icd.qiangc.net

ICD-10-CM TABULAR LIST of DISEASES and INJURIES

(2023)

Instructional Notations
Includes:

The word 'Includes' appears immediately under certain categories to further define, or give examples of, the content of the category.

Excludes Notes

The ICD-10-CM has two types of excludes notes. Each note has a different definition for use but they are both similar in that they indicate that codes excluded from each other are independent of each other.

Excludes1

A type 1 Excludes note is a pure excludes. It means 'NOT CODED HERE!' An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

Excludes2

A type 2 excludes note represents 'Not included here'. An excludes2 note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When an Excludes2 note appears under a code it is acceptable to use both the code and the excluded code together.

Code First/Use Additional Code notes (etiology/manifestation paired codes)

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a 'use additional code' note at the etiology code, and a 'code first' note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.

In most cases the manifestation codes will have in the code title, 'in diseases classified elsewhere.' Codes with this title are a component of the etiology/ manifestation convention. The code title indicates that it is a manifestation code. 'In diseases classified elsewhere' codes are never permitted to be used as first listed or principal diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.

Code Also

A code also note instructs that 2 codes may be required to fully describe a condition but the sequencing of the two codes is discretionary, depending on the severity of the conditions and the reason for the encounter.

7th characters and placeholder X

For codes less than 6 characters that require a 7th character a placeholder X should be assigned for all characters less than 6. The 7th character must always be the 7th character of a code

