They are provided for use as supplementary or additional codes when it is desired to identify the infectious agent(s) in diseases classified elsewhere.

B95  Streptococcus and staphylococcus as the cause of diseases classified to other chapters

B95.0   Streptococcus, group A, as the cause of diseases classified to other chapters

B95.1   Streptococcus, group B, as the cause of diseases classified to other chapters

B95.2   Streptococcus, group D, as the cause of diseases classified to other chapters

B95.3   Streptococcus pneumoniae as the cause of diseases classified to other chapters

B95.4   Other streptococcus as the cause of diseases classified to other chapters

B95.5   Unspecified streptococcus as the cause of diseases classified to other chapters

B95.6   Staphylococcus aureus as the cause of diseases classified to other chapters

B95.7   Other staphylococcus as the cause of diseases classified to other chapters

B95.8   Unspecified staphylococcus as the cause of diseases classified to other chapters

B96  Other specified bacterial agents as the cause of diseases classified to other chapters

B96.0   Mycoplasma pneumoniae [M. pneumoniae] as the cause of diseases classified to other chapters

Pleuro-pneumonia-like-organism [PPLO]

B96.1   Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified to other chapters

B96.2   Escherichia coli [E. coli] as the cause of diseases classified to other chapters

B96.3   Haemophilus influenzae [H. influenzae] as the cause of diseases classified to other chapters

B96.4   Proteus (mirabilis) (morganii) as the cause of diseases classified to other chapters

B96.5   Pseudomonas (aeruginosa) (mallei) (pseudomallei) as the cause of diseases classified to other chapters

B96.6   Bacillus fragilis [B. fragilis] as the cause of diseases classified to other chapters

B96.7   Clostridium perfringens [C. perfringens] as the cause of diseases classified to other chapters

B96.8   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

B97.0   Adenovirus as the cause of diseases classified to other chapters

B97.1   Enterovirus as the cause of diseases classified to other chapters

Coxsackievirus

Echovirus

B97.2   Coronavirus as the cause of diseases classified to other chapters

B97.3   Retrovirus as the cause of diseases classified to other chapters

Lentivirus

Oncovirus

B97.4   Respiratory syncytial virus as the cause of diseases classified to other chapters

B97.5   Reovirus as the cause of diseases classified to other chapters

B97.6   Parvovirus as the cause of diseases classified to other chapters

B97.7   Papillomavirus as the cause of diseases classified to other chapters

B97.8   Other viral agents as the cause of diseases classified to other chapters

Human metapneumovirus

Other infectious diseases (B99)

B99  Other and unspecified infectious diseases

CHAPTER II - Neoplasms (C00-D48)

This chapter contains the following broad groups of neoplasms:

C00-C97       Malignant neoplasms

C00-C75       Malignant neoplasms, stated or presumed to be primary, of specified sites, except of lymphoid, haematopoietic and related tissue

C00-C14       Lip, oral cavity and pharynx

C15-C26       Digestive organs

C30-C39       Respiratory and intrathoracic organs

C40-C41       Bone and articular cartilage

C43-C44       Skin

C45-C49       Mesothelial and soft tissue

C50              Breast

C51-C58       Female genital organs

C60-C63       Male genital organs

C64-C68       Urinary tract

C69-C72       Eye, brain and other parts of central nervous system

C73-C75       Thyroid and other endocrine glands

C76-C80       Malignant neoplasms of ill-defined, secondary and unspecified sites

C81-C96       Malignant neoplasms, stated or presumed to be primary, of lymphoid, haematopoietic and related tissue

C97              Malignant neoplasms of independent (primary) multiple sites

D00-D09      In situ neoplasms

D10-D36      Benign neoplasms

D37-D48      Neoplasms of uncertain or unknown behaviour [see note preceding D37 category]

Notes

1.  Primary, ill-defined, secondary and unspecified sites of malignant neoplasms

Categories C76-C80 include malignant neoplasms for which there is no clear indication of the original site of the cancer or the cancer is stated to be "disseminated", "scattered" or "spread" without mention of the primary site. In both cases the primary site is considered to be unknown.

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.

3.       Morphology

There are a number of major morphological (histological) groups of malignant neoplasms: carcinomas including squamous (cell) and adeno-carcinomas; 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, comprehensive separate morphology codes are provided within the Morphology chapter. These morphology codes are derived from the second edition of International Classification of Diseases for Oncology (ICD-O), which 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.

4.       Use of subcategories in Chapter II

Attention is drawn to the special use of subcategory .8 in this chapter [see note 5]. Where it has been necessary to provide subcategories for "other", these have generally been designated as subcategory .7.

5.  Malignant neoplasms overlapping site boundaries and the use of subcategory .8 (overlapping lesion)

Categories C00-C75 classify primary malignant neoplasms according to their point of origin. Many three-character categories are further divided into named parts or subcategories of the organ in question. A neoplasm that overlaps two or more contiguous sites within a three-character category and whose point of origin cannot be determined should be classified to the subcategory .8 ("overlapping lesion"), unless the combination is specifically indexed elsewhere.

For example, carcinoma of oesophagus and stomach is specifically indexed to C16.0 (cardia), while carcinoma of the tip and ventral surface of the tongue should be assigned to C02.8. On the other hand, carcinoma of the tip of the tongue extending to involve the ventral surface should be coded to C02.1 as the point of origin, the tip, is known. "Over-lapping" implies that the sites involved are contiguous (next to each other). Numerically consecutive subcategories are frequently anatomically contiguous, but this is not invariably so (e.g. bladder C67-) and the coder may need to consult anatomical texts to determine the topographical relationships.

Sometimes a neoplasm overlaps the boundaries of three-character categories within certain systems. To take care of this the following subcategories have been designated:

     C02.8      Overlapping lesion of tongue

     C08.8      Overlapping lesion of major salivary glands

     C14.8      Overlapping lesion of lip, oral cavity and pharynx

     C21.8      Overlapping lesion of rectum, anus and anal canal

     C24.8      Overlapping lesion of biliary tract

     C26.8      Overlapping lesion of digestive system

     C39.8      Overlapping lesion of respiratory and intrathoracic organs

     C41.8      Overlapping lesion of bone and articular cartilage

     C49.8      Overlapping lesion of connective and soft tissue

     C57.8      Overlapping lesion of female genital organs

     C63.8      Overlapping lesion of male genital organs

     C68.8      Overlapping lesion of urinary organs

     C72.8      Overlapping lesion of central nervous system

An example of this is a carcinoma of the stomach and small intestine, which should be coded to C26.8 (Overlapping lesion of digestive system).

6.       Malignant neoplasms of ectopic tissue

Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g. ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).

7.       Use of the Alphabetical Index in coding neoplasms

In addition to site, morphology and behaviour must also be taken into consideration when coding neoplasms, and reference should always be made first to the Alphabetical Index entry for the morphological description.

The introductory pages of Volume 3 include general instructions about the correct use of the Alphabetical Index. The specific instructions and examples pertaining to neoplasms should be consulted to ensure correct use of the categories and subcategories in Chapter II.

8.  Use of the second edition of International Classification of Diseases for Oncology (ICD-O)

For certain morphological types, Chapter II provides a rather restricted topographical classification, or none at all. The topography codes of ICD-O use for all neoplasms essentially the same three- and four-character categories that Chapter II uses for malignant neoplasms (C00-C77, C80), thus providing increased specificity of site for other neoplasms (malignant secondary (metastatic), benign, in situ and uncertain or unknown).

It is therefore recommended that agencies interested in identifying both the site and morphology of tumours, e.g. cancer registries, cancer hospitals, pathology departments and other agencies specializing in cancer, use ICD-O.

Malignant neoplasms (C00-C97)

Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)

C00  Malignant neoplasm of lip

Excludes:    skin of lip (C43.0, C44.0)

C00.0   External upper lip

Upper lip:

• NOS

• lipstick area

• vermilion border

C00.1   External lower lip

Lower lip:

• NOS

• lipstick area

• vermilion border

C00.2   External lip, unspecified

Vermilion border NOS

C00.3   Upper lip, inner aspect

Upper lip:

• buccal aspect

• frenulum

• mucosa

• oral aspect

C00.4   Lower lip, inner aspect

Lower lip:

• buccal aspect

• frenulum

• mucosa

• oral aspect

C00.5   Lip, unspecified, inner aspect

Lip, not specified whether upper or lower:

• buccal aspect

• frenulum

• mucosa

• oral aspect

C00.6   Commissure of lip

C00.8   Overlapping lesion of lip

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C00.9   Lip, unspecified

C01  Malignant neoplasm of base of tongue

Dorsal surface of base of tongue

Fixed part of tongue NOS

Posterior third of tongue

C02  Malignant neoplasm of other and unspecified parts of tongue

C02.0   Dorsal surface of tongue

Anterior two-thirds of tongue, dorsal surface

Excludes:    dorsal surface of base of tongue (C01)

C02.1   Border of tongue

Tip of tongue

C02.2   Ventral surface of tongue

Anterior two-thirds of tongue, ventral surface

Frenulum linguae

C02.3   Anterior two-thirds of tongue, part unspecified

Middle third of tongue NOS

Mobile part of tongue NOS

C02.4   Lingual tonsil

Excludes:    tonsil NOS (C09.9)

C02.8   Overlapping lesion of tongue

[See note 5 preceding Malignant Neoplasms (C00-C97)]

Malignant neoplasm of tongue whose point of origin cannot be classified to any one of the categories C01-C02.4

C02.9   Tongue, unspecified

C03  Malignant neoplasm of gum

Includes:    alveolar (ridge) mucosa

gingiva

Excludes:    malignant odontogenic neoplasms (C41.0-C41.1)

C03.0   Upper gum

C03.1   Lower gum

C03.9   Gum, unspecified

C04  Malignant neoplasm of floor of mouth

C04.0   Anterior floor of mouth

Anterior to the premolar-canine junction

C04.1   Lateral floor of mouth

C04.8   Overlapping lesion of floor of mouth

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C04.9   Floor of mouth, unspecified

C05  Malignant neoplasm of palate

C05.0   Hard palate

C05.1   Soft palate

Excludes:    nasopharyngeal surface of soft palate (C11.3)

C05.2   Uvula

C05.8   Overlapping lesion of palate

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C05.9   Palate, unspecified

Roof of mouth

C06  Malignant neoplasm of other and unspecified parts of mouth

C06.0   Cheek mucosa

Buccal mucosa NOS

Internal cheek

C06.1   Vestibule of mouth

Buccal sulcus (upper)(lower)

Labial sulcus (upper)(lower)

C06.2   Retromolar area

C06.8   Overlapping lesion of other and unspecified parts of mouth

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C06.9   Mouth, unspecified

Minor salivary gland, unspecified site

Oral cavity NOS

C07  Malignant neoplasm of parotid gland

C08  Malignant neoplasm of other and unspecified major salivary glands

Excludes:    malignant neoplasms of specified minor salivary which are classified according to their anatomical location

malignant neoplasms of minor salivary glands NOS (C06.9)

parotid gland (C07)

C08.0   Submandibular gland

Submaxillary gland

C08.1   Sublingual gland

C08.8   Overlapping lesion of major salivary glands

[See note 5 preceding Malignant Neoplasms (C00-C97)]

Malignant neoplasm of major salivary glands whose point of origin cannot be classified to any one of the categories C07-C08.1

C08.9   Major salivary gland, unspecified

Salivary gland (major) NOS

C09  Malignant neoplasm of tonsil

Excludes:    lingual tonsil (C02.4)

pharyngeal tonsil (C11.1)

C09.0   Tonsillar fossa

C09.1   Tonsillar pillar (anterior)(posterior)

C09.8   Overlapping lesion of tonsil

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C09.9   Tonsil, unspecified

Tonsil:

• NOS

• faucial

• palatine

C10  Malignant neoplasm of oropharynx

Excludes:    tonsil (C09-)

C10.0   Vallecula

C10.1   Anterior surface of epiglottis

Epiglottis, free border [margin]

Glossoepiglottic fold(s)

Excludes:    epiglottis (suprahyoid portion) NOS (C32.1)

C10.2   Lateral wall of oropharynx

C10.3   Posterior wall of oropharynx

C10.4   Branchial cleft

Branchial cyst [site of neoplasm]

C10.8   Overlapping lesion of oropharynx

[See note 5 preceding Malignant Neoplasms (C00-C97)]

Junctional region of oropharynx

C10.9   Oropharynx, unspecified

C11  Malignant neoplasm of nasopharynx

C11.0   Superior wall of nasopharynx

Roof of nasopharynx

C11.1   Posterior wall of nasopharynx

Adenoid

Pharyngeal tonsil

C11.2   Lateral wall of nasopharynx

Fossa of Rosenmuller

Opening of auditory tube

Pharyngeal recess

C11.3   Anterior wall of nasopharynx

Floor of nasopharynx

Nasopharyngeal (anterior) (posterior) surface of soft palate

Posterior margin of nasal:

• choana

• septum

C11.8   Overlapping lesion of nasopharynx

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C11.9   Nasopharynx, unspecified

Nasopharyngeal wall NOS

C12  Malignant neoplasm of pyriform sinus

Pyriform fossa

C13  Malignant neoplasm of hypopharynx

Excludes:    pyriform sinus (C12)

C13.0   Postcricoid region

C13.1   Aryepiglottic fold, hypopharyngeal aspect

Aryepiglottic fold:

• NOS

• marginal zone

Excludes:    aryepiglottic fold, laryngeal aspect (C32.1)

C13.2   Posterior wall of hypopharynx

C13.8   Overlapping lesion of hypopharynx

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C13.9   Hypopharynx, unspecified

Hypopharyngeal wall NOS

C14  Malignant neoplasm of other and ill-defined sites in the lip, oral cavity and pharynx

Excludes:    oral cavity NOS (C06.9)

C14.0   Pharynx, unspecified

C14.2   Waldeyer ring

C14.8   Overlapping lesion of lip, oral cavity and pharynx

[See note 5 preceding Malignant Neoplasms (C00-C97)]

Malignant neoplasm of lip, oral cavity and pharynx whose point of origin cannot be classified to any one of the categories C00-C14.2

Malignant neoplasms of digestive organs (C15-C26)

C15  Malignant neoplasm of oesophagus

Note:          Two alternative subclassifications are given:

.0-.2 by anatomical description

.3-.5 by thirds

This departure from the principle that categories should be mutually exclusive is deliberate, since both forms of terminology are in use but the resulting anatomical divisions are not analogous.

C15.0   Cervical part of oesophagus

C15.1   Thoracic part of oesophagus

C15.2   Abdominal part of oesophagus

C15.3   Upper third of oesophagus

C15.4   Middle third of oesophagus

C15.5   Lower third of oesophagus

C15.8   Overlapping lesion of oesophagus

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C15.9   Oesophagus, unspecified

C16  Malignant neoplasm of stomach

C16.0   Cardia

Cardiac orifice

Cardio-oesophageal junction

Gastro-oesophageal junction

Oesophagus and stomach

C16.1   Fundus of stomach

C16.2   Body of stomach

C16.3   Pyloric antrum

Gastric antrum

C16.4   Pylorus

Prepylorus

Pyloric canal

C16.5   Lesser curvature of stomach, unspecified

Lesser curvature of stomach, not classifiable to C16.1-C16.4

C16.6   Greater curvature of stomach, unspecified

Greater curvature of stomach, not classifiable to C16.0-C16.4

C16.8   Overlapping lesion of stomach

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C16.9   Stomach, unspecified

Gastric cancer NOS

C17  Malignant neoplasm of small intestine

C17.0   Duodenum

C17.1   Jejunum

C17.2   Ileum

Excludes:    ileocaecal valve (C18.0)

C17.3   Meckel diverticulum

C17.8   Overlapping lesion of small intestine

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C17.9   Small intestine, unspecified

C18  Malignant neoplasm of colon

C18.0   Caecum

Ileocaecal valve

C18.1   Appendix

C18.2   Ascending colon

C18.3   Hepatic flexure

C18.4   Transverse colon

C18.5   Splenic flexure

C18.6   Descending colon

C18.7   Sigmoid colon

Sigmoid (flexure)

Excludes:    rectosigmoid junction (C19)

C18.8   Overlapping lesion of colon

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C18.9   Colon, unspecified

Large intestine NOS

C19  Malignant neoplasm of rectosigmoid junction

Colon with rectum

Rectosigmoid (colon)

C20  Malignant neoplasm of rectum

Rectal ampulla

C21  Malignant neoplasm of anus and anal canal

C21.0   Anus, unspecified

Excludes:    anal:

• margin (C43.5, C44.5)

• skin (C43.5, C44.5)

perianal skin (C43.5, C44.5)

C21.1   Anal canal

Anal sphincter

C21.2   Cloacogenic zone

C21.8   Overlapping lesion of rectum, anus and anal canal

[See note 5 preceding Malignant Neoplasms (C00-C97)]

Anorectal junction

Anorectum

Malignant neoplasm of rectum, anus and anal canal whose point of origin cannot be classified to any one of the categories C20-C21.2

C22  Malignant neoplasm of liver and intrahepatic bile ducts

Excludes:    biliary tract NOS (C24.9)

secondary malignant neoplasm of liver (C78.7)

C22.0   Liver cell carcinoma

Hepatocellular carcinoma

Hepatoma

C22.1   Intrahepatic bile duct carcinoma

Cholangiocarcinoma

C22.2   Hepatoblastoma

C22.3   Angiosarcoma of liver

Kupffer cell sarcoma

C22.4   Other sarcomas of liver

C22.7   Other specified carcinomas of liver

C22.9   Liver, unspecified

C23  Malignant neoplasm of gallbladder

C24  Malignant neoplasm of other and unspecified parts of biliary tract

Excludes:    intrahepatic bile duct (C22.1)

C24.0   Extrahepatic bile duct

Biliary duct or passage NOS

Common bile duct

Cystic duct

Hepatic duct

C24.1   Ampulla of Vater

C24.8   Overlapping lesion of biliary tract

[See note 5 preceding Malignant Neoplasms (C00-C97)]

Malignant neoplasm involving both intrahepatic and extrahepatic bile ducts

Malignant neoplasm of biliary tract whose point of origin cannot be classified to any one of the categories C22.0-C24.1

C24.9   Biliary tract, unspecified

C25  Malignant neoplasm of pancreas

C25.0   Head of pancreas

C25.1   Body of pancreas

C25.2   Tail of pancreas

C25.3   Pancreatic duct

C25.4   Endocrine pancreas

Islets of Langerhans

C25.7   Other parts of pancreas

Neck of pancreas

C25.8   Overlapping lesion of pancreas

[See note 5 preceding Malignant Neoplasms (C00-C97)]

C25.9   Pancreas, unspecified

C26  Malignant neoplasm of other and ill-defined digestive organs

Excludes:    peritoneum and retroperitoneum (C48-)

C26.0   Intestinal tract, part unspecified

Intestine NOS

C26.1   Spleen

Excludes:    Hodgkin disease (C81-)

non-Hodgkin lymphoma (C82-C85)

C26.8   Overlapping lesion of digestive system

[See note 5 preceding Malignant Neoplasms (C00-C97)]

Malignant neoplasm of digestive organs whose point of origin cannot be classified to any one of the categories C15-C26.1

Excludes:    cardio-oesophageal junction (C16.0)

C26.9   Ill-defined sites within the digestive system

Alimentary canal or tract NOS

Gastrointestinal tract NOS

Malignant neoplasms of respiratory and intrathoracic organs (C30-C39)

Includes:    middle ear

Excludes:    mesothelioma (C45-)

C30  Malignant neoplasm of nasal cavity and middle ear

C30.0   Nasal cavity

Cartilage of nose

Concha, nasal

Internal nose

Septum of nose

Vestibule of nose

Excludes:    nasal bone (C41.0)

nose NOS (C76.0)

olfactory bulb (C72.2)

posterior margin of nasal septum and choana (C11.3)

skin of nose (C43.3, C44.3)

C30.1   Middle ear

Eustachian tube

Inner ear

Mastoid air cells

Excludes:    auricular canal (external) (C43.2, C44.2)

bone of ear (meatus) (C41.0)

cartilage of ear (C49.0)

skin of (external) ear (C43.2, C44.2)

C31  Malignant neoplasm of accessory sinuses

C31.0   Maxillary sinus

Antrum (Highmore) (maxillary)

C31.1   Ethmoidal sinus

C31.2   Frontal sinus

C31.3   Sphenoidal sinus

C31.8   Overlapping lesion of accessory sinuses

[See note 5 preceding Malignant Neoplasms C00-C97]

C31.9   Accessory sinus, unspecified

C32  Malignant neoplasm of larynx

C32.0   Glottis

Intrinsic larynx

Vocal cord (true) NOS

C32.1   Supraglottis

Aryepiglottic fold, laryngeal aspect

Epiglottis (suprahyoid portion) NOS

Extrinsic larynx

False vocal cord

Posterior (laryngeal) surface of epiglottis

Ventricular bands

Excludes:    anterior surface of epiglottis (C10.1)

aryepiglottic fold:

• NOS (C13.1)

• hypopharyngeal aspect (C13.1)

• marginal zone (C13.1)

C32.2   Subglottis

C32.3   Laryngeal cartilage

C32.8   Overlapping lesion of larynx

[See note 5 preceding Malignant Neoplasms C00-C97]

C32.9   Larynx, unspecified

C33  Malignant neoplasm of trachea

C34  Malignant neoplasm of bronchus and lung

C34.0   Main bronchus

Carina

Hilus (of lung)

C34.1   Upper lobe, bronchus or lung

C34.2   Middle lobe, bronchus or lung

C34.3   Lower lobe, bronchus or lung

C34.8   Overlapping lesion of bronchus and lung

[See note 5 preceding Malignant Neoplasms C00-C97]

C34.9   Bronchus or lung, unspecified

C37  Malignant neoplasm of thymus

C38  Malignant neoplasm of heart, mediastinum and pleura

Excludes:    mesothelioma (C45-)

C38.0   Heart

Pericardium

Excludes:    great vessels (C49.3)

C38.1   Anterior mediastinum

C38.2   Posterior mediastinum

C38.3   Mediastinum, part unspecified

C38.4   Pleura

C38.8   Overlapping lesion of heart, mediastinum and pleura

[See note 5 preceding Malignant Neoplasms C00-C97]

C39  Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs

Excludes:    intrathoracic NOS (C76.1)

thoracic NOS (C76.1)

C39.0   Upper respiratory tract, part unspecified

C39.8   Overlapping lesion of respiratory and intrathoracic organs

[See note 5 preceding Malignant Neoplasms C00-C97]

Malignant neoplasm of respiratory and intrathoracic organs whose point of origin cannot be classified to any one of the categories C30-C39.0

C39.9   Ill-defined sites within the respiratory system

Respiratory tract NOS

Malignant neoplasms of bone and articular cartilage (C40-C41)

Excludes:    bone marrow NOS (C96.7)

synovia (C49-)

C40  Malignant neoplasm of bone and articular cartilage of limbs

C40.0   Scapula and long bones of upper limb

C40.1   Short bones of upper limb

C40.2   Long bones of lower limb

C40.3   Short bones of lower limb

C40.8   Overlapping lesion of bone and articular cartilage of limbs

[See note 5 preceding Malignant Neoplasms C00-C97]

C40.9   Bone and articular cartilage of limb, unspecified

C41  Malignant neoplasm of bone and articular cartilage of other and unspecified sites

Excludes:    bones of limbs (C40-)

cartilage of:

• ear (C49.0)

• larynx (C32.3)

• limbs (C40-)

• nose (C30.0)

C41.0   Bones of skull and face

Maxilla (superior)

Orbital bone

Excludes:    carcinoma, any type except intraosseous or odontogenic of:

• maxillary sinus (C31.0)

• upper jaw (C03.0)

jaw bone (lower) (C41.1)

C41.1   Mandible

Lower jaw bone

Excludes:    carcinoma, any type except intraosseous or odontogenic of:

• jaw NOS (C03.9)

• lower (C03.1)

upper jaw bone (C41.0)

C41.2   Vertebral column

Excludes:    sacrum and coccyx (C41.4)

C41.3   Ribs, sternum and clavicle

C41.4   Pelvic bones, sacrum and coccyx

C41.8   Overlapping lesion of bone and articular cartilage

[See note 5 preceding Malignant Neoplasms C00-C97]

Malignant neoplasm of bone and articular cartilage whose point of origin cannot be classified to any one of the categories C40-C41.4

C41.9   Bone and articular cartilage, unspecified

Melanoma and other malignant neoplasms of skin (C43-C44)

C43  Malignant melanoma of skin

Includes:    morphology codes M872-M879 with behaviour code /3

Excludes:    malignant melanoma of skin of genital organs (C51-C52, C60-, C63-)

C43.0   Malignant melanoma of lip

Excludes:    vermilion border of lip (C00.0-C00.2)

C43.1   Malignant melanoma of eyelid, including canthus

C43.2   Malignant melanoma of ear and external auricular canal

C43.3   Malignant melanoma of other and unspecified parts of face

C43.4   Malignant melanoma of scalp and neck

C43.5   Malignant melanoma of trunk

Anal:

• margin

• skin

Perianal skin

Skin of breast

Excludes:    anus NOS (C21.0)

C43.6   Malignant melanoma of upper limb, including shoulder

C43.7   Malignant melanoma of lower limb, including hip

C43.8   Overlapping malignant melanoma of skin

[See note 5 preceding Malignant Neoplasms C00-C97]

C43.9   Malignant melanoma of skin, unspecified

Melanoma (malignant) NOS

C44  Other malignant neoplasms of skin

Includes:    malignant neoplasm of:

• sebaceous glands

• sweat glands

Excludes:    Kaposi sarcoma (C46-)

malignant melanoma of skin (C43-)

skin of genital organs (C51-C52, C60-, C63-)

C44.0   Skin of lip

Basal cell carcinoma of lip

Excludes:    malignant neoplasm of lip (C00-)

C44.1   Skin of eyelid, including canthus

Excludes:    connective tissue of eyelid (C49.0)

C44.2   Skin of ear and external auricular canal

Excludes:    connective tissue of ear (C49.0)

C44.3   Skin of other and unspecified parts of face

C44.4   Skin of scalp and neck

C44.5   Skin of trunk

Anal:

• margin

• skin

Perianal skin

Skin of breast

Excludes:    anus NOS (C21.0)

C44.6   Skin of upper limb, including shoulder

C44.7   Skin of lower limb, including hip

C44.8   Overlapping lesion of skin

[See note 5 preceding Malignant Neoplasms C00-C97]

C44.9   Malignant neoplasm of skin, unspecified

Malignant neoplasms of mesothelial and soft tissue (C45-C49)

C45  Mesothelioma

Includes:    morphology code M905 with behaviour code /3

C45.0   Mesothelioma of pleura

Excludes:    other malignant neoplasms of pleura (C38.4)

C45.1   Mesothelioma of peritoneum

Mesentery

Mesocolon

Omentum

Peritoneum (parietal) (pelvic)

Excludes:    other malignant neoplasms of peritoneum (C48-)

C45.2   Mesothelioma of pericardium

Excludes:    other malignant neoplasms of pericardium (C38.0)

C45.7   Mesothelioma of other sites

C45.9   Mesothelioma, unspecified

C46  Kaposi sarcoma

Includes:    morphology code M9140 with behaviour code /3

C46.0   Kaposi sarcoma of skin

C46.1   Kaposi sarcoma of soft tissue

C46.2   Kaposi sarcoma of palate

C46.3   Kaposi sarcoma of lymph nodes

C46.7   Kaposi sarcoma of other sites

C46.8   Kaposi sarcoma of multiple organs

C46.9   Kaposi sarcoma, unspecified

C47  Malignant neoplasm of peripheral nerves and autonomic nervous system

Includes:    sympathetic and parasympathetic nerves and ganglia

C47.0   Peripheral nerves of head, face and neck

Excludes:    peripheral nerves of orbit (C69.6)

C47.1   Peripheral nerves of upper limb, including shoulder

C47.2   Peripheral nerves of lower limb, including hip

C47.3   Peripheral nerves of thorax

C47.4   Peripheral nerves of abdomen

C47.5   Peripheral nerves of pelvis

C47.6   Peripheral nerves of trunk, unspecified

C47.8   Overlapping lesion of peripheral nerves and autonomic nervous system

[See note 5 preceding Malignant Neoplasms C00-C97]

C47.9   Peripheral nerves and autonomic nervous system, unspecified

C48  Malignant neoplasm of retroperitoneum and peritoneum

Excludes:    Kaposi sarcoma (C46.1)

mesothelioma (C45-)

C48.0   Retroperitoneum

C48.1   Specified parts of peritoneum

Mesentery

Mesocolon

Omentum

Peritoneum:

• parietal

• pelvic

C48.2   Peritoneum, unspecified

C48.8   Overlapping lesion of retroperitoneum and peritoneum

[See note 5 preceding Malignant Neoplasms C00-C97]

C49  Malignant neoplasm of other connective and soft tissue

Includes:    blood vessel

bursa

cartilage

fascia

fat

ligament, except uterine

lymphatic vessel

muscle

synovia

tendon (sheath)

Excludes:    cartilage (of):

• articular (C40-C41)

• larynx (C32.3)

• nose (C30.0)

connective tissue of breast (C50-)

Kaposi sarcoma (C46-)

mesothelioma (C45-)

peripheral nerves and autonomic nervous system (C47-)

peritoneum (C48-)

retroperitoneum (C48.0)

C49.0   Connective and soft tissue of head, face and neck

Connective tissue of:

• ear

• eyelid

Excludes:    connective tissue of orbit (C69.6)

C49.1   Connective and soft tissue of upper limb, including shoulder

C49.2   Connective and soft tissue of lower limb, including hip

C49.3   Connective and soft tissue of thorax

Axilla

Diaphragm

Great vessels

Excludes:    breast (C50-)

heart (C38.0)

mediastinum (C38.1-C38.3)

thymus (C37)

C49.4   Connective and soft tissue of abdomen

Abdominal wall

Hypochondrium

C49.5   Connective and soft tissue of pelvis

Buttock

Groin

Perineum

C49.6   Connective and soft tissue of trunk, unspecified

Back NOS

C49.8   Overlapping lesion of connective and soft tissue

[See note 5 preceding Malignant Neoplasms C00-C97]

Malignant neoplasm of connective and soft tissue whose point of origin cannot be classified to any one of the categories C47-C49.6

C49.9   Connective and soft tissue, unspecified

Malignant neoplasm of breast (C50)

C50  Malignant neoplasm of breast

Includes:    connective tissue of breast

Excludes:    skin of breast (C43.5, C44.5)

C50.0   Nipple and areola

C50.1   Central portion of breast

C50.2   Upper-inner quadrant of breast

C50.3   Lower-inner quadrant of breast

C50.4   Upper-outer quadrant of breast

C50.5   Lower-outer quadrant of breast

C50.6   Axillary tail of breast

C50.8   Overlapping lesion of breast

[See note 5 preceding Malignant Neoplasms C00-C97]

C50.9   Breast, unspecified

Malignant neoplasms of female genital organs (C51-C58)

Includes:    skin of female genital organs

C51  Malignant neoplasm of vulva

C51.0   Labium majus

Bartholin [greater vestibular] gland

C51.1   Labium minus

C51.2   Clitoris

C51.8   Overlapping lesion of vulva

[See note 5 preceding Malignant Neoplasms C00-C97]

C51.9   Vulva, unspecified

External female genitalia NOS

Pudendum

C52  Malignant neoplasm of vagina

C53  Malignant neoplasm of cervix uteri

C53.0   Endocervix

C53.1   Exocervix

C53.8   Overlapping lesion of cervix uteri

[See note 5 preceding Malignant Neoplasms C00-C97]

C53.9   Cervix uteri, unspecified

C54  Malignant neoplasm of corpus uteri

C54.0   Isthmus uteri

Lower uterine segment

C54.1   Endometrium

C54.2   Myometrium

C54.3   Fundus uteri

C54.8   Overlapping lesion of corpus uteri

[See note 5 preceding Malignant Neoplasms C00-C97]

C54.9   Corpus uteri, unspecified

C55  Malignant neoplasm of uterus, part unspecified

C56  Malignant neoplasm of ovary

C57  Malignant neoplasm of other and unspecified female genital organs

C57.0   Fallopian tube

Oviduct

Uterine tube

C57.1   Broad ligament

C57.2   Round ligament

C57.3   Parametrium

Uterine ligament NOS

C57.4   Uterine adnexa, unspecified

C57.7   Other specified female genital organs

Wolffian body or duct

C57.8   Overlapping lesion of female genital organs

[See note 5 preceding Malignant Neoplasms C00-C97]

Malignant neoplasm of female genital organs whose point of origin cannot be classified to any one of the categories C51-C57.7, C58

Tubo-ovarian

Utero-ovarian

C57.9   Female genital organ, unspecified

Female genitourinary tract NOS

C58  Malignant neoplasm of placenta

Choriocarcinoma NOS

Chorionepithelioma NOS

Excludes:    chorioadenoma (destruens) (D39.2)

hydatidiform mole:

• NOS (O01.9)

• invasive (D39.2)

• malignant (D39.2)

Malignant neoplasms of male genital organs (C60-C63)

Includes:    skin of male genital organs

C60  Malignant neoplasm of penis

C60.0   Prepuce

Foreskin

C60.1   Glans penis

C60.2   Body of penis

Corpus cavernosum

C60.8   Overlapping lesion of penis

[See note 5 preceding Malignant Neoplasms C00-C97]

C60.9   Penis, unspecified

Skin of penis NOS

C61  Malignant neoplasm of prostate

C62  Malignant neoplasm of testis

C62.0   Undescended testis

Ectopic testis [site of neoplasm]

Retained testis [site of neoplasm]

C62.1   Descended testis

Scrotal testis

C62.9   Testis, unspecified

C63  Malignant neoplasm of other and unspecified male genital organs

C63.0   Epididymis

C63.1   Spermatic cord

C63.2   Scrotum

Skin of scrotum

C63.7   Other specified male genital organs

Seminal vesicle

Tunica vaginalis

C63.8   Overlapping lesion of male genital organs

[See note 5 preceding Malignant Neoplasms C00-C97]

Malignant neoplasm of male genital organs whose point of origin cannot be classified to any one of the categories C60-C63.7

C63.9   Male genital organ, unspecified

Male genitourinary tract NOS

Malignant neoplasms of urinary tract (C64-C68)

C64  Malignant neoplasm of kidney, except renal pelvis

Excludes:    renal:

• calyces (C65)

• pelvis (C65)

C65  Malignant neoplasm of renal pelvis

Pelviureteric junction

Renal calyces

C66  Malignant neoplasm of ureter

Excludes:    ureteric orifice of bladder (C67.6)

C67  Malignant neoplasm of bladder

C67.0   Trigone of bladder

C67.1   Dome of bladder

C67.2   Lateral wall of bladder

C67.3   Anterior wall of bladder

C67.4   Posterior wall of bladder

C67.5   Bladder neck

Internal urethral orifice

C67.6   Ureteric orifice

C67.7   Urachus

C67.8   Overlapping lesion of bladder

[See note 5 preceding Malignant Neoplasms C00-C97]

C67.9   Bladder, unspecified

C68  Malignant neoplasm of other and unspecified urinary organs

Excludes:    genitourinary tract NOS:

• female (C57.9)

• male (C63.9)

C68.0   Urethra

Excludes:    urethral orifice of bladder (C67.5)

C68.1   Paraurethral gland

C68.8   Overlapping lesion of urinary organs

[See note 5 preceding Malignant Neoplasms C00-C97

Malignant neoplasm of urinary organs whose point of origin cannot be classified to any one of the categories C64-C68.1

C68.9   Urinary organ, unspecified

Urinary system NOS

Malignant neoplasms of eye, brain and other parts of central nervous system (C69-C72)

C69  Malignant neoplasm of eye and adnexa

Excludes:    connective tissue of eyelid (C49.0)

eyelid (skin) (C43.1, C44.1)

optic nerve (C72.3)

C69.0   Conjunctiva

C69.1   Cornea

C69.2   Retina

C69.3   Choroid

C69.4   Ciliary body

C69.5   Lacrimal gland and duct

Lacrimal sac

Nasolacrimal duct

C69.6   Orbit

Connective tissue of orbit

Extraocular muscle

Peripheral nerves of orbit

Retrobulbar tissue

Retro-ocular tissue

Excludes:    orbital bone (C41.0)

C69.8   Overlapping lesion of eye and adnexa

[See note 5 preceding Malignant Neoplasms C00-C97]

C69.9   Eye, unspecified

Eyeball

C70  Malignant neoplasm of meninges

C70.0   Cerebral meninges

C70.1   Spinal meninges

C70.9   Meninges, unspecified

C71  Malignant neoplasm of brain

Excludes:    cranial nerves (C72.2-C72.5)

retrobulbar tissue (C69.6)

C71.0   Cerebrum, except lobes and ventricles

Supratentorial NOS

C71.1   Frontal lobe

C71.2   Temporal lobe

C71.3   Parietal lobe

C71.4   Occipital lobe

C71.5   Cerebral ventricle

Excludes:    fourth ventricle (C71.7)

C71.6   Cerebellum

C71.7   Brain stem

Fourth ventricle

Infratentorial NOS

C71.8   Overlapping lesion of brain

[See note 5 preceding Malignant Neoplasms C00-C97]

C71.9   Brain, unspecified

C72  Malignant neoplasm of spinal cord, cranial nerves and other parts of central nervous system

Excludes:    meninges (C70-)

peripheral nerves and autonomic nervous system (C47-)

C72.0   Spinal cord

C72.1   Cauda equina

C72.2   Olfactory nerve

Olfactory bulb

C72.3   Optic nerve

C72.4   Acoustic nerve

C72.5   Other and unspecified cranial nerves

Cranial nerve NOS

C72.8   Overlapping lesion of brain and other parts of central nervous system

[See note 5 preceding Malignant Neoplasms C00-C97]

Malignant neoplasm of brain and other parts of central nervous system whose point of origin cannot be classified to any one of the categories C70-C72.5

C72.9   Central nervous system, unspecified

Nervous system NOS

Malignant neoplasms of thyroid and other endocrine glands (C73-C75)

C73  Malignant neoplasm of thyroid gland

C74  Malignant neoplasm of adrenal gland

C74.0   Cortex of adrenal gland

C74.1   Medulla of adrenal gland

C74.9   Adrenal gland, unspecified

C75  Malignant neoplasm of other endocrine glands and related structures

Excludes:    adrenal gland (C74-)

endocrine pancreas (C25.4)

ovary (C56)

testis (C62-)

thymus (C37)

thyroid gland (C73)

C75.0   Parathyroid gland

C75.1   Pituitary gland

C75.2   Craniopharyngeal duct

C75.3   Pineal gland

C75.4   Carotid body

C75.5   Aortic body and other paraganglia

C75.8   Pluriglandular involvement, unspecified

Note:          If the sites of multiple involvement are known, they should be coded separately.

C75.9   Endocrine gland, unspecified

Malignant neoplasms of ill-defined, secondary and unspecified sites (C76-C80)

C76  Malignant neoplasm of other and ill-defined sites

Excludes:    malignant neoplasm of:

• genitourinary tract NOS:

• female (C57.9)

• male (C63.9)

• lymphoid, haematopoietic and related tissue (C81-C96)

• unspecified site (C80)

C76.0   Head, face and neck

Cheek NOS

Nose

C76.1   Thorax

Axilla NOS

Intrathoracic NOS

Thoracic NOS

C76.2   Abdomen

C76.3   Pelvis

Groin NOS

Sites overlapping systems within the pelvis, such as:

• rectovaginal (septum)

• rectovesical (septum)

C76.4   Upper limb

C76.5   Lower limb

C76.7   Other ill-defined sites

C76.8   Overlapping lesion of other and ill-defined sites

[See note 5 preceding Malignant Neoplasms C00-C97]

C77  Secondary and unspecified malignant neoplasm of lymph nodes

Excludes:    malignant neoplasm of lymph nodes, specified as primary (C81-C87, C96-)

C77.0   Lymph nodes of head, face and neck

Supraclavicular lymph nodes

C77.1   Intrathoracic lymph nodes

C77.2   Intra-abdominal lymph nodes

C77.3   Axillary and upper limb lymph nodes

Pectoral lymph nodes

C77.4   Inguinal and lower limb lymph nodes

C77.5   Intrapelvic lymph nodes

C77.8   Lymph nodes of multiple regions

C77.9   Lymph node, unspecified

C78  Secondary malignant neoplasm of respiratory and digestive organs

C78.0   Secondary malignant neoplasm of lung

C78.1   Secondary malignant neoplasm of mediastinum

C78.2   Secondary malignant neoplasm of pleura

Malignant pleural effusion NOS

C78.3   Secondary malignant neoplasm of other and unspecified respiratory organs

C78.4   Secondary malignant neoplasm of small intestine

C78.5   Secondary malignant neoplasm of large intestine and rectum

C78.6   Secondary malignant neoplasm of retroperitoneum and peritoneum

Malignant ascites NOS

C78.7   Secondary malignant neoplasm of liver

C78.8   Secondary malignant neoplasm of other and unspecified digestive organs

C79  Secondary malignant neoplasm of other sites

C79.0   Secondary malignant neoplasm of kidney and renal pelvis

C79.1   Secondary malignant neoplasm of bladder and other and unspecified urinary organs

C79.2   Secondary malignant neoplasm of skin

C79.3   Secondary malignant neoplasm of brain and cerebral meninges

C79.4   Secondary malignant neoplasm of other and unspecified parts of nervous system

C79.5   Secondary malignant neoplasm of bone and bone marrow

C79.6   Secondary malignant neoplasm of ovary

C79.7   Secondary malignant neoplasm of adrenal gland

C79.8   Secondary malignant neoplasm of other specified sites

C80  Malignant neoplasm without specification of site

Cancer            

Carcinoma         

Carcinomatosis    

Generalized:      

• cancer             unspecified site (primary) (secondary)

• malignancy      

Malignancy        

Multiple cancer   

Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81-C96)

Note:          The terms used in categories C82-C85 for non-Hodgkin lymphomas are those of the Working Formulation, which attempted to find common ground among several major classification schemes. The terms used in these schemes are not given in the Tabular List but appear in the Alphabetical Index; exact equivalence with the terms appearing in the Tabular List is not always possible.

