I

NATIONAL CENTER Serbs 4

For HEALTH STATISTICS Number 6

VITAL and HEALTH STATISTICS

DOCUMENTS AND COMMITTEE REPORTS

Report of the

UnitedStatesDelegationto the

International Conference

for the EighthRevisionof the

International Classification

of Diseases

Geneva, Switzerland =My 6-12, 1965

Discussion and recommendations at the Conference that was

concerned primarily with Eighth Revision of the International

Classification of Diseases and gave some consideration to

multiple-cause tabulation and analysis and to hospital statistics.

DHEW Publication No. (HSM) 73-1264

Washington, D .C, September 1966

U.S. DEPARTMENT OF

HEALTH, EDUCATION, AND WELFARE Public Health Service

John W. Gardner William H. Stewart

Secretary Surgeon General
Public Health Service Publication No. 1000-Series 4-No. 6
NATIONAL CENTER FOR HEALTH STATISTICS

FORREST E. LINDER, PH. D., Director

THEODORE D. WOOLSEY, ~@@ ~i?’eC~Or

OSWALD K. SAGEN, Pr.x.D., ~ni-rtatzt Dir#ctor

WALT R. SIMMONS, M.A., statistical Advisor

ALICE M; WATERHOUSE, M. D., ilfedical ~dvifor

JAMES E. KELLY, D.D.S., Dental zfdvi.ror

LOUIS R. STOLCIS, M.A,, Executive Ojiccr

OFFICE OF HEALTH STATISTICS. ANALYSIS

IWAO M. MORIYAMA, PH. D., Ckiej

DIVISION OF VITAL STATISTICS

ROBERT D. GROVE, PH. D., (Wej

DIVISION OF HEALTH INTERVIEW STATISTICS

PHXLXPS. LAWRENCE, Sc. D., (Y@

DIVISION OF HEALTH RECORDS STATISTICS

MONROE G. SIRKEN, PH. D.j Chief

DIVISION OF HEALTH EXAMINATION STATISTICS

ARTHURJ. MCDOWELL, Chief

DIVISION OF DATA PROCESSING

SIDNEY BXNDEB,Chief

Public Health Service Publication No. 1000-Series 4-No. 6

Library of Congress Catalog Card Number 66-61306
CONTENTS

Page

Background of the Conference -------------------------------------------

Organization”of the Conference ------------------------------------------

Work oftieConference --------------------------------------------------

Eighth Revisionof tie ICD-----------=--------------------------------

International Form of Medical Certificate ofCause of Death-- ------------

Lists for Tabulation ofMorbidity and Mortali&Data- --------------------

Nomenclature Re~lations --------------------------------------------

Adaptation of the ICD for Diagnostic Index ofHospital Records ------- -----

Multiple-Cause Tabulation and Analysis --------------------------------

The Role of WHO in Developing Health Statistics ------------------------

Hospital Statistics ---------------------------------------------------

Implications of Advances in Automatic Data Processing ------ ------------

National Committees on Vital and Health Statistics ----------------------

Future Meetings ---------------------------------- --------------------

Conclusions ---------------------------------------- ------------------

Appendix I. Re~rtof tie Conference -------------------------------------

1.

2.

Eighth Revision of the International Classification

0?–

1.1

1.2

1.3

Diseases(ICD)------------------------------------------------

General Structure of the Classification ------- -------------------

1.1.1 Numbering System of theClassification --------------------

1.1.2 Classification ofSpptoms -------------------------------

1.1.3 Notes Under ICDCategories --------- ---------------------

1.1.4 Supplementary Classifications-- --------- --------- --------

Categories and Sub-Categories of the ICD-----------------------

Editing of Manual ---------------------------------------------

Related Matters -------- --------- -------- -------- -------- ------- --

2.1

2.2

2.3

2.4

2.5

2.6

International Form of Medical Certificate of Cause

of Mati ----------------------------------------------------

Lists for Tabulation ofMorbidity and MortalityData- -------------

WHO Nomenclamre Re~lations --------------------------------

Adaptation of the ICD for Diagnostic Indexingof

Hospital Records --------------------------------------------

Multiple-Cause Tabulation and Analysis-- -----------------------

Rules for Selection of Cause of Bati ---------------------------

1

1

2

2

2

3

3

3

3

4

5

5

5

6

6

8

9

9

9

9

9

9

9

10

10

10

10

10

11

11

11
CONTENTS—Continued

Appendix I. Report of the Conference—Continued Dam.

2.7 Definitions and Other Issues Relating to Perinatal r

Morbidity and Mortality --------- ----, --------------- ---------

2.7.1 Definition of Foetal Death --------------------------- ----

2,7.2 Definition of the Perinatal Period ------------------------

2.7.3 Recording of Causes of Perinatal Death -------------------

2.7.4 Recording of Other Data Pertinent to the

Perinatal Period -------------------------------------

2.8 Publication of RevisedManual ---------------------------------

3. National and International Developments in Health Statistics-- --------

3.1 Role of WHO in DevelopingHealth Statistics ---------------------

3.2 Hospital Statistics --------------------------- ----------------

3.3 Implications of Advances in Automatic Data Processing ----------

3.4 National Committees on Vital and Health Statistics ---------------

Appendix II.

Appendix 111.

.

1;:

III.

IV.

v.

VI.

VII.

VIII.

IX.

x.

XI.

XII.

XIII.

XIV.

xv.

XVI.

E XVII.

N XVII.

List of Participants at the Conference -----------------------

International Classification of Diseases—Eighth

Revision -----------------------------------------------

Infective and Parasitic Diseases ----------------------------

Neoplasms -----------------------------------------------

Endocrine, Nutritional and Metabolic Diseases ---------------

Diseases of Blood and Blood-Forming Organs ------ ----------

Mental Dsorders -----------------------------------------

Diseases of the Nervous System and Sense Organs-- ----------

Diseases of the Circulatory System -------------------------

Diseases pf the Respiratory System -------------------------

Diseases of the Digestive System ---------------------------

Diseases of Genito-Urinary System -------------------------

Complications of Pregnancy, Child-Birth andthe Puerperium--

Diseases of the Skin and Subcutaneous Tissue -------- --------

Diseases of the Musculoskeletal System and Connective Tissue--

Congenital Anomalies -------------------------------------

Certain Causes of Perinatal Morbidity and Mortality--- -------

Symptoms and Ill-DefinedConditions ------------------------

Accidents, Poisonings and Violence (External Cause) ---------

Accidents, Poisonings and Violence (Nature of Injury,

N8M-N999]---------------------------------------------

11

11

12

12

12

12

13

13

13

13

13

15

21

21

27

32

34

34

36

39

42

43

46

48

50

52

53

55

56

57

64
U.S. DELEGATION

Forrest E. Linder, Ph.D. (Chairman of Delegation)

Director, National Center for Health Statistics

Public Health Service

Washington, D.C.

Louis N. Dakil, M.D.

Physician and Surgeon

110 East Carl Albert Parkway

McAlister. Oklahoma

Paul M. Densen, D.SC.

Deputy Commissioner

New York City Department of Health

New York, New York

Robert Dyar, M.D.

Chief, Division of Research

California State Health Department

Berkeley, California

Eugene L. Hamilton

Director, Medical Statistics Agency

Surgeon General’s Office

Department of the Army

Washington, D.C.

Iwao M. Moriyama, Ph.D.

Chief, Office of Health Statistics Analysis

National Center for Health Statistics

I?ublic Health Service

Washington, D.C.

Brian MacMahon, M.D.

Professor and Chairman

Department of Epidemiology

Harvard School of Public Health

Cambridge, Massachusetts

William H. Stewart, M.D.

Assistant to Special Assistant to the

Secretary (Health and Medical Affairs)

Office of the Secretary

Department of Health, Education, and Welfare

Washington, D.C.

Franklin D. Yoder, M.D.

Director of Public Health

Illinois State Health Department

Springfield, Illinois
THIS IS A REPORT of the Inte?%ational Conference

fov the Eighth Revision of the Internutiomd Classij%

cation of Diseases.

The revised classification represents an important

advance and, with some adaptations, it is expected to

meet the major needs for a disease classification in

the United States. The Conference recommended that

the World Health Organization publish the Eighth Revision of the International Classification with analphabetic index early in 1967. The Eighth Revision is expected to go into efjiect on JanuaYy 1, 1968.
REPORT OF THE U.S. DELEGATION TO THE

INTERNATIONAL CONFERENCE FOR THE

EIGHTH REVISION OF THE ICD

BACKGROUND OF THE

CONFERENCE

The International Conference for the Eighth

Revision of the International Classification of

Diseases (ICD) convened by the World Health

Organization (WHO) met in the Palais des Nations,

Geneva, from July 6-12, 1965. As is evident from

the Conference title, its primary purpose was to

agree on the Eighth Revision of the International

Classification of Diseases and related matters.

Discussion of other topics related to health statistics was also included on the agenda.

The efforts of countries to achieve some

degree of standardization in the classification of

disease and causes of death is perhaps one of the

earliest efforts at international cooperation. The

first International Statistical Congress, held at

Brussels in 1853, requested Dr. William Farr

(England) and Dr. Marc d’Espine ‘(Switzerland)

to prepare ‘‘une nomenclature uniforme des

causes de d~c>s applicable> tous les pays. ” The

next Congress in 1855 adopted a nomenclature

with this objective in mind, and this first list was

revised in 1864, 1874, 1880, and 1886 in successive

sessions of the Congress. By 1891 the International

Statistical Institute, successor to the International

Statistical Congress, had taken up the task of

achieving international comparability in this field.

Acceptance of the proposed classifications was

slow, but in 1898 the generaI principles were

endorsed by the American Public Health Association; and other countries had begun to use the

internationally recommended concepts.

In 1900 the French Government convoked

in Paris the first International Conference for

the revision of the Bertillon Classification of

Causes of Death and this Conference, attended

by delegates from 26 countries, adopted the First

International Classification. The French Government called conferences for the successive revisions of this Classification in 1909, 1920.1929,

and 1938. At the time of the 1929 and 1938 revisions, the International Statistical Institute and

the Health Organization of the League of Nations

were active in the technical aspects of mortality

classification problems.

Because of the activity of the League of

Nations in this work, the responsibility for the

problem was embodied in Article 21 of the

Constitution of the World Health Organization,

which gives WHO the authority to adopt regulations concerning ‘‘. . . (b) nomenclature with respect to disease, causes of death and public

health practices. . . .“

Conferences for the revision of the ICD have

been held under the auspices of WHO in 1948 and

1955 and now in 1965.

ORGANIZATION OF THE

CONFERENCE

For the most part the Conference worked in

plenary sessions, establishing only one major

working group or committee. Delegates from

Australia, the United Kingdom, and the United

States and technical staff of the WHO Secretariat

were in this important working group. The function

of this committee was to examine the numerous

detailed revision proposals that various countries

submitted for consideration and to decide if the

1
proposals were minor or editorial in character

or if they were important decisions calling for

Conference action. The major” proposals as

identified by this committee were submitted to

the full Conference (WHO/HS/8 Rev. Conf./lO)

and final decisions taken at plenary sessions.

It is notable that the attendance of the

members of the delegations from the countries

was extremely high throughout every session—the

number of absences being unnoticeable. The discussions were of a strictly technical character

with no introduction of extraneous issues or comments at any time. The Conference functioned with

a high degree of goodwill and willingness to make

technical compromises in order to reach a consensus. At no time was it necessary to take a

formal vote, the Chairman being able to sense

‘and express a generally acceptable conclusion

after adequate expression of differing national

viewpoints by the various delegations.

The final re~rt of the Conference (WHO/HS/

8”Rev. Conf./ll.65) is given in Appimdixes I, II,

and III.

WORK OF THE CONFERENCE

Eighth Revision of the ICD

The Eighth Revision proposals were discussed on the assumption that the new Nomenclature Regulations would provide for obligatory

use of the three-digit categories of the International Classification of Diseases and leave the

use of the fourth-digit categories optional. It was

recognized that national needs varied and that

use of or form of fourth-digit subdivisions for

national purposes would differ from country to

country.

The Conference reviewed the proposals submitted section by section. The Chair entertained

only comments of a substantive nature and referred all matters of an editorial nature to the

Secretariat. These comments were later examined by a small working group established for

this purpose. (For report see WHO/HS/8 Rev.

cin’lf./lo.)

By and large, the issues that were raised

concerning the proposed revision were minor

in nature and generally dealt with fourth-digit

subdivisions. Most of the changes involving fourthdigit categories were not seen as presenting

particular problems in the United States. A

possible exception’ is the deletion of the proposed

fourth-digit subdivisions under diabetes mellitus

that show various clinical manifestations and

complications of the disease. It is expected that

some adjustment will need to be made in the

United States. The proposal for giving more

prominence to the reactive psychoses would

have caused difficulty, but the solution which was

adopted should” not cause any problems in the

compilation of mental disease statistics in the

United States.

At the conclusion of discussion of revision

proposals, the WHO Secretariat raised a question

about the status of fourth-digit subdivisions

which indicated a divergence of views from those

expressed by the Conference. The Conference

confirmed the notion of national options with

respect to fourth-digit categories but expressed

the hope that fourth-digit categories provided

in the International Classification of Diseases

would be used by countries electing to go to the

fourth-digit level of detail.

.There was considerable concern expressed

by several delegations such as Australia, Norway, Canada, the United Kingdom, and the United

States that WHO would not be able to publish the

Eighth Revision of the ICD with an alphabetic index in time for its use at the beginning of 1968.

Accordingly it was recommended in fairly strong

terms that WHO complete this task as early as

possible in 1967. The availability of manuals early

in 1967 is particularly important for countries

like the United States that need to develop

training material and organize training courses

to be offered to coders in State health departments before January 1, 1968.

International Form of Medical Certificate

of Cause of Death

Since no serious consideration had been

given to changes in the basic concept of causeof-death statistics, no substantive changes could

be proposed on the medical certificate form.

The Conference stressed the importance of

national studies of the completeness, reliability,

and validity of diagnostic information reported on

2
death certificates

quality of medical

evaluation studies.

and the need to improve the

certifications based on such

Lists for Tabulation of

Morbidity and Mortality Data

The topic concerned the development of short

lists of selected diagnoses to be used for special

tabulation purposes. WHO proposals suggested

two selected lists of 150 and 300 titles.

The U.S. delegation took the position that the

problems of developing short lists should be

discussed at the Conference but that final endorsement of such lists should not be made since WHO

proposals had not been available for study prior

to the Conference.

The WHO proposed lists were not generally

accepted by the Conference. Various discussants

pointed out the need for lists with fewer numbers

of titles. The U.S. delegation emphasized that the

lists would be more generally useful if fewer

titles were used for infectious diseases in order

to expand the number of titles available for

chronic diseases.

It was generally agreed that draft lists of

50 and 150 causes and an optional list of 250-300

causes should be prepared by WHOand circulated

to countries for comment.

Nomenclature Regulations

There was an extended discussion of the

Nomenclature Regulations and how they should

be modified in relation to the revised ICD. The

delegation from the’ United Kingdom was particularly concerned with this question and had submitted a note to the Conference stating modifications of the Regulations that were considered

necessary concurrent with the adoption of the

revised ICD. Revisions of the Regulations were

essential to restore the right of countries to make

reservations to changes in the ICD—such a right

to make reservations apparently expires at the

time of the prior revision.

The necessity for such changes in the Regulations was generally recognized and the proposals

of the United Kingdom were supported by the

U.S. delegation and the Conference in general.

Beyond this, it was also generally recognized

that the Regulations were somewhat obsolete

and unnecessarily y detailed in various respects.

The United States proposed that a thorough study

be made of the Regulations preliminary to a

general redrafting, and the Conference recommended that the Regulations be reexamined and

revised Regulations be submitted to the World

Health Assembly (wHA).

At the final session it was agreed that the

report of the Conference would indicate the

sequence of steps to be followed—namely, that

draft Regulations would be circulated to countries

for comment and that proposed new Regulations

would then be redrafted on the basis of such

comment prior to their circularization as WHA

working documents.

Adaptation of the ICD for

Diagnostic Index of Hospital Records

The importance of utilizing some form of the

ICD for indexing diagnostic data on hospital

records was recognized, especially with respect

to its implications in terms of hospital morbidity

statistics. There was no disagreement about the

desirability of an adaptation. Although a number

of countries had already made national adaptations of the ICD for diagnostic indexing purposes,

it was suggested that more experience was needed

before a satisfactory international adaptation

could be made. Therefore, it was suggested that

interested countries be encouraged to experiment with ways in which an adaptation could be

made and that WHO keep in touch with these

experiments so that the question of developing

an international adaptation could be examinec

at some time in the future. On the other hand,

there were those who felt that the proposed

Eighth Revision provided an adequate framework

of a classification suitable for hospital indexing

in some countries.

Multiple-Cause Tabulation and Analysis

The item was introduced by the U.S. delegation with a paper outlining studies of multiple

causes appearing on U.S. death certificates (WHO/

HS/ICD/75.65). The U.S. delegate noted the in-
tention of the United States to prepare multiplecause tabulations, the interest of other countries,

and the need for development of coding rules and

procedures. Although it is premature to seek

to establish international regulations in this

regard, the United States would welcome an expression of interest from other countries in cooperative approaches to the problems.

Interest in such studies was expressed by

the delegates from Germany, Norway, and the

United Kingdom. Several other countries are

clearly in a position to participate. The Netherlands has been coding and tabulating multiple

causes since 1961. Australia is about to begin

studies.

The delegates from Norway, the United

Kingdom, and the United States, as well as the

WHO Secretariat, stressed continuing interest

in tabulations based on a single condition selected

as the underlying cause. Such tabulations are

necessary for the study of trends and are based

on conditions of a degree of severity sufficient

to overcome some of the problems of diagnostic

accuracy and completeness of reporting associated with conditions of lesser severity.

The delegate from Australia suggested that

all diseases and conditions present at time of

death be included in multiple-cause tabulations.

It was felt that as long as the collection of multiple-cause data was based on information available

on death certificates, those conditions existing

coincidentally, that is, not contributing to death,

should not be considered part of multiple-cause

tabulations.

It was pointed out that the results of multiplecause tabulations will vary greatly according to

the form of the death certificate, the responsiveness of the medical certifiers to the possibilities

introduced by the new procedure, and other factors (Denmark, Norway, Yugoslavia, U.S.S.R.,

Australia, and Finland). These problems will

require considerable investigation. Nevertheless,

after recognizing the problems and limitations of

multiple-cause tabulations at the present time, it

still seems necessary to maximize the use of

information that is now recorded on certificates

(United States).

Denmark and the U.S.S.R. expressed interest

in undertaking multiple-cause tabulations on a

limited scale—perhaps on only three or four

diseases.

Two proposals for limited multiple-cause

analysis were made. One, put forward by WHO

Secretariat, provided a means for coding in a

single column selected cause combinations now

recognized as of special interest (WHO/HS/ICD/

79.65). This proposal was not commented upon.

The other, from Israel, proposed that a schedule

of conditions of particular interest be set up.

One or two of these conditions would be selected

each year and special efforts would be made by

all participating countries to assemble data on

the diseases associated with the condition selected

during the year (WHO/HS/ICD/77.65). Although

some countries in favor of limited multiplecause work (Denmark, U.S.S.R.) referred favorably to the Israeli proposal, no consideration was

given to the problems evident in the requirement

of the proposal that special efforts be made to

obtain more complete certification of the selected diseases.

The Chair proposed that countries interested

in development of multiple-cause statistics should

make their interest known to the WHO Secretariat

and that the Secretariat should take the initiative

in stimulating discussions at the international

level. This proposal had the agreement of the

Conference.

The Role of WHO in Developing

Health Statistics

This item and the topics discussed below were

general topics grouped under the agenda topic of

National and International Developments in Health

Statistics. Very little of the Conference time was

allotted to this group of topics since the principal

purpose of the Conference related to the Eighth

Revision of the ICD and associated questions.

The discussion of the role of WHO was based

on a document prepared by a WHO consultant

(WHO/HS/8 Rev. Conf./3.65) and comprised a

general review of the area of activities of the

WHO unit concerned with a critique of its effectiveness and program gaps. The ensuing discussion was rather discursive, although many

delegations made comments, and consisted to a

large degree of indications of areas of work in

health statistics that could properly be included

in the WHO program.

The Conference, in general, and the Secretariat seemed to accept the general appraisal of

4
the consultant’s report and no specific action

seemed appropriate.

Hospital Statistics

This topic was introduced by a member of the

Canadian delegation who described the program

of hospital statistics now being developed in

Canada and by a U.S.S.R. paper on the development

of hospital statistics in that country as related

to automatic data processing methods. The U.S.

delegation described briefly the new program of

hospital statistics being started in the United

States.

Hospital statistics may be used for planning

purposes relating to the size and nature and

financing of the hospital as a physical plant. They

may also relate to illnesses treated in the hospital which might be of value for epidemiological

purposes. With regard to the latter use, the

questions are intimately bound up with the

subject of the adaptation of the ICD for diagnostic

indexing purposes; therefore much of that discussion applies here.

There was general recognition that this

emergent area of health statistics would be of

increasing importance in many countries of the

world and that the field was still in a fluid state

as far as the technical aspects of the program

are concerned. Accordingly, WHO could make an

important contribution at this time by completing

material in the form of handbooks on methods

and on standardization of definitions and concepts

and by assisting in the clarification of concepts

and objectives. Recommendations to this end

had previously been made by the Expert Committee on Heaith Statistics in its Eighth Report.

The Conference gave general support to these

recommendations.

It was also agreed that it was desirable for

the various countries that are developing hospital

statistics to keep in close touch with each other

so that problems affecting international comparability may be discussed.

Implications of Advances in

Automatic Data Processing

This topic is obviously of major interest to a

few countries advanced enough to be using electronic equipment in processing health data. In

spite of this there was widespread interest in the

topic as presented in a paper prepared by the

General Register Office of the United Kingdom.

The U.S. delegation outlined current activities

in the United States in computer usage in health

fields. Recognizing the future importance of

these methods, the Conference recommended

that WHO act as a clearinghouse for information

on the use of computers in health statistics.

National Committees on

Vital and Health Statistics

The discussion on National Committees on

Vital and Health Statistics was opened by the WHO

Secretariat with a summary of the existence,

activities, and so forth of such Committees in 47

nations and a description of French experience

with a national coordinating committee for health

statistics. The issue here, if one existed, was

the role of WHO in relationship to such Committees, particularly in stimulating their formation and development and in appraising their

activities.

Discussion by delegates from Australia,

France, Yugoslavia, and the United States revealed

different patterns of numbers, responsibility, and

operations. Regardless of the pattern, there was

general support of the U.S. point of view that such

Committees should be: (1) National organizations,

reporting to a national agency to be determined

by the government concerned (and not international

in a direct sense); (2) Advisory @ot executive),

serving in the capacity that best suits the needs

of the government concerned, with full appreciation that advice may be accepted or rejected

(3) So characterized as to provide a representative

national forum for the definition of problems of

health statistics, stimulation of solutions by

appropriate ad hw subcommittees, and dissemination of information concerning their interests

and activities.

There was no expression of need for activity

on the part of WHO beyond response to national

requests for assistance in formation of a committee on health statistics and collection and

dissemination of information concerning their

use and accomplishments. It is a fair conclusion

to assume that those nations functioning by democratic processes use national advisory committees on health statistics in a variety of ways

5
(coordination, policy formulation, education, technical development, evaluation), depending on national need and desire, and generally find them

useful instruments in their national health statistics programs.

FUTURE MEETINGS

No decisions were made or discussed in a

formal way regarding future international conferences dealing with the questions of this Confer&nce. However, it was assumed throughout

the meeting that in 1975 or earlier there would

be a Ninth Revision Conference, and many points

were made regarding additional steps that could

be taken to achieve greater international comparability of mortality and morbidity statistics by

that time. It was also assumed that prior to the

Ninth Revision Conference there would be a long

program of national, bilateral, and multilateral

studies and consultations and various WHO Expert Committee activities preparatory to the next

revision. This would follow the established pattern

of previous revisions.

CONCLUSIONS

In preparing for the Eighth Revision of the

International Classification of Diseases begun

in 1959 in the United States, the various broad

needs for a disease classification were recognized. From the outset, the United States pressed

for a disease classification suitable for indexing

hospital diagnoses and for hospital morbidity

statistics in addition to the traditional uses of the

ICD for classifying causes of death. This view

was not shared by many countries which were

prec@upied with the need for obtaining more

information on causes of death by providing in

the body of the International Classification of

Diseases categories dealing with combinations

of various diseases. This approach to the classification of causes of death was criticized by Dorn i

as an inflexible and otherwise unsatisfactory

method for producing cause-of-death statistics.

lDom, H. F.: Some considerations in the revision of the

International Statistical Classification, Pub. Health Rep.

78:175-179, Feb. 1964.

Furthermore, the introduction of various combinations of diseases into the disease classification interferes with the use of the classification

for coding multiple diagnoses as needed in

classifying morbidity data and for securing maximum use of diagnostic information reported on

death certificates.

The preliminary draft classifications were

generally unsatisfactory from the U.S. point of

view. After successive modifications, the disease

classification finally adopted by the Conference

provides a generally satisfactory structure for

use in the United States. With certain adaptations

with respect to the details of the classification

as provided for by the Conference agreement, it

is expected that the major needs for a disease

classification in the United States will be satisfied.

The revised classification represents an

important advance over the previous revision of

the International Classification of Diseases. The I

proposed section on mental disorders is mQre

closely aligned with the views of American

psychiatry. Greater recognition is given to dental

conditions and to congenital anomalies that are

of interest in genetic studies of the human population. The classification of nature of injury,

especially adverse effects of drugs, has been

updated to meet needs of hospitals. The revision

proposed by the Conference goes a long way to

meet increased demands in the United States

during the coming decade for a suitable disease

classificatiofi for various purposes.

The structure of the classification provides

a satisfactory basic framework for adaptations

for various purposes. The U.S. delegation is of

the view that the option on fourth-digit categories

should be exercised and study given to the preparation of an adaptation of the ICD for hospital

indexing and for hospital morbidity statistics in

the United States. It would be important and

extremely desirable if a single adaptation would

serve all the official needs for a disease classification in the United States.

The U.S. delegation suggested that a fullscale multiple-cause coding and tabulation program be undertaken in the United States on a

regular basis after a study is made of methodological problems involved in coding and tabulating

multiple diagnoses reported on death certificates.

6
In view of the interest expressed by several

countries in preparing multiple-cause tabulations,

it was also suggested that the United States collaborate with interested countries with the view

to establishing comparable procedures and minimum tabulation specifications of associated diseases for comparative purposes.

It is expected that during the decade that the

Eighth Revision of the ICD will be in effect extensive use will be made of the classification for

morbidity statistics. This experience will be

invaluable for the next revision. However, more

opportunity should be given to study revision proposals than was provided for the Eighth Revision.

National and international work on the Ninth

Revision of the International Classification of

Diseases should be started as early as possible.

In this connection, consideration should be given

to reexamination of the concept of the underlying

cause of death as well as to the kind of multiplecause data that should be collected. In preparation for the Ninth Revision, it is suggested that

where possible studies be undertaken by the United

States in collaboration with one or more other

countries.

