ICD - what is it? Decoding the abbreviation. International Classification of Diseases (ICD) ICD Groups 10

International classification diseases (ICD) is a standard diagnostic technique for epidemiology, healthcare organization and disease diagnosis. The ICD allows you to analyze the health status of the population, organize monitoring of the incidence and spread of diseases, develop classifications of diseases and health disorders recorded in medical and civil documentary sources ( medical records, death certificates).

Ability to store and retrieve diagnostic information within the ICD for medical, epidemiological, and quality assurance purposes medical services, serves as the basis for compiling mortality and morbidity statistics for WHO member countries. Keeping statistics is of particular importance for making decisions about financing and resource allocation in the health system.

The ICD, 10th revision, was approved at the 43rd World Health Assembly in May 1990 and has been in use in WHO member states since 1994. The 11th revision procedure will be completed in 2015.

ICD-10 Online resource

Downloading materials

The International Classification of Diseases and accompanying materials are available for download in various formats (including ClaML) in a special section of our website. To gain access to the files, you must register and accept the terms of the license agreement.

Organization of training on ICD

Electronic tutorial according to ICD-10 can be used both for self-study, and for working in a study group. The modular structure of the manual allows, if necessary, to build the educational process depending on the needs of students.

The tutorial is available in two versions.

Question No. 26. International classification of diseases and health-related problems (ICD-10): structure, principles of construction, application in medical institutions.

International Statistical Classification of Diseases and Related Health Problems - document used as a guide statistical And classification basis in healthcare. Reviewed periodically (every ten years) under the guidance of WHO. ICD is normative document, ensuring the unity of methodological approaches and international comparability materials.

Currently, the International Classification of Diseases, Tenth Revision (ICD-10, ICD-10) is in force. In Russia, health authorities and institutions transitioned statistical accounting to ICD-10 in 1999

Goals, objectives and scope of the ICD.

The purpose of the ICD is to create conditions for the systematic recording, analysis, interpretation and comparison of mortality and morbidity data obtained in different countries or regions and at different times. The ICD is used to convert verbal diagnoses of diseases and other health problems into alphanumeric codes that make data easy to store, retrieve, and analyze.

The ICD has become the international standard diagnostic classification for all general epidemiological purposes and many health care management purposes. They include an analysis of the overall health situation of population groups, as well as calculations of the incidence and prevalence of diseases and other health problems in their relationship to various factors.

The International Conference on the Tenth Revision of the International Classification of Diseases was held by the World Health Organization in Geneva from September 25 to October 2, 1989. The main innovation in the Tenth Revision is the use of an alphanumeric coding system, which presupposes the presence of one letter in a four-digit rubric followed by three numbers, which made it possible to more than double the size of the coding structure. Introducing letters or groups of letters into rubrics allows up to 100 three-character categories to be coded in each class.

An important innovation was the inclusion at the end of some classes of a list of rubrics for disorders arising after medical procedures. These categories indicated serious conditions that occurred after various interventions, such as endocrine and metabolic disorders after organ removal or other pathological conditions such as dumping syndrome after gastric surgery.

Structure, principles of construction

In contrast to the international nomenclature of diseases, the statistical classification (ICD-10) is based on the hierarchical principle of grouping diseases by assigning each nosology (or disorder) a statistical code with a letter of the English alphabet as the first character and numbers in the second, third and fourth characters of the code.

The first three characters of the code constitute a category that generally identifies a disease of particular public health significance or high prevalence. The headings form the “core” of the classification and at their level, data is submitted to WHO on the causes of death and the prevalence of a number of diseases, in order to conduct basic international comparisons. The fourth character of the statistical code follows the decimal point, detailing the content of the rubric. The four-digit code is defined as a subcategory. Four-digit subcategories form an integral part of the ICD and at their level, causes of death and morbidity are coded for submission to state statistics bodies, for interregional comparisons and in-depth statistical developments in specific areas of medicine.

ICD-10 consists of three volumes.

Volume 1 of the classification includes a complete list of headings and subcategories, code numbers of which range from A00.0 to Z99.9. The diseases included in it are divided into 21 classes, each of which in turn is subdivided into “blocks” of homogeneous three-digit headings, interconnected by common characteristics. The highlighted blocks of rubrics give an idea of ​​the priorities of individual groups of diseases in assessments of population health and health care activities. The hierarchical principle of constructing a classification (class, blocks, headings, subheadings) makes it possible to carry out statistical development based on various levels details of the collected data:

Class II - Neoplasms

Class III - Blood diseases, hematopoietic organs and selected disorders involving the immune mechanism

Class IV - Diseases of the endocrine system, nutritional disorders and metabolic disorders

Class V - Mental and behavioral disorders

Class VI - Diseases nervous system

Class VII - Diseases of the eye and its adnexa

Class VIII - Diseases of the ear and mastoid process

Class IX - Diseases of the circulatory system

Class X - Respiratory diseases

Class XI - Diseases of the digestive system

Class XII - Diseases of the skin and subcutaneous tissue

Class XIII - Diseases of the musculoskeletal system and connective tissue

Class XIV - Diseases genitourinary system

Class XV - Pregnancy, childbirth and the puerperium

Class XVI - Selected conditions arising in the perinatal period

Class XVII - Congenital anomalies [blood defects], deformities and chromosomal disorders

Class XVIII - Symptoms, signs and abnormalities identified during clinical and laboratory research, not classified elsewhere

Class XIX - Injuries, poisoning and some other consequences of external causes

Class XX - External causes of morbidity and mortality

Class XXI - Factors influencing the health status of the population and visits to health care institutions

Volume 2 of the classification provides guidance on the use of ICD-10.

Volume 3 includes an Alphabetical Index to the full list of headings (Volume 1) and is a significant addition to it, as it contains a large number of diagnoses and less specified conditions presented in Volume 1. Thus, the Alphabetical Index includes almost all diagnostic terms , currently used in medical practice.

As mentioned above, the core of the classification is volume 1, which in the tenth revision included 21 classes. The first seventeen of them (A00-Q99) relate to diseases and other pathological conditions. Class 18 (R00-R99) covers symptoms, signs and abnormalities identified by clinical and laboratory tests, as well as ill-defined conditions for which there is no diagnosis that could be attributed to any of the first seventeen classes. This class also includes a block of rubrics (R95-R99) intended for coding inaccurately designated and unknown causes of death.

Grade 19 (S00-T98) includes rubrics identifying different kinds injuries, poisonings and other consequences of external causes, including headings designed to identify a number of complications of surgical and therapeutic interventions.

The 20th and 21st classes, which were previously considered as an addition to the main classification, now with the introduction of the tenth revision received equal status with other classes.

Class 20 “External causes of morbidity and mortality” (V01-Y98) is primarily used to classify incidents (conditions and places of their occurrence, circumstances) that caused injuries, poisonings and other adverse effects classified in the nineteenth class, and in cases of death from these conditions in statistical development, preference should be given to the headings of the twentieth grade.

Class 21 (Z00-Z99) makes it possible to take into account and classify factors that influence health and encourage a person who is not necessarily sick to contact a health care institution (for example, for preventive vaccination or examination, obtaining advice on an existing problem that affects health, etc.).

Question No. 27.

Population morbidity: definition, objectives and methods of study. Primary incidence and prevalence of diseases:

definition, methodology for calculating indicators, their levels in Russia.

Definition, objectives of study, methods of morbidity

Morbidity- one of the indicators of population health. Key population health indicators:

Medical and demographic.

Morbidity.

Disability.

Physical development.

Morbidity is one of the most important criteria characterizing the health of the population. Under morbidity refers to data on the prevalence, structure and dynamics of various diseases registered among the population as a whole or in its individual groups. Types of morbidity:

Morbidity according to primary appeal data, which includes general morbidity, infectious morbidity, hospital morbidity with temporary disability, the most important non-epidemic diseases (tuberculosis, syphilis).

Morbidity according to medical examinations and clinical observation.

Morbidity according to causes of death (data are taken from the registry office documents - death certificates).

If you need to study the incidence of illness with temporary disability, you need to take a certificate of incapacity for work, which is kept in the accounting department).

To study the general morbidity, a medical card and statistics are taken. ticket.

To study the incidence of tuberculosis, syphilis, and gonorrhea, a document is taken about the most important non-epidemic disease.

Each type of morbidity has an accounting and reporting form. Infectious hospital morbidity is the most important non-epidemic morbidity, morbidity with temporary disability are components of the general morbidity. The study of only one of the listed species is only part of the information on overall morbidity. The requirements for separate study of these types of morbidity are explained by certain reasons:

infectious morbidity - requires rapid implementation of anti-epidemic measures;

hospital morbidity - information about it is used to plan bed capacity;

morbidity with temporary disability - determines economic costs;

the most important non-epidemic morbidity - provides information about the prevalence of socially determined diseases.

Tasks

When studying morbidity and obtaining information about the health of the population, it is possible to determine:

risk factors

justify health-improving measures

evaluate the effectiveness of implemented measures

for operational management of the activities of healthcare institutions

for current and future personnel planning

to improve the structure of the health service as a whole and individual institutions

Methods for studying morbidity:

The study of morbidity is carried out according to the generally accepted scheme of statistical research and a strict sequence of stages. Stages:

1. collection of information

2. grouping and summary of materials and their encryption

3. counting processing

4. analysis of materials and their design (conclusions, recommendations).

When studying morbidity due to a condition environment a targeted study of environmental factors and an in-depth analysis of morbidity are necessary.

Sources of information on morbidity:

1. medical information about seeking medical care

2. medical data examinations

3. materials on causes of death

Request for medical care assistance is the absolute number of patients who applied to medical institutions for the first time in a calendar year due to a disease. All initial and repeat requests are characterized by attendance.

To assess population morbidity, coefficients are used, calculated as the ratio of the number of diseases to the number of population groups and recalculated to the standard (per 100 1000 10000 people). These coefficients allow us to estimate the probability of the risk of any disease occurring in the population. To obtain approximate ideas about the morbidity of the population, the calculation of general coefficients (extensive intensive) is provided. To identify cause-and-effect relationships, special coefficients are needed, that is, taking into account gender, profession, etc.

Primary morbidity and prevalence of diseases: definition, methodology for calculating indicators, their levels in Russia.

Morbidity rates. There are:

Primary or actual morbidity;

Widespread or painful;

Frequency of diseases detected during medical examinations or pathological involvement.

Definitions of primary incidence and prevalence:

Primary incidence- this is the number of diseases diagnosed for the first time in life within 1 year. All acute diseases and those diagnosed for the first time in life are taken into account chronic diseases upon first contact medical institution(relapses of chronic pathology occurring within a year are not taken into account).

Morbidity or prevalence of diseases- this is the totality of all acute and all chronic diseases registered in a given calendar year. Morbidity is always higher than the level of morbidity itself. The morbidity indicator, in contrast to morbidity, indicates dynamic processes occurring in the health of the population and is more preferable for identifying causal relationships. The morbidity indicator gives an idea of ​​both new cases of the disease and previously diagnosed cases, but with an exacerbation of which the population came in a given calendar year.

Pathological affection- the totality of all diseases and pathological conditions identified during comprehensive medical examinations. This indicator gives an idea of ​​the number of patients registered on a certain date. Mainly highlighted chronic pathology and in most cases of this disease with which the population did not go to medical institutions.

Methods for studying morbidity.Methodology for calculating indicators, their levels in Russia.

Solid;

Selective

Solid - acceptable for operational purposes. Selective - used to identify the relationship between disease incidence and environmental factors. The sampling method was used during census years. An example of this is the study of morbidity in individual territories. The choice of method for studying the morbidity of the population in a particular territory or its individual groups is determined by the purpose and objectives of the study. Approximate information about the levels, structure and dynamics of morbidity can be obtained from the reports of treatment and preventive institutions and reports from the central administration using the continuous method.

