Occupational Injury and Illness Classification Manual: Section 2

Definitions, Rules of Selection, and Titles and Descriptions

2.1 Nature of Injury or Illness

2.2 Part of Body Affected

2.3 Source of Injury or Illness; Secondary Source of Injury or Illness

2.4 Event or Exposure

SECTION 2.1

Nature of Injury or Illness

2.1.1 Definition, Rules of Selection

2.1.2 Titles and Descriptions

2.1.1 Nature of Injury or Illness--Definition, Rules of Selection

The nature of injury or illness identifies the principal physical characteristic(s) of the injury or illness.

1.0 DEFINITION

The nature of injury or illness identifies the principal physical characteristic(s) of the injury or illness.

RULES OF SELECTION:

1.1. Name the injury or illness indicated on the source document. Example: For strained back, choose Sprains, strains, tears

1.2. When two or more injuries or illnesses are indicated, and one is a sequela, aftereffect, or complication due to medical treatment, choose the initial injury or illness. Example: If a laceration became infected developing into septicemia, choose Cuts, lacerations

1.3. When two or more injuries or illnesses are indicated and one is more severe than the other(s), select the more severe injury or illness. Example: If sprained finger and fractured wrist, choose Fractures.

1.3.1 When a single event or exposure produces an injury and transmits a disease simultaneously, and one is more severe than the other(s), select the more severe injury or disease. Example: If a needle stick produces a puncture wound and transmits an infectious disease, serum hepatitis, choose serum hepatitis .

1.4. When two or more injuries or illnesses are indicated but no one can be determined as being more severe than the others, select the appropriate multiple injuries or illnesses classification code. Example: For fractured and burned left leg, choose Fractures and burns

2.1.2 Nature of Injury or Illness--Titles and Descriptions

The Nature of Injury or Illness code structure is arranged so that traumatic injuries and disorders are listed first (in Division 0) while diseases are listed in Divisions 1 through 8. Division 8 classifies multiple physical characteristerics whose individual codes are found in Divisions 1 through 5.

The Nature of Injury or Illness divisions are arranged as follows:

DIVISION & TITLE

0 Traumatic Injuries and Disorders

1 Systemic Diseases and Disorders

2 Infectious and Parasitic Diseases

3 Neoplasms, Tumors, and Cancer

4 Symptoms, Signs, and Ill-defined Conditions

5 Other Diseases, Conditions, and Disorders

8 Multiple Diseases, Conditions, and Disorders

9999 Nonclassifiable

0* TRAUMATIC INJURIES AND DISORDERS

This division classifies traumatic injuries and disorders, effects of external agents, and poisoning. Generally, a traumatic injury or disorder is the result of a single incident, event, or exposure.

00 Traumatic injuries and disorders, unspecified

This major group classifies traumatic injuries and disorders when the only
information available describes the incident as traumatic. For example, employee was hurt in car accident.

01* Traumatic injuries to bones, nerves, spinal cord

This major group classifies traumatic injuries to the bones, nerves, or spinal cord which include breaking and dislocating bones and cartilage and traumatic injury to the brain, spinal cord, and nerves.

010 Traumatic injuries to bones, nerves, spinal cord, unspecified

011 Dislocations

This nature group classifies displacement or dislocation of bone or cartilage.

Includes: subluxations; slipped, ruptured, or herniated disc; partial displacement; and fractured or broken cartilage

012 Fractures

This nature group classifies traumatic injuries that result in fractures of bones or teeth.

Includes: closed fractures for which no open wound exists; open fractures for which there is an accompanying open wound; comminuted, compound, depressed, elevated, fissured, greenstick, impacted, linear, march, simple, and spiral fracture; and slipped epiphysis.

Excludes: fatal fracture of the back (018), neck (018), rib (094), or skull (068); fracture of cartilage (011); malunion (17); nonunion (17); pathological or spontaneous fracture (17)

013 Traumatic injuries to spinal cord

This nature group classifies traumatic injuries to the spinal cord.

Includes: severed spinal cord, nonfatal severed spinal cord resulting from a gunshot wound, traumatic transient paralysis, anterior cord syndrome, lesion of spinal cord, and central cord syndrome

Excludes: spinal bone injury (011, 012, or 018)

014 Traumatic injuries to nerves, except the spinal cord

This nature group classifies traumatic injuries to nerves other than the spinal cord. Cranial nerves, peripheral nerve of the shoulder or pelvic girdle, and nerves of the limb are possible locations for injuries in this nature group. Diseases or disorders of the nervous system that occur over time as a result of repetitive activity, such as carpal tunnel syndrome, are classified in major group 12.

Includes: division of nerve, lesion in continuity, traumatic neuroma,

Excludes: diseases or disorders affecting the nervous system (12), diseases or disorders affecting the sense organs (12), carpal tunnel syndrome (1241), hearing loss (1261), loss of vision (1255), traumatic transient paralysis (013), and severed spinal cord (013)

018 Multiple traumatic injuries to bones, nerves, spinal cord

This nature group classifies multiple injuries and disorders of equal severity within Traumatic injuries to bones, nerves, spinal cord, major group 01.

019 Traumatic injuries to bones, nerves, spinal cord, n.e.c.

02* Traumatic injuries to muscles, tendons, ligaments, joints,etc.

This major group classifies traumatic injuries that affect the muscles, tendons, ligaments or joints.