Table of Contents
1. Certain infectious and parasitic diseases (A00-B99)
includes
  • diseases generally recognized as communicable or transmissible
excludes1
  • certain localized infections - see body system-related chapters
excludes2
  • carrier or suspected carrier of infectious disease (Z22.-)
  • infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
  • infectious and parasitic diseases specific to the perinatal period (P35-P39)
  • influenza and other acute respiratory infections (J00-J22)
useAdditionalCode
  • code to identify resistance to antimicrobial drugs (Z16.-)
Intestinal infectious diseases (A00-A09)
Tuberculosis (A15-A19)
includes
  • infections due to Mycobacterium tuberculosis and Mycobacterium bovis
excludes1
  • congenital tuberculosis (P37.0)
  • nonspecific reaction to test for tuberculosis without active tuberculosis (R76.1-)
  • pneumoconiosis associated with tuberculosis, any type in A15 (J65)
  • positive PPD (R76.11)
  • positive tuberculin skin test without active tuberculosis (R76.11)
  • sequelae of tuberculosis (B90.-)
  • silicotuberculosis (J65)
Certain zoonotic bacterial diseases (A20-A28)
Other bacterial diseases (A30-A49)
Infections with a predominantly sexual mode of transmission (A50-A64)
excludes1
  • human immunodeficiency virus [HIV] disease (B20)
  • nonspecific and nongonococcal urethritis (N34.1)
  • Reiter's disease (M02.3-)
Other spirochetal diseases (A65-A69)
excludes2
  • leptospirosis (A27.-)
  • syphilis (A50-A53)
Other diseases caused by chlamydiae (A70-A74)
excludes1
  • sexually transmitted chlamydial diseases (A55-A56)
Rickettsioses (A75-A79)
Viral and prion infections of the central nervous system (A80-A89)
excludes1
  • postpolio syndrome (G14)
  • sequelae of poliomyelitis (B91)
  • sequelae of viral encephalitis (B94.1)
Arthropod-borne viral fevers and viral hemorrhagic fevers (A90-A99)
Viral infections characterized by skin and mucous membrane lesions (B00-B09)
Other human herpesviruses (B10)
Viral hepatitis (B15-B19)
excludes1
  • sequelae of viral hepatitis (B94.2)
excludes2
  • cytomegaloviral hepatitis (B25.1)
  • herpesviral [herpes simplex] hepatitis (B00.81)
Human immunodeficiency virus [HIV] disease (B20)
Other viral diseases (B25-B34)
Mycoses (B35-B49)
excludes2
  • hypersensitivity pneumonitis due to organic dust (J67.-)
  • mycosis fungoides (C84.0-)
Protozoal diseases (B50-B64)
excludes1
  • amebiasis (A06.-)
  • other protozoal intestinal diseases (A07.-)
Helminthiases (B65-B83)
Pediculosis, acariasis and other infestations (B85-B89)
Sequelae of infectious and parasitic diseases (B90-B94)
codeFirst
  • condition resulting from (sequela) the infectious or parasitic disease
notes
  • Categories B90-B94 are to be used to indicate conditions in categories A00-B89 as the cause of sequelae, which are themselves classified elsewhere. The 'sequelae' include conditions specified as such; they also include residuals of diseases classifiable to the above categories if there is evidence that the disease itself is no longer present. Codes from these categories are not to be used for chronic infections. Code chronic current infections to active infectious disease as appropriate.
Bacterial and viral infectious agents (B95-B97)
notes
  • These categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere.
Other infectious diseases (B99)
2. Neoplasms (C00-D49)
notes
  • Functional activity
  • All neoplasms are classified in this chapter, whether they are functionally active or not. An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm.
  • Morphology [Histology]
  • Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc. The Table of Neoplasms should be used to identify the correct topography code. In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes.
  • Primary malignant neoplasms overlapping site boundaries
  • A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code .8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned.
  • Malignant neoplasm of ectopic tissue
  • Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).
Malignant neoplasms (C00-C96)
Malignant neoplasms, stated or presumed to be primary (of specified sites), and certain specified histologies, except neuroendocrine, and of lymphoid, hematopoietic and related tissue (C00-C75)
Malignant neoplasms of lip, oral cavity and pharynx (C00-C14)
Malignant neoplasms of digestive organs (C15-C26)
excludes1
  • Kaposi's sarcoma of gastrointestinal sites (C46.4)
excludes2
  • gastrointestinal stromal tumors (C49.A-)
Malignant neoplasms of respiratory and intrathoracic organs (C30-C39)
includes
  • malignant neoplasm of middle ear
excludes1
  • mesothelioma (C45.-)
Malignant neoplasms of bone and articular cartilage (C40-C41)
includes
  • malignant neoplasm of cartilage (articular) (joint)
  • malignant neoplasm of periosteum
excludes1
  • malignant neoplasm of bone marrow NOS (C96.9)
  • malignant neoplasm of synovia (C49.-)
Melanoma and other malignant neoplasms of skin (C43-C44)
Malignant neoplasms of mesothelial and soft tissue (C45-C49)
Malignant neoplasms of breast (C50)
Malignant neoplasms of female genital organs (C51-C58)
includes
  • malignant neoplasm of skin of female genital organs
Malignant neoplasms of male genital organs (C60-C63)
includes
  • malignant neoplasm of skin of male genital organs
Malignant neoplasms of urinary tract (C64-C68)
Malignant neoplasms of eye, brain and other parts of central nervous system (C69-C72)
Malignant neoplasms of thyroid and other endocrine glands (C73-C75)
Malignant neuroendocrine tumors (C7A)
Secondary neuroendocrine tumors (C7B)
Malignant neoplasms of ill-defined, other secondary and unspecified sites (C76-C80)
Malignant neoplasms of lymphoid, hematopoietic and related tissue (C81-C96)
excludes2
  • Kaposi's sarcoma of lymph nodes (C46.3)
  • secondary and unspecified neoplasm of lymph nodes (C77.-)
  • secondary neoplasm of bone marrow (C79.52)
  • secondary neoplasm of spleen (C78.89)
In situ neoplasms (D00-D09)
includes
  • Bowen's disease
  • erythroplasia
  • grade III intraepithelial neoplasia
  • Queyrat's erythroplasia
Benign neoplasms, except benign neuroendocrine tumors (D10-D36)
Benign neuroendocrine tumors (D3A)
Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes (D37-D48)
excludes1
  • neoplasms of unspecified behavior (D49.-)
notes
  • Categories D37-D44, and D48 classify by site neoplasms of uncertain behavior, i.e., histologic confirmation whether the neoplasm is malignant or benign cannot be made.
Neoplasms of unspecified behavior (D49)
3. Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
excludes2
  • autoimmune disease (systemic) NOS (M35.9)
  • certain conditions originating in the perinatal period (P00-P96)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • human immunodeficiency virus [HIV] disease (B20)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Nutritional anemias (D50-D53)
Hemolytic anemias (D55-D59)
Aplastic and other anemias and other bone marrow failure syndromes (D60-D64)
Coagulation defects, purpura and other hemorrhagic conditions (D65-D69)
Other disorders of blood and blood-forming organs (D70-D77)
Intraoperative and postprocedural complications of the spleen (D78)
Certain disorders involving the immune mechanism (D80-D89)
includes
  • defects in the complement system
  • immunodeficiency disorders, except human immunodeficiency virus [HIV] disease
  • sarcoidosis
excludes1
  • autoimmune disease (systemic) NOS (M35.9)
  • functional disorders of polymorphonuclear neutrophils (D71)
  • human immunodeficiency virus [HIV] disease (B20)
4. Endocrine, nutritional and metabolic diseases (E00-E89)
excludes1
  • transitory endocrine and metabolic disorders specific to newborn (P70-P74)
notes
  • All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
Disorders of thyroid gland (E00-E07)
Diabetes mellitus (E08-E13)
Other disorders of glucose regulation and pancreatic internal secretion (E15-E16)
Disorders of other endocrine glands (E20-E35)
excludes1
  • galactorrhea (N64.3)
  • gynecomastia (N62)
Intraoperative complications of endocrine system (E36)
Malnutrition (E40-E46)
excludes1
  • intestinal malabsorption (K90.-)
  • sequelae of protein-calorie malnutrition (E64.0)
excludes2
  • nutritional anemias (D50-D53)
  • starvation (T73.0)
Other nutritional deficiencies (E50-E64)
excludes2
  • nutritional anemias (D50-D53)
Overweight, obesity and other hyperalimentation (E65-E68)
Metabolic disorders (E70-E88)
excludes1
  • androgen insensitivity syndrome (E34.5-)
  • congenital adrenal hyperplasia (E25.0)
  • hemolytic anemias attributable to enzyme disorders (D55.-)
