ICD-10 Instruction manual 2010 Edition

ICD-10

International Statistical Classification of Diseases and Related Health Problems

10th Revision

Volume 2 Instruction manual

2010 Edition

WHO Library Cataloguing-in-Publication Data International statistical classification of diseases and related health problems. - 10th revision, edition 2010. 3 v. Contents: v. 1. Tabular list ? v. 2. Instruction manual ? v. 3. Alphabetical index. 1.Diseases - classification. 2.Classification. 3.Manuals. I.World Health Organization. II.ICD-10.

ISBN 978 92 4 154834 2

(NLM classification: WB 15)

? World Health Organization 2011

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All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

The 43rd World Health Assembly in 1990 approved the Tenth Revision of the International Classification of Diseases (WHA 43,24) and endorsed the recommendation of the International Conference for the Tenth Revision of the ICD held in Geneva from 26 September to 2 October 1989 concerning the establishment of an updating process within the 10-year revision cycle. This recommendation was put into motion at the annual meeting of WHO Collaborating Centres for the Family of International Classifications in Tokyo, Japan in 1996 and later a formal mechanism to guide the updating process was established. According to this updating mechanism minor updates are made each year while major updates are made, if required, every three years.

For more information regarding the updating process and a cumulative list of the updates please see . who.int/classifications. Future updates will also be posted on this site.

The 2010 edition of ICD-10 can also be referred to as the 4th edition of ICD-10. It includes updates that came into effect between 1998 and 2010, as well as the corrigenda to Volume 1, which appeared as an addendum to Volume 3 of the first edition.

Printed in Malta

Contents

1. Introduction

1

2. Description of the International Statistical

Classification of Diseases and Related Health Problems

3

2.1 Purpose and applicability

3

2.2 The concept of a `family' of disease and health-related

classifications

3

2.2.1 Diagnosis-related classifications

6

2.2.2 Non-diagnostic classifications

8

2.2.3 Information support to primary health care

11

2.2.4 International Nomenclature of Diseases

12

2.2.5 The role of WHO

13

2.3 General principles of disease classification

13

2.4 The basic structure and principles of classification of the ICD 14

2.4.1 Volumes

15

2.4.2 Chapters

15

2.4.3 Blocks of categories

16

2.4.4 Three-character categories

16

2.4.5 Four-character subcategories

16

2.4.6 Supplementary subdivisions for use at the fifth or

subsequent character level

17

2.4.7 The unused `U' codes

17

3. How to use the ICD

19

3.1 How to use Volume 1

19

3.1.1 3.1.2

3.1.3 3.1.4 3.1.5

Introduction

19

Use of the tabular list of inclusions and fourcharacter

subcategories

19

Two codes for certain conditions

20

Conventions used in the tabular list

23

Categories with common characteristics

26

3.2 How to use Volume 3

27

3.2.1 Arrangement of the Alphabetical Index

27

3.2.2 Structure

27

3.2.3 Code numbers

27

3.2.4 Conventions

28

3.3 Basic coding guidelines

28

iii

INTERNATIONAL CLASSIFICATION OF DISEASES

4. Rules and guidelines for mortality and morbidity coding

31

4.1 Mortality: guidelines for certification and rules for coding 31

4.1.1 Causes of death

31

4.1.2 Underlying cause of death

31

4.1.3 International form of medical certificate

of cause of death

32

4.1.4 Procedures for selection of the underlying

cause of death for mortality tabulation

34

4.1.5 Rules for selection of the originating antecedent cause 34

4.1.6 Some considerations on selection rules

35

4.1.7 Examples of the General Principle and selection rules 36

4.1.8 Modification of the selected cause

45

4.1.9 The modification rules

46

4.1.10 Examples of the modification rules

47

4.1.11 Notes for use in underlying cause mortality coding

53

4.1.12 Summary of linkages by code number

71

4.2 Notes for interpretation of entries of causes of death

78

4.2.1 Assumption of intervening cause

78

4.2.2 Accepted and rejected sequences for the selection of

underlying cause of death for mortality statistics

78

4.2.3 Effect of duration on classification

84

4.2.4 Sequelae

85

4.2.5 Consistency between sex of patient and diagnosis

86

4.2.6 Operations

86

4.2.7 Malignant neoplasms

87

4.2.8 Involvement of multiple types of substance use

109

4.2.9 Rheumatic fever with heart involvement

109

4.2.10 Congenital malformations, deformations

and chromosomal abnormalities

110

4.2.11 Nature of injury

110

4.2.12 Poisoning by drugs, medicaments

and biological substances

111

4.2.13 External causes

113

4.2.14 Expressions indicating doubtful diagnosis

114

4.2.15 Human immunodeficiency virus (HIV)

114

4.2.16 Death due to maternal (obstetric) causes

114

4.2.17 List of conditions that can cause diabetes

115

4.3 Perinatal mortality: guidelines for certification

and rules for coding

115

4.3.1 Certification of perinatal deaths

115

4.3.2 Statement of causes of death

116

4.3.3 Tabulation of perinatal mortality by cause

119

4.3.4 Coding of causes of death

119

4.3.5 Coding rules

120

iv

CONTENTS

4.4 Morbidity

122

4.4.1 Guidelines for recording diagnostic

information for single-condition analysis

of morbidity data

123

4.4.2 Guidelines for coding "main condition" and "other

conditions"

125

4.4.3 Rules for reselection when the main condition

is incorrectly recorded

131

4.4.4 Chapter-specific notes

137

5. Statistical presentation

147

5.1 Introduction

147

5.2 Source of data

147

5.3 Level of detail of cause in tabulations

147

5.4 The recommended special tabulation lists for mortality

148

5.4.1 The condensed lists

148

5.4.2 The selected lists

148

5.4.3 Use of prefixes to identify the mortality lists

148

5.4.4 Locally designed lists

148

5.5 The special tabulation list for morbidity

149

5.5.1 Description

149

5.5.2 Modification of the special tabulation list for

morbidity according to national requirements

150

5.6 Recommendations in relation to statistical tables

for international comparison

150

5.6.1 Statistical tables

150

5.6.2 Tabulation of causes of death

151

5.7 Standards and reporting requirements related

to fetal, perinatal, neonatal and infant mortality

151

5.7.1 Definitions

151

5.7.2 Reporting criteria

153

5.7.3 Statistics for international comparison

153

5.7.4 Presentation of causes of perinatal mortality

155

5.8 Standards and reporting requirements related

to maternal mortality

156

5.8.1 Definitions

156

5.8.2 International reporting

157

5.8.3 Published maternal mortality rates

157

5.8.4 Denominators for maternal mortality

157

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