Includes:    morphology codes M959-M994 with behaviour code /3

Excludes:    secondary and unspecified neoplasm of lymph nodes (C77-)

C81  Hodgkin disease

Includes:    morphology codes M965-M966 with behaviour code /3

C81.0   Lymphocytic predominance

Lymphocytic-histiocytic predominance

C81.1   Nodular sclerosis

C81.2   Mixed cellularity

C81.3   Lymphocytic depletion

C81.7   Other Hodgkin disease

C81.9   Hodgkin disease, unspecified

C82  Follicular [nodular] non-Hodgkin lymphoma

Includes:    follicular non-Hodgkin lymphoma with or without diffuse areas

morphology code M969 with behaviour code /3

C82.0   Small cleaved cell, follicular

C82.1   Mixed small cleaved and large cell, follicular

C82.2   Large cell, follicular

C82.7   Other types of follicular non-Hodgkin lymphoma

C82.9   Follicular non-Hodgkin lymphoma, unspecified

Nodular non-Hodgkin lymphoma NOS

C83  Diffuse non-Hodgkin lymphoma

Includes:    morphology codes M9593, M9595, M967-M968 with behaviour code /3

C83.0   Small cell (diffuse)

C83.1   Small cleaved cell (diffuse)

C83.2   Mixed small and large cell (diffuse)

C83.3   Large cell (diffuse)

Reticulum cell sarcoma

C83.4   Immunoblastic (diffuse)

C83.5   Lymphoblastic (diffuse)

C83.6   Undifferentiated (diffuse)

C83.7   Burkitt tumour

C83.8   Other types of diffuse non-Hodgkin lymphoma

C83.9   Diffuse non-Hodgkin lymphoma, unspecified

C84  Peripheral and cutaneous T-cell lymphomas

Includes:    morphology code M970 with behaviour code /3

C84.0   Mycosis fungoides

C84.1   Sezary disease

C84.2   T-zone lymphoma

C84.3   Lymphoepithelioid lymphoma

Lennert lymphoma

C84.4   Peripheral T-cell lymphoma

C84.5   Other and unspecified T-cell lymphomas

Note:          If T-cell lineage or involvement is mentioned in conjunction with a specific lymphoma, code to the more specific description.

C85  Other and unspecified types of non-Hodgkin lymphoma

Includes:    morphology codes M9590-M9592, M9594, M971 with behaviour code /3

C85.0   Lymphosarcoma

C85.1   B-cell lymphoma, unspecified

Note:          If B-cell lineage or involvement is mentioned in conjunction with a specific lymphoma, code to the more specific description.

C85.7   Other specified types of non-Hodgkin lymphoma

Malignant:

• reticuloendotheliosis

• reticulosis

Microglioma

C85.9   Non-Hodgkin lymphoma, unspecified type

Lymphoma NOS

Malignant lymphoma NOS

Non-Hodgkin lymphoma NOS

C88  Malignant immunoproliferative diseases

Includes:    morphology code M976 with behaviour code /3

C88.0   Waldenstrom macroglobulinaemia

C88.1   Alpha heavy chain disease

C88.2   Gamma heavy chain disease

Franklin disease

C88.3   Immunoproliferative small intestinal disease

Mediterranean disease

C88.7   Other malignant immunoproliferative diseases

C88.9   Malignant immunoproliferative disease, unspecified

Immunoproliferative disease NOS

C90  Multiple myeloma and malignant plasma cell neoplasms

Includes:    morphology codes M973, M9830 with behaviour code /3

C90.0   Multiple myeloma

Kahler disease

Myelomatosis

Excludes:    solitary myeloma (C90.2)

C90.1   Plasma cell leukaemia

C90.2   Plasmacytoma, extramedullary

Malignant plasma cell tumour NOS

Plasmacytoma NOS

Solitary myeloma

C91  Lymphoid leukaemia

Includes:    morphology codes M982, M9940-M9941 with behaviour code /3

C91.0   Acute lymphoblastic leukaemia

Excludes:    acute exacerbation of chronic lymphocytic leukaemia (C91.1)

C91.1   Chronic lymphocytic leukaemia

C91.2   Subacute lymphocytic leukaemia

C91.3   Prolymphocytic leukaemia

C91.4   Hairy-cell leukaemia

Leukaemic reticuloendotheliosis

C91.5   Adult T-cell leukaemia

C91.7   Other lymphoid leukaemia

C91.9   Lymphoid leukaemia, unspecified

C92  Myeloid leukaemia

Includes:    leukaemia:

• granulocytic

• myelogenous

morphology codes M986-M988, M9930 with behaviour code /3

C92.0   Acute myeloid leukaemia

Excludes:    acute exacerbation of chronic myeloid leukaemia (C92.1)

C92.1   Chronic myeloid leukaemia

C92.2   Subacute myeloid leukaemia

C92.3   Myeloid sarcoma

Chloroma

Granulocytic sarcoma

C92.4   Acute promyelocytic leukaemia

C92.5   Acute myelomonocytic leukaemia

C92.7   Other myeloid leukaemia

C92.9   Myeloid leukaemia, unspecified

C93  Monocytic leukaemia

Includes:    monocytoid leukaemia

morphology code M989 with behaviour code /3

C93.0   Acute monocytic leukaemia

Excludes:    acute exacerbation of chronic monocytic leukaemia (C93.1)

C93.1   Chronic monocytic leukaemia

C93.2   Subacute monocytic leukaemia

C93.7   Other monocytic leukaemia

C93.9   Monocytic leukaemia, unspecified

C94  Other leukaemias of specified cell type

Includes:    morphology codes M984, M9850, M9900, M9910, M9931-M9932 with behaviour code /3

Excludes:    leukaemic reticuloendotheliosis (C91.4)

plasma cell leukaemia (C90.1)

C94.0   Acute erythraemia and erythroleukaemia

Acute erythraemic myelosis

Di Guglielmo disease

C94.1   Chronic erythraemia

Heilmeyer-Schoner disease

C94.2   Acute megakaryoblastic leukaemia

Leukaemia:

• megakaryoblastic (acute)

• megakaryocytic (acute)

C94.3   Mast cell leukaemia

C94.4   Acute panmyelosis

C94.5   Acute myelofibrosis

C94.7   Other specified leukaemias

Lymphosarcoma cell leukaemia

C95  Leukaemia of unspecified cell type

Includes:    morphology code M980 with behaviour code /3

C95.0   Acute leukaemia of unspecified cell type

Blast cell leukaemia

Stem cell leukaemia

Excludes:    acute exacerbation of unspecified chronic leukaemia (C95.1)

C95.1   Chronic leukaemia of unspecified cell type

C95.2   Subacute leukaemia of unspecified cell type

C95.7   Other leukaemia of unspecified cell type

C95.9   Leukaemia, unspecified

C96  Other and unspecified malignant neoplasms of lymphoid, haematopoietic and related tissue

Includes:    morphology codes M972, M974 with behaviour code /3

C96.0   Letterer-Siwe disease

Nonlipid:

• reticuloendotheliosis

• reticulosis

C96.1   Malignant histiocytosis

Histiocytic medullary reticulosis

C96.2   Malignant mast cell tumour

Malignant:

• mastocytoma

• mastocytosis

Mast cell sarcoma

Excludes:    mast cell leukaemia (C94.3)

mastocytosis (cutaneous) (Q82.2)

C96.3   True histiocytic lymphoma

C96.7   Other specified malignant neoplasms of lymphoid, haematopoietic and related tissue

C96.9   Malignant neoplasm of lymphoid, haematopoietic and related tissue, unspecified

Malignant neoplasms of independent (primary) multiple sites (C97)

C97  Malignant neoplasms of independent (primary) multiple sites

Note:          For use of this category, reference should be made to the mortality coding rules and guidelines in Part 2a Instruction Manual (NCHS).

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.

Includes:    Bowen disease

erythroplasia

morphology codes with behaviour code /2

Queyrat erythroplasia

D00  Carcinoma in situ of oral cavity, oesophagus and stomach

Excludes:    melanoma in situ (D03-)

D00.0   Lip, oral cavity and pharynx

Aryepiglottic fold:

• NOS

• hypopharyngeal aspect

• marginal zone

Vermilion border of lip

Excludes:    aryepiglottic fold, laryngeal aspect (D02.0)

epiglottis:

• NOS (D02.0)

• suprahyoid portion (D02.0)

skin of lip (D03.0, D04.0)

D00.1   Oesophagus

D00.2   Stomach

D01  Carcinoma in situ of other and unspecified digestive organs

Excludes:    melanoma in situ (D03-)

D01.0   Colon

Excludes:    rectosigmoid junction (D01.1)

D01.1   Rectosigmoid junction

D01.2   Rectum

D01.3   Anus and anal canal

Excludes:    anal:

• margin (D03.5, D04.5)

• skin (D03.5, D04.5)

perianal skin (D03.5, D04.5)

D01.4   Other and unspecified parts of intestine

Excludes:    ampulla of Vater (D01.5)

D01.5   Liver, gallbladder and bile ducts

Ampulla of Vater

D01.7   Other specified digestive organs

Pancreas

D01.9   Digestive organ, unspecified

D02  Carcinoma in situ of middle ear and respiratory system

Excludes:    melanoma in situ (D03-)

D02.0   Larynx

Aryepiglottic fold, laryngeal aspect

Epiglottis (suprahyoid portion)

Excludes:    aryepiglottic fold:

• NOS (D00.0)

• hypopharyngeal aspect (D00.0)

• marginal zone (D00.0)

D02.1   Trachea

D02.2   Bronchus and lung

D02.3   Other parts of respiratory system

Accessory sinuses

Middle ear

Nasal cavities

Excludes:    ear (external)(skin) (D03.2, D04.2)

nose:

• NOS (D09.7)

• skin (D03.3, D04.3)

D02.4   Respiratory system, unspecified

D03  Melanoma in situ

Includes:    morphology codes M872-M879 with behaviour code /2

D03.0   Melanoma in situ of lip

D03.1   Melanoma in situ of eyelid, including canthus

D03.2   Melanoma in situ of ear and external auricular canal

D03.3   Melanoma in situ of other and unspecified parts of face

D03.4   Melanoma in situ of scalp and neck

D03.5   Melanoma in situ of trunk

Anal:

• margin

• skin

Breast (skin)(soft tissue)

Perianal skin

D03.6   Melanoma in situ of upper limb, including shoulder

D03.7   Melanoma in situ of lower limb, including hip

D03.8   Melanoma in situ of other sites

D03.9   Melanoma in situ, unspecified

D04  Carcinoma in situ of skin

Excludes:    erythroplasia of Queyrat (penis) NOS (D07.4)

melanoma in situ (D03-)

D04.0   Skin of lip

Excludes:    vermilion border of lip (D00.0)

D04.1   Skin of eyelid, including canthus

D04.2   Skin of ear and external auricular canal

D04.3   Skin of other and unspecified parts of face

D04.4   Skin of scalp and neck

D04.5   Skin of trunk

Anal:

• margin

• skin

Perianal skin

Skin of breast

Excludes:    anus NOS (D01.3)

skin of genital organs (D07-)

D04.6   Skin of upper limb, including shoulder

D04.7   Skin of lower limb, including hip

D04.8   Skin of other sites

D04.9   Skin, unspecified

D05  Carcinoma in situ of breast

Excludes:    carcinoma in situ of skin of breast (D04.5)

melanoma in situ of breast (skin) (D03.5)

D05.0   Lobular carcinoma in situ

D05.1   Intraductal carcinoma in situ

D05.7   Other carcinoma in situ of breast

D05.9   Carcinoma in situ of breast, unspecified

D06  Carcinoma in situ of cervix uteri

Includes:    cervical intraepithelial neoplasia [CIN], grade III, with or without mention of severe dysplasia

Excludes:    melanoma in situ of cervix (D03.5)

severe dysplasia of cervix NOS (N87.2)

D06.0   Endocervix

D06.1   Exocervix

D06.7   Other parts of cervix

D06.9   Cervix, unspecified

D07  Carcinoma in situ of other and unspecified genital organs

Excludes:    melanoma in situ (D03.5)

D07.0   Endometrium

D07.1   Vulva

Vulvar intraepithelial neoplasia [VIN], grade III, with or without mention of severe dysplasia

Excludes:    severe dysplasia of vulva NOS (N90.2)

D07.2   Vagina

Vaginal intraepithelial neoplasia [VAIN], grade III, with or without mention of severe dysplasia

Excludes:    severe dysplasia of vagina NOS (N89.2)

D07.3   Other and unspecified female genital organs

D07.4   Penis

Erythroplasia of Queyrat NOS

D07.5   Prostate

Excludes:    low grade dysplasia of prostate (N42.3)

D07.6   Other and unspecified male genital organs

D09  Carcinoma in situ of other and unspecified sites

Excludes:    melanoma in situ (D03-)

D09.0   Bladder

D09.1   Other and unspecified urinary organs

D09.2   Eye

Excludes:    skin of eyelid (D04.1)

D09.3   Thyroid and other endocrine glands

Excludes:    endocrine pancreas (D01.7)

ovary (D07.3)

testis (D07.6)

D09.7   Carcinoma in situ of other specified sites

D09.9   Carcinoma in situ, unspecified

Benign neoplasms (D10-D36)

Includes:    morphology codes with behaviour code /0

D10  Benign neoplasm of mouth and pharynx

D10.0   Lip

Lip (frenulum) (inner aspect) (mucosa) (vermilion border)

Excludes:    skin of lip (D22.0, D23.0)

D10.1   Tongue

Lingual tonsil

D10.2   Floor of mouth

D10.3   Other and unspecified parts of mouth

Minor salivary gland NOS

Excludes:    benign odontogenic neoplasms (D16.4-D16.5)

mucosa of lip (D10.0)

nasopharyngeal surface of soft palate (D10.6)

D10.4   Tonsil

Tonsil (faucial) (palatine)

Excludes:    lingual tonsil (D10.1)

pharyngeal tonsil (D10.6)

tonsillar:

• fossa (D10.5)

• pillars (D10.5)

D10.5   Other parts of oropharynx

Epiglottis, anterior aspect

Tonsillar:

• fossa

• pillars

Vallecula

Excludes:    epiglottis:

• NOS (D14.1)

• suprahyoid portion (D14.1)

D10.6   Nasopharynx

Pharyngeal tonsil

Posterior margin of septum and choanae

D10.7   Hypopharynx

D10.9   Pharynx, unspecified

D11  Benign neoplasm of major salivary glands

Excludes:    benign neoplasms of specified minor salivary glands which are classified according to their anatomical location

benign neoplasms of minor salivary glands NOS (D10.3)

D11.0   Parotid gland

D11.7   Other major salivary glands

Gland:

• sublingual

• submandibular

D11.9   Major salivary gland, unspecified

D12  Benign neoplasm of colon, rectum, anus and anal canal

D12.0   Caecum

Ileocaecal valve

D12.1   Appendix

D12.2   Ascending colon

D12.3   Transverse colon

Hepatic flexure

Splenic flexure

D12.4   Descending colon

D12.5   Sigmoid colon

D12.6   Colon, unspecified

Adenomatosis of colon

Large intestine NOS

Polyposis (hereditary) of colon

D12.7   Rectosigmoid junction

D12.8   Rectum

D12.9   Anus and anal canal

Excludes:    anal:

• margin (D22.5, D23.5)

• skin (D22.5, D23.5)

perianal skin (D22.5, D23.5)

D13  Benign neoplasm of other and ill-defined parts of digestive system

D13.0   Oesophagus

D13.1   Stomach

D13.2   Duodenum

D13.3   Other and unspecified parts of small intestine

D13.4   Liver

Intrahepatic bile ducts

D13.5   Extrahepatic bile ducts

D13.6   Pancreas

Excludes:    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

D14  Benign neoplasm of middle ear and respiratory system

D14.0   Middle ear, nasal cavity and accessory sinuses

Cartilage of nose

Excludes:    auricular canal (external) (D22.2, D23.2)

bone of:

• ear (D16.4)

• nose (D16.4)

cartilage of ear (D21.0)

ear (external)(skin) (D22.2, D23.2)

nose:

• NOS (D36.7)

• skin (D22.3, D23.3)

olfactory bulb (D33.3)

polyp (of):

• accessory sinus (J33.8)

• ear (middle) (H74.4)

• nasal (cavity) (J33-)

posterior margin of septum and choanae (D10.6)

D14.1   Larynx

Epiglottis (suprahyoid portion)

Excludes:    epiglottis, anterior aspect (D10.5)

polyp of vocal cord and larynx (J38.1)

D14.2   Trachea

D14.3   Bronchus and lung

D14.4   Respiratory system, unspecified

D15  Benign neoplasm of other and unspecified intrathoracic organs

Excludes:    mesothelial tissue (D19-)

D15.0   Thymus

D15.1   Heart

Excludes:    great vessels (D21.3)

D15.2   Mediastinum

D15.7   Other specified intrathoracic organs

D15.9   Intrathoracic organ, unspecified

D16  Benign neoplasm of bone and articular cartilage

Excludes:    connective tissue of:

• ear (D21.0)

• eyelid (D21.0)

• larynx (D14.1)

• nose (D14.0)

synovia (D21-)

D16.0   Scapula and long bones of upper limb

D16.1   Short bones of upper limb

D16.2   Long bones of lower limb

D16.3   Short bones of lower limb

D16.4   Bones of skull and face

Maxilla (superior)

Orbital bone

Excludes:    lower jaw bone (D16.5)

D16.5   Lower jaw bone

D16.6   Vertebral column

Excludes:    sacrum and coccyx (D16.8)

D16.7   Ribs, sternum and clavicle

D16.8   Pelvic bones, sacrum and coccyx

D16.9   Bone and articular cartilage, unspecified

D17  Benign lipomatous neoplasm

Includes:    morphology codes M885-M888 with behaviour code /0

D17.0   Benign lipomatous neoplasm of skin and subcutaneous tissue of head, face and neck

D17.1   Benign lipomatous neoplasm of skin and subcutaneous tissue of trunk

D17.2   Benign lipomatous neoplasm of skin and subcutaneous tissue of limbs

D17.3   Benign lipomatous neoplasm of skin and subcutaneous tissue of other and unspecified sites

D17.4   Benign lipomatous neoplasm of intrathoracic organs

D17.5   Benign lipomatous neoplasm of intra-abdominal organs

Excludes:    peritoneum and retroperitoneum (D17.7)

D17.6   Benign lipomatous neoplasm of spermatic cord

D17.7   Benign lipomatous neoplasm of other sites

Peritoneum

Retroperitoneum

D17.9   Benign lipomatous neoplasm, unspecified

Lipoma NOS

D18  Haemangioma and lymphangioma, any site

Includes:    morphology codes M912-M917 with behaviour code /0

Excludes:    blue or pigmented naevus (D22-)

D18.0   Haemangioma, any site

Angioma NOS

D18.1   Lymphangioma, any site

D19  Benign neoplasm of mesothelial tissue

Includes:    morphology code M905 with behaviour code /0

D19.0   Mesothelial tissue of pleura

D19.1   Mesothelial tissue of peritoneum

D19.7   Mesothelial tissue of other sites

D19.9   Mesothelial tissue, unspecified

Benign mesothelioma NOS

D20  Benign neoplasm of soft tissue of retroperitoneum and peritoneum

Excludes:    benign lipomatous neoplasm of peritoneum and retroperitoneum (D17.7)

mesothelial tissue (D19-)

D20.0   Retroperitoneum

D20.1   Peritoneum

D21  Other benign neoplasms of connective and other soft tissue

Includes:    blood vessel

bursa

cartilage

fascia

fat

ligament, except uterine

lymphatic channel

muscle

synovia

tendon (sheath)

Excludes:    cartilage:

• articular (D16-)

• larynx (D14.1)

• nose (D14.0)

connective tissue of breast (D24)

haemangioma (D18.0)

lipomatous neoplasm (D17-)

lymphangioma (D18.1)

peripheral nerves and autonomic nervous system (D36.1)

peritoneum (D20.1)

retroperitoneum (D20.0)

uterine:

• leiomyoma (D25-)

• ligament, any (D28.2)

vascular tissue (D18-)

D21.0   Connective and other soft tissue of head, face and neck

Connective tissue of:

• ear

• eyelid

Excludes:    connective tissue of orbit (D31.6)

D21.1   Connective and other soft tissue of upper limb, including shoulder

D21.2   Connective and other soft tissue of lower limb, including hip

D21.3   Connective and other soft tissue of thorax

Axilla

Diaphragm

Great vessels

Excludes:    heart (D15.1)

mediastinum (D15.2)

thymus (D15.0)

D21.4   Connective and other soft tissue of abdomen

D21.5   Connective and other soft tissue of pelvis

Excludes:    uterine:

• leiomyoma (D25-)

• ligament, any (D28.2)

D21.6   Connective and other soft tissue of trunk, unspecified

Back NOS

D21.9   Connective and other soft tissue, unspecified

D22  Melanocytic naevi

Includes:    morphology codes M872-M879 with behaviour code /0

naevus:

• NOS

• blue

• hairy

• pigmented

D22.0   Melanocytic naevi of lip

D22.1   Melanocytic naevi of eyelid, including canthus

D22.2   Melanocytic naevi of ear and external auricular canal

D22.3   Melanocytic naevi of other and unspecified parts of face

D22.4   Melanocytic naevi of scalp and neck

D22.5   Melanocytic naevi of trunk

Anal:

• margin

• skin

Perianal skin

Skin of breast

D22.6   Melanocytic naevi of upper limb, including shoulder

D22.7   Melanocytic naevi of lower limb, including hip

D22.9   Melanocytic naevi, unspecified

D23  Other benign neoplasms of skin

Includes:    benign neoplasm of:

• hair follicles

• sebaceous glands

• sweat glands

Excludes:    benign lipomatous neoplasms (D17.0-D17.3)

melanocytic naevi (D22-)

D23.0   Skin of lip

Excludes:    vermilion border of lip (D10.0)

D23.1   Skin of eyelid, including canthus

D23.2   Skin of ear and external auricular canal

D23.3   Skin of other and unspecified parts of face

D23.4   Skin of scalp and neck

D23.5   Skin of trunk

Anal:

• margin

• skin

Perianal skin

Skin of breast

Excludes:    anus NOS (D12.9)

skin of genital organs (D28-D29)

D23.6   Skin of upper limb, including shoulder

D23.7   Skin of lower limb, including hip

D23.9   Skin, unspecified

D24  Benign neoplasm of breast

Breast:

• connective tissue

• soft parts

Excludes:    benign mammary dysplasia (N60-)

skin of breast (D22.5, D23.5)

D25  Leiomyoma of uterus

Includes:    benign neoplasms of uterus with morphology code M889 and behaviour code /0

fibromyoma of uterus

D25.0   Submucous leiomyoma of uterus

D25.1   Intramural leiomyoma of uterus

D25.2   Subserosal leiomyoma of uterus

D25.9   Leiomyoma of uterus, unspecified

D26  Other benign neoplasms of uterus

D26.0   Cervix uteri

D26.1   Corpus uteri

D26.7   Other parts of uterus

D26.9   Uterus, unspecified

D27  Benign neoplasm of ovary

D28  Benign neoplasm of other and unspecified female genital organs

Includes:    adenomatous polyp

skin of female genital organs

D28.0   Vulva

D28.1   Vagina

D28.2   Uterine tubes and ligaments

Fallopian tube

Uterine ligament (broad)(round)

D28.7   Other specified female genital organs

D28.9   Female genital organ, unspecified

D29  Benign neoplasm of male genital organs

Includes:    skin of male genital organs

D29.0   Penis

D29.1   Prostate

Excludes:    hyperplasia of prostate (adenomatous) (N40)

prostatic:

• enlargement (N40)

• hypertrophy (N40)

D29.2   Testis

D29.3   Epididymis

D29.4   Scrotum

Skin of scrotum

D29.7   Other male genital organs

Seminal vesicle

Spermatic cord

Tunica vaginalis

D29.9   Male genital organ, unspecified

D30  Benign neoplasm of urinary organs

D30.0   Kidney

Excludes:    renal:

• calyces (D30.1)

• pelvis (D30.1)

D30.1   Renal pelvis

D30.2   Ureter

Excludes:    ureteric orifice of bladder (D30.3)

D30.3   Bladder

Orifice of bladder:

• urethral

• ureteric

D30.4   Urethra

Excludes:    urethral orifice of bladder (D30.3)

D30.7   Other urinary organs

Paraurethral glands

D30.9   Urinary organ, unspecified

Urinary system NOS

D31  Benign neoplasm of eye and adnexa

Excludes:    connective tissue of eyelid (D21.0)

optic nerve (D33.3)

skin of eyelid (D22.1, D23.1)

D31.0   Conjunctiva

D31.1   Cornea

D31.2   Retina

D31.3   Choroid

D31.4   Ciliary body

D31.5   Lacrimal gland and duct

Lacrimal sac

Nasolacrimal duct

D31.6   Orbit, unspecified

Connective tissue of orbit

Extraocular muscle

Peripheral nerves of orbit

Retrobulbar tissue

Retro-ocular tissue

Excludes:    orbital bone (D16.4)

D31.9   Eye, unspecified

Eyeball

D32  Benign neoplasm of meninges

D32.0   Cerebral meninges

D32.1   Spinal meninges

D32.9   Meninges, unspecified

Meningioma NOS

D33  Benign neoplasm of brain and other parts of central nervous system

Excludes:    angioma (D18.0)

meninges (D32-)

peripheral nerves and autonomic nervous system (D36.1)

retro-ocular tissue (D31.6)

D33.0   Brain, supratentorial

Cerebral ventricle

Cerebrum

Frontal     

Occipital   

Parietal       lobe

Temporal    

Excludes:    fourth ventricle (D33.1)

D33.1   Brain, infratentorial

Brain stem

Cerebellum

Fourth ventricle

D33.2   Brain, unspecified

D33.3   Cranial nerves

Olfactory bulb

D33.4   Spinal cord

D33.7   Other specified parts of central nervous system

D33.9   Central nervous system, unspecified

Nervous system (central) NOS

D34  Benign neoplasm of thyroid gland

D35  Benign neoplasm of other and unspecified endocrine glands

Excludes:    endocrine pancreas (D13.7)

ovary (D27)

testis (D29.2)

thymus (D15.0)

D35.0   Adrenal gland

D35.1   Parathyroid gland

D35.2   Pituitary gland

D35.3   Craniopharyngeal duct

D35.4   Pineal gland

D35.5   Carotid body

D35.6   Aortic body and other paraganglia

D35.7   Other specified endocrine glands

D35.8   Pluriglandular involvement

D35.9   Endocrine gland, unspecified

D36  Benign neoplasm of other and unspecified sites

D36.0   Lymph nodes

D36.1   Peripheral nerves and autonomic nervous system

Excludes:    peripheral nerves of orbit (D31.6)

D36.7   Other specified sites

Nose NOS

D36.9   Benign neoplasm of unspecified site

Neoplasms of uncertain or unknown behaviour (D37-D48)

Note:          Categories D37-D48 classify by site neoplasms of uncertain or unknown behaviour, i.e., there is doubt whether the neoplasm is malignant or benign. Such neoplasms are assigned behaviour code /1 in the classification of the morphology of neoplasms.

D37  Neoplasm of uncertain or unknown behaviour of oral cavity and digestive organs

D37.0   Lip, oral cavity and pharynx

Aryepiglottic fold:

• NOS

• hypopharyngeal aspect

• marginal zone

Major and minor salivary glands

Vermilion border of lip

Excludes:    aryepiglottic fold, laryngeal aspect (D38.0)

epiglottis:

• NOS (D38.0)

• suprahyoid portion (D38.0)

skin of lip (D48.5)

D37.1   Stomach

D37.2   Small intestine

D37.3   Appendix

D37.4   Colon

D37.5   Rectum

Rectosigmoid junction

D37.6   Liver, gallbladder and bile ducts

Ampulla of Vater

D37.7   Other digestive organs

Anal:

• canal

• sphincter

Anus NOS

Intestine NOS

Oesophagus

Pancreas

Excludes:    anal:

• margin (D48.5)

• skin (D48.5)

perianal skin (D48.5)

D37.9   Digestive organ, unspecified

D38  Neoplasm of uncertain or unknown behaviour of middle ear and respiratory and intrathoracic organs

Excludes:    heart (D48.7)

D38.0   Larynx

Aryepiglottic fold, laryngeal aspect

Epiglottis (suprahyoid portion)

Excludes:    aryepiglottic fold:

• NOS (D37.0)

• hypopharyngeal aspect (D37.0)

• marginal zone (D37.0)

D38.1   Trachea, bronchus and lung

D38.2   Pleura

D38.3   Mediastinum

D38.4   Thymus

D38.5   Other respiratory organs

Accessory sinuses

Cartilage of nose

Middle ear

Nasal cavities

Excludes:    ear (external)(skin) (D48.5)

nose:

• NOS (D48.7)

• skin (D48.5)

D38.6   Respiratory organ, unspecified

D39  Neoplasm of uncertain or unknown behaviour of female genital organs

D39.0   Uterus

D39.1   Ovary

D39.2   Placenta

Chorioadenoma destruens

Hydatidiform mole:

• invasive

• malignant

Excludes:    hydatidiform mole NOS (O01.9)

D39.7   Other female genital organs

Skin of female genital organs

D39.9   Female genital organ, unspecified

D40  Neoplasm of uncertain or unknown behaviour of male genital organs

D40.0   Prostate

D40.1   Testis

D40.7   Other male genital organs

Skin of male genital organs

D40.9   Male genital organ, unspecified

D41  Neoplasm of uncertain or unknown behaviour of urinary organs

D41.0   Kidney

Excludes:    renal pelvis (D41.1)

D41.1   Renal pelvis

D41.2   Ureter

D41.3   Urethra

D41.4   Bladder

D41.7   Other urinary organs

D41.9   Urinary organ, unspecified

D42  Neoplasm of uncertain or unknown behaviour of meninges

D42.0   Cerebral meninges

D42.1   Spinal meninges

D42.9   Meninges, unspecified

D43  Neoplasm of uncertain or unknown behaviour of brain and central nervous system

Excludes:    peripheral nerves and autonomic nervous system (D48.2)

D43.0   Brain, supratentorial

Cerebral ventricle

Cerebrum

Frontal     

Occipital   

Parietal       lobe

Temporal    

Excludes:    fourth ventricle (D43.1)

D43.1   Brain, infratentorial

Brain stem

Cerebellum

Fourth ventricle

D43.2   Brain, unspecified

D43.3   Cranial nerves

D43.4   Spinal cord

D43.7   Other parts of central nervous system

D43.9   Central nervous system, unspecified

Nervous system (central) NOS

D44  Neoplasm of uncertain or unknown behaviour of endocrine glands

Excludes:    endocrine pancreas (D37.7)

ovary (D39.1)

testis (D40.1)

thymus (D38.4)

D44.0   Thyroid gland

D44.1   Adrenal gland

D44.2   Parathyroid gland

D44.3   Pituitary gland

D44.4   Craniopharyngeal duct

D44.5   Pineal gland

D44.6   Carotid body

D44.7   Aortic body and other paraganglia

D44.8   Pluriglandular involvement

Multiple endocrine adenomatosis

D44.9   Endocrine gland, unspecified

D45  Polycythaemia vera

Morphology code M9950 with behaviour code /1

D46  Myelodysplastic syndromes

Includes:    morphology code M998 with behaviour code /1

D46.0   Refractory anaemia without sideroblasts, so stated

D46.1   Refractory anaemia with sideroblasts

D46.2   Refractory anaemia with excess of blasts

D46.3   Refractory anaemia with excess of blasts with transformation

D46.4   Refractory anaemia, unspecified

D46.7   Other myelodysplastic syndromes

D46.9   Myelodysplastic syndrome, unspecified

Myelodysplasia NOS

Preleukaemia (syndrome) NOS

D47  Other neoplasms of uncertain or unknown behaviour of lymphoid, haematopoietic and related tissue

Includes:    morphology codes M974, M976, M996-M997 with behaviour code /1

D47.0   Histiocytic and mast cell tumours of uncertain and unknown behaviour

Mast cell tumour NOS

Mastocytoma NOS

Excludes:    mastocytosis (cutaneous) (Q82.2)

D47.1   Chronic myeloproliferative disease

Myelofibrosis (with myeloid metaplasia)

Myeloproliferative disease, unspecified

Myelosclerosis (megakaryocytic) with myeloid metaplasia

D47.2   Monoclonal gammopathy (of undetermined significance (MGUS))

D47.3   Essential (haemorrhagic) thrombocythaemia

Idiopathic haemorrhagic thrombocythaemia

D47.7   Other specified neoplasms of uncertain or unknown behaviour of lymphoid,

haematopoietic and related tissue

D47.9   Neoplasm of uncertain or unknown behaviour of lymphoid, haematopoietic and related tissue, unspecified

Lymphoproliferative disease NOS

D48  Neoplasm of uncertain or unknown behaviour of other and unspecified sites

Excludes:    neurofibromatosis (nonmalignant) (Q85.0)

D48.0   Bone and articular cartilage

Excludes:    cartilage of:

• ear (D48.1)

• larynx (D38.0)

• nose (D38.5)

connective tissue of eyelid (D48.1)

synovia (D48.1)

D48.1   Connective and other soft tissue

Connective tissue of:

• ear

• eyelid

Excludes:    cartilage (of):

• articular (D48.0)

• larynx (D38.0)

• nose (D38.5)

connective tissue of breast (D48.6)

D48.2   Peripheral nerves and autonomic nervous system

Excludes:    peripheral nerves of orbit (D48.7)

D48.3   Retroperitoneum

D48.4   Peritoneum

D48.5   Skin

Anal:

• margin

• skin

Perianal skin

Skin of breast

Excludes:    anus NOS (D37.7)

skin of genital organs (D39.7, ^[ii]D40.7)

vermilion border of lip (D37.0)

D48.6   Breast

Connective tissue of breast

Cystosarcoma phyllodes

Excludes:    skin of breast (D48.5)

D48.7   Other specified sites

Eye

Heart

Peripheral nerves of orbit

Excludes:    connective tissue (D48.1)

skin of eyelid (D48.5)

D48.9   Neoplasm of uncertain or unknown behaviour, unspecified

"Growth" NOS

Neoplasm NOS

New growth NOS

Tumour NOS

CHAPTER III - Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)

Excludes:    autoimmune disease (systemic) NOS (M35.9)

certain conditions originating in the perinatal period (P00-P96)

complications of pregnancy, childbirth and the puerperium (O00-O99)

congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)

endocrine, nutritional and metabolic diseases (E00-E90)

human immunodeficiency virus [HIV] disease (B20-B24)

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)

This chapter contains the following blocks:

D50-D53      Nutritional anaemias

D55-D59      Haemolytic anaemias

D60-D64      Aplastic and other anaemias

D65-D69      Coagulation defects, purpura and other haemorrhagic conditions

D70-D77      Other diseases of blood and blood-forming organs

D80-D89      Certain disorders involving the immune mechanism

Asterisk categories for this chapter are provided as follows:

D63*       Anaemia in chronic diseases classified elsewhere

D77*       Other disorders of blood and blood-forming organs in diseases classified elsewhere

Nutritional anaemias (D50-D53)

D50  Iron deficiency anaemia

Includes:    anaemia:

• asiderotic

• hypochromic

D50.0   Iron deficiency anaemia secondary to blood loss (chronic)

Posthaemorrhagic anaemia (chronic)

Excludes:    acute posthaemorrhagic anaemia (D62)

congenital anaemia from fetal blood loss (P61.3)

D50.1   Sideropenic dysphagia

Kelly-Paterson syndrome

Plummer-Vinson syndrome

D50.8   Other iron deficiency anaemias

D50.9   Iron deficiency anaemia, unspecified

D51  Vitamin B

Excludes:    vitamin B₁₂ deficiency (E53.8)

D51.0   Vitamin B₁₂ deficiency anaemia due to intrinsic factor deficiency

Anaemia:

• Addison

• Biermer

• pernicious (congenital)

Congenital intrinsic factor deficiency

D51.1   Vitamin B₁₂ deficiency anaemia due to selective vitamin B₁₂ malabsorption with proteinuria

Imerslund(-Grasbeck) syndrome

Megaloblastic hereditary anaemia

D51.2   Transcobalamin II deficiency

D51.3   Other dietary vitamin B₁₂ deficiency anaemia

Vegan anaemia

D51.8   Other vitamin B₁₂ deficiency anaemias

D51.9   Vitamin B₁₂ deficiency anaemia, unspecified

D52  Folate deficiency anaemia

D52.0   Dietary folate deficiency anaemia

Nutritional megaloblastic anaemia

D52.1   Drug-induced folate deficiency anaemia

Use additional external cause code (Chapter XX), if desired, to identify drug.

D52.8   Other folate deficiency anaemias

D52.9   Folate deficiency anaemia, unspecified

Folic acid deficiency anaemia NOS

D53  Other nutritional anaemias

Includes:    megaloblastic anaemia unresponsive to vitamin B₁₂ or folate therapy

D53.0   Protein deficiency anaemia

Amino-acid deficiency anaemia

Orotaciduric anaemia

Excludes:    Lesch-Nyhan syndrome (E79.1)

D53.1   Other megaloblastic anaemias, not elsewhere classified

Megaloblastic anaemia NOS

Excludes:    Di Guglielmo disease (C94.0)

D53.2   Scorbutic anaemia

Excludes:    scurvy (E54)

D53.8   Other specified nutritional anaemias

Anaemia associated with deficiency of:

• copper

• molybdenum

• zinc

Excludes:   nutritional deficiencies without mention of anaemia, such as:

• copper deficiency (E61.0)

• molybdenum deficiency (E61.5)

• zinc deficiency (E60)

D53.9   Nutritional anaemia, unspecified

Simple chronic anaemia

Excludes:    anaemia NOS (D64.9)

Haemolytic anaemias (D55-D59)

D55  Anaemia due to enzyme disorders

Excludes:    drug-induced enzyme deficiency anaemia (D59.2)

D55.0   Anaemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency

Favism

G6PD deficiency anaemia

D55.1   Anaemia due to other disorders of glutathione metabolism

Anaemia (due to):

• enzyme deficiencies, except G6PD, related to the hexose monophosphate [HMP] shunt pathway

• haemolytic nonspherocytic (hereditary), type I

D55.2   Anaemia due to disorders of glycolytic enzymes

Anaemia:

• haemolytic nonspherocytic (hereditary), type II

• hexokinase deficiency

• pyruvate kinase [PK] deficiency

• triose-phosphate isomerase deficiency

D55.3   Anaemia due to disorders of nucleotide metabolism

D55.8   Other anaemias due to enzyme disorders

D55.9   Anaemia due to enzyme disorder, unspecified

D56  Thalassaemia

D56.0   Alpha thalassaemia

Excludes:    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)

D57  Sickle-cell disorders

Excludes:    other haemoglobinopathies (D58-)

D57.0   Sickle-cell anaemia with crisis

Hb-SS disease with crisis

D57.1   Sickle-cell anaemia without crisis

Sickle-cell:

• anaemia    

• disease       NOS

• disorder   

D57.2   Double heterozygous sickling disorders

Disease:

• Hb-SC

• Hb-SD

• Hb-SE

• sickle-cell thalassaemia

D57.3   Sickle-cell trait

Hb-S trait

Heterozygous haemoglobin S [HbAS]

D57.8   Other sickle-cell disorders

D58  Other hereditary haemolytic anaemias

D58.0   Hereditary spherocytosis

Acholuric (familial) jaundice

Congenital (spherocytic) haemolytic icterus

Minkowski-Chauffard syndrome

D58.1   Hereditary elliptocytosis

Elliptocytosis (congenital)

Ovalocytosis (congenital)(hereditary)

D58.2   Other haemoglobinopathies

Abnormal haemoglobin NOS

Congenital Heinz body anaemia

Disease:

• Hb-C

• Hb-D

• Hb-E

Haemoglobinopathy NOS

Unstable haemoglobin haemolytic disease

Excludes:    familial polycythaemia (D75.0)

Hb-M disease (D74.0)

hereditary persistence of fetal haemoglobin [HPFH] (D56.4)

high-altitude polycythaemia (D75.1)

methaemoglobinaemia (D74-)

D58.8   Other specified hereditary haemolytic anaemias

Stomatocytosis

D58.9   Hereditary haemolytic anaemia, unspecified

D59  Acquired haemolytic anaemia

D59.0   Drug-induced autoimmune haemolytic anaemia

Use additional external cause code (Chapter XX), if desired, to identify drug.