  • Marfan's syndrome (Q87.4)
  • 5-alpha-reductase deficiency (E29.1)
excludes2
  • Ehlers-Danlos syndromes (Q79.6-)
Postprocedural endocrine and metabolic complications and disorders, not elsewhere classified (E89)
5. Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
includes
  • disorders of psychological development
excludes2
  • symptoms, signs and abnormal clinical laboratory findings, not elsewhere classified (R00-R99)
Mental disorders due to known physiological conditions (F01-F09)
notes
  • This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved.
Mental and behavioral disorders due to psychoactive substance use (F10-F19)
Schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F20-F29)
Mood [affective] disorders (F30-F39)
Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48)
Behavioral syndromes associated with physiological disturbances and physical factors (F50-F59)
Disorders of adult personality and behavior (F60-F69)
Intellectual Disabilities (F70-F79)
excludes1
  • borderline intellectual functioning, IQ above 70 to 84 (R41.83)
codeFirst
  • any associated physical or developmental disorders
Pervasive and specific developmental disorders (F80-F89)
Behavioral and emotional disorders with onset usually occurring in childhood and adolescence (F90-F98)
notes
  • Codes within categories F90-F98 may be used regardless of the age of a patient. These disorders generally have onset within the childhood or adolescent years, but may continue throughout life or not be diagnosed until adulthood
Unspecified mental disorder (F99)
6. Diseases of the nervous system (G00-G99)
excludes2
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Inflammatory diseases of the central nervous system (G00-G09)
Systemic atrophies primarily affecting the central nervous system (G10-G14)
Extrapyramidal and movement disorders (G20-G26)
Other degenerative diseases of the nervous system (G30-G32)
Demyelinating diseases of the central nervous system (G35-G37)
Episodic and paroxysmal disorders (G40-G47)
Nerve, nerve root and plexus disorders (G50-G59)
excludes1
  • current traumatic nerve, nerve root and plexus disorders - see Injury, nerve by body region
  • neuralgia NOS (M79.2)
  • neuritis NOS (M79.2)
  • peripheral neuritis in pregnancy (O26.82-)
  • radiculitis NOS (M54.1-)
Polyneuropathies and other disorders of the peripheral nervous system (G60-G65)
excludes1
  • neuralgia NOS (M79.2)
  • neuritis NOS (M79.2)
  • peripheral neuritis in pregnancy (O26.82-)
  • radiculitis NOS (M54.10)
Diseases of myoneural junction and muscle (G70-G73)
Cerebral palsy and other paralytic syndromes (G80-G83)
Other disorders of the nervous system (G89-G99)
7. Diseases of the eye and adnexa (H00-H59)
excludes2
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • diabetes mellitus related eye conditions (E09.3-, E10.3-, E11.3-, E13.3-)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury (trauma) of eye and orbit (S05.-)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • syphilis related eye disorders (A50.01, A50.3-, A51.43, A52.71)
notes
  • Use an external cause code following the code for the eye condition, if applicable, to identify the cause of the eye condition
Disorders of eyelid, lacrimal system and orbit (H00-H05)
excludes2
  • open wound of eyelid (S01.1-)
  • superficial injury of eyelid (S00.1-, S00.2-)
Disorders of conjunctiva (H10-H11)
Disorders of sclera, cornea, iris and ciliary body (H15-H22)
Disorders of lens (H25-H28)
Disorders of choroid and retina (H30-H36)
Glaucoma (H40-H42)
Disorders of vitreous body and globe (H43-H44)
Disorders of optic nerve and visual pathways (H46-H47)
Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)
excludes2
  • nystagmus and other irregular eye movements (H55)
Visual disturbances and blindness (H53-H54)
Other disorders of eye and adnexa (H55-H57)
Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified (H59)
8. Diseases of the ear and mastoid process (H60-H95)
excludes2
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
notes
  • Use an external cause code following the code for the ear condition, if applicable, to identify the cause of the ear condition
Diseases of external ear (H60-H62)
Diseases of middle ear and mastoid (H65-H75)
Diseases of inner ear (H80-H83)
Other disorders of ear (H90-H94)
Intraoperative and postprocedural complications and disorders of ear and mastoid process, not elsewhere classified (H95)
9. Diseases of the circulatory system (I00-I99)
excludes2
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • transient cerebral ischemic attacks and related syndromes (G45.-)
Acute rheumatic fever (I00-I02)
Chronic rheumatic heart diseases (I05-I09)
Hypertensive diseases (I10-I16)
excludes1
  • neonatal hypertension (P29.2)
  • primary pulmonary hypertension (I27.0)
excludes2
  • hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)
useAdditionalCode
  • code to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)
Ischemic heart diseases (I20-I25)
codeAlso
  • the presence of hypertension (I10-I16)
Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)
Other forms of heart disease (I30-I5A)
Cerebrovascular diseases (I60-I69)
excludes1
  • traumatic intracranial hemorrhage (S06.-)
useAdditionalCode
  • code to identify presence of:
  • alcohol abuse and dependence (F10.-)
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • hypertension (I10-I16)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)
Diseases of arteries, arterioles and capillaries (I70-I79)
Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89)
Other and unspecified disorders of the circulatory system (I95-I99)
10. Diseases of the respiratory system (J00-J99)
excludes2
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • smoke inhalation (T59.81-)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
useAdditionalCode
  • code, where applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)
notes
  • When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
Acute upper respiratory infections (J00-J06)
excludes1
  • chronic obstructive pulmonary disease with acute lower respiratory infection (J44.0)
Influenza and pneumonia (J09-J18)
excludes2
  • allergic or eosinophilic pneumonia (J82)
  • aspiration pneumonia NOS (J69.0)
  • meconium pneumonia (P24.01)
  • neonatal aspiration pneumonia (P24.-)
  • pneumonia due to solids and liquids (J69.-)
  • congenital pneumonia (P23.9)
  • lipid pneumonia (J69.1)
  • rheumatic pneumonia (I00)
  • ventilator associated pneumonia (J95.851)
Other acute lower respiratory infections (J20-J22)
excludes2
  • chronic obstructive pulmonary disease with acute lower respiratory infection (J44.0)
Other diseases of upper respiratory tract (J30-J39)
Chronic lower respiratory diseases (J40-J47)
excludes1
  • bronchitis due to chemicals, gases, fumes and vapors (J68.0)
excludes2
  • cystic fibrosis (E84.-)
Lung diseases due to external agents (J60-J70)
excludes2
  • asthma (J45.-)
  • malignant neoplasm of bronchus and lung (C34.-)
Other respiratory diseases principally affecting the interstitium (J80-J84)
Suppurative and necrotic conditions of the lower respiratory tract (J85-J86)
Other diseases of the pleura (J90-J94)
Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified (J95)
Other diseases of the respiratory system (J96-J99)
11. Diseases of the digestive system (K00-K95)
excludes2
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Diseases of oral cavity and salivary glands (K00-K14)
Diseases of esophagus, stomach and duodenum (K20-K31)
excludes2
  • hiatus hernia (K44.-)
Diseases of appendix (K35-K38)
Hernia (K40-K46)
includes
  • acquired hernia
  • congenital [except diaphragmatic or hiatus] hernia
  • recurrent hernia
notes
  • Hernia with both gangrene and obstruction is classified to hernia with gangrene.
Noninfective enteritis and colitis (K50-K52)
includes
  • noninfective inflammatory bowel disease
excludes1
  • irritable bowel syndrome (K58.-)
  • megacolon (K59.3-)
Other diseases of intestines (K55-K64)
Diseases of peritoneum and retroperitoneum (K65-K68)
Diseases of liver (K70-K77)
excludes1
  • jaundice NOS (R17)
excludes2
  • hemochromatosis (E83.11-)
  • Reye's syndrome (G93.7)
  • viral hepatitis (B15-B19)
  • Wilson's disease (E83.0)
Disorders of gallbladder, biliary tract and pancreas (K80-K87)
Other diseases of the digestive system (K90-K95)
12. Diseases of the skin and subcutaneous tissue (L00-L99)
excludes2
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • lipomelanotic reticulosis (I89.8)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