Identification of patterns, morbidity, and connections is possible only with the selective method by copying passport and medical data from primary accounting documents onto a statistical card.

When assessing the level, structure and dynamics of morbidity among the population and its individual groups, it is recommended to compare with indicators for the Russian Federation, city, district, region. The unit of observation when studying general morbidity is the patient’s initial visit in the current calendar year regarding the disease. The main accounting documents for studying general morbidity are: a medical card and a statistical certificate for a specified diagnosis. The overall incidence is calculated per 1000, 10,000 population. In the structure of general morbidity in Russia, the first place is occupied by diseases of the respiratory system, diseases of the nervous system and sensory organs are in second place, and diseases of the circulatory system are in third place. Among children (0 -14) years old, infectious diseases occupy second place in the structure of overall morbidity, the share of which is 9.7%.

The incidence of infectious diseases is studied by recording each case of an infectious disease or suspicion of an infectious disease for which an accounting document is issued - emergency notice about an infectious disease. An emergency notification is sent within 12 hours to the center of state sanitary and epidemiological supervision and registered in a log infectious diseases. Based on the entries in this journal, a report is compiled on the movement of infectious diseases for each month, quarter, half-year, and year. The unit of observation when studying infectious morbidity is a case of infectious morbidity. Calculated for 10,000, 100,000 people. The study of infectious morbidity includes identifying the source of infection, analyzing seasonality, and analyzing the effectiveness of anti-epidemic measures. In the Russian Federation, the highest morbidity rate is in the ARVI group, which accounts for 87% of the total infectious morbidity rate. The incidence of influenza per 100,000 population is 3,721, acute infection of the upper respiratory tract 20. In recent years, vaccination recommended by WHO has been used for mass prevention. High level OKI. In recent years, more than 1 million 100 thousand have suffered from dysentery, typhoid fever, and salmonella. About 60% are children under 14 years of age. Unfavorable areas for dysentery: Korelia, Komi, Arkhangelsk, Kostroma, Penza regions. Calculation of the incidence of hepatitis, including hepatitis B and C. There is a normalization of the situation regarding cholera, including imported ones. The incidence of measles increased by 4 times, whooping cough by 63%. Diphtheria is epidemic in a number of regions. Overall, the incidence of diphtheria increased 4 times. The highest incidence rate is in St. Petersburg (more than 5 times higher than in Russia).

The most important non-epidemic diseases: tuberculosis, sexually transmitted diseases, mental illness, mycoses, malignant neoplasms, cardiovascular diseases. An accounting document is a notification about the most important non-epidemic diseases. The unit of observation for these diseases is the sick person. Morbidity records are kept in dispensaries. The incidence of tuberculosis in Russia increased by 25%, among children by 18%. The highest incidence rate is observed in Komi, Dagestan, Volgograd region, and Moscow. This situation is associated with large emigration of the population, with a decrease in the quality of nutrition, and with a decrease in the number of patients with open form of tuberculosis. The incidence of syphilis in Russia increased by 2.6 times, and gonorrhea by 37.4%. The incidence of sexually transmitted diseases in children and adolescents has increased. This happens due to negative social phenomena in society and the lack of work on the moral education of children and adolescents.

Morbidity with temporary disability. The unit of observation is each case of temporary disability. An accounting document - a certificate of incapacity for work (has not only medical and statistical, but also legal financial significance). Recalculation per 100 employees.

Basic indicators:

1. Morbidity structure in the case.

2. Morbidity structure in calendar days.

3. Number of cases per 100 workers.

4. Number of calendar days per 100 workers.

5. Average duration of one case of disease.

Average level in Russia:

80-120 cases per 100 workers

800-1200 calendar days per 100 workers.

The incidence rate is currently decreasing. Reporting document - Form 16 VN. Recently, for an in-depth methodology, an in-depth analysis technique has been used (not for everyone, but for those who have worked in the institution for at least 1 year). All 5 indicators are studied, but taking into account length of service, gender, and professional experience, and risk groups are determined.

In an in-depth study of risk groups:

1. Frequently ill: 4 times or more with etiologically related diseases and 6 times or more with etiologically unrelated diseases.

2. Long-term ill patients: in a calendar year, 40 days or more of etiologically related diseases and 60 days or more of etiologically unrelated diseases.

3. Frequently sick for a long time: 4 times or more in a calendar year and 40 days or more with etiologically related diseases, 6 times or more and 60 days or more with etiologically unrelated diseases.

With an in-depth study, a health index is calculated - this is the percentage of people who have never been sick this year (normally 50-60%).

The International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) is built on an alphanumeric basis and contains 21 classes of diseases. ICD-10 was adopted by the 43rd World Health Assembly, in Geneva (September 25 - October 2, 1989). The World Health Organization (WHO) recommended the introduction of ICD-10 from 01/01/1993.

By Order of the Ministry of Health of the Russian Federation dated May 27, 1997 No. 170“On the transition of healthcare authorities and institutions of the Russian Federation to ICD-10” the transition date was set as 01/01/1998, but in most regions of the Russian Federation it was postponed for a year. By Order of the Ministry of Health of the Russian Federation dated August 7, 1998 No. 241“On the improvement of medical documentation certifying cases of birth and death in connection with the transition to ICD-X”, from 01/01/1999, a new form of medical death certificate was introduced in accordance with the requirements of ICD-10.

Thus, the pathologist is entrusted with the functions of encrypting (coding) the causes of death in cases of pathological autopsies.

Performance Order of the Ministry of Health of the Russian Federation dated December 4, 1996 No. 398“On coding (encryption) of causes of death in medical documentation” is associated with the transfer of functions for coding causes of death in order to improve the quality of filling out medical death certificates to the pathological service. This work should be carried out under the control of the heads of territorial health authorities of the constituent entities of the Russian Federation.

ICD-10 contains the following new provisions:

- Specifically grouped classes of diseases have priority over classes, the construction of which is based on pathological changes in individual organs and systems. Among these specifically grouped classes, the classes “Pregnancy, childbirth and the postpartum period”, “Certain conditions arising in the perinatal period” take precedence over others.

The notes in the lists of disease classes apply to all cases of use of the ICD. Notes that relate to morbidity only or mortality only are provided in the special notes accompanying the morbidity or mortality coding rules.

Iatrogenic complications, if it is necessary to code them (in cases where they are interpreted as the original cause of death), are encrypted with class XIX codes - “Injuries, poisoning and some other consequences of external causes.”

- On medical death certificates, only the underlying cause of death is encrypted (encoded), and not direct, as is still often the case in erroneously issued medical reports (for example, “acute cardiovascular failure” instead of the original cause of death). Article 5 of the Nomenclature Regulations relating to disease and causes of death states: “WHO Member States shall approve a form of medical certificate of cause of death that allows the disease or injury causing or contributing to death to be recorded, clearly indicating the underlying cause. "

- Not all concepts and codes specified in ICD-10 can be used to formulate and encrypt the original cause of death, i.e. the underlying disease in the final clinical and pathological diagnoses. This is due to the fact that in ICD-10 includes not only nosological forms, but also syndromes, symptoms, pathological conditions, injuries, conditions of injury and trauma. Many of them are intended for coding the reasons for seeking medical help, for statistical analysis of pathological conditions that were the reasons for hospitalization, when the diagnosis of the underlying disease is not yet clear.

- When encoding the cause of death in pathoanatomical practice, the last character “.9” is not used, since the capabilities of an autopsy make it possible to clarify the nature of the disease. The “-” sign indicates that there is a fourth character in the ICD and should be used. Round and square brackets enclose additional terms, synonyms, and clarifications that allow you to more accurately select the desired code. The conjunction "and" means "or". In all subheadings, the fourth character “.8” means “other conditions not specified above,” and the fourth character “.9” means “unspecified information (disease, syndrome, etc.).”

- In case of exacerbation of a chronic disease, unless otherwise provided by a special ICD code, the acute form of the disease is encrypted. For example, with exacerbation of chronic cholecystitis, acute cholecystitis is coded.

ICD-O code numbers (oncological classification) consist of 5 digits: the first 4 determine the histological type of the neoplasm, and the 5th digit, which follows the dividing line or without it, indicates its nature in terms of the course of the disease: /0 - benign neoplasm, /1 – neoplasm that is not defined as benign or malignant, borderline malignancy, excluding ovarian cystadenomas, /2 – cancer (intraepithelial, non-infiltrative, non-invasive), /3 – malignant neoplasm, primary localization, /6 – metastatic malignant neoplasm, /9 – malignant neoplasm that is not defined as primary or metastatic.

Thus, there are 10 characters (digits) necessary for complete identification of the topography (4 characters), morphological type (4 characters), nature of the tumor (1 character) and histological grading or degree of differentiation of the neoplasm or its equivalent for leukemias and lymphomas (1 character ).

A number of other innovations compared to ICD-9 are noteworthy. Thus, in class 1X “Diseases of the circulatory system,” instead of the term “hypertension,” the group concept “hypertensive disease” is used. In this case, forms with congestive heart failure, with renal failure, with heart and kidney failure are distinguished. Cases (hereinafter referred to as independent nosological units) involving the arteries of the heart, brain, limbs, etc. are excluded from this section.

Coronary heart disease, as a group (generic) concept (not a nosological unit), includes a number of nosological forms, in particular, variants of angina pectoris, myocardial infarction, cardiosclerosis, etc. Presence hypertension in such patients it is recommended to mark it with a second code as a background disease.

Unfortunately, some terms appeared in ICD-10, literally translated into Russian, that do not correspond to modern concepts of domestic medicine, for example, “myocardial degeneration,” which is also important to consider when choosing codes that can be used in the practice of a pathologist.

Iatrogenic pathology deserves special consideration, which, in cases where iatrogenicity is elevated to the rank of the main disease, is often encrypted with a medical intervention code. The formulation of the diagnosis (how to interpret iatrogenicity - as the main disease or complication) depends in each specific case on the nature of the initial and immediate causes of death. ICD-10 clearly defines that iatrogenic fatal complications are indicated as the initial cause of death (the underlying disease) in case of erroneous overdose, incorrect prescription of a drug, unprofessional (with errors, not according to indications, with underestimation of the patient’s characteristics) diagnostic or therapeutic event. Other iatrogenic, even fatal complications that arose when medical care was provided correctly and according to indications should be considered as complications of the underlying disease (with the exception of anaphylactic shock and some other complications that are traditionally presented as the underlying disease).

Thus, in accordance with the requirements of ICD-10, underlying disease - it is a disease entity that should be used to analyze single-cause morbidity and mortality. This is the illness or injury that was treated or evaluated during the last episode of medical care or that was the cause of death. The underlying disease is defined as one that has been diagnosed at the end of the episode of care , for which mainly therapeutic or diagnostic procedures were carried out. If there is more than one such disease, choose the one that was of greater importance in thanatogenesis, is considered more severe or socially significant, and also which accounted for the largest part of the resources used, which corresponded to the profile medical institution or its branches.

It is not allowed to indicate as the main disease those nosological units that were diagnosed in earlier episodes of the diagnostic and treatment process, but which did not have an impact on the current episode and were not the cause of death. As rightly noted in ICD-10, limiting the analysis to a single nosological unit for each episode entails the loss of some of the available information. Therefore, ICD-10 recommends, whenever possible, coding and analysis of morbidity by multiple causes (double and multiple coding) to complement the usual data. This should be done, for example, in accordance with the design rules of the so-called. combined underlying disease.