D59.1   Other autoimmune haemolytic anaemias

Autoimmune haemolytic disease (cold type)(warm type)

Chronic cold haemagglutinin disease

Cold agglutinin:

• disease

• haemoglobinuria

Haemolytic anaemia:

• cold type (secondary)(symptomatic)

• warm type (secondary)(symptomatic)

Excludes:    Evans syndrome (D69.3)

haemolytic disease of fetus and newborn (P55-)

paroxysmal cold haemoglobinuria (D59.6)

D59.2   Drug-induced nonautoimmune haemolytic anaemia

Drug-induced enzyme deficiency anaemia

Use additional external cause code (Chapter XX), if desired, to identify drug.

D59.3   Haemolytic-uraemic syndrome

D59.4   Other nonautoimmune haemolytic anaemias

Haemolytic anaemia:

• mechanical

• microangiopathic

• toxic

Use additional external cause code (Chapter XX), if desired, to identify cause.

D59.5   Paroxysmal nocturnal haemoglobinuria [Marchiafava-Micheli]

Excludes:    haemoglobinuria NOS (R82.3)

D59.6   Haemoglobinuria due to haemolysis from other external causes

Haemoglobinuria:

• from exertion

• march

• paroxysmal cold

Use additional external cause code (Chapter XX), if desired, to identify cause.

Excludes:    haemoglobinuria NOS (R82.3)

D59.8   Other acquired haemolytic anaemias

D59.9   Acquired haemolytic anaemia, unspecified

Idiopathic haemolytic anaemia, chronic

Aplastic and other anaemias (D60-D64)

D60  Acquired pure red cell aplasia [erythroblastopenia]

Includes:    red cell aplasia (acquired)(adult)(with thymoma)

D60.0   Chronic acquired pure red cell aplasia

D60.1   Transient acquired pure red cell aplasia

D60.8   Other acquired pure red cell aplasias

D60.9   Acquired pure red cell aplasia, unspecified

D61  Other aplastic anaemias

Excludes:    agranulocytosis (D70)

D61.0   Constitutional aplastic anaemia

Aplasia, (pure) red cell (of):

• congenital

• infants

• primary

Blackfan-Diamond syndrome

Familial hypoplastic anaemia

Fanconi anaemia

Pancytopenia with malformations

D61.1   Drug-induced aplastic anaemia

Use additional external cause code (Chapter XX), if desired, to identify drug.

D61.2   Aplastic anaemia due to other external agents

Use additional external cause code (Chapter XX), if desired, to identify cause.

D61.3   Idiopathic aplastic anaemia

D61.8   Other specified aplastic anaemias

D61.9   Aplastic anaemia, unspecified

Hypoplastic anaemia NOS

Medullary hypoplasia

Panmyelophthisis

D62  Acute posthaemorrhagic anaemia

Excludes:    congenital anaemia from fetal blood loss (P61.3)

D63  Anaemia in chronic diseases classified elsewhere

D63.0* Anaemia in neoplastic disease (C00-D48†)

D63.8* Anaemia in other chronic diseases classified elsewhere

Anaemia in chronic kidney disease > stage 3 (N18.3-N18.5†)

D64  Other anaemias

Excludes:    refractory anaemia:

• NOS (D46.4)

• with excess of blasts (D46.2)

• with transformation (D46.3)

• with sideroblasts (D46.1)

• without sideroblasts (D46.0)

D64.0   Hereditary sideroblastic anaemia

Sex-linked hypochromic sideroblastic anaemia

D64.1   Secondary sideroblastic anaemia due to disease

Use additional code, if desired, to identify disease.

D64.2   Secondary sideroblastic anaemia due to drugs and toxins

Use additional external cause code (Chapter XX), if desired, to identify cause.

D64.3   Other sideroblastic anaemias

Sideroblastic anaemia:

• NOS

• pyridoxine-responsive NEC

D64.4   Congenital dyserythropoietic anaemia

Dyshaematopoietic anaemia (congenital)

Excludes:    Blackfan-Diamond syndrome (D61.0)

Di Guglielmo disease (C94.0)

D64.8   Other specified anaemias

Infantile pseudoleukaemia

Leukoerythroblastic anaemia

D64.9   Anaemia, unspecified

Coagulation defects, purpura and other haemorrhagic conditions (D65-D69)

D65  Disseminated intravascular coagulation [defibrination syndrome]

Afibrinogenaemia, acquired

Consumption coagulopathy

Diffuse or disseminated intravascular coagulation [DIC]

Fibrinolytic haemorrhage, acquired

Purpura:

• fibrinolytic

• fulminans

Excludes:    that (complicating):

• abortion or ectopic or molar pregnancy (O00-O07, O08.1)

• in newborn (P60)

• pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)

D66  Hereditary factor VIII deficiency

Deficiency factor VIII (with functional defect)

Haemophilia:

• NOS

• A

• classical

Excludes:    factor VIII deficiency with vascular defect (D68.0)

D67  Hereditary factor IX deficiency

Christmas disease

Deficiency:

• factor IX (with functional defect)

• plasma thromboplastin component [PTC]

Haemophilia B

D68  Other coagulation defects

Excludes:    those complicating:

• abortion or ectopic or molar pregnancy (O00-O07, O08.1)

• pregnancy, childbirth and the puerperium (O45.0, O46.0, O67.0, O72.3)

D68.0   Von Willebrand disease

Angiohaemophilia

Factor VIII deficiency with vascular defect

Vascular haemophilia

Excludes:    capillary fragility (hereditary) (D69.8)

factor VIII deficiency:

• NOS (D66)

• with functional defect (D66)

D68.1   Hereditary factor XI deficiency

Haemophilia C

Plasma thromoplastin antecedent [PTA] deficiency

D68.2   Hereditary deficiency of other clotting factors

Congenital afibrinogenaemia

Deficiency:

• AC globulin

• proaccelerin

Deficiency of factor:

• I [fibrinogen]

• II [prothrombin]

• V [labile]

• VII [stable]

• X [Stuart-Prower]

• XII [Hageman]

• XIII [fibrin-stabilizing]

Dysfibrinogenaemia (congenital)

Hypoproconvertinaemia

Owren disease

D68.3   Haemorrhagic disorder due to circulating anticoagulants

Haemorrhage during long term use of anticoagulants

Hyperheparinaemia

Increase in:

• antithrombin

• anti-VIIIa

• anti-IXa

• anti-Xa

• anti-XIa

Use additional external cause code (Chapter XX), if desired, to identify any administered anticoagulant.

Excludes:    long term use of anticoagulants without haemorrhage (^[i]Z92.1)

D68.4   Acquired coagulation factor deficiency

Deficiency of coagulation factor due to:

• liver disease

• vitamin K deficiency

Excludes:    vitamin K deficiency of newborn (P53)

D68.5   Primary thrombophilia

Activated protein C resistance [factor V Leiden mutation]

Deficiency:

• antithrombin

• protein C

• protein S

Prothrombin gene mutation

D68.6   Other thrombophilia

Anticardiolipin syndrome

Antiphospholipid syndrome

Presence of the lupus anticoagulant

Excludes:   disseminated intravascular coagulation (D65)

hyperhomocysteinemia (E72.1)

D68.8   Other specified coagulation defects

D68.9   Coagulation defect, unspecified

D69  Purpura and other haemorrhagic conditions

Excludes:    benign hypergammaglobulinaemic purpura (D89.0)

cryoglobulinaemic purpura (D89.1)

essential (haemorrhagic) thrombocythaemia (D47.3)

purpura fulminans (D65)

thrombotic thrombocytopenic purpura (M31.1)

D69.0   Allergic purpura

Purpura:

• anaphylactoid

• Henoch(-Schonlein)

• nonthrombocytopenic:

• haemorrhagic

• idiopathic

• vascular

Vasculitis, allergic

D69.1   Qualitative platelet defects

Bernard-Soulier [giant platelet] syndrome

Glanzmann disease

Grey platelet syndrome

Thromboasthenia (haemorrhagic)(hereditary)

Thrombocytopathy

Excludes:    von Willebrand disease (D68.0)

D69.2   Other nonthrombocytopenic purpura

Purpura:

• NOS

• senile

• simplex

D69.3   Idiopathic thrombocytopenic purpura

Evans syndrome

D69.4   Other primary thrombocytopenia

Excludes:    thrombocytopenia with absent radius (Q87.2)

transient neonatal thrombocytopenia (P61.0)

Wiskott-Aldrich syndrome (D82.0)

D69.5   Secondary thrombocytopenia

Use additional external cause code (Chapter XX), if desired, to identify cause.

D69.6   Thrombocytopenia, unspecified

D69.8   Other specified haemorrhagic conditions

Capillary fragility (hereditary)

Vascular pseudohaemophilia

D69.9   Haemorrhagic condition, unspecified

Other diseases of blood and blood-forming organs (D70-D77)

D70  Agranulocytosis

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.

Excludes:    transient neonatal neutropenia (P61.5)

D71  Functional disorders of polymorphonuclear neutrophils

Cell membrane receptor complex [CR3] defect

Chronic (childhood) granulomatous disease

Congenital dysphagocytosis

Progressive septic granulomatosis

D72  Other disorders of white blood cells

Excludes:    abnormal white blood cells (count)(R72)

basophilia (D75.8)

immunity disorders (D80-D89)

neutropenia (D70)

preleukaemia (syndrome) (D46.9)

D72.0   Genetic anomalies of leukocytes

Anomaly (granulation)(granulocyte) or syndrome:

• Alder

• May-Hegglin

• Pelger-Huet

Hereditary:

• leukocytic:

• hypersegmentation

• hyposegmentation

• leukomelanopathy

Excludes:    Chediak(-Steinbrinck)-Higashi syndrome (E70.3)

D72.1   Eosinophilia

Eosinophilia:

• allergic

• hereditary

D72.8   Other specified disorders of white blood cells

Leukaemoid reaction:

• lymphocytic

• monocytic

• myelocytic

Leukocytosis

Lymphocytosis (symptomatic)

Lymphopenia

Monocytosis (symptomatic)

Plasmacytosis

D72.9   Disorder of white blood cells, unspecified

D73  Diseases of spleen

D73.0   Hyposplenism

Asplenia, postsurgical

Atrophy of spleen

Excludes:    asplenia (congenital) (Q89.0)

D73.1   Hypersplenism

Excludes:    splenomegaly:

• NOS (R16.1)

• congenital (Q89.0)

D73.2   Chronic congestive splenomegaly

D73.3   Abscess of spleen

D73.4   Cyst of spleen

D73.5   Infarction of spleen

Splenic rupture, nontraumatic

Torsion of spleen

Excludes:    traumatic rupture of spleen (S36.0)

D73.8   Other diseases of spleen

Fibrosis of spleen NOS

Perisplenitis

Splenitis NOS

D73.9   Disease of spleen, unspecified

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

D75  Other diseases of blood and blood-forming organs

Excludes:    enlarged lymph nodes (R59-)

hypergammaglobulinaemia NOS (D89.2)

lymphadenitis:

• NOS (I88.9)

• acute (L04-)

• chronic (I88.1)

• mesenteric (acute)(chronic) (I88.0)

D75.0   Familial erythrocytosis

Polycythaemia:

• benign

• familial

Excludes:    hereditary ovalocytosis (D58.1)

D75.1   Secondary polycythaemia

Erythrocytosis NOS

Polycythaemia:

• acquired

• due to:

• erythropoietin

• fall in plasma volume

• high altitude

• stress

• emotional

• hypoxaemic

• nephrogenous

• relative

Excludes:   polycythaemia:

• neonatorum (P61.1)

• vera (D45)

D75.2   Essential thrombocytosis

Excludes:    essential (haemorrhagic) thrombocythaemia (D47.3)

D75.8   Other specified diseases of blood and blood-forming organs

Basophilia

D75.9   Disease of blood and blood-forming organs, unspecified

D76  Certain diseases involving lymphoreticular tissue and reticulohistiocytic system

Excludes:    Letterer-Siwe disease (C96.0)

malignant histiocytosis (C96.1)

reticuloendotheliosis or reticulosis:

• histiocytic medullary (C96.1)

• leukaemic (C91.4)

• lipomelanotic (I89.8)

• malignant (C85.7)

• nonlipid (C96.0)

D76.0   Langerhans cell histiocytosis, not elsewhere classified

Eosinophilic granuloma

Hand-Schuller-Christian disease

Histiocytosis X (chronic)

D76.1   Haemophagocytic lymphohistiocytosis

Familial haemophagocytic reticulosis

Histiocytoses of mononuclear phagocytes other than Langerhans cells NOS

D76.2   Haemophagocytic syndrome, infection-associated

Use additional code, if desired, to identify infectious agent or disease.

D76.3   Other histiocytosis syndromes

Reticulohistiocytoma (giant-cell)

Sinus histiocytosis with massive lymphadenopathy

Xanthogranuloma

D77  Other disorders of blood and blood-forming organs in diseases classified elsewhere

Fibrosis of spleen in schistosomiasis [bilharziasis] (B65†)

Certain disorders involving the immune mechanism (D80-D89)

Includes:    defects in the complement system

immunodeficiency disorders, except human immunodeficiency virus [HIV] disease

sarcoidosis

Excludes:    autoimmune disease (systemic) NOS (M35.9)

functional disorders of polymorphonuclear neutrophils (D71)

human immunodeficiency virus [HIV] disease (B20-B24)

human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium (O98.7)

D80  Immunodeficiency with predominantly antibody defects

D80.0   Hereditary hypogammaglobulinaemia

Autosomal recessive agammaglobulinaemia (Swiss type)

X-linked agammaglobulinaemia [Bruton] (with growth hormone deficiency)

D80.1   Nonfamilial hypogammaglobulinaemia

Agammaglobulinaemia with immunoglobulin-bearing B-lymphocytes

Common variable agammaglobulinaemia [CVAgamma]

Hypogammaglobulinaemia NOS

D80.2   Selective deficiency of immunoglobulin A [IgA]

D80.3   Selective deficiency of immunoglobulin G [IgG] subclasses

D80.4   Selective deficiency of immunoglobulin M [IgM]

D80.5   Immunodeficiency with increased immunoglobulin M [IgM]

D80.6   Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinaemia

D80.7   Transient hypogammaglobulinaemia of infancy

D80.8   Other immunodeficiencies with predominantly antibody defects

Kappa light chain deficiency

D80.9   Immunodeficiency with predominantly antibody defects, unspecified

D81  Combined immunodeficiencies

Excludes:    autosomal recessive agammaglobulinaemia (Swiss type) (D80.0)

D81.0   Severe combined immunodeficiency [SCID] with reticular dysgenesis

D81.1   Severe combined immunodeficiency [SCID] with low T- and B-cell numbers

D81.2   Severe combined immunodeficiency [SCID] with low or normal B-cell numbers

D81.3   Adenosine deaminase [ADA] deficiency

D81.4   Nezelof syndrome

D81.5   Purine nucleoside phosphorylase [PNP] deficiency

D81.6   Major histocompatibility complex class I deficiency

Bare lymphocyte syndrome

D81.7   Major histocompatibility complex class II deficiency

D81.8   Other combined immunodeficiencies

Biotin-dependent carboxylase deficiency

D81.9   Combined immunodeficiency, unspecified

Severe combined immunodeficiency disorder [SCID] NOS

D82  Immunodeficiency associated with other major defects

Excludes:    ataxia telangiectasia [Louis-Bar] (G11.3)

D82.0   Wiskott-Aldrich syndrome

Immunodeficiency with thrombocytopenia and eczema

D82.1   Di George syndrome

Pharyngeal pouch syndrome

Thymic:

• alymphoplasia

• aplasia or hypoplasia with immunodeficiency

D82.2   Immunodeficiency with short-limbed stature

D82.3   Immunodeficiency following hereditary defective response to Epstein-Barr virus

X-linked lymphoproliferative disease

D82.4   Hyperimmunoglobulin E [IgE] syndrome

D82.8   Immunodeficiency associated with other specified major defects

D82.9   Immunodeficiency associated with major defect, unspecified

D83  Common variable immunodeficiency

D83.0   Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function

D83.1   Common variable immunodeficiency with predominant immunoregulatory T-cell disorders

D83.2   Common variable immunodeficiency with autoantibodies to B- or T-cells

D83.8   Other common variable immunodeficiencies

D83.9   Common variable immunodeficiency, unspecified

D84  Other immunodeficiencies

D84.0   Lymphocyte function antigen-1 [LFA-1] defect

D84.1   Defects in the complement system

C1 esterase inhibitor [C1-INH] deficiency

D84.8   Other specified immunodeficiencies

D84.9   Immunodeficiency, unspecified

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]

D86.9   Sarcoidosis, unspecified

D89  Other disorders involving the immune mechanism, not elsewhere classified

Excludes:    hyperglobulinaemia NOS (R77.1)

monoclonal gammopathy (D47.2)

transplant failure and rejection (T86-)

D89.0   Polyclonal hypergammaglobulinaemia

Benign hypergammaglobulinaemic purpura

Polyclonal gammopathy NOS

D89.1   Cryoglobulinaemia

Cryoglobulinaemia:

• essential

• idiopathic

• mixed

• primary

• secondary

Cryoglobulinaemic:

• purpura

• vasculitis

D89.2   Hypergammaglobulinaemia, unspecified

D89.3   Immune reconstitution syndrome      

Immune reconstitution inflammatory syndrome [IRIS]

D89.8   Other specified disorders involving the immune mechanism, not elsewhere classified

D89.9   Disorder involving the immune mechanism, unspecified

Immune disease NOS

CHAPTER IV - Endocrine, nutritional and metabolic diseases (E00-E90)

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 hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.

Excludes:    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)

This chapter contains the following blocks:

E00-E07       Disorders of thyroid gland

E10-E14       Diabetes mellitus

E15-E16       Other disorders of glucose regulation and pancreatic internal secretion

E20-E35       Disorders of other endocrine glands

E40-E46       Malnutrition

E50-E64       Other nutritional deficiencies

E65-E68       Obesity and other hyperalimentation

E70-E90       Metabolic disorders

Asterisk categories for this chapter are provided as follows:

E35*            Disorders of endocrine glands in diseases classified elsewhere

E90*            Nutritional and metabolic disorders in diseases classified elsewhere

Disorders of thyroid gland (E00-E07)

E00   Congenital iodine-deficiency syndrome

Includes:    endemic conditions associated with environmental iodine deficiency either directly or as a consequence of maternal iodine deficiency. Some of the conditions have no current hypothyroidism but are the consequence of inadequate thyroid hormone secretion in the developing fetus. Environmental goitrogens may be associated.

Use additional code (F70-F79), if desired, to identify associated mental retardation.

Excludes:    subclinical iodine-deficiency hypothyroidism (E02)

E00.0   Congenital iodine-deficiency syndrome, neurological type

Endemic cretinism, neurological type

E00.1   Congenital iodine-deficiency syndrome, myxoedematous type

Endemic cretinism:

• hypothyroid

• myxoedematous type

E00.2   Congenital iodine-deficiency syndrome, mixed type

Endemic cretinism, mixed type

E00.9   Congenital iodine-deficiency syndrome, unspecified

Congenital iodine-deficiency hypothyroidism NOS

Endemic cretinism NOS

E01   Iodine-deficiency-related thyroid disorders and allied conditions

Excludes:    congenital iodine-deficiency syndrome (E00-)

subclinical iodine-deficiency hypothyroidism (E02)

E01.0   Iodine-deficiency-related diffuse (endemic) goitre

E01.1   Iodine-deficiency-related multinodular (endemic) goitre

Iodine-deficiency-related nodular goitre

E01.2   Iodine-deficiency-related (endemic) goitre, unspecified

Endemic goitre NOS

E01.8   Other iodine-deficiency-related thyroid disorders and allied conditions

Acquired iodine-deficiency hypothyroidism NOS

E02   Subclinical iodine-deficiency hypothyroidism

E03   Other hypothyroidism

Excludes:    iodine-deficiency-related hypothyroidism (E00-E02)

postprocedural hypothyroidism (E89.0)

E03.0   Congenital hypothyroidism with diffuse goitre

Goitre (nontoxic) congenital:

• NOS

• parenchymatous

Excludes:    transitory congenital goitre with normal function (P72.0)

E03.1   Congenital hypothyroidism without goitre

Aplasia of thyroid (with myxoedema)

Congenital:

• atrophy of thyroid

• hypothyroidism NOS

E03.2   Hypothyroidism due to medicaments and other exogenous substances

Use additional external cause code (Chapter XX), if desired, to identify cause.

E03.3   Postinfectious hypothyroidism

E03.4   Atrophy of thyroid (acquired)

Excludes:    congenital atrophy of thyroid (E03.1)

E03.5   Myxoedema coma

E03.8   Other specified hypothyroidism

E03.9   Hypothyroidism, unspecified

Myxoedema NOS

E03.90 Advanced hypothyroidism

Grave hypothyroidism

Severe hypothyroidism

E04   Other nontoxic goitre

Excludes:    congenital goitre:

• NOS              

• diffuse             (E03.0)

• parenchymatous   

 • iodine-deficiency-related goitre (E00-E02)

E04.0   Nontoxic diffuse goitre

Goitre, nontoxic:

• diffuse (colloid)

• simple

E04.1   Nontoxic single thyroid nodule

Colloid nodule (cystic)(thyroid)

Nontoxic uninodular goitre

Thyroid (cystic) nodule NOS

E04.2   Nontoxic multinodular goitre

Cystic goitre NOS

Multinodular (cystic) goitre NOS

E04.8   Other specified nontoxic goitre

E04.9   Nontoxic goitre, unspecified

Goitre NOS

Nodular goitre (nontoxic) NOS

E05   Thyrotoxicosis [hyperthyroidism]

Excludes:    chronic thyroiditis with transient thyrotoxicosis (E06.2)

neonatal thyrotoxicosis (P72.1)

E05.0   Thyrotoxicosis with diffuse goitre

Exophthalmic or toxic goitre NOS

Graves disease

Toxic diffuse goitre

E05.1   Thyrotoxicosis with toxic single thyroid nodule

Thyrotoxicosis with toxic uninodular goitre

E05.2   Thyrotoxicosis with toxic multinodular goitre

Toxic nodular goitre NOS

E05.3   Thyrotoxicosis from ectopic thyroid tissue

E05.4   Thyrotoxicosis factitia

E05.5   Thyroid crisis or storm

E05.8   Other thyrotoxicosis

Overproduction of thyroid-stimulating hormone

Use additional external cause code (Chapter XX), if desired, to identify cause.

E05.9   Thyrotoxicosis, unspecified

Hyperthyroidism NOS

Thyrotoxic heart disease† (I43.8*)

E06   Thyroiditis

Excludes:    postpartum thyroiditis (O90.5)

E06.0   Acute thyroiditis

Abscess of thyroid

Thyroiditis:

• pyogenic

• suppurative

Use additional code (B95-B97), if desired, to identify infectious agent.

E06.1   Subacute thyroiditis

Thyroiditis:

• de Quervain

• giant-cell

• granulomatous

• nonsuppurative

Excludes:    autoimmune thyroiditis (E06.3)

E06.2   Chronic thyroiditis with transient thyrotoxicosis

Excludes:    autoimmune thyroiditis (E06.3)

E06.3   Autoimmune thyroiditis

Hashimoto thyroiditis

Hashitoxicosis (transient)

Lymphadenoid goitre

Lymphocytic thyroiditis

Struma lymphomatosa

E06.4   Drug-induced thyroiditis

Use additional external cause code (Chapter XX), if desired, to identify drug.

E06.5   Other chronic thyroiditis

Thyroiditis:

• chronic:

• NOS

• fibrous

• ligneous

• Riedel

E06.9   Thyroiditis, unspecified

E07   Other disorders of thyroid

E07.0   Hypersecretion of calcitonin

C-cell hyperplasia of thyroid

Hypersecretion of thyrocalcitonin

E07.1   Dyshormogenetic goitre

Familial dyshormogenetic goitre

Pendred syndrome

Excludes:    transitory congenital goitre with normal function (P72.0)

E07.8   Other specified disorders of thyroid

Abnormality of thyroid-binding globulin

     Haemorrhage   

     Infarction       of thyroid

Sick-euthyroid syndrome

E07.9   Disorder of thyroid, unspecified

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:

• acididosis    

• ketoacidoss      without mention of coma

.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† (M14.6*)

.7       With multiple complications

.8       With unspecified complications

.9       Without complications

E10   Type 1 diabetes mellitus

[See before E10 for subdivisions]

Includes:    diabetes (mellitus):

• brittle

• juvenile-onset

• ketosis-prone

Excludes:    diabetes mellitus (in):

• malnutrition-related (E12-)

• neonatal (P70.2)

• pregnancy, childbirth and the puerperium (O24-)

glycosuria:

• NOS (R81)

• renal (E74.8)

impaired glucose tolerance (R73.0)

postsurgical hypoinsulinaemia (E89.1)

E11   Type 2 diabetes mellitus

[See before E10 for subdivisions]

Includes:    diabetes (mellitus)(nonobese)(obese):

• adult-onset

• maturity-onset

• nonketotic

• stable

Excludes:    diabetes mellitus (in):

• malnutrition-related (E12-)

• neonatal (P70.2)

• pregnancy, childbirth and the puerperium (O24-)

glycosuria:

• NOS (R81)

• renal (E74.8)

impaired glucose tolerance (R73.0)

postsurgical hypoinsulinaemia (E89.1)

E12   Malnutrition-related diabetes mellitus

[See before E10 for subdivisions]

Includes:    malnutrition-related diabetes mellitus:

• type 1

• type 2

Excludes:    diabetes mellitus in pregnancy, childbirth and the puerperium (O24-)

glycosuria:

• NOS (R81)

• renal (E74.8)

impaired glucose tolerance (R73.0)

neonatal diabetes mellitus (P70.2)

postsurgical hypoinsulinaemia (E89.1)

E13   Other specified diabetes mellitus

[See before E10 for subdivisions]

Excludes:    diabetes mellitus (in):

• malnutrition-related (E12-)

• neonatal (P70.2)

• pregnancy, childbirth and the puerperium (O24-)

• type 1 (E10-)

• type 2 (E11-)

glycosuria:

• NOS (R81)

• renal (E74.8)

impaired glucose tolerance (R73.0)

postsurgical hypoinsulinaemia (E89.1)

E14   Unspecified diabetes mellitus

[See before E10 for subdivisions]

Includes:    diabetes NOS

Excludes:    diabetes mellitus (in):

• malnutrition-related (E12-)

• neonatal (P70.2)

• pregnancy, childbirth and the puerperium (O24-)

• type 1 (E10-)

• type 2 (E11-)

glycosuria:

• NOS (R81)

• renal (E74.8)

impaired glucose tolerance (R73.0)

postsurgical hypoinsulinaemia (E89.1)

Other disorders of glucose regulation and pancreatic internal secretion (E15-E16)

E15   Nondiabetic hypoglycaemic coma

Drug-induced insulin coma in nondiabetic

Hyperinsulinism with hypoglycaemic coma

Hypoglycaemic coma NOS

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

E16   Other disorders of pancreatic internal secretion

E16.0   Drug-induced hypoglycaemia without coma

Use additional external cause code (Chapter XX), if desired, to identify drug.

E16.1   Other hypoglycaemia

Functional nonhyperinsulinaemic hypoglycaemia

Hyperinsulinism:

• NOS

• functional

Hyperplasia of pancreatic islet beta cells NOS

Posthypoglycaemic coma encephalopathy

E16.2   Hypoglycaemia, unspecified

E16.3   Increased secretion of glucagon

Hyperplasia of pancreatic endocrine cells with glucagon excess

E16.4   Abnormal secretion of gastrin

Hypergastrinaemia

Zollinger-Ellison syndrome

E16.8   Other specified disorders of pancreatic internal secretion

Increased secretion from endocrine pancreas of:

• growth hormone-releasing hormone

• pancreatic polypeptide

• somatostatin

• vasoactive-intestinal polypeptide

E16.9   Disorder of pancreatic internal secretion, unspecified

Islet-cell hyperplasia NOS

Pancreatic endocrine cell hyperplasia NOS

Disorders of other endocrine glands (E20-E35)

Excludes:    galactorrhoea (N64.3)

gynaecomastia (N62)

E20   Hypoparathyroidism

Excludes:    Di George 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

E21   Hyperparathyroidism and other disorders of parathyroid gland

Excludes:    osteomalacia:

• adult (M83-)

• infantile and juvenile (E55.0)

E21.0   Primary hyperparathyroidism

Hyperplasia of parathyroid

Osteitis fibrosa cystica generalisata [von Recklinghausen disease of bone]

E21.1   Secondary hyperparathyroidism, not elsewhere classified

Excludes:    secondary hyperparathyroidism of renal origin (N25.8)

E21.2   Other hyperparathyroidism

Tertiary hyperparathyroidism

Excludes:    familial hypocalciuric hypercalcaemia (E83.5)

E21.3   Hyperparathyroidism, unspecified

E21.4   Other specified disorders of parathyroid gland

E21.5   Disorder of parathyroid gland, unspecified

E22   Hyperfunction of pituitary gland

Excludes:    Cushing syndrome (E24-)

Nelson syndrome (E24.1)

overproduction of:

• ACTH not associated with Cushing disease (E27.0)

• pituitary ACTH (E24.0)

• thyroid-stimulating hormone (E05.8)

E22.0   Acromegaly and pituitary gigantism

Arthropathy associated with acromegaly† (M14.5*)

Overproduction of growth hormone

Excludes:    constitutional:

• gigantism (E34.4)

• tall stature (E34.4)

increased secretion from endocrine pancreas of growth hormone-releasing hormone (E16.8)

E22.1   Hyperprolactinaemia

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

E22.2   Syndrome of inappropriate secretion of antidiuretic hormone

E22.8   Other hyperfunction of pituitary gland

Central precocious puberty

E22.9   Hyperfunction of pituitary gland, unspecified

E23   Hypofunction and other disorders of pituitary gland

Includes:    the listed conditions whether the disorder is in the pituitary or the hypothalamus

Excludes:    postprocedural hypopituitarism (E89.3)

E23.0   Hypopituitarism

Fertile eunuch syndrome

Hypogonadotropic hypogonadism

Idiopathic growth hormone deficiency

Isolated deficiency of:

• gonadotropin

• growth hormone

• pituitary hormone

Kallmann syndrome

Lorain-Levi short stature

Necrosis of pituitary gland (postpartum)

Panhypopituitarism

Pituitary:

• cachexia

• insufficiency NOS

• short stature

Sheehan syndrome

Simmonds disease

E23.1   Drug-induced hypopituitarism

Use additional external cause code (Chapter XX), if desired, to identify drug.

E23.2   Diabetes insipidus

Excludes:    nephrogenic diabetes insipidus (N25.1)

E23.3   Hypothalamic dysfunction, not elsewhere classified

Excludes:    Prader-Willi syndrome (Q87.1)

Russell-Silver syndrome (Q87.1)

E23.6   Other disorders of pituitary gland

Abscess of pituitary

Adiposogenital dystrophy

E23.7   Disorder of pituitary gland, unspecified

E24   Cushing syndrome

E24.0   Pituitary-dependent Cushing disease

Overproduction of pituitary ACTH

Pituitary-dependent hyperadrenocorticism

E24.1   Nelson syndrome

E24.2   Drug-induced Cushing syndrome

Use additional external cause code (Chapter XX), if desired, to identify drug.

E24.3   Ectopic ACTH syndrome

E24.4   Alcohol-induced pseudo-Cushing syndrome

E24.8   Other Cushing syndrome

E24.9   Cushing syndrome, unspecified

E25   Adrenogenital disorders

Includes:    adrenogenital syndromes, virilizing or feminizing, whether acquired or due to adrenal hyperplasia consequent on inborn enzyme defects in hormone synthesis

female:

• adrenal pseudohermaphroditism

• heterosexual precocious pseudopuberty

male:

• isosexual precocious pseudopuberty

• macrogenitosomia praecox

• sexual precocity with adrenal hyperplasia

virilization (female)

E25.0   Congenital adrenogenital disorders associated with enzyme deficiency

Congenital adrenal hyperplasia

21-Hydroxylase deficiency

Salt-losing congenital adrenal hyperplasia

E25.8   Other adrenogenital disorders

Idiopathic adrenogenital disorder

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

E25.9   Adrenogenital disorder, unspecified

Adrenogenital syndrome NOS

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

E27   Other disorders of adrenal gland

E27.0   Other adrenocortical overactivity

Overproduction of ACTH, not associated with Cushing disease

Premature adrenarche

Excludes:    Cushing syndrome (E24-)

E27.1   Primary adrenocortical insufficiency

Addison disease

Autoimmune adrenalitis

Excludes:    amyloidosis (E85-)

tuberculous Addison disease (A18.7)

Waterhouse-Friderichsen syndrome (A39.1)

E27.2   Addisonian crisis

Adrenal crisis

Adrenocortical crisis

E27.3   Drug-induced adrenocortical insufficiency

Use additional external cause code (Chapter XX), if desired, to identify drug.

E27.4   Other and unspecified adrenocortical insufficiency

Adrenal:

• haemorrhage

• infarction

Adrenocortical insufficiency NOS

Hypoaldosteronism

Excludes:    adrenoleukodystrophy [Addison-Schilder] (E71.3)

Waterhouse-Friderichsen syndrome (A39.1)

E27.5   Adrenomedullary hyperfunction

Adrenomedullary hyperplasia

Catecholamine hypersecretion

E27.8   Other specified disorders of adrenal gland

Abnormality of cortisol-binding globulin

E27.9   Disorder of adrenal gland, unspecified

E28   Ovarian dysfunction

Excludes:    isolated gonadotropin deficiency (E23.0)

postprocedural ovarian failure (E89.4)

E28.0   Estrogen excess

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

E28.1   Androgen excess

Hypersecretion of ovarian androgens

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

E28.2   Polycystic ovarian syndrome

Sclerocystic ovary syndrome

Stein-Leventhal syndrome

E28.3   Primary ovarian failure

Decreased estrogen

Premature menopause NOS

Resistant ovary syndrome

Excludes:    menopausal and female climacteric states (N95.1)

pure gonadal dysgenesis (Q99.1)

Turner syndrome (Q96-)

E28.8   Other ovarian dysfunction

Ovarian hyperfunction NOS

E28.9   Ovarian dysfunction, unspecified

E29   Testicular dysfunction

Excludes:    androgen resistance syndrome (E34.5)

azoospermia or oligospermia NOS (N46)

isolated gonadotropin deficiency (E23.0)

Klinefelter syndrome (Q98.0-Q98.2, Q98.4)

postprocedural testicular hypofunction (E89.5)

testicular feminization (syndrome) (E34.5)

E29.0   Testicular hyperfunction

Hypersecretion of testicular hormones

E29.1   Testicular hypofunction

Defective biosynthesis of testicular androgen NOS

5-α-Reductase deficiency (with male pseudohermaphroditism)

Testicular hypogonadism NOS

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

E29.8   Other testicular dysfunction

E29.9   Testicular dysfunction, unspecified

E30   Disorders of puberty, not elsewhere classified

E30.0   Delayed puberty

Constitutional delay of puberty

Delayed sexual development

E30.1   Precocious puberty

Precocious menstruation

Excludes:    Albright(-McCune)(-Sternberg) syndrome (Q78.1)

central precocious puberty (E22.8)

congenital adrenal hyperplasia (E25.0)

female heterosexual precocious pseudopuberty (E25-)

male isosexual precocious pseudopuberty (E25-)

E30.8   Other disorders of puberty

Premature thelarche

E30.9   Disorder of puberty, unspecified

E31   Polyglandular dysfunction

Excludes:    ataxia telangiectasia [Louis-Bar] (G11.3)

dystrophia myotonica [Steinert] (G71.1)

pseudohypoparathyroidism (E20.1)

E31.0   Autoimmune polyglandular failure

Schmidt syndrome

E31.1   Polyglandular hyperfunction

Excludes:    multiple endocrine adenomatosis (D44.8)

E31.8   Other polyglandular dysfunction

E31.9   Polyglandular dysfunction, unspecified

E32   Diseases of thymus

Excludes:    aplasia or hypoplasia with immunodeficiency (D82.1)

myasthenia gravis (G70.0)

E32.0   Persistent hyperplasia of thymus

Hypertrophy of thymus

E32.1   Abscess of thymus

E32.8   Other diseases of thymus

E32.9   Disease of thymus, unspecified

E34   Other endocrine disorders

Excludes:    pseudohypoparathyroidism (E20.1)

E34.0   Carcinoid syndrome

Note:          May be used as an additional code, if desired, to identify functional activity associated with a carcinoid tumour.

E34.1   Other hypersecretion of intestinal hormones

E34.2   Ectopic hormone secretion, not elsewhere classified

E34.3   Short stature, not elsewhere classified

Short stature:

• NOS

• constitutional

• Laron-type

• psychosocial

Excludes:    progeria (E34.8)

Russell-Silver syndrome (Q87.1)

short-limbed stature with immunodeficiency (D82.2)

short stature:

• achondroplastic (Q77.4)

• hypochondroplastic (Q77.4)

• in specific dysmorphic syndromes - code to syndrome - see Alphabetical Index

• nutritional (E45)

• pituitary (E23.0)

• renal (N25.0)

E34.4   Constitutional tall stature

Constitutional gigantism

E34.5   Androgen resistance syndrome

Male pseudohermaphroditism with androgen resistance

Peripheral hormonal receptor disorder

Reifenstein syndrome

Testicular feminization (syndrome)

E34.8   Other specified endocrine disorders

Pineal gland dysfunction

Progeria

E34.9   Endocrine disorder, unspecified

Disturbance:

• endocrine NOS

• hormone NOS

E35   Disorders of endocrine glands in diseases classified elsewhere

E35.0* Disorders of thyroid gland in diseases classified elsewhere

Tuberculosis of thyroid gland (A18.8†)

E35.1* Disorders of adrenal glands in diseases classified elsewhere

Tuberculous Addison disease (A18.7†)

Waterhouse-Friderichsen syndrome (meningococcal) (A39.1†)

E35.8* Disorders of other endocrine glands in diseases classified elsewhere

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.

Excludes:    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.

Excludes:    marasmic kwashiorkor (E42)

E41   Nutritional marasmus

Severe malnutrition with marasmus

Excludes:    marasmic kwashiorkor (E42)

E42   Marasmic kwashiorkor

Severe protein-energy malnutrition [as in E43]:

• intermediate form

• with signs of both kwashiorkor and marasmus

E43   Unspecified severe protein-energy malnutrition

Severe loss of weight [wasting] in children or adults, or lack of weight gain in children leading to an observed weight that is at least 3 standard deviations below the mean value for the reference population (or a similar loss expressed through other statistical approaches). When only one measurement is available, there is a high probability of severe wasting when the observed weight is 3 or more standard deviations below the mean of the reference population.

Starvation oedema

E44   Protein-energy malnutrition of moderate and mild degree

E44.0   Moderate protein-energy malnutrition

Weight loss in children or adults, or lack of weight gain in children leading to an observed weight that is 2 or more but less than 3 standard deviations below the mean value for the reference population (or a similar loss expressed through other statistical approaches). When only one measurement is available, there is a high probability of moderate protein-energy malnutrition when the observed weight is 2 or more but less than 3 standard deviations below the mean of the reference population.

E44.1   Mild protein-energy malnutrition

Weight loss in children or adults, or lack of weight gain in children leading to an observed weight that is 1 or more but less than 2 standard deviations below the mean value for the reference population (or a similar loss expressed through other statistical approaches). When only one measurement is available, there is a high probability of mild protein-energy malnutrition when the observed weight is 1 or more but less than 2 standard deviations below the mean of the reference population.