  • systemic connective tissue disorders (M30-M36)
  • viral warts (B07.-)
Infections of the skin and subcutaneous tissue (L00-L08)
excludes2
  • hordeolum (H00.0)
  • infective dermatitis (L30.3)
  • local infections of skin classified in Chapter 1
  • lupus panniculitis (L93.2)
  • panniculitis NOS (M79.3)
  • panniculitis of neck and back (M54.0-)
  • Perlèche NOS (K13.0)
  • Perlèche due to candidiasis (B37.0)
  • Perlèche due to riboflavin deficiency (E53.0)
  • pyogenic granuloma (L98.0)
  • relapsing panniculitis [Weber-Christian] (M35.6)
  • viral warts (B07.-)
  • zoster (B02.-)
useAdditionalCode
  • code (B95-B97) to identify infectious agent.
Bullous disorders (L10-L14)
excludes1
  • benign familial pemphigus [Hailey-Hailey] (Q82.8)
  • staphylococcal scalded skin syndrome (L00)
  • toxic epidermal necrolysis [Lyell] (L51.2)
Dermatitis and eczema (L20-L30)
excludes2
  • chronic (childhood) granulomatous disease (D71)
  • dermatitis gangrenosa (L08.0)
  • dermatitis herpetiformis (L13.0)
  • dry skin dermatitis (L85.3)
  • factitial dermatitis (L98.1)
  • perioral dermatitis (L71.0)
  • radiation-related disorders of the skin and subcutaneous tissue (L55-L59)
  • stasis dermatitis (I87.2)
notes
  • In this block the terms dermatitis and eczema are used synonymously and interchangeably.
Papulosquamous disorders (L40-L45)
Urticaria and erythema (L49-L54)
excludes1
  • Lyme disease (A69.2-)
  • rosacea (L71.-)
Radiation-related disorders of the skin and subcutaneous tissue (L55-L59)
Disorders of skin appendages (L60-L75)
excludes1
  • congenital malformations of integument (Q84.-)
Intraoperative and postprocedural complications of skin and subcutaneous tissue (L76)
Other disorders of the skin and subcutaneous tissue (L80-L99)
13. Diseases of the musculoskeletal system and connective tissue (M00-M99)
excludes2
  • arthropathic psoriasis (L40.5-)
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • compartment syndrome (traumatic) (T79.A-)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
notes
  • Use an external cause code following the code for the musculoskeletal condition, if applicable, to identify the cause of the musculoskeletal condition
Arthropathies (M00-M25)
includes
  • Disorders affecting predominantly peripheral (limb) joints
Infectious arthropathies (M00-M02)
notes
  • This block comprises arthropathies due to microbiological agents. Distinction is made between the following types of etiological relationship:
  • a) direct infection of joint, where organisms invade synovial tissue and microbial antigen is present in the joint;
  • b) indirect infection, which may be of two types: a reactive arthropathy, where microbial infection of the body is established but neither organisms nor antigens can be identified in the joint, and a postinfective arthropathy, where microbial antigen is present but recovery of an organism is inconstant and evidence of local multiplication is lacking.
Autoinflammatory syndromes (M04)
Inflammatory polyarthropathies (M05-M14)
Osteoarthritis (M15-M19)
excludes2
  • osteoarthritis of spine (M47.-)
Other joint disorders (M20-M25)
excludes2
  • joints of the spine (M40-M54)
Dentofacial anomalies [including malocclusion] and other disorders of jaw (M26-M27)
excludes1
  • hemifacial atrophy or hypertrophy (Q67.4)
  • unilateral condylar hyperplasia or hypoplasia (M27.8)
Systemic connective tissue disorders (M30-M36)
includes
  • autoimmune disease NOS
  • collagen (vascular) disease NOS
  • systemic autoimmune disease
  • systemic collagen (vascular) disease
excludes1
  • autoimmune disease, single organ or single cell-type -code to relevant condition category
Dorsopathies (M40-M54)
Deforming dorsopathies (M40-M43)
Spondylopathies (M45-M49)
Other dorsopathies (M50-M54)
excludes1
  • current injury - see injury of spine by body region
  • discitis NOS (M46.4-)
Soft tissue disorders (M60-M79)
Disorders of muscles (M60-M63)
excludes1
  • dermatopolymyositis (M33.-)
  • myopathy in amyloidosis (E85.-)
  • myopathy in polyarteritis nodosa (M30.0)
  • myopathy in rheumatoid arthritis (M05.32)
  • myopathy in scleroderma (M34.-)
  • myopathy in Sjögren's syndrome (M35.03)
  • myopathy in systemic lupus erythematosus (M32.-)
excludes2
  • muscular dystrophies and myopathies (G71-G72)
Disorders of synovium and tendon (M65-M67)
Other soft tissue disorders (M70-M79)
Osteopathies and chondropathies (M80-M94)
Disorders of bone density and structure (M80-M85)
Other osteopathies (M86-M90)
excludes1
  • postprocedural osteopathies (M96.-)
Chondropathies (M91-M94)
excludes1
  • postprocedural chondropathies (M96.-)
Other disorders of the musculoskeletal system and connective tissue (M95)
Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified (M96)
Periprosthetic fracture around internal prosthetic joint (M97)
Biomechanical lesions, not elsewhere classified (M99)
14. Diseases of the genitourinary system (N00-N99)
excludes2
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Glomerular diseases (N00-N08)
excludes1
  • hypertensive chronic kidney disease (I12.-)
codeAlso
  • any associated kidney failure (N17-N19).
Renal tubulo-interstitial diseases (N10-N16)
includes
  • pyelonephritis
excludes1
  • pyeloureteritis cystica (N28.85)
Acute kidney failure and chronic kidney disease (N17-N19)
excludes2
  • congenital renal failure (P96.0)
  • drug- and heavy-metal-induced tubulo-interstitial and tubular conditions (N14.-)
  • extrarenal uremia (R39.2)
  • hemolytic-uremic syndrome (D59.3-)
  • hepatorenal syndrome (K76.7)
  • postpartum hepatorenal syndrome (O90.4)
  • posttraumatic renal failure (T79.5)
  • prerenal uremia (R39.2)
  • renal failure complicating abortion or ectopic or molar pregnancy (O00-O07, O08.4)
  • renal failure following labor and delivery (O90.4)
  • renal failure postprocedural (N99.0)
Urolithiasis (N20-N23)
Other disorders of kidney and ureter (N25-N29)
excludes2
  • disorders of kidney and ureter with urolithiasis (N20-N23)
Other diseases of the urinary system (N30-N39)
excludes2
  • urinary infection (complicating):
  • abortion or ectopic or molar pregnancy (O00-O07, O08.8)
  • pregnancy, childbirth and the puerperium (O23.-, O75.3, O86.2-)
Diseases of male genital organs (N40-N53)
Disorders of breast (N60-N65)
excludes1
  • disorders of breast associated with childbirth (O91-O92)
Inflammatory diseases of female pelvic organs (N70-N77)
excludes1
  • inflammatory diseases of female pelvic organs complicating:
  • abortion or ectopic or molar pregnancy (O00-O07, O08.0)
  • pregnancy, childbirth and the puerperium (O23.-, O75.3, O85, O86.-)
Noninflammatory disorders of female genital tract (N80-N98)
Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified (N99)
15. Pregnancy, childbirth and the puerperium (O00-O9A)
excludes1
  • supervision of normal pregnancy (Z34.-)
excludes2
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • postpartum necrosis of pituitary gland (E23.0)
  • puerperal osteomalacia (M83.0)
useAdditionalCode
  • code from category Z3A, Weeks of gestation, to identify the specific week of the pregnancy, if known.
notes
  • CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS
  • Codes from this chapter are for use for conditions related to or aggravated by the pregnancy, childbirth, or by the puerperium (maternal causes or obstetric causes)
  • Trimesters are counted from the first day of the last menstrual period. They are defined as follows:
  • 1st trimester- less than 14 weeks 0 days
  • 2nd trimester- 14 weeks 0 days to less than 28 weeks 0 days
  • 3rd trimester- 28 weeks 0 days until delivery
Pregnancy with abortive outcome (O00-O08)
excludes1
  • continuing pregnancy in multiple gestation after abortion of one fetus or more (O31.1-, O31.3-)
Supervision of high risk pregnancy (O09)
Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (O10-O16)
Other maternal disorders predominantly related to pregnancy (O20-O29)
excludes2
  • maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)
  • maternal diseases classifiable elsewhere but complicating pregnancy, labor and delivery, and the puerperium (O98-O99)
Maternal care related to the fetus and amniotic cavity and possible delivery problems (O30-O48)
Complications of labor and delivery (O60-O77)
Encounter for delivery (O80-O82)
Complications predominantly related to the puerperium (O85-O92)
excludes2
  • mental and behavioral disorders associated with the puerperium (F53.-)
  • obstetrical tetanus (A34)
  • puerperal osteomalacia (M83.0)
Other obstetric conditions, not elsewhere classified (O94-O9A)