Excludes: Joint fractures (012), cartilage fracture (011)

020 Traumatic injuries to muscles, tendons, ligaments, joints, etc., unspecified

021 Sprains, strains, tears

This nture group classifies cases of sprains and strains of muscles, joints tendons, and ligaments. Diseases or disorders affecting the musculoskeletal system, including tendonitis and bursitis, which generally occur over time as a result of repetitive activity should be coded in Musculoskeletal system and connective tissue diseases and disorders, major group 17

Includes: avulsion, hemarthrosis, quot;pull", rupture, strain, sprain, or tear of joint capsule, ligament, muscle, or tendon

Excludes: hernia (153), lacerations of tendons in open wounds(034), torn cartilage (011)

029 Injuries to muscles, tendons, ligaments, joints, etc., n.e.c.

This nature group classifies injuries to muscles, tendons, ligaments, etc. that are not classified elsewhere in this major group.

03* Open wounds

This major group classifies traumatic injuries involving open wounds--broken skin or outward opening, beyond the superficial skin surface.

Excludes: abrasions and scratches (041), burns (05)

030 Open wounds, unspecified

031* Amputations

This nature group classifies the traumatic loss of a limb or other external body part. For an injury to be classified in this nature group, bone must be lost.

Includes: nonfatal amputations resulting from a gunshot wound, medical amputations due to irreparable traumatic injuries

Excludes: traumatic injury without bone loss (033), enucleation--eye removal (035)

0311 Amputations, fingertip

0319 Amputations, except fingertip

032 Animal or insect bites

This nature group classifies nonvenomous traumatic injuries sustained from an animal or insect bite, such as human, snake, dog and rodent bites.

If an animal or insect bite simultaneously produces a parasitic or infectious disease or disorder select a code within Infectious and Parasitic Diseases, Division 2. If the manifestations of the animal or insect bite are the result of the venom or poison, select code 0951.

033 Avulsions

This nature group classifies traumatic injuries involve the ripping or tearing away of a body part or a nerve, such as the severing of the tip of the toe without bone loss.

Includes: injury without bone loss, loss of fingertip without bone loss

Excludes: amputation (031), avulsion of joint capsule, ligament, muscle or tendon (021)

034 Cuts, lacerations

035 Enucleations

This nature group classifies the traumatic removal of an organ, such as an eyeball, in its entirety.

036 Gunshot wounds

This nature group classifies all gunshot wounds regardless of severity or location, except when a nonfatal amputation, paralysis, or nonfatal severed spine results.

037 Punctures, except bites

This nature group classifies traumatic injuries that are the result of piercing or puncturing the body surface.

Includes: embedded foreign body, stab wounds, and impaling wounds

Excludes: animal or insect bites (032, 0951)

038 Multiple open wounds

This nature group classifies multiple injuries and disorders of equal severity within Open wounds, major group 03.

039 Open wounds, n.e.c.

04* Surface wounds and bruises

This major group classifies traumatic bruises and other injuries that occur to the surface of the body and generally do not involve open wounds.

040 Surface wounds and bruises, unspecified

041 Abrasions, scratches

This nature group classifies traumatic injuries where the skin, mucous membrane, or superficial epithelium have been removed or marked, usually as a result of rubbing, scratching, or scraping.

042 Blisters

This nature group classifies the localized collection of fluid in the epidermis associated with friction or impact.

Includes: blood blisters and friction blisters

Excludes: blisters associated with burns (045, 05), allergic reaction, or those associated with other diseases, disorders, or injuries

043 Bruises, contusions

This nature group classifies injuries that produce capillary hemorrhaging with the skin remaining intact.

Includes: hematoma, black eye

Excludes: concussion (062), hemarthrosis (021), nontraumatic cerebral hemorrhage (136), traumatic cerebral hemorrhage (061)

044 Foreign bodies (superficial splinters, chips)

Includes: foreign body without mention of penetration depth

Excludes: embedded foreign body (037)

045 Friction burns

Excludes: chemical burns (051) electrical burns (052), heat burns (053), scalds (053), and unspecified burns (050)

048 Multiple surface wounds and bruises

This nature group classifies multiple injuries and disorders of equal severity within Surface wounds and bruises, major group 04.

049 Surface wounds and bruises, n.e.c.

05* Burns

This major group classifies burns (tissue damage) resulting from a variety of sources including heat, flame, hot substance, lightning, radiation, the corrosive action of chemicals, chemical compounds or fumes, heat, extremely cold objects, and electricity.

Includes: first, second, and third degree burns, lightning burns(052), radiation burns (059)

Excludes: friction burns (045), frostbite (0711), sunburn (1839), and welder's flash (1256)

050 Burns, unspecified

051 Chemical burns

052 Electrical burns

053 Heat burns, scalds

058 Multiple burns

059 Burns, n.e.c.

06* Intracranial injuries

This major group classifies traumatic injuries to the cranium or skull and the structures within.

Includes: cerebral hemorrhage with no mention of an underlying cause (061), crushed head (060), fatal skull fractures (068), nonspecific crushing injuries to the head (060)

Excludes: cerebral hemorrhage or strokes resulting from cerebrovascular disease (136), cerebrovascular disease (136), intracranial nerve damage (014), nondescript loss of consciousness (4111), nonfatal skull fractures (012)

060 Intracranial injuries, unspecified

061 Cerebral hemorrhages

062 Concussions

068 Multiple intracranial injuries

069 Intracranial injuries, n.e.c.

07* Effects of environmental conditions

This major group classifies injuries or disorders that are a result of adverse environmental conditions.

Includes: effects of reduced temperature, general heat, light, and air pressure.

Excludes: injuries or disorders associated with fire or flame

070 Effects of environmental conditions, unspecified

071 Effects of reduced temperature

This nature group classifies injuries or disorders resulting from abnormally reduced body temperature which affects body tissues, or the functioning of the central nervous system, circulatory system, or the endocrine system.