When formulating a final clinical diagnosis, it is necessary to identify the disease (injury) that itself, or through complications associated with it, led the patient to death (but may not have been the reason for the patient seeking medical help or even the reason for medical measures). The same requirement applies to pathological diagnosis, since The main task of a pathoanatomical autopsy study is to determine the initial cause of death (main disease, injury) and the immediate cause of death (fatal complication).

The rubric of the final clinical and pathological diagnosis regarding the underlying disease should not include diseases for which diagnostic and therapeutic interventions were not undertaken in this episode (unless, of course, this particular case is a discrepancy in diagnoses). For example, stenosing atherosclerosis without an episode of diagnostic or therapeutic angiography or surgical intervention and in the presence of ischemic damage to a specific organ, it cannot be the underlying disease.

In order to streamline the recording of causes of death, the 20th World Health Assembly defined the causes of death that should be recorded on the medical death certificate as “all those diseases, pathological conditions or injuries that led to or contributed to death, as well as the circumstances of the accident or the act of violence that caused any such injury.” This definition was formulated to ensure that all death-related information is recorded. so that the person filling out the medical death certificate does not select certain conditions and exclude others when recording only at his own discretion, as is often, unfortunately, practiced to this day.

It should be noted that this definition does not provide for the inclusion in the medical death certificate of symptoms and phenomena accompanying the onset of death (mechanism of death), such as heart failure, asthenia, intoxication, etc.

The problem of classifying causes of death for vital statistics is solved relatively simply when there is only one nosological unit that was the original cause of death. However, in many cases (according to the Moscow city pathological service - in 60-70% of cases) death is caused by two or more diseases. This problem is solved by using the diagnosis of “combined underlying disease.” In these cases, in demographic statistics it has become a traditional practice to select for statistical development only one (first) of the nosological units indicated in the combined main disease - the causes of death. This cause has been labeled differently in the past: “cause of death”, “ primary cause death”, “principal cause of death”, “underlying or main cause of death”. To unify the terminology and methodology for choosing the cause of death when carrying out statistical developments, at the International Conference on the 6th revision of the ICD, an agreement was reached on the use of the term in medical statistical documentation “original cause of death.” According to ICD-10, causes of death that must be included in the death certificate and other medical documentation, in accordance with the definition given by the 20th World Health Assembly, are all those diseases, pathological conditions or injuries that led to death or contributed to its occurrence, as well as the circumstances of the accident or act of violence that caused such injuries.

The underlying cause of death must be considered to be: a) the disease or injury that caused the successive series of disease processes leading directly to death, or b) the circumstances of the accident or act of violence that caused the fatal injury.

ICD-10 is an abbreviation for the list of international classification of diseases, which underwent the next, tenth revision in 2010. This classification contains codes that designate all diseases known to medicine.

Very often, the diagnosis given to the patient is quite cumbersome, as it contains a whole set of concomitant ailments. For the convenience of its description, ICD-10 is used. Instead of the name of the disease, in the patient’s card, medical history, and most importantly, the Foundation’s documents health insurance enter the appropriate code.

What else is ICD 10 (international classification of diseases), what are the main disease codes? Let's talk about this in more detail on this page www.site:

Why is ICD-10 needed?

To provide a modern, normal level health care, actively develop medical science, it is necessary to regularly update data on the state of health of the population, have information about the activities of hospitals, clinics, and other health care institutions. For this it is necessary to develop Information Systems, increase their reliability and efficiency. The creation of such systems is impossible without using a code classification of diseases.

This classification is provided by one of the main statistical classification frameworks - the International Classification of Diseases (ICD). It also contains a list of injuries and causes of death. Medical science does not stand still and is actively developing. Therefore, under the leadership of WHO this system revised once every 10 years.

Thus, the ICD is a single regulatory document that ensures uniformity and comparability of international methodological approaches and materials to a specific disease.

At the last, tenth revision of this normative document, in addition to the usual, traditional structure of the ICD, an alphanumeric system of certain codes was compiled, which replaced the outdated digital one. The introduction of a new coding seriously expands the capabilities of modern classification. In addition, alphanumeric encoding does not disrupt the digital system during the next revision, which has often happened in the past.

ICD-10 is compiled more optimally than previous classifications. In particular, it expands the grouping of diseases of the eye, ear, as well as the adnexal apparatus and mastoid process. ICD-10 includes some blood diseases in the classification “Diseases of the blood and hematopoietic organs”. Besides, external factors, influencing the state of human health are included in the main part of the main classification. Previously they were included in additional parts.

This tenth classification was fully approved by the International Conference on the next revision of the ICD and adopted at the Forty-third World Health Assembly.

The document contains all regulatory definitions and an alphabetical list of known diseases. Includes: three-digit headings, four-digit sub-headings containing the necessary notes, lists of exceptions for the main disease, as well as statistics, rules for determining the main causes of death of patients. There is also a list of reasons for the necessary hospitalization of patients.

A detailed list of headings has been compiled, including short lists that help in developing data on morbidity, attendance at health care facilities, and mortality. There are guidelines for filling out perinatal mortality certificates.

Before practical use of ICD-10, it is necessary to carefully study the structure of the classification, carefully familiarize yourself with the presented groupings of painful conditions, study notes, inclusions, exclusions, selection rules, and coding of the main diagnosis.

ICD-10 classes

The document consists of 21 sections. Each section includes subsections with codes for known diseases and pathological conditions. The classification is presented as follows:

As an example, how condition codes are encrypted in ICD 10, Here's a breakdown of grade 15.

O00-O08. Gestation with abortion
O10-O16. Proteinuria, edema and blood pressure disorders during pregnancy, during and after childbirth
O20-O29. Other maternal diseases associated with pregnancy
O30-O48. Assistance from doctors to the mother in connection with indicators of the condition of the fetus and possible difficulties of delivery
O60-O75. Difficulties with childbirth
O80-O84. Singleton birth, spontaneous birth
O85-O92. Difficulties, mainly with the period after childbirth
O95-O99. Other obstetric conditions not meeting other criteria

In turn, state intervals have a more specific interpretation. I'll bring you example for codes O00-O08:

O00. Pregnancy outside the uterus (ectopic)
O01. Cystic skid
O02. Other abnormal conception defects
O03. Spontaneous abortion
O04. Medical abortion
O05. Other methods of abortion
O06. Unspecified abortion
O07. Abortion attempt unsuccessful
O08. Difficulties due to abortion, molar or ectopic pregnancy

There are also further clarifications in ICD-10. I'll bring you example for code O01 Bubble skid classic:

O01.0 Classic bubble skid
O01.1 Hydatidiform mole, partial and incomplete
O01.9 Unspecified hydatidiform skid

Important!

If you study the official list of ICD-10, you will see that the alphabetical index of diseases at the beginning of the diagnostic slots also contains unspecified conditions indicated by the signs 9, NOS, NCD. Here is the example above “O01.9 Unspecified vesicular skid”. It is recommended to use such encodings in extreme cases, but generally not advisable, since they are not informative for statistics. The doctor should seek clarification of the diagnosis, which corresponds to a certain classification.

For more accurate information on disease codes, use the official ICD-10 document! The codes given here are accurate enough to convey the spirit of the document, but not quite precise in the wording, which our popular presentation format allows.

ICD 10. CLASS XXI. FACTORS AFFECTING THE HEALTH OF THE POPULATION
AND APPLICATIONS TO HEALTH INSTITUTIONS (Z00-Z99)

NoteThis class should not be used to conduct
comparisons internationally or for primary
coding causes of death.

Categories Z00-Z99 are intended for those cases when, as
"diagnosis" or "problem" does not indicate illness, injury or external
reason related to sections A00-Y89, and other circumstances.
This situation can arise mainly in two cases.
a) When an individual, not necessarily sick at the time,
applies to a health care institution with any special
purpose, for example, to receive insignificant assistance
or for maintenance due to a current condition: as
organ or tissue donor, for prophylactic vaccination or
discussing a problem that is not itself caused by the disease
or injury.
b) When there are some circumstances or problems that affect health, but at the moment are not themselves a disease or injury. Such factors can be discovered during population health surveys, during which the individual may be sick or healthy; they also
may be recorded as additional circumstances that should be kept in mind when seeking help for any illness or injury.

This class contains the following blocks:
Z00-Z13 Visits to healthcare institutions for medical examination and examination
Z20-Z29 Potential health hazards associated with infectious diseases
Z30-Z39 with circumstances related to reproductive function
Z40-Z54 Appeals to healthcare institutions in connection with the need to carry out specific procedures and receive medical care
Z55-Z65 Potential health hazards associated with socioeconomic and psychosocial circumstances
Z70-Z76 Appeals to healthcare institutions due to other circumstances
Z80-Z99 Potential health hazards related to personal or family history and certain health conditions

APPEAL TO HEALTH INSTITUTIONS
FOR MEDICAL EXAMINATION AND EXAMINATION (Z00-Z13)

Note Non-specific deviations from the norm found in
during these surveys, should be coded using categories R70-R94.
Excluded: examinations related to pregnancy and reproductive function ( Z30-Z36, Z39. -)

Z00 General examination and examination of persons who have no complaints or established diagnosis

Excluded: medical examination for administrative purposes ( Z02. -)
Z11-Z13)

Z00.0 General medical examination
Health check NOS
Periodic examination (annual) (physical)
Excluded: general health check:
certain population groups ( Z10. -)
infant and early age (Z00.1)
Z00.1 Routine examination of the child's health status
Performing tests to assess the development of an infant or young child
Excluded: monitoring the health of foundlings or other
Z76.1-Z76.2)
Z00.2 Screening during rapid growth in childhood
Z00.3 Examination to assess the developmental status of an adolescent. State of pubertal development
Z00.4 General psychiatric examination, not elsewhere classified
Excluded: examination for forensic purposes ( Z04.6)
Z00.5 Examination of a potential organ and tissue donor
Z00.6 Examination for comparison with norm or control during clinical research programs
Z00.8 Other general examinations. Medical checkup during mass population surveys

Z01 Other special examinations and examinations of persons who do not have complaints or an established diagnosis

Included: routine examination of certain systems
Excluded: examination:
for administrative purposes ( Z02. -)
if you suspect a disease (condition) (unconfirmed) ( Z03. -)
special screening examinations ( Z11-Z13)

Z01.0 Eye and vision examination
Excluded: examination in connection with obtaining a driver's license ( Z02.4)
Z01.1 Ear and hearing examination
Z01.2 Dental examination
Z01.3 Blood pressure determination
Z01.4 Gynecological examination (general) (routine)
Examination of cervical Pap smears
Pelvic examination (annual) (periodic)
Excluded: tests or examinations to establish pregnancy ( Z32. -)
routine examination in connection with contraception ( Z30.4-Z30.5)
Z01.5 Diagnostic skin and sensitization tests
Allergy tests
Skin tests to determine:
bacterial disease
hypersensitivity
Z01.6 Radiological examination not elsewhere classified
Routine:
radiography chest
mammography
Z01.7 Laboratory examination
Z01.8 Other specified special examination
Z01.9 Special examination, unspecified