16. Certain conditions originating in the perinatal period (P00-P96)
includes
  • conditions that have their origin in the fetal or perinatal period (before birth through the first 28 days after birth) even if morbidity occurs later
excludes2
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • tetanus neonatorum (A33)
notes
  • Codes from this chapter are for use on newborn records only, never on maternal records
Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery (P00-P04)
notes
  • These codes are for use when the listed maternal conditions are specified as the cause of confirmed morbidity or potential morbidity which have their origin in the perinatal period (before birth through the first 28 days after birth).
Disorders of newborn related to length of gestation and fetal growth (P05-P08)
Abnormal findings on neonatal screening (P09)
Birth trauma (P10-P15)
Respiratory and cardiovascular disorders specific to the perinatal period (P19-P29)
Infections specific to the perinatal period (P35-P39)
inclusionTerm
  • Infections acquired in utero, during birth via the umbilicus, or during the first 28 days after birth
excludes2
  • asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
  • congenital gonococcal infection (A54.-)
  • congenital pneumonia (P23.-)
  • congenital syphilis (A50.-)
  • human immunodeficiency virus [HIV] disease (B20)
  • infant botulism (A48.51)
  • infectious diseases not specific to the perinatal period (A00-B99, J09, J10.-)
  • intestinal infectious disease (A00-A09)
  • laboratory evidence of human immunodeficiency virus [HIV] (R75)
  • tetanus neonatorum (A33)
Hemorrhagic and hematological disorders of newborn (P50-P61)
excludes1
  • congenital stenosis and stricture of bile ducts (Q44.3)
  • Crigler-Najjar syndrome (E80.5)
  • Dubin-Johnson syndrome (E80.6)
  • Gilbert syndrome (E80.4)
  • hereditary hemolytic anemias (D55-D58)
Transitory endocrine and metabolic disorders specific to newborn (P70-P74)
includes
  • transitory endocrine and metabolic disturbances caused by the infant's response to maternal endocrine and metabolic factors, or its adjustment to extrauterine environment
Digestive system disorders of newborn (P76-P78)
Conditions involving the integument and temperature regulation of newborn (P80-P83)
Other problems with newborn (P84)
Other disorders originating in the perinatal period (P90-P96)
17. Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
excludes2
  • inborn errors of metabolism (E70-E88)
notes
  • Codes from this chapter are not for use on maternal records
Congenital malformations of the nervous system (Q00-Q07)
Congenital malformations of eye, ear, face and neck (Q10-Q18)
excludes2
  • cleft lip and cleft palate (Q35-Q37)
  • congenital malformation of cervical spine (Q05.0, Q05.5, Q67.5, Q76.0-Q76.4)
  • congenital malformation of larynx (Q31.-)
  • congenital malformation of lip NEC (Q38.0)
  • congenital malformation of nose (Q30.-)
  • congenital malformation of parathyroid gland (Q89.2)
  • congenital malformation of thyroid gland (Q89.2)
Congenital malformations of the circulatory system (Q20-Q28)
Congenital malformations of the respiratory system (Q30-Q34)
Cleft lip and cleft palate (Q35-Q37)
excludes2
  • Robin's syndrome (Q87.0)
useAdditionalCode
  • code to identify associated malformation of the nose (Q30.2)
Other congenital malformations of the digestive system (Q38-Q45)
Congenital malformations of genital organs (Q50-Q56)
excludes1
  • androgen insensitivity syndrome (E34.5-)
  • syndromes associated with anomalies in the number and form of chromosomes (Q90-Q99)
Congenital malformations of the urinary system (Q60-Q64)
Congenital malformations and deformations of the musculoskeletal system (Q65-Q79)
Other congenital malformations (Q80-Q89)
Chromosomal abnormalities, not elsewhere classified (Q90-Q99)
excludes2
  • mitochondrial metabolic disorders (E88.4-)
18. Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
excludes2
  • abnormal findings on antenatal screening of mother (O28.-)
  • certain conditions originating in the perinatal period (P04-P96)
  • signs and symptoms classified in the body system chapters
  • signs and symptoms of breast (N63, N64.5)
notes
  • This chapter includes symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined conditions regarding which no diagnosis classifiable elsewhere is recorded.
  • Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. The residual subcategories, numbered .8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification.
  • The conditions and signs or symptoms included in categories R00-R94 consist of:
  • (a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;
  • (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;
  • (c) provisional diagnosis in a patient who failed to return for further investigation or care;
  • (d) cases referred elsewhere for investigation or treatment before the diagnosis was made;
  • (e) cases in which a more precise diagnosis was not available for any other reason;
  • (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.
Symptoms and signs involving the circulatory and respiratory systems (R00-R09)
Symptoms and signs involving the digestive system and abdomen (R10-R19)
excludes2
  • congenital or infantile pylorospasm (Q40.0)
  • gastrointestinal hemorrhage (K92.0-K92.2)
  • intestinal obstruction (K56.-)
  • newborn gastrointestinal hemorrhage (P54.0-P54.3)
  • newborn intestinal obstruction (P76.-)
  • pylorospasm (K31.3)
  • signs and symptoms involving the urinary system (R30-R39)
  • symptoms referable to female genital organs (N94.-)
  • symptoms referable to male genital organs (N48-N50)
Symptoms and signs involving the skin and subcutaneous tissue (R20-R23)
excludes2
  • symptoms relating to breast (N64.4-N64.5)
Symptoms and signs involving the nervous and musculoskeletal systems (R25-R29)
Symptoms and signs involving the genitourinary system (R30-R39)
Symptoms and signs involving cognition, perception, emotional state and behavior (R40-R46)
excludes2
  • symptoms and signs constituting part of a pattern of mental disorder (F01-F99)
Symptoms and signs involving speech and voice (R47-R49)
General symptoms and signs (R50-R69)
Abnormal findings on examination of blood, without diagnosis (R70-R79)
excludes2
  • abnormal findings on antenatal screening of mother (O28.-)
  • abnormalities of lipids (E78.-)
  • abnormalities of platelets and thrombocytes (D69.-)
  • abnormalities of white blood cells classified elsewhere (D70-D72)
  • coagulation hemorrhagic disorders (D65-D68)
  • diagnostic abnormal findings classified elsewhere - see Alphabetical Index
  • hemorrhagic and hematological disorders of newborn (P50-P61)
Abnormal findings on examination of urine, without diagnosis (R80-R82)
excludes1
  • abnormal findings on antenatal screening of mother (O28.-)
  • diagnostic abnormal findings classified elsewhere - see Alphabetical Index
  • specific findings indicating disorder of amino-acid metabolism (E70-E72)
  • specific findings indicating disorder of carbohydrate metabolism (E73-E74)
Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89)
excludes1
  • abnormal findings on antenatal screening of mother (O28.-)
  • diagnostic abnormal findings classified elsewhere - see Alphabetical Index
excludes2
  • abnormal findings on examination of blood, without diagnosis (R70-R79)
  • abnormal findings on examination of urine, without diagnosis (R80-R82)
  • abnormal tumor markers (R97.-)
Abnormal findings on diagnostic imaging and in function studies, without diagnosis (R90-R94)
includes
  • nonspecific abnormal findings on diagnostic imaging by computerized axial tomography [CAT scan]
  • nonspecific abnormal findings on diagnostic imaging by magnetic resonance imaging [MRI][NMR]
  • nonspecific abnormal findings on diagnostic imaging by positron emission tomography [PET scan]
  • nonspecific abnormal findings on diagnostic imaging by thermography
  • nonspecific abnormal findings on diagnostic imaging by ultrasound [echogram]
  • nonspecific abnormal findings on diagnostic imaging by X-ray examination
excludes1
  • abnormal findings on antenatal screening of mother (O28.-)
  • diagnostic abnormal findings classified elsewhere - see Alphabetical Index
Abnormal tumor markers (R97)
Ill-defined and unknown cause of mortality (R99)
19. Injury, poisoning and certain other consequences of external causes (S00-T88)
excludes1
  • birth trauma (P10-P15)
  • obstetric trauma (O70-O71)
useAdditionalCode
  • code to identify any retained foreign body, if applicable (Z18.-)
notes
  • Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