With regard to other items discussed by the

Conference, the U.S. delegation generally endorses the views expressed. In most instances,

the U.S. delegation would have Preferred stronger,

positive, and more far-reaching recommendations

on the various questions under discussion. For

example, the question of definition of the perinatal

period is an important one from the standpoint

of producing perinatal morbidity and mortality

statistics. For the purpose of assessing perinatal

and infant mortality statistics, it is necessary

to go further in determining actual reporting

practices of attendants at birth as well as registration and statistical practices. Studies of definitions actually used as well as completeness of

perinatal death registration are essential for

assessment of the level of infant mortality rates

in developed countries. In other areas of mortality statistics, it is important that studies be

made of the validity, reliability, and completeness

of diagnostic data reported on medical certification of causes of death. This is particularly true

for time-trend comparisons of national multiplecause information or international comparisons

of multiple-cause data. Although international

recommendations on these points did not emerge

from the Conference, the U.S. delegation notes

the essential nature of these evaluative studies

in the United States.

The question of use of electronic computers

is an academic one for many countries represented

at the Conference. For countries such as the

United States, the United Kingdom, and Canada,

the problem is a practical one. In fact, the

feasibility of conducting large-scale statistical

programs in hospital morbidity and on multiple

causes of death depends to some extent on the

future development of procedures for encoding

of diagnostic information by use of computers.

This is in areas where important developments

may be expected. The U.S. delegation noted

with interest the efforts devoted to this problem

and expressed the hope that international collaboration will be possible on a bilateral or

multilateral basis. A coordinated attack on this

problem is essential if satisfactory computer

encoding procedures are to be developed before

1968.

—ooo —

7
APPENDIX I

REPORT OF THE

The International Conference for the Eighth Re.

vision of the International Classification of Diseases

convened by the World Health Organization met in the

Palais des Nations, Geneva, from 6 to 12 July 1965.

The Conference was attended by the following 36

Member States and one Associate Member:

Australia

Austria

Bulgaria

Canada

Czechoslovakia

Denmark

Finland

France

Federal Republic

of Germany

Ghana

Guatemala

Hungary

India

Iran

Israel

Italy

Japan

Kuwait

Madagascar

Mali

Netherlands

Norway

Poland

Portugal

Romania

Saudi Arabia

Spain

Sweden

Switzerland

l%ailand

Togo

Union of Soviet

Socialist Republics

United Kingdom of

Great Britain and

Northern Ireland

United States of

America

Venezuela

Yugoslavia

Mauritius, Associate

Member

The United Nations Orgardzation and the International ‘Lakour Organisation as well as three international non-government organizations, namely, the

International League of Dermatological Societies, ‘the

International Society of Cardiology and the International

Union against Cancer, sent representatives to participate in the Conference. The list of participants is

attached as Appendix IIIto this report.

Dr. P. D. ~rolle, Deputy Director-General of the

World Health Organization, opened tie Conference on

behalf of the Director-General. It was agreed that the

sessions be public and that the Rules of Procedure

for Expert Committees. except Article 3, and Articles

CONFERENCE

43, 44 and 45 of the Rules of Procedure of the Executive

Board apply for the conduct of the sessions.

The Conference elected the following officers:

Chairman:

Vice-Chairmen:

Rapporteurs:

Mr. M. Reed

Registrar General for England and

Wales,

General Register Office

United Kingdom of Great Britain and

Northern Ireland

Dr. F. E. Linder

Director

National Center for Health Statistics

United States of America

Dr. V. K. Ov;arov

Chief

Health Statistics

Department of the Semashko Institute

of Health Administration and History

of Medicine

Union of Soviet Socialist

Dr. D. Curiel

formerly Medical Chief

Division of Epidemiology

$tatistics

Ministry of Health

Venezuela

Dr. M. J. Aubenque

Chef

Division des Statistiques

Republics

and Vital

sanitaires

Institut ‘national de la Statistique et

des Etudes economiques

France

Dr. R. H. C. Wells

First Assistant Director-General

Commonwealth Department of Health

Australia

The Conference adopted the aKenda* which, apart

from the Eighth Revision of the Int&national Classifi-
cation of Diseases and matters related to it, included dorsed the views of the Expert Committee on this

other items reflecting national and international de- subject.

velopments in the field of health statistics. It was also agreed that when it was appropriate

and p&+sible to include separate sub-categories for

1. EIGHTH REVISION OF THE INTERNATIONAL “Other” and “Unspecified,” they should be numbered

CLASSIFICATION OF DISEASES (ICD) “consistently .8 and .9.

1.1 General structure of the Classification 1.1.2 Classification of symptoms

Before reviewing the revision proposals for the

various sections of the Classification, the Conference

considered some of its more general aspects.

1.1.1 Numbering system of the Classification

The Conference recalled the comments of the

Expert Committee on Health Statistics in its Ninth

Report’: on the numbering system of the Classification

and endorsed the view that the three-digit categories

should form “the basic framework of the ICD in all its

varied applications.” ‘In regard to the fourth digit, the

Expert Committee had said

“The role of the fourth digit was the identification

of greater detail within the three-digit categories.

The extent of &e detail needed would vary for

different applications of the ICQ greater, for

example, in diagnostic indexing and special studies

than in routine statistical use. Furthermore, the

fourth-digit detail required in the various sections

of the Classification would 1differ in different

countries or regions. The ICD, therefore, should

include the essential and desirable fourth-digit

sub-divisions but countries should be free to use

them or not or even to prepare their own fourthdigit adaptations instead. The Committee considered, however, that the internationally recommended four-digit structure would be suitable

for most purposes and that countries would only

rarely need to depart from it. Any departure from

the fourth digits of the ICD must be clearly

identified as such and must not affect the contents

of the three-digit categories concerned. ”

The Conference appreciated the need for flexibill~

at the level of the fourth digit, though it was clear that

in some sections, e.g. the perinatal section, meaningful

statistics would require four-digit coding, but was concerned that the option to vary the fourth-digit breakdown should not be used more than is necessary. The

Conference considered that this option need be exercised only in exceptional circumstances, when the

internationally recommended fourth digits were inappropriate for national purposes and could not be

expanded with suitable additional fourth-digit categories. Subject to this comment, the Conference en2WH0/HSACD/74.65

The” Conference agreed on the continuing need for

a special section of the ICD for the classification of

symptoms which do not point definitely to a given

diagnosis and cannot therefore be asaigned to a category in the disease sections of the code. It was appreciated that a final revision of this section would require

a systematic review of all terms in the presmt alphabetical index in relation to this criterion.

1.1.3 Notes under ICD categories

The Conference requested WHO to review the notes

defining the content of categories with a view to making

them more immediately intelligible to coders and to

persons using the Classification for the purpose of

interpreting published statistics.

1.1.4 Supplementary classifications

The Conference reviewed the functions of the

supplementary (Y) classifications. hat for causes of

stillbirth would now disappear since it “was integrated

into Section XV, “Certain causes of pertiatal morbidity

and lmortality.” The categories YOO-Y29 were regarded

as essential to provide a full count of admissions to

hospital, sttendances at out-patient clinics, etc. in

respect of persons who were not sick and who could

not, therefore, be classified to the main code. ?&e

Conference accordingly considered that this classification, stlitably revised, should appear in the Manual of

the ICD.

The classification of impairments in categories

Y40-Y88 was seen as a parallel code, collecting in one

group a number of conditions scattered throughout the

main code. It had been used by some countries in health

surveys and the Conference, appreciating that such

surveys were likely to increase, considered that it

would be useful if such a classification appeared in the

Manual of the ICD for optional use.

1.2 Categories and sub-categories of the ICD

The Conference considered the recommendations

in the ninth report of the Expert Committee on Health

Statistics (WHO/HS/ICD/74.65) and the revision proposals annexed to it (WHO/HS/ICD/74.65 Add.1-17),

which were the outcome of two meetings of the SubCommittee on Classification of Diseases and of com9
ments from countries. ‘Ihe Conference established a

working group to examine national amendments submitted during the Conference.

Adopting, with a few modifications, the report of

the working group (WHO/HS/8 Rev. Conf./lO.65),

amending the revision proposals in WHO/HS/ICD/74.65

Add.1-17, the Conference

RECOMMENDS that the revised Detailed List of

Categories and Sub-Categories shown in Appendix 111

constitute the Eighth Revision of the International

Classification of Diseases.

1.3 Editing of Manual

me Conference recognized that certain inconsistencies may come to light during the process of editing,

especially in preparing the list of inclusions, and agreed

that the Secretariat effect the necessary corrections.

2. RELATED MATTERS

2.1 International Form of Medical Certificate of cause

of death

The Conference noted that the Expert Committee

on Health Statistics and its Sub-Committee did not propme any change of substance in the International Form.

While endorsing this view the Conference discussed the

value of some editorial changes which appeared useful IYom the experience of some countries. It was also

stressed that explicit definitions should be given in the

Manual of the ICD for the items contained in the medical

certificate. Attention was called to the need for additional questions outside the medical certificate of

cause of death to obtain information on the type and

circumstances of violent deaths which would allow

proper classification in the External-cause Section.

‘Ihe Conference having considered the views expressed on the medical certificate of cause’ of death

RECOMMENDS that no change of substance be

introduced in the In~ernational Form of Medical Certificate of Cause of Deati; that the International Form be

r,eviewed in respect of editorial improvement and that

explicit definitions be given in the Manual of the items

in the Medical Certificate of Cause of Death. Further

RECOMMENDS that countries who have not already

done so make provisions in the death certificate for

obtaining information on the type and circumstances

of violent deaths.

The Conference also discussed the variations bound

to exist in stating the cause of death in respect of

completeness, accuracy and reporting habits. It noted

with satisfaction the studies made or being made on the

national and international level and considered it

desirable that such studies be undertaken with a view

to increasing the reliability of the basic data and to

improve medical certification of cause of death.

2.2 Lists for tabulation of morbidity and mortality data

The Conference reviewed the lists of 100 and 300

titles submitted to the Conference? which had been

drawn up in accordance with a recommendation of the

Sub-Committee on Classification of Diseases.4 Concern

was expressed that these lists were too long for the

convenient publication of statistics, especially when

cross-classified with sex and age or other factors. The

Conference considered that lists of the present length

of 50 and 150 titles were sufficient for the purposes

required by the WHO Nomenclature Regulations:

RECOMMENDS that WHO revise the Intermediate

List of 150 Causes and the Abbreviated List of 50

Causes and circulate them to countries for comment

before deciding their final form and including them in

the Manual.

The Conference considered that a longer list, of

250 to 300 titles, might well be included in the Manual

for optional use.

2.3 WHO Nomenclature Regulations

The Conference considered and supported a proposal ~ for amending the Nomenclature Regulations to

enable countries to review and restate their positions

on these Regulations following each revision of the

ICD. It was recognized that the adoption of the Eighth

ICD Revision would necessitate consequential amendments to some of the articles of the Nomenclature

Regulations and that, in particular, Articles 1 and 20

of the present Regulations did not provide in a simple

manner for periodical revisions of the ICD. It was

suggested that the Regulations should be simplified

by removing technical details concerning items such as

age groupings flom the basic articles and by listing

them separately elsewhere within the Regulations. me

Conference further noted that some of the articles,

such as Article 11 referring to the confidential nature

of medical information given on death certificates, made

mandatory international obligations on matters which

are of solely national concern.

The Conference therefore

RECOMMENDS that WHO re-examine the Nomenclature Regulations taking into account the above

comments, and any fimther proposals put forward by

Member countries, and prepare revised draft regulations for submission to the World Health Assembly.

The Conference was informed that Member countries would be given an opportunity to examine and

comment upon a preliminary draft of the revised Regulations before preparation in a final form for submission to the World Health Assembly.

%HoAsAcD/78.65

4WEOASACDK!2& 50

%EO/HSACD/76.65

10
2,4 Adaptation of the ICD for diagnostic indexing of

hospital records

The Conference noted that the current ICDhadbeen

adapted by a number of countries for the purposea of

diagnostic indexing, and that these adaptations had been

welcomed and widely used in hospitals. Thefe was no

doubt that interest in this use of the ICD was both

strong and growing. At least one of these adaptations,

however, had found it necessary to depart from the

three-digit structure of the ICD, and this had led to

some confusion in coding.

The Expert Committee on Heal~ Statistics in its

ninth report o had recommended that WHO should prepare such an adaptation on the basis of the eighth

revision of the ICD, using the three-digit categories as

the framework. The view was expressed to the Conference that in some countries the same personnel

handled records from many sources and that for them

there would be some advantage if the fourth digits for

codfng and for indexing conformed as closely as possible.

The Conference noted that the Eighth Reyision of

the ICD had been constructed with hospital indexing

needs in mind and considered that the revised classification would be suitable in itself for hospital use in

some countries. However; it was recognized rhat the

basic Classification may provide inadequate detail for

diagnostic indexing in other countries.

The Conference, therefore,

RECOMMENDS that WHO, taking into consideration

the increased specificity required, prepare an adaptation of the revised classification more widery applfcidire

for hospital indexing.

An essential complement to a diagnostic index is a

code of operations and procedures. Examples of such

a code had been prepared by several countries and the

Sub-Committee on Classification of Diseases in its first

report ? recommended that WHO should take steps towards developing a similar code for international use.

‘Ihe Conference suggested that one of the national codes

should be circulated by W40 and the comments received

used as the basis for an international code.

2.5 Multiple-cause tabulation ~d analysis

Papers were presented to the Conference on the

need for and problems concerned in full-scale multiplecauae Snalysiss and on the possibilities of more modest

approaches;9~10 The Conference, altiough recognizing

the hnportance of the underlying cause of death for the

presentation of historical series, appreciated the need

6~o~s/f(7D/74.6 ~

7WE0/HSiICD/22

8WIi0/HSACD/75.66

9~o~sflcD/77m6s

10WEO/ESflCD/79.6K

to supplement single-cause statistics by total counts of

conditions reported on the medical certificate of cause

of death and, more hrqmrtantly, by the demonstration

of syndromes of associated conditions leading to death.

The Conference, noting that several countiies had

ei-tier started or were abut to start mtuapie cause

tabulations,

RECOMMENDS that interested countries inform

WHO of their plans for introducing multiple cause

analysis and that ~0 act as the co-ordinating body

for international collaboration in developing uniform

rules and procedures for coding and tabulation.

‘J%e conference considered that the value of a

more limited approach should not be overlooked.

This might take the form of a thorough analysis of one

or two different diseases each year” or the continuous

routine identification of a small number of associations.lz

The Conference stressed that the value of multiple

cause analysis depended on the, completeness of the

entries on the medical certificate of cause of death in

respect of the “syndrome of cause of death” and

contributory causes. In order to obtain the full value

of multiple cause analysis certifiers need advance

instruction on how to complete the certificate for this

purpose.

Multiple tabulation of cauaes of death should be

supplemented by the study of associations of diseases

through multiple tabulations of morbidity data.

2.6 Rules for selection of cause of death

Application of the rules of selection, and particularly comparisons of their uae in different coding

offices, had ehown the need for some.clarification and,

if possible, simplification in order to reduce the

possibili~ of differences in interpretation as stressed

by the Sub-Committee on Classificationof Diseases.la

Noting the experience acquiredincomparisons of coiiiiig

conducted by the WHO Centres for Classification of

Diseases and by Regional Offices of WHO, the Conference

RECOMMENDS that WHO revise the Rules’ for

selection of cause of death, seeking advice from the

WHO Centre and the Latin-American Centre for Classification of Diseases, from WHO Regional Offices with

experience in this matter, and from other competent

sources.

2.7 Definitions and other issues relating to perinatal

morbidity and mortali~

.

2.7.1 IXinition of.foetal death

The Conference recognized the difficulties encountered in many countries in the practical application

llwHo~flcD/77.65

12WEOmSflCD/79.65

18~ons~cD/g2

11
of tie criteria of “evidence of life” in the WHO defizdtion of foetal death as had already been pointed out by

the Sub-Committee on Classification of Diseases.14 It

was impossible to ensure that all birth attendants did

in fact strictly apply the definition, but these criteria

were intended as a guide to them in their decision as

to whether a child waa born alive or dead. Taking alao

into account the scant response from countries in respect of a change, the Conference did not see any useful

pur~se in amending the definition.

2.7.2 Definition of the perinatal period

The Conference endorsed the definition of the

perinatal period propmsed by the Sub-Committee on

Classification of Diseases in its second reportls as

extending from the 28th week of gestation to the

seventh day of life, While agreeing that these were

practical limits for international purposes, the Conference noted that some countries extended the collection of pertinent data down to the 20th week of

gestation and up to the 28th day of life, preparing

tabulations for both the restricted and the wider

period. The Conference considered that such extensions should be encouraged, since their effect was to

improve coverage of registration concerning the restricted period by removing the temptation to understate the duration of pregnancy at and around the 28th

week in order to avoid the inconvenience of registering

the birth.

In respect of tabulationa concerning the perinatal

period, the Conference urged the collection of data

on the period of gestation, birth-weight, parity and

other relevant factors and their cross-tabulation by

cause of death.

2.7.3 Recording of causes of perinatal death

The Conference endorsed the view of the SubCommittee on Classification of Diseases, expressed

in its second report, 18 that medical certificates of

cause of foetal death should be in the same sequential

arrangement as the normal death certificate. This

arrangement allowed the certifier to indicate his opinion

on the relationship between causes in the foetua and

causes in the mother, and was for this reason preferable to the independent recording of foetal and maternal

conditions.

Information on maternal conditions was also needed

for the neonatal deaths included in the perinatal period.

‘l%e Conference urged that where a certificate common

to the whole perinatal period was not in use, coun&ies

should make provisiona for the recording of details of

causes in the mother on whatever form of certificate

was in use for the neonatal deaths.

l%ZO/WZCD/22

15~OflsflcD/5(3

l%HO/HS/ICD/EiO

2.7.4 Recording of other data pertinent to the perinatal

period

The Conference agreed with the list of items regarded by the Sub-Committee ~ Classification of Diseaaes in its first report lTas the,minimum of information

required for a proper analysis of perinatal mortali~,

cause of death, time of death (ante-, intra-, or postpSIILUII),sex, maternal age, plurali~, birth order or

parity, attendant at birth, place of birth, duration of

pregnancy in weeks, birth-weight.

This type of information was easier to secure in

respect of foetal deaths, but was equally necessary for

the neonatal component of perinatal mortality. The

Conference noted that some countries used a common

form of certificate for the whole perinatal period

and, while regarding this as a useful solution to the

problem of securing comparable information on the

foetal and neonatal components, appreciated the difficulties attending its introduction in other countries.

In some countries, the information was available on the

birth record and a process of record-matching could

be used to relate it to the death. The Conference did

not recommend any particular solution, but stressed

the importance of securing the data by one method or

snother.

2.8’ Publication of revised Manual

The Conference noted that the Eighth Revision of

the ICD was intended to come into use on 1 January

1968, and recognized the large amount of work involved

in incorporating the revision changes, editing and producing the volumes of the Manual in several languages.

However, the Conference considered it essential that

the revised Manual be issued in 1967 so that countries

could take all necessary steps for introducing the

Eighth Revision into national practice by the begiming

of 1968, including compilation of national adaptations in

languages other than the official versions.

The Conference accordingly

RECOMMENDS that WHO should issue the revised

Manual as early as possible during 1967.

The Conference suggested that consideration should

be given to the inclusion in the Manual of the ICD of the

“Classification of Industrial Accidents According to

Agency”la prepared by the International Laixmr Office,

for use by countries which wished to supplement the

ICD code of external causes.

The Conference was informed that plans were

under consideration for publishing the Manual in

Russian as one of the official languages in addition

to the versions in English, French and Spanish.

17wHo/HsAcD/22

18AnnexJj~ Resolutionoonoeming statistic of eIDplOpetIt,injuries, adopted by the Tenth InternationeZ Conference of Labour Statisticians. International Labeur Organisation, Officiaz Bulletin, Vol.

XL W, No. 1, January 1968.

12
3. NATIONAL AND INTERNATIONAL DEVELOPMENTS

IN HEALTH STATISTICS

3.1 Role of WHO in developing health statistics

The paper presented to the Conference19 made a

critical assessment of the health statistics available

to health administrations, The scope of the subject

needed to be extended beyond the traditional emphasis

on mortality statistics to include statistics on morbidity, demography, anthropology and operational aspects of health services. Too often the same routine

statistics were produced year after year with little

relevance to current problems. In developing countries

there was an urgent need to devise means of prepsring

health statistics useful to administrators in the absence

of a sophisticated system of health statistical services.

‘flus Conference recognized the authoritative role

played by WHO in regard to mortality statistics; in

future the Organization should seek to establish a

similar position in the wider field of health statistics

as defined above. That WHO was aware of the problem

was evidenced by conference held recently by the WHO

Regional Office for Europe on the adjustment of statistical activities to consumer needs. Encouragement

should be given to the development of flexible and

experimental methods, e.g.. ad hoc surveys and sampling techniques, to investigate particular problems and

to supplement the broadly descriptive picture provided

by routine statistics. The needs of the developing

countries should be given priority by WHO; among

their most pressing requirements were manuals for

the training of personnel. The emphasis should be on

methods of providing sound internal statistics, having

in mind the desirability of. promoting international

comparability as progress was made.

The Conference expressed its appreciation of the

value of the work of WHOin the field of health statistics

and its encouragement to the Organization to expand

its activities on the lines indicated in the discussion.

3,2 Hospital statistics

The Conference took account of the growing expansion of hospital statistics progrsmmes and noted

with satisfaction the attention given to this field in

developing countries under WHO projects. 20 Papers

were presented on systems in two countries 2*using

computer techniques to correlate data reported on hospital facilities and services and to obtain a series of

detailed and useful indicators on the utilization of hospital resources. Similar techniques were being applied

to the processing of morbidity and other data reported

on discharged patients, allowing detailed presentation

19WR0/HS/8Rev.Conf./8.65

%lfO/RS/6 Rev.Conf./4.6Fi

21~O~s/8 RW.conf./l,65 ~d 8.65

of patients according to diagnosis, length of stay, type

of care given and orher factors of interest.

Considering the fast developments in hospital

statistics programmed, the Conference supported the

recommendation of the Expert Committee on Health

Statistics in its eighth report ~Zthat WHOprepare manuals to guide countries in the. c~mpilation of hospital

statistics. Attentton was called to the need for definitions of a number of items such as hospital bed, inpatient, admission, diagnosis for primary tabulation

and for measures of utilization of hospital facilities.

It was recognized that standardization of statistical

re~rting forms and procedures would take some time

but efforts should be made by WHO towards this objective by continuing the collection of information on

practices in various countries and by suggesting stsndsrds in the light of national experience.

3.3 Implications of advances in automatic data

processing

In the paper presented to the Conference,28 the most

important effect of automation on the use of the ICD

was seen as the great increase in utilization of hospital

statistics which it made possible. This might well

result in the replacement of mortality by morbidity

coding as the prime application of the ICD. Other uses

of electronic computers in comexion with the Classification were the much greater ease of performing

multiple-cause analyses and, eventually, the automatic

coding of entries on records of vital events. If the

latter were ever to be adopted, a considerable simplification of the coding rules would be required, tJough

this would be compensated by a more thorough analysis

of contributory causes.

The Conference noted the interest in this subject

already shown by WHO in the organization of conferences and symposia, particularly in the WHO European

Region, and recognized the need for a regular interchange of information in a field where rapid technical

progress was being made.

Accordingly, the Conference

RECOMMENDS that WHO act as a clearing house

for the exchange of information on the use of computers in health statistics, requesting details on current national developments and disseminating the information in a new document series devoted to this

subject, and stimulating discussion of computer topics

at meetings of appropriate bodies.

3.4 National Committees on Vital and Health Statistics

Two papers were submitted to the Conference.on

this subject24 and several delegates to the Conference

2%ld. Wth. Org. Techu. Rep. Ser., 1968,z61

2%R0/RS/8 Rev.Cnnf./5.65

2~oma18 R~V.tinf./2 awl6.65

13
reported on the experiences of their countries with cerned, and for contributing to studies of international

National Committees on Vital and Health Statistics. It value. The Conference appreciated the work being

appeared, as at similar previous occasions, that in done by W“O in promoting the establishment of national

certain countries national committees or their equiv- committees, in stimulating their efforts, in providing

alents proved an effective means for co-ordinating for an exchange of detailed information about the

activities in vital and health statistics, dealing with activities in other countries and in distributing material

problems of common interest to the agencies con- of a technical nature.

—000

14
Au8tralia

Au8tria

Bulgaria

Canada

APPENDIX

LIST OF PARTICIPANTS AT

II

THE CONFERENCE

~. L. G. Hopkins

Director

Demographic..atxt Sbcial

Statistics Section

Commonwealth Bureau of

Census and Statistics

Canberra

Dr. R. H. C. Wells (Rapporteur)

First Assistant DirectorGeneral

Commonwealth Department

of Health

Canberra

Dr. H. Hansluwka

Chief

Division of Population and

Health Statistic

Central Office of Statistics

Vienna

Professor L. Popper

Head

Fifth Department of

Internal Medicine

Wilhelminenspital

Vienna

Dr. T. Pascalev

Professor at the Institute

of Medical Specialization

and Higher Studies

Sofia

Mr. F. Harris

Director

Health and Welfare Division

Dominion Bureau of Statistics

Ottawa

Dr. B. D. B. Layton

Principal Medical Officer

International Health

Department of National

Health and Welfare

Ottawa

Dr. P. Parrot

Demographer

Quebec Ministry of Health

Quebec, P.Q.

Dr. A. H. Sellers

Director

Medical’ Statistics Branch

Ontario Department of Health

Toronto, Ont.