Z02 Examination and appeal for administrative purposes

Z02.0 Examination in connection with admission to educational establishments
Examination in connection with admission to preschool(educational)
Z02.1 Pre-employment examination
Excluded: professional examinations ( Z10.0)
Z02.2 Examination in connection with admission to a long-term care facility
Excluded: examination before placement in prison ( Z02.8)
routine general health check of persons living in special institutions ( Z10.1)
Z02.3 Survey of conscripts into the armed forces
Excluded: general health check of armed forces personnel ( Z10.2)
Z02.4 Examination in connection with obtaining a driver's license
Z02.5 Examination in connection with sports activities
Excluded: tests for blood alcohol or drug levels ( Z04.0)
general examination of sports team members ( Z10.3)
Z02.6 Insurance related examination
Z02.7 Application in connection with obtaining medical documents
Obtaining medical certificates about:
cause of death
professional suitability
disability
disability
Excluded: requests for general medical examination ( Z00-Z01, Z02.0-Z02.6, Z02.8-Z02.9,Z10. -)
Z02.8 Other surveys for administrative purposes
Examination for:
imprisoned
trip to summer camp
adoption
immigration
naturalization
entry into marriage
Excluded: monitoring the health of foundlings or other
healthy infants or young children ( Z76.1-Z76.2)
Z02.9 Survey for administrative purposes, unspecified

Z03 Medical observation and evaluation of suspected disease or condition

Included: cases characterized by some symptoms requiring investigation or obvious signs of abnormality, which, as shown by subsequent examination and observation, do not require further treatment or medical care
Excluded: cases of complaints caused by fear of illness in a person with an unknown diagnosis ( Z71.1)

Z03.0 Observation for suspected tuberculosis
Z03.1 Observation for suspected malignancy
Z03.2 Observation for suspected mental illness and conduct disorder
Observation for:
dissocial behavior)
complete arson) without manifestations of mental banditry disorder
shoplifting)
Z03.3 Observation for suspected nervous system disorder
Z03.4 Observation for suspected myocardial infarction
Z03.5 Observation for suspected other cardiovascular disease
Z03.6 Observation for suspected toxic effect ingested substances
Observation for suspected:
adverse effects of drugs
poisoning
Z03.8 Observation for suspected other diseases or conditions
Z03.9 Observation for suspected disease or unspecified condition

Z04 Survey and observation for other purposes

Included: examination for forensic purposes

Z04.0 Blood alcohol test and narcotic substances
Excluded: presence in blood:
alcohol ( R78.0)
narcotic substances ( R78. -)
Z04.1 Inspection and observation after a traffic accident
Excluded: after an accident at work ( Z04.2)
Z04.2 Examination and observation after an industrial accident
Z04.3 Examination and observation after another accident
Z04.4 Investigation and observation when reporting rape or seduction
Examination of the victim or alleged perpetrator in an allegation of rape or seduction
Z04.5 Examination and observation after other injury
Examination of the victim or alleged perpetrator after another injury has occurred
Z04.6 General psychiatric examination at the request of the institution
Z04.8 Examination and observation for other specified reasons. Request for a specialist opinion
Z04.9 Examination and observation for unspecified reasons. NOS examination

Z08 Follow-up examination after treatment of malignant neoplasm

Z42-Z51, Z54. -)

Z08.0 Follow-up examination after surgical removal of a malignant neoplasm
Z08.1 Follow-up examination after radiotherapy for malignancy
Z51.0)
Z08.2 Follow-up examination after chemotherapy for malignancy
Z51.1)
Z08.7 Follow-up examination after combined treatment of malignant neoplasm
Z08.8 Follow-up examination after using another method of treating malignancy
Z08.9 Follow-up examination after an unspecified treatment for malignancy

Z09 Follow-up examination after treatment of non-malignant conditions

Included: medical observation and control after treatment
Excluded: subsequent health care and state of recovery ( Z42-Z51, Z54. -)
medical observation and control after treatment of malignant neoplasm ( Z08. -)
control for:
contraception ( Z30.4-Z30.5)
prostheses and other medical devices ( Z44-Z46)

Z09.0 Follow-up testing after surgery for other conditions
Z09.1 Follow-up testing after radiotherapy for other conditions

Excluded: course of radiotherapy (maintenance) ( Z51.0)
Z09.2 Follow-up testing after chemotherapy for other conditions
Excluded: maintenance chemotherapy ( Z51.1-Z51.2)
Z09.3 Follow-up examination after psychotherapy
Z09.4 Follow-up examination after fracture treatment
Z09.7 Follow-up testing after combination treatment for other conditions
Z09.8 Follow-up testing after another treatment for other conditions
Z09.9 Follow-up examination after unspecified treatment for other conditions

Z10 Routine general health screening of specified population subgroups

Excluded: medical examination for administrative purposes ( Z02. -)

Z12 malignant neoplasms

Z12.0 Special screening examination to identify
stomach tumors
Z12.1 Special screening examination to identify
neoplasms gastrointestinal tract
Z12.2 Special screening examination to identify
neoplasms of the respiratory system
Z12.3 Special screening examination to identify
breast tumors
Excludes: routine mammography ( Z01.6)
Z12.4 Special screening examination to identify
cervical neoplasms
Excluded: when performed as a routine examination or
as part of a general gynecological examination ( Z01.4)
Z12.5 Special screening examination to identify
prostate tumors
Z12.6 Special screening examination to identify
bladder neoplasms
Z12.8 Special screening examination to identify
neoplasms of other organs
Z12.9 Special screening examination to identify
neoplasm, unspecified

Z13 Special screening examination to detect other diseases and disorders

Z13.0 A special screening examination to identify diseases of the blood and hematopoietic organs, as well as some disorders involving the immune mechanism
Z13.1 Special screening examination to detect diabetes mellitus
Z13.2 Special screening examination to detect eating disorders
Z13.3 Special screening examination to detect mental disorders and behavioral disorders
Alcoholism. Depression. Mental retardation
Z13.4 Special screening examination to identify deviations from normal development in childhood
Excluded: routine tests to determine developmental level
infant or young child ( Z00.1)
Z13.5 Special screening examination to detect eye and ear diseases
Z13.6 Special screening examination to identify disorders of the cardiovascular system
Z13.7 Special screening examination to identify
congenital anomalies, deformations and chromosomal disorders
Z13.8 A special screening examination to identify other specified diseases and conditions. Dental diseases
Diseases of the endocrine system and metabolic disorders
Excluded: diabetes (Z13.1)
Z13.9 Special screening examination, unspecified

POTENTIAL HEALTH HAZARDS
INFECTIOUS DISEASE RELATED (Z20-Z29)

Z20 Contact with a sick person and the possibility of contracting infectious diseases

Z20.0 Contact with a sick person and the possibility of contracting infectious intestinal diseases
Z20.1 Contact with a sick person and the possibility of contracting tuberculosis
Z20.2 Contact with a sick person and the possibility of contracting an infectious disease
a disease transmitted primarily through sexual contact
Z20.3 Contact with a sick person and the possibility of contracting rabies
Z20.4 Contact with a sick person and the possibility of rubella infection
Z20.5 Contact with a sick person and the possibility of infection with viral hepatitis
Z20.6 Contact with a sick person and the possibility of infection with human immunodeficiency virus [HIV]
Excluded: asymptomatic human immunodeficiency virus [HIV] infection
infection status ( Z21)
Z20.7 Contact with a patient and the possibility of infection with pediculosis, acariasis and other invasions
Z20.8 Contact with a sick person and the possibility of contracting other infectious diseases
Z20.9 Contact with a sick person and the possibility of infection with other unspecified infectious diseases

Z21 Asymptomatic human immunodeficiency virus [HIV] infection

HIV positive NOS
Excluded: contact with a sick person and the possibility of contracting the virus
human immunodeficiency [HIV] ( Z20.6)
disease caused by human immunodeficiency virus [HIV] ( B20-B24)
laboratory confirmation of the presence of human immunodeficiency virus [HIV] ( R75)

Z22 Carriage of an infectious disease agent

Included: suspected carriage of a pathogen

Z22.0 Carriage of the pathogen typhoid fever
Z22.1 Carriage of pathogens of other gastrointestinal diseases
Z22.2 Carriage of the causative agent of diphtheria
Z22.3 Carriage of pathogens of other specified bacterial diseases
Carrier:
meningococci
staphylococci
streptococci
Z22.4 Carriage of pathogens of infectious diseases transmitted primarily through sexual contact
Carriage of the pathogen:
gonorrhea
syphilis
Z22.5 Carriage of the pathogen viral hepatitis. Carriage of hepatitis B virus surface antigen
Z22.6 Carriage of human T-lymphotropic virus type I
Z22.8 Carriage of another pathogen infectious disease
Z22.9 Carriage of an unspecified infectious disease agent

Z23 Need for immunization against one bacterial disease

Excluded: immunization:
against combinations of diseases ( Z27. -)
unconducted ( Z28. -)

Z23.0 The need for immunization only against cholera
Z23.1 The need for immunization only against typhoid and paratyphoid fever
Z23.2 The need for immunization against tuberculosis [BCG]
Z23.3 The need for immunization against plague
Z23.4 The need for immunization against tularemia
Z23.5 The need for immunization against tetanus only
Z23.6 The need for immunization only against diphtheria
Z23.7 The need for immunization only against whooping cough
Z23.8 The need for immunization against another single bacterial disease

Z24 Need for immunization against one specific viral disease

Excluded: immunization:
against a combination of diseases ( Z27. -)
unconducted ( Z28. -)

Z24.0 The need for immunization against polio
Z24.1 The need for immunization against arthropod-borne viral encephalitis
Z24.2 The need for immunization against rabies
Z24.3 The need for immunization against yellow fever
Z24.4 The need for immunization against measles only
Z24.5 The need for immunization against rubella only
Z24.6 The need for immunization against viral hepatitis

Z25 Need for immunization against one of the other viral diseases

Excluded: immunization:
against combinations of diseases ( Z27. -)
unconducted ( Z28. -)
Z25.0 The need for immunization against mumps only
Z25.1 The need for influenza immunization
Z25.8 Need for immunization against another specified single viral disease

Z26 Need for immunization against one of the other infectious diseases

Excluded: immunization:
against combinations of diseases ( Z27. -)
unconducted ( Z28. -)

Z26.0 The need for immunization against leishmaniasis
Z26.8 Need for immunization against another specified infectious disease
Z26.9 Need for immunization against an unspecified infectious disease
Need for immunization NOS

Z27 The need for immunization against combinations of infectious diseases

Z28. -)

Z27.0 The need for immunization against cholera and typhoid-paratyphoid fever
Z27.1 The need for immunization against diphtheria-tetanus-pertussis [DTP]
Z27.2 The need for immunization against diphtheria-tetanus-whooping cough and typhoid-paratyphoid fever
Z27.3 The need for immunization against diphtheria-tetanus-pertussis and polio
Z27.4 The need for immunization against measles-mumps-rubella
Z27.8 The need for immunization against other combinations of infectious diseases
Z27.9 Need for immunization against unspecified combinations of infectious diseases

Z28 Immunization not carried out

Z28.0 Immunization was not carried out due to medical contraindications
Z28.1 Immunization was not carried out due to the patient’s refusal due to his beliefs or group pressure
Z28.2 Immunization not performed due to patient refusal for another or unspecified reason
Z28.8 Immunization was not carried out for another reason
Z28.9 Immunization was not carried out for an unspecified reason

Z29 Need for other preventive measures

Excluded: desensitization to allergens ( Z51.6)
preventive surgery ( Z40. -)

Z29.0 Insulation. Hospitalization intended to protect an individual from his environment or isolate him after contact with infectious patients
Z29.1 Preventive immunotherapy. Administration of immunoglobulin
Z29.2 Another type of preventive chemotherapy. Chemoprophylaxis
Administration of antibiotics for prophylactic purposes
Z29.8 Other specified preventive measures
Z29.9 Unspecified preventive measure

APPEAL TO HEALTH INSTITUTIONS IN CONNECTION
WITH CIRCUMSTANCES RELATING TO REPRODUCTIVE FUNCTION (Z30-Z39)

