ICD-10 Volume 2 Instruction manual Fifth edition

ICD-10

International

statistical

classi?cation

of diseases and

related health

problems

10th revision

Volume 2

Instruction manual

Sixth Edition 2019

WHO Library Cataloguing-in-Publication Data

International statistical classification of diseases and related health problems. - 10th revision, Sixth edition, 2019.

3 v.

Contents: v. 1. Tabular list -- v. 2. Instruction manual

1.Diseases -classification. 2.Classification. 3.Manuals. I.World Health Organization. II.ICD-10.

(NLM classification: WB 15)

? World Health Organization

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International Classification of Diseases Tenth Revision (ICD-10), Sixth Edition, 2019. Geneva: World Health Organization; 2019. License: CC BY-ND

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Table of Contents

1. Introduction

1

2. Description of the International Statistical Classification of

Diseases and Related Health Problems

2

2.1

Purpose and applicability

2.2

The concept of a ¡®family¡¯ of disease and health-related

classifications

2.2.1

Diagnosis-related classifications

2.2.2

Non-diagnostic classifications

2.2.3

Information support to primary health care

2.2.4

International Nomenclature of Diseases

2.2.5

The role of WHO

3

5

8

10

11

12

2.3

General principles of disease classification

12

2.4

The basic structure and principles of classification of the ICD

13

2.4.1

Volumes

14

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

2

18

3.1

How to use Volume 1

18

3.1.1

Introduction

18

3.1.2

Use of the tabular list of inclusions and four?character

subcategories

18

3.1.3

Two codes for certain conditions

20

3.1.4

Conventions used in the tabular list

22

3.1.5

Categories with common characteristics

25

3.2

How to use Volume 3

3.2.1

Arrangement of the Alphabetical Index

3.2.2

Structure

3.2.3

Code numbers

3.2.4

Conventions

26

26

26

27

27

INTERNATIONAL CLASSIFICATION OF DISEASES

3.3

Basic coding guidelines

4. Rules and guidelines for mortality and morbidity coding

27

29

4.1

Coding instructions for mortality: Underlying cause of death

29

4.1.1

Aim of the instructions: International comparability 29

4.1.2

The international death certificate

30

4.1.3

Basic concepts

31

4.2

Coding instructions for mortality: Selecting the underlying

cause of death

38

4.2.1

Find the starting point (Steps SP1 ¨C SP8)

39

4.2.2

Check for modifications of the starting point (Steps M1

¨C M4)

49

4.2.3

Special instructions on accepted and rejected sequences

(Steps SP3 ¨C SP4)

56

4.2.4

Special instructions on obvious cause (Step SP6)

63

4.2.5

Special instructions on linkages and other provisions

(Step M1)

72

4.2.6

Special instructions on main injury in deaths from

external causes (Step M4)

109

4.2.7

Special instructions on poisoning by drugs, medicaments

and biological substances (Step M4)

111

4.2.8

Special instructions on maternal mortality (Step M4) 117

4.2.9

Special instructions on surgery and other medical

procedures (Step M4)

119

4.3

Coding instructions for mortality: Multiple causes

4.3.1

Introduction

4.3.2

Uncertain diagnosis

4.3.3

Either ¨C or

4.3.4

Effect of connecting terms

4.3.5

Malignant neoplasms

4.3.6

Sequelae

4.3.7

Specific instructions on other ICD categories

4.3.8

Consistency between sex of patient and diagnosis

4.4

Perinatal mortality: guidelines for certification and rules for

coding

156

4.4.1

Certification of perinatal deaths

156

4.4.2

Statement of causes of death

157

4.4.3

Tabulation of perinatal mortality by cause

159

4.4.4

Coding of causes of death

159

4.4.5

Coding rules

160

122

122

122

122

125

128

152

153

155

4.5

Morbidity

4.5.1

Guidelines for recording diagnostic information for

single-condition analysis of morbidity data

4.5.2

Guidelines for coding ¡°main condition¡± and ¡°other

conditions¡±

4.5.3

Rules for reselection when the main condition is

incorrectly recorded

4.5.4

Chapter-specific notes

5. Statistical presentation

162

163

165

171

177

189

5.1

Introduction

189

5.2

Source of data

189

5.3

Level of detail of cause in tabulations

189

5.4

The recommended special tabulation lists for mortality

5.4.1

The condensed lists

5.4.2

The selected lists

5.4.3

Use of prefixes to identify the mortality lists

5.4.4

Locally designed lists

190

190

190

190

190

5.5

The special tabulation list for morbidity

191

5.5.1

Description

191

5.5.2

Modification of the special tabulation list for morbidity

according to national requirements

191

5.6

Recommendations in relation to statistical tables for

international comparison

5.6.1

Statistical tables

5.6.2

Tabulation of causes of death

192

192

193

Standards and reporting requirements related to fetal,

perinatal, neonatal and infant mortality

5.7.1

Definitions

5.7.2

Reporting criteria

5.7.3

Statistics for international comparison

5.7.4

Presentation of causes of perinatal mortality

193

193

195

195

198

5.7

5.8

Standards and reporting requirements related to maternal

mortality

199

5.8.1

Definitions

199

5.8.2

International reporting

199

5.8.3

Published maternal mortality rates

200

5.8.4

Denominators for maternal mortality

200

5.9

Proportion of deaths classified to ill-defined causes

201

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