REPUBLIC OF THE PHILIPPINES DEPARTMENT OF HEALTH PHILIPPINE ICD-10 MODIFICATIONS AUTHORS JUAN M. LOPEZ, MD, MP H National Epidemiology Center Departm ent of Health ICD-10 Modifications FLORINDA G. TUVILLO, BSE National Center for Health Facility Development Departm ent of Health THERESA D. TIMBANG, MP A National Epidemiology Center Departm ent of Health REGGIE R. GUILLEN, BSBS Health Informatics Section, Health Finance Policy Sector Philippine Health Insurance CONTRIBUTORS: ICD-10 NA TIONAL TW G MEMBERS ENRIQUE A. TAYAG, MD, PHSAE, FPSMID, CEO VI Chairperson, ICD-10 National TWG on Certain Diseases/Conditions and Related Health Problems in Health Care Facilities in the Philippines MADELEINE R. VALERA, MD, MSCIH Vice Chairperson, ICD-10 National TWG EUMELIA SALVA, MD, MPH MARY ANN EVANGELISTA,MD PHILIPPINE MEDICAL SPECIALTY SOCIETIES PHILIPPINE HEALTH CARE FACILITIES First Edition October 2008 iv i ii iii exchange of scientific information among a wide range Philippine ICD-10 Modifications First Edition October 2008 of users for clinical and public health purposes. In the Philippines, the implementation of ICD-10 coding has been made mandatory through the issuance of Administrative Order No. 47, s. 2000. issuance mandates all hospitals and health facilities to comply with the ICD-10 requirements for the issuance and renewal of hospital licenses. Philippine Health Insurance AUTHORS The said Likewise, Corporation the (PHIC) requires all health care providers to comply with the ICD-10 requirements for accreditation as well as the reimbursement of cl aims. The Department of Health through the National ICD-10 JUAN M. LOPEZ, MD, MPH National Epidemiology Center Department of Health FLORINDA G. TUVILLO, BSE National Center for Health Facility Development Department of Health THERESA D. TIMBANG, MPA National Epidemiology Center Department of Health REGGIE R. GUILLEN, BSBS Health Informatics Section, Health Finance Policy Sector Philippine Health Insurance Technical Working Group, in its efforts to assist health care providers in the implementation of ICD-10 diagnostic classification, initiated the development of the “Philippine ICD-10 Modifications, 1st Edition”. This handbook is not intended to replace the principal ICD-10 international standards of WHO but complement them through additional information for their local adoption and usage. Modifications to some categories, especially for several problematic diseases, viii v MESSAGE With the current initiatives of the Department of Health to strengthen the national health system through the Copyright © Department of Health 2009 Fourmula One for Health, there is now considerable demand to i mprove the reporting and coll ection of basic health statistics (mortality and morbidity data) in all health facilities in the country. Quality and timely information on these major health events has a direct impact on healthcare as it influences national health spending, the formulation of health policies as well as the prevention, treatment, and care of diseases and health condi tions that lead to them. A global classification system for classifying mortality and morbidity has been developed by the World Health Organization to become the standard for international comparison for the categorization of diseases across countries and health systems. The International Statistical Classification of Diseases version 10 (ICD10) endorsed by the World Health Assembly in 1990 has enabled the reporting, investigation and monitoring of deaths, diseases and injuries together with their causes which allowed for the systematic documentati on of medical conditions and the useful vi vii PREFACE were also introduced to facilitate the assignment of With the ever-growing interest in using health data to look at codes guided activity and performance ICD-10 document. of health services, there is an by the basic principles of the original increasing emphasis on improving the reliability and comparability of health data not only at the local and We thank and recognize the noble efforts of the national level, but also at an international level. The authors International Classification of Diseases version 10 (ICD-10) unselfishly sharing their expertise in helping us improve is the international standard classification for the coding of data coll ection strategies and tool s for monitoring at the diseases and other health issues for morbidity and mortality Department of Health. and contributors of this handbook for reporting. Health data coded in ICD-10 form the basic building blocks for the assessment of health system With this achievement toward the full and accurate performance. recording of diseases and deaths in our health hospital Use of the classification for the coding of discharges (morbidity) or death certificates facilities, we expect better adherence to local and (mortality) is encouraged by the World Health Organization international standards that shall guide our national (WHO) and its regional offices because health programs. Let us continue to work for timely, it ensures the comparability of health data between individual hospitals, provinces, regions or countries. In the country, the implementation of ICD-10 coding is made mandatory through the issuance of this Department of the Administrative Order No. 47, s. 2000. For the past years, the ICD-10 National Technical Working truthful and reliable health statistics to make our reforms more responsive to our local needs. Quality health information means quality health care for all Filipinos! Mabuhay tayong lahat! Group (TWG) composed of representatives from the National Epidemiology Center, National Center for Health Facility Development, Bureau of Health Facilities and FRANCISCO T. DUQUE III, MD, MSc. Secretary of Health xii ix MESSAGE Let us all build a health information systems that will The shortlist on “Certain Philippine Modifications on ICD-10“ highlights the initial step towards the improvement of the health information system in the country. lead to the advancement and quali ty health care for all. Mabuhay and mor e power! The ICD-10 is an international standard diagnostic classification for all diseases and various health related concepts and is beneficial in the development and enhancement of our health LORNA O. FAJARDO, CESO III Acting President and CEO programs. PhilHealth’s adoption of ICD-10 has resulted to a faster and transparent processing of claims reimbursement, improved information for disease management, more accurate reimbursement rates, and improving quality of care and patient safety. With great honor, I commend the people behind the creation of the ICD -10 Philippine Modifications. It is my hope that this booklet will be beneficial to all health care providers in terms of providing greater coding accuracy, opportuni ties for a detailed record keeping and enhanced documentati on to support accurate payment. x xi DISCLAIMER Services, this Department as well as other concerned This publication aims to assist coders in assigning ICD10 codes to certain diseases/condi tions and other related health problems. agencies such as National Statistics Office, Philippine Health Insurance Corporation (PHIC), San Lazaro Hospital The list of diseases/ and Association of Health Maintenance Organization of the conditions provided herein was taken from statistical Philippines (AHMOPI) has gathered data on the common and other reports prepared by various health care and uncommon diseases/conditions and other related health facilities in the country. Valuable inputs from several problems reported in various health care facilities in the medical specialty societies were also included. country. Data from PHIC and various medical societies such as the Philippine College of Physicians (PCP), Inasmuch as there are numerous ways physicians in Philippine College of Chest Physicians (PCCP), Philippine the countr y write their diagnoses it should be noted that Academy of Ophthalmology (PAO), Philippine Obstetrical the diseases / conditions listed herein may or may not and Gynecological Society (POGS), Philippine Society of represent the actual diagnostic statements provided in Nephrology the patient’s discharge diagnosis or even the causes of death in a death certificate. In the assignment of suitable ICD-10 codes, the authors considered the available descriptors, modifiers or qualifiers of the (PSN) and the Philippine Society of Microbiology and Infectious Disease (PSMID) were also considered. This is in line with the TWG’s intention to come up with a Shortlist of ICD-10 codes that would facilitate the assignment of the most appropriate ICD-10 codes to certain diseases / conditions. disease or condition regardless of their position in the diagnostic statement (ex. Acute bronchitis is treated similar to Bronchitis, acute). codes provided herein Likewise, the ICD-10 are mostly for less specific cases, for more specific conditions and/or other In view of the foregoing and with the primary objective of assisting the coders in the implementation of ICD-10 Coding, this initial edition of “Certain Philippine Modifications on ICD-10” was developed. However, it is not intended to replace the ICD-10 books published by the WHO which remain the primary tools in ICD-10 Coding. xvi xiii ACKNOWLEDGEMENTS Moreover, this humble work was made possible through the concerted efforts of the Department of Health, PHIC, NSO, various health care facilities, Philippine Medical Societies, and other concerned agencies. Thus, grateful appreciation The uniqueness of some diseases and conditions in the country necessitated the development of this is extended to those who have selflessly shared valuable publication. inputs to this undertaking. MODIFICATIONS PHILIPPINE The was completed ICD-10 through the concerted efforts of the principal authors and various Finally, all concerned must continue to work towards adherence to standards if we are to truly obtain quality health data that may be comparable over time and be genuinely useful in the assessment of the performance of health services in general and the health status of the concerned agencies who believe that the adoption of ICD-10 coding in the country would greatly contribute to the improvement in the quality of our health statistics. population in particular. Grateful acknowledgement is hereby made to those who have unselfishly shared their knowledge and The Authors expertise in the development of this shortlist. Again our heartfelt appreciation to all of you. xiv xv Cyst…………………………………………………………… Cystitis………………………………………… …………….. Cystolithiasis……..………………………………………… . Cystorectocele, female…………………………………… .. Deficiency…………………………………………………… Deficit………………………… .…………………………… . Dehydration………………………………………………… . Delivery……………………………………………………… Dementia………………………………… ………………… Depression………………………………………………… . Depressive Reaction……………………………………… . Dermatitis…………………………………………………… Diabetes Mellitus………………………………………… .. Diarrhea [ Gastroenteritis ]……………………………… .. Diptheria…………………………………………………… .. Disease……………………………………………………… . Dislocation, Hip, Traumatic………………………………… Disorder……………………………………………………… Distention…………………………………………………… . Distress……………………………………………………… . Dizziness [ Vertigo ]………………………………………… Dogbite……………………………………………………… . Dysarthria…………………………………………………… . Dyscrasia, Blood…………………………………………… . Dyslipidemia………………………………………………… . Dyspepsia…………………………………………………… . Dysphagia…………………………………………………… . Dysplasia…………………………………………………… .. Dyspnea [ Shortness of Breath ]………………………… ... Dysrhytmia………………………………………………… .. Dysuria [ Painful Urination ]………………………………… Eclampsia…………………………………………………… . Effusion, Pleura……………………………………………… Embolism…………………………………………………… .. Emesis [ Vomiting ]………………………………………… . Empyema……………………………… …………………….. Encephalopathy……………………………………………… Endometriosis……………………………………………… .. Enteritis [ Ileitis ]…………………………………………… .. Enuresis……………………………………………………… 34 35 35 35 35 35 35 36 41 42 42 42 42 44 45 45 46 46 47 47 47 47 48 48 48 48 48 48 48 48 48 48 49 49 49 49 49 49 49 49 combined diseases/ conditions applicable notes are given under related categories for guidance. Modifications in some codes were developed by the ICD-10 National Technical Working Group in consultation with the concerned medical societies in the country and coding experts from Australia. Though all the information has been checked for accuracy, neither the authors nor the publisher accept any responsibility or liability with regard to omissions, misuse or misinterpretation. The Authors xx xvii TABLE OF CONTENTS Messages Preface Acknowledgements Disclaimer List of ICD-10 Coded Diseases/Conditions Abnormality …………………………………………………… Abortion ……………………………………………………… . Abruptio Placenta …………………………………………… . Abscess……………………………………………………… .. Accident, Cerebrovascular (CVA)………………………….. AIDS / HIV…………………………………………………… .. Adenocarcinoma……………………………………………… Adenoma……………………………………………………… . Allergy………………………………………………………… . Amoebiasis…………………………………………………… . Anemia………………………………………………………… Angina Pectoris……………………………………………… . Anorexia……………………………………………………… . Anuria………………………………………………………… . Anxiety State………………………………………………… . Appendicitis…………………………………………………… Arrest………………………………………………………… .. Arteriosclerosis [Atherosclerosis]………………………… .. Arthralgia……………………………………………………… Arthritis……………………………………………………… .. Ascites, Abdominal………………………………………… .. Asphyxia, Neonatorum……………………………………… Asthma……………………………………………………… .. Atelectasis…………………………………………………… . Atresia………………………………………………………… Attack………………………………………………………… . Bedsore……………………………………………………… . Bell’s Palsy…………………………………………………… Bleeding [ Hemorrhage]…………………………………… . Blighted Ovum……………………………………………… . Block………………………………………………………… .. Bronchiectasis……………………………………………… . 1 1 2 2 3 4 7 7 7 7 8 10 10 10 10 11 11 11 12 12 13 13 13 14 14 14 14 14 14 14 14 14 Bronchitis…………………………………………………… . Bronchopneumonia ( BPN)……………………………… .. Burn………………………………………………………… .. Calcifications, Renal……………………………………… .. Calculus……………………………………………………… Cancer……………………………………………………… .. Carcinoma…………………………………………………… Cardiomegaly……………………………………………… .. Cardiomyopathy……………………………………………… Cataract……………………………………………………… . Cellulitis……………………………………………………… . Cephalgia [ Headache]……………………………………… Chalazion…………………………………………………… .. Check up, Health [ Examination, Health]…………………. Chemotheraphy, Maintenance for Neoplasm……………. Cholera……………………………………………………… . Cholecystitis………………………………………………… . Cholecystolithiasis………………………………………… .. Cholelithiasis………………………………………………… Cirrhosis……………………………………………………… Cleft Lip…………………….……………………………… ... Cleft Palate ……………..………………………………… ... Cleft Palate with Cleft Lip...