Z30 Monitoring contraceptive use

Z30.0 General Tips and consultations on contraception
Family Planning Council NOS. Initial contraceptive prescription
Z30.1 Insertion of (intrauterine) contraceptive device
Z30.2 Sterilization. Hospitalization for dressing fallopian tubes or vas deferens
Z30.3 Inducing menstruation. Abortion. Regulation of the menstrual cycle
Z30.4 Monitoring the use of contraceptive medications
Issuing a repeat prescription for birth control pills or other contraceptives
Routine medical examination in connection with contraception
Z30.5 Monitoring (intrauterine) contraceptive use
Checking, reinserting or removing the (intrauterine) contraceptive device
Z30.8 Another type of monitoring of contraceptive use. Sperm counting after vasectomy
Z30.9 Observation of contraceptive use, unspecified

Z31 Restoration and preservation of reproductive function

Excluded: complications associated with artificial insemination ( N98. -)

Z31.0 Tuboplasty or vasoplasty after previous sterilization
Z31.1 Artificial insemination
Z31.2 Fertilization. Hospitalization for the purpose of artificial insemination or
egg implantation
Z31.3 Other methods to promote fertilization
Z31.4 Research and testing to restore reproductive function
Blowing out the fallopian tubes. Sperm counting
Excluded: sperm count after vasectomy ( Z30.8)
Z31.5 Genetic counseling
Z31.6 General consultation and advice on restoring fertility
Z31.8 Other measures to restore fertility
Z31.9 Measure to restore reproductive function, unspecified

Z32 Examination and tests to establish pregnancy

Z32.0 Pregnancy (not yet) confirmed
Z32.1 Pregnancy confirmed

Z33 Condition characteristic of pregnancy

Pregnancy status NOS

Z34 Monitoring the course of normal pregnancy

Z34.0 Monitoring the course of a normal first pregnancy
Z34.8 Monitoring the progress of another normal pregnancy
Z34.9 Monitoring the course of normal pregnancy, unspecified

Z35 Monitoring the course of pregnancy in a woman at high risk

Z35.0 Monitoring the course of pregnancy in a woman with a history of infertility
Z35.1 Monitoring the course of pregnancy in a woman with a history of abortive miscarriages
Monitoring pregnancy in a woman with a history of:
hydatiform drift
hydatidiform mole
Excluded: cases of recurrent miscarriage:
requiring assistance during pregnancy ( O26.2)
in the absence of current pregnancy ( N96)
Z35.2 Monitoring the course of pregnancy in a woman with another
aggravated medical history related to childbirth or obstetric problems
Monitoring pregnancy in a woman with a history of:
conditions classified under headings O10-O92
neonatal death
stillbirth
Z35.3 Monitoring the course of pregnancy in a woman with a history of insufficient prenatal care
Pregnancy:
camouflaged
hidden
Z35.4 Monitoring the course of pregnancy in a multiparous woman
Excluded: this condition is in the absence of a current pregnancy ( Z64.1)
Z35.5 Observation of an old primigravida
Z35.6 Observation of a very young primigravida
Z35.7 Monitoring pregnancy in a woman at high risk due to social problems
Z35.8 Monitoring pregnancy in a woman susceptible to other
high risk
Z35.9 Monitoring pregnancy in a woman at high unspecified risk

Z36 Prenatal examination to detect pathology in the fetus [antenatal screening]

Excluded: violations during antenatal screening of the mother ( O28. -)
routine prenatal care ( Z34-Z35)

Z36.0 Antenatal screening to detect chromosomal abnormalities
Amniocentesis. Placenta samples (taken vaginally)
Z36.1 Antenatal screening to detect higher level alpha-fetoprotein in amniotic fluid
Z36.2 Another type of antenatal screening based on amniocentesis
Z36.3
physical methods to detect developmental abnormalities
Z36.4 Antenatal screening using ultrasound or other
physical methods to detect fetal growth restriction
Z36.5 Antenatal screening for isoimmunization
Z36.8 Another type of antenatal screening. Screening for hemoglobinopathy
Z36.9 Unspecified type of antenatal screening

Z37 Outcome of childbirth

Note: This category is intended to be used as an additional code for identification purposes.
outcome of childbirth in documents related to the mother.
Z37.0 One live birth
Z37.1 One stillborn
Z37.2 Twins, both live born
Z37.3 Twins, one live born, one stillborn
Z37.4 Twins, both stillborn
Z37.5 Other multiple births, all live births
Z37.6 Other multiple births, there are live births and stillbirths
Z37.7 Other multiple births, all stillborn
Z37.9 Unspecified birth outcome. Multiple births NOS. Singleton birth NOS

Z38 Live births, according to place of birth

Z38.0 One child born in a hospital
Z38.1 One child born outside the hospital
Z38.2 One child born in an unspecified location. Live born child NOS
Z38.3 Twins born in hospital
Z38.4 Twins born out of hospital
Z38.5 Twins born in unspecified place
Z38.6 Other newborns from multiple births born in hospital
Z38.7 Other newborns from multiple births born outside the hospital
Z38.8 Other newborns from multiple births born in an unspecified location

Z39 Postnatal care and examination

Z39.0 Care and examination immediately after birth
Assistance and observation in uncomplicated cases
Excluded: assistance with postpartum complications— see Alphabetical Index
Z39.1 Help and examination of a nursing mother. Monitoring lactation
Excluded: lactation disorder ( O92. -)
Z39.2 Routine postpartum care

APPEAL TO HEALTH INSTITUTIONS DUE TO NEED
CARRYING OUT SPECIFIC PROCEDURES AND RECEIVING MEDICAL CARE (Z40-Z54)

NoteCategories Z40-Z54 are intended to encode reasons,
giving grounds for receiving medical careThey
can be used when patients who have previously been treated for an illness or injury receive follow-up or preventive care or care necessary for recovery or consolidation of treatment results, for treatment residual effects, as well as to eliminate or prevent relapses.
Excluded: follow-up examination during medical supervision after treatment ( Z08-Z09)

Z40 Preventive surgery

Z40.0 Preventive surgery in the presence of risk factors, with malignant tumor
Hospitalization for the purpose of prophylactic organ removal
Z40.8 Another type of preventative surgery
Z40.9 Prophylactic surgery, unspecified

Z41 Procedures not performed for therapeutic purposes

Z41.0 Hairy skin transplantation
Z41.1 Other types of reconstructive surgery to eliminate defects in appearance
Breast implantation
Excluded: postoperative and post-traumatic reconstructive surgery ( Z42. -)
Z41.2 Conventional or ritual circumcision
Z41.3 Ear piercing
Z41.8 Other procedures that do not have therapeutic purposes
Z41.9 Unspecified procedure with no therapeutic purpose

Z42 Follow-up care using reconstructive surgery

Included: postoperative and post-traumatic reconstructive surgery
scar tissue replacement
Excluded: reconstructive surgery:
as a method of treating a current injury - coded in the corresponding injury (see Index)
as a cosmetic surgery that does not have medicinal purposes ( Z41.1)

Z42.0 Follow-up care with reconstructive surgery in the head and neck area
Z42.1 Follow-up care with breast reconstructive surgery
Z42.2 Follow-up care with reconstructive surgery for other parts of the body
Z42.3 Follow-up care using reconstructive surgery upper limbs
Z42.4 Follow-up care using reconstructive surgery lower limbs
Z42.8 Follow-up care with reconstructive surgery on other parts of the body
Z42.9 Follow-up care with reconstructive surgery, unspecified

Z43 Maintenance of artificial holes

Included: closure
probing or bougienage
correction
catheter removal
processing or washing
Excluded: condition associated with the presence of an artificial hole that does not require maintenance ( Z93. -)
complications associated with external stoma ( J95.0,K91.4, N99.5)
Z44-Z46)

Z43.0 Tracheostomy care
Z43.1 Gastrostomy tube care
Z43.2 Ileostomy care
Z43.3 Colostomy care
Z43.4 Caring for another artificial digestive tract opening
Z43.5 Caring for a cystostomy
Z43.6 Caring for another artificial urinary tract opening. Nephrostomy. Urethrostomy. Ureterostomy
Z43.7 Caring for an artificial vagina
Z43.8 Care of other specified artificial orifices
Z43.9 Care of unspecified artificial orifice

Z44 Fitting and fitting of external prosthetic device

Excluded: presence of a prosthetic device ( Z97. -)

Z44.0 Fitting and fitting of artificial arm (whole) (parts)
Z44.1 Fitting and fitting of artificial leg (whole) (parts)
Z44.2 Trying and fitting an artificial eye
Excluded: mechanical complication of the ocular prosthesis ( T85.3)
Z44.3 Fitting and fitting of external breast prosthesis
Z44.8 Fitting and fitting of other external prosthetic devices
Z44.9 Fitting and fitting of unspecified external prosthetic device

Z45 Installation and adjustment of the implanted device

Excluded: malfunction of the device or other
associated complication - see Alphabetical index for the presence of prostheses and other devices ( Z95-Z97)

Z45.0 Installation and adjustment of artificial heart pacemaker
Monitoring and testing the pulse generator [battery]
Z45.1 Installation and adjustment of the dropper
Z45.2 Installation and adjustment of the vascular condition monitoring device
Z45.3 Installation and adjustment of an implanted hearing device
Device providing bone conduction. Cochlear device
Z45.8 Installation and adjustment of other implanted devices
Z45.9 Installation and adjustment of unspecified implanted device

Z46 Trying and fitting other devices

Excluded: only issuance of repeated orders ( Z76.0)
device malfunction or other device-related complication - see Index
presence of prostheses and other devices ( Z95-Z97)

Z46.0 Trying and fitting glasses and contact lenses
Z46.1 Trying and fitting a hearing aid
Z46.2 Fitting and fitting of other devices related to the nervous system and sensory organs
Z46.3 Fitting and fitting of a dental prosthetic device
Z46.4 Fitting and fitting of an orthodontic device
Z46.5 Fitting and fitting of ileostomy and other intestinal devices
Z46.6 Trying and adjusting the urinary device
Z46.7 Fitting and fitting of an orthopedic device
Orthopedic:
staples
removable denture
corset
shoes
Z46.8 Fitting and fitting of another specified orthopedic device. Chairs on wheels
Z46.9 Trying and fitting other unspecified product

Z47 Other orthopedic follow-up care

Excluded: assistance including rehabilitation procedures ( Z50. -)
complications associated with internal orthopedic devices, implants or grafts
(T84. -)
follow-up examination after fracture treatment ( Z09.4)

Z47.0 Removal of the plate after fracture healing, as well as other internal fixation device
Removal:
nails
records
rods
screws
Excluded: removal of external fixation device ( Z47.8)
Z47.8 Other specified type of follow-up orthopedic care
Replacement, verification or removal:
external fixation or traction device
plaster cast
Z47.9 Follow-up orthopedic care, unspecified

Z48 Other types of subsequent surgical care

Excluded: care of artificial orifice ( Z43. -)
fitting and fitting of prosthesis and other devices ( Z44-Z46)
follow-up examination after:
operations ( Z09.0)
fracture treatment ( Z09.4)
subsequent orthopedic care ( Z47. -)

Z48.0 Care of surgical dressings and sutures. Change of bandages. Removing stitches
Z48.8 Other specified types of subsequent surgical care
Z48.9 Subsequent surgical care, unspecified

Z49 Care including dialysis

Included: preparation and implementation of dialysis
Excluded: condition associated with renal dialysis ( Z99.2)

Z49.0 Preparatory procedures for dialysis
Z49.1 Extracorporeal dialysis. Dialysis (renal) NOS
Z49.2 Another type of dialysis. Peritoneal dialysis

Z50 Assistance including the use of rehabilitation procedures

Excluded: consultations ( Z70-Z71)

