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International Classification of Procedures in Medicine

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International Classification of Procedures in Medicine Volume l 1. Procedures for Medical Diagnosis 2. Laboratory Procedures 4. Preventive Procedures 5. Surgical Procedures 8. Other Therapeutic Procedures 9. Ancillary Procedures Published for trial purposes in accordance with resolution WHA29.35 of the Twenty-ninth World Health Assembly, May 1976 WORLD HEALTH ORGANIZATION GENEVA @ World Health Organization 1978 Publications of the World Health Organization enjoy copyright protection in accor- dance with the provisions of Protocol 2 of the Universal Copyright Convention. For rights of reproduction or translation of WHO publications, in part or in toto, applica- tion should be made to the Office of Publications, World Health Organization, Geneva, Switzerland. The World Health Organization welcomes such applications. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. PRINTED IN SWITZERLAND TABLE OF CONTENTS Page INTRODUCTION TABULAR LIST 1. PROCEDURES FOR MEDICAL DIAGNOSIS . 1-1 2. LABORATORY PROCEDURES . 2-1 4. PREVENTIVE PROCEDURES . 4-1 5. SURGICAL PROCEDURES . 5-1 8. OTHER THERAPEUTIC PROCEDURES . 8-1 9. ANCILLARY PROCEDURES . , 9-1 ALPHABETICAL INDEX . , 1-1 To b'e published: 3. RADIOLOGY AND CERTAIN OTHER APPLICATIONS OF PHYSICS IN MEDICINE 6 and 7. DRUGS, MEDICAMENTS AND BIOLOGICAL AGENTS INT RODUCTI ON This Classification is intended to present in a systematic fashion the many procedures used in different branches of medicine, a task which the World Health Organization is undertaking for the first time. The difficulties and problems encountered in preparing a Classific- ation of Procedures in Medicine are similar to those experienced for the International Classification of Diseases, aggravated by the absence of international experience in the fields to be covered. Although certain countries have experience in these fields, especially in the classific- ation of surgical procedures, their views and methods of approach are divergent enough to make the task of harmonizing their classifications a complicated one. Probably these considerations motivated the cautious approach taken in the report of the International Conference for the Ninth Revision of the International Classification of Diseases, convened by the World Health Organization at WHO headquarters in Geneva from 30 September to 6 October 1975 : "2. Classification of Procedures in Medicine In response to requests from a number of Member States, the Organization had drafted a classification of therapeutic, diagnostic and prophylactic procedures in medicine, covering surgery, radiology, laboratory and other procedures. Various national classifications of this kind had been studied and advice sought from hospital associ- ations in a number of countries. The intention was to provide a tool for use in the analysis of health services provided to patients in hospitals, clinics, outpatient departments, etc. The Conference congratulates the Secretariat on this important development and Recommends that the provisional procedures classifications should be published as supplements to, and not as integral parts of, the Ninth Revision of the International Classification of Diseases. They should be published in some inexpensive form and, after two or three years' experience, revised in the light of users' comments." Subsequently the Twenty-ninth World Health Assembly, meeting in May 1976, endorsed this recommendation in resolution WHA29.35,in which it approved "the publication, for trial purposes, of supplementary classific- ations of Impairments and Handicaps and of Procedures in Medicine, as supplements to, but not as integral parts of, the International Classific- ation of Diseases." The present provisional edition of the Classification of Procedures in Medicine has been prepared by WHO in compliance with this resolution, in the hope that it will serve as a basis for further collaboration and development. World Health Organization. Manual of the international statistical Preparation of the Classification Activities for the preparation of the proposals for the International Classification of Procedures in Medicine began at about the same time as those for the Ninth Revision of the International Classification of Diseases and were carried out in parallel. Scope and form At a meeting of a working party convened in April 1971 in Chicago, USA, under the auspices of the American Hospital Association, the following consensus was reached on certain requisites to be fulfilled by the Classi- f ication : (a) it should be susceptible of expansion for those who need greater detail, but it should also offer the possibility of use in a condensed form; (b) it should be applicable to inpatients and outpatients; (c) it should include all types of procedures to be recorded for statistical, administrative, clinical or research purposes, encompassing exploratory, radiological, surgical and other procedures of a diagnostic, prophylactic or therapeutic nature. In accordance with these recommendations, the present provisional Classification consists of nine chapters: 1. Procedures for medical diagnosis 2. Laboratory procedures l 1 3. Radiology and certain other applications of physics in medicine 4. Preventive procedures 5. Surgical operations 1 6 and 7. Drugs, medicaments and biological agents 8. Other therapeutic procedures 9. Ancillary procedures Structure The International Classification of Procedures in Medicine has a structure similar to that of the International Classification of Diseases. Each volume will contain a tabular list and an alphabetical index. The complete series of categories for the nine chapters are numbered from 1-100 to 9-823, the first digit denoting the chapter number. The To be published subsequently. vii Classification is significant at the three-digit level; the fourth digit provides for greater detail and precision. Optional fifth-digit sub- divisions are provided for in some categories. Sources Cha~ter1, on "Procedures for medical diagnosis", is based mainly on physicians ' current procedural terminology (~mericanMedical ~ssociation), but other sources have been also used, such as Canada's Schedule of unit values, the Ontario Medical Association list of fees and the Nomenclature des actes professionels (France). The classification of laboratory procedures (chapter 2) is based largely on a French project which was modified in order to take into account the ever growing number of new techniques. The chapter on "Radiology and certain other applications of physics in medicine" (chapter 3) was originally based on a Swedish classification, a French proposal and the classification used in Switzerland by the Bureau national de la Sant6 et du Bien-Etre, and later modified by the WHO Radi- ation Medicine unit in order to take into consideration the opinion of specialists from the International Radiological Society. Chapter 4, on "Preventive proceduresf', is based on reports of health centres in several countries and includes mainly methods and techniques traditionally considered as preventive and susceptible of application to individuals. The Eighth Revision of the International Classification of Diseases (Adapted) (United States Public Health Service Publication No. 1693) served as a basis for the classification of surgical operations (chapter S), but some items were extracted from other sources, particularly the Dutch code (Algemene Ziekenfondsen, 1968) and the Classification of the Office of Population Censuses and Surveys (England and Wales, 1974), as well as several other lists and working documents issued by hospitals and public health administrations in all regions of the world. However, the arrange- ment of categories is based on topography, not surgical specialty. Two chapters are provided for the classification of drugs, medicaments and biological agents (chapters 6 and 7). They follow as closely as possible the corresponding series of categories in sections 960-979 of the Ninth Revision of ICD, which classify the toxic effects of these sub- stances. The code numbers have been derived by omitting the ICD first digit "9" and by adding an additional digit for further detail. For example, the ICD category 960.0 Penicillins becomes 6-00 in the Drugs classification and the subdivisi%s 6-000 to 6-009 allow for identifi- cation of the varieties of penicillin. Chapter 8, on "Other therapeutic procedures", as indicated by its title, includes medical therapeutic procedures not elsewhere classified. The axis chosen is the type of intervention instead of the anatomical system. The final chapter, "Ancillary procedures1' (chapter g), contains all procedures not included in the preceding chapters. It is, therefore, a collection of marginal activities which might seem to have little relation- ship with the aims of most users of this classification. However, they have been included because they are, or might be, encountered as recorded procedures having
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