Includes: chilblains (0719), erythema pernio (0719), and perniosis (0719)

Excludes: burns from extremely cold objects (059)

0710 Effects of reduced temperature, unspecified

0711 Frostbite

0712 Hypothermia

0713 Trench foot

0718 Multiple effects of reduced temperature

0719 Effects of reduced temperature, n.e.c.

072* Effects of heat and light

This nature group classifies injuries or disorders caused by the effects of heat and light.

Includes: heat apoplexy (0721), heat exhaustion (0729), heat pyrexia (0721), ictus solaris (0721), loss of consciousness associated with heat (0722), siriasis (0721), sunstroke (0721), and thermoplegia (0721)

Excludes: loss of consciousness without reference to heat (4111), sunburn (1839), heat burns (053)

0720 Effects of heat and light, unspecified

0721 Heat stroke

0722 Heat syncope

0723 Heat fatigue

0724 Heat edema

0728 Multiple effects of heat and light

0729 Effects of heat and light, n.e.c.

073* Effects of air pressure

This nature group classifies injuries or disorders resulting from effects of high, low, or changes in air pressure. Included are effects of high altitude or compressed air.

Includes: barosinusitis (0732), barotitis (0731), otitic barotrauma (0731), and sinus barotrauma (0732)

0730 Effects of air pressure, unspecified

0731 Aero-otitis media

0732 Aerosinusitis

0733 Caisson disease, bends, divers' palsy

0738 Multiple effects of air pressure

0739 Effects of air pressure, n.e.c.

078 Multiple effects of environmental conditions

079 Effects of environmental conditions, n.e.c.

08* Multiple traumatic injuries and disorders

This major group classifies combinations of multiple traumatic injuries or disorders from more than one subgroup within this division. For example, an incident which involved a burn and a fracture, of equal severity, would be coded as 083. Combinations involving equally severe cuts and bruises, cuts and abrasions, or cuts, abrasions, and bruises are included in 081.

Excludes: abrasions and bruises of equal severity (048)

080 Multiple traumatic injuries and disorders, unspecified

081 Cuts, abrasions, bruises

082 Sprains and bruises

083 Fractures and burns

084 Fractures and other injuries

085 Burns and other injuries

086 Intracranial injuries and injuries to internal organs

089 Other combinations of traumatic injuries and disorders, n.e.c.

09* Other traumatic injuries and disorders

This major group classifies other traumatic injuries or disorders that are not assigned to the other major groups in Division 0.

090 Other traumatic injuries and disorders, unspecified

This nature group classifies traumatic injuries or disorders that can be identified as belonging in codes 091-099, but not enough information is available to determine which code.

091 Asphyxiations/strangulations, suffocations

This nature group classifies fatal and nonfatal injuries that involve the lack of oxygen, stopping of the respiration process, or obstruction to breathing.

Includes: inhaling or choking on food or other substances, and traumatic asphyxiations

Excludes: drownings (092), strangulated hernia (153), and asphyxia from gas fumes and vapors (0959)

092 Drownings

This nature group classifies fatal suffocations as a result of submersion in liquid, especially in water.

093 Electrocutions, electric shocks

This nature group classifies fatal and nonfatal traumatic injuries that result from contact with electric current.

Excludes: electrical burns (052)

094 Internal injuries to organs and blood vessels of the trunk

This nature group classifies traumatic injuries that involve internal organs or the blood vessels which are not classified in any other major group throughout the nature of injury or illness structure.

Includes: arterial hematoma, internal injuries, traumatic rupturing of blood vessels, fatal crushing injury to trunk--abdomen, chest, or pelvis, and traumatic aneurysm or fistula

Excludes: bruises and contusions (043), blood blisters (042)

095* Other poisonings and toxic effects

This nature group classifies cases of poisoning or the toxic effects resulting from medicinals, drugs, chemicals (venoms), and other substances.

Includes: carbon monoxide poisoning (0959), toxic effects of food contaminants or noxious food stuffs--non-viral and non-bacterial (0959), and lead poisoning (0959)

Excludes: asphyxia from gas, fumes and vapors (0959), parasitic or infectious poisonings (Division 2), animal or insect bites that simultaneously produce a parasitic or infectious disease or disorder (Division 2), other manifestations from animal or insect bites that are not the result of the venom or poison (032), blood poisoning (2197), and radiation poisoning (149)

0950 Other poisonings and toxic effects, unspecified

0951 Animal or insect bites, venomous

0952 Radiation sickness

0959 Other poisonings and toxic effects, n.e.c.

096* Traumatic complications

This nature group classifies complications peculiar to medical or surgical procedures or certain medical complications following traumatic injuries and should be used only when the circumstances of the initial injury is unknown.

Includes: anaphylactic shock with no mention of the underlying injury or illness (0961), and unspecified reactions to injections such as tetanus or flu shots (0969)

Excludes: electric shock (093), lightning shock (093)

0960 Traumatic complications, unspecified

0961 Traumatic shock

0962 Embolism, air or fat

0968 Multiple traumatic complications

0969 Traumatic complications, n.e.c.

097* Nonspecified injuries and disorders

This nature group classifies nonspecified traumatic injuries and disorders where some description of the manifestation of the trauma is provided and generally where the part of body has been identified. For example sore neck: hurt arm, or pain in shoulder.