E45   Retarded development following protein-energy malnutrition

Nutritional:

• short stature

• stunting

Physical retardation due to malnutrition

E46   Unspecified protein-energy malnutrition

Malnutrition NOS

Protein-energy imbalance NOS

Other nutritional deficiencies (E50-E64)

Excludes:    nutritional anaemias (D50-D53)

E50   Vitamin A deficiency

Excludes:    sequelae of vitamin A deficiency (E64.1)

E50.0   Vitamin A deficiency with conjunctival xerosis

E50.1   Vitamin A deficiency with Bitot spot and conjunctival xerosis

Bitot spot in the young child

E50.2   Vitamin A deficiency with corneal xerosis

E50.3   Vitamin A deficiency with corneal ulceration and xerosis

E50.4   Vitamin A deficiency with keratomalacia

E50.5   Vitamin A deficiency with night blindness

E50.6   Vitamin A deficiency with xerophthalmic scars of cornea

E50.7   Other ocular manifestations of vitamin A deficiency

Xerophthalmia NOS

E50.8   Other manifestations of vitamin A deficiency

  Follicular keratosis      Follicular keratosis

  Xeroderma                 Xeroderma

E50.9   Vitamin A deficiency, unspecified

Hypovitaminosis A NOS

E51   Thiamine deficiency

Excludes:    sequelae of thiamine deficiency (E64.8)

E51.1   Beriberi

Beriberi:

• dry

• wet† (I98.8*)

E51.2   Wernicke encephalopathy

E51.8   Other manifestations of thiamine deficiency

E51.9   Thiamine deficiency, unspecified

E52   Niacin deficiency [pellagra]

Deficiency:

• niacin(-tryptophan)

• nicotinamide

Pellagra (alcoholic)

Excludes:    sequelae of niacin deficiency (E64.8)

E53   Deficiency of other B group vitamins

Excludes:    sequelae of vitamin B deficiency (E64.8)

vitamin B₁₂ deficiency anaemia (D51-)

E53.0   Riboflavin deficiency

Ariboflavinosis

E53.1   Pyridoxine deficiency

Vitamin B₆ deficiency

Excludes:    pyridoxine-responsive sideroblastic anaemia (D64.3)

E53.8   Deficiency of other specified B group vitamins

Deficiency:

• biotin

• cyanocobalamin

• folate

• folic acid

• pantothenic acid

• vitamin B₁₂

E53.9   Vitamin B deficiency, unspecified

E54   Ascorbic acid deficiency

Deficiency of vitamin C

Scurvy

Excludes:    scorbutic anaemia (D53.2)

sequelae of vitamin C deficiency (E64.2)

E55   Vitamin D deficiency

Excludes:    adult osteomalacia (M83-)

osteoporosis (M80-M81)

sequelae of rickets (E64.3)

E55.0   Rickets, active

Osteomalacia:

• infantile

• juvenile

Excludes:    rickets:

• coeliac (K90.0)

• Crohn (K50-)

• inactive (E64.3)

• renal (N25.0)

• vitamin-D-resistant (E83.3)

E55.9   Vitamin D deficiency, unspecified

Avitaminosis D

E56   Other vitamin deficiencies

Excludes:    sequelae of other vitamin deficiencies (E64.8)

E56.0   Deficiency of vitamin E

E56.1   Deficiency of vitamin K

Excludes:    deficiency of coagulation factor due to vitamin K deficiency (D68.4)

vitamin K deficiency of newborn (P53)

E56.8   Deficiency of other vitamins

E56.9   Vitamin deficiency, unspecified

E58   Dietary calcium deficiency

Excludes:    disorder of calcium metabolism (E83.5)

sequelae of calcium deficiency (E64.8)

E59   Dietary selenium deficiency

Keshan disease

Excludes:    sequelae of selenium deficiency (E64.8)

E60   Dietary zinc deficiency

E61   Deficiency of other nutrient elements

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

Excludes:    disorders of mineral metabolism (E83-)

iodine-deficiency-related thyroid disorders (E00-E02)

sequelae of malnutrition and other nutritional deficiencies (E64-)

E61.0   Copper deficiency

E61.1   Iron deficiency

Excludes:    iron deficiency anaemia (D50-)

E61.2   Magnesium deficiency

E61.3   Manganese deficiency

E61.4   Chromium deficiency

E61.5   Molybdenum deficiency

E61.6   Vanadium deficiency

E61.7   Deficiency of multiple nutrient elements

E61.8   Deficiency of other specified nutrient elements

E61.9   Deficiency of nutrient element, unspecified

E63   Other nutritional deficiencies

Excludes:    dehydration (E86)

failure to thrive (R62.8)

feeding problems in newborn (P92-)

sequelae of malnutrition and other nutritional deficiencies (E64-)

E63.0   Essential fatty acid [EFA] deficiency

E63.1   Imbalance of constituents of food intake

E63.8   Other specified nutritional deficiencies

E63.9   Nutritional deficiency, unspecified

Nutritional cardiomyopathy NOS† (I43.2*)

E64   Sequelae of malnutrition and other nutritional deficiencies

Note:          Not to be used for chronic malnutrition or nutritional deficiency. Code these to current malnutrition or nutritional deficiency.

E64.0   Sequelae of protein-energy malnutrition

Excludes:    retarded development following protein-energy malnutrition (E45)

E64.1   Sequelae of vitamin A deficiency

E64.2   Sequelae of vitamin C deficiency

E64.3   Sequelae of rickets

Use additional code (M40.1, M41.5) if desired, to identify spinal deformity.

E64.8   Sequelae of other nutritional deficiencies

E64.9   Sequelae of unspecified nutritional deficiency

Obesity and other hyperalimentation (E65-E68)

E65   Localized adiposity

Fat pad

E66   Obesity

Excludes:    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

E67   Other hyperalimentation

Excludes:    hyperalimentation NOS (R63.2)

sequelae of hyperalimentation (E68)

E67.0   Hypervitaminosis A

E67.1   Hypercarotenaemia

E67.2   Megavitamin-B₆ syndrome

E67.3   Hypervitaminosis D

E67.8   Other specified hyperalimentation

E68   Sequelae of hyperalimentation

Note:          Not to be used for chronic hyperalimentation. Code these to current hyperalimentation.

Metabolic disorders (E70-E90)

Excludes:    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-α-reductase deficiency (E29.1)

E70   Disorders of aromatic amino-acid metabolism

E70.0   Classical phenylketonuria

E70.1   Other hyperphenylalaninaemias

E70.2   Disorders of tyrosine metabolism

Alkaptonuria

Hypertyrosinaemia

Ochronosis

Tyrosinaemia

Tyrosinosis

E70.3   Albinism

Albinism:

• ocular

• oculocutaneous

Syndrome:

• Chediak(-Steinbrinck)-Higashi

• Cross

• Hermansky-Pudlak

E70.8   Other disorders of aromatic amino-acid metabolism

Disorders of:

• histidine metabolism

• tryptophan metabolism

E70.9   Disorder of aromatic amino-acid metabolism, unspecified

E71   Disorders of branched-chain amino-acid metabolism and fatty-acid metabolism

E71.0   Maple-syrup-urine disease

E71.1   Other disorders of branched-chain amino-acid metabolism

Hyperleucine-isoleucinaemia

Hypervalinaemia

Isovaleric acidaemia

Methylmalonic acidaemia

Propionic acidaemia

E71.2   Disorder of branched-chain amino-acid metabolism, unspecified

E71.3   Disorders of fatty-acid metabolism

Adrenoleukodystrophy [Addison-Schilder]

Muscle carnitine palmityltransferase deficiency

Very long chain acyl-CoA dehydrogenase (VLCAD) deficiency

Excludes:    Schilder disease (G37.0)

E72   Other disorders of amino-acid metabolism

Excludes:    abnormal findings without manifest disease (R70-R89)

disorders of:

• aromatic amino-acid metabolism (E70-)

• branched-chain amino-acid metabolism (E71.0-E71.2)

• fatty-acid metabolism (E71.3)

• purine and pyrimidine metabolism (E79-)

gout (M10-)

E72.0   Disorders of amino-acid transport

Cystine storage disease† (N29.8*)

Cystinosis

Cystinuria

Fanconi(-de Toni)(-Debre) syndrome

Hartnup disease

Lowe syndrome

Excludes:    disorders of tryptophan metabolism (E70.8)

E72.1   Disorders of sulfur-bearing amino-acid metabolism

Cystathioninuria

Homocystinuria

Methioninaemia

Sulfite oxidase deficiency

Excludes:    transcobalamin II deficiency (D51.2)

E72.2   Disorders of urea cycle metabolism

Argininaemia

Argininosuccinic aciduria

Citrullinaemia

Hyperammonaemia

Excludes:    disorders of ornithine metabolism (E72.4)

E72.3   Disorders of lysine and hydroxylysine metabolism

Glutaric aciduria

Hydroxylysinaemia

Hyperlysinaemia

Excludes:    Refsum disease (G60.1)

Zellweger syndrome (Q87.8)

E72.4   Disorders of ornithine metabolism

Ornithinaemia (types I, II)

E72.5   Disorders of glycine metabolism

Hyperhydroxyprolinaemia

Hyperprolinaemia (types I, II)

Non-ketotic hyperglycinaemia

Sarcosinaemia

E72.8   Other specified disorders of amino-acid metabolism

Disorders of:

• β-amino-acid metabolism

• γ-glutamyl cycle

E72.9   Disorder of amino-acid metabolism, unspecified

E73   Lactose intolerance

E73.0   Congenital lactase deficiency

E73.1   Secondary lactase deficiency

E73.8   Other lactose intolerance

E73.9   Lactose intolerance, unspecified

E74   Other disorders of carbohydrate metabolism

Excludes:    increased secretion of glucagon (E16.3)

diabetes mellitus (E10-E14)

hypoglycaemia NOS (E16.2)

mucopolysaccharidosis (E76.0-E76.3)

E74.0   Glycogen storage disease

Cardiac glycogenosis

Disease:

• Andersen

• Cori

• Forbes

• Hers

• McArdle

• Pompe

• Tarui

• Tauri

• von Gierke

Liver phosphorylase deficiency

E74.1   Disorders of fructose metabolism

Essential fructosuria

Fructose-1,6-diphosphatase deficiency

Hereditary fructose intolerance

E74.2   Disorders of galactose metabolism

Galactokinase deficiency

Galactosaemia

E74.3   Other disorders of intestinal carbohydrate absorption

Glucose-galactose malabsorption

Sucrase deficiency

Excludes:    lactose intolerance (E73-)

E74.4   Disorders of pyruvate metabolism and gluconeogenesis

Deficiency of:

• phosphoenolpyruvate carboxykinase

• pyruvate:

• carboxylase

• dehydrogenase

Excludes:    with anaemia (D55-)

E74.8   Other specified disorders of carbohydrate metabolism

Essential pentosuria

Oxalosis

Oxaluria

Renal glycosuria

E74.9   Disorder of carbohydrate metabolism, unspecified

E75   Disorders of sphingolipid metabolism and other lipid storage disorders

Excludes:    mucolipidosis, types I-III (E77.0-E77.1)

Refsum disease (G60.1)

E75.0   GM₂ gangliosidosis

Disease:

• Sandhoff

• Tay-Sachs

GM₂ gangliosidosis:

• NOS    

• adult

• juvenile

E75.1   Other gangliosidosis

Gangliosidosis:

• NOS

• GM₁

• GM₃

Mucolipidosis IV

E75.2   Other sphingolipidosis

Disease:

• Fabry(-Anderson)

• Gaucher

• Krabbe

• Niemann-Pick

Farber's syndrome

Metachromatic leukodystrophy

Sulfatase deficiency

Excludes:    adrenoleukodystrophy [Addison-Schilder] (E71.3)

E75.3   Sphingolipidosis, unspecified

E75.4   Neuronal ceroid lipofuscinosis

Disease:

• Batten

• Bielschowsky-Jansky

• Kufs

• Spielmeyer-Vogt

E75.5   Other lipid storage disorders

Cerebrotendinous cholesterosis [van Bogaert-Scherer-Epstein]

Wolman disease

E75.6   Lipid storage disorder, unspecified

E76   Disorders of glycosaminoglycan metabolism

E76.0   Mucopolysaccharidosis, type I

Syndrome:

• Hurler

• Hurler-Scheie

• Scheie

E76.1   Mucopolysaccharidosis, type II

Hunter syndrome

E76.2   Other mucopolysaccharidoses

β-Glucuronidase deficiency

Mucopolysaccharidosis, types III, IV, VI, VII

Syndrome:

• Maroteaux-Lamy (mild) (severe)

• Morquio(-like) (classic)

• Sanfilippo (type B) (type C) (type D)

E76.3   Mucopolysaccharidosis, unspecified

E76.8   Other disorders of glucosaminoglycan metabolism

E76.9   Disorder of glucosaminoglycan metabolism, unspecified

E77   Disorders of glycoprotein metabolism

E77.0   Defects in post-translational modification of lysosomal enzymes

Mucolipidosis II [I-cell disease]

Mucolipidosis III [pseudo-Hurler polydystrophy]

E77.1   Defects in glycoprotein degradation

Aspartylglucosaminuria

Fucosidosis

Mannosidosis

Sialidosis [mucolipidosis I]

E77.8   Other disorders of glycoprotein metabolism

E77.9   Disorder of glycoprotein metabolism, unspecified

E78   Disorders of lipoprotein metabolism and other lipidaemias

Excludes:    sphingolipidosis (E75.0-E75.3)

E78.0   Pure hypercholesterolaemia

Familial hypercholesterolaemia

Fredrickson hyperlipoproteinaemia, type IIa

Hyperbetalipoproteinaemia

Hyperlipidaemia, group A

Low-density-lipoprotein-type [LDL] hyperlipoproteinaemia

E78.1   Pure hyperglyceridaemia

Endogenous hyperglyceridaemia

Fredrickson hyperlipoproteinaemia, type IV

Hyperlipidaemia, group B

Hyperprebetalipoproteinaemia

Very-low-density-lipoprotein-type [VLDL] hyperlipoproteinaemia

E78.2   Mixed hyperlipidaemia

Broad- or floating-betalipoproteinaemia

Fredrickson hyperlipoproteinaemia, type IIb or III

Hyperbetalipoproteinaemia with prebetalipoproteinaemia

Hypercholesterolaemia with endogenous hyperglyceridaemia

Hyperlipidaemia, group C

Tubero-eruptive xanthoma

Xanthoma tuberosum

Excludes:    cerebrotendinous cholesterosis [van Bogaert-Scherer-Epstein] (E75.5)

E78.3   Hyperchylomicronaemia

Fredrickson hyperlipoproteinaemia, type I or V

Hyperlipidaemia, group D

Mixed hyperglyceridaemia

E78.4   Other hyperlipidaemia

Familial combined hyperlipidaemia

E78.5   Hyperlipidaemia, unspecified

E78.6   Lipoprotein deficiency

Abetalipoproteinaemia

High-density lipoprotein deficiency

Hypoalphalipoproteinaemia

Hypobetalipoproteinaemia (familial)

Lecithin cholesterol acyltransferase deficiency

Tangier disease

E78.8   Other disorders of lipoprotein metabolism

E78.9   Disorder of lipoprotein metabolism, unspecified

E79   Disorders of purine and pyrimidine metabolism

Excludes:    calculus of kidney (N20.0)

combined immunodeficiency disorders (D81-)

gout (M10-)

orotaciduric anaemia (D53.0)

xeroderma pigmentosum (Q82.1)

E79.0   Hyperuricaemia without signs of inflammatory arthritis and tophaceous disease

Asymptomatic hyperuricaemia

E79.1   Lesch-Nyhan syndrome

E79.8   Other disorders of purine and pyrimidine metabolism

Hereditary xanthinuria

E79.9   Disorder of purine and pyrimidine metabolism, unspecified

E80   Disorders of porphyrin and bilirubin metabolism

Includes:    defects of catalase and peroxidase

E80.0   Hereditary erythropoietic porphyria

Congenital erythropoietic porphyria

Erythropoietic protoporphyria

E80.1   Porphyria cutanea tarda

E80.2   Other porphyria

Hereditary coproporphyria

Porphyria:

• NOS

• acute intermittent (hepatic)

Use additional external cause code (Chapter XX), if desired, to identify cause.

E80.3   Defects of catalase and peroxidase

Acatalasia [Takahara]

E80.4   Gilbert syndrome

E80.5   Crigler-Najjar syndrome

E80.6   Other disorders of bilirubin metabolism

Dubin-Johnson syndrome

Rotor syndrome

E80.7   Disorder of bilirubin metabolism, unspecified

E83   Disorders of mineral metabolism

Excludes:    dietary mineral deficiency (E58-E61)

parathyroid disorders (E20-E21)

vitamin D deficiency (E55-)

E83.0   Disorders of copper metabolism

Menkes (kinky hair)(steely hair) disease

Wilson disease

E83.1   Disorders of iron metabolism

Haemochromatosis

Excludes:    anaemia:

• iron deficiency (D50-)

• sideroblastic (D64.0-D64.3)

E83.2   Disorders of zinc metabolism

Acrodermatitis enteropathica

E83.3   Disorders of phosphorus metabolism and phosphatases

Acid phosphatase deficiency

Familial hypophosphataemia

Hypophosphatasia

Vitamin-D-resistant:

• osteomalacia

• rickets

Excludes:    adult osteomalacia (M83-)

osteoporosis (M80-M81)

E83.4   Disorders of magnesium metabolism

Hypermagnesaemia

Hypomagnesaemia

E83.5   Disorders of calcium metabolism

Familial hypocalciuric hypercalcaemia

Idiopathic hypercalciuria

Excludes:    chondrocalcinosis (M11.1-M11.2)

hyperparathyroidism (E21.0-E21.3)

E83.8   Other disorders of mineral metabolism

E83.9   Disorder of mineral metabolism, unspecified

E84   Cystic fibrosis

Includes:    mucoviscidosis

E84.0   Cystic fibrosis with pulmonary manifestations

E84.1   Cystic fibrosis with intestinal manifestations

Distal intestinal obstruction syndrome

Meconium ileus (P75*)

Excludes:    meconium obstruction in cases where cystic fibrosis is known not to be present (P76.0)

E84.8   Cystic fibrosis with other manifestations

Cystic fibrosis with combined manifestations

E84.9   Cystic fibrosis, unspecified

E85   Amyloidosis

Excludes:    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

E86   Volume depletion

Dehydration

Depletion of volume of plasma or extracellular fluid

Hypovolaemia

Excludes:    dehydration of newborn (P74.1)

hypovolaemic shock:

• NOS (R57.1)

• postoperative (T81.1)

• traumatic (T79.4)

E87   Other disorders of fluid, electrolyte and acid-base balance

E87.0   Hyperosmolality and hypernatraemia

Sodium [Na] excess

Sodium [Na] overload

E87.1   Hypo-osmolality and hyponatraemia

Sodium [Na] deficiency

Excludes:    Syndrome of inappropriate secretion of antidiuretic hormone (E22.2)

E87.2   Acidosis

Acidosis:

• NOS

• lactic

• metabolic

• respiratory

Excludes:    diabetic acidosis (E10-E14 with common fourth character .1)

E87.3   Alkalosis

Alkalosis:

• NOS

• metabolic

• respiratory

E87.4   Mixed disorder of acid-base balance

E87.5   Hyperkalaemia

Potassium [K] excess

Potassium [K] overload

E87.6   Hypokalaemia

Potassium [K] deficiency

E87.7   Fluid overload

Excludes:    oedema (R60-)

E87.8   Other disorders of electrolyte and fluid balance, not elsewhere classified

Electrolyte imbalance NOS

Hyperchloraemia

Hypochloraemia

E88   Other metabolic disorders

Excludes:    histiocytosis X (chronic) (D76.0)

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

E88.0   Disorders of plasma-protein metabolism, not elsewhere classified

α-1-Antitrypsin deficiency

Alpha-1 antitrypsin deficiency

Bisalbuminaemia

Excludes:    disorder of lipoprotein metabolism (E78-)

monoclonal gammopathy (D47.2)

polyclonal hypergammaglobulinaemia (D89.0)

Waldenstrom macroglobulinaemia (C88.0)

E88.1   Lipodystrophy, not elsewhere classified

Lipodystrophy NOS

Excludes:    Whipple disease (K90.8)

E88.2   Lipomatosis, not elsewhere classified

Lipomatosis:

• NOS

• dolorosa [Dercum]

E88.3   Tumour lysis syndrome

Tumour lysis (following antineoplastic drug therapy) (spontaneous)

E88.8   Other specified metabolic disorders

Launois-Bensaude adenolipomatosis

Trimethylaminuria

E88.9   Metabolic disorder, unspecified

E89   Postprocedural endocrine and metabolic disorders, not elsewhere classified

E89.0   Postprocedural hypothyroidism

Postirradiation hypothyroidism

Postsurgical hypothyroidism

E89.1   Postprocedural hypoinsulinaemia

Postpancreatectomy hyperglycaemia

Postsurgical hypoinsulinaemia

E89.2   Postprocedural hypoparathyroidism

Parathyroprival tetany

E89.3   Postprocedural hypopituitarism

Postirradiation hypopituitarism

E89.4   Postprocedural ovarian failure

E89.5   Postprocedural testicular hypofunction

E89.6   Postprocedural adrenocortical(-medullary) hypofunction

E89.8   Other postprocedural endocrine and metabolic disorders

E89.9   Postprocedural endocrine and metabolic disorder, unspecified

E90   Nutritional and metabolic disorders in diseases classified elsewhere

CHAPTER V - Mental and behavioural disorders (F00-F99)

Includes:    disorders of psychological development

Excludes:    symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)

This chapter contains the following blocks:

F00-F09        Organic, including symptomatic, mental disorders

F10-F19        Mental and behavioural disorders due to psychoactive substance use

F20-F29        Schizophrenia, schizotypal and delusional disorders

F30-F39        Mood [affective] disorders

F40-F48        Neurotic, stress-related and somatoform disorders

F50-F59        Behavioural syndromes associated with physiological disturbances and 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

Asterisk categories for this chapter are provided as follows:

F00*            Dementia in Alzheimer disease

F02*            Dementia in other diseases classified elsewhere

Organic, including symptomatic, mental disorders (F00-F09)

This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved.

Dementia (F00-F03) is a syndrome due to disease of the brain, usually of a chronic or progressive nature, in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not clouded. The impairments of cognitive function are commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation. This syndrome occurs in Alzheimer disease, in cerebrovascular disease, and in other conditions primarily or secondarily affecting the brain.

Use additional code, if desired, to identify the underlying disease.

F00   Dementia in Alzheimer disease (G30.-†)

Alzheimer disease is a primary degenerative cerebral disease of unknown etiology with characteristic neuropathological and neurochemical features. The disorder is usually insidious in onset and develops slowly but steadily over a period of several years.

F00.0* Dementia in Alzheimer disease with early onset (G30.0†)

Dementia in Alzheimer disease with onset before the age of 65, with a relatively rapid deteriorating course and with marked multiple disorders of the higher cortical functions.

Alzheimer disease, type 2

Presenile dementia, Alzheimer type

Primary degenerative dementia of the Alzheimer type, presenile onset

F00.1* Dementia in Alzheimer disease with late onset (G30.1†)

Dementia in Alzheimer disease with onset after the age of 65, usually in the late 70s or thereafter, with a slow progression, and with memory impairment as the principal feature.

Alzheimer disease, type 1

Primary degenerative dementia of the Alzheimer type, senile onset

Senile dementia, Alzheimer type

F00.2* Dementia in Alzheimer disease, atypical or mixed type (G30.8†)

Atypical dementia, Alzheimer type

F00.9* Dementia in Alzheimer disease, unspecified (G30.9†)

F01   Vascular dementia

Vascular dementia is the result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease. The infarcts are usually small but cumulative in their effect. Onset is usually in later life.

Includes:    arteriosclerotic dementia

F01.0   Vascular dementia of acute onset

Usually develops rapidly after a succession of strokes from cerebrovascular thrombosis, embolism or haemorrhage. In rare cases, a single large infarction may be the cause.

F01.1   Multi-infarct dementia

Gradual in onset, following a number of transient ischaemic episodes which produce an accumulation of infarcts in the cerebral parenchyma.

Predominantly cortical dementia

F01.2   Subcortical vascular dementia

Includes cases with a history of hypertension and foci of ischaemic destruction in the deep white matter of the cerebral hemispheres. The cerebral cortex is usually preserved and this contrasts with the clinical picture which may closely resemble that of dementia in Alzheimer disease.

F01.3   Mixed cortical and subcortical vascular dementia

F01.8   Other vascular dementia

F01.9   Vascular dementia, unspecified

F02   Dementia in other diseases classified elsewhere

Cases of dementia due, or presumed to be due, to causes other than Alzheimer disease or cerebrovascular disease. Onset may be at any time in life, though rarely in old age.

F02.0* Dementia in Pick disease (G31.0†)

A progressive dementia, commencing in middle age, characterized by early, slowly progressing changes of character and social deterioration, followed by impairment of intellect, memory, and language functions, with apathy, euphoria and, occasionally, extrapyramidal phenomena.

F02.1* Dementia in Creutzfeldt-Jakob disease (A81.0†)

A progressive dementia with extensive neurological signs, due to specific neuropathological changes that are presumed to be caused by a transmissible agent. Onset is usually in middle or later life, but may be at any adult age. The course is subacute, leading to death within one to two years.

F02.2* Dementia in Huntington disease (G10†)

A dementia occurring as part of a widespread degeneration of the brain. The disorder is transmitted by a single autosomal dominant gene. Symptoms typically emerge in the third and fourth decade. Progression is slow, leading to death usually within 10 to 15 years.

Dementia in Huntington chorea

F02.3* Dementia in Parkinson disease (G20†)

A dementia developing in the course of established Parkinson disease. No particular distinguishing clinical features have yet been demonstrated.

Dementia in:

• paralysis agitans

• parkinsonism

F02.4* Dementia in human immunodeficiency virus [HIV] disease (B22.0†)

Dementia developing in the course of HIV disease, in the absence of a concurrent illness or condition other than HIV infection that could explain the clinical features.

F02.8* Dementia in other specified diseases classified elsewhere

Dementia (in):

• cerebral lipidosis (E75†)

• epilepsy (G40†)

• hepatolenticular degeneration (E83.0†)

• hypercalcaemia (E83.5†)

• hypothyroidism, acquired (E01†, E03†)

• intoxications (T36-T65†)

• Lewy body(ies)(disease) (G31.8†)

• multiple sclerosis (G35†)

• neurosyphilis (A52.1†)

• niacin deficiency [pellagra] (E52†)

• polyarteritis nodosa (M30.0†)

• systemic lupus erythematosus (M32†)

• trypanosomiasis (B56†, B57†)

• uraemia (N18.5†)

• vitamin B₁₂ deficiency (E53.8†)

F03   Unspecified dementia

Includes:    Presenile:

• dementia NOS

• psychosis NOS

Senile:

• dementia:

• NOS

• depressed or paranoid type

• psychosis NOS

Excludes:    senile dementia with delirium or acute confusional state (F05.1)

senility NOS (R54)

F04   Organic amnesic syndrome, not induced by alcohol and other psychoactive substances

A syndrome of prominent impairment of recent and remote memory while immediate recall is preserved, with reduced ability to learn new material and disorientation in time. Confabulation may be a marked feature, but perception and other cognitive functions, including the intellect, are usually intact. The prognosis depends on the course of the underlying lesion.

Korsakov psychosis or syndrome, nonalcoholic

Excludes:    amnesia:

• NOS (R41.3)

• anterograde (R41.1)

• dissociative (F44.0)

• retrograde (R41.2)

Korsakov syndrome:

• alcohol-induced or unspecified (F10.6)

• induced by other psychoactive substances (F11-F19 with common fourth character .6)

F05   Delirium, not induced by alcohol and other psychoactive substances

An etiologically nonspecific organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion, and the sleep-wake schedule. The duration is variable and the degree of severity ranges from mild to very severe.

Includes:    acute or subacute:

• brain syndrome

• confusional state (nonalcoholic)

• infective psychosis

• organic reaction

• psycho-organic syndrome

Excludes:    delirium tremens, alcohol-induced or unspecified (F10.4)

F05.0   Delirium not superimposed on dementia, so described

F05.1   Delirium superimposed on dementia

Conditions meeting the above criteria but developing in the course of a dementia (F00-F03)

F05.8   Other delirium

Delirium of mixed origin

F05.9   Delirium, unspecified

F06   Other mental disorders due to brain damage and dysfunction and to physical disease

Includes miscellaneous conditions causally related to brain disorder due to primary cerebral disease, to systemic disease affecting the brain secondarily, to exogenous toxic substances or hormones, to endocrine disorders, or to other somatic illnesses.

Excludes:    associated with:

• delirium (F05-)

• dementia as classified in F00-F03

resulting from use of alcohol and other psychoactive substances (F10-F19)

F06.0   Organic hallucinosis

A disorder of persistent or recurrent hallucinations, usually visual or auditory, that occur in clear consciousness and may or may not be recognized by the subject as such. Delusional elaboration of the hallucinations may occur, but delusions do not dominate the clinical picture; insight may be preserved.

Organic hallucinatory state (nonalcoholic)

Excludes:    alcoholic hallucinosis (F10.5)

schizophrenia (F20-)

F06.1   Organic catatonic disorder

A disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms. The extremes of psychomotor disturbance may alternate.

Excludes:    catatonic schizophrenia (F20.2)

stupor:

• NOS (R40.1)

• dissociative (F44.2)

F06.2   Organic delusional [schizophrenia-like] disorder

A disorder in which persistent or recurrent delusions dominate the clinical picture. The delusions may be accompanied by hallucinations. Some features suggestive of schizophrenia, such as bizarre hallucinations or thought disorder, may be present.

Paranoid and paranoid-hallucinatory organic states

Schizophrenia-like psychosis in epilepsy

Excludes:    disorder:

• acute and transient psychotic (F23-)

• persistent delusional (F22-)

• psychotic drug-induced (F11-F19 with common fourth character .5) schizophrenia (F20-)

F06.3   Organic mood [affective] disorders

Disorders characterized by a change in mood or affect, usually accompanied by a change in the overall level of activity, depressive, hypomanic, manic or bipolar (see F30-F38), but arising as a consequence of an organic disorder.

Excludes:    mood disorders, nonorganic or unspecified (F30-F39)

F06.4   Organic anxiety disorder

A disorder characterized by the essential descriptive features of a generalized anxiety disorder (F41.1), a panic disorder (F41.0), or a combination of both, but arising as a consequence of an organic disorder.

Excludes:    anxiety disorders, nonorganic or unspecified (F41-)

F06.5   Organic dissociative disorder

A disorder characterized by a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements (see F44-), but arising as a consequence of an organic disorder.

Excludes:    dissociative [conversion] disorders, nonorganic or unspecified (F44-)

F06.6   Organic emotionally labile [asthenic] disorder

A disorder characterized by emotional incontinence or lability, fatigability, and a variety of unpleasant physical sensations (e.g. dizziness) and pains, but arising as a consequence of an organic disorder.

Excludes:    somatoform disorders, nonorganic or unspecified (F45-)

F06.7   Mild cognitive disorder

A disorder characterized by impairment of memory, learning difficulties, and reduced ability to concentrate on a task for more than brief periods. There is often a marked feeling of mental fatigue when mental tasks are attempted, and new learning is found to be subjectively difficult even when objectively successful. None of these symptoms is so severe that a diagnosis of either dementia (F00-F03) or delirium (F05-) can be made. This diagnosis should be made only in association with a specified physical disorder, and should not be made in the presence of any of the mental or behavioural disorders classified to F10-F99. The disorder may precede, accompany, or follow a wide variety of infections and physical disorders, both cerebral and systemic, but direct evidence of cerebral involvement is not necessarily present. It can be differentiated from postencephalitic syndrome (F07.1) and postconcussional syndrome (F07.2) by its different etiology, more restricted range of generally milder symptoms, and usually shorter duration.

F06.8   Other specified mental disorders due to brain damage and dysfunction and to physical disease

Epileptic psychosis NOS

F06.9   Unspecified mental disorder due to brain damage and dysfunction and to physical disease

Organic:

• brain syndrome NOS

• mental disorder NOS

F07   Personality and behavioural disorders due to brain disease, damage and dysfunction

Alteration of personality and behaviour can be a residual or concomitant disorder of brain disease, damage or dysfunction.

F07.0   Organic personality disorder

A disorder characterized by a significant alteration of the habitual patterns of behaviour displayed by the subject premorbidly, involving the expression of emotions, needs and impulses. Impairment of cognitive and thought functions, and altered sexuality may also be part of the clinical picture.

Organic:

• pseudopsychopathic personality

• pseudoretarded personality

Syndrome:

• frontal lobe

• limbic epilepsy personality

• lobotomy

• postleucotomy

Excludes:    enduring personality change after:

• catastrophic experience (F62.0)

• psychiatric illness (F62.1)

postconcussional syndrome (F07.2)

postencephalitic syndrome (F07.1)

specific personality disorder (F60-)

F07.1   Postencephalitic syndrome

Residual nonspecific and variable behavioural change following recovery from either viral or bacterial encephalitis. The principal difference between this disorder and the organic personality disorders is that it is reversible.

Excludes:    organic personality disorder (F07.0)

F07.2   Postconcussional syndrome

A syndrome that occurs following head trauma (usually sufficiently severe to result in loss of consciousness) and includes a number of disparate symptoms such as headache, dizziness, fatigue, irritability, difficulty in concentration and performing mental tasks, impairment of memory, insomnia, and reduced tolerance to stress, emotional excitement, or alcohol.

Postcontusional syndrome (encephalopathy)

Post-traumatic brain syndrome, nonpsychotic

Excludes:    current concussion, brain (S06.0)

F07.8   Other organic personality and behavioural disorders due to brain disease, damage and dysfunction

Right hemispheric organic affective disorder

F07.9   Unspecified organic personality and behavioural disorder due to brain disease, damage and dysfunction

Organic psychosyndrome

F09   Unspecified organic or symptomatic mental disorder

Psychosis:

• organic NOS

• symptomatic NOS

Excludes:    psychosis NOS (F29)

Mental and behavioural disorders due to psychoactive substance use (F10-F19)

This block contains a wide variety of disorders that differ in severity and clinical form but that are all attributable to the use of one or more psychoactive substances, which may or may not have been medically prescribed. The third character of the code identifies the substance involved, and the fourth character specifies the clinical state. The codes should be used, as required, for each substance specified, but it should be noted that not all fourth-character codes are applicable to all substances.

Identification of the psychoactive substance should be based on as many sources of information as possible. These include self-report data, analysis of blood and other body fluids, characteristic physical and psychological symptoms, clinical signs and behaviour, and other evidence such as a drug being in the patient's possession or reports from informed third parties. Many drug users take more than one type of psychoactive substance. The main diagnosis should be classified, whenever possible, according to the substance or class of substances that has caused or contributed most to the presenting clinical syndrome. Other diagnoses should be coded when other psychoactive substances have been taken in intoxicating amounts (common fourth character .0) or to the extent of causing harm (common fourth character .1), dependence (common fourth character .2) or other disorders (common fourth character .3-.9).

Only in cases in which patterns of psychoactive substance-taking are chaotic and indiscriminate, or in which the contributions of different psychoactive substances are inextricably mixed, should the diagnosis of disorders resulting from multiple drug use (F19-) be used.

Excludes:    abuse of non-dependence-producing substances (F55)

The following fourth-character subdivisions are for use with categories F10-F19:

.0       Acute intoxication

A condition that follows the administration of a psychoactive substance resulting in disturbances in level of consciousness, cognition, perception, affect or behaviour, or other psycho-physiological functions and responses. The disturbances are directly related to the acute pharmacological effects of the substance and resolve with time, with complete recovery, except where tissue damage or other complications have arisen. Complications may include trauma, inhalation of vomitus, delirium, coma, convulsions, and other medical complications. The nature of these complications depends on the pharmacological class of substance and mode of administration.

"Bad trips" (drugs)

Trance and possession disorders in psychoactive substance intoxication

Excludes:    intoxication meaning poisoning (T36-T50)

.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).

Abuse

Acute drunkenness (in alcoholism)

Chronic use

Drunkenness NOS

DUI

Excess, excessive

Hangover

Heavy intake

Inebriated

Influence of (alcohol)

Intemperence

Misuse

Over indulgence

Problem

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.

Absinthemia

Absinthism

Addiction

Alcoholism

Chronic alcoholism

Chronic drunkenness

Continual excessive drinking

Dependence

Dipsomania

Drug addiction

Habit

Narcotism

Smokers syndrome

Tobaccoism

.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

Excludes:    alcohol- or other psychoactive substance-induced residual and late-onset psychotic disorder (F10-F19 with common fourth character .7)

.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

Excludes:    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

Excludes:    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

Consumption

Drinking NOS

Ingested, Ingestion

Intake

Smoking (chain)(former)(life long)(packs per day)

Use, user, usage

F10.- Mental and behavioural disorders due to use of alcohol

[See before F10 for subdivisions]

F11.- Mental and behavioural disorders due to use of opioids

[See before F10 for subdivisions]

F12.- Mental and behavioural disorders due to use of cannabinoids

[See before F10 for subdivisions]

F13.- Mental and behavioural disorders due to use of sedatives or hypnotics

[See before F10 for subdivisions]

F14.- Mental and behavioural disorders due to use of cocaine

[See before F10 for subdivisions]

F15.- Mental and behavioural disorders due to use of other stimulants, including caffeine

[See before F10 for subdivisions]

F16.- Mental and behavioural disorders due to use of hallucinogens

[See before F10 for subdivisions]

F17.- Mental and behavioural disorders due to use of tobacco

[See before F10 for subdivisions]

F18.- Mental and behavioural disorders due to use of volatile solvents

[See before F10 for subdivisions]

F19.- Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances

[See before F10 for subdivisions]

This category should be used when two or more psychoactive substances are known to be involved, but it is impossible to assess which substance is contributing most to the disorders. It should also be used when the exact identity of some or even all the psychoactive substances being used is uncertain or unknown, since many multiple drug users themselves often do not know the details of what they are taking.

Includes:    misuse of drugs NOS

Schizophrenia, schizotypal and delusional disorders (F20-F29)

This block brings together schizophrenia, as the most important member of the group, schizotypal disorder, persistent delusional disorders, and a larger group of acute and transient psychotic disorders. Schizoaffective disorders have been retained here in spite of their controversial nature.

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.

Excludes:    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

Excludes:    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

F20.2   Catatonic schizophrenia

Catatonic schizophrenia is dominated by prominent psychomotor disturbances that may alternate between extremes such as hyperkinesis and stupor, or automatic obedience and negativism. Constrained attitudes and postures may be maintained for long periods. Episodes of violent excitement may be a striking feature of the condition. The catatonic phenomena may be combined with a dream-like (oneiroid) state with vivid scenic hallucinations.

Catatonic stupor

Schizophrenic:

• catalepsy

• catatonia

• flexibilitas cerea

F20.3   Undifferentiated schizophrenia

Psychotic conditions meeting the general diagnostic criteria for schizophrenia but not conforming to any of the subtypes in F20.0-F20.2, or exhibiting the features of more than one of them without a clear predominance of a particular set of diagnostic characteristics.

Atypical schizophrenia

Excludes:    acute schizophrenia-like psychotic disorder (F23.2)

chronic undifferentiated schizophrenia (F20.5)

post-schizophrenic depression (F20.4)

F20.4   Post-schizophrenic depression

A depressive episode, which may be prolonged, arising in the aftermath of a schizophrenic illness. Some schizophrenic symptoms, either "positive" or "negative", must still be present but they no longer dominate the clinical picture. These depressive states are associated with an increased risk of suicide. If the patient no longer has any schizophrenic symptoms, a depressive episode should be diagnosed (F32-). If schizophrenic symptoms are still florid and prominent, the diagnosis should remain that of the appropriate schizophrenic subtype (F20.0-F20.3).

F20.5   Residual schizophrenia

A chronic stage in the development of a schizophrenic illness in which there has been a clear progression from an early stage to a later stage characterized by long-term, though not necessarily irreversible, "negative" symptoms, e.g. psychomotor slowing; underactivity; blunting of affect; passivity and lack of initiative; poverty of quantity or content of speech; poor nonverbal communication by facial expression, eye contact, voice modulation and posture; poor self-care and social performance.

Chronic undifferentiated schizophrenia

Restzustand (schizophrenic)

Schizophrenic residual state

F20.6   Simple schizophrenia

A disorder in which there is an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance. The characteristic negative features of residual schizophrenia (e.g. blunting of affect and loss of volition) develop without being preceded by any overt psychotic symptoms.

F20.8   Other schizophrenia

Cenesthopathic schizophrenia

Schizophreniform:

• disorder NOS

• psychosis NOS

Excludes:    brief schizophreniform disorders (F23.2)

F20.9   Schizophrenia, unspecified

F21   Schizotypal disorder

A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, though no definite and characteristic schizophrenic anomalies occur at any stage. The symptoms may include a cold or inappropriate affect; anhedonia; odd or eccentric behaviour; a tendency to social withdrawal; paranoid or bizarre ideas not amounting to true delusions; obsessive ruminations; thought disorder and perceptual disturbances; occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations, and delusion-like ideas, usually occurring without external provocation. There is no definite onset and evolution and course are usually those of a personality disorder.