  • The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
Injuries to the head (S00-S09)
includes
  • injuries of ear
  • injuries of eye
  • injuries of face [any part]
  • injuries of gum
  • injuries of jaw
  • injuries of oral cavity
  • injuries of palate
  • injuries of periocular area
  • injuries of scalp
  • injuries of temporomandibular joint area
  • injuries of tongue
  • injuries of tooth
excludes2
  • burns and corrosions (T20-T32)
  • effects of foreign body in ear (T16)
  • effects of foreign body in larynx (T17.3)
  • effects of foreign body in mouth NOS (T18.0)
  • effects of foreign body in nose (T17.0-T17.1)
  • effects of foreign body in pharynx (T17.2)
  • effects of foreign body on external eye (T15.-)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
codeAlso
  • for any associated infection
Injuries to the neck (S10-S19)
includes
  • injuries of nape
  • injuries of supraclavicular region
  • injuries of throat
excludes2
  • burns and corrosions (T20-T32)
  • effects of foreign body in esophagus (T18.1)
  • effects of foreign body in larynx (T17.3)
  • effects of foreign body in pharynx (T17.2)
  • effects of foreign body in trachea (T17.4)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
Injuries to the thorax (S20-S29)
includes
  • injuries of breast
  • injuries of chest (wall)
  • injuries of interscapular area
excludes2
  • burns and corrosions (T20-T32)
  • effects of foreign body in bronchus (T17.5)
  • effects of foreign body in esophagus (T18.1)
  • effects of foreign body in lung (T17.8)
  • effects of foreign body in trachea (T17.4)
  • frostbite (T33-T34)
  • injuries of axilla
  • injuries of clavicle
  • injuries of scapular region
  • injuries of shoulder
  • insect bite or sting, venomous (T63.4)
Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals (S30-S39)
includes
  • injuries to the abdominal wall
  • injuries to the anus
  • injuries to the buttock
  • injuries to the external genitalia
  • injuries to the flank
  • injuries to the groin
excludes2
  • burns and corrosions (T20-T32)
  • effects of foreign body in anus and rectum (T18.5)
  • effects of foreign body in genitourinary tract (T19.-)
  • effects of foreign body in stomach, small intestine and colon (T18.2-T18.4)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
Injuries to the shoulder and upper arm (S40-S49)
includes
  • injuries of axilla
  • injuries of scapular region
excludes2
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of elbow (S50-S59)
  • insect bite or sting, venomous (T63.4)
Injuries to the elbow and forearm (S50-S59)
excludes2
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of wrist and hand (S60-S69)
  • insect bite or sting, venomous (T63.4)
Injuries to the wrist, hand and fingers (S60-S69)
excludes2
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
Injuries to the hip and thigh (S70-S79)
excludes2
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • snake bite (T63.0-)
  • venomous insect bite or sting (T63.4-)
Injuries to the knee and lower leg (S80-S89)
excludes2
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • injuries of ankle and foot, except fracture of ankle and malleolus (S90-S99)
  • insect bite or sting, venomous (T63.4)
Injuries to the ankle and foot (S90-S99)
excludes2
  • burns and corrosions (T20-T32)
  • fracture of ankle and malleolus (S82.-)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
Injury, poisoning and certain other consequences of external causes (T07-T88)
Injuries involving multiple body regions (T07)
excludes1
  • burns and corrosions (T20-T32)
  • frostbite (T33-T34)
  • insect bite or sting, venomous (T63.4)
  • sunburn (L55.-)
Injury of unspecified body region (T14)
Effects of foreign body entering through natural orifice (T15-T19)
excludes2
  • foreign body accidentally left in operation wound (T81.5-)
  • foreign body in penetrating wound - See open wound by body region
  • residual foreign body in soft tissue (M79.5)
  • splinter, without open wound - See superficial injury by body region
Burns and corrosions (T20-T32)
includes
  • burns (thermal) from electrical heating appliances
  • burns (thermal) from electricity
  • burns (thermal) from flame
  • burns (thermal) from friction
  • burns (thermal) from hot air and hot gases
  • burns (thermal) from hot objects
  • burns (thermal) from lightning
  • burns (thermal) from radiation
  • chemical burn [corrosion] (external) (internal)
  • scalds
excludes2
  • erythema [dermatitis] ab igne (L59.0)
  • radiation-related disorders of the skin and subcutaneous tissue (L55-L59)
  • sunburn (L55.-)
Burns and corrosions of external body surface, specified by site (T20-T25)
includes
  • burns and corrosions of first degree [erythema]
  • burns and corrosions of second degree [blisters][epidermal loss]
  • burns and corrosions of third degree [deep necrosis of underlying tissue] [full- thickness skin loss]
useAdditionalCode
  • code from category T31 or T32 to identify extent of body surface involved
Burns and corrosions confined to eye and internal organs (T26-T28)
Burns and corrosions of multiple and unspecified body regions (T30-T32)
Frostbite (T33-T34)
excludes2
  • hypothermia and other effects of reduced temperature (T68, T69.-)
Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50)
includes
  • adverse effect of correct substance properly administered
  • poisoning by overdose of substance
  • poisoning by wrong substance given or taken in error
  • underdosing by (inadvertently) (deliberately) taking less substance than prescribed or instructed
excludes1
  • toxic reaction to local anesthesia in pregnancy (O29.3-)
excludes2
  • abuse and dependence of psychoactive substances (F10-F19)
  • abuse of non-dependence-producing substances (F55.-)
  • immunodeficiency due to drugs (D84.821)
  • drug reaction and poisoning affecting newborn (P00-P96)
  • pathological drug intoxication (inebriation) (F10-F19)
codeFirst
  • , for adverse effects, the nature of the adverse effect, such as:
  • adverse effect NOS (T88.7)
  • aspirin gastritis (K29.-)
  • blood disorders (D56-D76)
  • contact dermatitis (L23-L25)
  • dermatitis due to substances taken internally (L27.-)
  • nephropathy (N14.0-N14.2)
useAdditionalCode
  • code(s) to specify:
  • manifestations of poisoning
  • underdosing or failure in dosage during medical and surgical care (Y63.6, Y63.8-Y63.9)
  • underdosing of medication regimen (Z91.12-, Z91.13-)
notes
  • The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
Toxic effects of substances chiefly nonmedicinal as to source (T51-T65)
excludes1
  • contact with and (suspected) exposure to toxic substances (Z77.-)
useAdditionalCode
  • code(s):
  • for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70)
  • personal history of foreign body fully removed (Z87.821)
  • to identify any retained foreign body, if applicable (Z18.-)
notes
  • When no intent is indicated code to accidental. Undetermined intent is only for use when there is specific documentation in the record that the intent of the toxic effect cannot be determined.
Other and unspecified effects of external causes (T66-T78)
Certain early complications of trauma (T79)
Complications of surgical and medical care, not elsewhere classified (T80-T88)
excludes2
  • any encounters with medical care for postprocedural conditions in which no complications are present, such as:
  • artificial opening status (Z93.-)
  • closure of external stoma (Z43.-)
  • fitting and adjustment of external prosthetic device (Z44.-)
  • burns and corrosions from local applications and irradiation (T20-T32)
  • complications of surgical procedures during pregnancy, childbirth and the puerperium (O00-O9A)
  • mechanical complication of respirator [ventilator] (J95.850)
  • poisoning and toxic effects of drugs and chemicals (T36-T65 with fifth or sixth character 1-4 or 6)
  • postprocedural fever (R50.82)
  • specified complications classified elsewhere, such as:
  • cerebrospinal fluid leak from spinal puncture (G97.0)
  • colostomy malfunction (K94.0-)
  • disorders of fluid and electrolyte imbalance (E86-E87)
  • functional disturbances following cardiac surgery (I97.0-I97.1)
  • intraoperative and postprocedural complications of specified body systems (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95.6-, J95.7, K91.6-, L76.-, M96.-, N99.-)
  • ostomy complications (J95.0-, K94.-, N99.5-)
  • postgastric surgery syndromes (K91.1)
  • postlaminectomy syndrome NEC (M96.1)
  • postmastectomy lymphedema syndrome (I97.2)
  • postsurgical blind-loop syndrome (K91.2)
