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ICD-10 International Statistical Classification of Diseases and Related Health Problems

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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 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press through the WHO web site (http://www.who.int/about/licensing/copyright_form). 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 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. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. 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. 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 http://www. 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 Introduction 19 3.1.2 Use of the tabular list of inclusions and four-character subcategories 19 3.1.3 Two codes for certain conditions 20 3.1.4 Conventions used in the tabular list 23 3.1.5 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 v INTERNATIONAL CLASSIFICATION OF DISEASES 5.9 Proportion of deaths classified to ill-defined causes 158 5.10 Morbidity 158 5.11 Precautions needed when tabulation lists include subtotals 158 5.12 Problems of a small population 158 5.13 ‘Empty cells’ and cells with low frequencies 159 5.14 Recommendations 159 6. History of the development of the ICD 163 6.1 Early history 163 6.2 Adoption of the International List of Causes of Death 164 6.3 The Fifth Decennial Revision Conference 166 6.4 Previous classifications of diseases for morbidity statistics 167 6.5 United States Committee on Joint Causes of Death 169 6.6 Sixth Revision of the International Lists 170 6.7 The Seventh and Eighth Revisions 172 6.8 The Ninth Revision 172 6.9 Preparations for the Tenth Revision 173 7. Appendices 175 7.1 List of conditions unlikely to cause death 175 7.2 List of conditions that can cause diabetes 184 References 187 Index 189 vi 1.
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