……………………………… ... Coagulopathy, Coagulation………………………………… Cold…………………………………………………………… Colitis………………………………………………………… . Comatose…………………………………………………… . Complications……………………………………………… .. Concussion………………………………………………… .. Conjunctivitis………………………………………………… .. Constipation………………………………………………… . Contusion ………………………………………………… .. Convulsion…………………………………………………… Cor Pulmonale……………………………………………… . Costochondritis……………………………………………… Cough………………………………………………………… Crisis………………………………………………………… . Cyanosis…………………………………………………… .. xviii xix 15 16 16 18 18 18 21 25 25 25 29 29 29 29 29 30 30 30 30 30 30 31 31 31 31 32 32 32 32 32 32 33 33 33 33 33 34 34 Paraplegia……………………………………… …...…………… Parasitism………………………………………………………… Parkinson’s Disease [ Parkinsonism]………………………… .. Parotitis…………………………………………………………… Pelvic Inflammatory Disease…………………………………… Pharyngitis………………………………………………………… Physical Examination [ Check Up]…………………..…………. Pleural; Effusion……………………………………… ..………… Pleurisy………………………………………………… ….……… Pneumocystosis………………………………………… ..……… Pneumonia…………………………………………………… …… Pneumonitis……………………………………………………… . Pneumothorax…………………………………………………… . Poisoning………………………………………………………… . Poliomyelitis………………………… …………………………… . Polyp ……………………………………………………………… . Polypsis…………………………………………………………… . Polyuria…………………………………………………………… . Pregnancy………………………………………………………… Primary Complex………………………………………………… Procidentia Uteri………………………………………………… Prolapse…………………………………………………………… Psychosis………………………………………………………… .. Pterygium………………………………………………………… . Purpura…………………………………………………………… Pyelonephritis……………………………………………………… Quadriplegia, Late Effect………………………………………… Rabies……………………………………………………………… Reaction…………………………………………………………… Reflux……………………………………………………………… Retention…………………………………………………………… Reticulosarcoma…………………………………………………… Rheumatism………………………………………………………… Rhinitis……………………………………………………………… . Salmonellosis……………………………………………………… . Sarcoma, primary , malignant, site unspecified………………… Sarcoma, secondary , malignant, site unspecified…………… Scar………………………………………………………………… Schistosomiasis…………………………………………………… 80 80 81 81 81 81 82 82 82 82 82 83 83 84 87 88 88 88 88 88 88 88 89 89 89 89 89 89 89 90 90 90 91 91 91 91 92 93 93 Epilepsy……………………………………………………… Epistaxis [ Nosebleed ]…………………………………… .. Erysipelas…………………………………………………… . Erythema…………………………………………………… . Esophageal, Reflux………………………………………… . Esophagitis………………………………………………… .. Examination , Health……………………………………… .. Failure………………………………………………………… Fever………………………………………………………… . Fibroadenoma……………………………………………… . Fistula………………………………………………………… Fracture……………………………………………………… Gangrene…………………………………………………… . Gastritis………………………………………………………… . Gastroenteritis………………………………………………… .. Glaucoma……………………………………………………… .. Glioma…………………………………………………………… Glomerulonephritis…………………………………………… .. Goiter…………………………………………………………… . Gout……………………………………………………………… Glycosuria……………………………………………………… .. Grave’s Disease………………………………………………… Gun Shot Wound……………………………………………… .. Hansen’s Disease [ Leprosy]………………………………… .. Headache [ Cephalgia]………………………………………… . Hemangioma…………………………………………………… .. Hematuria………………………………………………………… Hemophilia……………………………………………………… .. Hemoptysis……………………………………………………… . Hemorrhage…………………………………………… ………… Hemorrhoids……………………………………………………… Hepatitis………………………………………………………… ... Hepatomegaly…………………………………………………… . Hernia…………………………………………………………… .. Hiccoughs………………………………………………………… Hodgkin’s Disease……………………………………………… . Hydronephrosis………………………………………………… .. Hyperacidity……………………………………………………… xxiv xxi 50 50 50 50 50 50 50 51 51 51 51 52 56 56 56 57 57 57 57 58 58 58 58 58 58 58 59 59 59 59 59 59 60 60 60 60 60 60 Hypercholesterolemia…………………………………………… Hyperemesis Gravidarum………………………………………… . Hyperesthesia, Skin…………………………………………… .. Hyperosmolar Coma [ Hyperglycemic Hyperosmolar Syndrome]…………………. Hyperkalemia…………………………………………………… .. Hyperlipidemia…………………………………………………… . Hyperplasia……………………………………………………… .. Hypersensitivity Reaction……………………………………… .. Hypertension…………………………………………………… ... Hyperthyroidism………………………………………………… .. Hypertrophy……………………………………………………… . Hyperuricemia…………………………………………………… . Hypoglycemia…………………………………………………… .. Hypokalemia……………………………………………………… Hypotension……………………………………………………… . Ileitis……………………………………………………………… .. Ileus……………………………………………………………… .. Imbalance………………….……………………………………… Impaction, Impacted………….………………………………… . Incontinence…….……………………………………………… .. Indigestion….…………………………………………………… . Infarction………..………………………………………………… Infection………………………………………………………… ... Influenza………………………………………………………… .. Injury……………………………………………………………… Insufficiency……………………………………………………… Jaundice………………………………………………………… .. Ketoacidosis…………………………………………………… .. Koch’s Disease, Koch’s Infection…………………………… .. Labor…………………………………………………………… .. Laryngitis………………………………………………………… Leprosy [ Hansen’s Disease]………………………………… .. Leukemia………………………………………………………… Ligation………………………………………………………… … Lipoma…………………………………………………………… Lumbago………………………………………………………… 60 60 60 Lupus……….……………………………………………… ……… Lymphoma………………………………………………………… 70 70 61 61 61 61 61 61 61 62 62 62 62 62 62 62 62 62 62 63 63 63 64 67 68 68 68 68 68 68 69 69 69 70 70 Lymphosarcoma………………………………………………… .. Malaria……………………………………………………………… Malignancy………………………………………………………… Malnutrition………………………………………………………… Mass……………………………………………………………… .. Measles………………………………………………………… …. Melanoma, Malignant, Skin……………………………………… Meningitis………………………………………………………… .. Meningioma……………………………………………………… .. Metastases………………………………………………………… Migraine…………………………………………………………… . Mumps…………………………………………………………… ... Myasthenia Gravis……………………………………………… .. Myeloma…………………………………………………………… Myelomata………………………………………………………… Myocarditis………………………………………………………… Myoma Uteri………………………………………………… ..…… Narrowing, rectal………………………………………………… .. Nausea [ Vomiting ]……………………………………………… . Necrosis…………………………………………………………… Nephritis…………………………………………………………… Nephrolithiasis…………………………………………………… .. Nephropathy……………………………………………………… . Neurodermatitis…………………………………………………… Neuropathy………………………………………………………… New Growth ……………………………… ……………………… . Nodules…………………………………………………………… .. Obesity…………………………………………………………… .. Obstruction………………………………………………………… Oliguria…………………………………………………………… .. Orchitis……………………………………………………………… Orthopnea………………………………………………………… . Osteoarthritis……………………………………………………… . Osteoporosis……………………………………………………… Otitis………………………………………………………………… Pain………………………………………………………………… Palpitations………………………………………………………… xxii xxiii 71 71 72 73 73 73 74 74 74 74 75 75 75 75 75 75 75 76 76 76 76 76 76 76 76 76 77 77 77 77 77 77 77 78 78 78 80 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE O06.9 Induced Abortion See also notes under “Abortion” O03. 90 Imminent Abortion Note: This is classified under spontaneous abortion, however, an additional 5th character “0” is included to distinguish imminent from inevitable abortion See also notes under “Abortion” O03. 91 Inevitable Abortion Note: This is classified under spontaneous abortion, however, an additional 5th character “1” is included to distinguish imminent from inevitable abortion See also notes under “Abortion” O03. 99 Non-Induced Abortion See also notes under “Abortion” O03. 99 Spontaneous Abortion See also notes under “Abortion” O02.1 O20.0 Missed Abortion Threatened Abortion ABRUPTIO PLACENTA O45.9 ABSCESS L02.9 K61.2 G06.0 G06.0 K75.0 A06.4 Anorectal Abscess Cerebellar Abscess Cerebral Abscess Liver Abscess Amoebic Liver Abscess Sciatica……………………………………………………………… . Sclerosis………………………………… ………………………… Seizures…………………………………………………………… Septicemia [ Sepsis ]………………………………………… . Sinusitis……………………………………………………………… Spherocystosis……………………………………………………… Stab Wound………………………………………………………… . Steatohepatitis, Non Alcoholic…………………………………… Stroke……………………………………………………………… Syndrome………………………………………………………… .. Tachycardia………………………………………………………… Tetanus……………………………………………………………… Thyroid Storm……………………………………………………… Tonsilitis…………………………………………………………… Tonsillopharyngitis…………………………… …………………… Toxicosis………………………………………………… .………… Transient Ischemic Attack………………………………………… . Tuberculosis of Lung, [ Pulmonary Tuberculosis]……………... Tympanomastoiditis……………………………………………… .. Ulcer………………………………………………………………… Uremia…………………………………… ………………………… Urolithiasis………………………………………………………… . Urosepsis…………………………………………………………… . Vasculitis…………………………………………………………… Vertigo [Dizziness]………………………………………………… . Vomiting…………………………………………………………… Weakness………………………………………………………… . Weight Loss, Abnormal…………………………………………… . Wound, Open……………………………………………………… 93 93 93 93 93 94 94 94 94 95 95 95 95 95 96 96 96 96 96 97 97 97 97 97 97 97 97 97 98 Ill Defined Conditions in terms of ICD-10 Code Assignment………………………………………………………… . 99 WHO Official Updates to ICD-10 100 References 109 2 xxv DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE ABNORMALITY Electrolyte Abnormality [ Electrolyte Imbalance] Urine Abnormality Asymptomatic Urine Abnormality ABORTION Note: E87.8 R82.9 R82.9 O06.9 If other information such as the completeness or incompleteness of abortion and its associated complication/s are indicated, a th more appropriate 4 character should be assigned instead of “9”. Refer to the sub-classification below for other applicable 4th character. The following 4th character subdivisions are for use with categories O03- O06 to indicate complications and whether the abortion is complete or incomplete: .0 - incomplete, complicated by genital tract and pelvic infection .1 - incomplete, complicated by delayed or excessive hemorrhage .2 - incomplete complicated by embolism .3 - incomplete with other and unspecified complications .4 - incomplete, without complication .5 - complete or unspecified, complicated by genital tract and pelvic infection .6 - complete or unspecified, complicated by delayed or excessive hemorrhage .7 - complete or unspecified, complicated by embolism .8 - complete or unspecified, with other and unspecified complications .9 - complete or unspecified, without complication 1 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE AIDS/HIV resulting in Multiple Malignant Neoplasm ICD-10 CODE B21.7 Amoebic Liver Abscess with Brain Abscess and Lung Abscess Amoebic Liver Abscess with Lung Abscess Refer to ICD-10 Vols. 1 & 3 for other specific codes to consider. B22.0 See also notes under “AIDs/HIV causing mycobacterial infection” AIDS/HIV resulting in Lymphoid Interstitial Pneumonitis AIDS/HIV resulting in Wasting Syndrome B22.1 See also notes under “AIDs/HIV causing mycobacterial infection” B22.2 See also notes under “AIDs/HIV causing mycobacterial infection” AIDS/HIV resulting in Multiple Diseases Note: B22.7 Supplemental code/s within B20-B24 subcategories should be added to indicate the code for HIV resulting to specific disease other specific information is indicated. Refer to ICD-10 Vols. 1 & 3 for other more specific codes to consider. AIDS/HIV resulting in Generalized Lymphadenopathy GUIDANCE Amoebic Liver Abscess with Brain Abscess Note: Supplemental code/s within B21 subcategories should be added to indicate the code for HIV resulting to specific malignant neoplasm if other specific information is indicated. AIDS/HIV resulting in Encephalopathy DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR B23.1 Lung Abscess Amoebic Lung Abscess with Liver Abscess Lung Abscess with Pneumonia Pharyngeal Abscess Perineal Abscess Peritonsillar Abscess Scrotal Abscess ACCIDENT, CEREBROVASCULAR (CVA) Cardioembolic CVA ICD-10 CODE A06.6† G07* A06.6† G07* A06.5† J99.8* J85.2 A06.5† J99.8* J85.1 J39.1 L02.2 J36 N49.2 I64 I64 Note: A more specific code instead of “I64” should be assigned if the specific artery involved is indicated. Refer to ICD-10 Vols. 1 & 3 for other specific codes to consider. CVA with Paralysis CVA with Right Hemiplegia CVA Infarct CVA with Infarction Hemorrhagic CVA Old or healed CVA with Paralysis 6 3 I64, G83.9 I64, G81.9 I63.9 I63.9 I61.9 G83.9 I69.8 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) / HUMAN IMMUNODEFICIENCY SYNDROME (HIV) ICD-10 CODE B24 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE AIDS/HIV resulting in Candidiasis AIDS/HIV resulting in Pneumocystis Carinii Pneumonia Refer to ICD-10 Vols. 1 & 3 for other specific codes to consider. Acute HIV Infection Syndrome B23.0 AIDS/HIV with Infection (Unspecified Infection) B20.9 B20.0 Note: Supplemental code/s should be added to indicate the code for the specific resulting condition/s if other specific details of the resulting condition is indicated. AIDS/HIV causing Tuberculosis AIDS/HIV resulting in Multiple Infections B20.6 See also notes under “AIDs/HIV causing mycobacterial infection” B20.7 Note: Supplemental code/s within B20 subcategories should be added to indicate the code for HIV resulting to specific infection if other specific information is indicated. Refer to ICD-10 Vols. 1 & 3 for other specific codes to consider. B20.0 See also notes under “AIDs/HIV causing Mycobacterial infection” AIDS/HIV causing Cytomegaloviral Disease B20.4 See also notes under “AIDs/HIV causing mycobacterial infection” Note: A more specific code should be assigned instead of “B24” if there are other resulting conditions indicated. AIDS/HIV causing Mycobacterial Infection ICD-10 CODE B20.2 See also notes under “AIDs/HIV causing Mycobacterial infection” AIDS/HIV resulting in Malignant Neoplasms (unspecified) AIDS/HIV resulting in Kaposi’s Sarcoma B21.9 B21.0 See also notes under “AIDs/HIV causing mycobacterial infection” AIDS/HIV resulting in Burkitt’s Lymphoma B21.1 See also notes under “AIDs/HIV causing mycobacterial infection” 4 5 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Malarial Anemia (Plasmodium Falciparum) Malarial Anemia (Plasmodium Vivax) Malarial Anemia (Plasmodium Malariae) Non-autoimmune Hemolytic Anemia due to Drugs ICD-10 CODE B50.8† D63.8* B51.8† D63.8* B52.8† D63.8* D59.2 I20.9 I20.0 Unstable Angina ANOREXIA [LOSS OF APETITE] ANURIA [ OLIGURIA ] R63.0 R34 ANXIETY STATE ADENOCARCINOMA C80 M8140/3 C54.1 M8140/3 Endometrial Adenocarcinoma Note: A more specific site code should be assigned instead of “D36.9” if the site is indicated. D51.0 D50.0 D64.9 F41.1 ICD-10 CODE B24 AIDS Related Complex (ARC) Pleomorphic Adenoma (site unspecified) Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. ANGINA PECTORIS GUIDANCE ADENOMA Note: Supplemental code from V01 – Y98 for the external cause should be added to D59.2 to identify the specific drug/medicine, if drug is specified. Pernicious Anemia Post Hemorrhagic Anemia Severe Anemia DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR D36.9 M8940/0 D36.9 M8940/0 Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. ALLERGY T78.4 Note: Codes within the category T78 is to be used as the primary code to identify the effects not elsewhere classifiable, of unknown, undetermined or ill-defined causes. J30.3 J45.0 J30.3 T78.1 Dust Allergy Dust Allergy with Asthma Epidermal Allergy Food Allergy See also notes under “Allergy” K52.2 Gastrointestinal Allergy AMOEBIASIS A06.9 A06.0 A06.0 Amoebiasis Colitis Amoebic Dysentery 10 7 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE A06.1 A06.0 Chronic Intestinal Amoebiasis Intestinal Amoebiasis ANEMIA D64.9 Note: A more specific code should be assigned instead of “D64.9” if other specific details on anemia is indicated. D62 O99.0 Note: Supplemental code/s for the specific type of anemia should be added to “O99.0”, if other specific information on anemia is indicated. Anemia secondary to Hepatoma Anemia secondary Bleeding Anemia secondary Anemia secondary Anemia secondary Anemia secondary to Upper Gastro Intestinal to Acute Blood Loss to Acute Hemorrhage to Chronic Blood Loss to Chronic Hemorrhage Anemia with Hypotension Anemia with Chronic Hypotension C34.9† D63.0* M8010/3 C22.0† D63.0* M8170/3 D50.0, K92.2 D62 D62 D50.0 D50.0 ICD-10 CODE D64.9, I95.9 I95.8† D63.8* D61.9 D59.0 Note: Supplemental code from V01 – Y98 for the external cause should be added to D59.0 to identify the specific drug/ medicine, if drug is specified. Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. Chronic Blood Loss Anemia Chronic Post Hemorrhagic Anemia Hemolytic Anemia due to Drugs Refer to ICD-10 Vols. 1 & 3 for the appropriate code/s to consider . Anemia secondary to Bronchogenic Ca GUIDANCE Aplastic Anemia Autoimmune Hemolytic Anemia due to Drugs Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. Acute Post Hemorrhagic Anemia Anemia complicating Pregnancy / Childbirth / Puerperium DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR D50.0 D50.0 D59.2 Note: Supplemental code from V01 – Y98 for the external cause should be added to D59.2 to identify the specific drug/ medicine, if drug is specified. Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. Hemolytic Anemia secondary to Infection Iron-deficiency Anemia Malarial Anemia Note: A more appropriate code should be assigned instead of “B54” if other specific details on malaria is indicated. Refer to the other codes on Malarial Anemia below or the ICD-10 Vols. 1 & 3 for the appropriate code to consider. 8 9 D59.4 D50.9 B54† D63.8* DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ATELECTASIS ICD-10 CODE J98.1 J98.1 Pulmonary Atelectasis DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE APPENDICITIS ATRESIA Q44.2 Q22.0 Q22.4 Biliary Atresia Pulmonary Valve Atresia Tricuspid Valve Atresia ATTACK Transient Ischemic Attack (TIA) BEDSORE G45.9 L89 BELL’S PALSY G51.0 BLEEDING [ HEMORRHAGE ] R58 K92.2 K92.2 K92.2 N95.0 N93.9 N93.9 N93.8 Gastro Intestinal Bleeding Lower Gastro Intestinal Bleeding Upper Gastro Intestinal Bleeding (UGIB) Post Menopausal Bleeding (PMB) Uterine Bleeding, not due to Menstruation Uterine hemorrhage, not due to Menstruation Dysfunctional Uterine Bleeding (DUB) BLIGHTED OVUM O02.0 BLOCK Left Bundle Branch Block (LBBB) Left Bundle Branch Hemiblock Left Bundle Branch Posterior Hemiblock Left Bundle Branch Anterior Hemiblock BRONCHIECTASIS I44.7 I44.6 I44.5 I44.4 J47 ICD-10 CODE K37 Note: A more appropriate code should be assigned instead of “K37” if other specific details on appendicitis is indicated. Refer to the other codes on Appendicitis below or the ICD-10 Vols. 1 & 3 for the appropriate code to consider. Acute Appendicitis Acute Appendicitis with Generalized Peritonitis Acute Appendicitis with Peritonitis Acute Ruptured Appendicitis Acute Suppurative Appendicitis Appendicitis with Generalized Peritonitis Appendicitis with Peritoneal Abscess Appendicitis with Peritonitis Chronic Appendicitis Inflamed Ruptured Appendicitis Recurrent Appendicitis Ruptured Appendicitis Ruptured Inflamed Appendix K35.9 K35.0 K35.0 K35.0 K35.9 K35.0 K35.1 K35.0 K36 K35.0 K36 K35.0 K35.0 ARREST Cardiac Arrest Cardio Respiratory Arrest Respiratory Arrest I46.9 I46.9 R09.2 ARTERIOSCLEROSI S [ATHEROSCLEROSIS] I70.9 Arteriosclerotic Cardiovascular Disease (ASCVD) I25.0 Atherosclerotic Cardiovascular Disease (ASCVD) I25.0 14 11 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Arteriosclerotic Cerebrovascular Disease Atherosclerotic Cerebrovascular Disease Arteriosclerotic Heart Disease (ASHD) Atherosclerotic Heart Disease (ASHD) Coronary Artery Disease (CAD) Generalized Arteriosclerosis Peripheral Arteriosclerotic Extremities ARTHRALGIA (site unspecified) ICD-10 CODE I67.2 I67.2 I25.1 I25.1 I25.1 I70.9 I70.2 Acute Rheumatoid Arthritis Chronic Rheumatoid Arthritis See also notes under “Arthritis” R18 Note: A 5th character code is added to category “J45.9” to indicate the presence/absence of exacerbation. J45.99 See also notes under “Asthma” J45.99 Bronchial Asthma See also notes under “Asthma” Refer to ICD-10 Vol. 1 for the appropriate site code to consider. Bronchial Asthma in Exacerbation M10.09 Gouty Arthritis M08.09 See also notes under “Arthritis” M06.99 Rheumatoid Arthritis See also notes under “Arthritis” J45.90 See also notes under “Asthma” See also notes under “Arthritis” Juvenile Rheumatoid Arthritis P21.9 J45.99 Asthmatic Bronchitis th Note: A more appropriate 5 character site code should be assigned instead of “9” if the site is indicated. M06.99 M00.99 Septic Arthritis ASTHMA M13.99 M06.99 See also notes under “Arthritis” ASPHYXIA, NEONATORUM F45.4 ICD-10 CODE See also notes under “Arthritis” ASCITES, ABDOMINAL Refer to the other site codes on ICD-10 Vol. 1 for the appropriate site code to consider. ARTHRITIS, (site unspecified) GUIDANCE M25.59 Note: A more appropriate 5th character site code should be assigned instead of “9” if the site is indicated. Psychogenic Arthralgia DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR Bronchial Asthma in Acute Exacerbation (BAIAE) J45.90 See also notes under “Asthma” J45.0 J45.1 Extrinsic Allergic Asthma Intrinsic Non-allergic Asthma 12 13 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE Burns, multiple (at least one burn of third degree) Burn, shoulder and/or upper limb except wrist and hand T29.3 See also notes under “Burns, multiple, unspecified degree” T22.0 See also notes under “Burn” GUIDANCE BRONCHITIS (not specified as acute or chronic ICD-10 CODE J40 and patient is 15 years of age or above) BRONCHITIS (not specified as acute or chronic J20.9 and patient is less than 15 years of age) J46 J20.9 Acute Asthmatic Bronchitis Acute Bronchitis T21.0 Burn, trunk See also notes under “Burn” Acute Bronchitis with Asthmatic Component See also notes under “Burn” CALCIFICATIONS, RENAL N28.8 J45.99 See also notes under “Asthma T23.0 Burn, wrist and/or hand Acute Bronchitis with Hyperactive Airways J45.99 See also notes under “Asthma” J45.99 Asthmatic Bronchitis See also notes under “Asthma” CALCULUS Bile Duct Calculus Bile Duct Calculus with Cholangitis Bile Duct Calculus with Cholecystitis Congenital Renal Calculus Congenital Staghorn Calculus Renal Calculus Staghorn Calculus CANCER, Primary Site (morphology and behavior codes: M8000/3) Note: DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR The coders need to determine whether the cancer site is primary, secondary (metastatic), in situ, benign, etc. so that the appropriate behavior and site codes can be assigned. K80.5 K80.3 K80.4 Q63.8 Q63.8 N20.0 N20.0 Chronic Asthmatic Bronchitis Chronic Asthmatic Bronchitis with Acute Lower Respiratory Infection J44.8 J44.0 Chronic Asthmatic Bronchitis with Acute Exacerbation Chronic Bronchitis Chronic Bronchitis primarily Emphysematous Component Chronic Bronchitis primarily Emphysematous Component with Acute Lower Respiratory Infection Chronic Bronchitis primarily Emphysematous Component with Acute Exacerbation Emphysematous Bronchitis Emphysematous Bronchitis with Acute Lower Respiratory Infection J44.1 18 15 J42 J44.8 J44.0 J44.1 J44.8 J44.0 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Emphysematous Bronchitis with Acute Exacerbation Severe Asthmatic Bronchitis BRONCHOPNEUMONIA (BPN) Bronchopneumonia due to Haemophilus Influenzae (H. Influenzae) Congenital Bronchopneumonia due to Haemophilus Influenzae (H. Influenzae) Bronchopneumonia due to S. Pneumoniae Congenital Bronchopneumonia due to S. Pneumoniae Bronchopneumonia with Measles Bronchopneumonia with Pleural Effusion Postmeasles Bronchopneumonia BURN (unspecified site and degree) Note: A more appropriate 4th character should be assigned instead of “0” if the degree of burn is indicated. Refer to the sub- classification below for other applicable 4th character code. The following 4th character subdivisions are for use with categories T20- T25 to indicate the degree of burn: .0 - unspecified degree .1 - first degree (erythema) .2 - second degree (blisters, epidermal loss) .3 - third degree (full thickness, skin loss) - deep third degree (deep necrosis of underlying tissue) ICD-10 CODE J44.1 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE assigned if the site of burn is indicated. J46 Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. Notes under T31 category in ICD-10 Vol. 1 should also be considered. J18.0 J14 P23.6 J13 P23.6 B05.2† J17.1* J18.0† J91* B05.2† J17.1* T30.0 ICD-10 CODE T25.0 Burn, ankle and/or foot See also notes under “Burn” T20.0 Burn, head and/or neck See also notes under “Burn” Burn, hip and/or lower limb, except ankle and foot Burns, multiple (unspecified degree) Note: Category “T29” includes burns and corrosions classifiable to more than one of the categories T20-T28. T24.0 See also notes under “Burn” T29.0 See also notes under “Burn” Supplemental codes for the individual burn should be included. Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. Burns, multiple (no more than first degree) T29.1 See also notes under “Burns, multiple, unspecified degree” Burns, multiple (no more than second degree) T29.2 See also notes under “Burns, multiple, unspecified degree” Moreover, a more appropriate code from categories T20-T29 should be 16 17 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Carcinoma, breast, malignant, primary site Note: If the specific part of the breast is indicated, a more specific site code should be assigned instead of C50.9. ICD-10 CODE C50.9, M8010/3 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE See also notes under “Carcinoma” Refer to ICD-10 Vol. 1 for additional specific coding guidelines. The term “cancer” when modified by an adjective or adjectival phrase indicating a morphological type, should be coded in the same manner as “carcinoma” with that adjective or phrase. Thus, “squamous cell cancer” is coded in the same manner as “squamous cell carcinoma”. A more specific morphology code should be assigned instead of M8000 if the specific morphological variety is identified. Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Carcinoma, cervical, malignant, primary site Note: If the specific part of the cervix is indicated, a more specific site code should be assigned instead of C53.9. C53.9, M8010/3 See also notes under “Carcinoma” Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Carcinoma, colorectal, malignant, primary site Cancer, bladder, primary, malignant C19, M8010/3 Note: See also notes under “Carcinoma” Carcinoma, gastric, malignant, primary site Note: If the specific part of the stomach is indicated, a more specific site code should be assigned instead of C16.9. C16.9, M8010/3 See also notes under “Carcinoma” See also notes under “Cancer” Cancer, breast, primary, malignant Note: If the specific part of the breast is indicated, a more specific site code should be assigned instead of C50.9. C50.9, M8000/3 See also notes under “Cancer” Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. C44.4, M8010/3 See also notes under “Carcinoma” 22 If the specific part of the bladder is indicated, a more specific site code should be assigned instead of C67.9. C67.9, M8000/3 Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Carcinoma, head and neck, malignant, primary Site ICD-10 CODE Cancer, colon, primary, malignant Note: If the specific part of the colon is indicated, a more specific site code should be assigned instead of C18.9. Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. 19 C18.9, M8000/3 See also notes under “Cancer” DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE Cancer, follicular thyroid C73, M8330/3 Cancer, gastric, primary, malignant C16.9, M8000/3 Note: If the specific part of the stomach is indicated, a more specific site code should be assigned instead of C16.9. Cancer, liver, primary, malignant If the specific part of the lung is indicated, a more specific site code should be assigned instead of C34.9. See also notes under “Cancer” Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Cancer, nasopharyngeal, primary, malignant Note: If the specific part of the nasopharynx is indicated, a more specific site code should be assigned instead of C11.9. C73, M8050/3 Cancer, prostate, primary, malignant C61, M8000/3 See also notes under “Cancer” C11.9, M8000/3 See also notes under “Cancer” C73, M8000/3 See also notes under “Cancer” C22.9, M8000/3 C34.9, M8000/3 ICD-10 CODE Cancer, papillary thyroid Cancer, thyroid, primary, malignant See also notes under “Cancer” Cancer, lung, primary, malignant GUIDANCE See also notes under “Cancer” Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Note: DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR CARCINOMA , Primary site Note: The morphology code may vary for other specific types of Carcinoma (ex. squamous cell, lobular, etc). Refer to ICD-10 Vols. 1 & 3 for other specific morphology codes to consider. Likewise , for carcinoma with other specified behavior ( ex. malignant secondary, in situ, etc.), a more appropriate behavior and site codes should be assigned. Refer to ICD-10 Vols. 1 & 3 for the appropriate codes and additional specific guidelines. Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. 