Z50.0 Rehabilitation for heart diseases
Z50.1 Another type of physical therapy. Therapeutic and corrective gymnastics
Z50.2 Rehabilitation of persons suffering from alcoholism
Z50.3 Rehabilitation of persons suffering from drug addiction
Z50.4 Psychotherapy not elsewhere classified
Z50.5 Speech therapy
Z50.6 Non-operative treatment of strabismus
Z50.7 Occupational therapy and vocational rehabilitation not elsewhere classified
Z50.8 Treatment, including other types of rehabilitation procedures
Smoking rehabilitation. NEC self-care training
Z50.9 Treatment including rehabilitation procedure, unspecified. Rehabilitation NOS

Z51 Other types of medical care

Excluded: follow-up examination after treatment ( Z08-Z09)

Z51.0 Radiotherapy course (maintenance)
Z51.1 Chemotherapy for neoplasm
Z51.2 Other types of chemotherapy. Maintenance chemotherapy NOS
Excludes: preventive chemotherapy for the purpose of immunization ( Z23-Z27, Z29. -)
Z51.3 Blood transfusion without a specified diagnosis
Z51.4 Preparatory procedures for subsequent treatment, not classified elsewhere
Excluded: preparatory procedures for dialysis ( Z49.0)
Z51.5 Palliative care
Z51.6 Desensitization to allergens
Z51.8 Other specified type of medical care
Excluded: provision of assistance during rest ( Z75.5)
Z51.9 Medical care unspecified

Z52 Organ and tissue donors

Excluded: examination of a potential donor ( Z00.5)

Z52.0 Blood donor
Z52.1 Skin donor
Z52.2 Bone donor
Z52.3 Bone marrow donor
Z52.4 Kidney donor
Z52.5 Cornea donor
Z52.8 Donor of another specified organ or tissue
Z52.9 Donor of unspecified organ or tissue. Donor NOS

Z53 Appeals to health care institutions in connection with unfulfilled specific procedures

Excluded: uncompleted immunization ( Z28. -)

Z53.0 The procedure was not performed due to contraindications
Z53.1 The procedure was not performed due to conscientious objection of the patient or due to group pressure
Z53.2 The procedure was not performed due to the patient’s refusal for other and unspecified reasons.
Z53.8 The procedure was not completed for other reasons
Z53.9 The procedure was not completed for an unspecified reason

Z54 State of recovery

Z54.0 State of recovery after surgery
Z54.1 State of recovery after radiotherapy
Z54.2 State of recovery after chemotherapy
Z54.3 State of recovery after psychotherapy
Z54.4 State of recovery after treatment of a fracture
Z54.7 State of recovery after combination treatment
State of recovery after any combination of treatments classified in Z54.0-Z54.4
Z54.8 State of recovery after other treatment
Z54.9 State of recovery after unspecified treatment

POTENTIAL HEALTH HAZARDS ASSOCIATED WITH
WITH SOCIO-ECONOMIC AND PSYCHOSOCIAL CIRCUMSTANCES (Z55-Z65)

Z55 Learning and literacy problems

Excluded: violations psychological development (F80-F89)
Z55.0 Illiteracy or low literacy level
Z55.1 Lack of learning ability
Z55.2 Failure in exams
Z55.3 Educational delay
Z55.4 Poor adaptation to the educational process, conflicts with teachers and fellow students
Z55.8 Other issues related to education and literacy. Inadequate training
Z55.9 Learning and literacy problem, unspecified

Z56 Problems related to work and unemployment

Excluded: exposure to industrial risk factors ( Z57. -)
problems related to the circumstances of housing and
economic nature ( Z59. -)

Z56.0 Absence of work unspecified
Z56.1 Job change
Z56.2 Threat of losing your job
Z56.3 Busy work schedule
Z56.4 Conflict with boss and co-workers
Z56.5 Unsuitable job. Difficult working conditions
Z56.6 Other physical and mental stress at work
Z56.7 Other and unspecified work-related problems

Z57 Impact of occupational risk factors

Z57.0 Adverse effects of industrial noise
Z57.1 Adverse effects of occupational radiation
Z57.2 Adverse effects of industrial dust
Z57.3 Adverse effects of other occupational air pollutants
Z57.4 Adverse effects of toxic substances used in agriculture
Z57.5 Adverse effects of toxic substances in other industries
Adverse effects from solid, liquid, gaseous and vapor substances
Z57.6 Adverse effects of industrial temperature extremes
Z57.7 Adverse effects of industrial vibration
Z57.8 Adverse effects of other risk factors
Z57.9 Adverse effects of unspecified risk factors

Z58 Problems related to physical environmental factors

Excluded: exposure to industrial risk factors ( Z57. -)

Z58.0 Exposure to noise
Z58.1 Impact of air pollution
Z58.2 Impact of water pollution
Z58.3 Impact of soil pollution
Z58.4 Impact of radiation pollution
Z58.5 Exposure to other pollution
Z58.6 Inadequate supply drinking water
Excluded: influence of thirst ( T73.1)
Z58.8 Other problems related to physical environmental factors
Z58.9 Problems related to physical environmental factors, unspecified

Z59 Problems related to housing and economic circumstances

Excluded: inadequate supply of drinking water ( Z58.6)

Z59.0 Lack of housing (homelessness)
Z59.1 Unsatisfactory living conditions
No heating. Limited living space. Technical deficiencies in the home that prevent adequate care. Unsatisfactory environment
Excluded: problems associated with physical environmental factors ( Z58. -)
Z59.2 Conflicts with neighbors, guests, owners
Z59.3 Problems associated with being in a permanent residence facility
Accommodation in a school boarding house
Excluded: educational institutions ( Z62.2)
Z59.4 Lack of adequate food
Excluded: influence of famine ( T73.0)
unacceptable diet or bad habits in food intake ( Z72.4)
malnutrition ( E40-E46)
Z59.5 Extreme poverty
Z59.6 Low level income
Z59.7 Failure social insurance and lateral support
Z59.8 Other problems relating to economic and housing conditions
Inability to get a loan. Living alone. Problems with creditors
Z59.9 Problem relating to economic and housing conditions, unspecified

Z60 Problems associated with adapting to lifestyle changes

Z60.0 Problems associated with adapting to lifestyle changes
Retirement (retirement). Loneliness syndrome
Z60.1 Atypical situation with parents. Problems associated with raising a child by one parent
or another person cohabiting with one of the biological parents
Z60.2 Living alone
Z60.3 Difficulties associated with accepting another culture. Migration. Changes in social status
Z60.4 Social isolation and ostracism
Social isolation and ostracism based on personal characteristics such as unusual appearance, illness
or behavior.
Excluded: Victim of racially hostile discrimination
or religious grounds ( Z60.5)
Z60.5 Victim of perceived discrimination or persecution
Harassment or discrimination (perceived or actual) based on group membership (skin color, religion, ethnic origin, etc.) rather than personal characteristics.
Excluded: social isolation and ostracism ( Z60.4)
Z60.8 Other problems related to the social environment
Z60.9 Problem related to social environmental factors, unspecified

Z61 Problems associated with adverse life events in childhood

T74. -)

Z61.0 Losing beloved relatives in childhood
Loss of an emotionally close relative, such as a parent, sibling, very close friend, or
a loved one, due to death, prolonged absence or separation.
Z61.1 Separation of a child from home. Placement in a shelter, hospital, or other institution that causes psychological distress, or conscription into the military from home for an extended period.
Z61.2 Changes in family relationships between relatives in childhood
The appearance of another person in the family as a result of unfavorable changes for the child in the relationship of relatives (this could be a new marriage of the parents or the birth of another child).
Z61.3 Events that lead to low self-esteem in childhood
Events that culminate in the child’s self-esteem (for example, failure in any business with high personal responsibility, discovery or disclosure of shameful or dishonest episodes of personal or family life, and others
factors that give rise to self-deprecation).
Z61.4 Concerns related to the possible sexual abuse of a child by a person belonging to the primary support group. Problems associated with any form of physical contact between an adult family member and a child or other means that cause sexual arousal and lead to sexual contact regardless of the child's desire (for example, touching or manipulation of the genitals, intentional exposure of the genitals or mammary glands ).
Z61.5 Problems associated with possible rape of a child by a stranger
Problems associated with various genital manipulations
organs and mammary glands, with undressing, caresses and
other actions with the child that incline or have
the purpose of inducing him to sexual intercourse, with his face, significantly
older in age, not a family member and
using their status or position, or acting
against the child's wishes.
Z61.6 Problems associated with possible physical violence
attitude towards the child
Problems associated with incidents in which a child is
past injuries were caused by any of the adults living in the house that required medical care (fractures,
obvious bruises), or in which the child was exposed
brutal forms of violence (beating with severe or sharp
objects, burns or binding).
Z61.7 Personal turmoil experienced in childhood
Experiences that may have an impact on the child's future, such as abduction, life-threatening natural catastrophes, injury that threatens safety or self-image, or trauma inflicted on a loved one in the child's presence.
Z61.8 Other adverse life events in childhood
Z61.9 Adverse life event in childhood, unspecified

Z62 Other problems related to raising a child

Excludes: abuse syndrome ( T74. -)

Z62.0 Inadequate care and control from parents
Lack of information from parents about what the child is doing and
where he is, poor control over him, lack of constant care for him and attempts to prevent risky
situations in which he may find himself.
Z62.1 Excessive parental care
An upbringing system that results in childishness and a child’s lack of independence and
independence.
Z62.2 Growing up in a closed institution
Group education, in which the responsibility of parents is largely transferred to the staff of various forms of institutions (such as children's homes, shelters
for orphans, boarding schools) or therapeutic care
for a long time in a hospital, institution for
convalescent or sanatoriums when the child is
without at least one parent.
Z62.3 Hostility and unfair claims against the child
Negative attitude of parents towards the child as an individual,
harshness and constant irritability towards
certain moments in the child’s behavior (for example, constant insults for any actions in the house or unnecessary accusations of the child).
Z62.4 Emotional abandonment of children
The tone of the parent's conversation with the child is dismissive or
indifferentLack of interest in the child, sensitive
attitude towards his difficulties, praise and support, an irritable reaction to a violation in the child’s behavior and the absence of an affectionate and warm attitude towards the child.
Z62.5 Other problems associated with deficiencies in upbringing
Lack of learning and play experience for the child
Z62.6 Unacceptable pressure from parents and other negative parenting factors
Parents force the child to do something that goes beyond accepted norms and does not correspond to gender (for example, dressing a boy in a girl’s dress),
age (for example, demanding from a child responsibility for his actions that is not yet available to him), his desire
or opportunities.
Z62.8 Other specified problems related to raising a child
Z62.9 Problem related to raising a child, unspecified

Z63 Other problems related to loved ones, including family circumstances

Excludes: abuse syndrome ( T74. -)
problems related to:
adverse life events in childhood ( Z61. -)
education ( Z62. -)

Z63.0 Problems related to relationships between spouses or partners
Disagreements between spouses (partners), leading to a prolonged or pronounced loss of control in the relationship,
hostility, unwillingness to understand each other, or a constant atmosphere of gross interpersonal violence (beatings,
fights).
Z63.1 Relationship problems with parents or in-laws
Z63.2 Insufficient family support
Z63.3 Absence of a family member
Z63.4 Disappearance or death of a family member. Feelings of guilt towards the deceased
Z63.5 Family breakdown due to separation or divorce. Alienation
Z63.6 Dependent family member requiring care at home
Z63.7 Other stressful life events affecting family and economic conditions
Worry (normal) about a sick family member. Health-related problems in the family
Illness or disorder in a family member. Isolated family
Z63.8 Other specified issues related to the primary support group
Disagreements in the BDU family. Excessive emotional level in family
Inadequate or disrupted family relationships
Z63.9 Problems related to the primary support team, unspecified