Includes: hurt back (0972), backache (0972), low back pain (0972)

Excludes: crushing injuries involving internal organs (094), and crushing injuries to the head (06)

0971 Crushing injuries

0972 Back pain, hurt back

0973 Soreness, pain, hurt, except the back

0978 Multiple nonspecified injuries and disorders

0979 Nonspecified injuries and disorders, n.e.c.

099 Other traumatic injuries and disorders, n.e.c.

1* SYSTEMIC DISEASES AND DISORDERS

This division classifies toxic and non-toxic diseases or disorders affecting systems of the body. Diseases or disorders included may affect the whole named body system, or more commonly, affect only a part of the named body systems at the time of diagnosis.

Excludes: traumatic injuries and disorders (Division 0); infectious and parasitic diseases (Division 2); neoplasms, cancers, and tumors (Division 3)

10 Systemic diseases and disorders, unspecified

11* Diseases of the blood and blood forming organs

This major group classifies toxic and non-toxic diseases of the blood and blood forming organs.

Includes: anemias; coagulation defects; pupura and other hemorrhagic conditions; and diseases of white blood cells

Excludes: leukemia (3134)

110 Diseases of the blood and blood forming organs, unspecified

111 Hemolytic anemia--non-autoimmune

This nature group classifies hereditary and acquired non-autoimmune hemolytic anemias.

Includes: enzyme deficiency and hemoglobinuria due to hemolysis from external causes; sickle-cell anemia; thalassemias; and hemolytic-uremic syndrome

112 Aplastic anemia

This nature group classifies aplastic anemias due to drugs, infection, chronic systemic disease, and radiation.

Includes: aplasia, pancytopenia, and toxic (paralytic) anemia

113 Agranulocytosis or neutropenia

This nature group classifies agranulocytosis and neutropenia, diseases of white blood cells.

Includes: Kostmann's syndrome

114 Methemoglobinemia

This nature group classifies toxic or acquired methemoglobinemia, a blood condition which can result in cyanosis.

115 Purpura and other hemorrhagic conditions

This nature group classifies purpura and other hemorrhagic conditions which may be caused by various factors including blood disorders, vascular abnormalities, and trauma.

Includes: allergic purpura, Evan's syndrome, qualitative platelet defects, thrombasthenia, thrombocytasthenia, and thrombocytopenia

119 Diseases of blood and blood forming organs, n.e.c.

This nature group classifies diseases of the blood and blood forming organs that are not classified in any other nature group within major group 11.

Includes: polycythemia, and chronic lymphadenitis

12* Nervous system and sense organs diseases

This major group classifies inflammatory, degenerative and other disorders of the central and peripheral nervous system. Also classified are disorders of the sense organs of sight and hearing.

120 Nervous system and sense organs diseases, unspecified

121* Inflammatory diseases of the central nervous system

This nature group classifies inflammatory diseases or disorders of the nerves and ganglia of the brain and spinal cord.

Includes: meningitis (1212) and encephalitis (1211) due to viral, bacterial, fungal and other organisms, and toxic chemicals;intracranial and intraspinal abscess (1219); and phlebitis and thrombophlebitis of intracranial venous sinuses (1219)

Excludes: traumatic injuries or disorders affecting the central nervous system (01), and traumatic intracranial injuries (06)

1210 Inflammatory diseases of the central nervous system, unspecified

1211 Encephalitis

1212 Meningitis

1219 Inflammatory diseases of the central nervous system, n.e.c.

122* Degenerative diseases of the central nervous system

This nature group classifies degenerative diseases of the central nervous system.

Includes: cerebellar ataxia (1221), other spinocerebellar disease (1229), vascular myelopathies (1229) and other myelopathies of the spinal cord (1229); Reye's syndrome (1222), Parkinson's disease (1229) spinocerebellar disease (1229); and anterior horn cell disease (1229)

Excludes: traumatic injuries or disorders affecting the central nervous system (01), and traumatic intracranial injuries (06)

1220 Degenerative diseases of the central nervous system, unspecified

1221 Cerebellar ataxia

1222 Reye's syndrome

1229 Degenerative diseases of the central nervous system, n.e.c.

123* Other disorders of the central nervous system

This nature group classifies demyelinating diseases and paralytic syndromes of the central nervous system.

Includes: epilepsy (1239), multiple sclerosis (1239), and paralytic syndromes without additional information (1239)

Excludes: traumatic injuries or disorders affecting the central nervous system (01), and traumatic intracranial injuries (06)

1230 Other disorders of the central nervous system, unspecified

1231 Anoxic brain damage

1232 Migraine

1239 Other disorders of the central nervous system, n.e.c.

124* Disorders of the peripheral nervous system

This nature group classifies disorders of the peripheral nervous system which includes the nerves and ganglia located outside the brain and spinal cord.

Includes: Bell's palsy (1249), carpal tunnel syndrome (1241), tarsal tunnel syndrome (1249); other mononeuritis of the extremities (1249), nontraumatic lesion of the median, ulnar and radial nerves (1249), muscular dystrophies (1249)

Excludes: traumatic injury affecting the peripheral nervous system (014)

1240 Disorders of the peripheral nervous system, unspecified

1241 Carpal tunnel syndrome

1242 Inflammatory and toxic neuropathy, toxic polyneuropathy

1243 Toxic myoneural disorders

1249 Other disorders of the peripheral nervous system, n.e.c.

125* Disorders of the eye, adnexa, vision

his nature group classifies disorders of the eye, adnexa, and vision.