Czechoslovakia Mr. V. Dolejsi

Chief

Health Statistics Section

Ministry of Health

Prague

Denmark Miss I. Alsing

Chief

Medical Statistics Section

National Health Service

Copenhagen

Dr. J. Mosbech

Medical Adviser

Medical Statistics Section

National Health Service

Copenhagen

Finland Dr. A. Isotalo

Chief Physician

National Board of HeaIth

Helsinki

Miss A. Korpela

Statistician

Central Office of Statistics

Helsinki

France Dr. M. J. Aubenque

(Rapporteur)

Chef

Division des Statistiques

sanitaires

Institut national de la

Statistique et des Etudes

efonomiques

Paris
Dr. J. Fonroget

Directeur g~ne<al adjoint

Minist&e de la Sante’

publique

Paris

Dr. X. Gene’

Mefiecin Statistician

Bureau des Statistiques

Institut national de la Sante’

et de la Recherche me’dicale

Paris

Dr. M. Guidevaux

Mabe de Recherche

Institut national de la Sante’

et de la Recherche me’dcale

Paris

Dr. J. P. Jardel

Mefiecin-Assistant

Section des Statistiques de

Sant& publique

Ecole nationale de la Sante’

publique

Rennes

Dr. R. Sadoun

Chef

Section de la Sante’mentale

et Psychiatric

Institut national de la Sante’

et de la Recherche me’dicale

Paris

Federal Republic Dr. H. E. Eiirhardt

of Germany Professor of Forensic and

Social Psychiatry

University of Marburg

Dr. J. Hailer

Lecturer and Research

Assistant

Department of Obstetrics

and Gynecology

University of Goettingen

Dr. H. R. Immich

Medical Officer

Department of Statistics

German Cancer. Research

Centre

Heidelberg

Dr. S. Keller

Institute for Medical Statistics

and Documentation

UniversiW of Mainz

Ghana

Guatemala

Hungary

India

Iran

Israel

Italy

Japan

Dr. R. Leutner

Medical Statistician

Public Health Section

Federal Office of Statistics

Wiesbaden

Dr. K. Saakwa-Mante

Chief

Biostatistics Unit

Ministry of Health

Accra

Professor F. J. Aguilar

Director-General of Public

Health

Guatemala City

Dr. Z. Marton

Chief

Department of Health

Statistics

Central Office of Statistics

Budapest

Dr. K. C. Patnaik

Director

Central Bureau of Health

Intelligence

New Delhi

Dr. A. Diba

Technical Adviser on WHO

Affairs

Permanent Delegation of Iran

to the International

Organizations

Geneva

Dr. G. Kallner

Medical Adviser to the

Government Statistician

Central Bureau of Statistics

Jerusalem

Dr. P. Morganti

Chief

Causes of Death Section

Division of Health Statistics

Central Institute of Statistics

Rome

Dr. R. Nakahara

Director

Division of Health and

Welfare Statistics

Ministry of Health and Welfare

Tokyo

16
Kuwait

Madagascar

Mali

Mauritius

Netherlands

Mr. N. Takizawa

First Secretary

Permanent Delegation of

Japan to the International

Organizations

Geneva

Dr. S. Watanabe

Adviser

Division of Health and

Welfare Statistics

Ministry of Health and

Welfare

Tokyo

Mr. A. A. A1-Mou’nes

Statistician

Ministry of Public Health

Kuwait

Dr. M. A. A. Abdul Salsm

Chief

Tuberculosis Control

Department

Ministry of Public Health

Kuwait

Mine. A. M. Raoely-James

Chef

Division des Etudes, Analyses

et Recherches

Institut national de la

Norway

Statistique et de la Recherche

e%onomique

Tanansrive

Dr. J. J. Leveuf

Conseiller technique

Direction g<ne<ale de la

Sante’

Minist’tie de la Sante’publique

et des Affaires sociales

Koulouba

Mr. N. Fomba

Minis/ere de la Sante’publique

et des Affaires sociales Poland

Koulouba

Mr. J. Y. Nadeau

Registrar of Health Statistics

Ministry of Health

Port Louis

Dr. A. C. Arntzenius

Head

Department of Cardiology

Out-Patient Service

University Hospital

Leiden

Portugal

Dr, B. V. Bekker

Chief

Bureau of Epidemiology and

Analysis

Department of Chief Medical

Officer,

The Hague

Dr. M. J: W. de Groot

Chief

Division of Health Statistics

Central Bureau of Statistics

me Hague

Dr. V. M. Oppers

Chief

Division of Health Statistics

Municipality of Amsterdam

Amsterdam

Dr. P. J. van der Schaar

Head

Psychiatric Clinic

Dijkzigt Hospital

Rotterdam

Dr. A. van Vianen

Health Council of the

Netherlands

The Hague

Mrs. E. B~x

Statistician

CentraI Bureau of Statistics

0s10

Dr. L. Linneberg

Chief Medical Adviser

National Social Insurance

Administration

0s10

Dr. K. Westlund

Head

Institute of Biostatistics

Oslo Municipal Hospital

Dr. Z. Branowitzer

Director

Department of Medical

Statistics

Ministry of Health and

Social Insurance

Warsaw

Dr. A. F. Gama Freire

Medical Statistician

Hospital do Ultramar

Lisbon

17
Romania

Saudi Arabia

Spain

Sweden

Switzerland

Dr. L. A. C. R. Cayolla da

Motta

Medical Officer

Directorate General of

Public Health

Lisbon

Dr. J. C. de Sousavaz Vieira

Chief of Division

National Institute of Statistics

Lisbon

Dr. G. Jelezov

Director

Division of Planning and

Statistics

Ministry of Health

Bucharest

Thailand

Dr. M. A. Mukim

Director Togo

Health Services

Mecca

Dr. J. P. Cortazar

Chief

Population Movement Section

National Institute of Statistics

Madrid

Dr. T. Gonz?i’lez

Chief

Demographic Statistics Service

National Institute of Statistics

Madrid 1

Dr. F. J. Y. Grijalba

Medical Officer

Study Sectiop

General Directorate of

Health

Madrid

Dr. P. Hall

Assistant Professor in

Medicine

Karolinska Institute

Stockholm

Mr. A. Sji5str6m

Acting Chief

Division of Statistics

National Board of Health

Stockholm

Dr. J. C. Htibscher

Chef

Service des Statistiques

me’dicales

Bureau f<d<ral de Statistique

Berne

Union of Soviet

Socialist Republics

United Kingdom of

Great Britain and

Northern Ireland

Dr. B. Subhamani

Director

Statistical Services

Ministry of Public

Bangkok

Dr. S. Teray+ont

Medical Officer

Health

Section of Hospital Statistics

Department of Medical

Services

Ministry. of Public Health

Bangkok

Dr. F. Vongsfak

Statistician

Division of Vital Statistics

Ministry of Public Health

Bangkok

Mr. M. Glikpo

Statistician

Minis/ere de la Sante

publique

Lom#

Dr. V. K. 0v6arov

(Vice-Chairman)

Chief

Health Statistics Section

Semashko Institute of Public

Health Administration and

History of Medicine

Moscow

Dr. M. Amott

Professor of Medicine

University of Birmingham

Mr. P. J. Cook

General Register Office for

England and Wales

London

Mr. L. M. Feery

Principal

International Branch

General Register Office

for England and Wales

London

Mr. M. Reed (Chairman)

Registrar General

General Register Office for

England and Walea

London

Dr. A. H. T. Robb-Smith

Director of Pathology

Radcliffe Infirmary

Oxford

18
Dr. A. Smith

Medical Statistician

General Registry Office for

Scotland

Edinburgh

Miss M. Markins

General Register Office for

England and Wales

London

United Statea of Dr. F. E. Linder

America (Vice-Chahxnan)

Director

National Center for Health

Statistics

Public Health Service

Department of Health,

Education, and Welfare

Washington, D.C.

Dr. L. N. Dakil

Physician and Surgeon

McAlester, Oklahoma

Dr. P. M. Densen

Deputy Commissioner of

Health

New York City, N.Y.

Dr. R. Dyar

Chief

Division of Research

California State Health

Department

Berkeley, California

Mr. E. L. Hamilton

Director

Medical Statistics Agency

Office of the Surgeon-General

US Army

Washington, D.C.

Dr. B. MacMahon

Professor and Chairman

Department of Epidemiology

Harvard School of Public

Health

Cambridge, Massachusetts

Dr. I. M. Moriyama

Chief

Office of Health Statistics

Analysis

National Centeq for Health

Statistics

Public Health Service

Department of Health,

Education, and Welfare

Washington, D.C.

Venezuela

Yugoslavia

United Nations

New York

International Labour

Organization

Geneva

Non-Governmental

Organizations

Dr. W. H. Stewart

Assistant to Special Assistant

to the Secretary (Health

and Medical Affairs)

Office of the Secretary

Department of HeaIth,

Education, and Welfare

Washington, D.C.

Dr. F, D. Yoder

Director of Public Health

Illinois State Health Department

Springfield, Illinois

Dr. D. Curiel (Vice-Chairman)

Formerly Medical Chief

Division of Epidemiology

and Vital Statistics

Ministry of Health

Caracas

Professor B. Pirc

Head

Department of Epidemiology

and fhthtics

School of Public Health

University of Zagreb

Dr. c. Vukmsnovic

Chief

Department of Health Statistics

Federal Institute of Health

Belgrade

Mr. p. J. LdtUS

Director

Statistical Office

Mrs. R. Ducommun

Statistical Branch

Dr. C. Msriska

General Section

Social Security Branch

International League of

Dermatological Societies:

Professeur W. Jadassohn

Directeur

Clinique de Dermatologie

Universit~ de Ger&e

International Society of

Cardiology

Dr. P. W. Duchosal

Professeur de M<decine

University’de Ge$eve

International Union Against

Cancer:

Dr. A.H. Sellers

Director

Medical Statistics Branch

Toronto, Ont.

19
WHO Centre for Dr. C. C. Spicer

Classification of Chief Medical Statistician,

Diseases General Register Office

Chief, WHO Centre for

Classification of Diseases

London

+atin American Dr. R. Fuenmayor Herrara

Center for Classi- Director

ficationof Diseases Latin American Center for

Classification of Diseases

Caracas

Secretariat Dr. M. Cakrtova (Secretary)

mief

Development of, Health

Statistical Services

WHo

Mr. H. G. Corbett

Statistician

Development of Health

Statistical Services

WHo

Professor J. Knowelden

(Consultant)

@partment of Preventive

Medicine and Public Health

Sheffield University

Dr. E. F. Krohn

Regional Officer for

Epidemiology and Health

statistics

WHO Regional Office for

Eurdpe

Dr. W. P. D. Logan

Director

Division of Health Statistics

WHo

Mr. J. Nielsen

Statistical Adviser

WHO Regional Office for ‘the

Eastern Mediterranean

Dr. R. R. Puffer

Chief of Health Statistics

Branch

WHO Regional Office for the

Americas

— ooo —
APPENDIX Ill

INTERNATIONAL CLASSIFICATION

EIGHTH

1. Three- and four-digit titles

The following three- and four-digit categories

constitute The Detailed List referred to in the Report

of the Conference under item 1.2. They are based on

the revision proposals submitted to the Conference

(WHO/HS/ICD/74.65 Add. 1-17) and on the amendments adopted by the Conference (~0/HS/8 Rev.

Conf./lO.65). Editorial changes suggested during the

Conference and not appearing in the amendments were

incorporated as far as appropriate. A few changes

of substance became advisable in the detailed review

of the revised classification.

2. Other indications

Apart from the three- and four-digit titles there

are various references and notes, in order to enable

countries to start work on national adaptations in

languages other than those of the international versions.

2.1 References to ICD numbers

New titles were related to the numbers of the current ICD whenever the content was the same or changed

in a way which could be expressed in a relatively simple

form. Such references were omitted in the Nature-ofinjury classification (N-code), the larger part of which

corresponds to the three-digit categories of the ICD

(Nos. N800-N959). No attempt was made in respect

of ICD references for sections which underwent a complete revision, e.g. mental disorders.

2.2 Exclusion notes

Although not exhaustive, exclusion notes were provided for titles that would raise doubts regarding their

content.

2.3 Inclusion terms

Inclusion terms are as a rule not stated, although

inclusion notes appear in some places. This particularly

applieq to diseases of the circulatory system, in view

of the complexity of the classification.

REVISION

Fourth digits .8/.9

As recommended by the Conference, fourth digits

.8 and .9 were respectively reserved for “Other” and

“Unspecified” where both titles conveyed a real meaning. Otherwise .9 was used for “Other and unspecified”

or “Other” only in order to save fourth digits for further sub-division. For the same reason absence of an

associated condition (“without mention of . . .“) was

given the fourth digit .9. It should be pointed out that

the arrangement may still undergo some changes during

the compilation of the full tabular list in the light of the

inclusions to be accommodated.

1. INFECTIVE AND PARASITIC DISEASES

This section includes diseases generally recognized as communicable or transmissible. It excludes

acute respiratory infections, influenza and pneumonia

and certain localized infections.

Intestinal infectious diseases (000-009)

Excludes helminthiasis (120-129)

000 Cholera

.0 Classical

.1 El Tor

.9 Unspecified

001 Typhoid fever

002 Paratyphoid fever

.0 Paratyphoid fever A

.1 Paratyphoid fever B

.2 Paratyphoid fever C

.9 Unspecified

003 Other Salmonella infections

As ICD 042

.0 Without mention of focal as vehicle of infection

.1 With food as vehicle of infection

21
004 Bacillary dysentery

.0 Shiga

.1 Flexner

005

006

.2 Boyd

,3 Sonne

,4 Schmitz-Stutzer

,8 Other

,9 Unspecified

Focal poisoning (bacterial)

Excludes Salmonella food poisoning (003.1)

.0 Staphylococcal

.1 Botulism

.2 Due to other clostridia

.8 Other bacterial food poisoning

.9 Unspecified

Amoebiasis

.0 With liver abscess

.8 With othe~ manifestations

.9 Unqualified

607 Other protozoal intestinal diseases

.0 Balantidiasis

.1 Giardiasis

.2 Cm”cidiosis

.9 Other and unspecified

008 Enteritis due to other specified organism

.0 Escherichia coli

.1 Arizona

.2 Other bacteria

.3 Bacterial enteritis NOS

.9 Other organism, not elsewhere classified

009 Diarrhoeal disease

.0 Dysentery NOS

.1 Diarrhoea

Without mention

\

.2 Gastro-enteritis and colitis of non-in fectiou~

.9 Other

etiology orinfecting organism

Tubemulosis (010-019)

010 Silicotuberculosis

011 Pulmonary tuberculosis

012 Other respiratory tuberculosis

Excludes respiratory tuberculosis,

(011)

.0 Primary

.1 Pleurisy specified as tuberculous

unqualified

.2 Pleurisy with effusion without mention of cause

.3 Tuberculous laryngitis

.9 Other

22

013 Tuberculosis of meninges

system

.0 Tuberculous meningitis

.9 Other

and central nervous

014 Tuberculosis of intestines, peritoneum and mesenteric glands

015 Tuberculosis of bones and joints

.0 Vertebral column

.1 Hip

.2 Knee

.8 Other

.9 Unspecified

016 Tuberculosis of genito-urinary system

017 Tuberculosis of other organs

.0 Skin and subcutaneous cellular tissue

.1 Peripheral lymphatic glands

.2 Eye

.3 Ear

.9 Other

018 Disseminated tuberculosis

.0 Acute miliary tuberculosis specified as nonpulmonary

.1 Acute miliary tuberculosis unspecified

.9 Other forms of disseminated tuberculosis

019 Late effects of tuberculosis

.0 Respiratory tuberculosis

.1 Central nervous system

.2 Bones and joints

.3 Genito-urinary system

.9 Other specified organs

Zoonotic bacteyial diseases (020-02?7

020 Plague

.0 Bubonic

.1 Pulmonic

.9 Unspecified

021 ‘lldaraemia

022 Anthrax

023 Brucellosis

.0 Br. melitensis

.1 Br. abortus

.2 Br. suis

.9 Unspecified

024 Glanders
025 Melioidosis

026 Rat-bite fever

.0 Spirillum minus

.1 Streptobacillus moniliformis

.9 Unspecified

027 Other zoonotic bacterial diseases

.0 Listeriosis

.1 Erysipelothrix infection

.9 Other

Other bacteyial diseases (030-039)

Excludes bacterial venereal diseases (098, 099)

and bartonellosis (089.0)

030 Leprosy

.0 Lepromatous

.1 Tuberculoid

.2 Indeterminate

.3 Borderline

.8 Other

.9 Unspecified

031 Other diseases due tomycobacteria

032 Diphtheria

033 Whooping cough

.OB. pertussis

.1 B. parapertussis

.9 Unspecified

034 Streptoccccal sore throat and scarlet fever

.0 Streptococcal sore throat

.1 Scarlet fever

035 Erysipelas

036 Meningococcal infection

.0 Meningococcal meningitis

.1 Meningococcaemia witbout mention of

meningitis

.8 Other forms of meningococcal infection

.9 Unspecified

037 Tetanus

038 Septicaemia-

.0 Streptococcal

.1 Staphylococcal

.2 Pneumoccccal

.8 Other bacterial

.9 Unspecified

039 Other bacterial diseases

.0 Gas gangrene

.1 Rhinoscleroma

.9 Other

Poliomyelitis and othev entewvirus diseases of central

nervous system (040-046)’

040 Acute paralytic poliomyelitis specified as bulbar

041 Acute poliomyelitis with other paralysis

042 Acute .non-paralytic poliomyelitis

043 Acute poliomyelitis, unspecified

044 Late effects of acute poliomyelitis

045 Aseptic meningitis due to enterovirus

Excludes aseptic meningitis duetm Poliovirus

(042); virus of herpes zoster (053) herpes

simplex (054); mumps (072} Qmphmytic

choriomeningitis (079.2)

.0 Coxsackie virus

.1 ECHO VirUS

.9 Aseptic meningitis, NOS

046 Other enterovirus diseases of central nervous

system

Viral diseases accompanied by exanthem (050-05?)

Excludes arthropod-borne viral diseases (060-068)

050 Smallpox

051

052

053

054

055

056

057

.0 Variola major

.1 Variola minor (slastrim)

.9 Unspecified

cowpox

ChickenPox

Herpes zoster

Herpes simplex

Measles

Rubella (German measles)

Other viral exanthem

.0 Erythema infectiosum (fifth disease)

.1 Exanthema subitum (Roseola infantum) (sixth

disease)

.8 Other

.9 Unspecified

23
Arthropod-borne viral diseases (060-06&

060 Yellow fever

061

062

063

064

.0 Sylvatic

.1 Urban

.9 Unspecified

Dengue

Excludes hemorrhagic fever caused by dengue

virus (067.8)

Mosquito-borne viral encephalitis

.0 Japanese encephalitis

.1 Western equine encephalitis

.2 Eastern equine encephalitis

.3 St. Louis encephalitis

.4 Murray Valley encephalitis

.9 Other and unspecified

Tick-borne viral encephalitis

.0 Russian spring-summer (“Taiga”)

.1 Louping-ill encephalitis

.2 Central-European encephalitis

.9 Other and unspecified

Viral encephalitis transmitted by other arthropods

065 Viral encephalitis, unspecified

066 LSte effects of viral encephalitis

067 Arthropod-borne hemorrhagic fever

.0 Crimean hemorrhagic fever

.1 Omsk hemorrhagic fever

.2 Kyasanur Forest disease

.3 Other tick-borne hemorrhagic fever

.4 Mosquito-borne hemorrhagic fever

.5 Hemorrhagic nephroso-nephritis

.9 Other and unspecified

068 Other arthropod-borne viral diseases

.0 Phlebotomus fever

.1 Tick-borne fever

.2 Mosquito-borne fever

.9 Other

Other viral diseases (070-079)

070 Infectious hepatitis

. Excludes serum hepatitis (N999.2)

071 Rabies

072 h’fumps

073 Psittacosis (Ornithoais)

074 Specific diseases due to Cocksackie virus

Excludes aseptic meningitis (045)

.0 Herpangina

.1 Epidemic pleurodynia (Bornholm disease)

.2 Epidemic myocarditis of newborn

.9 Other

075 Infectious mononucleosis

076 Trachoma, active

077 Late effects of trachoma

078 Other viral diseases of the conjunctival

.0 Inclusion conjunctivitis

.1 Epidemic kerato-conjunctivitis

.2 Acute adeno-viral follicular conjunctivitis

.8 Other

.9 Viral conjunctivitis NOS

079 Other viral diseases

.0 Molluscum contagiosum

.1 Viral warts

.2 Lymphocytic choriomeningitis

.3 Cat-scratch disease

.4 Foot and mouth disease

.5 Cytomegalic inclusion disease

.8 Other

.9 Viral infection NOS

Rickettsioses and otker avthropod-home infectious diseases (080-089)

Excludes arthropod-borne viral diseases

(060-068)

080 Epidemic louse-borne typhus

081 Other typhus

.0 Endemic flea-borne (murine)

.1 Brill’s disease

.2 Mite-borne (scrub)

.9 Unspecified

082 Tick-borne rickettsiosis

.0 Spotted fevers

.I Fi&re boutonneuse

.2 North-Asian tick-borne typhus fever

.9 Other

083 Other rickettsioses

.0 Rickettaialpox

.1 Q fever

.2 Wolhynian fever (trench fever)

.8 Other

.9 Ricketteiosis NOS

24
084 Malaria 1

.0 Falciparum malaria (malignant tertian)

.1 Vivsx malaria (benign tertian)

.2 Malariae malaria (quartan)

.3 Ovale malaria

.4 Backwater fever

.5 Recurrent induced malaria

.8 Other forms of malaria

.9 Unspecified

085 Leishmaniasis

.0 Visceral (Kala-azar and

.1 Cutaneous

.2 Mucocutaneous (American)

.9 Unspecified

Mediterranean w)

086 American trypanosomiasis (Chsgasl disease)

.0 With heart involvement

.8 With other organ involvement

.9 Without mention of organ involvement

087 Other trypanosomiasis

.0 Gambisn

.1 Rhodesisn

.8 African trypanosomiasis NOS

.9 Trypanosomiasi6 NOS

088 Relapsing fever

.0 Louse-borne

.1 Tick-borne

.9 Unspecified

089 Other arthropod-borne diseases

.0 Bartonellosis

.9 Other

Syphilis and other venereal diseases (090-099)

Excludes non-venereal syphilis (104.0)

090 Congeni@ syphilis

.0 Early congenital syphilis, symptomatic (less

than five years)

.1 Early congenital syphilis, latent (less than five

years)

.2 Early congenital syphilis, NOS

.3 Interstitial keratitis

.4 Juvenile neurosyphilis

.5 Other late congenital syphilis, symptomatic

(five years and over)

Iwhen ~Ore than ~n~ tm~ is mentioned, priority in classification

follows the order of listing of numbers in fourth digit.

,6 Late Congenital syphilis, latent (five years and

over)

.7 Late congenital syphilis NOS

.9 Congenital syphilis NOS

091 Early syphilis, symptomati~

.0 Primary syphilis, except extragenicd chancre

.1 Extragenital chancre

.2 Secondary syphilis of skin and mucous membranes

.3 Secondary syphilis, relapse (treated, untreated)

.8 Other recently acquired syphilis, symptomatic

.9 Early syphilis NOS

092 Early syphilis, latent

.0 Early syphilis, latent, serological relapse after

treatment

.9 Early syphilis, latent NOS

093 Cardiovascular syphilis

.0 Aneurysm of aorta, specified

.9 Other cardiovascular syphilis

094 Syphilis of central nervous system

.0 Tabes dorsalis

.1 General paresis

.9 Other syphilis of central nervous

as syphilitic

system

095 Other forms of late syphilis, with symptoms

096 Late syphilis latent (duration two years and over)

097 Other syphilis, and not specified

.0 Late syphilis NOS

.1 Latent syphilis NOS

.2 Syphilis NOS

098 Gonococcal infections

.0 Acute gonococcal infection of genito-urinary

system

.1 Chronic gonococcal infection of genito-urinary

system (over two months’ duration)

.2 Gonococcal infection of eye

.3 Gonococcal infection of joint

.8 Gonococcal infection of other sites

.9 Gonorrhea, unspecified

099 Other venereal diseases

.0 Chancroid

.1 Lymphogranuloma venereum (Nicolas Favre)

.2 Granuloma inguinale (Donovan)

.8 Other

.9 Unspecified

25
Othev spivochaetal diseases (100-104)

100 Leptospirosis

.0 Leptospirosis ictero-haemorrhagica (Weil’s

disease)

.8 Other

.9 Unspecified

101 Vincent’s angina

102 Yaws

.0 Initial lesions

“.1 Multiple papillomata and “wet crab” yaws

.2 Other early skin lesions

.3 Hyperkeratosis

.4 Gummata, ulcers

.5 Gangosa

.6 Bone and joint lesions

.7 Other manifestations

.8 Latent yaws

.9 Yaws NOS

103 Pinta (carate)

.0 Primary lesions

.1 Intermediate lesions

.2 Late lesions

,3 Mixed lesions

.9 Unspecified

104 Other spirochaetal infections

.0 Non-venereal endemic syphilis

.9 Other

Mycoses (110-llfi”

110 Dermatophytosis

111 Dermatomycosis, other and unspecified

.0 Pityriasis versicolor

.1 Tinea nigra

.2 Tinea blanca

.8 Other

.9 NOS

112 Candidiasis (moniliasis)

.2 South American

.9 Unspecified

117 Other systemic mycosis

.0 Rhinosporidioais

.1 Sporotrichosis

.2 Chromomycosis

.3 Aspergillosis

.4 Maduromycosis

.8 Other

.9 Unspecified

Helminthiases (120-129)

120 Schistosomiasis (bilharziasis)

.0 S. haematobium

.1 S. mansoni

.2 S. japonicum

.3 Cutaneous

.8 Other

.9 Unspecified

121 Other trematode infestation

.0 Opisthorchiasis

.1 Clonorchiasis

.2 Paragonimiasis

.3 Fascioliasis

.4 Fasciolopsiasis

.9 Other

122 Hydatidosis

.0 Liver

.1 Lung

.8 Other sites

.9 Unspecified

123 Other cestode infestation

.0 Taenia solium infestation, intestinal form

.1 Cysticercosis (larval form, Taenia solium)

.2 Taenia saginatajinfestation

.3 Taeniasis NOS

.4 Diphyllobothriasie intestinal

.5 Sparganosis (larval diphyllobothriasis)

.6 Hymenolepiasis

.9 Other

113 Actinomycoais

124 Trichiniasis

114 Coccidioidomycosis

115 Histoplasmosis

116 Blastomycosis

.0 European

.1 North American

125 Filarial infestation

.0 Wuchereriasis

.1 Brugia filariasis

.2 Loiasis

.3 Onchocercosis

.4 Acanthocheilonemiasis

26
.5 Mansonelliasis Il. NEOPLASMS

.8 Other filariasis

.9 Unspecified

126 Ancylostomiasis

.0 Ancylostoma duodenale

.1 Necator americanus

.8 Other ancyloatoma

.9 Unspecified

127 Other intestinal helminthiasis

.0 Ascariasis

.1 Strongyloidiasis

.2 Trichuriaais

.3 Enterobiasis

.4 Other intestinal nematode infestation

.5 Mixed intestinal helminthiasis

.9 Intestinal helminthiasis NOS

128 Other and unspecified helminthiasis

.0 Larva migrans, visceralis

.7 Other

.8 Mixed

.9 Unspecified

129 Intestinal parasitism, NOS

Other infective andparasitic diseases (130-136i

130 Toxoplasmosis

.0 Acquired

.1 Congenital active

.2 Late effects of intra-uterine infection

,9 Unspecified

131 Trichomoniasis urogenitalis

132 Pediculoais

133 Acariasis

134

.0 Scabies

.9 Other

Other infestation

.0 Myiasis

.1 Phthirus infestation

.2 Other arthropod infestation

.3 Hirudiniasis

.9 Other

135 Sarcoidoais

136 Other infective and parasitic diseases

M@nant neoplasm of buccal cavity and pharynx

(140-149)

140 Malignant neoplasm of lip

Excludes malignant neoplasm of skin of lip

(172.0, 173.0)

.0 Upper lip

.1 Lower lip

.2 Both lips

.9 Lip unspecified (including commissure)

141 Malignant neoplasm of tongue

.0 Base of tongue

.1 Dorsal surface

.2 Borders and tip

.3 Ventral surface

.9 Part unspecified

142 Malignant neoplasm of salivary gland

.0 Parotid gland

.8 Other specified salivary gland

.9 Unspecified salivary gland

143 Malignant neoplasm of gum

.0 Upper gum

.1 @wer gum

.9 Gum unspecified

144 Malignant neoplasm of floor of mouth

145 Malignant neoplasm of other and unspecified parts

of mouth

.0 Buccal mucosa

.1 Palate (hard) (soft)