20 21 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE Cataract (patient’s age ≥ 50) Cataract, left (patient’s age ≥ 50) Cataract, right (patient’s age ≥ 50) Cataract, bilateral (patient’s age ≥ 50) H25.99 H25.90 H25.91 H25.92 Cataract, immature, (patient’s age ≥ 50) Cataract, immature, left (patient’s age ≥ 50) Cataract, immature, right (patient’s age ≥ 50) Cataract, immature, bilateral (patient’s age ≥50) H25.99 H25.90 H25.91 H25.92 Cataract, immature (patient’s age < 50) Cataract, immature, left (patient’s age < 50) Cataract, immature, right (patient’s age < 50) Cataract, immature, bilateral (patient’s age < 50) H26.099 H26.090 H26.091 H26.092 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Carcinoma , hepatocellular, malignant, primary site H26.099 H26.090 H26.091 H26.092 Cataract, mature, (patient’s age ≥ 50) Cataract, mature, left (patient’s age ≥ 50) Cataract, mature, right (patient’s age ≥ 50) Cataract, mature, bilateral (patient’s age ≥ 50) H25.99 H25.90 H25.91 H25.92 Cataract, Cataract, Cataract, Cataract, H25.99 H25.90 H25.91 H25.92 senile senile, left senile, right senile, bilateral C22.0, M8170/3 See also notes under “Carcinoma” Carcinoma, lung, malignant, primary site Note: If the specific part of the lung is indicated, a more specific site code should be assigned instead of C34.9. C34.9, M8010/3 See also notes under “Carcinoma” Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Carcinoma, nasopharyngeal, malignant, primary site Note: Cataract, mature, (patient’s age <50) Cataract, mature, left (patient’s age <50) Cataract, mature, right (patient’s age <50) Cataract, mature, bilateral (patient’s age <50) ICD-10 CODE If the specific part of the nasopharynx is indicated, a more specific site code should be assigned instead of C11.9. C11.9, M8010/3 See also notes under “Carcinoma” Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Carcinoma, oral, malignant, primary site Note: If the specific part of the mouth is indicated, a more specific site code should be assigned instead of C06.9. C06.9, M8010/3 See also notes under “Carcinoma” Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Carcinoma, ovary, malignant, primary site C56, M8010/3 See also notes under “Carcinoma” 26 23 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Carcinoma, prostate, malignant, primary site ICD-10 CODE C61, M8010/3 See also notes under “Carcinoma” Carcinoma, thyroid (gland), malignant, primary site C73, M8010/3 See also notes under “Carcinoma” Carcinoma, follicular, thyroid (gland), malignant, primary site C73, M8330/3 See also notes under “Carcinoma” Carcinoma, papillary, thyroid (gland), malignant, primary site C73, M8050/3 See also notes under “Carcinoma” Carcinoma, follicular with papillary, thyroid (gland), malignant, primary site C73, M8340/3 See also notes under “Carcinoma” Carcinoma, uterus, malignant, primary site Note: If the specific part of the uterus is indicated, a more specific site code should be assigned instead of C55. C55, M8010/3 See also notes under “Carcinoma” DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE CARDIOMEGALY Cardiomegaly with Hypertension Cardiomegaly with Hypertension without Heart Failure Cardiomegaly with Hypertension with Heart Failure CARDIOMYOPATHY Dilated Cardiomyopathy Cardiomyopathy Complicating Pregnancy Cardiomyopathy in the Puerperium ICD-10 CODE I51.7 I11.9 I11.9 I11.0 I42.9 I42.0 O99.4, I42.9 O90.3 CATARACT Note: For conditions related to cataract, laterality is considered. An additional character is placed in the last position of the assigned code for the specific cataract condition . The laterality codes are as follows: 0 1 2 9 - left (OS) right (OD) bilateral (OU) unspecified Cataract (patient’s age <50) Cataract, left (patient’s age <50) Cataract, right (patient’s age <50) Cataract, bilateral (patient’s age <50) Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. 24 25 H26.099 H26.090 H26.091 H26.092 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR CHOLERA Classical Cholera Cholera due to Vibrio Cholerae 01, biovar Cholera Cholera due to Vibrio Cholerae 01, biovar eltor Cholera eltor CHOLECYSTITIS Acute Cholecystitis Acute Cholecystitis with Cholelithiasis Chronic Calculus Cholecystitis Chronic Cholecystitis Chronic Cholecystitis with Cholelithiasis Gallstone Cholecystitis CHOLECYSTOLITHIASIS Cholecystolithiasis without Cholecystitis CHOLELITHIASIS Cholelithiasis without Cholecystitis Cholelithiasis with Cholecystitis Cholelithiasis with Acute Cholecystitis CIRRHOSIS A00.9 A00.0 A00.0 A00.1 A00.1 K81.9 K81.0 K80.0 K80.1 K81.1 K80.1 K80.1 K80.2 K80.2 K80.2 K80.2 K80.1 K80.0 K74.6 K70.3 P78.8 K74.6 A52.7† K77.0* Alcoholic Liver Cirrhosis Congenital Liver Cirrhosis Liver Cirrhosis Syphilitic Liver Cirrhosis CLEFT LIP Q36.9 30 GUIDANCE Cataract, Cataract, Cataract, Cataract, senile, hypermature senile, hypermature, left senile, hypermature, right senile, hypermature , bilateral ICD-10 CODE H25.29 H25.20 H25.21 H25.22 Cataract, senile, immature Cataract, senile, immature, left Cataract, senile, immature, right Cataract, senile, immature, bilateral H25.99 H25.90 H25.91 H25.92 Cataract, senile, mature Cataract, senile, mature, left Cataract, senile, mature, right Cataract, senile, mature, bilateral H25.99 H25.90 H25.91 H25.92 Cataract, Cataract, Cataract, Cataract, senile, Morgagnian type senile, Morgagnian type, left senile, Morgagnian type, right senile, Morgagnian type, bilateral H25.29 H25.20 H25.21 H25.22 Congenial Congenial Congenial Congenial Cataract Cataract, left Cataract, right Cataract, bilateral Q12.09 Q12.00 Q12.01 Q12.02 Diabetic Cataract Note: Appropriate code from E10-E13 should be used instead of E14 if the specific type of diabetes is indicated. Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. Likewise, a more specific laterality code should be assigned instead of “9” for 27 E14.3† H28.09* DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE H28.0 code if the laterality of the cataract is specified. Infantile Cataract, immature Infantile Cataract, immature, left Infantile Cataract, immature, right Infantile Cataract, immature, bilateral H26.099 H26.090 H26.091 H26.092 Infantile Cataract, mature Infantile Cataract, mature, left Infantile Cataract, mature, right Infantile Cataract, mature, bilateral H26.099 H26.090 H26.091 H26.092 Juvenile Cataract, immature Juvenile Cataract, immature, left Juvenile Cataract, immature, right Juvenile Cataract, immature, bilateral H26.099 H26.090 H26.091 H26.092 Juvenile Cataract, mature Juvenile Cataract, mature, left Juvenile Cataract, mature, right Juvenile Cataract, mature, bilateral H26.099 H26.090 H26.091 H26.092 Presenile Cataract, immature Presenile Cataract, immature, left Presenile Cataract, immature, right Presenile Cataract, immature, bilateral H26.099 H26.090 H26.091 H26.092 Presenile Cataract, mature Presenile Cataract, mature, left Presenile Cataract, mature, right Presenile Cataract, mature, bilateral H26.099 H26.090 H26.091 H26.092 H26.219 H26.210 H26.211 H26.212 Uveitic Cataract Uveitic Cataract, left Uveitic Cataract, right Uveitic Cataract, bilateral CELLULITIS Note: ICD-10 CODE L03.9 If the site of the cellulitis is indicated, a more specific code from L03 subcategories should be assigned instead of L03.9. Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. CEPHALGIA [ HEADACHE ] R51 CHALAZION H00.1 CHECK UP, HEALTH [ EXAMINATION, HEALTH ] Z00.0 Note: Refer to ICD-10 Vols. 1 & 3 for other specific codes for Check-up of a particular population for a specified purpose/reason. Annual Physical Check Up Annual Physical Examination Dental Check Up General Medical Examination General Medical Check Up Infant Check Up Periodic Physical Check Up Routine Child Check Up CHEMOTHERAPHY, MAINTENANCE FOR NEOPLASM 28 29 Z00.0 Z00.0 Z01.2 Z00.0 Z00.0 Z00.1 Z00.0 Z00.1 Z51.1 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Psychogenic Cough Whooping Cough Whooping Cough due to Bordetella Pertussis Whooping Cough due to Bordetella Parapertussis ICD-10 CODE F45.3 A37.9 A37.0 A37.1 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Q36.9 Q36.0 Q36.1 Cleft Lip, unilateral Cleft Lip, bilateral Cleft Lip, medial CLEFT PALATE CRISIS E27.2 E27.2 Adrenocortical Crisis Adrenal Crisis CYANOSIS R23.0 Cleft Palate, medial Cleft Palate, soft Cleft Palate, hard Cleft Palate, hard, with Cleft soft palate CLEFT PALATE WITH CLEFT LIP CYST N75.0 N60.0 K63.8 Q33.0 Q44.7 J98.4 M67.8 N80.9 N85.8 N80.1 L72.0 L72.0 M67.4 L98.8 K76.8 N83.2 L72.9 N60.8 L72.1 N85.8 N89.8 Bartholin’s Cyst Breast Cyst Colon Cyst Congenital Cystic lung Congenital Liver Cyst Cystic Lung Disease Cyst of Tendon Ectopic Endometrial Cyst Endometrial Cyst Endometrial Cyst, Ovary Epidermal Cyst Epidermoid Cyst Ganglion Cyst Keratinous Cyst Liver Cyst Ovarian Cyst Scrotal Cyst Sebaceous Breast Cyst Sebaceous Cyst Uterine Cyst Vaginal Cyst ICD-10 CODE Cleft Hard Palate with Bilateral Cleft Lip Cleft Hard Palate with Unilateral Cleft Lip Cleft Hard Palate with Cleft Lip Cleft Soft Palate with Bilateral Cleft Lip Cleft Soft Palate with Unilateral Cleft Lip Cleft Soft Palate with Cleft Lip Cleft Hard and Soft Palate with Bilateral Cleft Lip Cleft Hard and Soft Palate with Unilateral Cleft Lip Cleft Hard and Soft Palate with Cleft Lip Cleft Palate with Bilateral Cleft Lip Cleft Palate with Unilateral Cleft Lip COAGULOPATHY [COAGULATION DEFECT] Disseminated Intravascular Coagulopathy Disseminated Intravascular Coagulation COLD Q35.9 Q35.5 Q35.3 Q35.1 Q35.5 Q37.9 Q37.0 Q37.1 Q37.1 Q37.2 Q37.3 Q37.3 Q37.4 Q37.5 Q37.5 Q37.8 Q37.9 D68.9 D65 D65 J00 J00 J00 Acute Nasopharyngitis Common Cold 34 31 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE COLITIS ICD-10 CODE A09 K52.0 A09 K51.9 Colitis due to Radiation Infectious Colitis Ulcerative Colitis COMATOSE R40.2 COMPLICATIONS Complication of Colostomy Complication of Ileostomy Complication of Tracheostomy CONCUSSION K91.4 K91.4 J95.0 S06.00 Note: Supplemental code from V01-Y98 is needed to indicate external cause of concussion for morbidity coding. For mortality coding the following codes for concussion should never be used as underlying cause code, they may only be considered as supplemental codes. Refer to ICD-10 Volume 2 for additional guidelines. Cerebral Concussion without Open Intracranial Wound Concussion without Open Intracranial Wound Cerebral Concussion with Open Intracranial Wound Concussion with Open Intracranial Wound CONJUNCTIVITIS S06.00 S06.00 S06.01 S06.01 H10.9 H10.3 H10.4 H10.5 Acute Conjunctivitis Chronic Conjunctivitis Blepharoconjunctivitis CONSTIPATION K59.0 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE CONTUSION ICD-10 CODE T14.0 Note: Supplemental code from V01-Y98 is needed to indicate external cause of concussion for morbidity coding. For mortality coding the following codes for contusion should never be used as underlying cause code, they may only be considered as supplemental codes. Refer to ICD-10 Volume 2 for additional guidelines. Cerebral Contusion without Open Intracranial Wound Contusion without Open Intracranial Wound Focal Contusion without Open Intracranial Wound Cerebral Contusion with Open Intracranial Wound Contusion with Open Intracranial Wound Focal Cerebral Contusion with Open Intracranial Wound CONVULSION Convulsion, newborn Febrile Convulsion Benign Febrile Convulsion, BFC Epileptic Convulsion Epileptic Seizure COR PULMONALE S06.20 S06.20 S06.30 S06.21 S06.21 S06.31 R56.8 P90 R56.0 R56.0 G40.9 G40.9 I27.9 COSTOCHONDRITIS M94.08 COUGH R05 32 33 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Caesarean Delivery due to Abruptio Placentae ICD-10 CODE O45.9 O82.0 (add outcome of delivery code) Caesarean Delivery due to Arrest in Descent ( the method of delivery in this case is always considered emergency caesarean delivery) Emergency Caesarean Delivery due to arrest in descent O63.1 O82.1 (add outcome of delivery code) O63.1 O82.1 (add outcome of delivery code) Elective Caesarean Delivery due to Breech Presentation O32.1 O82.0 (add outcome of delivery code) Emergency Caesarean Delivery due to Breech Presentation O64.1 O82.1 (add outcome of delivery code) Elective Caesarean Delivery due to CephaloPelvic Disproportion (CPD) O33.9 O82.0 (add outcome of delivery code) Emergency Caesarean Delivery due to Cephalo-Pelvic Disproportion (CPD) O65.4 O82.1 (add outcome of delivery code) DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE CYSTITIS ICD-10 CODE Acute Cystitis Interstitial Cystitis Irradiation Cystitis N30.9 N30.0 N30.1 N30.4 CYSTOLITHIASIS N21.0 CYSTORECTOCELE [CYSTOCELE] N81.1 N32.8 Cystorectocele, Female Cystorectocele, Male DEFICIENCY E56.9 E50.9 E53.9 E53.1 E53.8 E54 E55.9 E56.0 E56.1 E53.0 E61.1 Vitamin deficiency Vitamin A deficiency Vitamin B deficiency Vitamin B6 deficiency Vitamin B12 deficiency Vitamin C deficiency Vitamin D deficiency Vitamin E deficiency Vitamin K deficiency Riboflavin deficiency Iron deficiency DEFICIT Reversible Ischemic Neurologic Deficit DEHYDRATION I67.8 G93.8 E86.9 E86.0 E86.1 E86.2 Mild Dehydration Moderate Dehydration Severe Dehydration 38 35 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DELIVERY Note: st 1 The delivery conditions listed below are sanitized version of the actual diagnostic statements recorded on the patient’s chart. The Philippine Obstetrical and Gynecological Society (POGS) is adopting a standard way of writing delivery conditions as diagnoses, thus, for coding purposes only the vital information (such as maternal indication/ complication, method and outcome of delivery) necessary for the assignment of ICD-10 codes were extracted from the actual diagnostic statement. Codes must be assigned for the following delivery conditions in the given order of priority: - indication or any condition affecting labor and delivery, if any (particularly for cesarean delivery). If there is no indication or other maternal condition recorded then only the method and outcome should be coded nd 2 - method of delivery (O80 – O84) The use of the codes O80-O84 for the method of delivery as primary code in morbidity coding is limited only to situation where there is no other maternal conditions/indications recorded. If there are other maternal indications recorded, then codes O80-O84 should be used as additional codes only. For cesarean delivery, it is important for the physician to indicate if it is elective or emergency (with obstructed labor) so that the most appropriate code/s would be assigned. Normal Spontaneous Delivery Normal Spontaneous Cephalic Delivery O82.0 Elective Caesarean Delivery (add outcome of delivery code) rd Z37.0 Z37.1 Z37.2 Z37.3 Z37.4 Z37.5 Z37.6 Z37.7 Z37.9 Single live birth Single stillbirth Twins, both liveborn Twins, one liveborn, one stillborn Twins, both stillborn Other multiple births, all liveborn Other multiple births, some liveborn Other multiple births, all stillborn Outcome of delivery, unspecified O80.0 (add outcome of delivery code) 3 - outcome of delivery (Z37.0 – Z37.9) Outcome of Delivery Code: O80.9 (add outcome of delivery code) Emergency Caesarean Delivery O82.1 (add outcome of delivery code) Primary Elective Caesarean Delivery O82.0 (add outcome of delivery code) O34.2 O82.0 Repeat Caesarean Delivery (add outcome of delivery code) 36 37 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE F03 Senile Dementia DEPRESSION F32.9 F34.1 Neurotic Depression DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Caesarean Delivery due to Cord Prolapse DERMATITIS Allergic Dermatitis Contact Dermatitis Contact Irritant Dermatitis Dermatitis due to drugs or medicines F32.9 F32.9 F33.9 L30.9 L23.9 L25.9 L24.9 L27.0 Note: Supplemental code from V01 – Y98 for the external cause should be added to L27.0 to identify the specific drug/ medicine, if drug is specified. DIABETES MELLITUS (Unspecified type) Note: A more appropriate code from E10-E13 should be used instead of “E14” if the specific type of Diabetes is indicated. See categories below for other specified type of diabetes or refer to the ICD-10 Vol.1 pp.278279 and Vol.3 for other specific codes to consider. Emergency Caesarean Delivery due to Cord Prolapse E14.9 See categories below for other