Z64 Problems associated with certain psychosocial circumstances

Z64.0 Problems associated with unwanted pregnancy
Excluded: monitoring the course of pregnancy in a woman,
at risk due to social problems ( Z35.7)
Z64.1 Problems associated with having many children
Excluded: monitoring the course of pregnancy in a multiparous woman ( Z35.4)
Z64.2 Finding and using physical, food and chemical substances, known to be harmful and dangerous
Excluded: drug addiction - see Alphabetical Index
Z64.3 Seeking out and accepting behavioral and psychological behaviors known to be harmful and dangerous
Z64.4 Conflict with an advisor
Conflict with:
person responsible for the subject
social worker

Z65 Problems associated with other psychosocial circumstances

Excludes: current injury - see Index

Z65.0 Charged with a civil or criminal offense without imprisonment
Z65.1 Imprisonment and other forced deprivation of liberty
Z65.2 Problems associated with release from prison
Z65.3 Problems related to other legal circumstances. Arrest
Child custody or child support concerns. Litigation. Prosecution
Z65.4 Victim of crime and terrorism. Victim of torture
Z65.5 Victim of natural disaster, war or other hostile acts
Excluded: victim of perceived discrimination or persecution ( Z60.5)
Z65.8 Other specified problems associated with psychological circumstances
Z65.9 Problem associated with unspecified psychological circumstances

APPEAL TO HEALTH INSTITUTIONS IN CONNECTION
WITH OTHER CIRCUMSTANCES (Z70-Z76)

Z70 Counseling concerning sexual relations, behavior and orientation

Excludes: counseling about contraception or fertility ( Z30-Z31)

Z70.0 Counseling regarding attitudes towards sexual issues
A person who is embarrassed, timid, or otherwise uncomfortable about sexual matters
Z70.1 Counseling regarding sexual behavior or sexual orientation
Patient concerned:
impotence
lack of reaction
promiscuity
sexual orientation
Z70.2 Counseling regarding sexual behavior and orientation of a third party
Advice regarding sexual behavior or orientation:
baby
partner
spouse
Z70.3 Consulting regarding complex issues related to
with sexual relationships, behavior and orientation
Z70.8 Other counseling related to sex. Sex education
Z70.9 Sexual counseling, unspecified

Z71 Contacts to health care institutions for other consultations and medical advice, not classified elsewhere

Excluded: counseling about contraception or fertility ( Z30-Z31)
counseling regarding attitudes towards sexual issues ( Z70. -)

Z71.0 Seeking advice on behalf of another person
Getting advice or treatment recommendations for an absent third party
Excluded: concern (normal) about a sick family member ( Z63.7)
Z71.1 Complaints caused by fear of illness, in the absence of a diagnosed illness
The condition that caused the fear was not detected. Treatment of a healthy person caused by fear of illness
"The Imaginary Sick"
Excluded: medical observation and evaluation if suspected
for illness or pathological condition (Z03. -)
Z71.2 Seeking clarification of research results
Z71.3 Nutrition counseling
Nutrition counseling and related
observation (in connection with):
NOS
colitis
diabetes mellitus
food allergies or intolerances
gastritis
hypercholesterolemia
hypoglycemia
obese
Z71.4 Alcoholism counseling and monitoring
Excludes: rehabilitation of persons suffering from alcoholism ( Z50.2)
Z71.5 Drug addiction counseling and monitoring
Excluded: rehabilitation of persons suffering from drug addiction ( Z50.3)
Z71.6 Counseling and monitoring regarding smoking
Excludes: smoking rehabilitation ( Z50.8)
Z71.7 Counseling on issues related to human immunodeficiency virus [HIV]
Z71.8 Other specified counseling. Consultation regarding consanguinity
Z71.9 Consulting unspecified. Medical Council NOS

Z72 Lifestyle problems

Excluded: problems related to:
difficulties maintaining a normal lifestyle ( Z73. -)
socio-economic and psychosocial circumstances ( Z55-Z65)

Z72.0 Tobacco use
Excluded: tobacco addiction ( F17.2)
Z72.1 Alcohol consumption
Excluded: alcohol addiction (F10.2)
Z72.2 Drug use
Excluded: abuse of non-addictive substances ( F55)
drug addiction ( F11-F16, F19 with a common fourth character 2)
Z72.3 Lack of physical activity
Z72.4 Unacceptable diet and bad eating habits
Excludes: behavioral eating disorders of children
and adolescence ( F98.2-F98.3)
eating disorders ( F50. -)
lack of adequate food ( Z59.4)
malnutrition and other disorders
food ( E40-E64)
Z72.5 Sexual behavior with high degree risk
Z72.6 Addiction to gambling and betting
Excluded: compulsive or pathological gambling ( F63.0)
Z72.8 Other lifestyle problems. Self-harming behavior
Z72.9 Lifestyle problem, unspecified

Z73 Problems associated with difficulties maintaining a normal lifestyle

Excluded: problems related to socio-economic and psychosocial circumstances ( Z55-Z65)

Z73.0 Overwork. State of exhaustion of vitality
Z73.1 Accented personality traits. Type A behavioral structure (characterized by excessive ambition, need for high achievements, intolerance, incompetence and importunity)
Z73.2 Lack of rest and relaxation
Z73.3 Stressful condition not elsewhere classified
Physical and mental stress NOS
Excluded: relating to employment or unemployment ( Z56. -)
Z73.4 Inadequate social skills not elsewhere classified
Z73.5 Conflict related to social role, not elsewhere classified
Z73.6 Restrictions in activity caused by reduction or loss of ability to work
Excluded: dependence on a person providing assistance and care ( Z74. -)
Z73.8 Other problems associated with difficulties in maintaining a lifestyle
Z73.9 Problem associated with difficulty maintaining lifestyle, unspecified

Z74 Problems related to dependence on a person providing help and care

Excluded: dependence on a mechanism or other NEC device ( Z99. -)

Z74.0 Limited ability to move
Bedridden. Confinement to a wheelchair

Z74.1 Need for assistance with self-care
Z74.2 Need for help with housekeeping in the absence of a family member capable of providing assistance
Z74.3 Need for constant monitoring
Z74.8 Other problems associated with dependency on a caregiver
Z74.9 Problem related to dependence on a caregiver, unspecified

Z75 Problems related to medical provision and other medical assistance

Z75.0 Lack of medical care at home
Excluded: absence of another family member capable of providing assistance ( Z74.2)
Z75.1 A person awaiting admission to an appropriate facility to receive care
Z75.2 Another waiting period for examination and treatment appointment
Z75.3 Lack or inaccessibility of health care services
Excluded: lack of hospital space ( Z75.1)
Z75.4 Lack or inaccessibility of other institutions providing assistance
Z75.5 Providing assistance during holidays. Providing care for a sick person, usually cared for at home, with the aim of providing family members with opportunities for recreation. Respite from care
Z75.8 Other problems related to medical care and other types of patient care
Z75.9 Unspecified problem concerning medical and other patient care

Z76 Contacting health care institutions due to other circumstances

Z76.0 Issuing a repeat prescription
Issuing repeat prescriptions for:
device
medicines
glasses
Excluded: issuance of a medical certificate ( Z02.7)
issuing a repeat prescription for contraceptives ( Z30.4)
Z76.1 Monitoring and caring for the foundling's health
Z76.2 Watching others healthy child Infancy and early childhood and care
Medical or nursing care or health monitoring
child in the following situations:
unfavorable socio-economic home conditions
waiting for placement in a shelter or adoption
mother's illness
the number of children in the house makes it difficult or impossible
providing normal care
Z76.3 Healthy man accompanying the patient
Z76.4 Other persons in need of assistance from health care institutions
Excluded: homeless people ( Z59.0)
Z76.5 Feigning illness [conscious simulation]. Person feigning illness (with obvious motivation)
Excluded: fictitious violations ( F68.1) “eternal” patient ( F68.1)
Z76.8 Persons accessing health services in other specified circumstances
Z76.9 Person contacting health services in unspecified circumstances

POTENTIAL HEALTH HAZARDS RELATED TO PERSONAL
AND FAMILY HISTORY AND CERTAIN CONDITIONS,
AFFECTING HEALTH (Z80-Z99)

Excluded: follow-up examination ( Z08-Z09)
follow-up medical care and recovery status ( Z42 -Z51 , Z54 . -)
cases where family or personal history is the reason for special screening or other
examination or examination ( Z00-Z13)
cases where the possibility of fetal harm warrants observation or appropriate
actions during pregnancy ( O35. -)

Z80

Z80.0 Family history of malignancy
gastrointestinal tract. C15-C26
Z80.1 Family history of malignancy
trachea, bronchi and lung. Conditions classified in categories C33-C34
Z80.2 Family history of malignancy
C30-C32, C37-C39
Z80.3 Family history of malignancy
mammary gland. C50. Z80.4 There is a family history of malignant neoplasm of the genital organs. Conditions classified in categories C51-C63
Z80.5 Family history of malignancy
urinary organs. Conditions classified in categories C64-C68
Z80.6 Family history of leukemia. Conditions classified in categories C91-C95
Z80.7 Family history of other lymphoid neoplasms,
hematopoietic and related tissues. Conditions classified in categories C81-C90, C96. Z80.8 Family history of malignant neoplasms of other organs or systems
Conditions classified in categories C00-C14, C40-C49,C69-C79, C97
Z80.9 Family history of unspecified malignant neoplasm
Conditions classified under the rubric C80

Z81 Family history of mental and behavioral disorders

Z81.0 Family history mental retardation
Conditions classified in categories F70-F79
Z81.1 Family history of alcohol dependence
Conditions classified under the rubric F10. Z81.2 Family history of smoking
Conditions classified under the rubric F17. Z81.3 Family history of substance abuse. Conditions classified in categories F11-F16, F18-F19
Z81.4 Family history of abuse of other addictive drugs
Conditions classified under the rubric F55
Z81.8 Other family history mental disorders and behavioral disorders
Conditions classified in categories F00-F99

Z82 Family history of some diseases that reduce work ability and chronic diseases that lead to disability

Z82.0 Family history of epilepsy and other diseases of the nervous system
Conditions classified in categories G00-G99
Z82.1 There is a family history of blindness and vision loss. Conditions classified under the rubric H54, Z82.2 There is a family history of deafness and hearing loss. Conditions classified in categories H90-H91
Z82.3 Family history of stroke. Conditions classified in categories I60-I64
Z82.4 Family history ischemic disease heart and other diseases of the cardiovascular system. Conditions classified in categories I00-I52, I65-I99
Z82.5 Family history of asthma and others chronic diseases lower respiratory tract
Conditions classified in categories J40-J47
Z82.6 Family history of arthritis and other diseases of the musculoskeletal system and connective tissue
Conditions classified in categories M00-M99
Z82.7 Family history congenital anomalies, deformities and chromosomal disorders
Conditions classified in categories Q00-Q99
Z82.8 Family history of other disabling conditions and chronic disabling diseases not elsewhere classified

Z83 Family history of other specific disorders

Excluded: contact with a sick person or the possibility of contracting an infectious disease in the family ( Z20. -)

Z84.0 Family history of skin and subcutaneous tissue diseases
Conditions classified in categories L00-L99
Z84.1 Family history of renal and ureteral disorders
Conditions classified in categories N00-N29
Z84.2 Family history of other diseases of the genitourinary system
Conditions classified in categories N30-N99
Z84.3 Family history of consanguinity
Z84.8 Family history of other specified conditions