Latent schizophrenic reaction

Schizophrenia:

• borderline

• latent

• prepsychotic

• prodromal

• pseudoneurotic

• pseudopsychopathic

Schizotypal personality disorder

Excludes:    Asperger syndrome (F84.5)

schizoid personality disorder (F60.1)

F22   Persistent delusional disorders

Includes a variety of disorders in which long-standing delusions constitute the only, or the most conspicuous, clinical characteristic and which cannot be classified as organic, schizophrenic or affective. Delusional disorders that have lasted for less than a few months should be classified, at least temporarily, under F23-.

F22.0   Delusional disorder

A disorder characterized by the development either of a single delusion or of a set of related delusions that are usually persistent and sometimes lifelong. The content of the delusion or delusions is very variable. Clear and persistent auditory hallucinations (voices), schizophrenic symptoms such as delusions of control and marked blunting of affect, and definite evidence of brain disease are all incompatible with this diagnosis. However, the presence of occasional or transitory auditory hallucinations, particularly in elderly patients, does not rule out this diagnosis, provided that they are not typically schizophrenic and form only a small part of the overall clinical picture.

Paranoia

Paranoid:

• psychosis

• state

Paraphrenia (late)

Sensitiver Beziehungswahn

Excludes:    paranoid:

• personality disorder (F60.0)

• psychosis, psychogenic (F23.3)

• reaction (F23.3)

• schizophrenia (F20.0)

F22.8   Other persistent delusional disorders

Disorders in which the delusion or delusions are accompanied by persistent hallucinatory voices or by schizophrenic symptoms that do not justify a diagnosis of schizophrenia (F20-).

Delusional dysmorphophobia

Involutional paranoid state

Paranoia querulans

F22.9   Persistent delusional disorder, unspecified

F23   Acute and transient psychotic disorders

A heterogeneous group of disorders characterized by the acute onset of psychotic symptoms such as delusions, hallucinations, and perceptual disturbances, and by the severe disruption of ordinary behaviour. Acute onset is defined as a crescendo development of a clearly abnormal clinical picture in about two weeks or less. For these disorders there is no evidence of organic causation. Perplexity and puzzlement are often present but disorientation for time, place and person is not persistent or severe enough to justify a diagnosis of organically caused delirium (F05-). Complete recovery usually occurs within a few months, often within a few weeks or even days. If the disorder persists, a change in classification will be necessary. The disorder may or may not be associated with acute stress, defined as usually stressful events preceding the onset by one to two weeks.

F23.0   Acute polymorphic psychotic disorder without symptoms of schizophrenia

An acute psychotic disorder in which hallucinations, delusions or perceptual disturbances are obvious but markedly variable, changing from day to day or even from hour to hour. Emotional turmoil with intense transient feelings of happiness or ecstasy, or anxiety and irritability, is also frequently present. The polymorphism and instability are characteristic for the overall clinical picture and the psychotic features do not justify a diagnosis of schizophrenia (F20-). These disorders often have an abrupt onset, developing rapidly within a few days, and they frequently show a rapid resolution of symptoms with no recurrence. If the symptoms persist the diagnosis should be changed to persistent delusional disorder (F22-).

Bouffee delirante without symptoms of schizophrenia or unspecified

Cycloid psychosis without symptoms of schizophrenia or unspecified

F23.1   Acute polymorphic psychotic disorder with symptoms of schizophrenia

An acute psychotic disorder in which the polymorphic and unstable clinical picture is present, as described in F23.0; despite this instability, however, some symptoms typical of schizophrenia are also in evidence for the majority of the time. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20-).

Bouffee delirante with symptoms of schizophrenia

Cycloid psychosis with symptoms of schizophrenia

F23.2   Acute schizophrenia-like psychotic disorder

An acute psychotic disorder in which the psychotic symptoms are comparatively stable and justify a diagnosis of schizophrenia, but have lasted for less than about one month; the polymorphic unstable features, as described in F23.0, are absent. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20-).

Acute (undifferentiated) schizophrenia

Brief schizophreniform:

• disorder

• psychosis

Oneirophrenia

Schizophrenic reaction

Excludes:    organic delusional [schizophrenia-like] disorder (F06.2)

schizophreniform disorders NOS (F20.8)

F23.3   Other acute predominantly delusional psychotic disorders

Acute psychotic disorders in which comparatively stable delusions or hallucinations are the main clinical features, but do not justify a diagnosis of schizophrenia (F20-). If the delusions persist the diagnosis should be changed to persistent delusional disorder (F22-).

Paranoid reaction

Psychogenic paranoid psychosis

F23.8   Other acute and transient psychotic disorders

Any other specified acute psychotic disorders for which there is no evidence of organic causation and which do not justify classification to F23.0-F23.3.

F23.9   Acute and transient psychotic disorder, unspecified

Brief reactive psychosis NOS

Reactive psychosis

F24   Induced delusional disorder

A delusional disorder shared by two or more people with close emotional links. Only one of the people suffers from a genuine psychotic disorder; the delusions are induced in the other(s) and usually disappear when the people are separated.

Folie a deux

Induced:

• paranoid disorder

• psychotic disorder

F25   Schizoaffective disorders

Episodic disorders in which both affective and schizophrenic symptoms are prominent but which do not justify a diagnosis of either schizophrenia or depressive or manic episodes. Other conditions in which affective symptoms are superimposed on a pre-existing schizophrenic illness, or co-exist or alternate with persistent delusional disorders of other kinds, are classified under F20-F29. Mood-incongruent psychotic symptoms in affective disorders do not justify a diagnosis of schizoaffective disorder.

F25.0   Schizoaffective disorder, manic type

A disorder in which both schizophrenic and manic symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a manic episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, manic type.

Schizoaffective psychosis, manic type

Schizophreniform psychosis, manic type

F25.1   Schizoaffective disorder, depressive type

A disorder in which both schizophrenic and depressive symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a depressive episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, depressive type.

Schizoaffective psychosis, depressive type

Schizophreniform psychosis, depressive type

F25.2   Schizoaffective disorder, mixed type

Cyclic schizophrenia

Mixed schizophrenic and affective psychosis

F25.8   Other schizoaffective disorders

F25.9   Schizoaffective disorder, unspecified

Schizoaffective psychosis NOS

F28   Other nonorganic psychotic disorders

Delusional or hallucinatory disorders that do not justify a diagnosis of schizophrenia (F20-), persistent delusional disorders (F22-), acute and transient psychotic disorders (F23-), psychotic types of manic episode (F30.2), or severe depressive episode (F32.3).

Chronic hallucinatory psychosis

F29   Unspecified nonorganic psychosis

Psychosis NOS

Excludes:    mental disorder NOS (F99)

organic or symptomatic psychosis NOS (F09)

Mood [affective] disorders (F30-F39)

This block contains disorders in which the fundamental disturbance is a change in affect or mood to depression (with or without associated anxiety) or to elation. The mood change is usually accompanied by a change in the overall level of activity; most of the other symptoms are either secondary to, or easily understood in the context of, the change in mood and activity. Most of these disorders tend to be recurrent and the onset of individual episodes can often be related to stressful events or situations.

F30   Manic episode

All the subdivisions of this category should be used only for a single episode. Hypomanic or manic episodes in individuals who have had one or more previous affective episodes (depressive, hypomanic, manic, or mixed) should be coded as bipolar affective disorder (F31-).

Includes:    bipolar disorder, single manic episode

F30.0   Hypomania

A disorder characterized by a persistent mild elevation of mood, increased energy and activity, and usually marked feelings of well-being and both physical and mental efficiency. Increased sociability, talkativeness, over-familiarity, increased sexual energy, and a decreased need for sleep are often present but not to the extent that they lead to severe disruption of work or result in social rejection. Irritability, conceit, and boorish behaviour may take the place of the more usual euphoric sociability. The disturbances of mood and behaviour are not accompanied by hallucinations or delusions.

F30.1   Mania without psychotic symptoms

Mood is elevated out of keeping with the patient's circumstances and may vary from carefree joviality to almost uncontrollable excitement. Elation is accompanied by increased energy, resulting in overactivity, pressure of speech, and a decreased need for sleep. Attention cannot be sustained, and there is often marked distractibility. Self-esteem is often inflated with grandiose ideas and overconfidence. Loss of normal social inhibitions may result in behaviour that is reckless, foolhardy, or inappropriate to the circumstances, and out of character.

F30.2   Mania with psychotic symptoms

In addition to the clinical picture described in F30.1, delusions (usually grandiose) or hallucinations (usually of voices speaking directly to the patient) are present, or the excitement, excessive motor activity, and flight of ideas are so extreme that the subject is incomprehensible or inaccessible to ordinary communication.

Mania with:

• mood-congruent psychotic symptoms

• mood-incongruent psychotic symptoms

Manic stupor

F30.8   Other manic episodes

F30.9   Manic episode, unspecified

Mania NOS

F31   Bipolar affective disorder

A disorder characterized by two or more episodes in which the patient's mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). Repeated episodes of hypomania or mania only are classified as bipolar.

Includes:    manic depression

manic-depressive:

• illness

• psychosis

• reaction

Excludes:    bipolar disorder, single manic episode (F30-)

cyclothymia (F34.0)

F31.0   Bipolar affective disorder, current episode hypomanic

The patient is currently hypomanic, and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past.

F31.1   Bipolar affective disorder, current episode manic without psychotic symptoms

The patient is currently manic, without psychotic symptoms (as in F30.1), and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past.

F31.2   Bipolar affective disorder, current episode manic with psychotic symptoms

The patient is currently manic, with psychotic symptoms (as in F30.2), and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past.

F31.3   Bipolar affective disorder, current episode mild or moderate depression

The patient is currently depressed, as in a depressive episode of either mild or moderate severity (F32.0 or F32.1), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past.

F31.4   Bipolar affective disorder, current episode severe depression without psychotic symptoms

The patient is currently depressed, as in severe depressive episode without psychotic symptoms (F32.2), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past.

F31.5   Bipolar affective disorder, current episode severe depression with psychotic symptoms

The patient is currently depressed, as in severe depressive episode with psychotic symptoms (F32.3), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past.

F31.6   Bipolar affective disorder, current episode mixed

The patient has had at least one authenticated hypomanic, manic, depressive, or mixed affective episode in the past, and currently exhibits either a mixture or a rapid alteration of manic and depressive symptoms.

Excludes:    single mixed affective episode (F38.0)

F31.7   Bipolar affective disorder, currently in remission

The patient has had at least one authenticated hypomanic, manic, or mixed affective episode in the past, and at least one other affective episode (hypomanic, manic, depressive, or mixed) in addition, but is not currently suffering from any significant mood disturbance, and has not done so for several months. Periods of remission during prophylactic treatment should be coded here.

F31.8   Other bipolar affective disorders

Bipolar II disorder

Recurrent manic episodes NOS

F31.9   Bipolar affective disorder, unspecified

Manic depression NOS

F32   Depressive episode

In typical mild, moderate, or severe depressive episodes, the patient suffers from lowering of mood, reduction of energy, and decrease in activity. Capacity for enjoyment, interest, and concentration is reduced, and marked tiredness after even minimum effort is common. Sleep is usually disturbed and appetite diminished. Self-esteem and self-confidence are almost always reduced and, even in the mild form, some ideas of guilt or worthlessness are often present. The lowered mood varies little from day to day, is unresponsive to circumstances and may be accompanied by so-called "somatic" symptoms, such as loss of interest and pleasurable feelings, waking in the morning several hours before the usual time, depression worst in the morning, marked psychomotor retardation, agitation, loss of appetite, weight loss, and loss of libido. Depending upon the number and severity of the symptoms, a depressive episode may be specified as mild, moderate or severe.

Includes:    single episodes of:

• depressive reaction

• psychogenic depression

• reactive depression

Excludes:    adjustment disorder (F43.2)

recurrent depressive disorder (F33-)

when associated with conduct disorders in F91- (F92.0)

F32.0   Mild depressive episode

Two or three of the above symptoms are usually present. The patient is usually distressed by these but will probably be able to continue with most activities.

F32.1   Moderate depressive episode

Four or more of the above symptoms are usually present and the patient is likely to have great difficulty in continuing with ordinary activities.

F32.2   Severe depressive episode without psychotic symptoms

An episode of depression in which several of the above symptoms are marked and distressing, typically loss of self-esteem and ideas of worthlessness or guilt. Suicidal thoughts and acts are common and a number of "somatic" symptoms are usually present.

     Agitated depression   

     Major depression         single episode without psychotic

     Vital depression          symptoms

F32.3   Severe depressive episode with psychotic symptoms

An episode of depression as described in F32.2, but with the presence of hallucinations, delusions, psychomotor retardation, or stupor so severe that ordinary social activities are impossible; there may be danger to life from suicide, dehydration, or starvation. The hallucinations and delusions may or may not be mood-congruent.

Single episodes of:

• major depression with psychotic symptoms

• psychogenic depressive psychosis

• psychotic depression

• reactive depressive psychosis

F32.8   Other depressive episodes

Atypical depression

Single episodes of "masked" depression NOS

F32.9   Depressive episode, unspecified

Depression NOS

Depressive disorder NOS

F33   Recurrent depressive disorder

A disorder characterized by repeated episodes of depression as described for depressive episode (F32-), without any history of independent episodes of mood elevation and increased energy (mania). There may, however, be brief episodes of mild mood elevation and overactivity (hypomania) immediately after a depressive episode, sometimes precipitated by antidepressant treatment. The more severe forms of recurrent depressive disorder (F33.2 and F33.3) have much in common with earlier concepts such as manic-depressive depression, melancholia, vital depression and endogenous depression. The first episode may occur at any age from childhood to old age, the onset may be either acute or insidious, and the duration varies from a few weeks to many months. The risk that a patient with recurrent depressive disorder will have an episode of mania never disappears completely, however many depressive episodes have been experienced. If such an episode does occur, the diagnosis should be changed to bipolar affective disorder (F31-).

Includes:    recurrent episodes of:

• depressive reaction

• psychogenic depression

• reactive depression

seasonal depressive disorder

Excludes:    recurrent brief depressive episodes (F38.1)

F33.0   Recurrent depressive disorder, current episode mild

A disorder characterized by repeated episodes of depression, the current episode being mild, as in F32.0, and without any history of mania.

F33.1   Recurrent depressive disorder, current episode moderate

A disorder characterized by repeated episodes of depression, the current episode being of moderate severity, as in F32.1, and without any history of mania.

F33.2   Recurrent depressive disorder, current episode severe without psychotic symptoms

A disorder characterized by repeated episodes of depression, the current episode being severe without psychotic symptoms, as in F32.2, and without any history of mania.

Endogenous depression without psychotic symptoms

Major depression, recurrent without psychotic symptoms

Manic-depressive psychosis, depressed type without psychotic symptoms

Vital depression, recurrent without psychotic symptoms

F33.3   Recurrent depressive disorder, current episode severe with psychotic symptoms

A disorder characterized by repeated episodes of depression, the current episode being severe with psychotic symptoms, as in F32.3, and with no previous episodes of mania.

Endogenous depression with psychotic symptoms

Manic-depressive psychosis, depressed type with psychotic symptoms

Recurrent severe episodes of:

• major depression with psychotic symptoms

• psychogenic depressive psychosis

• psychotic depression

• reactive depressive psychosis

F33.4   Recurrent depressive disorder, currently in remission

The patient has had two or more depressive episodes as described in F33.0-F33.3, in the past, but has been free from depressive symptoms for several months.

F33.8   Other recurrent depressive disorders

F33.9   Recurrent depressive disorder, unspecified

Monopolar depression NOS

F34   Persistent mood [affective] disorders

Persistent and usually fluctuating disorders of mood in which the majority of the individual episodes are not sufficiently severe to warrant being described as hypomanic or mild depressive episodes. Because they last for many years, and sometimes for the greater part of the patient's adult life, they involve considerable distress and disability. In some instances, recurrent or single manic or depressive episodes may become superimposed on a persistent affective disorder.

F34.0   Cyclothymia

A persistent instability of mood involving numerous periods of depression and mild elation, none of which is sufficiently severe or prolonged to justify a diagnosis of bipolar affective disorder (F31-) or recurrent depressive disorder (F33-). This disorder is frequently found in the relatives of patients with bipolar affective disorder. Some patients with cyclothymia eventually develop bipolar affective disorder.

Affective personality disorder

Cycloid personality

Cyclothymic personality

F34.1   Dysthymia

A chronic depression of mood, lasting at least several years, which is not sufficiently severe, or in which individual episodes are not sufficiently prolonged, to justify a diagnosis of severe, moderate, or mild recurrent depressive disorder (F33-).

Depressive:

• neurosis

• personality disorder

Neurotic depression

Persistent anxiety depression

Excludes:    anxiety depression (mild or not persistent) (F41.2)

F34.8   Other persistent mood [affective] disorders

F34.9   Persistent mood [affective] disorder, unspecified

F38   Other mood [affective] disorders

Any other mood disorders that do not justify classification to F30-F34, because they are not of sufficient severity or duration.

F38.0   Other single mood [affective] disorders

Mixed affective episode

F38.1   Other recurrent mood [affective] disorders

Recurrent brief depressive episodes

F38.8   Other specified mood [affective] disorders

F39   Unspecified mood [affective] disorder

Affective psychosis NOS

Neurotic, stress-related and somatoform disorders (F40-F48)

Excludes:    when associated with conduct disorder in F91- (F92.8)

F40   Phobic anxiety disorders

A group of disorders in which anxiety is evoked only, or predominantly, in certain well-defined situations that are not currently dangerous. As a result these situations are characteristically avoided or endured with dread. The patient's concern may be focused on individual symptoms like palpitations or feeling faint and is often associated with secondary fears of dying, losing control, or going mad. Contemplating entry to the phobic situation usually generates anticipatory anxiety. Phobic anxiety and depression often coexist. Whether two diagnoses, phobic anxiety and depressive episode, are needed, or only one, is determined by the time course of the two conditions and by therapeutic considerations at the time of consultation.

F40.0   Agoraphobia

A fairly well-defined cluster of phobias embracing fears of leaving home, entering shops, crowds and public places, or traveling alone in trains, buses or planes. Panic disorder is a frequent feature of both present and past episodes. Depressive and obsessional symptoms and social phobias are also commonly present as subsidiary features. Avoidance of the phobic situation is often prominent, and some agoraphobics experience little anxiety because they are able to avoid their phobic situations.

Agoraphobia without history of panic disorder

Panic disorder with agoraphobia

F40.1   Social phobias

Fear of scrutiny by other people leading to avoidance of social situations. More pervasive social phobias are usually associated with low self-esteem and fear of criticism. They may present as a complaint of blushing, hand tremor, nausea, or urgency of micturition, the patient sometimes being convinced that one of these secondary manifestations of their anxiety is the primary problem. Symptoms may progress to panic attacks.

Anthropophobia

Social neurosis

F40.2   Specific (isolated) phobias

Phobias restricted to highly specific situations such as proximity to particular animals, heights, thunder, darkness, flying, closed spaces, urinating or defecating in public toilets, eating certain foods, dentistry, or the sight of blood or injury. Though the triggering situation is discrete, contact with it can evoke panic as in agoraphobia or social phobia.

Acrophobia

Animal phobias

Claustrophobia

Simple phobia

Excludes:    dysmorphophobia (nondelusional) (F45.2)

nosophobia (F45.2)

F40.8   Other phobic anxiety disorders

F40.9   Phobic anxiety disorder, unspecified

Phobia NOS

Phobic state NOS

F41   Other anxiety disorders

Disorders in which manifestation of anxiety is the major symptom and is not restricted to any particular environmental situation. Depressive and obsessional symptoms, and even some elements of phobic anxiety, may also be present, provided that they are clearly secondary or less severe.

F41.0   Panic disorder [episodic paroxysmal anxiety]

The essential feature is recurrent attacks of severe anxiety (panic), which are not restricted to any particular situation or set of circumstances and are therefore unpredictable. As with other anxiety disorders, the dominant symptoms include sudden onset of palpitations, chest pain, choking sensations, dizziness, and feelings of unreality (depersonalization or derealization). There is often also a secondary fear of dying, losing control, or going mad. Panic disorder should not be given as the main diagnosis if the patient has a depressive disorder at the time the attacks start; in these circumstances the panic attacks are probably secondary to depression.

Panic:

• attack

• state

Excludes:    panic disorder with agoraphobia (F40.0)

F41.1   Generalized anxiety disorder

Anxiety that is generalized and persistent but not restricted to, or even strongly predominating in, any particular environmental circumstances (i.e. it is "free-floating"). The dominant symptoms are variable but include complaints of persistent nervousness, trembling, muscular tensions, sweating, lightheadedness, palpitations, dizziness, and epigastric discomfort. Fears that the patient or a relative will shortly become ill or have an accident are often expressed.

Anxiety:

• neurosis

• reaction

• state

Excludes:    neurasthenia (F48.0)

F41.2   Mixed anxiety and depressive disorder

This category should be used when symptoms of anxiety and depression are both present, but neither is clearly predominant, and neither type of symptom is present to the extent that justifies a diagnosis if considered separately. When both anxiety and depressive symptoms are present and severe enough to justify individual diagnoses, both diagnoses should be recorded and this category should not be used.

Anxiety depression (mild or not persistent)

F41.3   Other mixed anxiety disorders

Symptoms of anxiety mixed with features of other disorders in F42-F48. Neither type of symptom is severe enough to justify a diagnosis if considered separately.

F41.8   Other specified anxiety disorders

Anxiety hysteria

F41.9   Anxiety disorder, unspecified

Anxiety NOS

F42   Obsessive-compulsive disorder

The essential feature is recurrent obsessional thoughts or compulsive acts. Obsessional thoughts are ideas, images, or impulses that enter the patient's mind again and again in a stereotyped form. They are almost invariably distressing and the patient often tries, unsuccessfully, to resist them. They are, however, recognized as his or her own thoughts, even though they are involuntary and often repugnant. Compulsive acts or rituals are stereotyped behaviours that are repeated again and again. They are not inherently enjoyable, nor do they result in the completion of inherently useful tasks. Their function is to prevent some objectively unlikely event, often involving harm to or caused by the patient, which he or she fears might otherwise occur. Usually, this behaviour is recognized by the patient as pointless or ineffectual and repeated attempts are made to resist. Anxiety is almost invariably present. If compulsive acts are resisted the anxiety gets worse.

Includes:    anankastic neurosis

obsessive-compulsive neurosis

Excludes:    obsessive-compulsive personality (disorder) (F60.5)

F42.0   Predominantly obsessional thoughts or ruminations

These may take the form of ideas, mental images, or impulses to act, which are nearly always distressing to the subject. Sometimes the ideas are an indecisive, endless consideration of alternatives, associated with an inability to make trivial but necessary decisions in day-to-day living. The relationship between obsessional ruminations and depression is particularly close and a diagnosis of obsessive-compulsive disorder should be preferred only if ruminations arise or persist in the absence of a depressive episode.

F42.1   Predominantly compulsive acts [obsessional rituals]

The majority of compulsive acts are concerned with cleaning (particularly handwashing), repeated checking to ensure that a potentially dangerous situation has not been allowed to develop, or orderliness and tidiness. Underlying the overt behaviour is a fear, usually of danger either to or caused by the patient, and the ritual is an ineffectual or symbolic attempt to avert that danger.

F42.2   Mixed obsessional thoughts and acts

F42.8   Other obsessive-compulsive disorders

F42.9   Obsessive-compulsive disorder, unspecified

F43   Reaction to severe stress, and adjustment disorders

This category differs from others in that it includes disorders identifiable on the basis of not only symptoms and course but also the existence of one or other of two causative influences: an exceptionally stressful life event producing an acute stress reaction, or a significant life change leading to continued unpleasant circumstances that result in an adjustment disorder. Although less severe psychosocial stress ("life events") may precipitate the onset or contribute to the presentation of a very wide range of disorders classified elsewhere in this chapter, its etiological importance is not always clear and in each case will be found to depend on individual, often idiosyncratic, vulnerability, i.e. the life events are neither necessary nor sufficient to explain the occurrence and form of the disorder. In contrast, the disorders brought together here are thought to arise always as a direct consequence of acute severe stress or continued trauma. The stressful events or the continuing unpleasant circumstances are the primary and overriding causal factor and the disorder would not have occurred without their impact. The disorders in this section can thus be regarded as maladaptive responses to severe or continued stress, in that they interfere with successful coping mechanisms and therefore lead to problems of social functioning.

F43.0   Acute stress reaction

A transient disorder that develops in an individual without any other apparent mental disorder in response to exceptional physical and mental stress and that usually subsides within hours or days. Individual vulnerability and coping capacity play a role in the occurrence and severity of acute stress reactions. The symptoms show a typically mixed and changing picture and include an initial state of "daze" with some constriction of the field of consciousness and narrowing of attention, inability to comprehend stimuli, and disorientation. This state may be followed either by further withdrawal from the surrounding situation (to the extent of a dissociative stupor-F44.2), or by agitation and over-activity (flight reaction or fugue). Autonomic signs of panic anxiety (tachycardia, sweating, flushing) are commonly present. The symptoms usually appear within minutes of the impact of 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), 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

Excludes:    separation anxiety disorder of childhood (F93.0)

F43.8   Other reactions to severe stress

F43.9   Reaction to severe stress, unspecified

F44   Dissociative [conversion] disorders

The common themes that are shared by dissociative or conversion disorders are a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements. All types of dissociative disorders tend to remit after a few weeks or months, particularly if their onset is associated with a traumatic life event. More chronic disorders, particularly paralyses and anaesthesias, may develop if the onset is associated with insoluble problems or interpersonal difficulties. These disorders have previously been classified as various types of "conversion hysteria". They are presumed to be psychogenic in origin, being associated closely in time with traumatic events, insoluble and intolerable problems, or disturbed relationships. The symptoms often represent the patient's concept of how a physical illness would be manifest. Medical examination and investigation do not reveal the presence of any known physical or neurological disorder. In addition, there is evidence that the loss of function is an expression of emotional conflicts or needs. The symptoms may develop in close relationship to psychological stress, and often appear suddenly. Only disorders of physical functions normally under voluntary control and loss of sensations are included here. Disorders involving pain and other complex physical sensations mediated by the autonomic nervous system are classified under somatization disorder (F45.0). The possibility of the later appearance of serious physical or psychiatric disorders should always be kept in mind.

Includes:    conversion:

• hysteria

• reaction

hysteria

hysterical psychosis

Excludes:    malingering [conscious simulation] (^[i]Z76.5)

F44.0   Dissociative amnesia

The main feature is loss of memory, usually of important recent events, that is not due to organic mental disorder, and is too great to be explained by ordinary forgetfulness or fatigue. The amnesia is usually centred on traumatic events, such as accidents or unexpected bereavements, and is usually partial and selective. Complete and generalized amnesia is rare, and is usually part of a fugue (F44.1). If this is the case, the disorder should be classified as such. The diagnosis should not be made in the presence of organic brain disorders, intoxication, or excessive fatigue.

Excludes:    alcohol- or other psychoactive substance-induced amnesic disorder (F10-F19 with common fourth character .6)

amnesia:

• NOS (R41.3)

• anterograde (R41.1)

• retrograde (R41.2)

nonalcoholic organic amnesic syndrome (F04)

postictal amnesia in epilepsy (G40-)

F44.1   Dissociative fugue

Dissociative fugue has all the features of dissociative amnesia, plus purposeful travel beyond the usual everyday range. Although there is amnesia for the period of the fugue, the patient's behaviour during this time may appear completely normal to independent observers.

Excludes:    postictal fugue in epilepsy (G40-)

F44.2   Dissociative stupor

Dissociative stupor is diagnosed on the basis of a profound diminution or absence of voluntary movement and normal responsiveness to external stimuli such as light, noise, and touch, but examination and investigation reveal no evidence of a physical cause. In addition, there is positive evidence of psychogenic causation in the form of recent stressful events or problems.

Excludes:    organic catatonic disorder (F06.1)

stupor:

• NOS (R40.1)

• catatonic (F20.2)

• depressive (F31-F33)

• manic (F30.2)

F44.3   Trance and possession disorders

Disorders in which there is a temporary loss of the sense of personal identity and full awareness of the surroundings. Include here only trance states that are involuntary or unwanted, occurring outside religious or culturally accepted situations.

Excludes:    states associated with:

• acute and transient psychotic disorders (F23-)

• organic personality disorder (F07.0)

• postconcussional syndrome (F07.2)

• psychoactive substance intoxication (F10-F19 with common fourth character .0)

• schizophrenia (F20-)

F44.4   Dissociative motor disorders

In the commonest varieties there is loss of ability to move the whole or a part of a limb or limbs. There may be close resemblance to almost any variety of ataxia, apraxia, akinesia, aphonia, dysarthria, dyskinesia, seizures, or paralysis.

Psychogenic:

• aphonia

• dysphonia

F44.5   Dissociative convulsions

Dissociative convulsions may mimic epileptic seizures very closely in terms of movements, but tongue-biting, bruising due to falling, and incontinence of urine are rare, and consciousness is maintained or replaced by a state of stupor or trance.

F44.6   Dissociative anaesthesia and sensory loss

Anaesthetic areas of skin often have boundaries that make it clear that they are associated with the patient's ideas about bodily functions, rather than medical knowledge. There may be differential loss between the sensory modalities which cannot be due to a neurological lesion. Sensory loss may be accompanied by complaints of paraesthesia. Loss of vision and hearing are rarely total in dissociative disorders.

Psychogenic deafness

F44.7   Mixed dissociative [conversion] disorders

Combination of disorders specified in F44.0-F44.6

F44.8   Other dissociative [conversion] disorders

Ganser syndrome

Multiple personality

Psychogenic:

• confusion

• twilight state

F44.9   Dissociative [conversion] disorder, unspecified

F45   Somatoform disorders

The main feature is repeated presentation of physical symptoms together with persistent requests for medical investigations, in spite of repeated negative findings and reassurances by doctors that the symptoms have no physical basis. If any physical disorders are present, they do not explain the nature and extent of the symptoms or the distress and preoccupation of the patient.

Excludes:    dissociative disorders (F44-)

hair-plucking (F98.4)

lalling (F80.0)

lisping (F80.8)

nail-biting (F98.8)

psychological or behavioural factors associated with disorders or diseases classified elsewhere (F54)

sexual dysfunction, not caused by organic disorder or disease (F52-)

thumb-sucking (F98.8)

tic disorders (in childhood and adolescence) (F95-)

Tourette syndrome (F95.2)

trichotillomania (F63.3)

F45.0   Somatization disorder

The main features are multiple, recurrent and frequently changing physical symptoms of at least two years' duration. Most patients have a long and complicated history of contact with both primary and specialist medical care services, during which many negative investigations or fruitless exploratory operations may have been carried out. Symptoms may be referred to any part or system of the body. The course of the disorder is chronic and fluctuating, and is often associated with 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

Excludes:    malingering [conscious simulation] (^[i]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

Excludes:    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

• diarrhoea

• dyspepsia

• dysuria

• flatulence

• hiccough

• hyperventilation

• increased frequency of micturition

• irritable bowel syndrome

• pylorospasm

Excludes:    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

Excludes:    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, which are not mediated through the autonomic nervous system, which are limited to specific systems or parts of the body, and which 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

F48   Other neurotic disorders

F48.0   Neurasthenia

Considerable cultural variations occur in the presentation of this disorder, and two main types occur, with substantial overlap. In one type, the main feature is a complaint of increased fatigue after mental effort, often associated with some decrease in occupational performance or coping efficiency in daily tasks. The mental fatiguability is typically described as an unpleasant intrusion of distracting associations or recollections, difficulty in concentrating, and generally inefficient thinking. In the other type, the emphasis is on feelings of bodily or physical weakness and exhaustion after only minimal effort, accompanied by a feeling of muscular aches and pains and inability to relax. In both types a variety of other unpleasant physical feelings is common, such as dizziness, tension headaches, and feelings of general instability. Worry about decreasing mental and bodily well-being, irritability, anhedonia, and varying minor degrees of both depression and anxiety are all common. Sleep is often disturbed in its initial and middle phases but hypersomnia may also be prominent.

Fatigue syndrome

Use additional code, if desired, to identify previous physical illness.

Excludes:    asthenia NOS (R53)

burn-out (^[i]Z73.0)

malaise and fatigue (R53)

postviral fatigue syndrome (G93.3)

psychasthenia (F48.8)

F48.1   Depersonalization-derealization syndrome

A rare disorder in which the patient complains spontaneously that his or her mental activity, body, and surroundings are changed in their quality, so as to be unreal, remote, or automatized. Among the varied phenomena of the syndrome, patients complain most frequently of loss of emotions and feelings of estrangement or detachment from their thinking, their body, or the real world. In spite of the dramatic nature of the experience, the patient is aware of the unreality of the change. The sensorium is normal and the capacity for emotional expression intact. Depersonalization-derealization symptoms may occur as part of a diagnosable schizophrenic, depressive, phobic, or obsessive-compulsive disorder. In such cases the diagnosis should be that of the main disorder.

F48.8   Other specified neurotic disorders

Dhat syndrome

Occupational neurosis, including writer cramp

Psychasthenia

Psychasthenic neurosis

Psychogenic syncope

F48.9   Neurotic disorder, unspecified

Neurosis NOS

Behavioural syndromes associated with physiological disturbances and physical factors (F50-F59)

F50   Eating disorders

Excludes:    anorexia NOS (R63.0)

feeding:

• difficulties and mismanagement (R63.3)

• disorder of infancy or childhood (F98.2)

polyphagia (R63.2)

F50.0   Anorexia nervosa

A disorder characterized by deliberate weight loss, induced and sustained by the patient. It occurs most commonly in adolescent girls and young women, but adolescent boys and young men may also be affected, as may children approaching puberty and older women up to the menopause. The disorder is associated with a specific psychopathology whereby a dread of fatness and flabbiness of body contour persists as an intrusive overvalued idea, and the patients impose a low weight threshold on themselves. There is usually undernutrition of varying severity with secondary endocrine and metabolic changes and disturbances of bodily function. The symptoms include restricted dietary choice, excessive exercise, induced vomiting and purgation, and use of appetite suppressants and diuretics.

Excludes:    loss of appetite (R63.0)

• psychogenic (F50.8)

F50.1   Atypical anorexia nervosa

Disorders that fulfill some of the features of anorexia nervosa but in which the overall clinical picture does not justify that diagnosis. For instance, one of the key symptoms, such as amenorrhoea or marked dread of being fat, may be absent in the presence of marked weight loss and weight-reducing behaviour. This diagnosis should not be made in the presence of known physical disorders associated with weight loss.

F50.2   Bulimia nervosa

A syndrome characterized by repeated bouts of overeating and an excessive preoccupation with the control of body weight, leading to a pattern of overeating followed by vomiting or use of purgatives. This disorder shares many psychological features with anorexia nervosa, including an over concern with body shape and weight. Repeated vomiting is likely to give rise to disturbances of body electrolytes and physical complications. There is often, but not always, a history of an earlier episode of anorexia nervosa, the interval ranging from a few months to several years.

Bulimia NOS

Hyperorexia nervosa

F50.3   Atypical bulimia nervosa

Disorders that fulfill some of the features of bulimia nervosa, but in which the overall clinical picture does not justify that diagnosis. For instance, there may be recurrent bouts of overeating and overuse of purgatives without significant weight change, or the typical over concern about body shape and weight may be absent.

F50.4   Overeating associated with other psychological disturbances

Overeating due to stressful events, such as bereavement, accident, childbirth, etc.

Psychogenic overeating

Excludes:    obesity (E66-)

F50.5   Vomiting associated with other psychological disturbances

Repeated vomiting that occurs in dissociative disorders (F44-) and hypochondriacal disorder (F45.2), and that is not solely due to conditions classified outside this chapter.

Psychogenic vomiting

Use additional code (O21.-), if desired, to identify excess vomiting in pregnancy.

Excludes:    nausea (R11)

vomiting NOS (R11)

F50.8   Other eating disorders

Pica in adults

Psychogenic loss of appetite

Excludes:    pica of infancy and childhood (F98.3)

F50.9   Eating disorder, unspecified

F51   Nonorganic sleep disorders

In many cases, a disturbance of sleep is one of the symptoms of another disorder, either mental or physical. Whether a sleep disorder in a given patient is an independent condition or simply one of the features of another disorder classified elsewhere, either in this chapter or in others, should be determined on the basis of its clinical presentation and course as well as on the therapeutic considerations and priorities at the time of the consultation. Generally, if the sleep disorder is one of the major complaints and is perceived as a condition in itself, the present code should be used along with other pertinent diagnoses describing the psychopathology and pathophysiology involved in a given case. This category includes only those sleep disorders in which emotional causes are considered to be a primary factor, and which are not due to identifiable physical disorders classified elsewhere.

Excludes:    sleep disorders (organic) (G47-)

F51.0   Nonorganic insomnia

A condition of unsatisfactory quantity and/or quality of sleep, which persists for a considerable period of time, including difficulty falling asleep, difficulty staying asleep, or early final wakening. Insomnia is a common symptom of many mental and physical disorders, and should be classified here in addition to the basic disorder only if it dominates the clinical picture.

Excludes:    insomnia (organic) (G47.0)

F51.1   Nonorganic hypersomnia

Hypersomnia is defined as a condition of either excessive daytime sleepiness and sleep attacks (not accounted for by an inadequate amount of sleep) or prolonged transition to the fully aroused state upon awakening. In the absence of an organic factor for the occurrence of hypersomnia, this condition is usually associated with mental disorders.

Excludes:    hypersomnia (organic) (G47.1)

narcolepsy (G47.4)

F51.2   Nonorganic disorder of the sleep-wake schedule

A lack of synchrony between the sleep-wake schedule and the desired sleep-wake schedule for the individual's environment, resulting in a complaint of either insomnia or hypersomnia.

Psychogenic inversion of:

• circadian      

• nyctohemeral      rhythm

• sleep          

Excludes:    disorders of the sleep-wake schedule (organic) (G47.2)

F51.3   Sleepwalking [somnambulism]

A state of altered consciousness in which phenomena of sleep and wakefulness are combined. During a sleepwalking episode the individual arises from bed, usually during the first third of nocturnal sleep, and walks about, exhibiting low levels of awareness, reactivity, and motor skill. Upon awakening, there is usually no recall of the event.

F51.4   Sleep terrors [night terrors]

Nocturnal episodes of extreme terror and panic associated with intense vocalization, motility, and high levels of autonomic discharge. The individual sits up or gets up, usually during the first third of nocturnal sleep, with a panicky scream. Quite often he or she rushes to the door as if trying to escape, although very seldom leaves the room. Recall of the event, if any, is very limited (usually to one or two fragmentary mental images).

F51.5   Nightmares

Dream experiences loaded with anxiety or fear. There is very detailed recall of the dream content. The dream experience is very vivid and usually includes themes involving threats to survival, security, or self-esteem. Quite often there is a recurrence of the same or similar frightening nightmare themes. During a typical episode there is a degree of autonomic discharge but no appreciable vocalization or body motility. Upon awakening the individual rapidly becomes alert and oriented.

Dream anxiety disorder

F51.8   Other nonorganic sleep disorders

F51.9   Nonorganic sleep disorder, unspecified

Emotional sleep disorder NOS

F52   Sexual dysfunction, not caused by organic disorder or disease

Sexual dysfunction covers the various ways in which an individual is unable to participate in a sexual relationship as he or she would wish. Sexual response is a psychosomatic process and both psychological and somatic processes are usually involved in the causation of sexual dysfunction.

Excludes:    Dhat syndrome (F48.8)

F52.0   Lack or loss of sexual desire

Loss of sexual desire is the principal problem and is not secondary to other sexual difficulties, such as erectile failure or dyspareunia.

Frigidity

Hypoactive sexual desire disorder

F52.1   Sexual aversion and lack of sexual enjoyment

Either the prospect of sexual interaction produces sufficient fear or anxiety that sexual activity is avoided (sexual aversion) or sexual responses occur normally and orgasm is experienced but there is a lack of appropriate pleasure (lack of sexual enjoyment).

Anhedonia (sexual)

F52.2   Failure of genital response

The principal problem in men is erectile dysfunction (difficulty in developing or maintaining an erection suitable for satisfactory intercourse). In women, the principal problem is vaginal dryness or failure of lubrication.

Female sexual arousal disorder

Male erectile disorder

Psychogenic impotence

Excludes:    impotence of organic origin (N48.4)

F52.3   Orgasmic dysfunction

Orgasm either does not occur or is markedly delayed.

Inhibited orgasm (male)(female)

Psychogenic anorgasmy

F52.4   Premature ejaculation

The inability to control ejaculation sufficiently for both partners to enjoy sexual interaction.

F52.5   Nonorganic vaginismus

Spasm of the pelvic floor muscles that surround the vagina, causing occlusion of the vaginal opening. Penile entry is either impossible or painful.

Psychogenic vaginismus

Excludes:    vaginismus (organic) (N94.2)

F52.6   Nonorganic dyspareunia

Dyspareunia (or pain during sexual intercourse) occurs in both women and men. It can often be attributed to local pathology and should then properly be categorized under the pathological condition. This category is to be used only if there is no primary nonorganic sexual dysfunction (e.g. vaginismus or vaginal dryness).