Includes: disorders of the globe of the eye; nontraumatic retinal detachments (1259); chorioretinal inflammations (1253); disorders of choroid (1259); disorders of the iris and ciliary body (1259); glaucoma (1257); cataracts (1254); nontraumatic visual disturbances (1258); keratitis (1253); disorders of the eyelids, lacrimal system, and other parts of the eye (1259); nonspecific conjunctivitis (1252); traumatic and nontraumatic loss of vision (1255); and ultraviolet keratoconjunctivitis (1259)

Excludes: traumatic injuries occurring to the eye and adnexa of the eye (Division 0); foreign body in eye (044); chemical burns to the eye (051); viral conjunctivitis (2262); and eye strain (4123)

1250 Disorders of the eye, adnexa, vision, unspecified

1251 Solar retinopathy

1252 Conjunctivitis--non-viral

1253 Inflammation except conjunctivitis (including ophthalmia, iritis, chalazion)

1254 Cataract

1255 Blindness, low vision

1256 Welder's flash

1257 Glaucoma

1258 Visual disturbances

1259 Disorders of the eye, adnexa, vision, n.e.c.

126* Disorders of the ear, mastoid process, hearing

This major group classifies diseases and disorders of the external, middle and inner ear; disorders of tympanic membrane; disorders of the vestibular system; Eustachian tube disorders, and of the mastoid process.

Includes: mastoiditis (1264), otitis externa (1269), otitis media (1265), otosclerosis (1269), and hearing loss sustained from sudden or repeated noise (1261), traumatic and nontraumatic hearing loss (1261)

Excludes: aero-otitis media (0731), and earache without further description (4122)

1260 Disorders of the ear, mastoid process, hearing, unspecified

1261 Deafness, hearing loss or impairment

1262 Tinnitis

1263 Otalgia

1264 Mastoiditis

1265 Otitis media (except aero-)

1269 Disorders of ear, mastoid process, and hearing, n.e.c.

129 Nervous system and sense organs diseases, n.e.c.

This nature group classifies diseases of the nervous system and sense organs that are not classified by any other code within major group 12.

13* Circulatory system diseases

This major group classifies diseases or disorders of the circulatory system.

Includes: heart attack (1331), chronic rheumatic heart disease and acute rheumatic fever (131); hypertensive heart disease (132), ischemic heart disease (133); diseases of pulmonary circulation (134); cerebrovascular disease (136); diseases of arteries, arterioles, and capillaries (137); and diseases of veins and lymphatics (138), and other diseases of the circulatory system

130 Circulatory system diseases, unspecified

131 Rheumatic fever with heart involvement

Includes: chronic rheumatic heart disease, and rheumatic carditis.

132 Hypertensive disease

This nature group classifies essential hypertension; hypertensive heart disease; and hypertensive renal disease.

133* Ischemic heart disease, including heart attack

This nature group classifies ischemic heart disease with or without mention of hypertension.

1330 Ischemic heart disease, unspecified

1331 Myocardial infarction (heart attack)

heart attacks resulting from atherosclerosis or coronary artery

disease;

cardiac infarction;

coronary (artery) embolism, occlusion,rupture, or thrombosis;

infarction of heart, myocardium, or ventricle

1332 Angina

angina pectoris prinzmetal angina

1339 Ischemic heart disease, n.e.c.

coronary atherosclerosis;

nontraumatic aneurysm of heart wall, and coronary vessels.

134* Diseases of pulmonary circulation

This nature group classifies acute and chronic pulmonary heart disease, and other diseases of pulmonary circulation.

1340 Diseases of pulmonary circulation, unspecified

1341 Pulmonary heart disease

acute cor pulmonale

acute pulmonary artery or vein embolism and infarction

primary pulmonary hypertension

kyphoscoliotic heart disease.

1349 Diseases of pulmonary circulation, n.e.c.

arteriovenous fistula of pulmonary vessels

nontraumatic aneurysm of pulmonary artery

135* Other forms of heart disease

This nature group classifies heart disease that is not classified in any other nature group in major group 13.

Includes: acute pericarditis (1359); acute and subacute endocarditis (1359); acute myocarditis, toxic (1351) and non-toxic (1359; cardiomyopathy (1359); cardiac dysrhythmias (1359); heart failure (1352); and ill-defined descriptions and complications of heart disease (1353)

1350 Other forms of heart disease , unspecified

1351 Toxic myocarditis

1352 Heart failure

1353 Ill-defined descriptions and complications of heart disease

1359 Other forms of heart disease, n.e.c.

136* Cerebrovascular disease

This nature group classifies subarachnoid, intracerebral, and other and unspecified intracranial hemorrhage that are not associated with a traumatic event.

Includes: occlusion and stenosis of precerebral arteries including embolism and thrombosis (1369); occlusion of cerebral arteries (1369); transient cerebral ischemia (1362); and other acute, ill-defined cerebrovascular diseases (1369)

Excludes: traumatic intracranial injuries (06), traumatic bruises and contusions (043)

1360 Cerebrovascular disease, unspecified

1361 Stroke

1362 Transient ischemic attacks

1369 Cerebrovascular disease, n.e.c.

137* Diseases of arteries, arterioles, capillaries

This nature group classifies diseases peculiar to arteries, arterioles, and capillaries.

Includes: atherosclerosis (1379), aortic and other nontraumatic aneurysms (1372), nontraumatic arterial embolism and thrombosis (1379), Buerger's disease (1379), Goodpasture's syndrome (1379) Raynaud's syndrome (1371), and other peripheral vascular disease (1379)

Excludes: traumatic internal injuries to organs and blood vessels of the trunk (094), traumatic bruises and contusions (043), and traumatic intracranial injuries (06)

1370 Diseases of arteries, arterioles, capillaries, unspecified

1371 Raynaud's syndrome or phenomenon

1372 Aneurysm--nontraumatic

1379 Diseases of arteries, arterioles, capillaries, n.e.c.

138* Diseases of the veins, lymphatics

This nature group classifies diseases of the veins and lymphatics.