Z85 Personal history of malignant neoplasm

Z42-Z51, Z54. -)
follow-up examination after treatment of malignant neoplasm ( Z08. -)

Z85.0 Personal history of malignant neoplasm
C15-C26
Z85.1 Personal history of malignant neoplasm of the trachea,
bronchi and lung. Conditions classified in categories C33-C34
Z85.2
respiratory and chest organs. Conditions classified in categories C30-C32, C37-C39
Z85.3 Personal history of malignant neoplasm of breast
glands. Conditions classified under the rubric C50. Z85.4 Personal history of malignant neoplasm of the genitalia
organs. Conditions classified in categories C51-C63
Z85.5 Personal history of malignant neoplasm of the urinary organs
Conditions classified in categories C64-C68
Z85.6 Personal history of leukemia. Conditions classified in categories C91-C95
Z85.7 Personal history of malignant neoplasm of lymphoid, hematopoietic and related tissues
Conditions classified in categories C81-C90, C96. Z85.8 Personal history of malignant neoplasm of others
organs and systems. Conditions classified in categories C00-C14, C40-C49,C69-C79, C97
Z85.9 Personal history of unspecified malignant neoplasm
Conditions classified in categories C80

Z86 Personal history of some other illnesses

Excluded: follow-up medical care and convalescent status ( Z42-Z51, Z54. -)

Excluded: follow-up medical care and convalescent status ( Z42-Z51, Z54. -)

Z87.0 Personal history of respiratory diseases
Conditions classified in categories J00-J99
Z87.1 Personal history of diseases of the digestive system
Conditions classified in categories K00-K93
Z87.2 Personal history of diseases of the skin and subcutaneous tissue
Conditions classified in categories L00-L99
Z87.3 Personal history of diseases of the musculoskeletal system and connective tissue
Conditions classified in categories M00-M99
Z87.4 Personal history of diseases of the genitourinary system
Conditions classified in categories N00-N99
Z87.5 Personal history of complications during pregnancy, childbirth and postpartum
Conditions classified in categories O00-O99
Personal history of trophoblastic disease
Excluded: recurrent miscarriage ( N96)
monitoring the course of pregnancy in a woman with
unfavorable obstetric history ( Z35. -)
Z87.6 Personal history of some conditions occurring in the perinatal period
Conditions classified in categories P00-P96
Z87.7 Personal history of congenital anomalies, deformities and chromosomal abnormalities
Conditions classified in categories Q00-Q99
Z87.8 Personal history of other specified conditions
Conditions classified in categories S00-T98

Z88 Personal history of allergies to drugs, medications and biological substances

Z88.0 Personal history of allergy to penicillin
Z88.1 Personal history of allergies to other antibiotics
Z88.2 Personal history of allergy to sulfa drugs
Z88.3 Personal history of allergies to other anti-infective drugs
Z88.4 Personal history of allergy to anesthetic
Z88.5 Personal history of allergy to a narcotic drug
Z88.6 Personal history of allergy to an analgesic agent
Z88.7 Personal history of allergy to serum or vaccine
Z88.8 Personal history of allergies to other drugs, medications and biological substances
Z88.9 Personal history of allergies to unspecified drugs
drugs, medicines and biological substances

Z89 Acquired absence of limb

Includes: limb loss:
postoperative
post-traumatic
Excluded: acquired limb deformity ( M20-M21)
congenital absence of limbs ( Q71-Q73)

Z89.0 Acquired absence of finger(s), including thumb, unilateral
Z89.1 Acquired absence of the hand and wrist
Z89.2 Acquired absence of the upper limb above the wrist. Hands NOS
Z89.3 Acquired absence of both upper limbs (at any level)
Acquired absence of finger(s) bilateral
Z89.4 Acquired absence of a foot and ankle joint
Acquired absence of toe(s)
Z89.5 Acquired absence of a leg up to or below the knee
Z89.6 Acquired absence of a leg above the knee. Legs NOS
Z89.7 Acquired absence of both lower extremities (any level except fingers)
Z89.8 Acquired absence of upper and lower limbs (at any level)
Z89.9 Acquired absence of limb, unspecified

Z90 Acquired absence of organs, not elsewhere classified

Included: post-operative or post-traumatic loss of a body part NEC
Excluded: congenital absence of organs - see Index
postoperative absence:
endocrine glands ( E89. -)
spleen ( D73.0)

Z90.0 Acquired absence of part of the head or neck. Eyes. Throat. Nose
Excluded: teeth ( K08.1)
Z90.1 Acquired absence of mammary glands (mammary glands)
Z90.2 Acquired absence of a lung (or part of it)
Z90.3 Acquired absence of part of the stomach
Z90.4 Acquired absence of other parts of the digestive tract
Z90.5 Acquired absence of a kidney
Z90.6 Acquired absence of other parts of the urinary tract
Z90.7 Acquired absence of sexual organ(s)
Z90.8 Acquired absence of another organ

Z91 Personal history of risk factors not classified elsewhere

Excluded: exposure to pollution and other issues affecting
physical factors environment ( Z58. -)
impact of production risk factors ( Z57. -)
personal history of substance abuse ( Z86.4)

Z91.0 Personal history of allergies to substances other than drugs and biological substances
Excluded: personal history of allergies to medications
agents and biological substances ( Z88. -)
Z91.1 Personal history of non-compliance with treatment procedures and non-compliance with the regime
Z91.2 Personal history of poor compliance with personal hygiene measures
Z91.3 Personal history of sleep-wake disorder
Excluded: sleep disorders ( G47. -)
Z91.4 Personal history of psychological trauma not classified elsewhere
Z91.5 Personal history of self-harm. Parasuicide. Self-poisoning. Suicide attempt
Z91.6 Personal history of other physical trauma
Z91.8 Personal history of other specified risk factors not classified elsewhere
Abuse of NOS. Bad treatment NOS

Z92 Personal history of treatment

Z92.0 Personal history of contraceptive use
Excluded: counseling or current contraceptive use ( Z30. -)
presence of (intrauterine) contraceptive device ( Z97.5)
Z92.1 Personal history of long-term (current) use of anticoagulants
Z92.2 Personal history of long-term (current) use of other medications. Aspirin
Z92.3 Personal history of radiation exposure. Irradiation for therapeutic purposes
Excluded: exposure to ambient physical radiation
environment ( Z58.4)
exposure to radiation at work ( Z57.1)
Z92.4 Personal history of major surgery not classified elsewhere
Excluded: the presence of an artificial hole ( Z93. -)
postoperative conditions ( Z98. -)
presence of functional implants and transplants ( Z95-Z96)
presence of transplanted organs or tissues ( Z94. -)
Z92.5 Personal history of rehabilitation procedures
Z92.8 Personal history of other types of treatment
Z92.9 In personal history medical treatment unspecified

Z93 Condition associated with the presence of an artificial hole

Excluded: artificial hole requiring attention or maintenance ( Z43. -)
complications of external stoma ( J95.0, K91.4, N99.5)

Z93.0 Presence of tracheostomy
Z93.1 Presence of gastrostomy
Z93.2 Presence of ileostomy
Z93.3 Having a colostomy
Z93.4 Presence of another artificial opening of the gastrointestinal tract
Z93.5 Presence of cystostomy
Z93.6 The presence of artificial openings in the urinary tract. Nephrostomies. Urethrostomies. Ureterostomies
Z93.8 The presence of another artificial hole
Z93.9 Presence of artificial orifice, unspecified

Z94 Presence of transplanted organs and tissues

Includes: organ or tissue replaced by hetero- or homograft
Excluded: complications related to the transplanted organ
or cloth - see Index
Availability:
vascular graft ( Z95. -)
artificial heart valve (Z95.3)

Z94.0 Having a transplanted kidney
Z94.1 Having a transplanted heart
Excluded: condition associated with the presence of an artificial heart valve ( Z95.2-Z95.4)
Z94.2 Having a transplanted lung
Z94.3 Having a transplanted heart and lung
Z94.4 Presence of a liver transplant
Z94.5 Presence of grafted skin. Presence of autogenous skin graft
Z94.6 Presence of transplanted bone
Z94.7 Presence of a transplanted cornea
Z94.8 The presence of other transplanted organs and tissues. Bone marrow. Intestines
Pancreas
Z94.9 Presence of transplanted organ and tissue, unspecified

Z95 Presence of cardiac and vascular implants and grafts

Excluded: complications due to cardiac and vascular devices, implants and grafts ( T82. -)

Z95.0 Presence of an artificial heart pacemaker
Excluded: installation and adjustment of artificial heart pacemaker ( Z45.0)
Z95.1 Presence of coronary artery bypass graft
Z95.2 Having a prosthetic heart valve
Z95.3 Presence of a xenogeneic heart valve
Z95.4 Having another heart valve replacement
Z95.5 Presence of coronary angioplasty implant and graft
Presence of a prosthesis coronary artery. Condition after coronary angioplasty NOS
Z95.8 Presence of other cardiac and vascular implants and grafts
Presence of intravascular prosthesis NKDR. Condition after peripheral angioplasty NOS
Z95.9 Presence of cardiac and vascular implant and transplant, unspecified

Z96 Availability of other functional implants

Excluded: complications due to internal prosthetic devices, implants and flaps ( T82-T85)
fitting and fitting of prosthesis and other devices ( Z44-Z46)

Z96.0 Presence of genitourinary implants
Z96.1 Presence of intraocular lenses. Pseudophakia
Z96.2 Availability of otological and audiological implants
Bone conductive hearing aid. Cochlear implant
Implant eustachian tube. Implant in the opening of the eardrum. Stirrup substitute
Z96.3 Presence of an artificial larynx
Z96.4 Presence of endocrine gland implants. Insulin delivery device
Z96.5 Presence of dental and jaw implants
Z96.6 Presence of orthopedic joint implants
Finger joint replacement. Substitution hip joint(partial) (full)
Z96.7 The presence of implants of other bones and tendons. Cranial plate
Z96.8 Presence of another specified functional implant
Z96.9 Presence of a functional implant, unspecified

Z97 Availability of other devices

Excluded: complications due to internal prosthetic devices, implants and grafts ( T82-T85)
fitting and fitting of prosthesis and other devices ( Z44-Z46)
presence of a device for drainage of cerebrospinal fluid ( Z98.2)

Z97.0 Presence of an artificial eye
Z97.1 Presence of an artificial limb (full) (partial)
Z97.2 Availability of a dental prosthetic device
Z97.3 Availability of glasses and contact lenses
Z97.4 Presence of an external hearing aid
Z97.5 Presence of (intrauterine) contraceptive device
Excluded: control, reintroduction or removal
contraceptive device ( Z30.5)
introduction of a contraceptive ( Z30.1)
Z97.8 Availability of another specified device

Z98 Other post-surgical conditions

Excluded: follow-up medical care and convalescent status ( Z42-Z51, Z54. -)
postoperative and post-procedural complications - see Alphabetical Index

Z98.0 Condition associated with intestinal anastomosis
Z98.1 Condition associated with arthrodesis
Z98.2 A condition associated with the cerebrospinal fluid drainage device. Cerebrospinal fluid shunt
Z98.8 Other specified post-surgical conditions

Z99 Dependence on life-sustaining mechanisms and devices, not elsewhere classified

Z99.0 Aspirator dependence
Z99.1 Respirator dependency
Z99.2 Renal dialysis dependence. Presence of arteriovenous shunt for dialysis
Kidney dialysis status
Excluded: preparation for dialysis, its implementation or course ( Z49. -)
Z99.3 Wheelchair addiction
Z99.8 Dependence on other auxiliary mechanisms and devices
Z99.9 Dependence on life-supporting mechanisms and devices, unspecified