  • ventilator associated pneumonia (J95.851)
useAdditionalCode
  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
  • code(s) to identify the specified condition resulting from the complication
  • code to identify devices involved and details of circumstances (Y62-Y82)
20. External causes of morbidity (V00-Y99)
notes
  • This chapter permits the classification of environmental events and circumstances as the cause of injury, and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used secondary to a code from another chapter of the Classification indicating the nature of the condition. Most often, the condition will be classifiable to Chapter 19, Injury, poisoning and certain other consequences of external causes (S00-T88). Other conditions that may be stated to be due to external causes are classified in Chapters I to XVIII. For these conditions, codes from Chapter 20 should be used to provide additional information as to the cause of the condition.
Accidents (V00-X58)
Transport accidents (V00-V99)
excludes1
  • agricultural vehicles in stationary use or maintenance (W31.-)
  • assault by crashing of motor vehicle (Y03.-)
  • automobile or motor cycle in stationary use or maintenance- code to type of accident
  • crashing of motor vehicle, undetermined intent (Y32)
  • intentional self-harm by crashing of motor vehicle (X82)
excludes2
  • transport accidents due to cataclysm (X34-X38)
useAdditionalCode
  • code to identify:
  • Airbag injury (W22.1)
  • Type of street or road (Y92.4-)
  • Use of cellular telephone and other electronic equipment at the time of the transport accident (Y93.C-)
notes
  • This section is structured in 12 groups. Those relating to land transport accidents (V00-V89) reflect the victim's mode of transport and are subdivided to identify the victim's 'counterpart' or the type of event. The vehicle of which the injured person is an occupant is identified in the first two characters since it is seen as the most important factor to identify for prevention purposes. A transport accident is one in which the vehicle involved must be moving or running or in use for transport purposes at the time of the accident.
  • Definitions related to transport accidents:
  • (a) A transport accident (V00-V99) is any accident involving a device designed primarily for, or used at the time primarily for, conveying persons or good from one place to another.
  • (b) A public highway [trafficway] or street is the entire width between property lines (or other boundary lines) of land open to the public as a matter of right or custom for purposes of moving persons or property from one place to another. A roadway is that part of the public highway designed, improved and customarily used for vehicular traffic.
  • (c) A traffic accident is any vehicle accident occurring on the public highway [i.e. originating on, terminating on, or involving a vehicle partially on the highway]. A vehicle accident is assumed to have occurred on the public highway unless another place is specified, except in the case of accidents involving only off-road motor vehicles, which are classified as nontraffic accidents unless the contrary is stated.
  • (d) A nontraffic accident is any vehicle accident that occurs entirely in any place other than a public highway.
  • (e) A pedestrian is any person involved in an accident who was not at the time of the accident riding in or on a motor vehicle, railway train, streetcar or animal-drawn or other vehicle, or on a pedal cycle or animal. This includes, a person changing a tire, working on a parked car, or a person on foot. It also includes the user of a pedestrian conveyance such as a baby stroller, ice-skates, skis, sled, roller skates, a skateboard, nonmotorized or motorized wheelchair, motorized mobility scooter, or nonmotorized scooter.
  • (f) A driver is an occupant of a transport vehicle who is operating or intending to operate it.
  • (g) A passenger is any occupant of a transport vehicle other than the driver, except a person traveling on the outside of the vehicle.
  • (h) A person on the outside of a vehicle is any person being transported by a vehicle but not occupying the space normally reserved for the driver or passengers, or the space intended for the transport of property. This includes a person travelling on the bodywork, bumper, fender, roof, running board or step of a vehicle, as well as, hanging on the outside of the vehicle.
  • (i) A pedal cycle is any land transport vehicle operated solely by nonmotorized pedals including a bicycle or tricycle.
  • (j) A pedal cyclist is any person riding a pedal cycle or in a sidecar or trailer attached to a pedal cycle.
  • (k) A motorcycle is a two-wheeled motor vehicle with one or two riding saddles and sometimes with a third wheel for the support of a sidecar. The sidecar is considered part of the motorcycle. This includes a moped, motor scooter, or motorized bicycle.
  • (l) A motorcycle rider is any person riding a motorcycle or in a sidecar or trailer attached to the motorcycle.
  • (m) A three-wheeled motor vehicle is a motorized tricycle designed primarily for on-road use. This includes a motor-driven tricycle, a motorized rickshaw, or a three-wheeled motor car.
  • (n) A car [automobile] is a four-wheeled motor vehicle designed primarily for carrying up to 7 persons. A trailer being towed by the car is considered part of the car. It does not include a van or minivan - see definition (o)
  • (o) A pick-up truck or van is a four or six-wheeled motor vehicle designed for carrying passengers as well as property or cargo weighing less than the local limit for classification as a heavy goods vehicle, and not requiring a special driver's license. This includes a minivan and a sport-utility vehicle (SUV).
  • (p) A heavy transport vehicle is a motor vehicle designed primarily for carrying property, meeting local criteria for classification as a heavy goods vehicle in terms of weight and requiring a special driver's license.
  • (q) A bus (coach) is a motor vehicle designed or adapted primarily for carrying more than 10 passengers, and requiring a special driver's license.
  • (r) A railway train or railway vehicle is any device, with or without freight or passenger cars couple to it, designed for traffic on a railway track. This includes subterranean (subways) or elevated trains.
  • (s) A streetcar, is a device designed and used primarily for transporting passengers within a municipality, running on rails, usually subject to normal traffic control signals, and operated principally on a right-of-way that forms part of the roadway. This includes a tram or trolley that runs on rails. A trailer being towed by a streetcar is considered part of the streetcar.
  • (t) A special vehicle mainly used on industrial premises is a motor vehicle designed primarily for use within the buildings and premises of industrial or commercial establishments. This includes battery-powered airport passenger vehicles or baggage/mail trucks, forklifts, coal-cars in a coal mine, logging cars and trucks used in mines or quarries.
  • (u) A special vehicle mainly used in agriculture is a motor vehicle designed specifically for use in farming and agriculture (horticulture), to work the land, tend and harvest crops and transport materials on the farm. This includes harvesters, farm machinery and tractor and trailers.
  • (v) A special construction vehicle is a motor vehicle designed specifically for use on construction and demolition sites. This includes bulldozers, diggers, earth levellers, dump trucks. backhoes, front-end loaders, pavers, and mechanical shovels.
  • (w) A special all-terrain vehicle is a motor vehicle of special design to enable it to negotiate over rough or soft terrain, snow or sand. Examples of special design are high construction, special wheels and tires, tracks, and support on a cushion of air. This includes snow mobiles, All-terrain vehicles (ATV), and dune buggies. It does not include passenger vehicle designated as Sport Utility Vehicles. (SUV)
  • (x) A watercraft is any device designed for transporting passengers or goods on water. This includes motor or sail boats, ships, and hovercraft.
  • (y) An aircraft is any device for transporting passengers or goods in the air. This includes hot-air balloons, gliders, helicopters and airplanes.
  • (z) A military vehicle is any motorized vehicle operating on a public roadway owned by the military and being operated by a member of the military.
Pedestrian injured in transport accident (V00-V09)
includes