Includes: phlebitis and thrombophlebitis (1383); thrombosis and embolism of veins (1389); varicose veins (1381); hemorrhoids (1382); noninfectious disorders of lymphatic channels (1389); hypotension (1389); and other diseases of the veins and lymphatics not elsewhere classified (1389)

Excludes: traumatic internal injuries to organs and blood vessels of the trunk (094), traumatic bruises and contusions (043), and traumatic intracranial injuries (06)

1380 Diseases of the veins, lymphatics, unspecified

1381 Varicose veins

1382 Hemorrhoids

1383 Phlebitis

1389 Diseases of the veins, lymphatics, n.e.c.

139 Circulatory system diseases, n.e.c.

This nature group classifies circulatory system diseases that are not classified by any other code in the major group 13.

Includes: nontraumatic hemorrhage or rupture of blood vessels, n.e.c.; spontaneous hemorrhage, n.e.c.; and peripheral venous insufficiency, n.e.c.

14* Respiratory system diseases

This major group consists of diseases of the respiratory system.

Includes: acute and chronic diseases of the upper respiratory tract (141 and 142 respectively); pneumonia and influenza (143); chronic obstructive pulmonary diseases (144); and pneumoconioses (145)

140 Respiratory system diseases, unspecified

141 Acute respiratory infections (including common cold)

This nature group classifies acute respiratory infections.

Includes: nasopharyngitis, sinusitis, pharyngitis, tonsillitis, laryngitis and tracheitis, and bronchitis and bronchiolitis.

142* Other diseases of upper respiratory tract

This nature group classifies a variety of other upper respiratory tract diseases that are not classified elsewhere.

Includes: allergic rhinitis (1421), chronic pharyngitis and nasopharynitis (1422); chronic sinusitis (1422); chronic diseases of tonsils and adenoids (1422), chronic laryngitis and laryngotracheitis (1422); nasal polyps (1429), and peritonsillar abscess (1429)

1420 Other diseases of upper respiratory tract, unspecified

1421 Allergic rhinitis

1422 Chronic conditions of upper respiratory tract (including chronic sinusitis, pharyngitis)

1429 Other diseases of upper respiratory tract, n.e.c.

143* Pneumonia, influenza

This nature group classifies pneumonia due to viral or bacterial agents; pneumonia, due to unspecified organisms; bronchopneumonia; and influenza with or without pneumonia.

1430 Pneumonia, influenza, unspecified

1431 Pneumonia

1432 Influenza

1433 Legionnaires' disease

1439 Pneumonia, influenza, n.e.c.

144* Chronic obstructive pulmonary disease and allied conditions

This nature group classifies chronic obstructive pulmonary disease and allied conditions.

Includes: bronchiectasis (1449), bronchitis (1441), emphysema (1442), extrinsic asthma (1443), extrinsic allergic alveolitis (1444), and intrinsic asthma (1449)

Excludes: cotton-dust asthma (1461) and stripper's asthma (1461)

1440 Chronic obstructive pulmonary disease and allied conditions, unspecified

1441 Bronchitis

1442 Emphysema

1443 Extrinsic asthma

1444 Extrinsic allergic alveolitis and pneumonitis (including farmers' lung, bagassosis)

1449 Chronic obstructive pulmonary diseases and allied conditions, n.e.c.

145* Pneumoconioses

This group is comprised of conditions characterized by permanent deposition of substantial amounts of particulate matter in the lungs, and by the tissue reaction to its presence. Particulate matter includes inorganic as well as organic dusts.

Includes: bauxite fibrosis (1459), graphic fibrosis (1459), and stannosis (1459)

1450 Pneumoconioses, unspecified

1451 Coal workers' pneumoconiosis (including anthracosis, black lung, miner's asthma)

1452 Asbestosis

1453 Silicosis

1454 Talcosis

1455 Aluminosis

1456 Berylliosis

1457 Siderosis

1458 Pneumoconiosis with tuberculosis

1459 Pneumoconioses, n.e.c.

146* Pneumonopathy

This nature group classifies lung diseases due to external agents that have not been classified elsewhere.

Includes: Brown lung (1461), cotton-dust asthma (1461), cotton-mill fever (1461), metal fume fever (1462), Monday fever (1461), and stripper's asthma (1461)

1460 Pneumonopathy, unspecified

1461 Byssinosis, Mill fever

1462 Metal fume fever

1469 Pneumonopathy, n.e.c.

149* Other respiratory system diseases

This nature group classifies other respiratory system diseases that are not classified elsewhere.

Includes: atelectasis or collapsed lung (1495), empyema (1499), humidifier fever (1491), other forms of pneumonitis (1492), pleurisy (1499), pulmonary edema (1493), pulmonary fibrosis (1494), and spontaneous pneumothorax (1499)

1490 Other respiratory system diseases, unspecified

1491 Humidifier fever

1492 Pneumonitis, n.e.c.

1493 Pulmonary edema

1494 Pulmonary fibrosis, n.e.c.

1495 Atelectasis, collapsed lung

1499 Other respiratory system diseases, n.e.c.

15* Digestive system diseases and disorders

This major group classifies diseases of the digestive system.

Includes: diseases of the oral cavity, salivary glands and jaws (151); diseases of the esophagus, stomach, and duodenum (152); hernias of the abdominal cavity (153); noninfectious enteritis and colitis (154)

150 Digestive system diseases and disorders, unspecified

151 Diseases of oral cavity, salivary glands, jaws

This nature group classifies diseases of the teeth, bone support and surrounding tissues, jaws, salivary glands, lips, and tongue.