.8 Other specified parts

.9 Part unspecified

146 Malignant neoplasm of oropharynx

.0 Tonsil

.8 Other specified parts

.9 Part unspecified

147 Malignant neoplasm of nasopharynx

148 Malignant neoplasm of hypopharynx

.0 Postcricoid region

.1 Pyriform foasa

.8 Other specified parts

.9 Part unspecified

149 Malignant neoplasm of pharynx, unspecified

27
Malignant neoplasm of digestive organs and pem”toneum

(150-159)

150 Malignant neoplasm of oesophagus

151 Malignant neoplasm of stomach

.0 Cardia

.1 Pylorus

, .80ther sp-ecified parts

.9 Part unspecified

152 Malignant neoplasm of small intestine, including

duodenum

.0 Duodenum

.8 Other specified parts

.9 Part unspecified

153 Malignant neoplasm of large intestine, except

rectum

.0 Caecum, appendix and ascending colon

.1 Transverse colon, including hepatic and splenic

flexures

.2 Descending colon

.3 Sigmoid colon

.8 Large intestine (including colon), part unspecified

.9 Intestinal tract, part unspecified

154 Malignant neoplasm of rectum and rectosigmoid

junction

.0 Rectosigmoid junction

.1 Rectum

.2 Anal canal

155 Malignant neoplasm of liver and intrahepatic bile

ducts, specified as primary

.0 Liver

.1 Intrahepatic bile ducts

156 Malignant neoplasm of gall-bladder and bile ducts

.0 Gall-bladder

.1 Extrahepatic bile ducts

.2 Ampulla of Vater

.9 Biliary tract NOS

157 Malignant neoplasm of pancreas

.0 Head

.8 Other specified parts

.9 Unspecified

158 Malignant neoplasm of peritoneum and retroperitoneal tissue

.0 Retroperitoneal tissue

.9 Other and unspecified parts

159 Malignant neoplasm of unspecified digestive organs

Ma&zant neoplasm of vespivatoqv system (160-163)

160 Malignant neoplasm of nose, nasal cavities, middle ear and accessory sinuses

.0 Nose (internal) and nasal cavities

.1 Eustachian tube and middle ear

.2 Maxillary sinus

.8 Other sinus

.9 Unspecified sinus (accessory)

161 Malignant neoplasm of larynx

.0 Glottis, true vocal cords

.8 Other specified parts

.9 Part unspecified

162 Malignant neoplasm of trachea bronchus and lung

.0 Trachea

.1 Bronchus and lung

163 Malignant neoplasm of other and unspecified

respiratory organs

.0 Pleura

.1 Mediastinum

.9 Site unspecified

Malignant neoplasm of bone, connective tissue, skin and

breast (170-174)

17(JMalignant neoplasm of bone

.0 Bones of skull and face

.1 Lower jaw bone

.2 Vertebral columxi(excluding sacrum and CCCCYX)

.3 Ribs, sternum and clavicle

.4 Long bones of upper limb and scapula

.5 Upper limb, short bones

.6 Pelvic bones, sacrum, coccyx

.7 Lower limb, long bones

.8 Lower limb, short bones

.9 Site unspecified

171 Malignant neoplasm of connective and other soft

tissue

.0 Head, face and neck

.1 Trunk

.2 Upper limb (including shoulder)

.3 Lower limb (including hip)

.9 Site unspecified

172 Malignant melanoma of skin

.0 Lips

.1 Eyelids, including canthi

.2 Ear and external auricular canal

.3 Other and unspecified parts of face
A Scalp and neck

.5 Scrotum

.6 Trunk, except scrotum

.7 Upper limb

.8 Lower limb

.9 Site unspecified

173 Other malignant neoplasm of skin

.0 Lips

.1 Eyelids, including canthi

.2 Ear and external aurictdar canal

.3 Other and unspecified parts of face

.4 Scalp and neck

.5 Scrotum

.6 Trunk, except scrotum

.7 Upper limb

.8 Lower limb

.9 Site unspecified

174 Malignant neoplasm of breast

Malignant neoplasm of genito-uti?uavyoygans (180-189)

180 Malignant neoplasm of cervix uteri

181 Chorionepithelioma

182 Other malignant neoplasm of uterus

.0 Corpus uteri

.9 Uterus unspecified

183 Malignant neoplasm of ovary, Fallopian tube,

and broad ligament

.0 Ovary

.1 Fallopian tube and broad ligament

.9 Part unspecified

184 Malignant neoplasm of other and unspecified female genital organs

.0 Vagina

.1 Vulva

.8 Other specified sites

.9 Site unspecified

185 Malignant neoplasm of prostate

186 Malignant neoplasm of testis

187 Malignant neoplasm of other and unspecified

male genital organs

.0 Penis

.8 Other specified sites

.9 Site unspecified

188 Malignant neoplasm of bladder

189 Malignantneoplasm of other and unspecified

Urblary organs

.0 Kidney, except pelvis

.1 Pelvis of kidney

.2 Ureter

.9 Other and unspecified

Malignant neoplasm of other and unspem”fiedsites

(190-199)

190 Malignant neoplasm of eye

191 Malignant neoplasm of brain

192 Malignant neoplasm of other parts of nervous

system

.0 Spinal cord

.1 Meninges

.2 Peripheral nerves

.3 Sympathetic nervous system

.9 Site unspecified

193 Malignant neoplasm of thyroid gland

194 Malignant neoplasm of other endocrine glands

.0 Suprarenal gland

.1 Parathyroid gland

.2 Thymus

.3 Pituitary gland and craniopbaryngeal duct

.4 I?ineal giand

.8 Other

.9 Unspecified endocrine gland

195 Malignant neoplasm of ill-defined sites

.0 Abdomen, intra-abdominal cancer

.1 Pelvis. pelvic viscera, rectovaginal septum

.9 Other

196 Secondary and unspecified malignant neoplasm

of lymph nodes

.0 Head, face and neck

.1 Intrathoracic

.2 Intra-abdominal

.3 Axillary and upper limb

.4 Ingubml and lower limb

.7 Other specified sites

.8 Multiple sites

.9 Site unspecified

197 Other secondary malignant neoplasm, primary

site unspecified

,0 Lung, specified as secondary

.1 Liver, specified as seccdary

.2 Liver, unspecified as prixnary or secondary

.3 Brain, specified as secondary

29
.4 Bone, specified as secondary

.9 Other sites, specified as secondary

198 Malignant neoplasm without specification of site

.0 Multiple

.1 Other

199 Seconclarymaligqant neoplasm, primary site known

Not to be used for primary mortality classification

.0 Lymph nodes

.1 Thoracic organs

.2 Liver

.3 Brain

.4 Bone

.9 Other

Neoplasms of lymphatic and haernatopm”etic tissue

(2?00-209)

200 Lymphosarcoma and reticulosarcoma

.0 Reticulum-cell sarcoma

.1 Lymphosarcoma

201 Hodgkin’s disease

202 Other neoplasms of lymphoid tissue

.0 Giant follictdar Iymphoma (Brill-Symmers’

disease)

.1 Mycosis fungoides

.2 Other primary malignant neoplasms of lymphoid

tissue

.9 Other forms of Iymphoma (reticulosis)

203 Multiple myeloma (plasmacytoma)

204 Lymphatic leukaemia

.0 Acute

.1 Chronic

.9 Unspecified

205 Myeloid Ieukaemia

.0 Acute

.1 Chronic

.9 Unspecified

206 Monocytic Ieukaemia

.0 Acute

.1 chronic

.9 Unspecified

207 Other and unspecified leukaemia

.0 Leukaemia, acute

.1 Leukaemia, chronic

.2 Acute erythraemia (Di Guglielmo’s disease)

.9 Leukaemia, unspecified

208 Polycythaemia vera

Excludes secondary polycythaemia (289.0) and

acute erythraemia (207,2)

209 Myelofibrosis

Benigw neoplasm (210-228)

210 Benign neoplasm of buccal cavity and pharynx

Excludes cyst of jaw (526) and oral soft tissues

(528)

.0 Lip

.1 Tongue.

.2 Salivary gland

.3 Floor of mouth

.4 Other and unspecified parts of mouth

.5 Tonsil

.6 Other parts of oropharynx

.7 Nasopharynx

.8 Hypopharynx

.9 Pharynx unspecified

211 Benign neoplasm of other parts of digestive system

.0 Oesophagus

.1 Stomach

.2 Small intestine

.3 Large intestine, except rectum

.4 Rectum

.5 Liver and biliary passages

.6 Pancreas

.7 Peritoneum and retroperitoneal tissue

.9 Unspecified site

212 Benign neoplasm of respiratory system

.0 Nose, nasal cavities, middle ear and accessory

sinuses”

.1 Larynx

.2 Trachea

.3 Bronchus and lung

.4 Pleura

.5 Mediastinum

.9 Unspecified site

213 Benign neoplasm of bone and cartilage

214 Lipoma

215 Other benign neoplasm of muscular and connective

tissue

216 Benign neoplasm of skin

.0 Epidermis

.1 Hair follicles and sebaceous glands

.2 Sweat glands and sweat ducts

30
.8 Other

Excludes benign melanoma (757.1)

.9 Unspecified

217 Benign neoplasm of breast

218 Uterine fibromyoma

219 Other benign neoplasm of uterus

.0 Endometriosis, endometrioma

,1 Adenomyosis, adenomyoma

.2 Papilloma, polyp

.3 Benign cyst

.9 Other and unspecified

220 Benign neoplasm of ovary

221

222

223

Excludes the listed conditions with ovarian

hyperfunction (256.0)

Benign neoplasm of other female genital organs

,0 Fallopian tube and broad ligament

,1 Vagina

.2 Vulva

.8 Other specified sites

.9 Unspecified site

Benign neoplasm of male genital organs

.0 Testis

Excludes the listed conditions with testicular

hyperfunction (257.0)

,I Penis

.8 Other specified sites

.9 Unspecified site

Benign neoplasm of kidney and other urinary

organs

.0 Kidney, except pelvis

.1 Pelvis of kidney

.2 Ureter

.3 Bladder

,8 Other specified sites

.9 Unspecified site

224 Benign neoplasm of eye

225 Benign neoplasm of brain and other parts of

nervous system

Excludes neurofibromatosis (743.3)

,0 Brain

.1 Spinal cord

.2 Meninges

,3 Peripheral nerves

,4 Sympathetic nervous system

.9 Unspecified site

226 Benign neoplasm of endocrine glands

Excludes the listed conditions with endocrine

hyperfunction (253, 254, 255, 258)

.0 Suprarenal gland

.1 Thymus

.2 Pituitary gland and craniopharyngeal duct

.3 PineaI gland

.8 Other specified endocrine glands

.9 Unspecified site

227 Haemangioma and lymphangioma

228 Benign neoplasm of other and unspecified organs

and tissues

Neoplasm of unspecified natwe (230-239)

230 Neoplasm of unspecified nature of digestive organs

.0 Oesophagus

.1 Stomach

.2 Small intestine

.3 Large intestine

.4 Rectum

.5 Liver and biliary passages

.6 Pancreas

.7 Peritoneum

.9 Unspecified site

231 Neoplasm of unspecified nature

organs

of respiratory

.0 Nose, nasal cavities, middle ear and accessory

sinuses

.1 Larynx

.2 Trachea

.3 Bronchus and lung

.4 Pleura

.5 Mediastinum

.9 Unspecified site

232 Neoplasm of unspecified nature of skin and

musculo-skeletal system

,0 Bone and cartilage

.1 Muscular and connective tissue

.2 Skin

233 Neoplasm of unspecified nature of breast

234 Neoplasm of unspecified nature of uterus

.0 Carcinoma in situ of cervix uteri

.1 Cervix uteri, other

.9 Othe~ and unspecified parts

235 Neoplasm of unspecified nature of ovary
236 Neoplasm of unspecified nature of other female

genital organs

OFallopian tube and broad ligament

.1 Vagina

.2 Vulva

.8 Other specified sites

.9 Unspecified site

237 Neoplasm of unspecified nature of other genitourinary organs

.0 Testis

.1 Penis

.2 Other and unspecified male genital organs

.3 Kidney, except pelvis

.4 Pelvis of kidney

.5 Ureter

.6 EUmider

.9 Other and unspecified urinary organs

238 Neoplasm of unspecified nature of eye, brain and

other parts of nervous system

.0 Eye

.1 Brain

.2 Spinal cord

.3 Meninges

.4 Peripheral nerves

.5 Sympathetic nervous system

.9 Unspecified site

239 Neoplasm of unspecified nature of other and unspecified organs

.0 Buccal cavity and pharynx

.1 Endccrine glands

.9 Other and unspecified sites

Ill. ENDOCRINE. NIITRITIONAL

AND METABOLIC DISEASES

Diseases of thyroid gtand (240-246).

240 Simple goitre

As ICD 250 with sub-divisions:

.0 Endemic

.1 Sporadic

.9 Unspecified

241 Non-toxic ncdular goitre

AS ICD 251 With SUb-diViSiOIM3:

.0 Endemic

.1 Sporadic

.9 Unspecified

242 ThYrotoxicosis with or without goitre

.0 Toxic diffuse goitre

As ICD 252.0 except for 242.2 below

.1 Toxic nodular goitre

AS ICD 252.1

.2 Thyrotoxicosis without mention of goitre

243 Cretinism of congenital origin

244 Myxoedema

245 Thyroiditis

246 Other diseases of thyroid gland

As ICD 254 except thyroiditis (245)

Diseases of othev endocvine glands (250-258)

250 Diabetes mellitus

AS ICD 260

251 Disorders of pancreatic internal secretion other

than diabetes mellitus

AS ICD 270

252 Diseases of parathyroid gland

AS ICD 271

.0 Hyperparathyroidism

.1 Hypoparathyroidism

.9 Other and unspecified

253 Diseases of pituitary gland

As ICD 272 with sub-divisions:

.0 Anterior pituitary hyperfunction

.1 Anterior pituitary hypofunction

.2 Chromophobe adenoma, pituitary

.9 Other and unspecified

Remainder of ICD 272

254 Diseases of thymus gland

AS ICD 273

255 Diseases of adrenal glands

.0 Adrenal cortical hyperfunction

Excludes congenital hyperadrenocorticism

(272.0)

.1 Adrenal cortical hypofunction

.2 P~ecchromocytoma

.9 Other and unspecified

256 Ovarian dysfunction

As ICD,275 with sub-divisions:

.0 Hyperfunction

.1 Hypofunction

.9 Ovarian dysfunction NOS

257 Testicular dysfunction

As ICD 276 with sub-divisions:

.0 Hyperfunction

32
.1 Hypofunction Other metabolic diseases (270-279)

.9 T&ticular dysfunction NOS

258 Polyglandular dysfunction and other diseases of

endocrine glands

.0 “Pituitary basopbilism

.1 Polyglandular dysfunction

.9 Other and unspecified diseases of endocrine

system

Remainder of ICD 277 excepti

Congenital dwarfism (7S6.6)

Cushing’s syndrome (255.0)

Avitaminoses and other nutritional deficiency (260-269)

Excludes deficiency anaemias (280, 281)

260 Vitamin A deficiency

.0 Night blindness

.1 Xerophthalmia, keratomalacia

,8 Other manifestation

.9 Unspecified

261 Thiamine deficiency (including beriberi)

262 Niacin deficiency (including pellagra)

263 Other vitamin B deficiency

.0 Ariboflavinosis

.1 Vitamin B6 deficiency

.8 Other

.9 Unspecified

264 Ascorbic acid deficiency (including scurvy)

265 Vitamin D deficiency

.0 Rickets, active

.1 Rickets, late effect

.2 Osteomalacia

.9 Unspecified

266 Other vitamin deficiency states

.II Vitamin K deficiency

.8 Other

.9 Unspecified

267 Protein malnutrition

268 Nutritional marasmus

269 Other nutritional deficiency

.0 Sprue and steatorrhoea

.1 Malabsorption syndrome NOS

.9 Other and unspecified

270 Congenital disorder of amino-acid metabolism

.0 Phenylketonuria

.1 Cystinuria

.2 Other disorders of amino-acid renal transport

.3 Cystinosis

.4 Maple syrup disease

.5 Disorders of purine andpyrimidine metabolism

.6 Alcaptonuria

.8 Other

.9 Unspecified

271 Congenital disorders of carbohydrate metabcdfsm

.0 Glycogen storage disease

.1 Galactosaemia

.2 Von Gierke’s disease

.8 Other

.9 Unspecified

272 Congenital disorders of lipid metabolism

Excludes amaurotic familial idiocy (342.0) and

leukodystrophy (342.1)

.0 Disorders of steroid metabolism

.1 Xanthomatosis

.8 Other

.9 Unspecified

273 Other and unspecified congenital disorders of

metabolism

.0 Cystic fibrosis (mucoviscidosis)

.1 Disorders of porphyrin metaklism

.2 Haemochromatosis

.3 Hepatolenticular degeneration

.4 Other disorders involving metabolism of minerals

.5 Defective bilirubin excretion

.8 Other

.9 Unspecified

274 Gout

AS ICD 288

275 Plasma protein abnormalities

.0 Agammaglobulinaemia

.1 Hypogammaglobulinaemia

.2 Analbuminaemia

.3 Bisalbuminaemia

.4 Cryoglobulinaemia

.5 Macroglobulinaetnia

.9 Other and unspecified

276 Amyloidosis

AS ICD 289.1

33
277 ObesiW not specified as of endocrine origin

As ICD 287

278 Other hyperalimentation

Excludes conditions due to excess administra.

tion of drugs (N963.6)

.0 Hypervitaminosis A ]

.1 Carotinaemia

.2 Hypervitaminosis D

I

of dietary origin

.9 Other and unspecified

279 Other and unspecified metabolic diseases

Excludes congenital metabolic defects (270-273)

‘IV. DISEASES OF BLOOD AND

BLOOD-FORMING ORGANS

280 Iron deficiency anaemias

281

AS ICD 29i

Other deficiency anaemias

.0 Pernicious anaemia

.1 Other vitamin B12 deficiency anaemia

.2 Folic acid deficiency anaemia

.3 Vitamin B6 deficiency anaemia

.4 Protein deficiency anaemia

.9 Other and unspecified deficiency anaemia

282 Hereditary haemolytic anaemias

.0 Familial acholuric jaundice

.1 Heredkarynon-spherccytic haemolytic anaemia

.2 Hereditary elliptocytosis

.3 Mediterranean anaemia

.4 Haemoglobinopathies

.5 Anaemia due to glucose-6-phoaphste dehydrogenase deficiency

.9 Other

283 Acquired haemolytic anaemias

.0 Acute

.9 Other

Acquired acholuric jaundice

284 Aplastic anaemias

285 Other and unspecified anaemias

.0 Hypochromic anaemia with iron loading

.8 Other specified anaemias

..9 Anaemia unspecified

As ICD 293

286 Coagulation defects

.0 Hemophilia

.1 Christmas disease

.2 PTA &ficiency

.3 Vascular hemophilia

.4 Hemorrhagic flbrinolysis (fibrinogenolyais)

.5 Circulating anticoagulants

.9 Other

287 Purpura and oth& hemorrhagic conditions

.0 Allergic purpura

.1 llrombocytopenia

.2 Hemorrhagic thrombocythaemia

.9 Other

288 Agramdocytosis

AS ICD 297

289 Other diseases of blood and blood-forming organa

.0 Polycythaemia, secondary

.1 Diseases of spleen

As ICD 298 except hepatolienalfibrosis (571)

.2 Chronic Iymphadenitis

AS ICD 468.0

.3 Non-specific mesenteric lymphadenitis

AS ICD 468.1

.4 Lymphadenitis, unspecified

& ICD 468.2

.8 Other

.9 Unspecified

V. MENTAL DISORDERS

This section is intended primarily for the classification of admissions to mental hospitals, psychiatric

clinics, mental deficiency institutions, etc. For this

reason, all forms, of mental disorder are claasifled

here, even though associated with or secondary to

physical conditions as in categories 290-294, 309, 310-

315. For primary mortaliW classification and for morbidity classification where the mafn interest is not in

the mental state, these categories should not he used

but assignment made to the underlying cause.

Psychoses (2%)-299)

290 Senile and pre-senile dementia

.0 Senile dementia

.1 Pre-senile dementia

291 AIcohdic psychosis

.0 Delirium tremens

.1 Korsakoff’s psychosis (alcoholic)

.2 Other alcoholic hallucinosis

.3 Alcoholic paranoia

.9 Other and unspecified

292 Psychosis associated with intracranial infection

.0 With general paralysis

34
.1 With other syphilis of central nervous system

.2 With epidemic encephalitis

.3 With other and unspecified encephalitis

.9 With other and unspecified intracranial infection

293 Psychosis associated with other cerebral condition

.0 With cerebral arteriosclerosis

.1 With other cerebrovascular disturbances

.2 With epilepsy

.3 With intracranial neoplasm

.4 With degenerative diseases of central nervous

system

.5 With brain trauma

.9 With other and unspecified cerebral condition

294 Psychosis associated with other physical condition

.0 With endocrine disorders

.1 With metabolic and nutritional disorders

.2 With systemic infections

.3 With drug or poison intoxication

Excludes alcoholic psychosis (291)

.4 With childbirth

Excludes psychosis of specified type arising

during the puerperium (295-298)

.8 With other physical conditions

.9 With physical condition, NOS

295 Schizophrenia

.0 Simple type

.1 Hebephrenic type

.2 Catatonic type

.3 Paranoid type

.4 Acute schizophrenic episode

Excludes acute schizophrenia of the types

listed above

.5 Latent schizophrenia

.6 Residual schizophrenia

.7 Schizo-affective type

.8 Other

.9 Unspecified type

296 Affective psychoses

.0 Involutional melancholia

.1 Manic-depressive psychosis, manic type

.2 Manic-depressive psychosis, depressed type

Includes endogenous depression

.3 Manic-depressive psychosis, circular type

.8 Other

,9 Unspecified

297 Paranoid states

Excludes acute paranoid reaction (298.3)

.0 Paranoia

.1 Involutional parap~enia

.9 Other

298 Other psychoses

.0 Reactive depressive psychosis

.1 Reactive excitation

.2 Reactive confusion

.3 Acute paranoid reaction

.9 Reactive psychosis unspecified

299 Unspecified psychosis

Newosis, penwnulity disorders and othey non-psychotic

mental disordeys (300-309)

300 Neuroses

.0 Anxiety neurosis

.1 Hysterical neurosis

.2 Phobic neurosis

.3 Obsessive compulsive neurosis

.4 Expressive neurosis

.5 Neurasthenia

.6 Depersonalization syndrome

.7 Hypochondriacal neurosis

.8 Other

.9 Unspecified neurosis

301 PersonaliW disorders

.0 Paranoid

.1 Affective (cyclothymic)

.2 Schizoid

.3 Explosive

.4 Anancastic (obsessive-compulsive)

.5 Hysterical

.6 Asthenic

.7 Antisocial

.8 Other

.9 Unspecified

302 Sexual deviation

.0 Homosexuality

.1 Fetishism

.2 Pedopbilia

.3 Transvestitism

.4 Exhibitionism

.8 Other

.9 Unspecified

303 Alcoholism

Excludes alcoholic psychosis (291J acute poisoning by alcohol (E860, N980). For primary

cause classification it excludes alcoholic cirrhosis of the liver (571.0)

.0 Episodic excessive drinking

.1 Habitual excessive drinking

.2 Alcoholic addiction

.9 Other and unspecified alcoholism

35
304 Drug dependence

.00pium, opium alkaloids and their derivatives

.1 Synthetic analgesics with morphine-like effecta

.2 Barbiturates

.3 Other hypnotics andsedatives or’’tianquilizers”

.4 Cocaine

,5 Cannabis sativa (hashish, marihuana)

.6 Other psycho-stimulants

.7 Hallucinogenic

.8 Other

.9 Unspecified

305 Physical disorders of presumably psychogenic

origin

.0 Skin

.1 Musculo-skeletal

.2 Respiratory

.3 Cardiovascular

.4 Haemic and lymphatic

.5 Gastro-intestinal

.6 Genito-urinary

.7 Endocrine

.8 Organs of special sense

.9 Other

306 Special symptoms not elsewhere classified

.0 Speech disturbance

.1 Specific learning disturbance

.2 Tics

.3 Other psychomotor disorders

.4 Disorders of sleep

.5 Feeding disturbances

.6 Enuresis

.7 Encopresis

.8 Cephalalgia

.9 Other

307 Transient situational disturbances

308 Behaviour disorders of childhood

309 Mental disorders not specified as psychotic associated with ‘physical conditions

.0 With intracranial infections

.1 With drug, poison of systemic ~intoxication

Excludes alcoholism (303) and drug de.

pendence (304)

.2 Witi brain trauma

.3 With circulatory disturbance

.4 With epilepsy

.5 With disturbance of metabolism, growth or

nutrition

.6 With senile or pre-senile brain disease

.7 With intracranial neoplasm

.8

.9

With degenerative diseases of central nervous

system

With other and unspecified physical conditions

Mental retardation (310-315)

310 Borderline mental retardation

IQ 68-85

311 I@d mental retardation

IQ 52-67

312 Moderate mental retardation

IQ 36-51

313 Severe mental retar&tion

IQ 20-35

314 Profound mental retardation

IQ under 20

315 Unspecified mental retardation

The following fourth-digit sub-divisions should

be used with each of the almve categories:

.0 Following infections and intoxications

.1 Following trauma or physical agents

.2 With disorders of metabolism, growth ornutrition

.3 Associated with gross brain disease (postnatal)

.4 Associated with diseases and conditions due to

(unknown) pre-natal influence

.5 With chromosome abnormalities

.6 Associated with prematurity

.7 Following major psychiatric disorder

.8 With psycho-social (environmental) deprivation

.9 other and unspecified

V1. DISEASES OF THE NERVOUS SYSTEM

AND SENSE ORGANS

InjlammatoYy diseases of centval nervow system

(J20-324)

320 Meningitis, except meningococcal, tuberculous and

viral

,0 H. influenza

.1 Pneumococcus

.8 Due to other specified organism

.9 With no organism specified as cause

321 Phlebitis and thrombophlebitis of intracranial

venous sinuses

As ICD 341

36
322 Intracranial and intraspinal abscess

As ICD 342

323 Encephalitis, myelitis, and encephalomyelitis

(except acute infectious)

As ICD 343

324 Late effects of intracranial abscess or pyogenic

infection

As ICD 344

Hereditary and familial diseases of nervous system

(330-333)

330 Heredi@ry neuromuscular disorders

,0 Neuropathic muscular atrophy

.1 Familial progressive spinal muscular atrophy

.2 Amyotonia congenita

.3 Progressive muscular dystrophy

.9 Other

331 Hereditary diseases of the striato-pallidal system

Excludes hepatolenticular degeneration (273.3)

,0 Hereditary chores

.1 Dystonia musculorum deformans

.2 Progressive familial myoclonic epilepsy

(Unverricht-Lundberg)