Psychogenic dyspareunia

Excludes:    dyspareunia (organic) (N94.1)

F52.7   Excessive sexual drive

Nymphomania

Satyriasis

F52.8   Other sexual dysfunction, not caused by organic disorder or disease

F52.9   Unspecified sexual dysfunction, not caused by organic disorder or disease

F53   Mental and behavioural disorders associated with the puerperium, not elsewhere classified

This category includes only mental disorders associated with the puerperium (commencing within six weeks of delivery) that do not meet the criteria for disorders classified elsewhere in this chapter, either because insufficient information is available, or because it is considered that special additional clinical features are present that make their classification elsewhere inappropriate.

F53.0   Mild mental and behavioural disorders associated with the puerperium, not elsewhere classified

Depression:

• postnatal NOS

• postpartum NOS

F53.1   Severe mental and behavioural disorders associated with the puerperium, not elsewhere classified

Puerperal psychosis NOS

F53.8   Other mental and behavioural disorders associated with the puerperium, not elsewhere classified

F53.9   Puerperal mental disorder, unspecified

F54   Psychological and behavioural factors associated with disorders or diseases classified elsewhere

This category should be used to record the presence of psychological or behavioural influences thought to have played a major part in the etiology of physical disorders which can be classified to other chapters. Any resulting mental disturbances are usually mild, and often prolonged (such as worry, emotional conflict, apprehension) and do not of themselves justify the use of any of the categories in this chapter.

Psychological factors affecting physical conditions

Examples of the use of this category are:

• asthma F54 and J45-

• dermatitis F54 and L23-L25

• gastric ulcer F54 and K25-

• mucous colitis F54 and K58-

• ulcerative colitis F54 and K51-

• urticaria F54 and L50-

Use additional code, if desired, to identify the associated physical disorder.

Excludes:    tension-type headache (G44.2)

F55   Abuse of non-dependence-producing substances

A wide variety of medicaments and folk remedies may be involved, but the particularly important groups are: (a) psychotropic drugs that do not produce dependence, such as antidepressants, (b) laxatives, and (c) analgesics that may be purchased without medical prescription, such as aspirin and paracetamol.

Persistent use of these substances often involves unnecessary contacts with medical professionals or supporting staff, and is sometimes accompanied by harmful physical effects of the substances. Attempts to dissuade or forbid the use of the substance are often met with resistance; for laxatives and analgesics this may be in spite of warnings about (or even the development of) physical harm such as renal dysfunction or electrolyte disturbances. Although it is usually clear that the patient has a strong motivation to take the substance, dependence or withdrawal symptoms do not develop as in the case of the psychoactive substances specified in F10-F19.

Abuse of:

• antacids

• herbal or folk remedies

• steroids or hormones

• vitamins

Laxative habit

Excludes:    abuse of psychoactive substances (F10-F19)

F59   Unspecified behavioural syndromes associated with physiological disturbances and physical factors

Psychogenic physiological dysfunction NOS

Disorders of adult personality and behaviour (F60-F69)

This block includes a variety of conditions and behaviour patterns of clinical significance which tend to be persistent and appear to be the expression of the individual's characteristic lifestyle and mode of relating to himself or herself and others. Some of these conditions and patterns of behaviour emerge early in the course of individual development, as a result of both constitutional factors and social experience, while others are acquired later in life. Specific personality disorders (F60-), mixed and other personality disorders (F61-), and enduring personality changes (F62-) are deeply ingrained and enduring behaviour patterns, manifesting as inflexible responses to a broad range of personal and social situations. They represent extreme or significant deviations from the way in which the average individual in a given culture perceives, thinks, feels and, particularly, relates to others. Such behaviour patterns tend to be stable and to encompass multiple domains of behaviour and psychological functioning. They are frequently, but not always, associated with various degrees of subjective distress and problems of social performance.

F60   Specific personality disorders

These are severe disturbances in the personality and behavioural tendencies of the individual; not directly resulting from disease, damage, or other insult to the brain, or from another psychiatric disorder; usually involving several areas of the personality; nearly always associated with considerable personal distress and social disruption; and usually manifest since childhood or adolescence and continuing throughout adulthood.

F60.0   Paranoid personality disorder

Personality disorder characterized by excessive sensitivity to setbacks, unforgiveness of insults; suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous; recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner; and a combative and tenacious sense of personal rights. There may be excessive self-importance, and there is often excessive self-reference.

Personality (disorder):

• expansive paranoid

• fanatic

• querulant

• paranoid

• sensitive paranoid

Excludes:    paranoia (F22.0)

• querulans (F22.8)

paranoid:

• psychosis (F22.0)

• schizophrenia (F20.0)

• state (F22.0)

F60.1   Schizoid personality disorder

Personality disorder characterized by withdrawal from affectional, social and other contacts with preference for fantasy, solitary activities, and introspection. There is a limited capacity to express feelings and to experience pleasure.

Excludes:    Asperger syndrome (F84.5)

delusional disorder (F22.0)

schizoid disorder of childhood (F84.5)

schizophrenia (F20-)

schizotypal disorder (F21)

F60.2   Dissocial personality disorder

Personality disorder characterized by disregard for social obligations, and callous unconcern for the feelings of others. There is gross disparity between behaviour and the prevailing social norms. Behaviour is not readily modifiable by adverse experience, including punishment. There is a low tolerance to frustration and a low threshold for discharge of aggression, including violence; there is a tendency to blame others, or to offer plausible rationalizations for the behaviour bringing the patient into conflict with society.

Personality (disorder):

• amoral

• antisocial

• asocial

• psychopathic

• sociopathic

Excludes:    conduct disorders (F91-)

emotionally unstable personality disorder (F60.3)

F60.3   Emotionally unstable personality disorder

Personality disorder characterized by a definite tendency to act impulsively and without consideration of the consequences; the mood is unpredictable and capricious. There is a liability to outbursts of emotion and an incapacity to control the behavioural explosions. There is a tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or censored. Two types may be distinguished: the impulsive type, characterized predominantly by emotional instability and lack of impulse control, and the borderline type, characterized in addition by disturbances in self-image, aims, and internal preferences, by chronic feelings of emptiness, by intense and unstable interpersonal relationships, and by a tendency to self-destructive behaviour, including suicide gestures and attempts.

Personality (disorder): 

• aggressive

• borderline

• explosive

Excludes:    dissocial personality disorder (F60.2)

F60.4   Histrionic personality disorder

Personality disorder characterized by shallow and labile affectivity, self-dramatization, theatricality, exaggerated expression of emotions, suggestibility, egocentricity, self-indulgence, lack of consideration for others, easily hurt feelings, and continuous seeking for appreciation, excitement and attention.

Personality (disorder):

• hysterical

• psychoinfantile

F60.5   Anankastic personality disorder

Personality disorder characterized by feelings of doubt, perfectionism, excessive conscientiousness, checking and preoccupation with details, stubbornness, caution, and rigidity. There may be insistent and unwelcome thoughts or impulses that do not attain the severity of an obsessive-compulsive disorder.

Personality (disorder):

• compulsive

• obsessional

• obsessive-compulsive

Excludes:    obsessive-compulsive disorder (F42-)

F60.6   Anxious [avoidant] personality disorder

Personality disorder characterized by feelings of tension and apprehension, insecurity and inferiority. There is a continuous yearning to be liked and accepted, a hypersensitivity to rejection and criticism with restricted personal attachments, and a tendency to avoid certain activities by habitual exaggeration of the potential dangers or risks in everyday situations.

F60.7   Dependent personality disorder

Personality disorder characterized by pervasive passive reliance on other people to make one's major and minor life decisions, great fear of abandonment, feelings of helplessness and incompetence, passive compliance with the wishes of elders and others, and a weak response to the demands of daily life. Lack of vigour may show itself in the intellectual or emotional spheres; there is often a tendency to transfer responsibility to others.

Personality (disorder):

• asthenic

• inadequate

• passive

• self-defeating

F60.8   Other specific personality disorders

Personality (disorder):

• eccentric

• "haltlose" type

• immature

• narcissistic

• passive-aggressive

• psychoneurotic

F60.9   Personality disorder, unspecified

Character neurosis NOS

Pathological personality NOS

F61   Mixed and other personality disorders

This category is intended for personality disorders that are often troublesome but do not demonstrate the specific pattern of symptoms that characterize the disorders described in F60-. As a result they are often more difficult to diagnose than the disorders in F60-.

Examples include:

• mixed personality disorders with features of several of the disorders in F60- but without a predominant set of symptoms that would allow a more specific diagnosis

• troublesome personality changes, not classifiable to F60- or F62-, and regarded

as secondary to a main diagnosis of a coexisting affective or anxiety disorder.

Excludes:    accentuated personality traits (^[i]Z73.1)

F62   Enduring personality changes, not attributable to brain damage and disease

Disorders of adult personality and behaviour that have developed in persons with no previous personality disorder following exposure to catastrophic or excessive prolonged stress, or following a severe psychiatric illness. These diagnoses should be made only when there is evidence of a definite and enduring change in a person's pattern of perceiving, relating to, or thinking about the environment and himself or herself. The personality change should be significant and be associated with inflexible and maladaptive behaviour not present before the pathogenic experience. The change should not be a direct manifestation of another mental disorder or a residual symptom of any antecedent mental disorder.

Excludes:    personality and behavioural disorder due to brain disease, damage and dysfunction (F07-)

F62.0   Enduring personality change after catastrophic experience

Enduring personality change, present for at least two years, following exposure to catastrophic stress. The stress must be so extreme that it is not necessary to consider personal vulnerability in order to explain its profound effect on the personality. The disorder is characterized by a hostile or distrustful attitude toward the world, social withdrawal, feelings of emptiness or hopelessness, a chronic feeling of "being on edge" as if constantly threatened, and estrangement. Post-traumatic stress disorder (F43.1) may precede this type of personality change.

Personality change after:

• concentration camp experiences

• disasters

• prolonged:

• captivity with an imminent possibility of being killed

• exposure to life-threatening situations such as being a victim of terrorism

• torture

Excludes:    post-traumatic stress disorder (F43.1)

F62.1   Enduring personality change after psychiatric illness

Personality change, persisting for at least two years, attributable to the traumatic experience of suffering from a severe psychiatric illness. The change cannot be explained by a previous personality disorder and should be differentiated from residual schizophrenia and other states of incomplete recovery from an antecedent mental disorder. This disorder is characterized by an excessive dependence on and a demanding attitude towards others; conviction of being changed or stigmatized by the illness, leading to an inability to form and maintain close and confiding personal relationships and to social isolation; passivity, reduced interests, and diminished involvement in leisure activities; persistent complaints of being ill, which may be associated with hypochondriacal claims and illness behaviour; dysphoric or labile mood, not due to the presence of a current mental disorder or antecedent mental disorder with residual affective symptoms; and longstanding problems in social and occupational functioning.

F62.8   Other enduring personality changes

Chronic pain personality syndrome

F62.9   Enduring personality change, unspecified

F63   Habit and impulse disorders

This category includes certain disorders of behaviour that are not classifiable under other categories. They are characterized by repeated acts that have no clear rational motivation, cannot be controlled, and generally harm the patient's own interests and those of other people. The patient reports that the behaviour is associated with impulses to action. The cause of these disorders is not understood and they are grouped together because of broad descriptive similarities, not because they are known to share any other important features.

Excludes:    habitual excessive use of alcohol or psychoactive substances (F10-F19)

impulse and habit disorders involving sexual behaviour (F65-)

F63.0   Pathological gambling

The disorder consists of frequent, repeated episodes of gambling that dominate the patient's life to the detriment of social, occupational, material, and family values and commitments.

Compulsive gambling

Excludes:    excessive gambling by manic patients (F30-)

gambling and betting NOS (^[i]Z72.6)

gambling in dissocial personality disorder (F60.2)

F63.1   Pathological fire-setting [pyromania]

Disorder characterized by multiple acts of, or attempts at, setting fire to property or other objects, without apparent motive, and by a persistent preoccupation with subjects related to fire and burning. This behaviour is often associated with feelings of increasing tension before the act, and intense excitement immediately afterwards.

Excludes:    fire-setting (by)(in):

• adult with dissocial personality disorder (F60.2)

• alcohol or psychoactive substance intoxication (F10-F19, with common fourth character .0)

• as the reason for observation for suspected mental disorder, ruled out (^[i]Z03.2)

• conduct disorders (F91-)

• organic mental disorders (F00-F09)

• schizophrenia (F20-)

F63.2   Pathological stealing [kleptomania]

Disorder characterized by repeated failure to resist impulses to steal objects that are not acquired for personal use or monetary gain. The objects may instead be discarded, given away, or hoarded. This behaviour is usually accompanied by an increasing sense of tension before, and a sense of gratification during and immediately after, the act.

Excludes:    depressive disorder with stealing (F31-F33)

organic mental disorders (F00-F09)

shoplifting as the reason for observation for suspected mental disorder, ruled out(^[i]Z03.2)

F63.3   Trichotillomania

A disorder characterized by noticeable hair-loss due to a recurrent failure to resist impulses to pull out hairs. The hair-pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. This diagnosis should not be made if there is a pre-existing inflammation of the skin, or if the hair-pulling is in response to a delusion or a hallucination.

Excludes:    stereotyped movement disorder with hair-plucking (F98.4)

F63.8   Other habit and impulse disorders

Other kinds of persistently repeated maladaptive behaviour that are not secondary to a recognized psychiatric syndrome, and in which it appears that the patient is repeatedly failing to resist impulses to carry out the behaviour. There is a prodromal period of tension with a feeling of release at the time of the act.

Intermittent explosive disorder

F63.9   Habit and impulse disorder, unspecified

F64   Gender identity disorders

F64.0   Transsexualism

A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex, and a wish to have surgery and hormonal treatment to make one's body as congruent as possible with one's preferred sex.

F64.1   Dual-role transvestism

The wearing of clothes of the opposite sex for part of the individual's existence in order to enjoy the temporary experience of membership of the opposite sex, but without any desire for a more permanent sex change or associated surgical reassignment, and without sexual excitement accompanying the cross-dressing.

Gender identity disorder of adolescence or adulthood, nontranssexual type

Excludes:    fetishistic transvestism (F65.1)

F64.2   Gender identity disorder of childhood

A disorder, usually first manifest during early childhood (and always well before puberty), characterized by a persistent and intense distress about assigned sex, together with a desire to be (or insistence that one is) of the other sex. There is a persistent preoccupation with the dress and activities of the opposite sex and repudiation of the individual's own sex. The diagnosis requires a profound disturbance of the normal gender identity; mere tomboyishness in girls or girlish behaviour in boys is not sufficient. Gender identity disorders in individuals who have reached or are entering puberty should not be classified here but in F66-.

Excludes:    egodystonic sexual orientation (F66.1)

sexual maturation disorder (F66.0)

F64.8   Other gender identity disorders

F64.9   Gender identity disorder, unspecified

Gender-role disorder NOS

F65   Disorders of sexual preference

Includes:    paraphilias

F65.0   Fetishism

Reliance on some non-living object as a stimulus for sexual arousal and sexual gratification. Many fetishes are extensions of the human body, such as articles of clothing or footwear. Other common examples are characterized by some particular texture such as rubber, plastic or leather. Fetish objects vary in their importance to the individual. In some cases they simply serve to enhance sexual excitement achieved in ordinary ways (e.g. having the partner wear a particular garment).

F65.1   Fetishistic transvestism

The wearing of clothes of the opposite sex principally to obtain sexual excitement and to create the appearance of a person of the opposite sex. Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines. It can occur as an earlier phase in the development of transsexualism.

Transvestic fetishism

F65.2   Exhibitionism

A recurrent or persistent tendency to expose the genitalia to strangers (usually of the opposite sex) or to people in public places, without inviting or intending closer contact. There is usually, but not invariably, sexual excitement at the time of the exposure and the act is commonly followed by masturbation.

F65.3   Voyeurism

A recurrent or persistent tendency to look at people engaging in sexual or intimate behaviour such as undressing. This is carried out without the observed people being aware, and usually leads to sexual excitement and masturbation.

F65.4   Paedophilia

A sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age.

F65.5   Sadomasochism

A preference for sexual activity which 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

F66   Psychological and behavioural disorders associated with sexual development and orientation

Note:          Sexual orientation by itself is not to be regarded as a disorder.

F66.0   Sexual maturation disorder

The patient suffers from uncertainty about his or her gender identity or sexual orientation, which causes anxiety or depression. Most commonly this occurs in adolescents who are not certain whether they are homosexual, heterosexual or bisexual in orientation, or in individuals who, after a period of apparently stable sexual orientation (often within a longstanding relationship), find that their sexual orientation is changing.

F66.1   Egodystonic sexual orientation

The gender identity or sexual preference (heterosexual, homosexual, bisexual, or prepubertal) is not in doubt, but the individual wishes it were different because of associated psychological and behavioural disorders, and may seek treatment in order to change it.

F66.2   Sexual relationship disorder

The gender identity or sexual orientation (heterosexual, homosexual, or bisexual) is responsible for difficulties in forming or maintaining a relationship with a sexual partner.

F66.8   Other psychosexual development disorders

F66.9   Psychosexual development disorder, unspecified

F68   Other disorders of adult personality and behaviour

F68.0   Elaboration of physical symptoms for psychological reasons

Physical symptoms compatible with and originally due to a confirmed physical disorder, disease or disability become exaggerated or prolonged due to the psychological state of the patient. The patient is commonly distressed by this pain or disability, and is often preoccupied with worries, which may be justified, of the possibility of prolonged or progressive disability or pain.

Compensation neurosis

F68.1   Intentional production or feigning of symptoms or disabilities, either physical or psychological [factitious disorder]

The patient feigns symptoms repeatedly for no obvious reason and may even inflict self-harm in order to produce symptoms or signs. The motivation is obscure and presumably internal with the aim of adopting the sick role. The disorder is often combined with marked disorders of personality and relationships.

Hospital hopper syndrome

Munchhausen syndrome

Peregrinating patient

Excludes:    factitial dermatitis (L98.1)

person feigning illness (with obvious motivation) (^[i]Z76.5)

F68.8   Other specified disorders of adult personality and behaviour

Character disorder NOS

Relationship disorder NOS

F69   Unspecified disorder of adult personality and behaviour

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.

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

Use additional code, if desired, to identify associated conditions such as autism, other developmental disorders, epilepsy, conduct disorders, or severe physical handicap.

F70   Mild mental retardation

Approximate IQ range of 50 to 69 (in adults, mental age from 9 to under 12 years). Likely to result in some learning difficulties in school. Many adults will be able to work and maintain good social relationships and contribute to society.

Includes:    feeble-mindedness

mild mental subnormality

F71   Moderate mental retardation

Approximate IQ range of 35 to 49 (in adults, mental age from 6 to under 9 years). Likely to result in marked developmental delays in childhood but most can learn to develop some degree of independence in self-care and acquire adequate communication and academic skills. Adults will need varying degrees of support to live and work in the community.

Includes:    moderate mental subnormality

F72   Severe mental retardation

Approximate IQ range of 20 to 34 (in adults, mental age from 3 to under 6 years). Likely to result in continuous need of support.

Includes:    severe mental subnormality

F73   Profound mental retardation

IQ under 20 (in adults, mental age below 3 years). Results in severe limitation in self-care, continence, communication and mobility.

Includes:    profound mental subnormality

F78   Other mental retardation

F79   Unspecified mental retardation

Includes:    mental:

• deficiency NOS

• subnormality NOS

Disorders of psychological development (F80-F89)

The disorders included in this block have in common: (a) onset invariably during infancy or childhood; (b) impairment or delay in development of functions that are strongly related to biological maturation of the central nervous system; and (c) a steady course without remissions and relapses. In most cases, the functions affected include language, visuo-spatial skills, and motor coordination. Usually, the delay or impairment has been present from as early as it could be detected reliably and will diminish progressively as the child grows older, although milder deficits often remain in adult life.

F80   Specific developmental disorders of speech and language

Disorders in which normal patterns of language acquisition are disturbed from the early stages of development. The conditions are not directly attributable to neurological or speech mechanism abnormalities, sensory impairments, mental retardation, or environmental factors. Specific developmental disorders of speech and language are often followed by associated problems, such as difficulties in reading and spelling, abnormalities in interpersonal relationships, and emotional and behavioural disorders.

F80.0   Specific speech articulation disorder

A specific developmental disorder in which the child's use of speech sounds is below the appropriate level for its mental age, but in which there is a normal level of language skills.

Developmental:

• phonological disorder

• speech articulation disorder

Dyslalia

Functional speech articulation disorder

Lalling

Excludes:    speech articulation impairment (due to):

• aphasia NOS (R47.0)

• apraxia (R48.2)

• hearing loss (H90-H91)

• mental retardation (F70-F79)

• with language developmental disorder:

• expressive (F80.1)

• receptive (F80.2)

F80.1   Expressive language disorder

A specific developmental disorder in which the child's ability to use expressive spoken language is markedly below the appropriate level for its mental age, but in which language comprehension is within normal limits. There may or may not be abnormalities in articulation.

Developmental dysphasia or aphasia, expressive type

Excludes:    acquired aphasia with epilepsy [Landau-Kleffner] (F80.3)

dysphasia and aphasia:

• NOS (R47.0)

• developmental, receptive type (F80.2)

elective mutism (F94.0)

mental retardation (F70-F79)

pervasive developmental disorders (F84-)

F80.2   Receptive language disorder

A specific developmental disorder in which the child's understanding of language is below the appropriate level for its mental age. In virtually all cases expressive language will also be markedly affected and abnormalities in word-sound production are common.

Congenital auditory imperception

Developmental:

• dysphasia or aphasia, receptive type

• Wernicke aphasia

Word deafness

Excludes:    acquired aphasia with epilepsy [Landau-Kleffner] (F80.3)

autism (F84.0-F84.1)

dysphasia and aphasia:

• NOS (R47.0)

• developmental, expressive type (F80.1)

elective mutism (F94.0)

language delay due to deafness (H90-H91)

mental retardation (F70-F79)

F80.3   Acquired aphasia with epilepsy [Landau-Kleffner]

A disorder in which the child, having previously made normal progress in language development, loses both receptive and expressive language skills but retains general intelligence; the onset of the disorder is accompanied by paroxysmal abnormalities on the EEG, and in the majority of cases also by epileptic seizures. Usually the onset is between the ages of three and seven years, with skills being lost over days or weeks. The temporal association between the onset of seizures and loss of language is variable, with one preceding the other (either way round) by a few months to two years. An inflammatory encephalitic process has been suggested as a possible cause of this disorder. About two-thirds of patients are left with a more or less severe receptive language deficit.

Excludes:    aphasia (due to):

• NOS (R47.0)

• autism (F84.0-F84.1)

• disintegrative disorders of childhood (F84.2-F84.3)

F80.8   Other developmental disorders of speech and language

Lisping

F80.9   Developmental disorder of speech and language, unspecified

Language disorder NOS

F81   Specific developmental disorders of scholastic skills

Disorders in which the normal patterns of skill acquisition are disturbed from the early stages of development. This is not simply a consequence of a lack of opportunity to learn, it is not solely a result of mental retardation, and it is not due to any form of acquired brain trauma or disease.

F81.0   Specific reading disorder

The main feature is a specific and significant impairment in the development of reading skills that is not solely accounted for by mental age, visual acuity problems, or inadequate schooling. Reading comprehension skill, reading word recognition, oral reading skill, and performance of tasks requiring reading may all be affected. Spelling difficulties are frequently associated with specific reading disorder and often remain into adolescence even after some progress in reading has been made. Specific developmental disorders of reading are commonly preceded by a history of disorders in speech or language development. Associated emotional and behavioural disturbances are common during the school age period.

"Backward reading"

Developmental dyslexia

Specific reading retardation

Excludes:    alexia NOS (R48.0)

dyslexia NOS (R48.0)

reading difficulties secondary to emotional disorders (F93-)

F81.1   Specific spelling disorder

The main feature is a specific and significant impairment in the development of spelling skills in the absence of a history of specific reading disorder, which is not solely accounted for by low mental age, visual acuity problems, or inadequate schooling. The ability to spell orally and to write out words correctly are both affected.

Specific spelling retardation (without reading disorder)

Excludes:    agraphia NOS (R48.8)

spelling difficulties:

• associated with a reading disorder (F81.0)

• due to inadequate teaching (^[i]Z55.8)

F81.2   Specific disorder of arithmetical skills

Involves a specific impairment in arithmetical skills that is not solely explicable on the basis of general mental retardation or of inadequate schooling. The deficit concerns mastery of basic computational skills of addition, subtraction, multiplication, and division rather than of the more abstract mathematical skills involved in algebra, trigonometry, geometry, or calculus.

Developmental:

• acalculia

• arithmetical disorder

• Gerstmann syndrome

Excludes:    acalculia NOS (R48.8)

arithmetical difficulties:

• associated with a reading or spelling disorder (F81.3)

• due to inadequate teaching (^[i]Z55.8)

F81.3   Mixed disorder of scholastic skills

An ill-defined residual category of disorders in which both arithmetical and reading or spelling skills are significantly impaired, but in which the disorder is not solely explicable in terms of general mental retardation or of inadequate schooling. It should be used for disorders meeting the criteria for both F81.2 and either F81.0 or F81.1.

Excludes:    specific:

• disorder of arithmetical skills (F81.2)

• reading disorder (F81.0)

• spelling disorder (F81.1)

F81.8   Other developmental disorders of scholastic skills

Developmental expressive writing disorder

F81.9   Developmental disorder of scholastic skills, unspecified

Knowledge acquisition disability NOS

Learning:

• disability NOS

• disorder NOS

F82   Specific developmental disorder of motor function

A disorder in which the main feature is a serious impairment in the development of motor coordination that is not solely explicable in terms of general intellectual retardation or of any specific congenital or acquired neurological disorder. Nevertheless, in most cases a careful clinical examination shows marked neurodevelopmental immaturities such as choreiform movements of unsupported limbs or mirror movements and other associated motor features, as well as signs of impaired fine and gross motor coordination.

Clumsy child syndrome

Developmental:

• coordination disorder

• dyspraxia

Excludes:    abnormalities of gait and mobility (R26-)

lack of coordination (R27-)

• secondary to mental retardation (F70-F79)

F83   Mixed specific developmental disorders

A residual category for disorders in which there is some admixture of specific developmental disorders of speech and language, of scholastic skills, and of motor function, but in which none predominates sufficiently to constitute the prime diagnosis. This mixed category should be used only when there is a major overlap between each of these specific developmental disorders. The disorders are usually, but not always, associated with some degree of general impairment of cognitive functions. Thus, the category should be used when there are dysfunctions meeting the criteria for two or more of F80-, F81- and F82

F84   Pervasive developmental disorders

A group of disorders characterized by qualitative abnormalities in reciprocal social interactions and in patterns of communication, and by a restricted, stereotyped, repetitive repertoire of interests and activities. These qualitative abnormalities are a pervasive feature of the individual's functioning in all situations.

Use additional code, if desired, to identify any associated medical condition and mental retardation.

F84.0   Childhood autism

A type of pervasive developmental disorder that is defined by: (a) the presence of abnormal or impaired development that is manifest before the age of three years, and (b) the characteristic type of abnormal functioning in all the three areas of psychopathology: reciprocal social interaction, communication, and restricted, stereotyped, repetitive behaviour. In addition to these specific diagnostic features, a range of other nonspecific problems are common, such as phobias, sleeping and eating disturbances, temper tantrums, and (self-directed) aggression.

Autistic disorder

Infantile:

• autism

• psychosis

Kanner syndrome

Excludes:    autistic psychopathy (F84.5)

F84.1   Atypical autism

A type of pervasive developmental disorder that differs from childhood autism either in age of onset or in failing to fulfill all three sets of diagnostic criteria. This subcategory should be used when there is abnormal and impaired development that is present only after age three years, and a lack of sufficient demonstrable abnormalities in one or two of the three areas of psychopathology required for the diagnosis of autism (namely, reciprocal social interactions, communication, and restricted, stereotyped, repetitive behaviour) in spite of characteristic abnormalities in the other area(s). Atypical autism arises most often in profoundly retarded individuals and in individuals with a severe specific developmental disorder of receptive language.

Atypical childhood psychosis

Mental retardation with autistic features

Use additional code (F70-F79), if desired, to identify mental retardation.

F84.2   Rett syndrome

A condition, so far found only in girls, in which apparently normal early development is followed by partial or complete loss of speech and of skills in locomotion and use of hands, together with deceleration in head growth, usually with an onset between seven and 24 months of age. Loss of purposive hand movements, hand-wringing stereotypies, and hyperventilation are characteristic. Social and play development are arrested but social interest tends to be maintained. Trunk ataxia and apraxia start to develop by age four years and choreoathetoid movements frequently follow. Severe mental retardation almost invariably results.

F84.3   Other childhood disintegrative disorder

A type of pervasive developmental disorder that is defined by a period of entirely normal development before the onset of the disorder, followed by a definite loss of previously acquired skills in several areas of development over the course of a few months. Typically, this is accompanied by a general loss of interest in the environment, by stereotyped, repetitive motor mannerisms, and by autistic-like abnormalities in social interaction and communication. In some cases the disorder can be shown to be due to some associated encephalopathy but the diagnosis should be made on the behavioural features.

Dementia infantilis

Disintegrative psychosis

Heller syndrome

Symbiotic psychosis

Use additional code, if desired, to identify any associated neurological condition.

Excludes:    Rett syndrome (F84.2)

F84.4   Overactive disorder associated with mental retardation and stereotyped movements

An ill-defined disorder of uncertain nosological validity. The category is designed to include a group of children with severe mental retardation (IQ below 34) who show major problems in hyperactivity and in attention, as well as stereotyped behaviours. They tend not to benefit from stimulant drugs (unlike those with an IQ in the normal range) and may exhibit a severe dysphoric reaction (sometimes with psychomotor retardation) when given stimulants. In adolescence, the overactivity tends to be replaced by underactivity (a pattern that is not usual in hyperkinetic children with normal intelligence). This syndrome is also often associated with a variety of developmental delays, either specific or global. The extent to which the behavioural pattern is a function of low IQ or of organic brain damage is not known.

F84.5   Asperger syndrome

A disorder of uncertain nosological validity, characterized by the same type of qualitative abnormalities of reciprocal social interaction that typify autism, together with a restricted, stereotyped, repetitive repertoire of interests and activities. It differs from autism primarily in the fact that there is no general delay or retardation in language or in cognitive development. This disorder is often associated with marked clumsiness. There is a strong tendency for the abnormalities to persist into adolescence and adult life. Psychotic episodes occasionally occur in early adult life.

Autistic psychopathy

Schizoid disorder of childhood

F84.8   Other pervasive developmental disorders

F84.9   Pervasive developmental disorder, unspecified

F88   Other disorders of psychological development

Developmental agnosia

F89   Unspecified disorder of psychological development

Developmental disorder NOS

Behavioural and emotional disorders with onset usually occurring in childhood and adolescence (F90-F98)

F90   Hyperkinetic disorders

A group of disorders characterized by an early onset (usually in the first five years of life), lack of persistence in activities that require cognitive involvement, and a tendency to move from one activity to another without completing any one, together with disorganized, ill-regulated, and excessive activity. Several other abnormalities may be associated. Hyperkinetic children are often reckless and impulsive, prone to accidents, and find themselves in disciplinary trouble because of unthinking breaches of rules rather than deliberate defiance. Their relationships with adults are often socially disinhibited, with a lack of normal caution and reserve. They are unpopular with other children and may become isolated. Impairment of cognitive functions is common, and specific delays in motor and language development are disproportionately frequent. Secondary complications include dissocial behaviour and low self-esteem.

Excludes:    anxiety disorders (F41-)

mood [affective] disorders (F30-F39)

pervasive developmental disorders (F84-)

schizophrenia (F20-)

F90.0   Disturbance of activity and attention

Attention deficit:

• disorder with hyperactivity

• hyperactivity disorder

• syndrome with hyperactivity

Excludes:    hyperkinetic disorder associated with conduct disorder (F90.1)

F90.1   Hyperkinetic conduct disorder

Hyperkinetic disorder associated with conduct disorder

F90.8   Other hyperkinetic disorders

F90.9   Hyperkinetic disorder, unspecified

Hyperkinetic reaction of childhood or adolescence NOS

Hyperkinetic syndrome NOS

F91   Conduct disorders

Disorders characterized by a repetitive and persistent pattern of dissocial, aggressive, or defiant conduct. Such behaviour should amount to major violations of age-appropriate social expectations; it should therefore be more severe than ordinary childish mischief or adolescent rebelliousness and should imply an enduring pattern of behaviour (six months or longer). Features of conduct disorder can also be symptomatic of other psychiatric conditions, in which case the underlying diagnosis should be preferred.

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.

Excludes:    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.

F91.8   Other conduct disorders

F91.9   Conduct disorder, unspecified

Childhood:

• behavioural disorder NOS

• conduct disorder NOS

F92   Mixed disorders of conduct and emotions

A group of disorders characterized by the combination of persistently aggressive, dissocial or defiant behaviour with overt and marked symptoms of depression, anxiety or other emotional upsets. The criteria for both conduct disorders of childhood (F9l.-) and emotional disorders of childhood (F93-) or an adult-type neurotic diagnosis (F40-F48) or a mood disorder (F30-F39) must be met.

F92.0   Depressive conduct disorder

This category requires the combination of conduct disorder (F91-) with persistent and marked depression of mood (F32-), as demonstrated by symptoms such as excessive misery, loss of interest and pleasure in usual activities, self-blame, and hopelessness; disturbances of sleep or appetite may also be present.

Conduct disorder in F91- associated with depressive disorder in F32-

F92.8   Other mixed disorders of conduct and emotions

This category requires the combination of conduct disorder (F91-) with persistent and marked emotional symptoms such as anxiety, obsessions or compulsions, depersonalization or derealization, phobias, or hypochondriasis.

Conduct disorder in F91- associated with:

• emotional disorder in F93-

• neurotic disorder in F40-F48

F92.9   Mixed disorder of conduct and emotions, unspecified

F93   Emotional disorders with onset specific to childhood

Mainly exaggerations of normal developmental trends rather than phenomena that are qualitatively abnormal in themselves. Developmental appropriateness is used as the key diagnostic feature in defining the difference between these emotional disorders, with onset specific to childhood, and the neurotic disorders (F40-F48).

Excludes:    when associated with conduct disorder (F92-)

F93.0   Separation anxiety disorder of childhood

Should be diagnosed when fear of separation constitutes the focus of the anxiety and when such anxiety first arose during the early years of childhood. It is differentiated from normal separation anxiety when it is of a degree (severity) that is statistically unusual (including an abnormal persistence beyond the usual age period), and when it is associated with significant problems in social functioning.

Excludes:    mood [affective] disorders (F30-F39)

neurotic disorders (F40-F48)

phobic anxiety disorder of childhood (F93l)

social anxiety disorder of childhood (F93.2)

F93.1   Phobic anxiety disorder of childhood

Fears in childhood that show a marked developmental phase specificity and arise (to some extent) in a majority of children, but that are abnormal in degree. Other fears that arise in childhood but that are not a normal part of psychosocial development (for example agoraphobia) should be coded under the appropriate category in section F40-F48.

Excludes:    generalized anxiety disorder (F41.1)

F93.2   Social anxiety disorder of childhood

In this disorder there is a wariness of strangers and social apprehension or anxiety when encountering new, strange, or socially threatening situations. This category should be used only where such fears arise during the early years, and are both unusual in degree and accompanied by problems in social functioning.

Avoidant disorder of childhood or adolescence

F93.3   Sibling rivalry disorder

Some degree of emotional disturbance usually following the birth of an immediately younger sibling is shown by a majority of young children. A sibling rivalry disorder should be diagnosed only if the degree or persistence of the disturbance is both statistically unusual and associated with abnormalities of social interaction.

Sibling jealousy

F93.8   Other childhood emotional disorders

Identity disorder

Overanxious disorder

Excludes:    gender identity disorder of childhood (F64.2)

F93.9   Childhood emotional disorder, unspecified

F94   Disorders of social functioning with onset specific to childhood and adolescence

A somewhat heterogeneous group of disorders that have in common abnormalities in social functioning which begin during the developmental period, but which (unlike the pervasive developmental disorders) are not primarily characterized by an apparently constitutional social incapacity or deficit that pervades all areas of functioning. In many instances, serious environmental distortions or privations probably play a crucial role in etiology.

F94.0   Elective mutism

Characterized by a marked, emotionally determined selectivity in speaking, such that the child demonstrates a language competence in some situations but fails to speak in other (definable) situations. The disorder is usually associated with marked personality features involving social anxiety, withdrawal, sensitivity, or resistance.

Selective mutism

Excludes:    pervasive developmental disorders (F84-)

schizophrenia (F20-)

specific developmental disorders of speech and language (F80-)

transient mutism as part of separation anxiety in young children (F93.0)

F94.1   Reactive attachment disorder of childhood

Starts in the first five years of life and is characterized by persistent abnormalities in the child's pattern of social relationships that are associated with emotional disturbance and are reactive to changes in environmental circumstances (e.g. fearfulness and hypervigilance, poor social interaction with peers, aggression towards self and others, misery, and growth failure in some cases). The syndrome probably occurs as a direct result of severe parental neglect, abuse, or serious mishandling.

Use additional code, if desired, to identify any associated failure to thrive or growth retardation.

Excludes:    Asperger syndrome (F84.5)

disinhibited attachment disorder of childhood (F94.2)

maltreatment syndromes (T74-)

normal variation in pattern of selective attachment

sexual or physical abuse in childhood, resulting in psychosocial problems (^[i]Z61.4-Z61.6)

F94.2   Disinhibited attachment disorder of childhood

A particular pattern of abnormal social functioning that arises during the first five years of life and that tends to persist despite marked changes in environmental circumstances, e.g. diffuse, nonselectively focused attachment behaviour, attention-seeking and indiscriminately friendly behaviour, poorly modulated peer interactions; depending on circumstances there may also be associated emotional or behavioural disturbance.

Affectionless psychopathy

Institutional syndrome

Excludes:    Asperger syndrome (F84.5)

hospitalism in children (F43.2)

hyperkinetic disorders (F90-)

reactive attachment disorder of childhood (F94l)

F94.8   Other childhood disorders of social functioning

F94.9   Childhood disorder of social functioning, unspecified

F95   Tic disorders

Syndromes in which the predominant manifestation is some form of tic. A tic is an involuntary, rapid, recurrent, nonrhythmic motor movement (usually involving circumscribed muscle groups) or vocal production that is of sudden onset and that serves no apparent purpose. Tics tend to be experienced as irresistible but usually they can be suppressed for varying periods of time, are exacerbated by stress, and disappear during sleep. Common simple motor tics include only eye-blinking, neck-jerking, shoulder-shrugging, and facial grimacing. Common simple vocal tics include throat-clearing, barking, sniffing, and hissing. Common complex tics include hitting oneself, jumping, and hopping. Common complex vocal tics include the repetition of particular words, and sometimes the use of socially unacceptable (often obscene) words (coprolalia), and the repetition of one's own sounds or words (palilalia).

F95.0   Transient tic disorder

Meets the general criteria for a tic disorder but the tics do not persist longer than 12 months. The tics usually take the form of eye-blinking, facial grimacing, or head-jerking.

F95.1   Chronic motor or vocal tic disorder

Meets the general criteria for a tic disorder, in which there are motor or vocal tics (but not both), that may be either single or multiple (but usually multiple), and last for more than a year.

F95.2   Combined vocal and multiple motor tic disorder [de la Tourette]

A form of tic disorder in which there are, or have been, multiple motor tics and one or more vocal tics, although these need not have occurred concurrently. The disorder usually worsens during adolescence and tends to persist into adult life. The vocal tics are often multiple with explosive repetitive vocalizations, throat-clearing, and grunting, and there may be the use of obscene words or phrases. Sometimes there is associated gestural echopraxia which may also be of an obscene nature (copropraxia).

F95.8   Other tic disorders

F95.9   Tic disorder, unspecified

Tic NOS

F98   Other behavioural and emotional disorders with onset usually occurring in childhood and adolescence

A heterogeneous group of disorders that share the characteristic of an onset in childhood but otherwise differ in many respects. Some of the conditions represent well-defined syndromes but others are no more than symptom complexes that need inclusion because of their frequency and association with psychosocial problems, and because they cannot be incorporated into other syndromes.

Excludes:    breath-holding spells (R06.8)

gender identity disorder of childhood (F64.2)

Kleine-Levin syndrome (G47.8)

obsessive-compulsive disorder (F42-)

sleep disorders due to emotional causes (F51-)

F98.0   Nonorganic enuresis

A disorder characterized by involuntary voiding of urine, by day and by night, which is abnormal in relation to the individual's mental age, and which is not a consequence of a lack of bladder control due to any neurological disorder, to epileptic attacks, or to any structural abnormality of the urinary tract. The enuresis may have been present from birth or it may have arisen following a period of acquired bladder control. The enuresis may or may not be associated with a more widespread emotional or behavioural disorder.