  • person changing tire on transport vehicle
  • person examining engine of vehicle broken down in (on side of) road
excludes1
  • fall due to non-transport collision with other person (W03)
  • pedestrian on foot falling (slipping) on ice and snow (W00.-)
  • struck or bumped by another person (W51)
Pedal cycle rider injured in transport accident (V10-V19)
includes
  • any non-motorized vehicle, excluding an animal-drawn vehicle, or a sidecar or trailer attached to the pedal cycle
excludes2
  • rupture of pedal cycle tire (W37.0)
Motorcycle rider injured in transport accident (V20-V29)
includes
  • electric bicycle
  • e-bike
  • e-bicycle
  • moped
  • motorcycle with sidecar
  • motorized bicycle
  • motor scooter
excludes1
  • three-wheeled motor vehicle (V30-V39)
Occupant of three-wheeled motor vehicle injured in transport accident (V30-V39)
includes
  • motorized tricycle
  • motorized rickshaw
  • three-wheeled motor car
excludes1
  • all-terrain vehicles (V86.-)
  • motorcycle with sidecar (V20-V29)
  • vehicle designed primarily for off-road use (V86.-)
Car occupant injured in transport accident (V40-V49)
includes
  • a four-wheeled motor vehicle designed primarily for carrying passengers
  • automobile (pulling a trailer or camper)
excludes1
  • bus (V50-V59)
  • minibus (V50-V59)
  • minivan (V50-V59)
  • motorcoach (V70-V79)
  • pick-up truck (V50-V59)
  • sport utility vehicle (SUV) (V50-V59)
Occupant of pick-up truck or van injured in transport accident (V50-V59)
includes
  • a four or six wheel motor vehicle designed primarily for carrying passengers and property but weighing less than the local limit for classification as a heavy goods vehicle
  • minibus
  • minivan
  • sport utility vehicle (SUV)
  • truck
  • van
excludes1
  • heavy transport vehicle (V60-V69)
Occupant of heavy transport vehicle injured in transport accident (V60-V69)
includes
  • 18 wheeler
  • armored car
  • panel truck
excludes1
  • bus
  • motorcoach
Bus occupant injured in transport accident (V70-V79)
includes
  • motorcoach
excludes1
  • minibus (V50-V59)
Other land transport accidents (V80-V89)
Water transport accidents (V90-V94)
Air and space transport accidents (V95-V97)
excludes1
  • military aircraft accidents in military or war operations (Y36, Y37)
Other and unspecified transport accidents (V98-V99)
excludes1
  • vehicle accident, type of vehicle unspecified (V89.-)
Other external causes of accidental injury (W00-X58)
Slipping, tripping, stumbling and falls (W00-W19)
excludes1
  • assault involving a fall (Y01-Y02)
  • fall from animal (V80.-)
  • fall (in) (from) machinery (in operation) (W28-W31)
  • fall (in) (from) transport vehicle (V01-V99)
  • intentional self-harm involving a fall (X80-X81)
excludes2
  • at risk for fall (history of fall) Z91.81
  • fall (in) (from) burning building (X00.-)
  • fall into fire (X00-X04, X08)
Exposure to inanimate mechanical forces (W20-W49)
excludes1
  • assault (X92-Y09)
  • contact or collision with animals or persons (W50-W64)
  • exposure to inanimate mechanical forces involving military or war operations (Y36.-, Y37.-)
  • intentional self-harm (X71-X83)
Exposure to animate mechanical forces (W50-W64)
excludes1
  • Toxic effect of contact with venomous animals and plants (T63.-)
Accidental non-transport drowning and submersion (W65-W74)
excludes1
  • accidental drowning and submersion due to fall into water (W16.-)
  • accidental drowning and submersion due to water transport accident (V90.-, V92.-)
excludes2
  • accidental drowning and submersion due to cataclysm (X34-X39)
Exposure to electric current, radiation and extreme ambient air temperature and pressure (W85-W99)
excludes1
  • exposure to:
  • failure in dosage of radiation or temperature during surgical and medical care (Y63.2-Y63.5)
  • lightning (T75.0-)
  • natural cold (X31)
  • natural heat (X30)
  • natural radiation NOS (X39)
  • radiological procedure and radiotherapy (Y84.2)
  • sunlight (X32)
Exposure to smoke, fire and flames (X00-X08)
excludes1
  • arson (X97)
excludes2
  • explosions (W35-W40)
  • lightning (T75.0-)
  • transport accident (V01-V99)
Contact with heat and hot substances (X10-X19)
excludes1
  • exposure to excessive natural heat (X30)
  • exposure to fire and flames (X00-X08)
Exposure to forces of nature (X30-X39)
Overexertion and strenuous or repetitive movements (X50)
Accidental exposure to other specified factors (X52-X58)
Intentional self-harm (X71-X83)
inclusionTerm
  • Purposely self-inflicted injury
  • Suicide (attempted)
Assault (X92-Y09)
includes
  • homicide
  • injuries inflicted by another person with intent to injure or kill, by any means
excludes1
  • injuries due to legal intervention (Y35.-)
  • injuries due to operations of war (Y36.-)
  • injuries due to terrorism (Y38.-)
Event of undetermined intent (Y21-Y33)
inclusionTerm
  • Undetermined intent is only for use when there is specific documentation in the record that the intent of the injury cannot be determined. If no such documentation is present, code to accidental (unintentional)
Legal intervention, operations of war, military operations, and terrorism (Y35-Y38)
Complications of medical and surgical care (Y62-Y84)
includes
  • complications of medical devices
  • surgical and medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure
Misadventures to patients during surgical and medical care (Y62-Y69)
excludes1
  • surgical and medical procedures as the cause of abnormal reaction of the patient, without mention of misadventure at the time of the procedure (Y83-Y84)
excludes2
  • breakdown or malfunctioning of medical device (during procedure) (after implantation) (ongoing use) (Y70-Y82)
Medical devices associated with adverse incidents in diagnostic and therapeutic use (Y70-Y82)
includes
  • breakdown or malfunction of medical devices (during use) (after implantation) (ongoing use)
excludes2
  • later complications following use of medical devices without breakdown or malfunctioning of device (Y83-Y84)
  • misadventure to patients during surgical and medical care, classifiable to (Y62-Y69)
  • surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure (Y83-Y84)
Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure (Y83-Y84)
excludes1
  • misadventures to patients during surgical and medical care, classifiable to (Y62-Y69)
excludes2
  • breakdown or malfunctioning of medical device (after implantation) (during procedure) (ongoing use) (Y70-Y82)
Supplementary factors related to causes of morbidity classified elsewhere (Y90-Y99)
notes
  • These categories may be used to provide supplementary information concerning causes of morbidity. They are not to be used for single-condition coding.
21. Factors influencing health status and contact with health services (Z00-Z99)
notes
  • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
  • (a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
  • (b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.
Persons encountering health services for examinations (Z00-Z13)
excludes1
  • examinations related to pregnancy and reproduction (Z30-Z36, Z39.-)
notes
  • Nonspecific abnormal findings disclosed at the time of these examinations are classified to categories R70-R94.
Genetic carrier and genetic susceptibility to disease (Z14-Z15)
Resistance to antimicrobial drugs (Z16)
Estrogen receptor status (Z17)
Retained foreign body fragments (Z18)
Hormone sensitivity malignancy status (Z19)
Persons with potential health hazards related to communicable diseases (Z20-Z29)
Persons encountering health services in circumstances related to reproduction (Z30-Z39)
Encounters for other specific health care (Z40-Z53)
inclusionTerm
  • Categories Z40-Z53 are intended for use to indicate a reason for care. They may be used for patients who have already been treated for a disease or injury, but who are receiving aftercare or prophylactic care, or care to consolidate the treatment, or to deal with a residual state
excludes2
  • follow-up examination for medical surveillance after treatment (Z08-Z09)
Persons with potential health hazards related to socioeconomic and psychosocial circumstances (Z55-Z65)
Do not resuscitate status (Z66)
Blood type (Z67)
Body mass index [BMI] (Z68)
Persons encountering health services in other circumstances (Z69-Z76)
Persons with potential health hazards related to family and personal history and certain conditions influencing health status (Z77-Z99)
codeAlso
  • any follow-up examination (Z08-Z09)
22. Codes for special purposes (U00-U85)
Provisional assignment of new diseases of uncertain etiology or emergency use (U00-U49)