.9 Other

332 Hereditary ataxia

.0 Hereditary spinal ataxia

,1 Hereditary cerebella ataxia

.9 Other and unspecified

333 Other hereditary and familial diseases of nervous

system

.0 Amaurotic familial idiocy

.1 Progressive cerebral leukodystrophy

.9 Other and unspecified

Other diseases of central nervous system (340-349)

340 Multiple sclerosis

Excludes diffuse cerebral sclerosis (341)

As ICD 345

341 Other demyelinating diseases of central nervous

system

342 Paralysis agitans

As ICD 350

343 Cerebral spastic infantile paralysis

As ICD 351

344 Other cerebral paralysis

AS ICD 352

345 Epilepsy

.0 Generalized non-convulsive

.1 Generalized convulsive

.2 Partial (focalized)

.3 Status epileptics

.9 Other and unspecified

346 Migraine

As ICD 354

347 Other diseases of brain

.0 Cataplexy and narcolepsy

.9 Other

348 Motor neurone disease

.0 Amyotrophic lateral sclerosis

AS ICD 356.1

.1 Progressive bulbar palsy

.2 Other progressive muscular atrophy

.9 Other and unspecified manifestations

As ICD 356.3 except primary muscular

atrophy (733. 1)

349 Other diseases of spinal cord

.0 Syringomyelia and syringobulbia

.9 Other

Excludes Landry’s paralysis (354)

Diseases of nerves and pen”pheral ganglti (350-358)

350 Facial paralysis

As ICD 360

351 Trigeminal neuralgia

J’% ICD 361

352 Brachial neuritis

As ICD 362 except brachial radiculitis (728-3)

353 Sciatica

As ICD 363 except Iumbosacral radiculitis

(728-8)

354 Polyneuritis and polyradiculitis

355 Other and unspecified forms of neuralgia and

neuritis

As ICD 366

356 Other diseases of cranial nerves

AS ICD 367

357 Other diseases of peripheral nerves except autonomic

As ICD 368 except vertebrogenic conditions

(728)

37
358 Diseases of peripheral autonomic nervous system

As ICD 369 except vertebr~enic conditions

(728)

Inflamm,atov diseases of the eye (360-369)

360 Conjunctivitis and ophthalmia

Excludes viral conjunctivitis (078) and gonoCWCiC (098.2)

361 Blepharitis

As ICD 371

362 Hordeolum (sty)

AS ICD 372

363 Iritis

364 Keratitis

.0 With ulceration

AS ICD 381

.9 Without mention of ulcer

As ICD 374

365 Choroiditis

As ICD 375

366 Other inflammation of uveal tract

As ICD 376 except cyclitis and iridccyclitis

(363)

367 Inflammation of optic nerve and retina

As ICD 377

368 Inflammation of lachrymal glands and ducts

AS ICD 3/5

,369 Other inflammatory diseases of eye

As ICD 379

Other diseases and conditions of eye (370-379)

370 Refractive errors

AS ICD 380

371 Corneal opacity

AS ICD 382

372 Pterygium

AS ICD 383

373 Strabismus

AS ICD 384

374 Cataract

h ICD 385

375 Glaucoma

As ICD 387 with sub-divisions:

.0 Primary acute

.1 Chronic (primary)

.2 Secondary

.9 Unspecified

376 Detachment of retina

AS ICD 386

377 Other diseases of retina and optic nerve

.0 Vascular lesions of retina

.1 Degeneration of retina

.2 Amblyopia

.3 Colour blindness

.8 Other

.9 Unspecified

378 Other diseases of eye

.0 Chalazion

.9 Other

379 Blindness

AS ICD 389

.0 Blindness, both eyes, specifically defined

.1 Blindness, both eyes, not specifically defined

.2 Blindness, one eye, specifically defined

.3 Blindness, one eye, not specifically defined

Diseases of the ear and mastoid process (380-389)

380 Otitis externa

As ICD 390

381 Otitis media without mention of mastoiditis

As ICD 391

.0 Acute

.1 Chronic

.2 Unspecified

382 O~itis media with mastoiditis

AS ICD 392

.0 Acute

.1 Chronic

.2 Unspecified

383 Mastoiditis without mention of otitis media

As ICD 393

.0 Acute

.1 Chronic

.2 Unspecified

384 Other inflammatory diseases of ear

As ICD 394

385 M&i&e’s disease

As ICD 395

38
386 Otoscleroais

387 Other diseases of ear and mastoid prcwess

.0 Cholesteatoma of ear

.1 Wax in ear

.9 Other and unspecified

388 Deaf mutism

As ICD 397

389 Other deafness

AS ICD 398

.0 Deafness, both ears

.1 Deafness, one ear, and partial deafness in other

.2 Deafness, one ear

.3 Impairment of hearing, one or both ears

WI. DISEASES OF THE CIRCULATORY SYSTEM

Active Yheumatic fever (390-392)

390 Rheumatic fever without mention of heart involvement

As ICD 400

391 Rheumatic fever with heart involvement

Excludes chronic heart diseases of rheumatic

origin (393-398) unless rheumatic fever is

also present or there is evidence of recrudescence or activity of the rheumatic process.

In cases where there is doubt as to rheumatic

activity at the time of death, see Rules for

Classification

.0 Active rheumatic pericarditis

.1 Active rheumatic endocarditis

.2 Active rheumatic myocarditis

.9 Other active rheumatic heart disease

392 Chorea

.0 With heart involvement

h ICD 402.1

.9 Without mention of heart involvement

h ICD 402.0

Chvonic vheumatic heart disease (393-398)

393

394

.,

Diseases of pericardium, specified as rheumatic

Diseases of mitral valve

Includes the listed conditions with disease of

pulmonary or tricuspid valves

.0 Specified as rheumatic

.9 Not specified as rheumatic

Diseases of aortic valve, specified as rhetimatic

Includes the listed conditions with disease of

pulmonary or tricuspid valves

As ICD 411

396 Diseases of mitral and aortic valves

Includes the listed conditions with disease of

pulmonary or tricuspid valves

.0 Specified as rheumatic

.9 Not specified as rheumatic

397 Diseases of other endocardial structures, specified as rheumatic

As ICD 412-414, specified as rheumatic

398 Other heart disease, specified as rheumatic

Hypertensive disease (400-404)

Categories 400-404 include the listed conditions

with arteriosclerosis; they exclude them with

ischaemic heart disease (410-414)

400 Malignant hypertension

Includes any condition in 401-404 if specified

as malignant or associated with malignant

hypertension

.0 Without mention of organ damage

.1 With heart involvement (any condition in 427-

429)

.2 With cerebrovascular involvement (any condition in 430-438)

.3 With renal involvement (any condition in 580-

584, 593.2, 792)

.9 With multiple organ involvement

401 Essential benign hypertension

As ICD 444, 447

Excludes the listed conditions with cerebrovascular disease (430-438)

402 Hypertensive heart disease

Includes any condition in 427-429 with hypertension (benign)

Excludes the listed conditions with any conditions in 403, 584 (404)

403 Hypertensive renal disease

k ICD 446

Excludes the listed conditions with any condition

in 402, 427-429 (404)

404 Hypertensive heart and renal disease

Includes any condition in 402 with any condition

in 403

Ischaemic heart disease (410-414)

Categories 410-414 include the listed conditions

with arteriosclerosis, hypertension (benign)

(malignant), or any condition in 427-429. The

39
following fourth-&git sub-divisions should be

used with these categories:

.0 With hypertension (benign) (malignant)

.9 Without mention of hypertension

410 Acute myosardial infarction

Includes any condition in 412 specified as acute

or with a stated duration of eight weeks or

less. Excludes the listed conditions specified

as chronic or with a stated duration of over

eight weeks (412). Includes them with conditions in 411-413

411 Other acute and sub-acute forms of ischaemic

heari disease

412 Chronic ischaemic heart disease

Includes any condition in 410 specified as

chronic or with a stated duration of over

eight weeks. Excludes the listed conditions

specified as acute or with a stated duration

of eight weeks or less (410). Includes thenx

with conditions in 413

413 Angina pectoris

414 Asympmmatic ischaemic heart disease

Otherforms of heart disease (42V-429)

420 Acute pericarditis

421 Acute and sub-acute endccarditis

.0 Acute and sub-acute bacterial

As ICD 430.0

.9 Other acute endocarditis

‘As ICD 430.1

422 Acute myocardjtis

As ICD 431

423 Chronic disease of pericardium

endocarditis

424 Chronic disease of endocardium, not specified as

rheumatic

Includes the listed conditions when specified as

due to hypertension (benign) or arteriosclerosis. When more than one valve is menticmed,

priority in classification is in the order mitral

valve, agrtic valve, other

.0 Mitral valvk, specified as non-rheumatic

.1 Aortic valve

.9 Other endocardial structures

425 Cardiomyopathy

426 Pulmonary heart disease

For primary mortality classification, excludes

the listed conditions when the underlying

pulmonary condition is known

427 Symptomatic heart disease

Excludes the listed conditions with malignant

hypertension (400.1), other hypertension (402)

and ischaemic heart disease (410-414)

.0 Congestive heart failure

.1 Left ventricular failure

.2 Heart block

.9 Other disorders of heart rhythm

428 Other myocardial insufficiency

Excludes the listed conditions with malignant

hypertension (400.1), other hypertension (402)

and ischaemic heart disease (410-414)

.0 With arteriosclerosis

.9 Other

Excludes the listed conditions with arteriosclerosis (428.0)

429 Ill-defined heart disease

E’xcludes the listed conditions with malignant

hypertension ‘(400.1), other hypertension (402)

and ischaemic heart disease (410-414)

Cevebrovascular disease (430-438)

Categories 430-438 include the listed conditions

with arteriosclerosis or hypertension (benign).

They exclude them with malignant hypertension

(400.2). The following fourth-digit sub-divisions

should be used with these categories:

.0 With hypertension (benign)

.9 Without mention of hypertension

430 Subarachnoid hemorrhage

As ICD 330 I

431 Cerebral hemorrhage

As ICD 331 I

432 Occlusion of pre-cerebral arteries I

433 Cerebral thrombosis I

434 Cerebral embolism

Includes cerebral infarction NOS, cerebral

(artery) ooclusion NOS

435 Transient cerebral ischae”mia

436 Acute but ill-defined

437 Generalized ischaemic

cerebrovascular

cerebrovascular

disease

diseast=

40
438 Other and ill-defined cerebrovascular disease.

Excludes hemiplegia (old orlong-standing)of

uncertain origin (344) but

Includes hemiplegia specified as duetohypertension or arteriosclerosis

Diseases of arteties, atferioles andcapillaties (440-44?7

440 Arterioacleroais

Excludes the listed conditions with anycondition in 400-404,410-414,430-438 (assign to

these conditions), 428.9 (428.0) and 445.9

(445.0), and when reported asthe underlying

cause of any condition in 342,424,427,441-

444 (assign to these conditions) or of the

terms nephritis (chronic) (interstitial) and

Bright’s disease (chronic) (403)

.0 Of aorti

.1 Of renal artery

.2 Of peripheral arteries

.3 Of other specified arteries

Excludes arteriosclerosis, coronary (412)

and cerebral (437)

.9 Generalized and unspecified

441 Aortic aneurysm (non-syphilitic)

Includes the listed conditions when specified as

due to hypertension or arteriosclerosis

.0 Dissecting aneurysm of aorta (any part)

.1 Aneurysm of aorta, thoracic or unspecified

.2 Aneurysm of aorta, abdominal

.9 Other

442 Other aneurysm

AS ICD 452

443 Other peripheral vascular disease

As ICD 453

.0 Raynaud’s syndrome

.1 Thrombo-angiitis obliterans (Buerger’s

disease)

.2 Chilblains

.9 Other

444 Arterial embolism and thrombosis

.0 Mesenteric

.1 Renal

.2 Peripheral arteries

.9 Other arteries, not els?where classified

445 Gangrene

Excludes diabetic gangrene (250), gas gangrene

(039.0), and gangrene of certain sites (see

Alphabetical Index)

.0 Arteriosclerotic gangrene

.9 Gangrene not elsewhere classified

446 Other diseases of arteries and arterioles

.0 Polyarteritis nodosa

.1 Hypersensitivity angiitis

.2 Rheumatic arteritis

.3 Wegener’s gramdomatosis

.4 Cranial arteritis

.5 Thrombotic microangiopathy

.9 Other

447 Diseases of capillaries

AS ICD 467.1

Diseases of veins and lymphatic, and other diseases

of circulatory system (450-458)

450 Pulmonary embolism and infarction

AS ICD 465

451 Phlebitis and thrombopblebitis

.0 Of lower extremities

i% ICD 463

.9 Of other sites

& ICD 464

452 Portal vein thrombosis

453 Other venous embolism and thrombosis

i% ICD 466

454 Varicose veins of lower extremities

.0 With ulcer

.9 Without mention of ulcer

455 Hemorrhoids

h ICD 461

456 Varicoae veins of other sites

457

458

AS ICD 462

.0 Of oesophagus

.1 Of scrotum

.9 Of other sites

Non-infective disease of lymphatic channels

AS ICD 468.3

Excludes Iymphangitis with celhditis (682) and

lymphadenitis, acute (683), chronic (289.2),

mesenteric (289.3), unqualified (289.4)

Other diseases of circulatory system

As ICD 467 except diseases of capillaries (447)

.0 Hypotension

.9 Other and unspecified circulatory diseases .

41
ViIl. DISEASES OF THE RESPIRATORY SYSTEM

Acizterespiratory infections (except influenzd (460-466)

460 Acute nasopharyngitis (common cold)

As ICD 470

461 Acute sinusitis

As ICD 471

462 Acute pharyngitis

As ICD 472 without sub-divisions

463 Acute tonsillitis

As ICD 473

464 Acute laryngitis and tracheitis

As ICD 474

465 Acute upper respiratory infection of multiple

or unspecified sites

As ICD 475

466 Acute bronchitis and bronchiolitis

As ICD 500 and bronchiolitis

.3 Staphylococcus

.9 Other

483 Pneumonia due to other specified organism

Excludes pneumonia in coccidioidomycosis

(114); histoplasmosis (115); Q-fever (083.1);

and other diseases classified as infectious

(000-136)

484 Acute interstitial pneumonia

485 Bronchopneumonia, unspecified

Excludes bronchiolitis (466) and lipoid pneumonia (519.2)

486 Pneumonia, unspecified

Bronchitis, emphysema and asthma (490-493)

Excludes acute bronchitis (466)

490 Bronchitis, unqualified

As ICD S01

Excludes the listed conditions with emphysema

(491)

491 Chronic bronchitis

As ICD 502 without sub-divisions

Influenzq (470-474)

470 Influenza unqualified

471 Influenza with pneumonia

AS ICD 480

472 Influenza with other respiratory manifestations

473 Influenza with digestive manifestations

AS ICD 482

474 Influenza with nervous manifestations

AS ICD 483

Pneumonia (480-486)

Excludes lipid pneumonias and eosinophilic pneumonitis (519.2)

480 Viral pneumonia

Excludes influenza virus pneumonia (471~

measles pneumonia (055); psittacotic pneumonia (073)

481 Pneumococcal pneumonia

482 Other bacterial pneumonia

.0 Friedltinder’s bacillus

.1 Haemopbilus influenza

.2 Streptomxcus

492 Emphysema

AS ICD 527.1

Excludes the listed conditions with bronchitis,

chronic or unqualified (491)

493 Asthma

AS ICD 241

Excludes the listed conditions with bronchitis:

acute (466), chronic (491 ), unqualified (490)

and emphysema (492)

Othevdiseases of upper vespivatory tract (500-508J

500 Hypertrophy of tonsils and adenoids

As ICD 510.0

501 Peritonsillar abscess (quinsy)

As ICD 511

.502 Chronic pbaryngitis and nasopharyngitis

AS ICD 512

.0 Chronic pharyngitis

.1 Chronic nasopharyngitis

503 Chronic sinusitis

As ICD 513

504 Deflected nasal septum

As ICD 514
505 Nasal polyp

As ICD 515

506 Chronic laryngitis

AS ICD 516

507 Hay fever

As ICD240

508 Other diseases of upper respiratory tract

As ICD 517

Other diseases of respiyatovy system (510-519)

510 Empyema

AS ICD 518

511 Pleurisy

As ICD S19

.0 Without mention of effusion or tuberculosis

.1 With effusion, with mention of a bacterial cause

other than tuberculosis

.2 Other specified forms of effusion, except tuberCulous

512 Spontaneous pneumothorax

AS ICD 520

513 Abscess of lung

h ICD 521

514 Pulmonary congestion and hypostasis

AS ICD 522

515 Pneumoconiosis due to siiica and silicates

Excludes silicotuberculosis (010)

.0 Silicosis

.1 Anthracosilicosis

.2 Asbestosis

.9 Other, including pneumoconiosis unspecified

516 Other pneumoconioses and related diseases

.0 Due to inhalation of other inorganic dust

.1 Due to inhalation of other dust

.2 Due to inhalation of fumes

517 Other chronic interstitial pneumonia

As ICD 525 (with deletion of note)

518 Bronchiectasis

.4s ICD 526

519 Other diseases of respiratory system

.0 Pulmonary collapse

AS ICD 527.0

.1 Acute oedema of lung without mention of heart

.2 Other diseases of lung

.9 Other

As ICD 527.2, except acute oedema of lung

(519.1)

IX. DISEASES OF THE DIGESTIVE SYSTEM

Diseases of oral cavity, salivary glands and jaws

(520-529)

520 Disorders of tooth development and eruption

.0 Anodontia

Excludes missing tooth with abnormal

spacing (524 ,3)

,1 Supernumerary teeth

Excludes supernumerary teeth causing

crowding (524.3)

.2 Abnormalities of size and form

.3 Mottled teeth

.4 Enamel hypoplasia

.5 Hereditary disturbances in tooth structure NEC

.6 Disturbances in tooth eruption

Excludes impacted, embedded teeth with abnormal position of such teeth or adjacent

teeth (524.3)

.7 Teething syndrome

.9 Other and unspecified

521 Diseases of hard tissues of the teeth

.0 Dental caries

.1 Attrition

.2 Abrasion

.3 Erosion

.4 Resorption

.5 Hypercementosis

.6 hkylosis

.7 Posteruptive colour changes

.8 Irradiated enamel

.9 Other and unspecified

522 Diseases of pulp and periapical tissues

.0 Pulpitis

.1 Necrosis of the pulp

.2 Pulp degenerations

.3 Abnormal hard tissue formation in pulp

.4 Acute apical periodontitis

.5 Periapical abscess

.6 Chronic apical periodontitis (granuloma)

.7 Fistula from periapical lesions

.8 Radicular cyst

.9 Other and unspecified

523 Periodontal diseases

.0 Acute gingivitis

.1 Chronic gingivitis

43
.2 Gingival recession

.3 Acute periodontitis

.4 Chronic periodontitis

.5 Periodontosis

.6 Accretions on teeth

.9 Other and unspecified

524 Dento-facial anomalies including malocclusion

.0 Major anomalies of jaw size

.1 Anomalies of jaw-cranial base relationship

.2 Anomalies of dental arch relationship

.3”Anomalies of tooth position

.4 Malocclusion NOS

.5 Dento-facial functional abnormalities

.9 Other and unspecified

525 ~er diseases and conditions of the teeth and

supporting structures

.0 Acquired absence of teeth

Excludes missing teeth causing malocclusion

(524.3)

.1 Atrophy of edentulous alveolar ridge

.9 Other and unspecified

526 Diseases of the jaws

.0 Developmental dental cysts

Excludes radicular cyst (522.8)

.1 Fissural cysts

.2 Other cysts

.3 Reparative giant cell granuloma

.4 Inflammatory conditions

.5 Alveolitis (dry socket)

.9 Other and unspecified

527 Diseases of the salivary glands

.0 Atrophy

.1 Hypertrophy

.2 Sialoadenitis

.3 Abscess

.4 Fistula

.5 Sialolithiasis

.6 Mucocele (ranula)

.7 Disturbances of salivary secretion

.8 Sialosis

.9 Other and unspecified

528 Diseases of the oral soft tissues, excluding gingiva

and tongue

.0 Stomatitis

Excludes Vincen~s stomatitis (101)

.1 Cancrum oris (noms)

.2 Oral aphthous ulceration

.3 Celhditis and abscess

.4 cysts

.5 Diseases pf lips

Excludes angular cheilosis in vitamin deficiency (262, 263)

.6 Leukoplakia

.7 Other disturbances of keratinisation

.8 Oral submucous fibrosis

.9 Other and unspecified

529 Diseases of the ton~e and other oral conditions

.0 Median rhomboid glossitis

.1 Geqyapical tongue (benign, rnigratoryglossitis)

.2 Other gloesitis

.3 Hypertrophy of tongue papillae

.4 Atrophy of tongue papillae

.5 Plfcated tongue

.6 GIossodynia (ghxmopyrosis)

.9 Other and unspecified

Diseases of oesophqgus, stonuzch and duodenum (530-

53i7

530 Diseases of oesophagus

As ICD 539

.0 Functional disorders of oesophagus

.9 Other

531 Ulcer of stomach

As ICD 540 except peptic ulcer NOS (533)

.0 With perforation

.9 Without menti”m of perforatim

532 Ulcer of duodenum

As ICD 541

.0 With perforation

.9 Without mention of perforation

533 Peptic ulcer, site unspecified

.0 With perforation

.9 Without mention of perforation

534 Gastrojejunal ulcer

As ICD 542

.0 With perforation

.9 Withoutmention of perforation

535 Gastritis and duodenitis

As ICD 543

536 Disorders of function of stomach

As ICD 544

.0 Disorders of gastric secretion

.1 Disorders of gastric mot@y

.9 Other

44
537 Other diseases of stomach and d.ucdenum

As ICD 545

Appendicitis (540-543)

540 Acute appendicitis

As ICD 550

.0 With peritonitis

,9 Without mention of peritonitis

541 Appendicitis, unqualified

As ICD 551

542 Other appendicitis

As ICD 552

543 Other diseases of appendix

As ICD 553

Hernia of abdominal cavity (550-553)

5S0 Inguinal hernia without mention of obstruction

As ICD 560.0

551 Other hernias of abdominal cavity without mention of obstruction

.0 Femoral

AS ICD 560.1

.1 Umbilical

h ICD 560.2

.2 Ventral (incisional)

AS ICD 560.3

.3 Diaphragmatic.

Excludes hernias due to gross congenital

defect of diaphragm (756.8)

.8 Of other specified sites

As ICD 560.4 except diaphragmatic hernia

above

.9 Of unspecified site

AS ICD 560.5

552 Inguinal hernias with obstruction

AS ICD 561.0

553 Other hernia of abdominal cavity with obstruction

.0 Femoral

AS ICD 561.1

.1 Umbilical

AS ICD 561.2

,2 Ventral (incisional)

h ICD 561.3

.3 Diaphragmatic

Excludes hernia due to gross congenital

defect of diaphragm (756.8)

.8 Of other specified sites

As ICD 561.4 except

above

.9 Of unspecified site

f% ICD 561.5

diaphragmatic hernia

Other diseases of intestine and peritoneum (560-569)

560 Intestinal obstruction without mention of hernia

As ICD 570 except mesenteric infarction (447.0)

.0 Intussusception

.1 Paralytic ileus

.2 Volvulus

.3 Impaction of intestine

.9 Other and unspecified

561 Gastro-enteritis and colitis, except ulcerative, of

non-infectious origin

Excludes colitis, diarrhoea, enteritis, gastroenteritis, infectious or unspecified (009)

562 Diverticula of intestine

.0 Small intestine

.1 GoIon

563 Chronic enteritis and ulcerative colitis

.0 Regional enteritis

i% ICD 572.0

.1 Ulcerative colitis

AS ICD 572.2

.9 Other

AS ICD 572.3

564 Functional disorders

;0 Constipation

As ICD 573.0

.1 Irritable colon

.9 Other

As ICD 573.3

(564.1)

of intestines

except membranous colitis

565 Anal fissure and fistula

.0 Anal fissure

.1 Anal fistula

566 Abscess of anal and rectal regions

As ICD 575

567 Peritonitis

& ICD 576

568 Peritoneal adhesions

As ICD 577

45
5690ther diseases

AS ICD 578

of intestines and peritoneum

Diseases of liver, gallbladder and pancyeas (570-577)

570 Acute and subacute necrosis of liver

I% ICD 580

571 Cirrhosis of liver

.0 Alcoholic

.9 Other

572 Suppurative hepatitis and liver abscess

f% ICD 582

573 Other diseases of liver

As ICD 583 except portal vein obstruction

(452)

574 Cholelithiasis

AS ICD 584

575 Cholecystitis and cholangitis, without mention of

calculi

As ICD 585

576 Other diseases of gallbladder and biliary ducts

AS ICD 586

577 Diseases of pancreas

.0 Acute pancreatitis

AS ICD 587.0

.1 Chronic pancreatitis

i% ICD587.1

.9 Other diseases of pancreas

As ICD 587.2 except fibrocystic disease

of pancreas (273.0)

X. DISEASES OF GENITO-URINARY SYSTEM

Nephritis andnephYosis (580-584)

Categories 580-583 (but not 584) include thelisted

conditions with hypertension (benign) butexclude

them with malignant hypertension (400.3)

580 Acute nephritis

581 Nephrotic syndrome

582 Chronic nephritis

Excludes the terms’ ‘chronic Bright’s disease, ”

“chronic interstitial nephritis” and “chronic

nephritis NOS” when specified as arteriosclerotic or due to any condition in 440 (403)

583 Nephritis unqualified

Excludes the terms “Bright’s disease, NOS,”

“interstitial nephritis NOS” and “nephritis

NOS” when specified as arteriosclerotic or

due to any condition in440 (403)

584 Renal sclerosis, unqualified

Excludes the conditions when specified as

arteriosclerotic or due to any condition in 401,

403 (403), 402, (404) or malignant hypertension

(400.3). It also excludes contracted kidney,

hydronephrotic (591) and pyelonephritic(590 .0)

Other diseases of winary system (590-599)

590 Infections of kidney

.0 Chronic pyelonephritis

.1 Other pyelonepbritis, pyelitis and pyelocystitis

Remainder of ICD 600.0

.2 Abscess of kidney and perirenal tissue

AS ICD 600.1

.9 Other

AS ICD 600.2

591 Hydronephrosis

AS ICD 601

592 Calculi of kidney and ureter

AS ICD 602

593 Other diseases of kidney and ureter

.0 Renal dwarfism

.1 Acute tubular nephrosis

Excludes traumatic anuria (crush syndrome)

(N996.7)

.2 Other renal disease

.3 Obstruction of ureter, not elsewhere classified

.4 Other diseases of ureter

Rest of ICD 603

594 Calculi of other parts of the urinary system

As ICD 604

595 Cystitis

AS ICD 605

596 Other diseases of bladder

As ICD 606

597 Urethritis (non-venereal)

h ICD 607

598 Stricture of urethra

As ICD 608

599 Other diseases of urinary tract

Diseases of male genital ovgans (600-60~

600 Hyperplasia of prostate

AS ICD 610

46
601 Prostatitis

AS ICD 611

602 Other diseases of prostate

i% ICD 612

603 Hydrocele

As ICD 613

604 Orchitis and epididymitis

AS ICD 614

605 Redundant prepuce and phimosis

AS ICD 615

606 Sterility, male

As ICD 616

607 Other diseases of male genital organs

As ICD 617 with sub-divisions:

.0 Leukoplakia of penis

.1 Erythroplasia of penis

.2 Chronic ulceration of penis

.3 Balanitis

.4 Seminal vesiculitis

.5 Other inflammatory diseases

.6 Spermatocele

.7 Torsion of testis

.8 Atrophy of testicle

.9 Other

Remainder of ICD 617

Diseases Of breast, ovary, Fallopian tube and pavametvium (610-616)

610 Chronic cystic disease of breast

611

612

613

614

AS ICD 620

Other diseases of breast

.0 Acute mastitis not associated with lactation

AS ICD 621.0

.1 Hypertrophy of breast

AS ICD 621.1

.2 Fissure of nipple

.9 Other

Remainder of ICD 621.2

Acute salpingitis and oophoritis

AS ICD 622

Chronic salpingitis and oophoritis

AS ICD 623

Salpingitis and oophoritis, unqualified

AS ICD 624

615 Other diseases of ovary and Fallopian tube

As ICD 625 with sub-divisions:

.0 Prolapse of ovary

.1 Hydrosalpinx.