152 Diseases of esophagus, stomach, duodenum

This nature group classifies inflammation and other diseases and disorders of the esophagus, stomach and duodenum.

Includes: duodenal ulcer, duodenitis, gastric ulcer, gastritis, gastrojejunal ulcer, and peptic ulcer

153* Hernia

This nature group classifies hernias of the abdominal cavity.

Includes: femoral (1539), esophageal (1539), hiatal (1532), inguinal (1531), paraesophageal (1539) scrotal (1531), umbilical (1539), and ventral (1533) hernias

Excludes: herniated disc (011), herniated brain (1231), and strangulations (091)

1530 Hernia, unspecified

1531 Inguinal hernia

1532 Hiatal hernia

1533 Ventral hernia

1539 Hernia, n.e.c.

154 Noninfectious enteritis and colitis (including ileitis)

This nature group classifies noninfectious inflammations of the ilium, colon, and small intestines; and acute vascular insufficiency of the intestines.

155 Other diseases of intestines or peritoneum

This nature group classifies other diseases of the intestines or peritoneum such as intestinal diverticula and abscess, and peritonitis.

156 Toxic hepatitis--noninfective

This nature group classifies non-infective hepatitis due to toxic agents.

Excludes: infectious or viral hepatitis (225)

159 Digestive system diseases and disorders, n.e.c.

This nature group classifies other diseases of the digestive system, n.e.c.

Includes: cirrhosis of the liver and pancreatitis

16* Genitourinary system diseases and disorders

This major group classifies diseases and disorders of the genitourinary system.

Includes: nephritis (1611), nephrotic syndrome (1612), nephrosis (1613); diseases and disorders of the genital tract (163); and other diseases of the urinary system (162)

160 Genitourinary system diseases and disorders, unspecified

161* Nephritis, nephrotic syndrome, and nephrosis

This nature group classifies acute and chronic glomerulonephritis, a nonsuppurative inflammatory kidney disease.

Excludes: hydronephrosis (1629)

1610 Nephritis, nephrotic syndrome, and nephrosis, unspecified

1611 Nephritis

1612 Nephrotic syndrome

1613 Nephrosis

162* Other diseases of urinary system

This nature group classifies inflammation and other disorders of the urinary bladder.

Includes: cystitis (1621), hydronephrosis (1629), renal failure (1623), urethral stricture (1629), and urethritis (1629)

1620 Other diseases of urinary system, unspecified

1621 Cystitis

1623 Renal failure

1629 Other diseases of urinary system, n.e.c.

163* Diseases and disorders of the genital tract

This nature group classifies noninfective and nonparasitic diseases and disorders of the genital tract.

1630 Diseases and disorders of the genital tract, unspecified

1631 Infertility

1632 Spontaneous abortion, miscarriage

1639 Diseases and disorders of the genital tract, n.e.c.

164 Disorders of breast

This nature group classifies disorders of the breast.

Includes: abscess, benign mammary dysplasias; and mastitis of the breast

Excludes: breast cancer (3112)

169 Genitourinary system diseases and disorders, n.e.c.

17* Musculoskeletal system and connective tissue diseases and disorders

This major group classifies diseases of the musculoskeletal system and connective tissue.

Includes: arthropathies (171); dorsopathies (172); rheumatism, except affecting the back (173); rheumatism affecting the back (1729); and osteopthies, chondropathies, and acquired musculoskeletal deformities (174)

Excludes: sprains and strains (021), traumatic injuries to muscles, tendons, ligaments, or joints (02)

170 Musculoskeletal system and connective tissue diseases and disorders, unspecified

171 Arthropathies and related disorders (arthritis)

This nature group classifies joint diseases and related disorders with or without association with infections.

Includes: ankylosis of the joint, arthritis, arthropathy, and polyarthritis

Excludes: disorders of the spine (172), gouty arthropathy (1919), rheumatic fever with heart involvement(131)

172* Dorsopathies

This nature group classifies conditions affecting the back and spine.

Includes: spondylitis and spondylosis of the spine (1729); intevertebral disc disorders, except dislocation (1723); sciatica (1721); lumbago (1722); and other nontraumatic backaches (1729)

Excludes: dislocated disc (011), curvature of the spine (1741), fractured spine (012), herniated disc (011), ruptured disc (011), traumatic sprains and strains involving the back (021), and other traumatic injuries to muscles, tendons, ligaments, or joints of the back (02), and traumatic back pain or backache (0972)

1720 Dorsopathies, unspecified

1721 Sciatica

1722 Lumbago

1723 Disc disorders, except dislocation

1729 Dorsopathies, n.e.c.

173* Rheumatism, except the back

This nature group classifies disorders marked by inflammation, degeneration, or metabolic derangement of the connective tissue structure of the body, especially the joints and related structures of muscles, bursae, tendons and fibrous tissue. Generally, these codes should be used when the condition occurred over time as a result of repetitive activity.

Includes: rotator cuff syndrome (1739), rupture of synovium (1739), and trigger finger (1739)

Excludes: rheumatism affecting the back is included in code (172), traumatic injuries and disorders affecting the muscles, tendons, ligaments and joints (02)

1730 Rheumatism, except the back, unspecified

1731 Bursitis

1732 Synovitis

1733 Tendonitis

1734 Tenosynovitis

1735 Ganglion/cystic tumor

1736 Myositis

1739 Rheumatism, except the back, n.e.c.

174* Osteopathies, chondropathies, acquired deformities

This group is comprised of diseases of bones, diseases of cartilage, and acquired musculoskeletal deformities.