Enuresis (primary)(secondary) of nonorganic origin

Functional enuresis

Psychogenic enuresis

Urinary incontinence of nonorganic origin

Excludes:    enuresis NOS (R32)

F98.1   Nonorganic encopresis

Repeated, voluntary or involuntary passage of faeces, usually of normal or near-normal consistency, in places not appropriate for that purpose in the individual's own sociocultural setting. The condition may represent an abnormal continuation of normal infantile incontinence, it may involve a loss of continence following the acquisition of bowel control, or it may involve the deliberate deposition of faeces in inappropriate places in spite of normal physiological bowel control. The condition may occur as a monosymptomatic disorder, or it may form part of a wider disorder, especially an emotional disorder (F93-) or a conduct disorder (F91-).

Functional encopresis

Incontinence of faeces of nonorganic origin

Psychogenic encopresis

Use additional code, if desired, to identify the cause of any coexisting constipation.

Excludes:    encopresis NOS (R15)

F98.2   Feeding disorder of infancy and childhood

A feeding disorder of varying manifestations usually specific to infancy and early childhood. It generally involves food refusal and extreme faddiness in the presence of an adequate food supply, a reasonably competent caregiver, and the absence of organic disease. There may or may not be associated rumination (repeated regurgitation without nausea or gastrointestinal illness).

Rumination disorder of infancy

Excludes:    anorexia nervosa and other eating disorders (F50-)

feeding:

• difficulties and mismanagement (R63.3)

• problems of newborn (P92-)

pica of infancy or childhood (F98.3)

F98.3   Pica of infancy and childhood

Persistent eating of non-nutritive substances (such as soil, paint chippings, etc.). It may occur as one of many symptoms that are part of a more widespread psychiatric disorder (such as autism), or as a relatively isolated psychopathological behaviour; only the latter is classified here. The phenomenon is most common in mentally retarded children and, if mental retardation is also present, F70-F79 should be selected as the main diagnosis.

F98.4   Stereotyped movement disorders

Voluntary, repetitive, stereotyped, nonfunctional (and often rhythmic) movements that do not form part of any recognized psychiatric or neurological condition. When such movements occur as symptoms of some other disorder, only the overall disorder should be recorded. The movements that are of a non self-injurious variety include: body-rocking, head-rocking, hair-plucking, hair-twisting, finger-flicking mannerisms, and hand-flapping. Stereotyped self-injurious behaviour includes repetitive head-banging, face-slapping, eye-poking, and biting of hands, lips or other body parts. All the stereotyped movement disorders occur most frequently in association with mental retardation (when this is the case, both should be recorded). If eye-poking occurs in a child with visual impairment, both should be coded: eye-poking under this category and the visual condition under the appropriate somatic disorder code.

Stereotype/habit disorder

Excludes:    abnormal involuntary movements (R25-)

movement disorders of organic origin (G20-G25)

nail-biting (F98.8)

nose-picking (F98.8)

stereotypies that are part of a broader psychiatric condition (F00-F95)

thumb-sucking (F98.8)

tic disorders (F95-)

trichotillomania (F63.3)

F98.5   Stuttering [stammering]

Speech that is characterized by frequent repetition or prolongation of sounds or syllables or words, or by frequent hesitations or pauses that disrupt the rhythmic flow of speech. It should be classified as a disorder only if its severity is such as to markedly disturb the fluency of speech.

Excludes:    cluttering (F98.6)

tic disorders (F95-)

F98.6   Cluttering

A rapid rate of speech with breakdown in fluency, but no repetitions or hesitations, of a severity to give rise to diminished speech intelligibility. Speech is erratic and dysrhythmic, with rapid jerky spurts that usually involve faulty phrasing patterns.

Excludes:    stuttering (F98.5)

tic disorders (F95-)

F98.8   Other specified behavioural and emotional disorders with onset usually occurring in childhood and adolescence

Attention deficit disorder without hyperactivity

Excessive masturbation

Nail-biting

Nose-picking

Thumb-sucking

F98.9   Unspecified behavioural and emotional disorders with onset usually occurring in childhood and adolescence

Unspecified mental disorder (F99)

F99   Mental disorder, not otherwise specified

Mental illness NOS

Excludes:    organic mental disorder NOS (F06.9)

CHAPTER VI - Diseases of the nervous system (G00-G99)

Excludes:    certain conditions originating in the perinatal period (P00-P96)

certain infectious and parasitic diseases (A00-B99)

complications of pregnancy, childbirth and the puerperium (000-099)

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)

This chapter contains the following blocks:

G00-G09      Inflammatory diseases of the central nervous system

G10-G14      Systemic atrophies primarily affecting the central nervous system

G20-G26      Extrapyramidal and movement disorders

G30-G32      Other degenerative diseases of the nervous system

G35-G37      Demyelinating diseases of the central nervous system

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

Asterisk categories for this chapter are provided as follows:

G01*            Meningitis in bacterial diseases classified elsewhere

G02*            Meningitis in other infectious and parasitic diseases classified elsewhere

G05*            Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere

G07*            Intracranial and intraspinal abscess and granuloma in diseases classified elsewhere

G13*            Systemic atrophies primarily affecting central nervous system in diseases classified elsewhere

G22*            Parkinsonism in diseases classified elsewhere

G26*            Extrapyramidal and movement disorders in diseases classified elsewhere

G32*            Other degenerative disorders of nervous system in diseases classified elsewhere

G46*            Vascular syndromes of brain in cerebrovascular diseases

G53*            Cranial nerve disorders in diseases classified elsewhere

G55*            Nerve root and plexus compressions in diseases classified elsewhere

G59*            Mononeuropathy in diseases classified elsewhere

G63*            Polyneuropathy in diseases classified elsewhere

G73*            Disorders of myoneural junction and muscle in diseases classified elsewhere

G94*            Other disorders of brain in diseases classified elsewhere

G99*            Other disorders of nervous system in diseases classified elsewhere

Inflammatory diseases of the central nervous system (G00-G09)

G00  Bacterial meningitis, not elsewhere classified

Includes:

arachnoiditis leptomeningitis meningitis pachymeningitis

bacterial

Excludes:    bacterial:

• meningoencephalitis (G04.2)

• meningomyelitis (G04.2)

G00.0   Haemophilus meningitis

Meningitis due to Haemophilus influenzae

G00.1   Pneumococcal meningitis

G00.2   Streptococcal meningitis

G00.3   Staphylococcal meningitis

G00.8   Other bacterial meningitis

Meningitis due to:

• Escherichia coli

• Friedlander bacillus

• Klebsiella

G00.9   Bacterial meningitis, unspecified

Meningitis:

• purulent NOS

• pyogenic NOS

• suppurative NOS

G01  Meningitis in bacterial diseases classified elsewhere

Meningitis (in):

• anthrax (A22.8†)

• gonococcal (A54.8†)

• leptospirosis (A27†)

• listerial (A32.1†)

• Lyme disease (A69.2†)

• meningococcal (A39.0†)

• neurosyphilis (A52.1†)

• salmonella infection (A02.2†)

• syphilis:

• congenital (A50.4†)

• secondary (A51.4†)

• tuberculous (A17.0†)

• typhoid fever (A01.0†)

Excludes:    meningoencephalitis and meningomyelitis in bacterial diseases classified elsewhere (G05.0*)

G02  Meningitis in other infectious and parasitic diseases classified elsewhere

Excludes:    meningoencephalitis and meningomyelitis in other infectious and parasitic diseases classified elsewhere (G05.1-G05.2*)

G02.0* Meningitis in viral diseases classified elsewhere

Meningitis (due to):

• adenoviral (A87.1†)

• enteroviral (A87.0†)

• herpesviral [herpes simplex] (B00.3†)

• infectious mononucleosis (B27†)

• measles (B05.1†)

• mumps (B26.1†)

• rubella (B06.0†)

• varicella [chickenpox] (B01.0†)

• zoster (B02.1†)

G02.1* Meningitis in mycoses

Meningitis (in):

• candidal (B37.5†)

• coccidioidomycosis (B38.4†)

• cryptococcal (B45.1†)

G02.8* Meningitis in other specified infectious and parasitic diseases classified elsewhere

Meningitis due to:

• African trypanosomiasis (B56†)

• Chagas disease (chronic) (B57.4†)

G03  Meningitis due to other and unspecified causes

Includes:

arachnoiditis leptomeningitis meningitis pachymeningitis

due to other and unspecified causes

Excludes:    meningoencephalitis (G04-)

meningomyelitis (G04-)

G03.0   Nonpyogenic meningitis

Nonbacterial meningitis

G03.1   Chronic meningitis

G03.2   Benign recurrent meningitis [Mollaret]

G03.8   Meningitis due to other specified causes

G03.9   Meningitis, unspecified

Arachnoiditis (spinal) NOS

G04  Encephalitis, myelitis and encephalomyelitis

Includes:    acute ascending myelitis

meningoencephalitis

meningomyelitis

Excludes:    myalgic encephalomyelitis (G93.3)

encephalopathy:

• NOS (G93.4)

• alcoholic (G31.2)

• toxic (G92)

multiple sclerosis (G35)

myelitis:

• acute transverse (G37.3)

• subacute necrotizing (G37.4)

G04.0   Acute disseminated encephalitis

  Encephalitis        

  Encephalomyelitis      postimmunization

Use additional external cause code (Chapter XX), if desired, to identify vaccine.

G04.1   Tropical spastic paraplegia

G04.2   Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified

G04.8   Other encephalitis, myelitis and encephalomyelitis

Postinfectious encephalitis and encephalomyelitis NOS

G04.9   Encephalitis, myelitis and encephalomyelitis, unspecified

Ventriculitis (cerebral) NOS

G05  Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere

Includes:    meningoencephalitis and meningomyelitis in diseases classified elsewhere

G05.0* Encephalitis, myelitis and encephalomyelitis in bacterial diseases classified elsewhere

Encephalitis, myelitis or encephalomyelitis (in):

• listerial (A32.1†)

• meningococcal (A39.8†)

• syphilis:

• congenital (A50.4†)

• late (A52.1†)

• tuberculous (A17.8†)

G05.1* Encephalitis, myelitis and encephalomyelitis in viral diseases classified elsewhere

Encephalitis, myelitis or encephalomyelitis (in):

• adenoviral (A85.1†)

• cytomegaloviral (B25.8†)

• enteroviral (A85.0†)

• herpesviral [herpes simplex] (B00.4†)

• influenza:

     • seasonal virus identified (J10.8†)

     • virus not identified (J11.8†)

     • zoonotic or pandemic influenza virus identified (J09†)

• measles (B05.0†)

• mumps (B26.2†)

• postchickenpox (B01.1†)

• rubella (B06.0†)

• zoster (B02.0†)

G05.2* Encephalitis, myelitis and encephalomyelitis in other infectious and parasitic diseases classified elsewhere

Encephalitis, myelitis or encephalomyelitis in:

• African trypanosomiasis (B56†)

• Chagas disease (chronic) (B57.4†)

• naegleriasis (B60.2†)

• toxoplasmosis (B58.2†)

Eosinophilic meningoencephalitis (B83.2†)

G05.8* Encephalitis, myelitis and encephalomyelitis in other diseases classified elsewhere

Encephalitis in systemic lupus erythematosus (M32.1†)

G06  Intracranial and intraspinal abscess and granuloma

Use additional code (B95-B97), if desired, to identify infectious agent.

G06.0   Intracranial abscess and granuloma

Abscess (embolic)(of):

• brain [any part]

• cerebellar

• cerebral

• otogenic

Intracranial abscess or granuloma:

• epidural

• extradural

• subdural

G06.1   Intraspinal abscess and granuloma

Abscess (embolic) of spinal cord [any part]

Intraspinal abscess or granuloma:

• epidural

• extradural

• subdural

G06.2   Extradural and subdural abscess, unspecified

G07  Intracranial and intraspinal abscess and granuloma in diseases classified elsewhere

Abscess of brain:

• amoebic (A06.6†)

• gonococcal (A54.8†)

• tuberculous (A17.8†)

Schistosomiasis granuloma of brain (B65†)

Tuberculoma of:

• brain (A17.8†)

• meninges (A17.1†)

G08  Intracranial and intraspinal phlebitis and thrombophlebitis

Septic:

• embolism           

• endophlebitis         of intracranial or intraspinal venous

• phlebitis              sinuses and veins

• thrombophlebitis   

• thrombosis         

Excludes:    intracranial phlebitis and thrombophlebitis:

• complicating:

• abortion or ectopic or molar pregnancy (O00-O07, O08.7)

• pregnancy, childbirth and the puerperium (O22.5, O87.3)

• of nonpyogenic origin (I67.6)

nonpyogenic intraspinal phlebitis and thrombophlebitis (G95.1)

G09  Sequelae of inflammatory diseases of central nervous system

Note:          Category G09 is to be used to indicate conditions whose primary classification is to G00-G08 (i.e. excluding those marked with an asterisk (*)) as the cause of sequelae, themselves classifiable elsewhere. The "sequelae" include conditions specified as such or as late effects, or those present one year or more after onset of the causal condition. For use of this category reference should be made to the relevant morbidity coding rules and guidelines in Volume 2 or mortality coding rules and guidelines in Part 2a Instruction Manual (NCHS).

Not to be used for chronic inflammatory disease of the central nervous system. Code these to current inflammatory disease of the central nervous system.

Systemic atrophies primarily affecting the central nervous system (G10-G14)

G10  Huntington disease

Huntington chorea

G11  Hereditary ataxia

Excludes:    cerebral palsy (G80-)

hereditary and idiopathic neuropathy (G60-)

metabolic disorders (E70-E90)

G11.0   Congenital nonprogressive ataxia

G11.1   Early-onset cerebellar ataxia

Note:          Onset usually before the age of 20

Early-onset cerebellar ataxia with:

• essential tremor

• myoclonus [Hunt ataxia]

• retained tendon reflexes

Friedreich ataxia (autosomal recessive)

X-linked recessive spinocerebellar ataxia

G11.2   Late-onset cerebellar ataxia

Note:          Onset usually after the age of 20

G11.3   Cerebellar ataxia with defective DNA repair

Ataxia telangiectasia [Louis-Bar]

Excludes:    Cockayne syndrome (Q87.1)

xeroderma pigmentosum (Q82.1)

G11.4   Hereditary spastic paraplegia

G11.8   Other hereditary ataxias

G11.9   Hereditary ataxia, unspecified

Hereditary cerebellar:

• ataxia NOS

• degeneration

• disease

• syndrome

G12  Spinal muscular atrophy and related syndromes

G12.0   Infantile spinal muscular atrophy, type I [Werdnig-Hoffman]

G12.1   Other inherited spinal muscular atrophy

Progressive bulbar palsy of childhood [Fazio-Londe]

Spinal muscular atrophy:

• adult form

• childhood form, type II

• distal

• juvenile form, type III [Kugelberg-Welander]

• scapuloperoneal form

G12.2   Motor neuron disease

Familial motor neuron disease

Kennedy disease

Lateral sclerosis:

• amyotrophic

• primary

Progressive:

• bulbar palsy

• spinal muscular atrophy

G12.20 Advanced motor neuron disease

Grave motor neuron disease

Severe motor neuron disease

G12.8   Other spinal muscular atrophies and related syndromes

G12.9   Spinal muscular atrophy, unspecified

G13  Systemic atrophies primarily affecting central nervous system in diseases classified elsewhere

G13.0* Paraneoplastic neuromyopathy and neuropathy

Carcinomatous neuromyopathy (C00-C97†)

Sensorial paraneoplastic neuropathy [Denny Brown] (C00-D48†)

G13.1* Other systemic atrophy primarily affecting central nervous system in neoplastic disease

Paraneoplastic limbic encephalopathy (C00-D48†)

G13.2* Systemic atrophy primarily affecting central nervous system in myxoedema (E00.1†, E03†)

G13.8* Systemic atrophy primarily affecting central nervous system in other diseases classified elsewhere

G14  Postpolio syndrome

Postpolio myelitic syndrome

Excludes:    sequelae of poliomyelitis (B91)

Extrapyramidal and movement disorders (G20-G26)

G20  Parkinson disease

Hemiparkinsonism

Paralysis agitans

Parkinsonism or Parkinson disease:

• NOS

• idiopathic

• primary

G20.00 Advanced Parkinson disease

Grave Parkinson disease

Severe Parkinson disease

G21  Secondary parkinsonism

G21.0   Malignant neuroleptic syndrome

Use additional external cause code (Chapter XX), if desired, to identify drug.

G21.1   Other drug- secondary parkinsonism

Use additional external cause code (Chapter XX), if desired, to identify drug.

G21.2   Secondary parkinsonism due to other external agents

Use additional external cause code (Chapter XX), if desired, to identify external agent.

G21.3   Postencephalitic parkinsonism

G21.4   Vascular parkinsonism

G21.8   Other secondary parkinsonism

G21.9   Secondary parkinsonism, unspecified

G22  Parkinsonism in diseases classified elsewhere

Syphilitic parkinsonism (A52.1†)

G23  Other degenerative diseases of basal ganglia

Excludes:    multi-system degeneration (G90.3)

G23.0   Hallervorden-Spatz disease

Pigmentary pallidal degeneration

G23.1   Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski]

G23.2   Striatonigral degeneration

G23.8   Other specified degenerative diseases of basal ganglia

Calcification of basal ganglia

G23.9   Degenerative disease of basal ganglia, unspecified

G24  Dystonia

Includes:    dyskinesia

Excludes:    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

Excludes:    torticollis NOS (M43.6)

G24.4   Idiopathic orofacial dystonia

Orofacial dyskinesia

G24.5   Blepharospasm

G24.8   Other dystonia

G24.9   Dystonia, unspecified

Dyskinesia NOS

G25  Other extrapyramidal and movement disorders

G25.0   Essential tremor

Familial tremor

Excludes:    tremor NOS (R25.1)

G25.1   Drug-induced tremor

Use additional external cause code (Chapter XX), if desired, to identify drug.

G25.2   Other specified forms of tremor

Intention tremor

G25.3   Myoclonus

Drug-induced myoclonus

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

Excludes:    facial myokymia (G51.4)

myoclonic epilepsy (G40-)

G25.4   Drug-induced chorea

Use additional external cause code (Chapter XX), if desired, to identify drug.

G25.5   Other chorea

Chorea NOS

Excludes:    chorea NOS with heart involvement (I02.0)

Huntington chorea (G10)

rheumatic chorea (I02-)

Sydenham chorea (I02-)

G25.6   Drug-induced tics and other tics of organic origin

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

Excludes:    de la Tourette syndrome (F95.2)

tic NOS (F95.9)

G25.8   Other specified extrapyramidal and movement disorders

Restless legs syndrome

Stiff-person[man] syndrome

G25.9   Extrapyramidal and movement disorder, unspecified

G26  Extrapyramidal and movement disorders in diseases classified elsewhere

Other degenerative diseases of the nervous system (G30-G32)

G30  Alzheimer disease

Includes:    senile and presenile forms

Excludes:    senile:

• degeneration of brain NEC (G31.1)

• dementia NOS (F03)

senility NOS (R54)

G30.0   Alzheimer disease with early onset

Note:          Onset usually before the age of 65

G30.1   Alzheimer disease with late onset

Note:          Onset usually after the age of 65

G30.8   Other Alzheimer disease

G30.9   Alzheimer disease, unspecified

G31  Other degenerative diseases of nervous system, not elsewhere classified

Excludes:    Reye syndrome (G93.7)

G31.0   Circumscribed brain atrophy

Frontotemporal dementia (FTD)

Pick disease

Progressive isolated aphasia

G31.1   Senile degeneration of brain, not elsewhere classified

Excludes:    Alzheimer disease (G30-)

senility NOS (R54)

G31.2   Degeneration of nervous system due to alcohol

Alcoholic:

• cerebellar:

• ataxia

• degeneration

• cerebral degeneration

• encephalopathy

Dysfunction of autonomic nervous system due to alcohol

G31.8   Other specified degenerative diseases of nervous system

Grey-matter degeneration [Alpers]

Lewy body(ies) (dementia) (disease) (F02.8*)

Subacute necrotizing encephalopathy [Leigh]

G31.9   Degenerative disease of nervous system, unspecified

G32  Other degenerative disorders of nervous system in diseases classified elsewhere

G32.0* Subacute combined degeneration of spinal cord in diseases classified elsewhere

Subacute combined degeneration of spinal cord in vitamin B₁₂ deficiency (E53.8†)

G32.8* Other specified degenerative disorders of nervous system in diseases classified elsewhere

Demyelinating diseases of the central nervous system (G35-G37)

G35  Multiple sclerosis

Multiple sclerosis (of):

• NOS

• brain stem

• cord

• disseminated

• generalized

G36  Other acute disseminated demyelination

Excludes:    postinfectious encephalitis and encephalomyelitis NOS (G04.8)

G36.0   Neuromyelitis optica [Devic]

Demyelination in optic neuritis

Excludes:    optic neuritis NOS (H46)

G36.1   Acute and subacute haemorrhagic leukoencephalitis [Hurst]

G36.8   Other specified acute disseminated demyelination

G36.9   Acute disseminated demyelination, unspecified

G37  Other demyelinating diseases of central nervous system

G37.0   Diffuse sclerosis

Periaxial encephalitis

Schilder disease

Excludes:    adrenoleukodystrophy [Addison-Schilder] (E71.3)

G37.1   Central demyelination of corpus callosum

G37.2   Central pontine myelinolysis

G37.3   Acute transverse myelitis in demyelinating disease of central nervous system

Acute transverse myelitis NOS

Excludes:    multiple sclerosis (G35)

neuromyelitis optica [Devic] (G36.0)

G37.4   Subacute necrotizing myelitis

G37.5   Concentric sclerosis [Balo]

G37.8   Other specified demyelinating diseases of central nervous system

G37.9   Demyelinating disease of central nervous system, unspecified

Episodic and paroxysmal disorders (G40-G47)

G40  Epilepsy

Excludes:    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

G40.1   Localization-related (focal)(partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures

Attacks without alteration of consciousness

Simple partial seizures developing into secondarily generalized seizures

G40.2   Localization-related (focal)(partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures

Attacks with alteration of consciousness, often with automatisms

Complex partial seizures developing into secondarily generalized seizures

G40.3   Generalized idiopathic epilepsy and epileptic syndromes

Benign:

• myoclonic epilepsy in infancy

• neonatal convulsions (familial)

Childhood absence epilepsy [pyknolepsy]

Epilepsy with grand mal seizures on awakening

Juvenile:

• absence epilepsy

• myoclonic epilepsy [impulsive petit mal]

Nonspecific epileptic seizures:

• atonic

• clonic

• myoclonic

• tonic

• tonic-clonic

G40.4   Other generalized epilepsy and epileptic syndromes

Epilepsy with:

• myoclonic absences

• myoclonic-astatic seizures

Infantile spasms

Lennox-Gastaut syndrome

Salaam attacks

Symptomatic early myoclonic encephalopathy

West syndrome

G40.5   Special epileptic syndromes

Epilepsia partialis continua [Kozhevnikof]

Epileptic seizures related to:

• alcohol

• drugs

• hormonal changes

• sleep deprivation

• stress

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

G40.6   Grand mal seizures, unspecified (with or without petit mal)

G40.7   Petit mal, unspecified, without grand mal seizures

G40.8   Other epilepsy

Epilepsies and epileptic syndromes undetermined as to whether they are focal or generalized

G40.9   Epilepsy, unspecified

Epileptic:

• convulsions NOS

• fits NOS

• seizures NOS

G41  Status epilepticus

G41.0   Grand mal status epilepticus

Tonic-clonic status epilepticus

Excludes:    epilepsia partialis continua [Kozhevnikof] (G40.5)

G41.1   Petit mal status epilepticus

Epileptic absence status

G41.2   Complex partial status epilepticus

G41.8   Other status epilepticus

G41.9   Status epilepticus, unspecified

G43  Migraine

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

Excludes:    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

G43.9   Migraine, unspecified

G44  Other headache syndromes

Excludes:    atypical facial pain (G50.1)

headache NOS (R51)

trigeminal neuralgia (G50.0)

G44.0   Cluster headache syndrome

Chronic paroxysmal hemicrania

Cluster headache:

• chronic

• episodic

G44.1   Vascular headache, not elsewhere classified

Vascular headache NOS

G44.2   Tension-type headache

Chronic tension-type headache

Episodic tension headache

Tension headache NOS

G44.3   Chronic post-traumatic headache

G44.4   Drug-induced headache, not elsewhere classified

Use additional external cause code (Chapter XX), if desired, to identify drug.

G44.8   Other specified headache syndromes

G45  Transient cerebral ischaemic attacks and related syndromes

Excludes:    neonatal cerebral ischaemia (P91.0)

G45.0   Vertebro-basilar artery syndrome

G45.1   Carotid artery syndrome (hemispheric)

G45.2   Multiple and bilateral precerebral artery syndromes

G45.3   Amaurosis fugax

G45.4   Transient global amnesia

Excludes:    amnesia NOS (R41.3)

G45.8   Other transient cerebral ischaemic attacks and related syndromes

G45.9   Transient cerebral ischaemic attack, unspecified

Spasm of cerebral artery

Transient cerebral ischaemia NOS

G46  Vascular syndromes of brain in cerebrovascular diseases (I60-I67†)

G46.0* Middle cerebral artery syndrome (I66.0†)

G46.1* Anterior cerebral artery syndrome (I66.1†)

G46.2* Posterior cerebral artery syndrome (I66.2†)

G46.3* Brain stem stroke syndrome (I60-I67†)

Syndrome:

• Benedikt

• Claude

• Foville

• Millard-Gubler

• Wallenberg

• Weber

G46.4* Cerebellar stroke syndrome (I60-I67†)

G46.5* Pure motor lacunar syndrome (I60-I67†)

G46.6* Pure sensory lacunar syndrome (I60-I67†)

G46.7* Other lacunar syndromes (I60-I67†)

G46.8* Other vascular syndromes of brain in cerebrovascular diseases (I60-I67†)

G47  Sleep disorders

Excludes:    nightmares (F51.5)

nonorganic sleep disorders (F51-)

sleep terrors (F51.4)

sleepwalking (F51.3)

G47.0   Disorders of initiating and maintaining sleep [insomnias]

G47.1   Disorders of excessive somnolence [hypersomnias]

G47.2   Disorders of the sleep-wake schedule

Delayed sleep phase syndrome

Irregular sleep-wake pattern

G47.3   Sleep apnoea

Sleep apnoea:

• central

• obstructive

Excludes:    pickwickian syndrome (E66.2)

sleep apnoea of newborn (P28.3)

G47.4   Narcolepsy and cataplexy

G47.8   Other sleep disorders

Kleine-Levin syndrome

G47.9   Sleep disorder, unspecified

Nerve, nerve root and plexus disorders (G50-G59)

Excludes:    current traumatic nerve, nerve root and plexus disorders - see nerve injury by body region

neuralgia      neuralgia

neuritis       neuritis

peripheral neuritis in pregnancy (O26.8)

radiculitis NOS (M54.1)

G50  Disorders of trigeminal nerve

Includes:    disorders of 5th cranial nerve

G50.0   Trigeminal neuralgia

Syndrome of paroxysmal facial pain

Tic douloureux

G50.1   Atypical facial pain

G50.8   Other disorders of trigeminal nerve

G50.9   Disorder of trigeminal nerve, unspecified

G51  Facial nerve disorders

Includes:    disorders of 7th cranial nerve

G51.0   Bell palsy

Facial palsy

G51.1   Geniculate ganglionitis

Excludes:    postherpetic geniculate ganglionitis (B02.2)

G51.2   Melkersson syndrome

Melkersson-Rosenthal syndrome

G51.3   Clonic hemifacial spasm

G51.4   Facial myokymia

G51.8   Other disorders of facial nerve

G51.9   Disorder of facial nerve, unspecified

G52  Disorders of other cranial nerves

Excludes:    disorders of:

• acoustic [8th] nerve (H93.3)

• optic [2nd] nerve (H46, H47.0)

paralytic strabismus due to nerve palsy (H49.0-H49.2)

G52.0   Disorders of olfactory nerve

Disorder of 1st cranial nerve

G52.1   Disorders of glossopharyngeal nerve

Disorder of 9th cranial nerve

Glossopharyngeal neuralgia

G52.2   Disorders of vagus nerve

Disorder of pneumogastric [10th] nerve

G52.3   Disorders of hypoglossal nerve

Disorder of 12th cranial nerve

G52.7   Disorders of multiple cranial nerves

Polyneuritis cranialis

G52.8   Disorders of other specified cranial nerves

G52.9   Cranial nerve disorder, unspecified

G53  Cranial nerve disorders in diseases classified elsewhere

G53.0* Postzoster neuralgia (B02.2†)

Postherpetic:

• geniculate ganglionitis

• trigeminal neuralgia

G53.1* Multiple cranial nerve palsies in infectious and parasitic diseases classified elsewhere (A00-B99†)

G53.2* Multiple cranial nerve palsies in sarcoidosis (D86.8†)

G53.3* Multiple cranial nerve palsies in neoplastic disease (C00-D48†)

G53.8* Other cranial nerve disorders in other diseases classified elsewhere

G54  Nerve root and plexus disorders

Excludes:    current traumatic nerve root and plexus disorders - see nerve injury by body region

intervertebral disc disorders (M50-M51)

neuralgia or neuritis NOS (M79.2)

neuritis or radiculitis:

• brachial NOS      

• lumbar NOS        

• lumbosacral NOS   

• thoracic NOS         (M54.1)

radiculitis NOS     

radiculopathy NOS   

spondylosis (M47-)

G54.0   Brachial plexus disorders

Thoracic outlet syndrome

G54.1   Lumbosacral plexus disorders

G54.2   Cervical root disorders, not elsewhere classified

G54.3   Thoracic root disorders, not elsewhere classified

G54.4   Lumbosacral root disorders, not elsewhere classified

G54.5   Neuralgic amyotrophy

Parsonage-Aldren-Turner syndrome

Shoulder-girdle neuritis

G54.6   Phantom limb syndrome with pain

G54.7   Phantom limb syndrome without pain

Phantom limb syndrome NOS

G54.8   Other nerve root and plexus disorders

G54.9   Nerve root and plexus disorder, unspecified

G55  Nerve root and plexus compressions in diseases classified elsewhere

G55.0* Nerve root and plexus compressions in neoplastic disease (C00-D48†)

G55.1* Nerve root and plexus compressions in intervertebral disc disorders

(M50-M51†)

G55.2* Nerve root and plexus compressions in spondylosis (M47†)

G55.3* Nerve root and plexus compressions in other dorsopathies (M45-M46†,

M48†, M53-M54†)

G55.8* Nerve root and plexus compressions in other diseases classified elsewhere

G56  Mononeuropathies of upper limb

Excludes:    current traumatic nerve disorder - see nerve injury by body region

G56.0   Carpal tunnel syndrome

G56.1   Other lesions of median nerve

G56.2   Lesion of ulnar nerve

Tardy ulnar nerve palsy

G56.3   Lesion of radial nerve

G56.4   Causalgia

G56.8   Other mononeuropathies of upper limb

Interdigital neuroma of upper limb

G56.9   Mononeuropathy of upper limb, unspecified

G57  Mononeuropathies of lower limb

Excludes:    current traumatic nerve disorder - see nerve injury by body region

G57.0   Lesion of sciatic nerve

Excludes:    sciatica:

• NOS (M54.3)

• attributed to intervertebral disc disorder (M51.1)

G57.1   Meralgia paraesthetica

Lateral cutaneous nerve of thigh syndrome

G57.2   Lesion of femoral nerve

G57.3   Lesion of lateral popliteal nerve

Peroneal nerve palsy

G57.4   Lesion of medial popliteal nerve

G57.5   Tarsal tunnel syndrome

G57.6   Lesion of plantar nerve

Morton metatarsalgia

G57.8   Other mononeuropathies of lower limb

Interdigital neuroma of lower limb

G57.9   Mononeuropathy of lower limb, unspecified

G58  Other mononeuropathies

G58.0   Intercostal neuropathy

G58.7   Mononeuritis multiplex

G58.8   Other specified mononeuropathies

G58.9   Mononeuropathy, unspecified

G59  Mononeuropathy in diseases classified elsewhere

G59.0* Diabetic mononeuropathy (E10-E14† with common fourth character .4)

G59.8* Other mononeuropathies in diseases classified elsewhere

Polyneuropathies and other disorders of the peripheral nervous system (G60-G64)

Excludes:    neuralgia NOS (M79.2)

neuritis NOS (M79.2)

peripheral neuritis in pregnancy (O26.8)

radiculitis NOS (M54.1)

G60  Hereditary and idiopathic neuropathy

G60.0   Hereditary motor and sensory neuropathy

Disease:

• Charcot-Marie-Tooth

• Dejerine-Sottas

Hereditary motor and sensory neuropathy, types I-IV

Hypertrophic neuropathy of infancy

Peroneal muscular atrophy (axonal type)(hypertrophic type)

Roussy-Levy syndrome

G60.1   Refsum disease

G60.2   Neuropathy in association with hereditary ataxia

G60.3   Idiopathic progressive neuropathy

G60.8   Other hereditary and idiopathic neuropathies

Morvan disease

Nelaton syndrome

Sensory neuropathy:

• dominantly inherited

• recessively inherited

G60.9   Hereditary and idiopathic neuropathy, unspecified

G61  Inflammatory polyneuropathy

G61.0   Guillain-Barre syndrome

Acute (post-)infective polyneuritis

Miller Fisher Syndrome

G61.1   Serum neuropathy

Use additional external cause code (Chapter XX), if desired, to identify cause.

G61.8   Other inflammatory polyneuropathies

G61.9   Inflammatory polyneuropathy, unspecified

G62  Other polyneuropathies

G62.0   Drug-induced polyneuropathy

Use additional external cause code (Chapter XX), if desired, to identify drug.

G62.1   Alcoholic polyneuropathy

G62.2   Polyneuropathy due to other toxic agents

Use additional external cause code (Chapter XX), if desired, to identify toxic agent.

G62.8   Other specified polyneuropathies

Radiation-induced polyneuropathy

Use additional external cause code (Chapter XX), if desired, to identify cause.

G62.9   Polyneuropathy, unspecified

Neuropathy NOS

G63  Polyneuropathy in diseases classified elsewhere

G63.0* Polyneuropathy in infectious and parasitic diseases classified elsewhere

Polyneuropathy (in):

• diphtheria (A36.8†)

• infectious mononucleosis (B27†)

• leprosy (A30†)

• Lyme disease (A69.2†)

• mumps (B26.8†)

• postherpetic (B02.2†)

• syphilis, late (A52.1†)

• congenital (A50.4†)

• tuberculous (A17.8†)

G63.1* Polyneuropathy in neoplastic disease (C00-D48†)

G63.2* Diabetic polyneuropathy (E10-E14† with common fourth character .4)

G63.3* Polyneuropathy in other endocrine and metabolic diseases (E00-E07†,

E15-E16†, E20-E34†, E70-E89†)

G63.4* Polyneuropathy in nutritional deficiency (E40-E64†)

G63.5* Polyneuropathy in systemic connective tissue disorders (M30-M35†)

G63.6* Polyneuropathy in other musculoskeletal disorders (M00-M25†, M40-M96†)

G63.8* Polyneuropathy in other diseases classified elsewhere

Uraemic neuropathy (N18.5†)

G64  Other disorders of peripheral nervous system

Disorder of peripheral nervous system NOS

Diseases of myoneural junction and muscle (G70-G73)

G70  Myasthenia gravis and other myoneural disorders

Excludes:    botulism (A05.1)

transient neonatal myasthenia gravis (P94.0)

G70.0   Myasthenia gravis

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

G70.1   Toxic myoneural disorders

Use additional external cause code (Chapter XX), if desired, to identify toxic agent.

G70.2   Congenital and developmental myasthenia

G70.8   Other specified myoneural disorders

G70.9   Myoneural disorder, unspecified

G71  Primary disorders of muscles

Excludes:    arthrogryposis multiplex congenita (Q74.3)

metabolic disorders (E70-E90)

myositis (M60-)

G71.0   Muscular dystrophy

Muscular dystrophy:

• autosomal recessive, childhood type, resembling Duchenne or Becker

• benign [Becker]

• benign scapuloperoneal with early contractures [Emery-Dreifuss]

• distal

• facioscapulohumeral

• limb-girdle

• ocular

• oculopharyngeal

• scapuloperoneal

• severe [Duchenne]

Excludes:    congenital muscular dystrophy:

• NOS (G71.2)

• with specific morphological abnormalities of the muscle fibre (G71.2)

G71.1   Myotonic disorders

Dystrophia myotonica [Steinert]

Myotonia:

• chondrodystrophic

• drug-induced

• symptomatic

Myotonia congenita:

• NOS

• dominant [Thomsen]

• recessive [Becker]

Neuromyotonia [Isaacs]

Paramyotonia congenita

Pseudomyotonia

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

G71.2   Congenital myopathies

Congenital muscular dystrophy:

• NOS

• with specific morphological abnormalities of the muscle fibre

Disease:

• central core

• minicore

• multicore

Fibre-type disproportion

Myopathy:

• myotubular (centronuclear)

• nemaline

G71.3   Mitochondrial myopathy, not elsewhere classified

G71.8   Other primary disorders of muscles

G71.9   Primary disorder of muscle, unspecified

Hereditary myopathy NOS

G72  Other myopathies

Excludes:    arthrogryposis multiplex congenita (Q74.3)

dermatopolymyositis (M33-)

ischaemic infarction of muscle (M62.2)

myositis (M60-)

polymyositis (M33.2)

G72.0   Drug-induced myopathy

Use additional external cause code (Chapter XX), if desired, to identify drug.

G72.1   Alcoholic myopathy

G72.2   Myopathy due to other toxic agents

Use additional external cause code (Chapter XX), if desired, to identify toxic agent.

G72.3   Periodic paralysis

Periodic paralysis (familial):

• hyperkalaemic

• hypokalaemic

• myotonic

• normokalaemic

G72.4   Inflammatory myopathy, not elsewhere classified

G72.8   Other specified myopathies

G72.9   Myopathy, unspecified

G73  Disorders of myoneural junction and muscle in diseases classified elsewhere

G73.0* Myasthenic syndromes in endocrine diseases

Myasthenic syndromes in:

• diabetic amyotrophy (E10-E14† with common fourth character .4)

• thyrotoxicosis [hyperthyroidism] (E05†)

G73.1* Eaton-Lambert syndrome (C80†)

G73.2* Other myasthenic syndromes in neoplastic disease (C00-D48†)

G73.3* Myasthenic syndromes in other diseases classified elsewhere

G73.4* Myopathy in infectious and parasitic diseases classified elsewhere

G73.5* Myopathy in endocrine diseases

Myopathy in:

• hyperparathyroidism (E21.0-E21.3†)

• hypoparathyroidism (E20†)

Thyrotoxic myopathy (E05†)

G73.6* Myopathy in metabolic diseases

Myopathy in:

• glycogen storage disease (E74.0†)

• lipid storage disorders (E75†)

G73.7* Myopathy in other diseases classified elsewhere

Myopathy in:

• rheumatoid arthritis (M05-M06†)

• scleroderma (M34.8†)

• sicca syndrome [Sjogren] (M35.0†)

• systemic lupus erythematosus (M32.1†)

Cerebral palsy and other paralytic syndromes (G80-G83)

G80  Cerebral palsy

Excludes:    hereditary spastic paraplegia (G11.4)

G80.0   Spastic quadriplegic cerebral palsy

Spastic tetraplegic cerebral palsy

G80.1   Spastic diplegic cerebral palsy

Congenital spastic paralysis (cerebral)

Spastic cerebral palsy NOS

G80.2   Spastic hemiplegic cerebral palsy

G80.3   Dyskinetic cerebral palsy

Athetoid cerebral palsy

Dystonic cerebral palsy

G80.4   Ataxic cerebral palsy

G80.8   Other cerebral palsy

Mixed cerebral palsy syndromes

G80.9   Cerebral palsy, unspecified

Cerebral palsy NOS

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.

Excludes:    congenital cerebral palsy (G80-)

G81.0   Flaccid hemiplegia

G81.1   Spastic hemiplegia

G81.9   Hemiplegia, unspecified

G82  Paraplegia and tetraplegia

Note:          For primary coding, this category is to be used only when the listed conditions are reported without further specification, or are stated to be old or longstanding but of unspecified cause. The category is also for use in multiple coding to identify these conditions resulting from any cause.

Excludes:    congenital cerebral palsy (G80-)

G82.0   Flaccid paraplegia

G82.1   Spastic paraplegia

G82.2   Paraplegia, unspecified

Paralysis of both lower limbs NOS

Paraplegia (lower) NOS

G82.3   Flaccid tetraplegia

G82.4   Spastic tetraplegia

G82.5   Tetraplegia, unspecified

Quadriplegia NOS

G83  Other paralytic syndromes

Note:          For primary coding, this category is to be used only when the listed conditions are reported without further specification, or are stated to be old or longstanding but of unspecified cause. The category is also for use in multiple coding to identify these conditions resulting from any cause.