.2 Ovarian cyst, retention

.9 Other

Remainder of ICD 625

616 Diseases of parametrium and pelvic peritoneum

(female)

As ICD 626 with sub-divisions:

.0 Pelvic inflammatory disease

.1 Pelvic peritoneal adhesions, female

.2 Pelvic congestion, female

.9 Other

Remainder” of ICD 626 except rectovaginal

fistula (629.8)

Diseases of uterus and othey female genital oygans

(620-629)

620 Infective diseases of cervix uteri

Excludes trichomonal infections (131)

.0 Chronic cervicitis

.1 Other cervicitis

621 Other diseases of cervix

.0 Leukoplakia of cervix

.1 Erytbroplasia of cervix

.2 Hyperplastic endometritis of cervix

.3 Chronic erosion and ulceration of cervix

.4 Old laceration of cervix

.5 Stricture of cervix

.6 Atrophy of cervix

.9 Other

622 Infective diseases of uterus (except cervix), vagina and vulva

Excludes trichomonal infections (131)

.0 Infective disease of uterus, except cervix

f% ICD 630.1

.1 Vaginitis and vulvitis

AS ICD 630.2

623 Uterovaginal prolapse

.0 Cystocele

.1 Rectocele

.2 Uretbrocele

.3 Vaginal enterocele

.9 Other

Remainder of ICD 631

47
624 Malposition of uterus

As ICD 632 with sub-divisions:

.0 Retroversion and retroflexion

.8 Other

.9 Unspecified

Remainder of ICD 632

625 Other diseases of uterus

.0 Hyperplasia of endometrium

.1 Atrophy of uterus

.2 Subinvolution of uterus

.9 Other

626 Disorders of menstruation

As ICD 634 with sub-divisions:

.0 Absent

.1 Scanty

.2 Excessive

.3 Painful

.4 Frequent

.5 Irregular

.6 Iiwermenstrual bleeding

.7 Postmenopausal bleeding

.9 Other

Remainder of ICD 634

627 Menopausal symptoms

h ICD 635

628 Sterility, female

As ICD 636

629 Other diseases of female genital organs

.0 Leukoplakia of vagina

.1 Erythroplasia of vagina and vulva

.2 Kraurosis of vulva

.3 Leukorrhoea

/%s ICD 637.0

.4 Unspecified infection

.5 Vaginal bleeding

.6 Old laceration

.7 Stricture or atresia of vagina and hymen

.8 Rectovaginal fistula

.9 Other

Xl. COMPLICATIONS OF PREGNANCY,

CHILD-BIRTH AND THE PUERPERIUM

Complications of pyegnancy (630-634)

630 Infections of genital tract during pregnancy

Any condition in 612, 613, 614, 616, 620 or

622 arising during pregnancy

631 Ectopic pregnancy

.0 Abdominal pregnancy, without mention of sepsis

.1 Tubal pregnancy, without mention of sepsis

.2 Ovarian pregnancy, without mention of sepsis

.3 Other or unspecified ectopic pregnancy, without mention of sepsis

.4 Abdominal pregnancy, with sepsis

.5 Tubal pregnancy, with sepsis

.6 Ovarian pregnancy, with sepsis

.9 Other or unspecified ectopic pregnancy, with

sepsis

632 Hemorrhage of pregnancy

.0 Placenta praevia

.1 Premature separation of placenta

.2 Hemorrhage from marginal sinus

.3 Threatened abortion

,4 Due to afibrinogenaemia

.9 Other and unspecified

633 Anaemia of pregnancy

As ICD 646 with sub-divisions:

.0 Macrocytic anaemia of pregnancy

.1 Iron deficiency anaemia of pregnancy

.9 Other and unspecified anaemia of pregnancy

634 Other complications of pregnancy

.0 Malposition of foetus in uterus

Excludes delivery with abnormal presentation (656)

.1 Rupture of pregnant uterus

.2 Hydatidiform mole

.3 Placental abnormalities not elsewhere classified

.4 Hydramnios

.5 Air embolism during pregnancy

.6 Molar pregnancy, undelivered

.9 Other

Urinat-y infections and toxaemias of pregnancy and the

puevperium (635-639)’

635 Urinary infections arising during pregnancy and

the puerperium

.0 Pyelitis and pyelonephritis

.9 Other urinary infection

636 Renal disease arising during pregnancy and the

puerperium

Any condition in 580, 581 or 583 arising during

pregnancy and the puerperium. Excludes the

listed conditions with pre-eclampsia (637.0)

or eclampsia (637.1)

48
637 Pre-eclampsia,

specified

eclsmpsia and toxaemia, un-

.0 Pre-eclampsia

.1 Eclampsia

.9 Toxaemia, unspecified

638 Hyperemesis gravidarum

.0 With neuritis

.9 Without. mention of neuritis

639 Orher toxaemias of pregnancy and the puerperium

.0 Acute and subacute necrosis of liver

.9 Other

Abo~tion (640-645)

Categories 640-645 include aQy interruption of

pregnancy before 28 weeks of gestation with a

dead foetus. The following fourth-digit sub-divisions should be used with categories 640, 641,

643-645

.0 With sepsis

With mention of sepsis or any condition

in 635, 670, 671 or 673.9

.1 With toxaemia

With mention of toxaemia or any condition in

636-639

.2 With sepsis and toxaemia

.9 Without mention of sepsis or toxaemia

640 Abortion induced for medical indications

For primary mortality tabulations, excludes

the listed conditions if the complication of

pregnancy or other pre-existing disease requiring the induction ia known

641 Abortion induced for other legal indications

&2 Abortion induced for other reasons

.0 With sepsis

.1 With hemorrhage

.2 With sepsis and hemorrhage

.3 With laceration of pelvic organ (with or without mention of sepsis and hemorrhage)

.9 Without mention of sepsis, hemorrhage or

laceration

643 Abortion specified as spontaneous

644 Abortion not specified as induced or spontaneous

645 Other abortion

Delive?y (650-662)

The following fourth-digit sub-divisions should be

used with these categories:

.0 Spontaneous

.1 Manipulation without instruments

.2 Forceps, mid and high

.3 Forceps, low

.4 Forceps, unspecified

.5 Vacuum extractor

.6 Caesarian section

.8 Other surgical or instrumental

.9 Unspecified type of delivery

650 Delivery without mention of complication

As ICD 660

651 Delivery complicated by placenta praevia or

antepartum hemorrhage

AS ICD 670

652 Delivery complicated by retained placenta

AS ICD 671

653 Delivery complicated by other postpartum

hemorrhage

AS ICD 672

654 Delivery complicated by abnormality of bony

pelvis

AS ICD 673

655 Delivery complicated by foetopelvic disproportion

Excludes the conditions with mention of abnormality of bony pelvis (654)

656 Delivery complicated by malpresentation of foetus

Excludes the conditions with mention of disproportion (655)

657 Delivery complicated by prolonged labour of other

origin

AS ICD 675

658 Delivery with laceration of perineum, without

mention of other laceration

AS ICD 676

659 Delivery with rupture of uterus

660 Delivery with other obstetrical trauma

As ICD 677 except rupture of uterus (659)

661 Delivery with other complications

As ICD 678

662 Anesthetic death in uncomplicated delivery

Excludes anesthetic death in complicated

deliveries (651-661)

Complications of the puerpen”um (670-678)

670 Sepsis of child-birth and the puerperium

As ICD 681

49
671 Puerperal phlebitis and thrombosis

AS ICD 682

672 Pyrexia of unknown origin during the puerperium

AS ICD 683

673 Puerperal pulmonary embolism

.0 Air embolism

.i Amniotic fluid embolism

.9 Other and unspecified

674 Cerebral hemorrhage in the puerperium

AS ICD 687

675 Puerperal blood dyscrasias

676 Anaemia of puerperium

677

678

As ICD 688.0

Other and unspecified complications of the puerperium

.0 Sudden death from unknown cause in the puerperium

AS ICD 688.2

.9 Other

AS ICD 688.3

Mastitis and other disorders of lactation

AS ICD 689

X11. DISEASES OF THE SKIN AND

SUBCUTANEOUS TISSUE

Infections of skin and subcutaneous tissue (680-686)

Excludes viral warts (079. 1) and molluscum contagiosum (079.0)

680 Boil and carbuncle

AS ICD 690

.0 Of face

,1 Of neck

.2 Of trunk

.3 Of upper arm and forearm

.4 Of hand

.5 Of buttock

.6 Of other parts of lower extremity

.8 Of other and multiple sites

.9 Of unspecified site

681 Cellulitis of finger and toe

AS ICD 691

682 Other cellulitis and abscess

As ICD. 692 and 693

.0 Of head and neck

.1 Of trunk

.2 Of upper arm and forearm

.3 Of hand, exceut fingers

.4 Of leg

.5 Of foot, except toes

.9 Of other, multiple, and unspecified sites

683 Acute lymphadenitis

h ICD 694

684 Impetigo

i% ICD 695

685 Pilonidal cyst

As ICD 221

686 Other local infections of skin and subcutaneous

tissue

As ICD 698 with sub-divisions:

.0 Pyoderma

.1 Pyogenic granuloma

.9 Other

Other inflammatory conditions of skin and subcutaneous

tissue (690-698)

690 Seborrhoeic dermatitis

As ICD 700

691 Infantile eczema and related conditions

692 Other eczema and dermatitis

Includes allergic eczema and contact dermatitis

.0 Due to detergents

.1 Due to oils and greases

As ICD 703.1

.2 Due to solvents

AS ICD 703.2

.3 Due to drugs

As ICD 703.3

.4 Due to other chemicals

As ICD 703.4

.5 Due to food

.6 Due to plants (except fcod)

As ICD 703.0

.7 Due to radiation, except sunburn

As ICD 703.5

.8 13ueto other specified agents

AS ICD 703.6 phls SLUlbUITl

.9 Unspecified cause

693 Dermatitis herpetiformis

As ICD 704.0

694 Pemphigus

As ICD 704.1

50

* U. S. (20VSS,NMSNT PRINTING OFFICE :1973 515-214/69
695 Erythematous conciitiona

As ICD 705

.0 Toxic erythema

,1 Erythema multiform (erytbema iris)

,2 Erythema nodosum

.3 Rosacea

.4 Lupus erythematosus

.9 Other and unqualified

696 Psoriasis and similar disorders

.0 Psoriatic arthropathy

.1 Other psoriasis

h ICD 706.0

.2 Parapsoriasis

AS ICD 706.1

.3 Pityriasis rosea

AS ICD 706.2

.4 Pityriasis rubra pilaris

.5 Other and unspecified pityriasis

Remainder of ICD 706.3

.9 Other

i% ICD 706.4

697 Lichen

.0 Lichen planus

.1 Lichen nitidus

.9 Other and unspecified

Remainder of ICD 707

698 Pruritus and related conditions

.0 Pruritus ani

/% ICD 708.0

.1 Pruritus of genital organs

AS ICD 708.1

.2 Prurigo

J% ICD 708.2

.3 Lichenification and lichen simplex chronicus

As ICD 708.3 except diffuse neurodermatitis

(Brocq) and atopic eczema (691)

.4 Dermatitis factitia (artefacta)

As ICD 708.4

.9 Other pruritic conditions

AS ICD 708.5

Other diseases of skin and avbcutaneaus tisane (700-

709)

700 Corns and callosities

As ICD 709

701 Other hypertrophic and atrophic conditions of skin

Excludes hereditary oedema of legs (757.0);

scleroderma (generalized) (737.0} and dermatomyositis (716.0)

.0 Circumscribed scleroderma

.1 Keratoderma

As ICD 710.1

Except congenital conditions (757.1 ) seborrhoeic warts and seborrhoeic keratosis

(216.0)

.2 Striae atropliicae

As ICD 710.3

.3 KeIoid scar

As ICD 710.4

.9 Other hypertrophic and atrophic conditions of

skin

As ICD 710.5

702 other dermatoses

As ICD 711 except congenital conditions (757.2)

and senile wart (216.0)

703 Diseases of nail

As ICD 712 except congenital conditions (757.4)

704 Diseases of hair and hair follicles

As ICD713 except congenital conditions (757.3)

705 Diseases of sweat glands

.0 Anhidrosis

.1 Prickly heat

.9 Other

Remainder of ICD714.0 except hidrocystoma

(216.2)

706 Diseases of sebaceous glands

.1 Acne varioliformis

.2 Other acne

Remainder. of ICD 714.1

.3 Sebaceous cyst

.4 Seborrhoea

.9 Other

Remainder of ICD 714.2

707 Chronic ulcer of skin

As ICD 715

708 Urticaria

.0 Angioneurotic oedema

AS ICD 242

.9 Other

f% ICD 243

709 other diseases of skin

As ICD 716 except congenital conditions (757.2,

757.9)

51
X111. DISEASES OF THE MUSCULOSKELETAL

SYSTEM AND CONNECTIVE TISSkJE

A?thn”tis and rheumatism, except vheumatic fever

(710-718)

710 Acute arthritis due to pyogenic organisms

AS XCD720

711 Acute non-pyogenic arthritis

AS ICD 721

712 Rheumatoid arthritis and allied conditions

.0 Juvenile rheumatoid arthritis

.1 Rheumatoid arthritis with spleno-adenomegaly

and leukopenia

,2 Palindromic rheumatism

.3 Other rheumatoid arthritis

Remainder of ICD 722.0

.4 Spondylitis ankylopoietica

AS ICD 722.1

.5 Chronic rheumatic nodular fibrositis

h ICD 722;2

713 Osteo-arthritis (arthrosis) and allied conditions

.0 Osteo-arthritis (arthrosis)

z% ICD 723.0

.1 Spondylitis osteo-arthritica (spondylarthrosis)

.2 Traumatic spondylopathy

714 other specified forms of arthritis

.0 Traumatic arthritis

.9 Other

Remainder of ICD 724

715 Arthritis, unspecified

As ICD 725

716 Myositis

Excludes infective myositis (732)

.0 Dermatomyositis

.1 Chronic polymyositis

.9 Other

717 Other non-articular rheumatism

.0 Lumbago

As ICD 726.0

.1 Myofibrosis scapulohumeral

.2 Torticollis not specified as congenital, psychogenic, or traumatic

AS ICD 726.2

.9 Other muscular Rheumatism, fibrositis, and

myalgia

718 Rheumatism, unspecified

AS ICD 727

52

Osteomyelitis and othev diseases of bone and @int 1

(720-729)

720 Osteomyelitis and periostitis

As ICD 730 except osteomyelitis and periostitis

of the jaw (526.4)

.0 Acute osteomyelitis

.1 Chronic osteomyelitis

.2 Unspecified o~teomyelitis

.3 Periostitis without mention of osteomyelitis

721 Osteitis deformans

As ICD 731

722 Osteochondrosis

.0 Juvenile osteochondrosis of spine

.1 Juvenile osteochondrosis of hip

.2 Other juvenile osteochondrosis.

.8 Other specified forms of osteochondrosis

.9 Unspecified

723 other diseases of bne

.0 Osteoporosis

.1 Hypertrophic pulmonary osteo-arthropathy

.9 Other

Remainder of 733 excepc Polyostotic fibrous

dysplasia of bone (756.6); Cyst of jaw

(526.0-526.2); Granuloma of jaw (526.3);

Prognathism retrognathia (524.1)

724 Internal derangement of joint

.0 Elbow

.1 Knee

.9 Other

725 Displacement of intervertebral disc

As ICD 735 with sub-divisions:

.0Cervical

.1 Lumbar and lumkosacrsl

.8 Other

.9 Unspecified

726 Affection of sacroiliac joint

AS ICD 736

727 Ankylosis of joint

As ICD 737 with sub-divisions:

.0 Of spine

.1 Of shoulder

.2 Of elbow

.3 of wrist

.4 Of finger

.5 Of hip

.6 Of knee

.7 Of ankle

.8 Of other and multiple sites

.9 Of unspecified site
728 Vertebrogenic’ pain syndromes

Excludes the conditions stated as due to displacement of intervertebral disc (725); rheumatoid arthritis (712); spondyloarthrosis

(713.1); spondylitis (713.2)

.0 Cervicalgia

.1 Cervico-cranial syndrome

.2 Cervico-brachial diffuse syndrome

.3 Radicular syndrome of upper limbs

Excludes brachial neuritis NOS (352)

.4 Cervical myelopathy

,5 Pain in thoracic spine (with radicular and

visceral pain)

.6 Thoracic myelopathy

.7 Lumbalgia

.8 Radicular syndrome of lower limbs

Excludes sciatic neuritis NOS (353)

.9 Compression syndrome of cauda equina

729 Other diseases of joint

As ICD 738 except peri-arthritis (717)

Other diseases of m.usculoskeletal system (730-738)

730 Bunion

As ICD 740

731 Synovitis, bursitis and tenosynovitis

As ICD 741 and 742

732 Infective myositis and other inflammatory diseases

of tendon and fascia

As ICD 743

733 Other diseases of muscle, tendon and fascia

Excludes inborn defects of muscle (330); myositis (716); myofibrosis (717)

.0 Myasthenia gravis

As ICD 744.0

,1 Muscular atrophy (idiopathic)

.9 Other

Remainder of ICD 744.2

734 Diffuse diseases of connective tissue

Excludes polyarteritis nodosa (446.0)

.0 Progressive systemic sclerosis

.1 Systemic lupus erythematosus

.9 Other

735 Curvature of spine

As ICD 745 except congenital (756.1)

736 Flat foot

As ICD 746 except congenital (755.9)

737 Hallux valgus and varus

As ICD 747 except congenital (755.9)

738 Other deformities

XIV. CONGENITAL ANOMALIES

740 Anencephalus

741 Spina bifida

Excludes spina bifida occults (756.1)

.0 With hydrocephalus

.9 Without mention of hydrocephalus

742 Congenital hydrocephalus

Excludes the listed conditions with spins bifida

(741.0)

743 Other congenital anomalies of nervous system

.0 Encephalocele

.1 Microcephalus

.2 Other specified anomalies of brain

.3 Other specified anomalies of spinal cord

.4 Neurofibromatosis

.8 Other anomalies of peripheral nervous system

.9 Unspecified anomalies of brain, spinal cord

or nervous system

744 Congenital anomalies of eye

.0 Anophthalmoa

.1 Microphthalmos

.2 Buphthalmos

.3 Congenital cataract

.4 ColoLmma

.5 Aniridia

.8 Other specified anomalies of eye

.9 Unspecified anomalies of eye

745 Congenital anomalies of ear, face and neck

Excludes: cleft lip (749.1), anomalies of cervical spine (756.1), thyroid gland (758.2),

parathyroid gland (758.3) and larynx (748.3)

.0 Anomalies of ear causing impairment of hearing.

.1 Accessory auricle

.2 Other specified anomalies of ear

.3 Unspecified anomalies of ear

.4 Branchial cleft, cyst or fistula; pre-auricular

sinus

.5 Webbing of neck

,8 Other specified anomalies of face and neck

.9 Unspecified anomalies of face and neck

53
746 Congenital anomalies of heart

.

.0 Common truncus

.1 Transposition of great vessels

.2 Tetralogy of Fallot

.3 Ventricular septal defect

.4 Atrial septal defect

.5 Ostium atrioventriculare commune

.6 Anomalies of heart valves

.7 Fibroelastosis cordis

.8 Other specified anomalies of heart

.9 Unspecified anomalies of heart

747 Other congenital anomalies of circulatory system

.0 Patent ductus arteriosus

.1 Coarctation of aorta

.2 Other anomalies of aorta

.3 Stenosis or atresia of pulmonary artery

.4 Anomalies of great veins

.5 Absence . or hypoplasia of umbilical artery

.6 Other anomalies of peripheral vascular system

.8 Other specified anomalies of circulatory system

.9 Unspecified anomalies of circulatory system

748 Congenital anomalies of respiratory syStem

.0 Choanal atresia

.1 Other anomalies of nose

.2 Web of larynx

.3 Other anomalies of larynx, trachea and bronchus

.4 Congenital cystic lung

.5 Agenesis of lung

.6 Other anomalies of lung

.8 Other specified anomalies of respiratory system

.9 Unspecified anomalies of respiratory system

749 Cleft palate and cleft lip

.0 Cleft palate

.1 Cleft lip

.2 Cleft palate with cleft lip

750 Other congenital anomalies

tract

of upper alimentary

.0 Tracheoesophageal fistula, oesophageal atreaia

and stenosis

.1 Pyloric stenosis

.2 Anomalies of tongue

.8 Other specified anomalies of upper alimentary

tract

.9 Unspecified anomalies of upper alimentary tract

751 Other congenital anomalies of digestive system

.0 Meckel’s diverticulum

.1 Atresia and stenosis of small intestine

.2 Atresia and stenosis of rectum and anal canal

.3 Hirschsprung’s disease

.4 Anomalies of intestinal fixation

.5 Other anomalies 0? intestine

.6 Anomalies of gallbladder, bile ducts and liver

.7 Anomalies of pancreas

.8 Other specified anomalies of digestive system

.9 Unspecified anomalies of digestive system

752 Congenital anomalies of genital organs

Excludes: male hypogonadism (Klinefelter’s

syndrome) (759.5), gonadal agenesis (Turner’s syndrome) (759.5)

.0 Indeterminate sex

.1 Undescended testicle

.2 Hypspadias

.3 Epispadias

.4 Hydrocele

.5 Anomalies of ovary, Fallopian tube and uterus

.6 Anomalies of vagina and external female genitalia

.7 Pseudohermaphroditism

.8 Other specified anomalies of genital organs

.9 Unspecified anomalies of genital organs

753 Congenital anomalies of urinary system

.0 Renal agenesis

.1 Cystic kidney disease

.2 Obstructive defects of urinary tract

.3 Other specified anomalies of kidney

.4 Other specified anomalies of ureter

.5 Extrophy of urinary bladder

.6 Atresia and stenosis of urethra and bladder

neck

.8 Other specified anomalies of bladder and

urethra

.9 Unspecified anomalies of urinary system

754 Congenital clubfoot

755 Other congenital anomalies of limbs

.0 Polydactyly

.1 Syndactyly

.2 Reduction deformity confined to hand

.3 Reduction deformity of arm (and hand)

.4 Reduction deformi~ of leg and foot

.5 Reduction deformity, unspecified limb

.6 Other anomaly of upper limb (including shoulder girdle)

.7 Dislocation of hip

.8 Other anomaly of lower limb (including pelvic

girdle)

.9 Other and unspecified anomaly of unspecified

limb

756 Other congenital anomalies of musculoskeletal

system

.0 Anomalies of skull and face bones

Excludes anomalies of jaw (524.0)

54
.1 Anomalies of spine

.2 Cervical rib

.3 Other anomalies of ribs and sternum

.4 Chondrodystrophy

.5 Osteogenesis imperfects

.6 Other generalized anomalies of skeleton

.8 Other specified anomalies of muscle, tendon

and fascia

.9 Unspecified anomalies of musculoskeletal system

757 Congenital anomalies of skin, hair and nails

.0 Hereditary oedema of legs (Milroy’s disease)

.1 Pigmented naevus

.2 Other specified anomalies of skin

.3 Specified anomalies of hair

.4 Specified anomalies of nails

.9 Unspecified anomalies of skin, hair and nails

758 Other and unspecified congenital anomalies

.0 Anomalies of spleen

.1 Anomalies of adrenal gland

.2 Anomalies of thyroid gland

.3 Anomalies of other endocrine glands

.8 Other specified congenital anomaly

.9 Unspecified congenital anomaly

759 Congenital syndromes affecting multiple systems

.0 Sims inversus

.1 Conjoined twins

.2 Other forms of monster

Excludes anencephaly (740)

.3 Langdon-Down disease

.4 Other syndromes due to autosomal abnormality

.5 Syndromes due to sex chromosome abnormality

.6 Tuberous sclerosis

.8 Other specified syndromes

.9 Multiple congenital anomalies NOS

XV, CERTAIN CAUSES OF PERINATAL

MORBIDITY AND MORTALITY

760 Chronic circulatory and genito-urinary disease in

mother

Includes the listed conditions with asphyxia,

anoxia or hypoxia in the foetus or infant

.0 Chronic rheumatic heart disease

.1 Congenital heart disease

,2 Chronic hypertension

.3 Other chronic diseaae of circulatory system

.4 Chronic nephritis

.5 Other chronic disease of genito-urinary system

761 Other maternal conditions unrelated to pregnancy

Includes the listed conditions with asphyxia,

anoxia or hypoxia in the foetus or infant

.0 Syphilis

.1 Diabetes mellitus

.2 Influenza

.3 Rubella

.4 Toxoplasmosis

.S Injury

.6 Operation

.7 Chemical substances transmitted through placenta

.9 Other maternal causes

762 Toxaemias of pregnancy

Includes the listed conditions with asphyxia,

anoxia or hypoxia in the foetus or infant

.0 Renal disease arising during pregnancy

.1 Pre-eclampsia of pregnancy

.2 Eclampsia of pregnancy

.3 Toxaemia unspecified

.4 Hyperemesis gravidarum

.5 Acute and subacute necrosis of liver arising

during pregnancy

.9 Other toxaemia of pregnancy

763 Matetial ante- and intra-partum infection

Includes the listed conditions with asphyxia,

anoxia or hypoxia in the foetus or infant

.0 Pyelitis and pyelonephritis of pregnancy

.1 Other infections of genito-urinary tract during

pregnancy

.9 Other

7& Difficult labour with abnormality of bones, organs

or tissues of pelvis

.0 With birth injury to brain

.1 With birth injury to spinal cord

.2 With birth injury to bone or nerve

.3 With other or unspecified birth injury

.4 With asphyxia, anoxia or hypoxia

.9 Without mention of birth injury, asphyxia, anoxia or hypoxia

765 Difficult labour with disproportion, but no mention of abnormality of pelvis

.0 With birth injury to brain

.1 With birth injury to spinal cord

.2 With birth injury to bone or nerve

.3 With other or unspecified birth injury

.4 With asphyxia, anoxia or hypoxia

.9 Without mention of birth injury, asphyxia, anoxia or hypoxia

55
766 Difficult labour with mal~sition of foetus

Excludes the listed conditions with disproportion (765)

