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, 9o 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

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-10th Revision: First Meeting. Geneva, World Health Organization, 1984 (unpublished document DES/EC/ICD-10/84.34).

3.     Report of the Expert Committee on the International Classification of Diseases-10th Revision: Second Meeting. Geneva, World Health Organization. 1987 (unpublished document WHO/DES/EC/ICD-10/87.38).

4.     Report of the Preparatory Meeting on ICD-10. Geneva, World Health Organization, 1983 (unpublished document DES/ICD-10/83.19).

5.     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