specified type of diabetes O69.0 O82.1 (add outcome of delivery code) Caesarean Delivery due to Eclampsia in Labor ( the method of delivery in this case is always considered emergency caesarean delivery) Caesarean Delivery due to Elderly Primi L59.8 L26 L21.9 Dermatitis due to Radiation Exfoliative Dermatitis Seborrhic Dermatitis O69.0 O82.0 (add outcome of delivery code) DEPRESSIVE REACTION Brief Depressive Reaction Grief Reaction Prolonged Depressive Reaction ICD-10 CODE Note: If other indication is recorded then the code for the recorded indication should be assigned as the main condition code. O15.1 O82.1 (add outcome code) O82.0 (add outcome of delivery code) Refer to ICD-10 Vols. 1 & 3 for the appropriate code/s. Caesarean Delivery due to Fetal Distress ( the method of delivery in this case is always considered emergency caesarean delivery) Elective Caesarean Delivery due to Failure in Descent Moreover, if there is complication/s of th Diabetes recorded, a more specific 4 character should be assigned instead of “9”. O68.9 O82.1 (add outcome of delivery code) O32.4 O82.0 (add outcome of delivery code) 42 39 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Emergency Caesarean Delivery due to Failure in Descent ICD-10 CODE O64.9 O82.1 (add outcome of delivery code) Emergency Caesarean Delivery due to Fetal Distress O68.9 O82.1 (add outcome of delivery code) Elective Caesarean Delivery due to Malpresentation O32.9 O82.0 (add outcome of delivery code) Emergency Caesarean Delivery due to Malpresentation O64.9 O82.1 (add outcome of delivery code) Elective Caesarean Delivery due to Meconium Stained Baby O36.3 O82.0 (add outcome of delivery code) Emergency Caesarean Delivery due to Meconium Stained Baby O68.1 O82.1 (add outcome of delivery code) Caesarean Delivery due to Placenta Previa w/ Hemorrhage O44.1 O82.0 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Caesarean Delivery due to Placenta Previa w/o Hemorrhage O44.0 O82.0 (add outcome of delivery code) Caesarean Delivery due to Pre-eclampsia O14.9 O82.0 (add outcome of delivery code) Caesarean Delivery due to Prolonged Labor ( the method of delivery in this case is always considered emergency caesarean delivery) Caesarean Delivery due to Prolonged Second Stage of Labor ( the method of delivery in this case is always considered emergency caesarean delivery) Elective Caesarean Delivery due to Transverse Lie or Presentation O63.9 O82.1 (add outcome of delivery code) O63.1 O82.1 (add outcome of delivery code) O32.3 O82.0 (add outcome of delivery code) Emergency Caesarean Delivery due to Transverse Lie or Presentation O64.8 O82.1 (add outcome code) Non-institutional Delivery [Care and Examination immediately after Delivery] Preterm Delivery Z39.0 O60.1 (add method & outcome of delivery codes) (add outcome of delivery code) DEMENTIA 40 ICD-10 CODE F03 F03 Presenile Dementia 41 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Fibrocystic Disease, Breast Fibrocystic Liver Disease Gallbladder Disease Gastroesophageal Reflux Disease Heart Disease (organic) Hyperactive Airways Disease Hypertensive Atherosclerotic Cardiovascular Disease Hypertensive Cardiovascular Disease (HCVD) Hypertensive Heart Disease Ischemic Heart Disease (IHD) Pelvic Inflammatory Disease (PID) Peptic Ulcer Disease (PUD) Peripheral Vascular Occlusive Disease Rheumatic Heart Disease Thyrotoxic Heart Disease Tuberculous Disease Viral Disease DISLOCATION, HIP, TRAUMATIC Note: ICD-10 CODE N60.1 Q44.6 K82.9 K21.9 I51.9 J68.3 I11.9 I11.9 I11.9 I25.9 N73.9 K27.9 I73.9 I09.9 E05.9† I43.8* A16.9 B34.9 S73.0 For morbidity coding, supplemental code from V01 – Y98 should be added to the code for the dislocation to indicate the external cause of the condition. DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE th Refer to the 4 character subcategories below for the appropriate code to consider. th The following 4 character subdivisions are for use with categories E10- E14 to indicate the complications of diabetes mellitus: .0 - with coma .1 - with ketoacidosis .2† - with renal complications Diabetic nephropathy (N08.3*) Intracapillary glomerulonephrosis (N08.3*) Kimmelstiel-W ilson syndrome (N08.3*) .3† - with ophthalmic complications Diabetic: o Cataract (H28.0*) o Retinopathy (H36.0*) .4† - with neurological complications Diabetic: o Amyotrophy (G73.0*) o autonomic neuropathy (G99.0*) o mononeuropathy (G59.0*) o polyneuropathy (G63.2*) o polyneuropathy, autonomic (G99.0*) .5 - with peripheral circulatory complications Diabetic: o gangrene o peripheral angiopathy† (I79.2*) o ulcer .6 - with other specified complications Diabetic arthropathy† (M14.2*) o neuropathic† (M14.2*) .7 - with multiple complications .8 - with unspecified complications .9 - without complications Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. However, for mortality coding, S73.0 should never be used as underlying cause code, it may only be included as a supplemental code. DISORDER G47.9 Sleep Disorder 46 43 ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Insulin Dependent Diabetes Mellitus (IDDM) (Type I) Non-Insulin Dependent Diabetes Mellitus (NIDDM) (Type II) Malnutrition-Related Diabetes Mellitus ICD-10 CODE E10. 9 See also notes under “Diabetes Mellitus” E11.9 See also notes under “Diabetes Mellitus” E12.9 See also notes under “Diabetes Mellitus” E14.5 Diabetic Foot See also notes under “Diabetes Mellitus” E14.1 Diabetic Ketoacidosis See also notes under “Diabetes Mellitus” DIARRHEA [ GASTROENTERITIS ] Infectious Diarrhea Diarrhea with Dehydration ( level of Dehydration not specified) Infectious Diarrhea with Dehydration ( level of Dehydration not specified) Diarrhea with some Dehydration Infectious Diarrhea with mild Dehydration Infectious Diarrhea with some Dehydration A09 A09 A09, E86.9 A09, E86.9 A09, E86.0 A09, E86.0 A09, E86.0 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Diarrhea with mild Dehydration Diarrhea with moderate Dehydration Diarrhea with marked Dehydration Infectious Diarrhea with moderate Dehydration Infectious Diarrhea with marked Dehydration Infectious Diarrhea with severe Dehydration Diarrhea with severe Dehydration Diarrhea with no Dehydration Infectious Diarrhea with no Dehydration Non-infectious Diarrhea Non-infectious Neonatal Diarrhea DIPTHERIA ICD-10 CODE A09, E86.0 A09, E86.1 A09, E86.1 A09, E86.1 A09, E86.1 A09, E86.2 A09, E86.2 A09 A09 K52.9 P78.3 A36.9 DISEASE Acid Peptic Disease (APD) Alcoholic Liver Disease Atherosclerotic Cardiovascular Disease Atherosclerotic Heart Disease Bleeding Peptic Ulcer Disease (PUD bleeding) Chronic Liver Disease Chronic Obstructive Pulmonary Disease (COPD) Chronic Obstructive Lung Disease Chronic Obstructive Pulmonary Disease (COPD) primarily Emphysematous Component Chronic Renal Disease Cerebrovascular Disease Cerebrovascular Disease, Thrombotic Infarct Congenital Heart Disease Coronary Artery Disease End Stage Renal Disease (ESRD) 44 45 K31.9 K70.9 I25.0 I25.1 K27.4 K76.9 J44.9 J44.9 J44.8 N03.9 I67.9 I63.9 Q24.9 I25.1 N18.0 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE EPILEPSY Epileptic Convulsions Epileptic Fits Epileptic Seizures Epileptic Seizures related to Alcohol Epileptic Seizures related to Drugs Grand Mal Status Epilepticus Status Epilepticus EPISTAXIS [ NOSEBLEED ] ERYSIPELAS ICD-10 CODE G40.9 G40.9 G40.9 G40.9 G40.5 G40.5 G41.0 G41.9 R04.0 A46 ERYTHEMA L53.9 ESOPHAGEAL REFLUX K21.9 K21.0 Esophageal Reflux with Esophagitis ESOPHAGITIS K20 A18.8† K23.0* Tuberculous Esophagitis EXAMINATION, HEALTH Examination for Medico-legal Purposes Health Examination for Administrative Purpose Health Examination for Potential Organ Donor Health Examination for Pre-employment Occupational Health Examination Pregnancy Examination, unconfirmed Pregnancy Examination, confirmed Postpartum Examination immediately after Delivery Routine Follow-up Postpartum Examination Z00.0 Z04.8 Z02.9 Z00.5 Z02.1 Z10.0 Z32.0 Z32.1 Z39.0 Z39.2 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISTENTION R14 Abdominal Distention DISTRESS Abdominal Distress Epigastric Distress Fetal Distress Fetal Distress first noted before onset of labor Fetal Distress first noted during labor and Delivery Gastrointestinal Distress Intestinal Distress Respiratory Distress Respiratory Distress, adult Respiratory Distress, newborn DIZZINESS [ VERTIGO ] K30 K59.9 R06.0 J80 P22.9 R42 DOGBITE Note: R10.4 R10.1 P20.9 P20.0 P20.1 T14.1, W54.99 If the part of the body bitten is indicated, a more specific code should be assigned instead of “T14.1”. Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. Likewise, if the place and activity of th occurrence is indicated, a more specific 4 th and 5 characters for the external cause code W54 should be assigned instead of “99”. Refer to ICD-10 Vol. 1 for the specific place of occurrence and activity codes. For mortality coding, the code T14.1 should never be used as underlying cause code, it may only be included as a supplemental code . 50 47 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR DYSARTHRIA R47.1 DYSCRASIA, BLOOD D75.9 DYSLIPIDEMIA DYSPEPSIA E78.9 K30.9 K30.9 K30.1 K30.1 F45.3 F45.3 F45.3 Uninvestigated Dyspepsia Non-ulcer Dyspepsia Investigated Dyspepsia Psychogenic Dyspepsia Nervous Dyspepsia Neurotic Dyspepsia DYSPHAGIA R13 DYSPLASIA N87.9 N87.9 N87.9 Cervical Dysplasia Cervix uterine Dysplasia Epithelial Dysplasia DYSPNEA [SHORTNESS OF BREATH] R06.0 DYSRHYTHMIA GUIDANCE EFFUSION, PLEURA Malignant Pleural Effusion Parapneumonic Pleural Effusion EMBOLISM EMESIS [ Vomiting ] R11 EMPYEMA Empyema not due to Tuberculosis Empyema with fistula, not due to Tuberculosis Empyema, Tuberculous, confirmed bacteriologically/ histologically ENCEPHALOPATHY Alcoholic Encephalopathy Hepatic Encephalopathy Hypoxic Encephalopathy Hypoxic Ischemic Encephalopathy DYSURIA [PAINFUL URINATION] ECLAMPSIA I49.9 G40.9 ENTERITIS [ ILEITIS ] R30.0 ENURESIS O15.9 O15.1 O15.0 O15.2 Eclampsia in Labor Eclampsia in Pregnancy Eclampsia in Puerperium J90 C78.2, M8000/6 J18.9† J91* I74.9 I26.9 Pulmonary Embolism ENDOMETRIOSIS Cardiac Dysrhythmia Cerebral Dysrhythmia ICD-10 CODE J86.9 J86.9 J86.0 A15.6 G93.4 G31.2 K72.9 G93.1 G93.1 N80.9 A09 R32 F98.0 F98.0 F98.0 Functional Enuresis Non-organic origin Enuresis Psychogenic Enuresis 48 49 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE S72.01 Fracture, hip, open See also notes under “Fracture” S42.30 Fracture, humerus See also notes under “Fracture” S42.30 Fracture, humerus,closed See also notes under “Fracture” S42.31 Fracture, humerus, open See also notes under “Fracture” Fracture, intertrochanteric, femur S72.10 See also notes under “Fracture” Fracture, intertrochanteric, femur, closed S72.10 See also notes under “Fracture” Fracture, intertrochanteric, femur, open S72.11 See also notes under “Fracture” S02.60 Fracture, mandible See also notes under “Fracture” DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE FAILURE Acute Hepatic Failure Acute Renal Failure Chronic Renal Failure (CRF) Cardiorespiratory Failure Congestive Heart Failure (CHF) Heart Failure Respiratory Failure K72.0 N17.9 N18.9 R09.2 I50.0 I50.9 J96.9 FEVER Typhoid Fever Dengue Fever (Dengue Fever Syndrome) Dengue Hemorrhagic Fever Dengue Hemorrhagic Fever, Stage I Dengue Hemorrhagic Fever, Stage II Dengue Hemorrhagic Fever, Stage III Dengue Hemorrhagic Fever, Stage IV (Dengue Shock Syndrome) Fever of Unknown Origin (FUO) Pyrexia Rheumatic Fever Rheumatic Fever with Heart Involvement A01.0 A90 A91.9 A91.0 A91.1 A91.2 A91.3 R50.9 R50.9 I00 I01.9 FIBROADENOMA D24, M9010/0 Fibroadenoma, Breast FISTULA L98.8 K60.5 I77.0 K63.2 K60.3 Anorectal Fistula Carotid Cavernous Fistula Enterocutaneous Fistula Fistula in Ano 54 51 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Tracheoesophageal Fistula following Tracheostomy FRACTURE Note: ICD-10 CODE J95.0 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE S82.40 Fracture, fibula See also notes under “Fracture” T14.20 For fracture due to external causes, both the nature of the fracture and the circumstance of the external cause should be coded. Fracture, fibula, closed For morbidity coding, the fracture code is assigned as the primary code and the external cause code from V01 – Y98 as supplemental code. Fracture, fibula, open S82.40 See also notes under “Fracture” S82.41 See also notes under “Fracture” However, for mortality coding, the code for the fracture should never be used as underlying cause code, it may only be included as a supplemental code . Fracture, fibula, mid 3rd tibia S82.20 See also notes under “Fracture” Refer to ICD-10 Vols. 1, 2 and 3 for the appropriate code and additional guidelines. Fracture, fibula, mid 3rd tibia, closed S72.90 Fracture, femur See also notes under “Fracture” See also notes under “Fracture” Fracture, fibula, mid 3rd tibia, open See also notes under “Fracture” S82.21 See also notes under “Fracture” S72.00 Fracture, hip See also notes under “Fracture” S72.91 Fracture, femur, open S82.20 See also notes under “Fracture” S72.90 Fracture, femur, closed ICD-10 CODE S72.00 Fracture, hip, closed See also notes under “Fracture” 52 53 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GOUT M10.99 GUIDANCE S02.60 Fracture, mandible, closed See also notes under “Fracture” Note: If the specific site of gout is indicated, a more appropriate 5th character site code should be used instead of “9”. S02.61 Fracture, mandible, open See also notes under “Fracture” Refer to ICD-10 Vol. 1 for the other specific site codes to consider. S02.40 Fracture, maxilla GLYCOSURIA See also notes under “Fracture” R81 GRAVE’S DISEASE E05.0 S02.40 Fracture, maxilla, closed GUN SHOT WOUND [ WOUND, OPEN ] See also notes under “Fracture” Fracture, multiple (unspecified) Note: Refer to ICD-10 Vol. 2 for additional guidelines Refer to ICD-10 Vol. 1 for the specific place of occurrence and activity codes. HEMANGIOMA S02.41 Fracture, maxilla, open Likewise, if the place and activity of occurrence is indicated, a more specific 4th and 5th characters for the external cause code “ W34” should be assigned instead of “99”. HEADACHE [ CEPHALGIA ] See also notes under “Fracture” T14.1, W34.99 Note: If the part of the body wounded is indicated, a more appropriate injury code should be used instead of “T14.1”. HANSEN’S DISEASE [ LEPROSY ] ICD-10 CODE M84.49 Fracture, Pathologic A30.9 R51 D18.0, M9120/0 T02.9 See also notes under “Fracture” Note: If the specific site of fracture is indicated, a more appropriate 5th character site code should be used instead of “9”. Refer to ICD-10 Vol. 1 for the other specific site codes to consider. 