.0 With birth injury to brain

.1 With birth injury to spinal cord

.2 With birth injury to bone or nerve

.3 With other or unspecified birth injury

.4 With asphyxia, anoxia or hypoxia

.9 Without mention of birth injury, asphyxia, anoxia or hypoxia

767 Difficult labour with abnormality of forces of

lalmur

.0 With birth injury to brain

.1 With birth injury to spinal cord

.2 With birth injury to bone or nerve

.3 With other or unspecified birth injury

.4 With asphyxia, anoxia or hypoxia

.9 Without mention of birth injury, asphyxia, anoxia or hypoxia

768 Difficult labour with other and unspecified complications

.0 With birth injury to brain

.1 With birth injury to spinal cord

.2 With birth injury to lmne or nerve

.3 With other or unspecified birth injury

.4 With asphyxia, anoxia or hypoxia

.9 Without mention of birth injury, asphyxia,

anoxia or hypoxia

769 Other complications of pregnancy and child-birth

Includes the listed conditions with asphyxia,

anoxia or hypoxia in the foetus or infant

.0 Incompetent cervix

.1 Premature rupture of membranes

.2 Hydramnios

.3 Ectopic pregnancy

.4 Multiple pregnancy

.5 Maternal death unspecified

.9 Other

77o Conditions of placenta

Includes the listed conditions with asphyxia,

anoxia or hypoxia in the foetus or infant

.0 Placenta praevia

.1 Premature separation of placenta

.2 Placental infarction

.9 Other

771 Conditions of umbilical cord

Includes the listed conditions with asphyxia,

anoxia or hypoxia in the foetus or infant

.0 Compression of cord

.1 Prolapse of cord without mention of compression

.9 Other

%

772 Birth injury without mention of cause

.0 To brain

.1 To spinal cord

.2 To Lmneor nerve

.9 Other and unspecified

773 Termination of pregnancy

Not to be used for primary mortality classification if reason for termination is known

and is classifiable elsewhere in this section

774 Haemolytic disease of newborn with kernicterus

.0 With Rh incompatibility

.1 With ABO incompatibility

.2 With other or unspecified blood incompatibility

.9 Without mention of cause

775 Haemolytic disease of newborn without mention

of kernicterus

.0 With Rh incompatibility

.1 With ABO incompatibility

.2 With other or unspecified blood incompatibility

.9 Without mention of cause

776 Anoxic and h~xic conditions not elsewhere

classified

.0 Aspiration of content of birth canal

.1 Hyaline membrane disease

.2 Respiratory distress syndrome

.3 Foetal distress

.4 Intra-uterine anoxia

.9 Asphyxia of newborn unspecified

777 Immaturity NOS

778 Other conditions of foetus

.0 Foetal blood loss before birth

.1 Chorio-amnionitis

.2 Post-maturity

.3 Hemorrhagic disease of nevkorn

.4 Cold injury syndrome

.9 Other

779 Foetal death of unknown cause

.0 Maceration

.9 Other

XVI. SYMPTOMS AND ILL-DEFINED CONDITIONS

There had not been a document prepared on the

revision of the section as its form is dependent to some

extent “on the final arrangement and contxsmt of the

disease sections I-XV. A separate three-digit category

will be provided for 795.2 sudden death (cause unknown).
Certain transfers may already bs considered accepted,

either of sub-categories or of inclusion terms. Transfers of sub-categories from Section XVI involve ICD

780.3 Jacksonian epilepsy (to Section VI), ICD 785.6

Diarrhoea, age two years and over (to Section I, without age distinction); ICD 787.5 Pain in back (to Section

X111).In respect of inclusion terms it has been agreed

to reclassify “Cerebella ataxia” (from ICD 780.5

Disturbance of co-ordination, to Section VI); “Narcolepsy” (from ICD 780.7 Disturbance of sleep, to Section VI). Transfers into Section XVI affect ICD 534

Toothache from unspecified cause, and inclusion term

“Earache of unknown cause” in ICD 394 O,ther inflammatory diseases of ear. other transfers have been

suggested such as that of ICD 784.6 Excessive salivation (to Section IX) or of ICD 789.1 Albuminuria

ortbostatic (to Section X). However, only systematic

review of all terms in the present alphabetical index

assigned to Section XVI as well aa other sections will

allow conclusions on the merits’ of a few additional

transfers and facilitate consistent decisions.

E XVII. ACCIDENTS, POISONINGS AND VIOLENCE

(EXTERNAL CAUSE)

Railway accidents (E800-E8077

To identify the injured person, the following

fourth digits are for use with categories E800-

E807:

.0 Railway employee

.1 Passenger on railway

.2 Pedestrian

.3 Pedal cyclist

.8 Other specified person

.9 Unspecified person

E800 Railway accident involving collision with rolling

stock

E801 Railway accident involving collision with stationary

object

E802 Railway accident involving derailment without

antecedent collision

E803 Railway accident involving explosion, fire, burning

E804 Fall in, on, or from train

E805 Hit by rolling stock

E806 Other specified railway accident

E807 Railway accident of unspecified nature

MotoY vehicle traflc accidents (E81O-E819)

To identify the injured person, the following

fourth digits are for use with categories E810-

E819:

.0 Driver of motor vehicle other than motorcycle

.1 Passenger in motor vehicle other than motorcycle

.2 Motorcyclist

.3 Passenger on motorcycle

.4 Occupant of streetcar

.5 Rider of animal; occupant of animal-drawn

vehicle

.6 Pedal cyclist

.7 Pedestrian

.8 Other specified person

.9 Unspecified person

E81O Motor vehicle traffic accident involving collision

with train

E811 Motor vehicle traffic accident involving collision

with streetcar

E812 Motor vehicle traffic accident involving collision

with another motor vehicle

E813 Motor vehicle traffic accident involving collision

with other vehicle

E814 Motor vehicle traffic accident involving collision

with pedestrian

E815 Other motor vehicle traffic accident involving

collision

E816 Non-collision motor vehicle traffic accident due to

loss of control

E817 Non-collision motor vehicle traffic accident while

Lmarding or alighting

E818 Other non-collision motor vehicle traffic accident

E819 Motor vehicle traffic accident of unspecified nature

Motor vehicle non-trafic accidents (E820-E823)

To identify the injured person the following

fourth digits are for use with categories E820-

E823:

.0 Driver of motor vehicle other than motorcycle

.1 Passenger in motor vehicle other than motorcycle

.2 Motorcyclist

.3 Passenger on motorcycle

57
.4 Occupant of streetcar

.5 Rider of animal; occupant of animal-drawn

vehicle

.6 Pedal cyclist

.7 Pedestrian

.8 Other specified person

.9 Unspecified person

E820 Motor vehicle non-traffic accident involving collision with moving object

E821 Motor vehicle non-traffic accident involving collision with stationary object

E822 Motor vehicle non-traffic accident while boarding

or alighting

E823 Motor vehicle non-traffic accident of other and

unspecified nature

Othey Yoad vehicle accidents (E825-E827)

E825 Streetcar accident, except collision with motor

vehicle

.0 Injury to pedestrian

.1 Injury to pedal cyclist

.2 Injury to occupant of streetcar

.8 Injury to other specified person

.9 Injury to unspecified person

E826 Pedal cycle accident, except collision with motor

vehicle or streetcar

.0 Injury to pedestrian

.1 Injury to pedal cyclist

.8 Injury to other specified person

.9 Injury to unspecified person

E827 Other non-motor road vehicle accidents

.0 Injury to pedestrian

.8 Injury to other specified person

.9 Injury to unspecified person

Water transport accidents (E830-E838)

To identify the injured person, the following fourth

digits are for use with categories E830-E838:

.0 Occupant of small boat

E830

.1 Occupant of other water craft-crew

.2 Occupant of other water craft-other than crew

,3 Bckers, stevedores

.8 Other specified person

.9 Unspecified person

Accident to water craft causing submersion

E831 Accident to water craft causing other injury

E832 Other accidental submersion or drowning in water

transport

E833”Fall on stairs or ladders in water transport

i% ICD E852

E834 Other fall from one level to another in water

transport

AS ICD E853

E835 Other and unspecified fall in water transport

As ICD E854 and E855

E836 Machinery accident in water transport

AS ICD E856

E837 Explosion, fire, burning, in water transport

E838 Other and unspecified water transport accident

AiY and space transport accidents (E8@-E845)

To identify the injured person, the following fourth

digits are for use with categories E840-E846:

.0 Occupant of space craft

.1 Occupant of military aircraft

.2 Occupant of commercial aircraft, crew

.3 Other occupant of commercial aircraft

.4 Occupant of other and unspecified aircraft

.5 Ground crew, airline employee

.8 Other specified person

.9 Unspecified person

E840 Accident to powered aircraft at take-off or landing

E841 Accident to powered aircraft, other and unspecified

E842 Accident to unpowered aircraft

E843 Fall in, on, or from aircraft

E844 Other specified air transport accidents

E845 Accident involving spacecraft

Accidental poisoni~ by dvugs and rnedicaments ,(E850-

E859)

Excludes (contact) dermatitis due to drugs and

medicaments (692.3), complication and misadventures in administration of anesthetics for

purposes of medical care (E930-E936), and

idiosyncratic and hypersensitive reactions to

drugs (E930-E936)

58
E850 Accidental poisoning by antibiotics and other antiE851

E852

E853

E854

mfectives

.0 Penicillin, any

.1 Antifungal antibiotic

.2 Chloramphenicol

,3 Erythromycins, stxeptomycins, tetracycline

.4 Other antibiotics

.5 Sulfonamides

.6 Arsenic anti-infectives

.7 Silver and its compounds

.8 Quinoline and hydroxyquinoline derivatives

.9 Other anti-infectives

Accidental poisoning by hormones and synthetic

substitutes

.0 Adrenals

.1 Androgens and anabolic congeners

.2 Oestrogens

.3 Insulins and antidiabetic agents

.4 Anterior pituitary extracts

.5 Posterior pituitary extracts

.6 Progestogens

.7 ‘l%yroid and thyroid derivatives

.8 Antithyroid agents

.9 Other hormones and synthetic substitutes

Accidental poisoning by primarily systemic and

haematologic agents

.0 Antihiatsmine and anti-emetic drugs

.1 Antineoplastic agents

.2 Other electrolytic. caloric and water balance

agents

.3 Vitamins

.4 Other primarily systemic agents

.5 Iron and its compounds.

.6 Anticoagulants

.7 Vitamin K products

.8 Other coagulant

.9 Other primarily haematologic agents

Accidental poisoning by analgesics and antipyretics

.0 Opiates and synthetic analogues.

.1 Salicylates and congeners

.2 Cinchophen and congeners

.3 Colchicine

.4 Aniline derivatives

.8 Other coal tar derivatives

.9 Other analgesics and antipyretics

Accidental poisoning by other sedatives and hypnotics

.0 Barbiturates

.1 Chloral hydrate

.2 Paraldehyde

.3 Bromides

.9 Other sedatives and hypnotics

E855 Accidental poisonirig by autonomic nervous system and psychotherapeutic drugs

.0 Antidepressants

.1 Tranquilizers

.2 Other psychotherapeutic agents

.3 Parasympathomimetics (cholinergics)

.4 Parasympathol@cs (snticholinergics)

.5 Sympathomimetics (adrenergics)

.6 Autonomic nervous system relaxants

.9 Other

E856 Accidental poisoning by other central nervous

system depressants and stimulants

.0 Anticonvulsants

.1 Skeletal muscle relaxants

.2 Anesthetic gases

.3 Other CNS depressants

.4 Amphetamine

.8 Other CNS stimulants

.9 Other and unspecified

E857 Accidental poisoning by cardiovascular drugs

.0 Cardiac depressants

.1 Cardiac tonics

.2 Cholesterol lowering agents

.3 Ganglionic blocking agents

.4 Vasodilators

.5 Other hypotensive agents

.6 Sclerosing agents

.9 Other

E858 Accidental ~isoning by gastro-intestinal drugs

.0 Antacids and antidiarrhoeal agents

.1 Intestinal irritant cathartics

.2 Emollient cathartics

.3 Saline cathartics

.4 Faecal softeners

.5 Other cathartics

.6 Emetics

.9 Other

E859 Accidental poisoning by other and unspecified

drugs and medicaments

.0 Local anesthetics

.1 Mercurial diuretics

.2 Xanthine derivatives

.3 Other diuretics

.4 Agents acting directly on musculo-skeletal

system

.5 Liniments

.6 Ointments

.7 Other medicinal for external use

.8 Other specified drugs

.9 Drug NOS

59
Accidental @m-sm”w by

stances (E860-E869)

other so&t and liquid eubExcludes (contact) dermatitis due to detergents

(692.0), oils and greases (692.1), solvents (692.2),

and other chemicals (692.4)

E860 Accidental poisoning by alcohol

As ICD 1%880

E861 Accidental poisoning by cleansing and polishing

agents

E862 Accidental poisoning by disinfectants

E863 Accidental poisoning by paints and varnishes

E864 Accidental poisoning by petroleum products and

other solvents

As ICD E881 and E882

E865 Accidental poisoning by pesticides, fertilizers,

plant foods

E866 Accidental poisoning by heavy metals and their

fumes

E867 Accidental ~isoning by corrosives and caustics,

not elsewhere classified

E868 Accidental poisoning by noxious foodstuffs aid

poisonous plants

E869 Accidental poisoning by other and unspecified

solid and liquid substances

Acm”dental pm”soniqg by gases and vapors (E870-E87ZJ

E870 Accidental poisoning by gas distributed by pipe.

line

E871 Accidental poisoning by liquified petroleum gas

distributed in mobile containers

E872 Accidental poisoning by other utility gas

E873 Accidental poisoning by motor vehicle exhaust

gas

f% ICD E891

E874 Accidental poisoning by carlmn monoxide from

incomplete combustion of domestic fuels

E87S Accidental poisoning by other carbon monoxide

E876 Accidental poisoning by other gases and vapors

As ICD E893 and E894

E877 Accidental poisoning by unspecified gases and

vapors

AS ICD E895

Accidental falls (E880-E88?j

E880 Fall on or from stairs or steps

E881 Fall on or from ladders or scaffolding

E882 Fall from or out of building or other structure

E883 Fall into hole or other opening in surface

E884 Other fall from one level to another

E885 Fag on same level from slipping, tripping or

stumbling

E886 Fall on same level from collision, pushing or

shoving by or with other person

E887 Otlier and unspecified fall

Accidetits caused by fires (E890-E899)

E890 Accident caused by conflagration in private dwelling

E891 Accident caused by conflagration in other building

m- structure

E892 Accident caused by conflagration not in building

or structure

E893 Accident caused by ignition of clothing

E894 Accident caused by ignition of highly inflammable

material

E895 Accident caused by controlled fire in private

dwelling

E896 Accident caused by controlled fire in other building

or structure

E897 Accident caused by controlled fire not in building

or structure

E898 Accident caused by other specified fires

E899 Accident caused by unspecified fire

60
Accidents due to natural and environmental factors

(E900-E909)

E900 Excessive heat

As ICD E931 except sunburn (692.8)

E901 Excessive cold

AS ICD E932

E902 High and low air pressure

AS ICD E930

E903 Effects of travel and motion

E904 Hunger, thirst, exposure and neglect

As ICD E926 and E933

E905 Bites and stings of venomous animals and insects

AS ICD E927

E906 Other accidents caused by animals

AS ICD E928

E907 Lighming

AS ICD E935

E908 Cataclysm

J% ICD E934

E909 Accident due to other natural and environmental

factors

Other accidents (E91O-E929)

E910 Accidental drowning and submersion

Excludes drowning and submersion in transport accidents

.0 In recreational activities

.9 Other and unspecified

E911 Inhalation and ingestion of food causing obstruction

or suffocation

AS ICD E921

E912 Inhalation and ingestion of other object causing

obstruction or suffocation

AS ICD E922

IZ913Accidental mechanical suffocation

.0 In bed or cradle

AS ICD E924

.9 Other and unspecified

AS ICD E925

E914 Foreign l.mdy entering accidentally eye and adnexa

AS ICD E920

E915 Foreign body entering

h ICD E923

accidentally other orifice

E916 Struck accidentally by falling object

E917 Striking against or struck accidentally by objects

E918 Caught accidentally in or between objects

E919 Over-exertion and strenuous movements

E920 Accident caused by cutting or piercing

ments

As ICD E913 with sub-divisions:

,0 Powered hand tools

,1 Other hand tools

,2 Other machinery

,8 Other

.9 Unspecified

instruE921

E922

E923

E924

E925

E926

Accident caused by explosion of pressure vessel

As ICD E915 with sub-divisions:

.0 Boilers

.1 Gas cylinders

,8 Other

,9 Unspecified

Accident caused by firearms wea~ns

As ICD E919 with sub-divisions:

.0 Accidentally self-inflicted

.9 Other and unspecified

Accident caused by explosive material

.0 Fireworks

.1 Blasting materials

.2 Explosive gases

.8 Other

.9 Unspecified

Accident caused by hot substance, corrosive liquid,

and steam

As ICD E917 except burns NOS (E899)

Accident caused by electric current

As ICD E914 with sub-divisions:

.0 Home wiring or appliances

.1 Industrial wiring or appliances

.8 Other

.9 Unspecified

Accident caused by radiation

As ICD E918 with sub-divisions:

.0 Non-ionizing

.1 Ionizing
E927 Vehicle accidents not elsewhere classifiable

E928 Machinery accidents not elsewhere classifiable

E929 Other and unspecified accidents

3ur@”cal and medical complications and misadventures

(E930-E936)

Excludes (contact) dermatitis due to drugs and

medicaments (692.3) and accidental overdose

of drugs and wrong drug given in error (E850-

E859)

E930 Complications and misadventures in operative

therapeutic procedures

Not to be used for primary death classification

if the condition for which the treatment was

given is known

.0 In surgical treatment, excluding effects of

anesthetic management

.1 In anesthesia during operative treatment

,2 In infusion or transfusion during operative

treatment

.9 In other procedures during operative treatment

E931 Complications and misadventures in other and unspecified therapeutic procedures

Not to be used for primary death classification

if the condition for which treatment was given

is known

.0 In use of X-rays and radioactive substances

.1 In administration of drugs and biological

.2 In infusion and transfusion

.3 In local applications

.8 In other therapeutic procedures

.9 In unspecified therapeutic procedures

E932 Complications and misadventures in diagnostic

procedures

Not to be used for primary death classification

if a diagnosis was made

.0 In surgical procedures, excluding effects of

anesthetic management

.1 In anesthesia

.2 In use of X-rays or radioactive substances

.3 In administration of drugs and biological

.8 In other diagnostic procedures

.9 In unspecified diagnostic procedures

E933 Complications and misadventures in prophylaxis

with bacterial vaccines

.0 BCG vaccine

.1 Typhoid and paratyphoid vaccine

.2 Cholera vaccine

.3 Plague vaccine

.4 Tetanus vaccine

.5 Diphtheria vaccine

.6 Pertussis vaccine, including combinations with

a pertussis component

.8 Other and unspecified bacterial vaccines

.9 Mixed bacterial vaccine, except combinations

with a pertussis component

E934 Complications and misadventures in prophylaxis

with other vaccines

.0 Smallpox vaccine

.1 Rabies vaccine

.2 Typhus vaccine

.3 Yellow fever vaccine

.4 Measles vaccine

.5 Poliomyelitis vaccine

.6 Other and unspecified viral or rickettsial vaccines

.7 Mixed viral/rickettsial and bacterial vaccines,

except combinations with a pertussis component

.9 Other and unspecified vaccines

E935 Complications and misadventures in other prophy.

lactic procedures

.0 In surgical procedures, excluding effects of

anesthetic management

.1”In anesthesia during prophylactic procedures

.2 In use of X-rays and radioactive substances

.3 In administration of drugs and biological

.9 In other and unspecified prophylactic procedures

E936 Complications and misadventures in other nontherapeutic procedures

.0 In surgical procedures, excluding effects of

anesthetic management

.1 In anesthesia

.9 In other and unspecified procedures

Late effects of aca”dental injury (E940-E949)

E940 Late effect of motor vehicle accident

E941 Late effect of other transport accident

E942 Late effect of accidental poisoning

E943 Late effect of accidental fall

E944 Late effect of accident caused by fire

E945 Late effect of accident due to natural and environmental factors

E946 Late effect of other accident

62
E947 Late effect of surgical operation E960 Fight, brawl, rape

Excludes . strangulation (E963), submersion

(E964), and injuries caused by weapons (E965,

E966)

E948 Late effect of irradiation

.

E949 Late effect of other surgical and medical procedures E961 Assault by corrosive or caustic substance, except

poisoning

Suicide and self-injlicted injury (E950-E959)

Categories E950-E959 include injuries in suicide

and attempted suicide and other self-inflicted

injuries when specified as intentional. Suicide

said to be “due to” any disease is to be classified as suicide

E962 Assault by p-aisoning

AS ICD E980

E963 Assault by hanging and strangulation

E964 Assault by submersion (drowning)

E950 Suicide and self-inflicted poisoning by solid or

liquid substances

As ICD E970, E971

E965 Assault by firearms and explosives

h ICD E981

E951 Suicide and self-inflicted poisoning by gases in

domestic use

AS ICD E972

E966 Assault by cutting and piercing instruments

AS ICD E982

E967 Assault by pushing from high place

E952 Suicide and self-inflicted poisoning by other gases

AS ICD E973 E968 Assault by other and unspecified means

E953 Suicide and self-inflicted injury by hanging and

strangulation

As ICD E974

E969 Late effect of injury purposely inflicted by other

person

AS ICD E964

E954 Suicide and self-inflicted injury by submersion

(drowning)

Aa ICD E975

Legal intervention (E970-E978)

Categories E970-E979 include injuries during

legal action by police or other law-enforcing

agents, including military on duty

E955 Suicide dnd self-inflicted injury by firearms and

explosives

AS ICD E976

E970 Injury due to legal intervention by firearms

E971 Injury due to legal intervention by explosives

E956 Suicide and self-inflicted injury by cutting and

piercing instruments

AS ICD E977

E972 Injury due to legal intervention by gas

E973 Injury due to legal intervention by blunt object

E957 Suicide and self-inflicted injury by jumping from

high place

h ICD ’978

E974 Injury due to legal intervention by cutting and

piercing instruments

E958 Suicide and self-inflicted injury by other and unspecified means

k ICD E979

E975 Injury due to legal intervention by other specified

means

E976 Injury due to legal intervention Iiy unspecified

E959 Late means effect of suicide and self-inflicted injury

AS ICD E963

E977 Late effect of injuries due to legal intervention

Homicide and injwy purposely inflicted by other persons (E960-E969)

Categories E960-E969 exclude injuries due to legal

intervention (E970-E979) and to war operations

(E990-E999)

E978 Legal execution

63
Injtq undetermined wizethey accidentally OYpuvposely

inflicted (E980-E989)

Categories E980-E989 are for use when it is not

determined whether the injuries were accidental,

suicidal or homicidal. ‘hey include self-inflicted

injuries not specified either as accidental or as

intentional

E980 Poisoning by solid or liquid substances, undetermined whether accidentally or purposely inflicted

E981 Poisoning hy gases in domestic use, undetermined

whether accidentally or purposely inflicted

E982 Poisoning by other gases, undetermined whether

accidentally or purposely inflicted

E983 Hanging and strangulation, undetermined whether

accidentally or purposely inflicted

E984 Submersion (drowning), undetermined whether

accidentally or purposely inflicted

E985 Injury by firearms and explosives, undetermined

whether accidentally or purposely inflicted

E986 Injury by cutting and piercing instruments, undetermined whether accidentally or purposely

inflicted

E987 Falling from high place, undetermined whether

accidentally or purposely inflicted

E988 Injury by other and unspecified means, undetermined whether accidentally or purposely inflicted

E989 Late effect of injury, undetermined whether accidentally or purposely inflicted

InjuYy resultiqg from operations of war (E990-E999)

Categories E990-E999 include injuries caused by

war and civil insurrections, but exclude accidents during training of military personnel,

manufacture of war material and transport, unless attributable to enemy action. Injuries by

explosion of bombs and mines placed during the

war, if the explosion occurred after cessation of

hostilities, are included in category E998

E990 Injury due to war operations by fires and conflagrations

E991 Injury due to war operations by bullets and fragments

E992 Injury due to war operations by explosion of

marine weapons

E993 Injury due to war operations by other explosion

E994 Injury due to war operations by destruction of aircraft

AS ICD E997

E995 Injury due to war operations by other and unspecified forms of conventional warfare

i’%ICD E998

E996 Injury due to war operations by nuclear weapons

E997 Injury due to war operations by other forms of

unconventional warfare

E998 Injuries due to war operations but occurring

after cessation of hostilities

h ICD E999

E999 Late effect of injury due to war operations

AS ICD E965

N XVII. ACCIDENTS, POISONINGS AND VIOLENCE

(NATURE OF INJURY, N800-N999)

FRACTURES (N800-N829)

The following fourth digits are applicable for categories N800-N829 unless otherwise indicated:

.0 Closed fracture

.1 Open fracture

.9 Late effect

Fracture of skull, spine, and trunk (N800-N809)

N800 Fracture of vault of skull

N801 Fracture of base of skull

N802 Fracture of face bones

.0 Nasal bones, closed

.1 Nasal bones, open

.2 Mandible, closed

.3 Mandible, open

.4 Other, closed

.5 Other, open

.9 Late effect, any facial tines

N803 Other and unqualified skull fractures

N804 Multiple fractures involving skull or face with

other bones

N805 Fracture and fracture dislocation of vertebral

column without mention of spinal cord lesion

.0 Cervical, closed

.1 Cervical, open

64
.2 Dorsal or thoracic, closed

.3 Dorsal or thoracic, open

.4 Lumbar, closed

.5 Lumbar, open

.6 Sacrum and coccyx, closed

.7 Sacrum and coccyx, open

.8 Late effect, any vertebra

N806 Fracture and fracture dislocation of vertebral column with spinal cord lesion

Excludes: spinal cord lesion without fracture

(N958)

.0 Cervical, closed

.1 Cervical, open

.2 Dorsal or thoracic, closed

.3 Dorsal or thoracic, open

.4 Lumbar, closed

.5 Lumbar, open

,6 Sacrum and coccyx, closed

.7 Sacrum and coccyx, open

.9 Late effect, any vertebra

N807 Fracture of rib(s), sternum and larynx

.0 Rib, closed

.1 Rib, open

.2 Sternum, closed

.3 Sternum, open

.4 Larynx, closed

.5 Larynx, open

.9 Late effect, rib(s), sternum or larynx

N808 Fracture of pelvis

N809 Multiple and ill-defined fractures of trunk

Fractwe of upper limb (N81O-N819)

N81O Fracture of clavicle

N811 Fracture of scapula

N812 Fracture of humerus

.0 Upper extremi~, closed

.1 Upper extremity, open

.2 Shaft, or unspecified part, closed

.3 Shaft, or unspecified part, open

.4 Lower extremity, closed

.5 Lower extremity, open

.9 Late effect, any part

N813 Fracture of radius and ulna (either or both)