Includes:    paralysis (complete)(incomplete), except as in G80-G82

G83.0   Diplegia of upper limbs

Diplegia (upper)

Paralysis of both upper limbs

G83.1   Monoplegia of lower limb

Paralysis of lower limb

G83.2   Monoplegia of upper limb

Paralysis of upper limb

G83.3   Monoplegia, unspecified

G83.4   Cauda equina syndrome

Neurogenic bladder due to cauda equina syndrome

Excludes:    cord bladder NOS (G95.8)

G83.8   Other specified paralytic syndromes

Todd paralysis (postepileptic)

G83.9   Paralytic syndrome, unspecified

Other disorders of the nervous system (G90-G99)

G90  Disorders of autonomic nervous system

Excludes:    dysfunction of autonomic nervous system due to alcohol (G31.2)

G90.0   Idiopathic peripheral autonomic neuropathy

Carotid sinus syncope

G90.1   Familial dysautonomia [Riley-Day]

G90.2   Horner syndrome

Bernard(-Horner) syndrome

G90.3   Multi-system degeneration

Neurogenic orthostatic hypotension [Shy-Drager]

Excludes:    orthostatic hypotension NOS (I95.1)

G90.4   Autonomic dysreflexia

G90.8   Other disorders of autonomic nervous system

G90.9   Disorder of autonomic nervous system, unspecified

G91  Hydrocephalus

Includes:    acquired hydrocephalus

Excludes:    hydrocephalus:

• 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

G92  Toxic encephalopathy

Use additional external cause code (Chapter XX), if desired, to identify toxic agent.

G93  Other disorders of brain

G93.0   Cerebral cysts

Arachnoid cyst

Porencephalic cyst, acquired

Excludes:    acquired periventricular cysts of newborn (P91.1)

congenital cerebral cysts (Q04.6)

G93.1   Anoxic brain damage, not elsewhere classified

Excludes:    complicating:

• abortion or ectopic or molar pregnancy (O00-O07, O08.8)

• pregnancy, labour or delivery (O29.2, O74.3, O89.2)

• surgical and medical care (T80-T88)

neonatal anoxia (P21.9)

G93.2   Benign intracranial hypertension

Excludes:    hypertensive encephalopathy (I67.4)

G93.3   Postviral fatigue syndrome

Myalgic encephalomyelitis

G93.4   Encephalopathy, unspecified

Excludes:    encephalopathy:

• alcoholic (G31.2)

• toxic (G92)

G93.5   Compression of brain

  Compression       of brain (stem)

  Herniation       

Excludes:    traumatic compression of brain (diffuse) (S06.2)

• focal (S06.3)

G93.6   Cerebral oedema

Excludes:    cerebral oedema:

• due to birth injury (P11.0)

• traumatic (S06.1)

G93.7   Reye syndrome

Use additional external cause code (Chapter XX), if desired, to identify cause.

G93.8   Other specified disorders of brain

Postradiation encephalopathy

Use additional external cause code (Chapter XX), if desired, to identify cause.

G93.9   Disorder of brain, unspecified

G94  Other disorders of brain in diseases classified elsewhere

G94.0* Hydrocephalus in infectious and parasitic diseases classified elsewhere (A00-B99†)

G94.1* Hydrocephalus in neoplastic disease (C00-D48†)

G94.2* Hydrocephalus in other diseases classified elsewhere

G94.8* Other specified disorders of brain in diseases classified elsewhere

G95  Other diseases of spinal cord

Excludes:    myelitis (G04-)

G95.0   Syringomyelia and syringobulbia

G95.1   Vascular myelopathies

Acute infarction of spinal cord (embolic)(nonembolic)

Arterial thrombosis of spinal cord

Haematomyelia

Nonpyogenic intraspinal phlebitis and thrombophlebitis

Oedema of spinal cord

Subacute necrotic myelopathy

Excludes:    intraspinal phlebitis and thrombophlebitis, except non-pyogenic (G08)

G95.2   Cord compression, unspecified

G95.8   Other specified diseases of spinal cord

Cord bladder NOS

Myelopathy:

• drug-induced

• radiation-induced

Use additional external cause code (Chapter XX), if desired, to identify external agent.

Excludes:    neurogenic bladder:

• NOS (N31.9)

• due to cauda equina syndrome (G83.4)

neuromuscular dysfunction of bladder without mention of spinal cord lesion (N31-)

G95.9   Disease of spinal cord, unspecified

Myelopathy NOS

G96  Other disorders of central nervous system

G96.0   Cerebrospinal fluid leak

Excludes:    from spinal puncture (G97.0)

G96.1   Disorders of meninges, not elsewhere classified

Meningeal adhesions (cerebral)(spinal)

G96.8   Other specified disorders of central nervous system

G96.9   Disorder of central nervous system, unspecified

G97  Postprocedural disorders of nervous system, not elsewhere classified

G97.0   Cerebrospinal fluid leak from spinal puncture

G97.1   Other reaction to spinal and lumbar puncture

G97.2   Intracranial hypotension following ventricular shunting

G97.8   Other postprocedural disorders of nervous system

G97.9   Postprocedural disorder of nervous system, unspecified

G98  Other disorders of nervous system, not elsewhere classified

Nervous system disorder NOS

G99  Other disorders of nervous system in diseases classified elsewhere

G99.0* Autonomic neuropathy in endocrine and metabolic diseases

Amyloid autonomic neuropathy (E85†)

Diabetic autonomic neuropathy (E10-E14† with common fourth character .4)

G99.1* Other disorders of autonomic nervous system in other diseases classified elsewhere

G99.2* Myelopathy in diseases classified elsewhere

Anterior spinal and vertebral artery compression syndromes (M47.0†)

Myelopathy in:

• intervertebral disc disorders (M50.0†, M51.0†)

• neoplastic disease (C00-D48†)

• spondylosis (M47†)

G99.8* Other specified disorders of nervous system in diseases classified elsewhere

Uraemic paralysis (N18.5†)

CHAPTER VII - Diseases of the eye and adnexa (H00-H59)

Excludes:    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)

This chapter contains the following blocks:

H00-H06      Disorders of eyelid, lacrimal system and orbit

H10-H13      Disorders of conjunctiva

H15-H22      Disorders of sclera, cornea, iris and ciliary body

H25-H28      Disorders of lens

H30-H36      Disorders of choroid and retina

H40-H42      Glaucoma

H43-H45      Disorders of vitreous body and globe

H46-H48      Disorders of optic nerve and visual pathways

H49-H52      Disorders of ocular muscles, binocular movement, accommodation and refraction

H53-H54      Visual disturbances and blindness

H55-H59      Other disorders of eye and adnexa

Asterisk categories for this chapter are provided as follows:

H03*            Disorders of eyelid in diseases classified elsewhere

H06*            Disorders of lacrimal system and orbit in diseases classified elsewhere

H13*            Disorders of conjunctiva in diseases classified elsewhere

H19*            Disorders of sclera and cornea in diseases classified elsewhere

H22*            Disorders of iris and ciliary body in diseases classified elsewhere

H28*            Cataract and other disorders of lens in diseases classified elsewhere

H32*            Chorioretinal disorders in diseases classified elsewhere

H36*            Retinal disorders in diseases classified elsewhere

H42*            Glaucoma in diseases classified elsewhere

H45*            Disorders of vitreous body and globe in diseases classified elsewhere

H48*            Disorders of optic nerve and visual pathways in diseases classified elsewhere

H58*            Other disorders of eye and adnexa in diseases classified elsewhere

Disorders of eyelid, lacrimal system and orbit (H00-H06)

H00  Hordeolum and chalazion

H00.0   Hordeolum and other deep inflammation of eyelid

  Abscess    

  Furuncle      of eyelid

  Stye       

H00.1   Chalazion

H01  Other inflammation of eyelid

H01.0   Blepharitis

Excludes:    blepharoconjunctivitis (H10.5)

H01.1   Noninfectious dermatoses of eyelid

  Dermatitis:                   

• allergic                    

• contact                     

• eczematous                     of eyelid

  Discoid lupus erythematosus   

  Xeroderma                     

H01.8   Other specified inflammation of eyelid

H01.9   Inflammation of eyelid, unspecified

H02  Other disorders of eyelid

Excludes:    congenital malformations of eyelid (Q10.0-Q10.3)

H02.0   Entropion and trichiasis of eyelid

H02.1   Ectropion of eyelid

H02.2   Lagophthalmos

H02.3   Blepharochalasis

H02.4   Ptosis of eyelid

H02.5   Other disorders affecting eyelid function

Ankyloblepharon

Blepharophimosis

Lid retraction

Excludes:    blepharospasm (G24.5)

tic (disorder):

• NOS (F95.9)

• organic origin (G25.6)

• psychogenic (F95-)

H02.6   Xanthelasma of eyelid

H02.7   Other degenerative disorders of eyelid and periocular area

  Chloasma    

  Madarosis      of eyelid

  Vitiligo    

H02.8   Other specified disorders of eyelid

Hypertrichosis of eyelid

Retained foreign body in eyelid

H02.9   Disorder of eyelid, unspecified

H03  Disorders of eyelid in diseases classified elsewhere

H03.0* Parasitic infestation of eyelid in diseases classified elsewhere

Dermatitis of eyelid due to Demodex species (B88.0†)

Parasitic infestation of eyelid in:

• leishmaniasis (B55†)

• loiasis (B74.3†)

• onchocerciasis (B73†)

• phthiriasis (B85.3†)

H03.1* Involvement of eyelid in other infectious diseases classified elsewhere

Involvement of eyelid in:

• herpesviral [herpes simplex] infection (B00.5†)

• leprosy (A30†)

• molluscum contagiosum (B08.1†)

• tuberculosis (A18.4†)

• yaws (A66†)

• zoster (B02.3†)

H03.8* Involvement of eyelid in other diseases classified elsewhere

Involvement of eyelid in impetigo (L01.0†)

H04  Disorders of lacrimal system

Excludes:    congenital malformations of lacrimal system (Q10.4-Q10.6)

H04.0   Dacryoadenitis

Chronic enlargement of lacrimal gland

H04.1   Other disorders of lacrimal gland

Dacryops

Dry eye syndrome

Lacrimal:

• cyst

• gland atrophy

H04.2   Epiphora

H04.3   Acute and unspecified inflammation of lacrimal passages

  Dacryocystitis (phlegmonous)   

  Dacryopericystitis                acute, subacute or unspecified

  Lacrimal canaliculitis         

Excludes:    neonatal dacryocystitis (P39.1)

H04.4   Chronic inflammation of lacrimal passages

  Dacryocystitis    

  Lacrimal:         

• canaliculitis      chronic

• mucocele        

H04.5   Stenosis and insufficiency of lacrimal passages

Dacryolith

Eversion of lacrimal punctum

Stenosis of lacrimal:

• canaliculi

• duct

• sac

H04.6   Other changes in lacrimal passages

Lacrimal fistula

H04.8   Other disorders of lacrimal system

H04.9   Disorder of lacrimal system, unspecified

H05  Disorders of orbit

Excludes:    congenital malformation of orbit (Q10.7)

H05.0   Acute inflammation of orbit

  Abscess         

  Cellulitis      

  Osteomyelitis      of orbit

  Periostitis     

  Tenonitis       

H05.1   Chronic inflammatory disorders of orbit

Granuloma of orbit

H05.2   Exophthalmic conditions

Displacement of globe (lateral) NOS

     Haemorrhage      Haemorrhage

     Oedema           Oedema

H05.3   Deformity of orbit

  Atrophy        Atrophy

  Exostosis      Exostosis

H05.4   Enophthalmos

H05.5   Retained (old) foreign body following penetrating wound of orbit

Retrobulbar foreign body

H05.8   Other disorders of orbit

Cyst of orbit

H05.9   Disorder of orbit, unspecified

H06  Disorders of lacrimal system and orbit in diseases classified elsewhere

H06.0* Disorders of lacrimal system in diseases classified elsewhere

H06.1* Parasitic infestation of orbit in diseases classified elsewhere

Echinococcus infection of orbit (B67†)

Myiasis of orbit (B87.2†)

H06.2* Dysthyroid exophthalmos (E05†)

H06.3* Other disorders of orbit in diseases classified elsewhere

Disorders of conjunctiva (H10-H13)

H10  Conjunctivitis

Excludes:    keratoconjunctivitis (H16.2)

H10.0   Mucopurulent conjunctivitis

H10.1   Acute atopic conjunctivitis

H10.2   Other acute conjunctivitis

H10.3   Acute conjunctivitis, unspecified

Excludes:    ophthalmia neonatorum NOS (P39.1)

H10.4   Chronic conjunctivitis

H10.5   Blepharoconjunctivitis

H10.8   Other conjunctivitis

H10.9   Conjunctivitis, unspecified

H11  Other disorders of conjunctiva

Excludes:    keratoconjunctivitis (H16.2)

H11.0   Pterygium

Excludes:    pseudopterygium (H11.8)

H11.1   Conjunctival degenerations and deposits

Conjunctival:

• argyrosis [argyria]

• concretions

• pigmentation

• xerosis NOS

H11.2   Conjunctival scars

Symblepharon

H11.3   Conjunctival haemorrhage

Subconjunctival haemorrhage

H11.4   Other conjunctival vascular disorders and cysts

Conjunctival:

• aneurysm

• hyperaemia

• oedema

H11.8   Other specified disorders of conjunctiva

Pseudopterygium

H11.9   Disorder of conjunctiva, unspecified

H13  Disorders of conjunctiva in diseases classified elsewhere

H13.0* Filarial infection of conjunctiva (B74†)

H13.1* Conjunctivitis in infectious and parasitic diseases classified elsewhere

Conjunctivitis (due to):

• Acanthamoeba (B60.1†)

• adenoviral follicular (acute) (B30.1†)

• chlamydial (A74.0†)

• diphtheritic (A36.8†)

• gonococcal (A54.3†)

• haemorrhagic (acute)(epidemic) (B30.3†)

• herpesviral [herpes simplex] (B00.5†)

• meningococcal (A39.8†)

• Newcastle (B30.8†)

• zoster (B02.3†)

H13.2* Conjunctivitis in other diseases classified elsewhere

H13.3* Ocular pemphigoid (L12†)

H13.8* Other disorders of conjunctiva in diseases classified elsewhere

Disorders of sclera, cornea, iris and ciliary body (H15-H22)

H15  Disorders of sclera

H15.0   Scleritis

H15.1   Episcleritis

H15.8   Other disorders of sclera

Equatorial staphyloma

Scleral ectasia

Excludes:    degenerative myopia (H44.2)

H15.9   Disorder of sclera, unspecified

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

H17  Corneal scars and opacities

H17.0   Adherent leukoma

H17.1   Other central corneal opacity

H17.8   Other corneal scars and opacities

H17.9   Corneal scar and opacity, unspecified

H18  Other disorders of cornea

H18.0   Corneal pigmentations and deposits

Haematocornea

Kayser-Fleischer ring

Krukenberg spindle

Staehli line

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

H18.1   Bullous keratopathy

Excludes:    keratopathy (bullous aphakic) following cataract surgery (H59.0)

H18.2   Other corneal oedema

H18.3   Changes in corneal membranes

  Fold         Fold

  Rupture      Rupture

H18.4   Corneal degeneration

Arcus senilis

Band keratopathy

Excludes:    Mooren ulcer (H16.0)

H18.5   Hereditary corneal dystrophies

Dystrophy:

• corneal:

     • epithelial

     • granular

     • lattice

     • macular

• Fuchs

H18.6   Keratoconus

H18.7   Other corneal deformities

Corneal:

• ectasia

• staphyloma

Descemetocele

Excludes:    congenital malformations of cornea (Q13.3-Q13.4)

H18.8   Other specified disorders of cornea

  Anaesthesia         

  Hypaesthesia           of cornea

  Recurrent erosion   

H18.9   Disorder of cornea, unspecified

H19  Disorders of sclera and cornea in diseases classified elsewhere

H19.0* Scleritis and episcleritis in diseases classified elsewhere

Syphilitic episcleritis (A52.7†)

Tuberculous episcleritis (A18.5†)

Zoster scleritis (B02.3†)

H19.1* Herpesviral keratitis and keratoconjunctivitis (B00.5†)

Dendritic and disciform keratitis

H19.2* Keratitis and keratoconjunctivitis in other infectious and parasitic diseases classified elsewhere

Epidemic keratoconjunctivitis (B30.0†)

Keratitis and keratoconjunctivitis (interstitial) in:

• acanthamoebiasis (B60.1†)

• measles (B05.8†)

• syphilis (A50.3†)

• tuberculosis (A18.5†)

• zoster (B02.3†)

H19.3* Keratitis and keratoconjunctivitis in other diseases classified elsewhere

Keratoconjunctivitis sicca (M35.0†)

H19.8* Other disorders of sclera and cornea in diseases classified elsewhere

Keratoconus in Down syndrome (Q90†)

H20  Iridocyclitis

H20.0   Acute and subacute iridocyclitis

  Anterior uveitis   

  Cyclitis              acute, recurrent or subacute

  Iritis             

H20.1   Chronic iridocyclitis

H20.2   Lens-induced iridocyclitis

H20.8   Other iridocyclitis

H20.9   Iridocyclitis, unspecified

H21  Other disorders of iris and ciliary body

Excludes:    sympathetic uveitis (H44.1)

H21.0   Hyphaema

Excludes:    traumatic hyphaema (S05.1)

H21.1   Other vascular disorders of iris and ciliary body

Neovascularization of iris or ciliary body

Rubeosis of iris

H21.2   Degeneration of iris and ciliary body

Degeneration of:

• iris (pigmentary)

• pupillary margin

Iridoschisis

Iris atrophy (essential)(progressive)

Miotic pupillary cyst

Translucency of iris

H21.3   Cyst of iris, ciliary body and anterior chamber

Cyst of iris, ciliary body or anterior chamber:

• NOS

• exudative

• implantation

• parasitic

Excludes:    miotic pupillary cyst (H21.2)

H21.4   Pupillary membranes

Iris bombe

Pupillary:

• occlusion

• seclusion

H21.5   Other adhesions and disruptions of iris and ciliary body

Goniosynechiae

Iridodialysis

Recession, chamber angle

Synechiae (iris):

• NOS

• anterior

• posterior

Excludes:    corectopia (Q13.2)

H21.8   Other specified disorders of iris and ciliary body

H21.9   Disorder of iris and ciliary body, unspecified

H22  Disorders of iris and ciliary body in diseases classified elsewhere

H22.0* Iridocyclitis in infectious and parasitic diseases classified elsewhere

Iridocyclitis in:

• gonococcal infection (A54.3†)

• herpesviral [herpes simplex] infection (B00.5†)

• syphilis (secondary) (A51.4†)

• tuberculosis (A18.5†)

• zoster (B02.3†)

H22.1* Iridocyclitis in other diseases classified elsewhere

Iridocyclitis in:

• ankylosing spondylitis (M45†)

• sarcoidosis (D86.8†)

H22.8* Other disorders of iris and ciliary body in diseases classified elsewhere

Disorders of lens (H25-H28)

H25  Senile cataract

Excludes:    capsular glaucoma with pseudoexfoliation of lens (H40.1)

H25.0   Senile incipient cataract

Senile cataract:

• coronary

• cortical

• punctate

Subcapsular polar senile cataract (anterior)(posterior)

Water clefts

H25.1   Senile nuclear cataract

Cataracta brunescens

Nuclear sclerosis cataract

H25.2   Senile cataract, morgagnian type

Senile hypermature cataract

H25.8   Other senile cataract

Combined forms of senile cataract

H25.9   Senile cataract, unspecified

H26  Other cataract

Excludes:    congenital cataract (Q12.0)

H26.0   Infantile, juvenile and presenile cataract

H26.1   Traumatic cataract

Use additional external cause code (Chapter XX), if desired, to identify cause.

H26.2   Complicated cataract

Cataract in chronic iridocyclitis

Cataract secondary to ocular disorders

Glaucomatous flecks (subcapsular)

H26.3   Drug-induced cataract

Use additional external cause code (Chapter XX), if desired, to identify drug.

H26.4   After-cataract

Secondary cataract

Soemmerring ring

H26.8   Other specified cataract

H26.9   Cataract, unspecified

H27  Other disorders of lens

Excludes:    congenital lens malformations (Q12-)

mechanical complications of intraocular lens (T85.2)

pseudophakia (^[i]Z96.1)

H27.0   Aphakia

H27.1   Dislocation of lens

H27.8   Other specified disorders of lens

H27.9   Disorder of lens, unspecified

H28  Cataract and other disorders of lens in diseases classified elsewhere

H28.0* Diabetic cataract (E10-E14† with common fourth character .3)

H28.1* Cataract in other endocrine, nutritional and metabolic diseases

Cataract in hypoparathyroidism (E20†)

Malnutrition-dehydration cataract (E40-E46†)

H28.2* Cataract in other diseases classified elsewhere

Myotonic cataract (G71.1†)

H28.8* Other disorders of lens in diseases classified elsewhere

Disorders of choroid and retina (H30-H36)

H30  Chorioretinal inflammation

H30.0   Focal chorioretinal inflammation

Focal:

• chorioretinitis

• choroiditis

• retinitis

• retinochoroiditis

H30.1   Disseminated chorioretinal inflammation

Disseminated:

• chorioretinitis

• choroiditis

• retinitis

• retinochoroiditis

Excludes:    exudative retinopathy (H35.0)

H30.2   Posterior cyclitis

Pars planitis

H30.8   Other chorioretinal inflammations

Harada disease

H30.9   Chorioretinal inflammation, unspecified

  Chorioretinitis     

  Choroiditis         

  Retinitis              NOS

  Retinochoroiditis   

H31  Other disorders of choroid

H31.0   Chorioretinal scars

Macula scars of posterior pole (postinflammatory)(post-traumatic)

Solar retinopathy

H31.1   Choroidal degeneration

  Atrophy        Atrophy

  Sclerosis      Sclerosis

Excludes:    angioid streaks (H35.3)

H31.2   Hereditary choroidal dystrophy

Choroideremia

Dystrophy, choroidal (central areolar)(generalized)(peripapillary)

Gyrate atrophy, choroid

Excludes:    ornithinaemia (E72.4)

H31.3   Choroidal haemorrhage and rupture

Choroidal haemorrhage:

• NOS

• expulsive

H31.4   Choroidal detachment

H31.8   Other specified disorders of choroid

H31.9   Disorder of choroid, unspecified

H32  Chorioretinal disorders in diseases classified elsewhere

H32.0* Chorioretinal inflammation in infectious and parasitic diseases classified elsewhere

Chorioretinitis:

• syphilitic, late (A52.7†)

• toxoplasma (B58.0†)

• tuberculous (A18.5†)

H32.8* Other chorioretinal disorders in diseases classified elsewhere

Albuminurica retinitis (N18.5†)

Renal retinitis (N18.5†)

H33  Retinal detachments and breaks

Excludes:    detachment of retinal pigment epithelium (H35.7)

H33.0   Retinal detachment with retinal break

Rhegmatogenous retinal detachment

H33.1   Retinoschisis and retinal cysts

Cyst of ora serrata

Parasitic cyst of retina NOS

Pseudocyst of retina

Excludes:    congenital retinoschisis (Q14.1)

microcystoid degeneration of retina (H35.4)

H33.2   Serous retinal detachment

Retinal detachment:

• NOS

• without retinal break

Excludes:    central serous chorioretinopathy (H35.7)

H33.3   Retinal breaks without detachment

  Horseshoe tear      Horseshoe tear

  Round hole          Round hole

Excludes:    chorioretinal scars after surgery for detachment (H59.8)

peripheral retinal degeneration without break (H35.4)

H33.4   Traction detachment of retina

Proliferative vitreo-retinopathy with retinal detachment

H33.5   Other retinal detachments

H34  Retinal vascular occlusions

Excludes:    amaurosis fugax (G45.3)

H34.0   Transient retinal artery occlusion

H34.1   Central retinal artery occlusion

H34.2   Other retinal artery occlusions

Hollenhorst plaque

Retinal:

• artery occlusion:

     • branch

     • partial

• microembolism

H34.8   Other retinal vascular occlusions

Retinal vein occlusion:

• central

• incipient

• partial

• tributary

H34.9   Retinal vascular occlusion, unspecified

H35  Other retinal disorders

H35.0   Background retinopathy and retinal vascular changes

Changes in retinal vascular appearance

Retinal:

• micro-aneurysms

• neovascularization

• perivasculitis

• varices

• vascular sheathing

• vasculitis

Retinopathy:

• NOS

• background NOS

• Coats

• exudative

• hypertensive

H35.1   Retinopathy of prematurity

Retrolental fibroplasia

H35.2   Other proliferative retinopathy

Proliferative vitreo-retinopathy

Excludes:    proliferative vitreo-retinopathy with retinal detachment (H33.4)

H35.3   Degeneration of macula and posterior pole

  Angioid streaks         

  Cyst                    

  Drusen (degenerative)      of macula

  Hole                    

  Puckering               

Kuhnt-Junius degeneration

Senile macular degeneration (atrophic)(exudative)

Toxic maculopathy

Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.

H35.4   Peripheral retinal degeneration

Degeneration, retina:

• NOS

• lattice

• microcystoid

• palisade

• paving stone

• reticular

Excludes:    with retinal break (H33.3)

H35.5   Hereditary retinal dystrophy

Dystrophy:

• retinal (albipunctate)(pigmentary)(vitelliform)

• tapetoretinal

• vitreoretinal

Retinitis pigmentosa

Stargardt disease

H35.6   Retinal haemorrhage

H35.7   Separation of retinal layers

Central serous chorioretinopathy

Detachment of retinal pigment epithelium

H35.8   Other specified retinal disorders

H35.9   Retinal disorder, unspecified

H36  Retinal disorders in diseases classified elsewhere

H36.0* Diabetic retinopathy (E10-E14† with common fourth character .3)

H36.8* Other retinal disorders in diseases classified elsewhere

Atherosclerotic retinopathy (I70.8†)

Proliferative sickle-cell retinopathy (D57†)

Retinal dystrophy in lipid storage disorders (E75†)

Glaucoma (H40-H42)

H40  Glaucoma

Excludes:    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

H42  Glaucoma in diseases classified elsewhere

H42.0* Glaucoma in endocrine, nutritional and metabolic diseases

Glaucoma in:

• amyloidosis (E85†)

• Lowe syndrome (E72.0†)

H42.8* Glaucoma in other diseases classified elsewhere

Glaucoma in onchocerciasis (B73†)

Disorders of vitreous body and globe (H43-H45)

H43  Disorders of vitreous body

H43.0   Vitreous prolapse

Excludes:    vitreous syndrome following cataract surgery (H59.0)

H43.1   Vitreous haemorrhage

H43.2   Crystalline deposits in vitreous body

H43.3   Other vitreous opacities

Vitreous membranes and strands

H43.8   Other disorders of vitreous body

Vitreous:

• degeneration

• detachment

Excludes:    proliferative vitreo-retinopathy with retinal detachment (H33.4)

H43.9   Disorder of vitreous body, unspecified

H44  Disorders of globe

Includes:    disorders affecting multiple structures of eye

H44.0   Purulent endophthalmitis

Panophthalmitis

Vitreous abscess

H44.1   Other endophthalmitis

Parasitic endophthalmitis NOS

Sympathetic uveitis

H44.2   Degenerative myopia

H44.3   Other degenerative disorders of globe

Chalcosis

Siderosis of eye

H44.4   Hypotony of eye

H44.5   Degenerated conditions of globe

Absolute glaucoma

Atrophy of globe

Phthisis bulbi

H44.6   Retained (old) intraocular foreign body, magnetic

Retained (old) magnetic foreign body (in):

• anterior chamber

• ciliary body

• iris

• lens

• posterior wall of globe

• vitreous body

H44.7   Retained (old) intraocular foreign body, nonmagnetic

Retained (nonmagnetic)(old) foreign body (in):

• anterior chamber

• ciliary body

• iris

• lens

• posterior wall of globe

• vitreous body

H44.8   Other disorders of globe

Haemophthalmos

Luxation of globe

H44.9   Disorder of globe, unspecified

H45  Disorders of vitreous body and globe in diseases classified elsewhere

H45.0* Vitreous haemorrhage in diseases classified elsewhere

H45.1* Endophthalmitis in diseases classified elsewhere

Endophthalmitis in:

• cysticercosis (B69.1†)

• onchocerciasis (B73†)

• toxocariasis (B83.0†)

H45.8* Other disorders of vitreous body and globe in diseases classified elsewhere

Disorders of optic nerve and visual pathways (H46-H48)

H46  Optic neuritis

Optic

• neuropathy, except ischaemic

• papillitis

Retrobulbar neuritis NOS

Excludes:    ischaemic optic neuropathy (H47.0)

neuromyelitis optica [Devic] (G36.0)

H47  Other disorders of optic [2nd] nerve and visual pathways

H47.0   Disorders of optic nerve, not elsewhere classified

Compression of optic nerve

(Foster-)Kennedy syndrome

Haemorrhage in optic nerve sheath

Ischaemic optic neuropathy

H47.1   Papilloedema, unspecified

H47.2   Optic atrophy

Temporal pallor of optic disc

H47.3   Other disorders of optic disc

Drusen of optic disc

Pseudopapilloedema

H47.4   Disorders of optic chiasm

H47.5   Disorders of other visual pathways

Disorders of optic tracts, geniculate nuclei and optic radiations

H47.6   Disorders of visual cortex

H47.7   Disorder of visual pathways, unspecified

H48  Disorders of optic [2nd] nerve and visual pathways in diseases classified elsewhere

H48.0* Optic atrophy in diseases classified elsewhere

Optic atrophy in late syphilis (A52.1†)

H48.1* Retrobulbar neuritis in diseases classified elsewhere

Retrobulbar neuritis in:

• late syphilis (A52.1†)

• meningococcal infection (A39.8†)

• multiple sclerosis (G35†)

H48.8* Other disorders of optic nerve and visual pathways in diseases classified elsewhere

Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)

Excludes:    nystagmus and other irregular eye movements (H55)

H49  Paralytic strabismus

Excludes:    ophthalmoplegia:

• internal (H52.5)

• internuclear (H51.2)

• progressive supranuclear (G23.1)

H49.0   Third [oculomotor] nerve palsy

H49.1   Fourth [trochlear] nerve palsy

H49.2   Sixth [abducent] nerve palsy

H49.3   Total (external) ophthalmoplegia

H49.4   Progressive external ophthalmoplegia

H49.8   Other paralytic strabismus

External ophthalmoplegia NOS

Kearns-Sayre syndrome

H49.9   Paralytic strabismus, unspecified

H50  Other strabismus

H50.0   Convergent concomitant strabismus

Esotropia (alternating)(monocular), except intermittent

H50.1   Divergent concomitant strabismus

Exotropia (alternating)(monocular), except intermittent

H50.2   Vertical strabismus

Hypertropia

Hypotropia

H50.3   Intermittent heterotropia

Intermittent:

• esotropia      • esotropia

• exotropia      • exotropia

H50.4   Other and unspecified heterotropia

Concomitant strabismus NOS

Cyclotropia

Microtropia

Monofixation syndrome

H50.5   Heterophoria

Alternating hyperphoria

Esophoria

Exophoria

H50.6   Mechanical strabismus

Brown sheath syndrome

Strabismus due to adhesions

Traumatic limitation of duction of eye muscle

H50.8   Other specified strabismus

Duane syndrome

H50.9   Strabismus, unspecified

H51  Other disorders of binocular movement

H51.0   Palsy of conjugate gaze

H51.1   Convergence insufficiency and excess

H51.2   Internuclear ophthalmoplegia

H51.8   Other specified disorders of binocular movement

H51.9   Disorder of binocular movement, unspecified

H52  Disorders of refraction and accommodation

H52.0   Hypermetropia

H52.1   Myopia

Excludes:    degenerative myopia (H44.2)

H52.2   Astigmatism

H52.3   Anisometropia and aniseikonia

H52.4   Presbyopia

H52.5   Disorders of accommodation

Internal ophthalmoplegia (complete)(total)

     Paresis      Paresis

     Spasm        Spasm

H52.6   Other disorders of refraction

H52.7   Disorder of refraction, unspecified

Visual disturbances and blindness (H53-H54)

H53  Visual disturbances

H53.0   Amblyopia ex anopsia

Amblyopia:

• anisometropic

• deprivation

• strabismic

H53.1   Subjective visual disturbances

Asthenopia

Day blindness

Hemeralopia

Metamorphopsia

Photophobia

Scintillating scotoma

Sudden visual loss

Visual halos

Excludes:    visual hallucinations (R44.1)

H53.2   Diplopia

Double vision

H53.3   Other disorders of binocular vision

Abnormal retinal correspondence

Fusion with defective stereopsis

Simultaneous visual perception without fusion

Suppression of binocular vision

H53.4   Visual field defects

Enlarged blind spot

Generalized contraction of visual field

Hemianop(s)ia (heteronymous)(homonymous)

Quadrant anop(s)ia

Scotoma:

• arcuate

• Bjerrum

• central

• ring

H53.5   Colour vision deficiencies

Achromatopsia

Acquired colour vision deficiency

Colour blindness

Deuteranomaly

Deuteranopia

Protanomaly

Protanopia

Tritanomaly

Tritanopia

Excludes:    day blindness (H53.1)

H53.6   Night blindness

Excludes:    due to vitamin A deficiency (E50.5)

H53.8   Other visual disturbances

H53.9   Visual disturbance, unspecified

H54  Visual impairment including blindness (binocular or monocular)

Note:          For definition of visual impairment categories see table below.

Excludes:    amaurosis fugax (G45.3)

H54.0   Blindness, binocular

Visual impairment categories 3, 4, 5

H54.1   Severe visual impairment, binocular

Visual impairment category 2

H54.2   Moderate visual impairment, binocular

Visual impairment category 1

H54.3   Mild or no visual impairment, binocular

Visual impairment category 0

H54.4   Blindness, monocular

Visual impairment categories 3, 4, 5 in one eye and categories 0, 1, 2 or 9 in the other eye

H54.5   Severe visual impairment, monocular

Visual impairment category 2 in one eye and categories 0, 1 or 9 in other eye

H54.6   Moderate visual impairment, monocular

Visual impairment category 1 in one eye and categories 0 or 9 in other eye

H54.9   Unspecified visual impairment (binocular)

Visual impairment category 9

Note:          The table below gives a classification of severity of visual impairment recommended by the Resolution of the International Council of Opthalmology (2002) and the Recommendations of the WHO Consultation on “Development of Standards for Characterization of Vision Loss and Visual Functioning” (Sept. 2003).

For characterizing visual impairment for codes H54.0 to H54.3, visual acuity should be measured with both eyes open with presenting correction if any. For characterizing visual impairment for codes H54.4 to H54.6, visual acuity should be measured monocularly with presenting correction if any.

If the extent of the visual field is taken into account, patients with a visual field of the better eye no greater than 10º in radius around central fixation should be placed under category 3. For monocular blindness (H54.4), this degree of field loss would apply to the affected eye.

	Presenting distance visual acuity
Category	Worse than:	Equal to or better than:
Mild or no visual impairment 0		6/18 3/10 (0.3) 20/70
Moderate visual impairment 1	6/18 3/10 (0.3) 20/70	6/60 1/10 (0.1) 20/200
Severed visual impairment 2	6/60 1/10 (0.1) 20/200	3/60 1/20 (0.05) 20/400
Blindness 3	3/60 1/20 (0.05) 20/400	1/60* 1/50 (0.02) 5/300 (20/1200)
Blindness 4	1/60* 1/50 (0.02) 5/300 (20/1200)	Light perception
Blindness 5	No light perception
9	Undetermined or unspecified
*Or counts fingers (CF) at 1 metre

Note:          The term visual impairment in category H54 comprises category 0 for mild or no visual impairment, category 1 for moderate visual impairment, category 2 for severe visual impairment, categories 3, 4, and 5 for blindness and category 9 for unqualified visual impairment. The term “low vision” included in the previous revision has been replaced by categories 1 and 2 to avoid confusion with those requiring low vision care.

Other disorders of eye and adnexa (H55-H59)

H55  Nystagmus and other irregular eye movements

Nystagmus:

• NOS

• congenital

• deprivation

• dissociated

• latent

H57  Other disorders of eye and adnexa

H57.0   Anomalies of pupillary function

H57.1   Ocular pain

H57.8   Other specified disorders of eye and adnexa

H57.9   Disorder of eye and adnexa, unspecified

H58  Other disorders of eye and adnexa in diseases classified elsewhere

H58.0* Anomalies of pupillary function in diseases classified elsewhere

Argyll Robertson phenomenon or pupil, syphilitic (A52.1†)

H58.1* Visual disturbances in diseases classified elsewhere

H58.8* Other specified disorders of eye and adnexa in diseases classified elsewhere

Syphilitic oculopathy NEC:

• congenital:

• early (A50.0†)

• late (A50.3†)

• early (secondary) (A51.4†)

• late (A52.7†)

H59  Postprocedural disorders of eye and adnexa, not elsewhere classified

Excludes:    mechanical complication of:

• intraocular lens (T85.2)

• other ocular prosthetic devices, implants and grafts (T85.3)

pseudophakia (^[i]Z96.1)

H59.0   Keratopathy (bullous aphakic) following cataract surgery

Vitreous (touch) syndrome

Vitreal corneal syndrome

H59.8   Other postprocedural disorders of eye and adnexa

Chorioretinal scars after surgery for detachment

H59.9   Postprocedural disorder of eye and adnexa, unspecified

CHAPTER VIII - Diseases of the ear and mastoid process (H60-H95)

Excludes:    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)

This chapter contains the following blocks:

H60-H62      Diseases of external ear

H65-H75      Diseases of middle ear and mastoid

H80-H83      Diseases of inner ear

H90-H95      Other disorders of ear

Asterisk categories for this chapter are provided as follows:

H62*            Disorders of external ear in diseases classified elsewhere

H67*            Otitis media in diseases classified elsewhere

H75*            Other disorders of middle ear and mastoid in diseases classified elsewhere

H82*            Vertiginous syndromes in diseases classified elsewhere

H94*            Other disorders of ear in diseases classified elsewhere

Diseases of external ear (H60-H62)

H60  Otitis externa

H60.0   Abscess of external ear

  Boil        

  Carbuncle      of auricle or external auditory canal

  Furuncle    

H60.1   Cellulitis of external ear

Cellulitis of:

• auricle

• external auditory canal

H60.2   Malignant otitis externa

H60.3   Other infective otitis externa

Otitis externa:

• diffuse

• haemorrhagic

Swimmer ear

H60.4   Cholesteatoma of external ear

Keratosis obturans of external ear (canal)

H60.5   Acute otitis externa, noninfective

Acute otitis externa:

• NOS

• actinic

• chemical

• contact

• eczematoid

• reactive

H60.8   Other otitis externa

Chronic otitis externa NOS

H60.9   Otitis externa, unspecified

H61  Other disorders of external ear

H61.0   Perichondritis of external ear

Chondrodermatitis nodularis chronica helicis

Perichondritis of:

• auricle

• pinna

H61.1   Noninfective disorders of pinna

Acquired deformity of:

• auricle

• pinna

Excludes:    cauliflower ear (M95.1)

H61.2   Impacted cerumen

Wax in ear

H61.3   Acquired stenosis of external ear canal

Collapse of external ear canal

H61.8   Other specified disorders of external ear

Exostosis of external canal

H61.9   Disorder of external ear, unspecified

H62  Disorders of external ear in diseases classified elsewhere

H62.0* Otitis externa in bacterial diseases classified elsewhere

Otitis externa in erysipelas (A46†)

H62.1* Otitis externa in viral diseases classified elsewhere

Otitis externa in:

• herpesviral [herpes simplex] infection (B00.1†)

• zoster (B02.8†)

H62.2* Otitis externa in mycoses

Otitis externa in:

• aspergillosis (B44.8†)

• candidiasis (B37.2†)

Otomycosis NOS (B36.9†)

H62.3* Otitis externa in other infectious and parasitic diseases classified elsewhere

H62.4* Otitis externa in other diseases classified elsewhere

Otitis externa in impetigo (L01†)

H62.8* Other disorders of external ear in diseases classified elsewhere

Diseases of middle ear and mastoid (H65-H75)

H65  Nonsuppurative otitis media

Use additional code to identify presence of perforated tympanic membrane (H72-).

Includes:    with myringitis

H65.0   Acute serous otitis media

Acute and subacute secretory otitis media

H65.1   Other acute nonsuppurative otitis media

Otitis media, acute and subacute:

• allergic (mucoid)(sanguinous)(serous)

• mucoid

• nonsuppurative NOS

• sanguinous

• seromucinous

Excludes:    otitic barotrauma (T70.0)

otitis media (acute) NOS (H66.9)

H65.2   Chronic serous otitis media

Chronic tubotympanal catarrh

H65.3   Chronic mucoid otitis media

Glue ear

Otitis media, chronic:

• mucinous