58 55 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Fracture, Pathologic with Osteoporosis ICD-10 CODE M80.99 See note under “Arthritis and Fracture, pathologic” Fracture, tibia, condyles, closed S82.10 See notes under “Fracture” GANGRENE R02 I70.2 E14.5 Atherosclerotic Gangrene Diabetic Gangrene Note: A more appropriate code from E10-E13 should be used instead of “E14” if the specific type of Diabetes is indicated. GUIDANCE Acute Gastroenteritis (AGE) Acute Gastroenteritis (AGE), with Dehydration (level unspecified) Acute Gastroenteritis (AGE) with mild/some Dehydration Acute Gastroenteritis (AGE) with moderate/ marked Dehydration Acute Gastroenteritis (AGE) with severe Dehydration Acute Gastroenteritis (AGE) with no signs of Dehydration GLAUCOMA GLIOMA R02 GASTRITIS Pontine Glioma GLOMERULONEPHRITIS Acute Gastritis Acute Hemorrhagic Gastritis Chronic Gastritis Erosive Gastritis GASTROENTERITIS A09 A09, E86.0 A09, E86.1 A09, E86.2 A09 N05.9 N00.9 N03.9 Acute Glomerulonephritis Chronic Glomerulonephritis K29.7 K29.1 K29.0 K29.5 K29.1 A09 A09, E86.9 C71.9, M9380/3 C71.7, M9380/3 Note: If the cause of gangrene is specified, a more specific code should be assigned. Refer to ICD-10 Vols.1 & 3 for the appropriate code to consider. ICD-10 CODE H40.9 H40.1 Q15.0 Open-angle Glaucoma Congenital Glaucoma Refer to ICD-10 Vols.1 & 3 for the appropriate code to consider. Gangrene of foot DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GOITER E04.9 E04.9 E04.9 E04.2 E03.0 E01.0 E04.9 Adenomatous Goiter Colloid Adenomatous Goiter Cystic Goiter Congenital Diffuse Goiter Endemic Diffuse Goiter Nodular Goiter 56 57 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE HYPERTHYROIDISM ICD-10 CODE E05.9 HYPERTROPHY N40 Benign Prostatic Hypertrophy HYPERURICEMIA E79.0 HYPOGLYCEMIA E16.2 HYPOKALEMIA E87.6 HYPOTENSION I95.9 G90.3 Neurogenic Hypotension ILEITIS [ ENTERITIS ] A09 A01.0 Typhoid Ileitis ILEUS K56.7 K56.0 Paralytic Ileus IMBALANCE Electrolyte Imbalance Electrolyte Imbalance following Abortion Neonatal Electrolyte Imbalance R26.8 E87.8 O08.5 P74.4 IMPACTION, IMPACTED K56.4 K56.4 H61.2 Colon Impaction Fecal Impaction Impacted Cerumen INCONTINENCE R32 R15 N39.3 R32 Fecal Incontinence Stress Incontinence Urine Incontinence 62 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE HEMATURIA R31 HEMOPHILIA Hemophilia A Hemophilia B D66 D66 D67 HEMOPTYSIS R04.2 HEMORRHAGE R58 I61.9 K92.2 O72.1 I60.9 Cerebral Hemorrhage Gastric Hemorrhage (gastrointestinal) Post-partum Hemorrhage Subarachnoid Hemorrhage HEMORRHOIDS Internal Hemorrhoids Internal Hemorrhoids, grade 1 Internal Hemorrhoids, grade 2 Internal Thrombosed Hemorrhoids Internal Hemorrhoids, grade 3-4 Internal Hemorrhoids without Complication Internal Hemorrhoids, grade 1 without Complication Internal Hemorrhoids, grade 2 without Complication Internal Hemorrhoids, grade 3-4 without Complication HEPATITIS I84.9 I84.2 I84.2 I84.2 I84.0 I84.2 I84.2 I84.2 I84.2 I84.2 K75.9 K72.0 K75.4 K73.9 B18.9 Acute Hepatitis Autoimmune Hepatitis Chronic Hepatitis Chronic Viral Hepatitis 59 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Chronic Viral Hepatitis, type B Chronic Viral Hepatitis, type C Drug Induced Hepatitis Viral Hepatitis Viral Hepatitis, type A Viral Hepatitis, type C ICD-10 CODE B18.1 B18.2 K71.6 B19.9 B15.9 B18.2 HEPATOMEGALY R16.0 HERNIA K46.9 K40.9 K40.9 Inguinal Hernia Indirect Inguinal Hernia HICCOUGHS R06.6 HODGKIN’S DISEASE C81.9, M9650/3 HYDRONEPHROSIS Hydronephrosis with Pyelonephritis N13.3 N11.1 HYPERACIDITY K31.8 HYPERCHOLESTEROLEMI A E78.0 HYPEREMESIS GRAVIDARUM O21.0 O21.0 Hyperemesis Gravidarum, mild (before the end of 22 weeks) Hyperemesis Gravidarum, after the end of 22 weeks HYPERESTHESIA, SKIN O21.2 R20.3 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE HYPEROSMOLAR COMA [HYPERGLYCEMIC HYPEROSMOLAR SYNDROME ] E14.0 HYPERKALEMIA E87.5 HYPERLIPIDEMIA E78.5 HYPERPLASIA N40 N85.0 N85.0 Benign Prostatic Hyperplasia Hyperplasia of Endometrium Proliferative Endometrium HYPERSENSITIVITY REACTION Note: T78.4 For morbidity coding, supplemental code from V01 – Y98 should be added to T78.4 to indicate the external cause. However, for mortality coding, this code should never be used as underlying cause code, it may only be included as a supplemental code. Refer to ICD-10 Vol. 2 for additional guidelines. HYPERTENSION (HPN) I10.9 I10.9 I10.0 I10.1 I11.9 I10.9 Essential Hypertension Hypertension, stage I Hypertension, stage II Hypertensive heart disease Malignant Hypertension 60 61 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE INFLUENZA (VIRUS IDENTIFIED EXCEPT H. INFLUENZAE) ICD-10 CODE J10.1 Bronchial Influenza (specific virus identified except H. Influenzae) Influenza with Acute Upper Respiratory Infection (specific virus identified except H. Influenzae) Influenza with Laryngitis (specific virus identified except H. Influenzae) Influenza with Pharyngitis (specific virus identified except H. Influenzae) Influenza with Pleural Effusion (specific virus identified except H. Influenzae) Influenza with Upper Respiratory Infection, specific virus identified except H. Influenzae J10.1 Viral Influenza (specific virus identified except H. Influenzae) J10.1 Influenza with Pneumonia (specific virus identified except H. Influenzae) Influenza with Bronchopneumonia (specific virus identified except H. Influenzae) Influenzal Bronchopneumonia (specific virus identified except H. Influenzae) Influenzal Pneumonia (specific virus identified except H. Influenzae) J10.0 Influenza with Gastroenteritis (specific virus identified except H. Influenzae) Influenza with Enteritis (specific virus identified except H. Influenzae) J10.8 J10.1 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE INDIGESTION ICD-10 CODE K30 INFARCTION J10.1 J10.1 J10.1 J10.1 J10.0 J10.0 J10.0 J10.8 Acute Myocardial Infarction or with a stated duration of 4 weeks or less Acute Myocardial Infarction, lateral wall Chronic Myocardial Infarction or with a stated duration of over 4 weeks Healed Myocardial Infarction Myocardial Infarction Old Myocardial Infarction Old Myocardial Infarction, anterior wall Subsequent Myocardial Infarction Subendocardial Infarction I21.9 I21.2 I25.8 I25.2 I21.9 I25.2 I25.2 I22.9 I21.4 INFECTION Acute Lower Respiratory Tract Infection Acute Lower Respiratory Infection Acute Respiratory Infection Acute Respiratory Tract Infection Acute Upper Respiratory Infection Acute Upper Respiratory Tract Infection Central Nervous System (CNS) Infection Central Nervous System (CNS) Infection, Viral Chronic Respiratory Infection Chronic Respiratory Tract Infection Lower Respiratory Infection Lower Respiratory Tract Infection Respiratory Infection Respiratory Tract Infection Systemic Viral Infection (SVI) 66 63 J22 J22 J22 J22 J06.9 J06.9 G04.9 A89 J98.8 J98.8 J22 J22 J98.8 J98.8 B34.9 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Upper Respiratory Infection Upper Respiratory Tract Infection (URTI) Upper Respiratory Tract Infection, Viral Urinary Tract Infection (UTI) INFLUENZA ICD-10 CODE J06.9 J06.9 J06.9 N39.0 J11.1 Avian Influenza Avian Influenza with Pneumonia Avian Influenza with Respiratory Manifestation/s except Pneumonia Avian Influenza with other Manifestations except Pneumonia and other Respiratory Manifestation/s H. Influenzae Infection Influenza-like Disease Influenza-like Illness Influenza with Encephalitis (specific virus not identified) Influenza with Encephalitis (specific virus identified except H. Influenzae) Influenza with Encephalomyelitis (specific virus identified except H. Influenzae) Influenza with Encephalomyelitis (specific virus not identified) Influenza with Myocarditis (specific virus not identified) Influenza with Myocarditis (specific virus identified except H. Influenzae) Influenza with Myelitis (specific virus not identified) Influenza with Myelitis (specific virus identified except H. Influenzae) Influenza due to H. Influenzae J10.1 J10.0 J10.1 J10.8 A49.2 J11.1 J11.1 J11.8† G05.1* J10.8† G05.1* J10.8† G05.1* J11.8† G05.1* J11.8† I41.1* J10.8† I41.1* J11.8† G05.1* J10.8† G05.1* A49.2 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE INFLUENZA, (VIRUS NOT IDENTIFIED) ICD-10 CODE J11.1 Bronchial Influenza (specific virus not identified) Influenza with Acute Upper Respiratory Infection (specific virus not identified) Influenza with Laryngitis (specific virus not identified) Influenza with Pharyngitis (specific virus not identified) Influenza with Pleural Effusion (specific virus not identified) Influenza with Upper Respiratory Infection (specific virus not identified) Viral Influenza (specific virus not identified) J11.1 Influenza with Pneumonia (specific virus not identified) Influenzal Bronchopneumonia (specific virus not identified) Influenzal Pneumonia (specific virus not identified) Influenza with Bronchopneumonia (specific virus not identified) J11.0 Influenza with Enteritis (specific virus not identified) Influenza with Gastroenteritis (specific virus not identified) Influenza with Involvement of Gastrointestinal Tract (specific virus not identified) Influenzal Gastroenteritis (specific virus not identified) J11.8 64 65 J11.1 J11.1 J11.1 J11.1 J11.1 J11.1 J11.0 J11.0 J11.0 J11.8 J11.8 J11.8 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE C92.9, M9860/3 Myeloid Leukemia LIGATION Z30.2 Bilateral Tubal Ligation LIPOMA D17.9, M8850/0 LUMBAGO M54.59 M32.9 M32.1† J99.1* M32.1† N16.4* C85.9, M9590/3 C82.9, M9690/3 C85.9, M9590/3 C82.9, M9690/3 Follicular Lymphoma Malignant Lymphoma Nodular Lymphoma INJURY J10.8 J10.8 T14.9 Note: A more appropriate nature of injury code For injury both the nature of the injury and the circumstance of the external cause should be coded. LUPUS LYMPHOMA Influenzal Gastroenteritis (specific virus identified except H. Influenzae) Influenza with Involvement of Gastrointestinal Tract (specific virus identified except H. Influenzae) Refer to ICD-10 Vols. 1 & 3 for the other specific codes to consider. Refer to ICD-10 Vol. 1 for the other specific site codes to consider. Systemic Lupus Erythematous (SLE) with Renal Tubulo Interstitial Disease GUIDANCE ICD-10 CODE should be used if the injury is specified as to type, site, and laterality. Note: If the specific site of lumbago is indicated, a more appropriate 5th character site code should be used instead of “9”. Systemic Lupus Erythematous (SLE) Systemic Lupus Erythematous (SLE) with Lung Involvement DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR For morbidity coding, the fracture code is assigned as the primary code and the external cause code from V01 – Y98 as supplemental code. However, for mortality coding, the injury code should never be used as underlying cause code, it may only be included as a supplemental code to the underlying cause code. Refer to ICD-10 Vols. 1 & 2 for additional guidelines. Brain Injury with Open Intracranial Wound S06.91 See also notes under “Injury” Brain Injury without Open Intracranial Wound S06.90 See also notes under “Injury” S09.9 Head Injury See also notes under “Injury” 70 67 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE T07 Multiple Injuries Note: Refer to ICD-10 Vol. 2 for additional See also notes under “Injury” guidelines INSUFFICIENCY DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. Acute Laryngitis Acute Coronary Insufficiency Sub-Acute Coronary Insufficiency Vertebrobasilar Insufficiency JAUNDICE I24.8 I24.8 G45.0 J04.0 See also notes under “Laryngitis” J37.0 Chronic Laryngitis See also notes under “Laryngitis” R17 KETOACIDOSIS E87.2 Diabetic Ketoacidosis (DKA) (Type of Diabetes unspecified) E14.1 Note: A more appropriate code from E10-E13 should be used instead of “E14” if the specific type of Diabetes is indicated. Refer to ICD-10 Vols.1 & 3 for the appropriate code to consider. LEPROSY [ HANSEN’S DISEASE ] Macular Leprosy Tuberculoid Leprosy LEUKEMIA Acute Lymphocytic Leukemia KOCH’S DISEASE, KOCH’S INFECTION A16.9 LABOR Acute Myelocytic Leukemia Chronic Myelocytic Leukemia False Labor (<37 weeks gestation) False Labor (>37 weeks gestation) Preterm Labor , not resulting to Delivery Preterm Labor, resulting to Delivery LARYNGITIS Note: ICD-10 CODE O47.0 O47.1 O60.0 O60.1 J04.0 A code from B95-B97 should be added to the code for the condition if the infectious agent is identified. Chronic Myelogenous Leukemia Lymphatic Leukemia Lymphosaroma cell Leukemia Monocytic Leukemia 68 69 A30.9 A30.9 A30.1 C95.9, M9800/3 C91.0, M9821/3 C92.0, M9861/3 C92.1, M9863/3 C92.1, M9863/3 C91.9, M9820/3 C94.7, M9850/3 C93.9, M9890/3 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Measles with Bronchopneumonia Measles with Pneumonia Postmeasles Pneumonia Postmeasles Bronchopneumonia MELANOMA, MALIGNANT, SKIN MENINGITIS Bacterial Meningitis Haemophilus Meningitis Meningitis due to Haemophilus Influenzae Tuberculous Meningitis Viral Meningitis MENINGIOMA ICD-10 CODE B05.2+ J17.1* B05.2+ J17.1* B05.2+ J17.1* B05.2+ J17.1* C43.9, M8720/3 G03.9 G00.9 G00.0 G00.0 A17.0† G01* A87.9 D32.9, M9530/0 D32.0 M9530/0 Sthenorbital Meningioma METASTASES Bone Metastases Note: A more specific morphology code should be assigned instead of the “M8000” code if the specific morphological variety is indicated. Refer to ICD-10 Vols. 1 & 3 for the appropriate morphology code. C79.5, M8000/6 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE C85.9, M9591/3 Non-Hodgkin’s Lymphoma LYMPHOSARCOMA Follicular Lymphosarcoma Mixed Cell Type Follicular Lymphosarcoma Nodular Lymphosarcoma MALARIA (Clinically diagnosed Malaria without C85.0, M9592/3 C82.9, M9690/3 C82.1, M9691/3 C82.9, M9690/3 B54 Parasitological confirmation) Note: For other malaria conditions with parasitological confirmation consider the categories below or refer to ICD-10 Vols. 1 & 3 for the other appropriate code to consider. Cerebral Malaria Plasmodium Falciparum Malaria, without Complication Plasmodium Falciparum Malaria, with Cerebral Complications Plasmodium Vivax Malaria, without Complication Plasmodium Vivax Malaria, with Rupture of Spleen Plasmodium Malariae Malaria, without Complication Plasmodium Malariae Malaria, with Nephropathy 74 71 B50.0+ G94.8* B50.9 B50.0 B51.9 B51.0 B52.9 B52.0 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Severe Plasmodium Falciparum Malaria Plasmodium Vivax Malaria with Ruptured Spleen ICD-10 CODE B50.8 B51.0+ D77* MALIGNANCY Note: A more specific morphology code should be assigned instead of the “M8000” code if the specific morphological variety is indicated. Refer to ICD-10 Vols. 1 & 3 for the appropriate morphology code. Colonic Malignancy Note: If the specific part of the colon is indicated, a more specific site code should be assigned instead of C18.9. Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. Gastric Malignancy Note: If the specific part of the stomach is indicated, a more specific site code should be assigned instead of C16.9. Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider. C18.9, M8000/3 See also notes under “Malignancy, Cancer and Carcinoma” C16.9, M8000/3 See also notes under “Malignancy, Cancer and Carcinoma” C22.9, M8000/3 Liver Malignancy See also notes under “Malignancy, Cancer and Carcinoma” DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE MALNUTRITION 1st degree Malnutrition 1st degree Protein-energy (calorie) Malnutrition nd 2 degree Malnutrition nd 2 degree Protein-energy (calorie) Malnutrition rd 3 degree Malnutrition rd 3 degree Protein-energy (calorie) Malnutrition Mild Malnutrition Mild Protein-energy (calorie) Malnutrition Moderate Malnutrition Moderate Protein-energy (calorie) Malnutrition Protein- energy (calorie) Malnutrition Severe Malnutrition Severe Protein-energy (calorie) Malnutrition ICD-10 CODE E46 E44.1 E44.1 E44.0 E44.0 E43 E43 E44.1 E44.1 E44.0 E44.0 E46 E43 E43 MASS Abdominal Mass Breast Mass Liver Mass (Non-specific abnormal findings on Diagnostic Imaging) Liver Mass (without Diagnostic Imaging) Lung Mass (Non-specific abnormal findings on Diagnostic Imaging) Lung Mass (without Diagnostic Imaging) Nasopharyngeal Mass R19.0 N63 R93.2 K76.9 R91 J98.4 D37.0 M8000/1 J39.2 H05.9 Nasopharyngeal Cystic Mass Orbital Mass MEASLES B05.9 B06.9 German Measles 72 73 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE character site code should be used instead of “9”. GUIDANCE MIGRAINE Refer to ICD-10 Vol. 1 for the other specific site codes to consider. OSTEOPOROSIS M81.99 Note: If the specific site of osteoporosis is indicated, a more appropriate 5th character site code should be used instead of “9”. Mumps Meningitis See also notes under “Osteoporosis” H66.9 H66.9 H66.9 H60.9 H83.0 H66.9 Acute Otitis Media Chronic Otitis Media Otitis Externa Otitis Interna Otitis Media PAIN Abdominal Pain Anterior Chest Wall Pain Arm Pain Back Pain Note: If a more specific site is indicated, a more appropriate 5th character site code should be used instead of “9”. R52.9 R10.4 R07.3 M79.69 M54.99 ICD-10 CODE G43.9 G43.1 G43.0 N94.3 G43.8 B26.9 B26.0+ N51.1* B26.1+ G02.0* B26.2+ G05.1* Mumps Orchitis M81.89 OTITIS Classical Migraine Common Migraine Menstrual Migraine Ophthamoplegic Migraine (retinal) MUMPS Refer to ICD-10 Vol. 1 for the other specific site codes to consider. Senile Osteoporosis DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR Mumps Encephalitis MYASTHENIA GRAVIS G70.0 MYELOMA C90.0, M9732/3 C90.0, M9732/3 Multiple Myeloma MYELOMATA C90.0, M9732/3 C90.0, M9732/3 Multiple Myelomata MYOCARDITIS I51.4 MYOMA UTERI D25.9, M8890/0 D25.9, M8890/0 Uterine Myomata 78 75 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR NARROWING, RECTAL K62.4 NAUSEA [ VOMITING ] R11 NECROSIS R02 K72.9 Liver Necrosis NEPHRITIS N05.9 M32.1† N08.5* Lupus Nephritis NEPHROLITHIASIS N20.0 NEPHROPATHY DM Nephropathy Note: A more appropriate code from E10-E13 should be used instead of “E14” if the specific type of Diabetes is indicated. N28.9 E14.2† N08.3* GUIDANCE Note: For new growth with other specified behavior ( ex. malignant secondary, in situ, etc.), a more appropriate behavior and site codes should be assigned. Refer to ICD-10 Vols. 1 & 3 for the appropriate codes and additional specific guidelines. Ovarian New Growth, Malignant C56, M8000/3 Ovarian New Growth D39.1, M8000/1 NODULES Thyroid Nodules Thyroid Nodules with Hyperthyroidism Toxic Thyroid Nodules OBESITY Refer to the ICD-10 Vols.1 & 3 for the appropriate code to consider. ICD-10 CODE E04.1 E05.2 E05.2 E66.9 OBSTRUCTION K56.6 N13.8 N02.8 Intestinal Obstruction Renal Obstruction NEURODERMATITIS L28.0 OLIGURIA [ ANURIA ] NEUROPATHY G62.9 G90.9 G62.9 ORCHITIS N45.9 ORTHOPNEA R06.0 IgA Nephropathy Autonomic Neuropathy Peripheral Neuropathy NEW GROWTH [NEOPLASM] (Unspecified site) 76 D48.9, M8000/1 R34 OSTEOARTHRITIS M19.99 Note: If the specific site of osteoarthritis is th indicated, a more appropriate 5 77 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR except H. Influenzae) GUIDANCE PHYSICAL EXAMINATION [ CHECK-UP ] Refer to ICD-10 Vol. 1 for the other specific site codes to consider. Z00.0 R39.8 Bladder Pain PLEURAL EFFUSION J90 M89.89 Bone Pain PLEURISY Tuberculous Pleurisy (confirmed bacteriologically or histologically) Tuberculous Pleurisy (without mention of bacteriological or histological confirmation) PNEUMOCYSTOSIS A16.5 J18.9 If the organism is identified, a more specific code should be considered. Refer to ICD-10 Vols. 1 & 3 for the other specific codes to consider. J69.0 Aspiration Pneumonia Note: If a more specific site is indicated, a th more appropriate 5 character site code should be used instead of “9”. Refer to ICD-10 Vol. 1 for the other specific site codes to consider. B59 PNEUMONIA Note: R09.1 A15.6 R07.4 R10.4 R51 M79.63 R52.9 R51 K10.8 M25.59 Chest Pain Colon Pain Facial Pain Forearm Pain Generalized Pain Head Pain Jaw Pain Joint Pain Note: If a more specific site is indicated, a th more appropriate 5 character site code should be used instead of “9”. Note: If the cause (ie. food, oils, essences, etc.) is indicated, a more specific code should be assigned instead of J69.0. Refer to ICD-10 Vol. 1 for the other specific site codes to consider. Supplemental code from V01-Y98 should be added to J69.0 if the external cause of the condition is indicated M79.66 Leg Pain Refer to ICD-10 Vols. 1 & 3 for the appropriate code/s to consider. Community Acquired Pneumonia (CAP), Organism not specified ICD-10 CODE J18.9 See also notes under “ Pneumonia” 82 79 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE M54.49 Low Back Pain M79.19 See note under “Back Pain” M79.29 See note under “Back Pain” Rectal Pain K62.8 Sciatic Pain M54.39 Note: If a more specific site is indicated, a th more appropriate 5 character site code should be used instead of “9”. Refer to ICD-10 Vol. 1 for the other specific site codes to consider. R10.1 R07.0 K08.8 M79.62 PALPITATIONS R00.2 PARAPLEGIA G82.2 PARASITISM G20 Parkinson’s Disease due to Drugs(except neuroleptic drugs) Parkinsonism due to Drugs (except neuroleptic drugs) Parkinson’s Disease due to Neuroleptic Drugs Parkinsonismn due to Neuroleptic Drugs Parkinson’s Disease due to Encephalitis Parkinsonismn due to Encephalitis PAROTITIS B89 G21.1 G21.1 G21.0 G21.0 G21.3 G21.3 K11.2 B26.9 B26.9 K91.8 K91.8 Epidemic Parotitis Infectious Parotitis Post Operative Parotitis Parotitis, Surgical PELVIC INFLAMMATORY DISEASE Stomach Pain Throat Pain Tooth Pain Upper arm Pain ICD-10 CODE B82.9 PARKINSON’S DISEASE [PARKINSONISM] Refer to ICD-10 Vol. 1 for the other specific site codes to consider. Nerve Pain GUIDANCE Intestinal Parasitism Note: If a more specific site is indicated, a more appropriate 5th character site code should be used instead of “9”. Muscle Pain DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR Acute Pelvic Inflammatory Disease Chronic Pelvic Inflammatory Disease Pelvic Inflammatory Disease Complicating Pregnancy Pelvic Inflammatory Disease following Abortion Tuberculous Pelvic Inflammatory Disease PHARYNGITIS Acute Pharyngitis Chronic Pharyngitis Viral Pharyngitis Pharyngitis with Influenza (virus not identified) Pharyngitis with Influenza (virus identified 80 81 N73.9 N73.0 N73.1 O23.5 O08.0 A18.1† N74.1* J02.9 J02.9 J31.2 J02.8 J11.1 J10.1 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE See also notes under “Poisoning” Hydrogen Sulfide Poisoning, intentional self harm T59.0 X67.99 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE J18.2 Hypostatic Pneumonia J18.9, Y95 Nosocomial Pneumonia See also notes under “ Pneumonia” See also notes under “Poisoning” T56.0 X49.99 Lead Poisoning, accidental See also notes under “Poisoning” Lead Poisoning, intentional self harm T56.0 X69.99 See also notes under “Poisoning” T56.1 X49.99 Mercury Poisoning, accidental See also notes under “Poisoning” Mercury Poisoning, intentional self harm T56.1 X69.99 See also notes under “Poisoning” T61.2 X49.99 Mussels Poisoning, accidental See also notes under “Poisoning” Organophosphate Poisoning, accidental T60.0 X48.99 See also notes 86 ICD-10 CODE Pneumonia with Pleural Effusion Post Measles Pneumonia Radiation Pneumonia Streptococcal Lobar Pneumonia Streptococcal (Streptococcal pneumoniae) Lobar Pneumonia Streptococcal (Streptococcus Group B) Lobar Pneumonia Tuberculous Pneumonia J18.9†J91* B05.2† J17.1* J70.0 J15.4 J13 J15.3 A16.2 Tuberculous Pneumonia, confirmed by Sputum Microscopy with or without Culture Tuberculous Pneumonia, Bacteriologically and Histologically negative Tuberculous Pneumonia, Bacteriological and Histological Examination not done PNEUMONITIS Acute Pneumonitis A15.0 PNEUMOTHORAX Pneumothorax of, fetus or newborn Spontaneous Pneumothorax Traumatic Pneumothorax without Open Wound into Thoracic Cavity J93.9 P25.1 J93.1 S27.00 Note: A supplemental code from V01-Y98 should be added to S27.00 if the external cause of the condition is indicated. 83 A16.0 A16.1 J18.9 J18.9 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Refer to ICD-10 Vols. 1 & 3 for the appropriate code/s to consider. Traumatic Pneumothorax with Open Wound into Thoracic Cavity Note: See also notes under “Poisoning” S27.01 Arsenic Poisoning, intentional self harm A supplemental code from V01-Y98 should be added to S27.01 if the external cause of the condition is indicated Ciguatera Fish Poisoning, accidental T61.0, X49.99 See also notes under “Poisoning” T65.9 Cyanide Poisoning, accidental Note: Both the nature and circumstance of poisoning should be coded. T65.0 X49.99 See also notes under “Poisoning” For morbidity coding, the poisoning code is assigned as the primary code and the external cause code from X40-X49 as supplemental code. Cyanide Poisoning, intentional self harm T65.0 X69.99 See also notes under “Poisoning” However, for mortality coding, the code for poisoning should never be used as underlying cause code, it may only be included as a supplemental code. T61.2 X49.99 Fish Poisoning, accidental If the specific place of occurrence and activity relative to the external cause is indicated then more specific place of occurrence and activity codes should be used instead of the codes “.99” See also notes under “Poisoning” T62.9 X49.99 Food Poisoning, accidental Refer to ICD-10 Volume 1 for the appropriate code and Volume 2 for additional guidelines. See also notes under “Poisoning” T57.0 X48.99 Arsenic Poisoning, accidental T57.0 X68.99 See also notes under “Poisoning” Refer to ICD-10 Vols. 1 & 3 for the appropriate code/s to consider. POISONING ICD-10 CODE Hydrogen Sulfide Poisoning, accidental 84 85 T59.6 X47.99 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Abnormal Reaction to Tuberculin Test [ Abnormal Result of Mantoux Test] Blood Transfusion Reaction ICD-10 CODE R76.1 RETENTION K21.9 K21.0 K21.9 K21.9 K21.0 K21.9 K21.0 RETICULOSARCOMA ICD-10 CODE under “Poisoning” Organophosphate Poisoning, intentional self harm T60.0 X68.99 See also notes under “Poisoning” Seafood Poisoning, accidental T61.9 X49.99 See also notes under “Poisoning” K21.9 Shellfish Poisoning, accidental K21.9 R33 F45.3 R33 Psychogenic Urine Retention Urine Retention GUIDANCE T80.9 REFLUX Esophageal Reflux Disease Esophageal Reflux Disease with Esophagitis Esophageal Reflux Disease without Esophagitis Gastroesophageal Reflux Disease (GERD) Gastroesophageal Reflux Disease (GERD) with Esophagitis Gastroesophageal Reflux Disease (GERD) without Esophagitis Laryngopharyngeal Reflux Disease (LPRD) Laryngopharyngeal Reflux (LPRD) with Esophagitis Laryngopharyngeal Reflux (LPRD) without Esophagitis DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR T61.2 X49.99 See also notes under “Poisoning” T65.8,T57.8, T57.1, T65.3 X49.99 Watusi Poisoning, accidental See also notes under “Poisoning” C83.9, M9593/3 Watusi Poisoning, intentional self harm T65.8,T57.8, T57.1, T65.3 X69.99 See also notes under “Poisoning” POLIOMYELITIS A80.9 90 87 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Acute Poliomyelitis Congenital Poliomyelitis Non-paralytic Poliomyelitis Paralytic Poliomyelitis Poliomyelitis with paralysis Spinal Poliomyelitis Vaccine associated paralytic Poliomyelitis ICD-10 CODE A80.9 P35.8 A80.4 A80.3 A80.3 A80.9 A80.0 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE Mitral Valve Prolapse Prolapse of Uterus Prolapse of Uterus, 1st degree Prolapse of Uterus, 2nd degree rd Prolapse of Uterus, 3 degree PSYCHOSIS POLYP N84.1 Endocervical Polyp POLYPOSIS J33.9 Nasal Polyposis POLYURIA R35 F45.3 Psychogenic Polyuria Typhoid Psychosis, culture proven Typhoid Psychosis, clinically proven ICD-10 CODE I34.1 N81.4 N81.2 N81.2 N81.3 F29 A01.00 A01.01 PTERYGIUM H11.0 PURPURA D69.2 D69.3 D69.3 D69.2 Acute Idiopathic Thrombocytopenic Purpura Chronic Idiopathic Thrombocytopenic Purpura Eosinophilic Purpura PREGNANCY Note: PYELONEPHRITIS For conditions complicating pregnancy or aggravated by the pregnant state, priority of coding should be given to the pregnant state and the code/s for the specific condition/s should be used as supplemental code/s if necessary. Acute Pyelonephritis Chronic Pyelonephritis Pyelonephritis with Calculus Pyelonephritis with Calculus and Hydronephrosis Pyelonephritis complicating Pregnancy Refer to ICD-10 Vols. 1 & 3 for the appropriate code/s to consider. PRIMARY COMPLEX A16.7 PROCIDENTIA UTERI N81.3 O23.0 QUADRIPLEGIA, LATE EFFECT G82.5 RABIES A82.9 A82.0 A82.1 Sylvatic Rabies Urban Rabies PROLAPSE 88 N12 N10 N11.9 N20.9 N13.2 REACTION 89 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE J01.1 J01.9 J30.4 Acute Frontal Sinusitis Acute Sinusitis Allergic Sinusitis SPHEROCYSTOSIS D58.8 D58.8 Hereditary Spherocystosis STAB WOUND DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE RHEUMATISM ICD-10 CODE M79.09 Note: If the specific site of rheumatism is indicated, a more appropriate 5th character site code should be used instead of “9”. T14.1 Refer to ICD-10 Vol. 1 for the other specific site codes to consider. Note: If the part of the body wounded is specified the code would be different. RHINITIS Refer to ICD-10 Vols.1 & 3 for the appropriate code. For morbidity coding a supplementary code for the external cause of the injury should be used. However, for mortality coding this code should be used as a supplemental code only. STEATOHEPATITIS, NON ALCOHOLIC STROKE J31.0 J30.4 J45.0 Allergic Rhinitis Allergic Rhinitis with Asthma SALMONELLOSIS A02.0 SARCOMA, primary, malignant, site unspecified K76.0 I64 Note: C49.9, M8800/3 The coders need to determine whether the sarcoma is primary, secondary (metastatic), in situ, benign, etc. so that the appropriate behavior and site codes can be assigned. Refer to ICD-10 Vols. 1 & 3 for the appropriate site code to consider and Vol. 1 for additional specific coding guidelines. C46.9, M9140/3 Kaposi’s Sarcoma See also notes under “Sarcoma, primary, malignant” Kaposi’s Sarcoma, connective tissue 94 91 C46.1, DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE M9140/3 See also notes under “Sarcoma, primary, malignant” Kaposi’s