.0 Upper extremity or unspecified part, closed

.1 Upper extremity or unspecified part, open

,2 Shaft, closed

.3 Shaft, open

.4 Lower extremity, closed

.5 Lower extremity, open

.9 Late effect, any part

N814 Fracture of carpal bone(s)

N815 Fracture of metacarpal /mne(s)

N816 Fracture of one or more phalanges of hand

N817 Multiple fractures of hand bones

N818 Other, multiple, and ill-defined fractures of upper

limb

N819 Multiple fractures both upper limbs, and upper

limb with rib(s) and sternum

Fracture of lower limb (N820-N829)

N820 Fracture of neck of femur

N821

N822

N823

N824

N825

Fracture of other and unspecified parts of femur

.0 Shaft or unspecified part, closed

.1 Shaft or unspecified part, open

.2 Lower extremity, closed

.3 Lower extremity, open

.9 Late effect, either part

Fracture of patella

Fracture of tibia and fibula (either or both)

.0 Upper extremity or unspecified part, closed

,1 Upper extremity or unspecified part, open

,2 Shaft, closed

.3 Shaft, open

,9 Late effect, either part

Fracture of ankle

Fracture of one or more tarsal and metatarsal

bones

N826 Fracture of one or more phalanges of foot

N827 Other, multiple, and ill-defined fractures of lower

limb

N828 Multiple fractures involving both lower limbs,

lower with upper limb, and lower limb(s) with

rib(s) and sternum

N829 Fracture of unspecified bones

DISLOCATION WITHOUT FRACTURE (N830-N839)

Excludes: congenital dislocation (755, 756)

fracture dislocation (N800-N829)

65
recurrent or pathological dislocation

(729)

The following fourth digits are applicable for categories N830-N839 unless otherwise indicated:

.0 Simple dislocation

.1 Compound dislocation

,Q Late effect

N830 Dislocation of jaw

N831 Dislocation of shoulder

N832 Dislocation of elbow

N833 Dislocation of wrist

N834 Dislocation of finger

N835 Dislocation of hip

N836 Dislocation of knee

N847 Sprains and strains of other and unspecified parts

of back

.0 Neck

.8 Other

.9 Unspecified

N848 Other and ill-defined sprains and strains

INTRACRANIAL INJURY (EXCLUDING THOSE WITH

SKULL FRACTURE) (N850-N854)

Excludes: nerve injury (N950, N951)

The following fourth digits are applicable for categories N850-N854 unless otherwise indicated:

.0 Without mention of open intracranial wound

.1 With open intracranial wound

.9 Late effect

N850 Concussion

.0 Current or unspecified

.9 Late effect

N837 Dislocation of ankle

N851 Cerebral laceration and contusion

N838 Dislocation of foot

N839 Other, multiple, and ill-defined dislocations

.0 Cervical vertebra, simple

.1 Cervical vertebra, compound

.5 Other location, simple

.6 Other location, compound

.7 Multiple and ill-defined, simple

.8 Multiple and ill-defined, compound

.9 Late effect, cervical vertebra or other

SPRAINS AND STRAINS OF JOINTS AND ADJACENT

MUSCLES (N840-N848)

Excludes: tear, rupture or laceration of muscle associated with open wound (N870-N908)

N840 Sprains and strains of shoulder arid upper arm

N841 Sprains and strains of elbow and forearm

N842 Sprains and strains of wrist and hand

N843 Sprains and strains of hip and thigh

N844 Sprains and strains of knee and leg

N845 Sprains and strains of ankle and foot

N846 Sprains and strains of sacro-iliac region

N852 Subarachnoid, subdural and extramural hemorrhage, following injury (without mention of cerebral laceration or contusion)

N853 Other and unspecified intracranial hemorrhage

following injury (without mention of cerebral

laceration or contusion)

N854 Intracranial injury of other and unspecified nature

INTERNAL INJURY OF CHEST, ABDOMEN AND

PELVIS (N860-N869)

Excludes: foreign body entering through orifice

(N934-N939)

N860 Traumatic pneumothorax and haemothorax

.0 Without mention of open wound into thorax

.1 With open wound into thorax

.9 Late effect

N861 Injury to heart and lung

.0 Heart without mention of open wound into thorax

.1 Heart with open wound into thorax

.2 Lung without mention of open wound into thorax

.3 Lung with open wound into thorax

.9 Late effect, either organ

66
N862 Injury to other and unspecified intrathoracic

organs

.0 Withaut mention of open wound into thorax

.1 With open wound into thorax

.9 Late effect

N863 Injury to gastro-intestinal tract

.0 Without mention of open wound into abdominal

cavity

.1 With open wound into abdominal cavity

.9 Late effect

N864 Injury to liver

.0 Without mention of open wound into alxlominal

cavity

.1 With open wound into abdominal cavity

.9 Late effect

N865 Injury to spleen

,0 Without mention of open wound into abdominal

cavity

.1 With open wound into abdominal cavity

.9 Late effect

N866 Injury to kidney

.0 Without mention of open wound into abdominal

cavity

,1 With open wound into abdominal cavity

.9 Late effect

N867

N868

Injury to pelvic organs

.0 Without mention of open wound into akdominal

cavity

.1 With open wound into abdominal cavity

.9 Late effect

[njury to other and unspecified intra-abdominal

organs

.0 Without mention of open wound into abdominal

cavity

,1 With open wound into abdominal cavity

,9 Late effect

N869 Internal injury, unspecified or involving intrathoracic and intra-abdominsl organs

.0 Without mention of open wound into thoracic or

abdominal cavity

.1 With open wound into thoracic or alxIominal

cavity

.9 Late effect

LACERATION AND OPEN WOUND (N870-N908)

Excludes: burn (N940-N949)

crushing without open wound

(N920-N929)

foreign lmdy entering through orifice

(N930-N939)

late amputation stump complication

(following surgical amputation)

(N998.1)

superficial injury (N91O-N918)

that incidental to:

cerebral injury (N850-N854)

dislocation (N830-N839)

fracture (N800-N829)

internal injury (N860-N869)

nerve injury (N950-N959)

Laceration and open wound of head, neck and trunk

(N870-N879)

N870 Open wound of eye and orbit

.0 Without mention of complication

.1 Complicated

.9 Late effect

N871 Enucleation of eye

N872 Open wound of ear

.0 Without mention of complication

.1 Complicated

.9 Late effect

N873 Other and unspecified laceration of head

.0 Scalp without mention of complication

.1 Scalp complicated

.2 Nose without mention of complication

.3 Nose complicated

.7 Other face without mention of complication

.8 Other face complicated

.9 Late effect, nose, other face and scalp

N874 open wound of neck

.0 Without mention of complication

.1 Complicated

.9 Late effect

N875 Open wound of chest (wall)

.0 Without mention of complication

.1 Complicated

.9 Late effect

N876 Open wound of back

.0 Without mention of complication

.1 Complicated

.9 Late effect

67
N877 Open wound of buttock N885 Traumatic amputation of thumb (complete) (partial)

.0 Without mention of complication

.1 Complicated

.9 Late effect

N878 Open wound of genital organs (external) including

traumatic amputation

.0 Without mention of complication

.1 Complicated

.9 Late effect

N879 Other, multiple and unapecifietl open wounds of

head, neck and trunk

.0 Other specified sites of trunk without mention

of complication

.1 Other specified sites of trunk complicated

.7 Multiple and unspecified sites without mention

of complication

.8 Multiple and unspecified sites complicated

.9 Late effect, other ,specified, multiple and-unspecified sites

Laceration and open wound of uppev limb (N880-N88~

N880 Open wound of shoulder and upper arm

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N881 Open wound of elbow, forearm and wrist

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N882 Open wound of hand(s) except finger(s) alone

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N883 Open wound of finger(s)

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N884 Multiple and unspecified open wound of upper

limb

.0 Without mention of complication

.1Complicated

.2 With tendon involvement

.9 Late effect

.0 Without mention of complication

.1 Complicated

.!2Late effect

N886 Traumatic amputation of other finger(s) (complete) (partial)

.0 Without mention of complication

.1 Complicated

.9 Late effect

N887 Traumatic amputation of arm and hand (complete)

(partial)

.0 Without mention of complication

.1 Complicated

.9 Late effect

Laceration and open wound of lower limbs (N890-N89?)

N890 Open wound of hip and thigh

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N891 Open wound of knee, leg (except thigh) and ankle

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N892 Open wound of foot except toe(a) alone

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N893 Open wound of toe(s)

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N894 Multiple and unspecified open wound of lower limb

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N895 Traumatic amputation of toe(s) (complete) (partial)

.0 Without mention of complication

.1 Complicated

.9 Late effect

68
N896 Traumatic amputation of foot (complete) (partial)

.0 Without mention of complication

.1 Complicated

.9 Late effect

N897 Traumatic amputation of leg(s) (complete) (partial)

.0 Without mention of complication

.1 Complicated

.9 Late effect

Laceration and open wounds of multiple location (N900-

N908)

N900Multiple open wounds of both upper limbs

.0 Without mention of complication

,1 Complicated

.2 With tendon involvement

.9 Late effect

N901 Multiple open wounds of both lower limbs

,0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N902 Multiple open wounds of both upper and lower

limb(s)

,0 Without mention of complication

,1 Complicated

.2 With tendon involvement

.9 Late effect

N903 Multiple open wounds of both hands

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N904 Multiple open wounds of both head and limb(s)

,0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N905 Multiple open wounds of both head and trunk

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

,9 Late effect

N906 Multiple open wounds of both trunk and limb(s)

.0 Without mention of complication

.1 Complicated

.2 With tendon involvement

.9 Late effect

N907 Multiple open wounds of face and other sites

.0 Without mention of complication

1 Complicated

.2 With tendon involvement

.9 Late effect

N908 Multiple open wounds of other and unspecified

location

.0 Without mention of complication

.1 Complicated

.9 Late effect

SUPERFICIAL INJURY (N91O-N918)

Excludes: burn (N940-N949)

contusion (N920-N929)

insect bite, venomous (N989.4)

The following fourth digits are applicable to categories N91O-N918 unless otherwise indicate&

.0 Without mention of infection

.1 Infected

N91O Superficial injury of face, neck, scalp

N911 Superficial injury of trunk

N912 Superficial injury of shoulder and upper arm

N913 Superficial injury of elbow, forearm and wrist

N914 Superficial injury of hand(s) except finger(s) alone

N915 Superficial injury of finger(s)

N916 Superficial injury of hip, thigh, leg and ankle

N917 Superficial injury of foot and toe(s)

N918 Superficial injury of other, multiple and unspecified

sites

CONTUSION AND CRUSHING WITH INTACT SKIN

SURFACE (N920-N929)

Excludes: concussion (N850, N860-N869)

that incidental to:

cerebral injury (N850-N854)

dislocation (N830-N839)

fracture (N800-N829)

internal injury (N860-N869)

nerve injury (N950-N959)

69
N920 Contusion of face, scalp, and neck except eye(s)

“N921Contusion of eye and orbit

N922 Contusion of trunk

N923 Contusion of shoulder and upper arm

N924 Contusion of elbow, forearm and wrist

N925 Contusion of hand(s) except finger(s) alone

N926 Contusion of finger(s)

N927 Contusion of hip, thigh, leg and ankle

N928 Contusion of foot and toe(s)

N929 Contusion of other, multiple and unspecified sites

FOREIGN BODY ENTERING THROUGH ORIFICE

(N930-N939)

Excludes: foreign lwdy in open wound (N800-N839,

N851-N908)

foreign body inadvertently left in operation wound (N998.6)

N930 Foreign body in eye and adnexa

N931 Foreign body in ear

N932 Foreign body in nose

N933 Foreign l.mdy in pharynx and larynx

N934 Foreign body in bronchus and lung

N935 Foreign body in mouth, oesophagus, stomach

N936 Intestine and colon

N937 Anus and rectum

N938 Digestive system, unspecified

N939 Foreign body in genito-urinsry tract

BURN (N940-N949)

Excludes: blister (N91O-N918)

burn due to swallowing corrosive substance (N983)

effect ofi

electricity (N995.6)

lighming (N994.0)

radiation other than burn (N990)

The following fourth digits are applicable to

categories N940-N949 unless otherwise indicated

.0 Burn, unspecified degree, without mention of

complication

.1 Burn, first degree, without mention of complication

.2 Burn, second degree, without mention of complication

.3 Bum, third degree, without mention of complication

.8 Complicated burn

.9 Late effect

N940 Bum confined to eye

N941 Burn confined to face, head and neck

N942 Bum confined to trunk

N943 Bum confined to upper limb except wrist and hand

N944 Bum confined to wrist(s) and hand(s)

N945 Burn confined to lower limb(s)

N946 Bum involving face, head and neck with limb(s)

N947 Bum involving trunk with limb(s)

N948 Burn involving face, head and neck with trunk

and limb(s)

N949 Burn involving other and unspecified parts

INWRY TO NERVES AND SPINAL CORD (N950-N959)

The following fourth iTigit!ppiicsble for categories N950-N959 unless otherwise indicated

.0 Injury to nerve, without mention of open wound

.1 Injury to nerve, with open wound

.9 Late effect

N950 Injury to optic nerve(s)

N951 Injury to other cranial nerve(s)

N952 Injury to nerve(s) in upper arm

N953 Injury to nerve(s) in forearm

N954 Injury to nerve(s) in wrist and hand

N955 Injury to nerve(s) in thigh

70
N956 Injury to nerve(s) in lower leg

N957 Injury to nerve(s) in ankle and foot

N958 Spinal cord lesion without evidence of spinal kme

injury

.0 Cervical without mention of open wound

.1 Cervical with open wound

.2 Dorsal or thoracic without mention of open

wound

.3 Dorsal or thoracic with open wound

.4 Lumbar without mention of open wound

.5 Lumbar with open wound

,7 Sacral without mention of open wound

.8 Sacral with open wound

.9 Late effect, any part

N959 Other nerve injury including nerve injury in several parts

.0 Cervical sympathetic without mention of open

wound

.1 Cervical sympathetic with open wound

.6 Other and in several parts without mention of

open wound

.7 Other and in several parts with open wound

.9 Late effect, either

ADVERSE EFFECTS OF CHEMICAL SUESTANCES

(N960-N989)

Excludes: dermatitis due to contact (692)

external chemical burns (N940-N949)

Advevse effect of medicinal agents (N960-I?979)

N960 Adverse effect of antibiotics

.0 Penicillin, any

.1 Antifungal antibiotics

.2 Chloramphenicol

.3 Erythromycins

.4 Streptomycin

.5 Tetracycline

,9 Other antibiotics

N961 Adverse effect of other anti-infectives

.0 Sulfonamides

.1 Arsenic anti-infectives

.2 Silver and its compounds

.3 Quinoline and hydroxyquinoline derivatives

.9 Other anti-infectives

N962 Adverse effect of hormones and synthetic substimtes

.0 Adrenals

.1 Androgens and anabolic congeners

.2 Oestrogens

.3 Insulins and antidiabetic agents

.4 Anterior pituitary extracts

.5 Posterior pituitary extracta

.6 Progestogens

.7 Thyroid and thyroid derivatives

.8 Antithyroid agents

.9 Other hormones and synthetic substitutes

N963 Adverse effect of primarily systemic agents

.0 Antihistaminic and anti-emetic drugs

.1 Antineoplastic agents

.2 Acidifying agents

.3 Alkalinizing agents

.4 Other electrolytic, caloric and water balance

agents

.5 Enzymes

.6 Vitamins

.9 Systemic agents, not elsewhere classified

N964 Adverse effect of agents primarily affecting blood

constituents

.0 Iron and its compounds

.1 Liver and liver extracts

.2 Anticoagulants

.3 Vitamin K products

.4 Other coagulant

.9 Other agents primarily affecting blood constituents

N965 Adverse effect of analgesics and antipyretics

.0 Opiates and synthetic analogs

.1 Salicylates and congeners

.2 Cinchophen and congeners

.3 Colchicine

.4 Aniline derivatives

.5 Other coal-tar derivatives

.9 Other analgesics and antipyretics

N966 Adverse effect of anticonvulsants

.0 Dione derivatives

.1 Hydantoin derivatives

.9 Other anticonvulsants

N967 Adverse effect of other sedatives

.0 Barbiturates

.1 Chloral hydrate

.2 Paraldehyde

.3 Bromides

.9 Other sedatives and hypnotics

and hypnotics

N968 Adverse effect of other central nervous system

depressants

.0 Central nervous system muscle relaxants

.1 Anesthetic gases

.9 Other

71
N969

N970

N971

N972

N973

N974

N975

N976

N977

72

Adverse effect of local anesthetics

Adverse effect of psychotherapeutics

.0 Antidepressants

.1 Tranquilizers

.9 Other psychotherapeutic agents

Adverse effect of other central nervous system

stimulants

Adverse effect of agents primarily affecting the

autonomic nervous system

.0 Parasympathomimetics (cholinergics)

.1 Parasympatholytics (anticholinergics)

.2 Sympathomimetics (adrenergics)

.3 Autonomic nervous system relaxants

.9 Other

Adverse effect of agents primarily affecting

cardiovascular system

.0 Cardiac depressants

.3 Cardiac tonics

.4 Cholesterol lowering agents

.5 Ganglionic blocking agents

.6 Vasodilators

.7 Other hypotensive agents

.8 Sclerosing agents

.9 Other

Adverse effect of drugs primarily affecting gastrointestinal system

.0 Antacids and antidiarrheal agents

.1 Intestinal irritant cathartics

.2 Emollient cathartics

.3 Saline cathartics

.4 Faecal softeners

.5 Other cathartics

.6 Emetics

.9 Other.

Adverse effect of diuretics

.0 Mercurial diuretics

.1 Xanthine derivatives

.2 Carbonic acid anbydrase inhibitors

.3 Saluretics

.9 Other diuretic agents

Adverse effect of agents acting dfrectly upon

musculoskeletal system

.0 Oxytocics

.1 Spasmolytics

.2 Gold and its compounds

.9 Other

Adverse effect of other and unspecified drugs

.0 External medicinal, not elsewhere classified

.1 Pharmaceutical dyes, not elsewhere classified

.2 Diagnostic agents

,8 Other specified drugs, not elsewhere classified

.9 Drugs, unspecified

N978 Adverse effect of two or more medicinal agents

in specified combinations

.0 Opium derivatives with barbiturates or tranquilizers

.1 Salicylates with decongestants, antihistamines,

etc.

.2 Barbiturates with salicylates or other nonaddicting analgesics

.3 Non-barbiturate sedatives with salicylates or

other non-addicting analgesics

.4 Psychopharmacologic agents with barbiturates

N979 Alcohol in combination with specified medicinal

agents

.0 Opium derivatives

.1 Barbiturates

.2 Non-barbiturate sedatives

.3 Antihistamines

.4 Psychopharmacologic agents

Tom-c effect of substances chiefly non-medicinal as to

sowce. (N980-N989)

N980 - - ‘- - ‘l--L-l

N981

N982

Loxlc ettect or alvullui

.0 Ethyl alcohol

.1 Methyl alcohol

.2 Isopropyl alcohol

.9 Other

Toxic effect of petroleum products

.0 Kerosene

.1 Gasoline

.2 Petroleum naphtha

.9 Other

Toxic effect of industrial solvents

Excludes petroleum products N981

.0 Benzine and homologies

.1 Carbon tetrachloride

.2 Carbon disulfide

.9 Other

N983 Toxic effect of corrosive aromatics, acids and

caustic alkalis

.0 Corrosive aromatics

.1 Acids

.2 Caustic alkalis

.9 Caustic NOS

N984 Toxic effect of lead and its compounds (including

fumes)
N985 Toxic effect of other metals chiefly non-medicinal

as to source

.0 Mercury and its compounds

.1 Arsenic and its compounds

,2 Manganese and its compounds

,3 Beryllium and its compounds

.9 Other

N986 Toxic effect of carbon monoxide

N987 Toxic effect of other gases, fumes or vapours

.0 Liquefied petroleum gases (butane, propane)

.1 Other hydrocarbon gas (methane, water-gas,

acetylene)

.2 Nitrogen dioxide

.3 Sulfur dioxide

.4 Frion

.9 Other

~988 Toxic effect of noxious food-stuffs

.0 Shellfish

.1 Mushrooms

.2 Other plants used as food

.9 Other

N989 Toxic effect of other substances chiefly nonmedicinal as to source

.0 Cyanide (including gas)

.1 Strychnine

.2 Chlorinated pesticides

.3 Other pesticides

.4 Venom

.5 Soaps and detergents

.9 Other

OTHER ADVERSE EFFECTS (N990-N999)

N990 Effect of radiation

Excludes: dermatitis due to radiation (692.7)

sunburn (692.8)

burns (N940-N949)

.0 Effect of radioactivity, neither diagnostic nor

therapeutic

.1 Adverse effect of diagnostic X-ray

.2 Adverse effect of radioactive isotope or tracer

substance

.3 Other radiation

.4 Adverse effect of radiotherapy, external

.5 Adverse effect of radiotherapy, internal

.6 Adverse effect of other radiotherapy

.9 Unspecified radiation

N991 Effects of reduced temperature

.0 Frostbite of face

.1 Frostbite of hand

.2 Frostbite of foot

.3 Frostbite of other and unspecified sites

.4 Immersion foot

.9 Other

N992 Effects of heat

N993

N994

Excludes sunburn (692.8)

.0 Heat stroke (heat pyrexia)

.1 Heat syncope

.2 Heat cramps

.3 Heat exhaustion, anhydrous

.4 Heat exhaustion, salt snd/or water depletion

.5 Heat exhaustion, NOS

.6 Heat fatigue, transient

.7 Heat oedema

.9 Other heat effects

Effects of air pressure

.0 Barotrauma, otitic

.1 Barotrauma, sinus

.2 Other and unspecified effects of high altitude

.3 Caisson disease

Effects of exposure and deprivation

.0 Effects of lighming

.1 Drowning and non-fatal submersion

.2 Effects of hunger

.3 Effects of thirst

.9 Other effects of exposure, not elsewhere classified

N995 Other general effects of external causes

.0 Effects of excessive exertion

.1 Motion (sea) sickness

.2 Car and train sickness

.3 Air sickness

.4 Other motion (travel) sickness

.5 Asphyxiation and strangulation

.6 Electrocution and non-fatal effects of electric

current

.9 Other general effects of external causes not

elsewhere classified

N996 Certain early complications of trauma

.0 Air emlmlism

.1 Fat embolism

.2 Secondary and recurrent hemorrhage

73
.3 Traumatic aneuryam and arterial injury

.4 Nerve injury complicating bone injury (fracture)

.5 Local infection of wound

.6 “Shock”

.7 Traumatic anuria (crush syndrome)

.8 Volkmam’s ischemic contracture

.9 Other early complications of trauma

N997 Injury other and unspecified

.0 Face and neck, except eyes

.1 Trunk

.2 Shoulder and upper arm

.3 Elbow, forearm and wrist

.4 Hand except finger(s)

.5 Finger(s)

.6 Hip and thigh

.7 Knee, leg, ankle and foot

.8 Other specified site, including multiple

.9 Unspecified site

N998 Complications of surgical procedures

.0 Reaction to lumbar or spinal puncture

.1 Late amputation stump complication

.2 Post-operative shock

.3 Post-operative hemorrhage or haematoma

.4 Accidental puncture or laceration

.5 Disruption of operation wound

.6 Foreign body inadvertently left in operation

wound

.7 Post-operative wound infection

.8 Persistent post-operative fistula

.9 Other complications of surgical procedures

N999 Other complications of medical care

.0 Generalized vaccinia

.1 Post-immunization encephalitis

.2 Serum hepatitis

.3 Other infection

.4. Anaphylactic shock

.5 Other serum reaction

.6 ABO incompatibility reaction

.7 Rh incompatibility reaction

.8 Other transfusion reaction

.9 Other

Excludes: contact dermatitis due to drugs

(692.3)

adverse effects due to drugs

(N960-N979)

000

74
OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS

Public Health Service Publication No. 1000

Series 1. I+ogvams and collection procedures. —Reports which describe the general programs of the National

Center for Health Statistics and its offices and divisions, data collection methods used, definitions, and

other material necessary for understanding the data.

Reports number 1-4

Series 2. Data evaluation and methods research. —Studies of new statistical methodology including: experimental

tests of new survey methods, studies of vital statistics collection methods, new analytical techniques,

objective evaluations of reliability of collected data, contributions to statistical theory.

Reports number 1-19

Series 3. Analytical studies. — Reports presenting analytical or interpretive studies based on vital and health statistics, carrying the analysis further than the expository types of reports in the other series.

Reports number 1-4

SeVies 4. Documents and committee reports. —Final reports of major committees concerned with vital and health

Seyies 10.

Series 11.

Series 12.

SeYies 20.

Series 21.

Series 22.

statistics, and documents such as recommended mcdel vital registration laws and revised birth and

death certificates.

Reports number 1-6

Data From the Health Interuiew Sur6,ey .—Statistics on illness, accidental injuries, disability, use of

hospital, medical, dental, and other services, and other health-related topics, based on data collected in

a continuing national household interview survey.

Reports number 1-32

Data F~om the Health Examination SuYvey.— Statistics based on the direct examination, testing, and

measurement of national samples of the population, including the medically defined prevalence of specific diseases, and distributions of the population with respect to various physical and physiological

measurements.

Reports number 1-19

Data From the Health Records Survey. —Statistics from records of hospital discharges and statistics

relating to the health characteristics of persons in institutions, and on hospital, medical, nursing, and

personal care received, based on national samples of establishments providing these services and

samples of the residents or patients.

Reports number 1-5

Data on movtality. —Various statistics on mortality other than as included in annual or monthly reportsspecial analyses by cause of death, age, and other demographic variables, also geographic and time

series analyses.

Reports number 1-3

Data on ruztality, marriage, and divorce. —Various statistics on natality, marriage, and divorce other

than as included in annual or monthly reports— special analyses by demagrapbic variables, also geographic and time series analyses, studies of fertility.

Reports number 1-9

Data Fvom the National Natality and Mortality surveys. —Statistics on characteristics of birtha and

deaths not available from the vital records, based on sample surveys stemming from these records,

including such topics as mortality by socioeconomic class, medical experience in the last year of life,

characteristics of pregnancy, etc.

Reports number. 1-3

For a list of titles of reparts publisbed in these series, write to: National Center for Health Statistics

U.S. Public Health Service

Washington, D.C. 20201
(J.S,, [) EPA F{TMENT OF

HEALTH, EDUCATION, AND WELFARE

PosTAGE AN[) FEES PAID

U.S. D= ARTMENT OF HEW Public Hlealth Service

HEALT’H SER\/lCES AND MENTAL HEALTH ADMINISTRATION HEW 396

!560(1 Fishers Lane

lRoclwil le. Mawland 20852

IOFFIC IAL B(JSINESS

I>enallty for Private Use, $300

r1‘:

IIBIII I,,,,,,, ,,,,

9

II

p ~

-1111 Ii ih

Usml,l 1111.

,mllll IllIml

THIRDC LASS

BLK. RT.

.. ,——..————— —— ———.