Sarcoma, lymph nodes C46.3, M9140/3 See also notes under “Sarcoma, primary, malignant” C46.0, M9140/3 Kaposi’s Sarcoma, skin See also notes under “Sarcoma, primary, malignant” DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE SCAR L90.5 SCHISTOSOMIASIS B65.9 SCIATICA M54.39 Note: If a more specific site is indicated, a more appropriate 5th character site code should be used instead of “9”. Refer to ICD-10 Vol. 1 for the other specific site codes to consider. M54.49 Sciatica with Lumbago See also notes under “Sciatica” SCLEROSIS SARCOMA, secondary, malignant , site unspecified C80, M8800/6 See also notes under “Sarcoma, primary, malignant” SARCOMATOSIS, site unspecified C80, M8800/6 See also notes under “Sarcoma, primary, malignant” G37.9 I25.1 G35 G95.8 Brain Sclerosis Cardiac Sclerosis Multiple Sclerosis Spinal Sclerosis SEIZURES R56.8 R56.8 I69.4 P90 Post Stroke Seizures Seizure, newborn SEPTICEMIA [ SEPSIS ] A41.9 O85 P36.9 P36.9 Postpartum Sepsis Sepsis Neonatorum Septicemia, newborn SINUSITIS J32.9 92 93 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE WOUND, OPEN T14.1 Note: If the part of the body wounded is indicated, a more specific code should be assigned instead of “T14.1”. Refer to ICD-10 Vols. 1 & 3 for the appropriate code to consider. For morbidity coding a supplementary code from V01-Y98 to indicate the external cause of the injury should be added to T14.1. However, for mortality coding this code should be used as a supplemental code only. ICD-10 CODE SYNDROME Carpal Tunnel Syndrome Hyperglycemic Hyperosmolar Syndrome [Hyperglycemic Hyperosmolar Coma] G56.0 E14.0 Note: A more appropriate code from E10-E13 should be used instead of “E14” if the specific type of Diabetes is indicated. Refer to ICD-10 Vol.1 for other specific codes to consider. Hypereosinophilic Syndrome Irritable Bowel Syndrome Myelodysplastic Syndrome Myofascial Pain Syndrome Nephrotic Syndrome Respiratory Distress Syndrome, child Respiratory Distress Syndrome, adult Severe Acute Respiratory Syndrome (SARS) Sudden Infant Death Syndrome Thalassemia Syndrome TACHYCARDIA D72.1 K58.9 D46.9, M9989/1 M79.08 N04.9 P22.0 J80 U04.9 R95 D56.9 R00.0 I47.9 Paroxysmal Tachycardia TETANUS A35 A33 A34 Tetanus Neonatorum Obstetrical Tetanus THYROID STORM E05.5 TONSILITIS J03.9 J03.9 Acute Tonsilitis 98 95 DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR GUIDANCE ICD-10 CODE Note: Refer to ICD-10 Vol.1 for additional guidelines. GUIDANCE J35.0 J03.9 Chronic Tonsilitis Septic Tonsilitis TONSILLOPHARYNGITIS J06.8 J06.8 Acute Tonsillopharyngitis TOXICOSIS R68.8 TRANSIENT ISCHEMIC ATTACK (TIA) G45.9 TUBERCULOSIS OF LUNG , [ PULMONARY TUBERCULOSIS (PTB)] A16.2 PTB class 3 by Sputum Confirmation PTB class 3,4 by X-ray Confirmation and Bacteriologically and Histologically negative PTB class 3,4 by X-ray Confirmation and Bacteriological and Histological examination not done PTB PTB class 3,4 by X-ray confirmation without mention of Bacteriological and Histological Confirmation PTB class 5 PTB suspect MDRTB without Culture Sensitivity PTB class 1,2 MDRTB confirmed by Culture TYMPANOMASTOIDITIS A15.0 A16.0 A16.1 A16.2 A16.2 ULCER Bleeding Peptic Ulcer Bleeding Peptic Ulcer with Perforation Decubitus Ulcer Duodenal Bleeding Gastric Ulcer with Hemorrhage Peptic Ulcer Peptic Ulcer with Perforation Skin Ulcer Stasis Ulcers UREMIA Z03.0 Z03.0 Z03.0 Z20.1 A15.1 ICD-10 CODE L98.4 K27.4 K27.6 L89 K26.9 K25.4 K27.9 K27.5 L98.4 I83.0 N19 N18.9 Chronic Uremia UROLITHIASIS N20.9 UROSEPSIS N39.0 VASCULITIS I77.6 VERTIGO [ DIZZINESS ] H73.9, H70.9 H73.1, H70.1 Chronic Tympanomastoiditis DISEASES/C ONDITIONS NOTE: READ THE DISCLAIMER CAREFULLY FOR R42 H81.1 H81.4 H81.3 R42 H81.4 Benign Paroxysmal Vertigo Benign, Positional Vertigo Peripheral Vertigo Toxic Vertigo Vertigo of Central Origin VOMITING [ NAUSEA ] R11 WEAKNESS R53 WEIGHT LOSS, ABNORMAL 96 97 R63.4 ICD-10 CODES (Updated) E64.3 DISEASES/CONDITIONS and/or CATEGORY TITLES Remarks - do - E64.3 Kyphoscoliosis, Late Effect of Rickets Kyphotic Late Effect of Rickets E64.3 Lordosis, Late Effect of Rickets - do - E64.3 Rachitic Lordosis - do - E64.3 Rachitic Spine Deformity - do - E72.3 Pipecolic Acidemia F45.0 Briquet’s Disorder “ILL-DEFINED” CONDITIONS IN TERMS OF ICD-10 CODE ASSIGNMENT: - do - Code revised, previously the condition was coded to E71.3 Added as inclusion term under existing category - do - G31.8 Lewy Body G31.8 Lewy Dementia - do - G31.8 Lewy Disease - do - G90.4 Autonomic Dysreflexia New Code G92 H50.2 Heroin Vapor Leukoencephalopathy Hypertropia H50.2 Hypotropia Added under existing category Code revised, previously the condition was coded to H50.4 - do - I27.8 Eisenmenger’s Complex I27.8 Eisenmenger’s Syndrome The use of the following as diagnostic statements is not encouraged, however, if a more specific diagnosis cannot be made then the ICD-10 codes provided below should be assigned. DISEASES/C ONDITIONS CHRONIC RESPIRATORY INSUFFICIENCY DIABETIC GASTROPATHY DIABETIC HYPERMOTILITY DIABETIC MACROVASCULAR DISEASE ENTERIC FEVER GASTROPATHY METABOLIC ENCEPHALOPATHY MULTIPLE ORGAN FAILURE NON-ALCOHOLIC STEATOHEPATITIS (NASH) NSAID GASTROPATHY RENAL SCAR SOFT TISSUE MASS SOFT TISSUE RHEUMATISM Added under existing category, excluded from category Q21.8 - do - 102 99 ICD-10 CODE R06.8 E14.6, K31.9 E14.6, K31.9 E14.7 I21.9, I63.9 A01.0 K31.9 G93.4† E90* R68.8 K76.0 K31.9 Y56.0 N28.9 M35.9 M79.09 WHO OFFICIAL UPDATE TO ICD-10* As of January 2006 ICD-10 CODES (Updated) A04.7 DISEASES/CONDITIONS and/or CATEGORY TITLES ICD-10 CODES (Updated) Remarks A04.7 Foodborne intoxication by Clostridium Difficile Pseudomembranous Colitis Added under existing category - do - A07.8 Intestinal microsporidiosis A48.1 Legionnaire’s Pneumonia A49.3 Pleuro-pneumonia like Organism (PPLO) infection A81 Atypical Virus Infections of Central Nervous system Other Atypical Virus Infections of Central Nervous system Atypical Virus Infections of Central Nervous system, unspecified Viral Hepatitis C Added under existing category Code revised, previously a Dagger and Asterisk Code Code revised, previously the condition was coded to A49.8 Title of existing category revised - do - A81.8 A81.9 B18.2 B77.0 B77.9 Ascariasis infection with intestinal complications Ascariasis infection with other complications Ascariasis Infection B77.9 Ascariasis Infestation B82.0 Roundworm Infestation B77.8 - do Code revised, previously the condition was coded to B17.1 Added under existing category - do - do - DISEASES/CONDITIONS and/or CATEGORY TITLES C78.2 (Site Code) D13.1 (Site Code) Malignant Pleural Effusion D12.6 (Site Code) D12.6 (Site Code) D57.2 Adenomatous polyp of colon D59.1 Dyke-Young Anemia D75.8 Myelofibrosis E14.4† G63.2* E14.4† G63.2* E16.4 Diabetic Neuritis Remarks Diabetic Neuropathy Added under existing category Code revised, previously the condition was coded to K31.7 Added under existing category Added under existing category Code revised, previously the condition was coded to D56.1 Code revised, previously the condition was coded to D59.8 Added under existing category, excluded from category M85.8 Added under existing category - do - Abnormal secretion of gastrin New code E16.4 Hypergasterinemia E16.4 Zollinger-Ellison Syndrome E64.3 Curvature, Late effect of Rickets New code, previously the condition was coded to E16.8 New code, previously the condition was coded to E16.8 Code revised, previously a Dagger and Asterisk Code Adenomatous polyp of stomach Polyposis of colon Sickle Cell Thalassaemia Disease - do Code revised, previously the condition was coded to B77.9 100 101 ICD-10 CODES (Updated) DISEASES/CONDITIONS and/or CATEGORY TITLES M79.7 Fibromyalgia M79.7 Fibromyositis M79.7 Fibrositis Remarks I49.1 Atrial Extrasystoles I49.1 Auricular Extrasystoles I49.1 Junctional Extrasystoles I49.1 Ventricular Extrasystoles I85.9 Oesophageal Varices J34.1 Cyst and mucocele of nose and nasal sinus Chronic Asthmatic Bronchitis with Acute Lower Respiratory Infection Chronic Bronchitis with Acute Lower Respiratory Infection Chronic Emphysematous Bronchitis with Acute Lower Respiratory Infection Chronic Obstructive Bronchitis with Acute Lower Respiratory Infection Chronic Asthmatic Bronchitis with Acute Exacerbation Chronic Bronchitis with Acute Exacerbation Chronic Emphysematous Bronchitis with Acute Exacerbation Chronic Obstructive Bronchitis with Acute Exacerbation Acute Respiratory Inflammation due to Radiation Exfoliativa Glossodynia N93.9 Uterine Bleeding O60.0 Preterm Labor without Delivery O60.1 Preterm Labor with Delivery New Code O60.1 Preterm Labor with Preterm Delivery Labor Obstructed by Cicatrix of Cervix Hypoxic Ischemic Encephalopathy of Newborn Keratoglobus, congenital with glaucoma New ode Myofibrositis Acquired Osteosclerosis M9442/3 Gliosarcoma N17.9 Acute Kidney Impairment N17.9 Acute Renal Impairment N84.3 Pudendum Polyp O65.5 P91.6 Q15.0 DISEASES/CONDITIONS and/or CATEGORY TITLES Code revised, previously the condition was coded to M79.0 New Code Code revised, previously the condition was coded to M79.0 New Code Added under existing category Code revised, previously the condition was coded to M9380/3 Added as inclusion term under existing category Added as inclusion term under existing category Code revised, previously the condition was coded to N84.8 Added under existing category New Code M79.7 M85.8 ICD-10 CODES (Updated) Added under existing category New Code J44.0 J44.0 J44.0 J44.0 J44.1 J44.1 J44.1 J44.1 J70.0 K14.0 Title of existing category revised 106 103 Remarks Code revised, previously the condition was coded to I49.4 Added under existing category - do - do Added as inclusion term under existing category Title of existing category revised Added under existing category - do - do - - do - - do - do - do - - do - do - do - ICD-10 CODES (Updated) DISEASES/CONDITIONS and/or CATEGORY TITLES Remarks K22.1 Barrett’s Ulcer K22.7 Barrett’s Disease Added as inclusion term under existing category New Code K22.7 Barrett’s Esophagus New Code K22.7 Barrett’s Syndrome New Code K31.7 Polyp of stomach and duodenum New Code K56.0 Neurogenic Ileus Code revised, previously the condition was coded to K56.7 K56.0 Obstruction, Reflex K70.1 Alcoholic Inflammatory Liver Disease Added under existing category - do - ICD-10 CODES (Updated) K85.8 DISEASES/CONDITIONS and/or CATEGORY TITLES Remarks K85.9 Other Acute Pancreatitis (This category includes other specified Pancreatitis not classified under categories K85.0-K85.3, K85.9) Acute Pancreatitis New Code K85.9 Acute Hemorrhagic Pancreatitis K85.9 Acute Edematous Pancreatitis - do - K85.9 Acute Recurrent Pancreatitis - do - K85.9 Subacute Pancreatitis - do - K85.9 Acute Necrotic Pancreas - do - K85.9 Suppurative Pancreatitis - do - K85.9 Gangrenous Pancreatitis - do - Code revised, previously the condition was coded to K85 - do - K74.6 Cruveilhier- Baumgarten Cirrhosis - do - K85.9 Abscess, Pancreas - do - K74.6 Non-Alcoholic Cirrhosis - do - K85.9 Acute Necrosis of the Pancreas - do - K75.4 Autoimmune hepatitis New Code K85.9 Infective Necrosis of the Pancreas - do - K75.8 Bacterial Hepatitis K85.9 Infection, Pancreas - do - K85.0 Idiopathic Acute Pancreatitis Added under existing category New Code L64.8 Premature Alopecia K85.1 Acute Biliary Pancreatitis New Code K85.1 Acute Gallstone Pancreatitis New Code M31.7 Microscopic Polyangiitis Code revised, previously the condition was coded to L65.9 New Code K85.1 Gallstone Pancreatitis New Code M31.7 Microscopic Polyarteritis New Code K85.2 Alcohol-Induced Acute Pancreatitis New Code M31.7 † N08.5* Glomerular Microscopic Polyangiitis Disease New Code K85.3 Drug-Induced Acute Pancreatitis (Use additional code to identify drug if specified) New Code M31.7 † N08.5* Polyneuropathy in Microscopic Polyangiitis New Code 104 105 ICD-10 CODES (Updated) DISEASES/CONDITIONS and/or CATEGORY TITLES Remarks Q15.0 Macrocornea with glaucoma Q21.8 Eisenmenger’s Defect Q43.1 Hirschsprung’s Disease Q43.1 Neurogenic Ileus Q75.4 Franceschetti Syndrome Q75.4 Treacher Collins Syndrome Q76.4 Sacralization Q77.4 Congenital Osteosclerosis R00.0 Sinoauricular Tachycardia R00.0 Sinus Tachycardia R00.1 Sinoatrial Bradycardia - do - R00.1 Sinus Bradycardia - do - R00.1 Vagal Bradycardia - do - R29.6 Tendency to Fall, Not Elsewhere Classified (Category Title) 110 107 Added as inclusion term under existing category Inclusion term under existing category revised Added under existing category Added under existing category Added as inclusion term under existing category Code revised, previously the condition was coded to Q87.0 Code revised, previously the condition was coded to M43.2 Added as inclusion term under existing category Added under existing category - do - New Code ICD-10 CODES (Updated) DISEASES/CONDITIONS and/or CATEGORY TITLES R50.8 Fever with Chills R50.8 Fever with Rigors R50.8 Persistent Fever R50.8 Persistent Pyrexia S37 Injury of Urinary and Pelvic Organs Complication of Arthroplasty T84.9 U04.9 Remarks Code revised, previously the condition was coded to R50.0 - do Code revised, previously the condition was coded to R50.1 - do Title of existing category revised Code revised, previously the condition was coded to T84.0 New Code W46 Severe Acute Respiratory Syndrome (SARS) Contact with Hypodermic Needle Z52.6 Liver Donor New Code Z52.7 Heart Donor New Code Z58.7 Exposure to Tobacco Smoke New Code Z58.7 Passive Smoking New Code Z92.6 Personal History of Chemotheraphy for Neoplastic Disease Ankylosis, Arthrodesis Status New Code Z98.1 New Code Added as inclusion term under existing category REFERENCES 1. Hospital Medical Records Management Manual, 2nd Edition, Manila, Department of Health, 1994. 2. ICD-10 Coding Fundamentals, 1st edition, M Sue Meads, Faye Brown, California, Practice Management Information Corporation (PIMC),1997. 3. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Geneva, World Health Organization, 1993. 4. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, 2nd edition Geneva, World Health Organization, 2004. 5. ICD-10 Student WorkBook, 3rd edition, Sue Walker and Maryann Wood, Brisbane, National Centre for Classification in Health, 1997. 6. WHO – Update Reference Committee (URC) Report, 2004. 7. WHO – Update Reference Committee (URC) Report, 2005 8. [email protected], “Application to Dermatology of International Classification of Diseases (ICD-10)” * Extracted with permission from the WHO –Update Reference Committee (URC) 2004 and 2005 Reports. 108 109 111 Let us continue to work for timely, truthful and reliable health statistics to make our reforms more responsive to our local needs. Quality health information means quality health care for all Filipinos! Mabuhay tayong lahat! FRANCISCO T. DUQUE III, MD, MSc. Secretary of Health 112 113
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