Includes: osteomyelitis, periostitis and other infections involving bone; and acquired curvature of the spine

1740 Osteopathies, chondropathies, acquired deformities, unspecified

1741 Curvature of spine

1749 Osteopathies, chondropathies, acquired deformities, n.e.c.

179 Musculoskeletal system and connective tissue diseases and disorders, n.e.c.

This nature group classifies musculoskeletal system and connective tissue diseases and disorders that are not classified elsewhere.

18* Disorders of the skin and subcutaneous tissue

This major group classifies diseases and disorders of the skin and subcutaneous tissue.

Includes: boils, furunculosis, lymphaladenitis, and other infections of skin and underlying tissue; dermatitis; other inflammatory conditions of the skin; diseases of sebaceous glands; and other disorders of the skin and subcutanous tissue

180 Disorders of the skin and subcutaneous tissue, unspecified

181* Infections of the skin and subcutaneous tissue

This nature group classifies local infections of the skin and underlying tissue and of the lymph glands and nodes.

Includes: boils (1811), cellulitis (1812), impetigo (1814), acute lymphadenitis (1813)

Excludes: Erysipelas (2194), Erysipeloid of Rosenbach (2129), Herpes simplex (2235), Herpes zoster (2234), Molluscum contagiosum (2299), and Viral warts (2299)

1810 Infections of the skin and subcutaneous tissue, unspecified

1811 Carbuncle and furuncle

1812 Cellulitis and abscess

1813 Acute lymphadenitis (acute abscess of lymph gland or node)

1814 Impetigo

1815 Pilonidal cyst

1816 Pyoderma

1819 Infections of the skin and subcutaneous tissue, n.e.c.

182* Dermatitis

This nature group classifies dermatitis, or inflammation of the skin, resulting from contact with allergens or irritant substances; lowered cutaneous threshold to pruritis (itching) and related conditions; and from substances taken internally.

1820 Dermatitis, unspecified

1821 Atopic dermatitis and related conditions

1822 Contact dermatitis and other eczema

1823 Allergic dermatitis

1824 Irritant dermatitis

1825 Other contact dermatitis

1826 Dermatitis due to substances taken internally

1829 Dermatitis, n.e.c.

183* Other inflammatory conditions of the skin

This nature group classifies other inflammatory conditions of the skin and underlying tissue that are not classified elsewhere.

Includes: dermatoses (1831, 1832); erythematous conditions (1834); lichen (1836); pruritus (1837); psoriasis (1835)

1830 Other inflammatory conditions of the skin, unspecified

1831 Erythematosquamous dermatosis (including dandruff, parakeratosis, pityriasis)

1832 Bullous dermatoses

1833 Rosacea

1834 Other erythematous conditions

1835 Psoriasis and similar disorders

1836 Lichen

1837 Pruritus and related conditions

1839 Other inflammatory conditions, n.e.c.

184* Diseases of sebaceous glands

This nature group classifies diseases of the sebaceous glands.

Includes: acne varioliformis and other forms of acne (1841); atheroma (1842), keratin (1842), and wen (1842); asteatosis--cutis (1849), and xerosis cutis (1849)

1840 Diseases of sebaceous glands, unspecified

1841 Acne

1842 Sebaceous cyst

1849 Diseases of sebaceous glands, n.e.c.

189* Other diseases and disorders of the skin and subcutaneous tissue

This nature group classifies other diseases or disorders of the skin and underlying tissue: hypertrophic and atrophic conditions of the skin; diseases of the nail, hair, and hair follicles; disorders of the sweat glands.

Includes: callosities (1891), corns (1891); chronic ulcers of skin (1897); and uticaria (1898)

Excludes: traumatic disorders of the skin (Division 0), blisters (042), bruises and contusions (043), burns (05), effects of environmental conditions (07), friction burns (045), lacerations (034), and puncture wounds (037)

1890 Other diseases and disorders of the skin and subcutaneous tissue, unspecified

1891 Corns and callosities (including callus, clavus)

1892 Other hypertrophic and atrophic conditions (including acquired keratoderma)

1893 Diseases of the nail (including ingrowing nail)

1894 Diseases of hair and hair follicles (including folliculitis)

1895 Disorders of sweat glands (including prickly heat)

1896 Vitiligo

1897 Chronic skin ulcers

1898 Urticaria, hives

1899 Other diseases and disorders of the skin and subcutaneous tissue, n.e.c.

19 Other systemic diseases and disorders

This major group classifies systemic diseases or disorders not elsewhere classified.

190 Other systemic diseases and disorders, unspecified

191* Endocrine, nutritional, metabolic, and immunity disorders

This nature group classifies diseases and disorders of the endocrine glands, nutritional deficiencies, and other metabolic and immunity disorders.

Excludes: AIDS (2211), HIV infection (221)

1910 Endocrine, nutritional, metabolic, and immunity disorders, unspecified

1911 Diseases and disorders of thyroid gland

toxic and nontoxic goiter thyroiditis

1912 Diseases and disorders of other endocrine glands

This code classifies disorders of the pancreas; disorders of the parathyroid, pituitary, thymus, and adrenal glands, and other endocrine disorders.

Includes: diabetes and ovarian and testicular dysfunction

1919 Endocrine, nutritional, metabolic, and immunity disorders, n.e.c.

This code classifies endocrine, nutritional, metabolic, and immunity disorders that are not classified by any other code within nature group 19.

Includes: cystic fibrosis; vitamin or mineral deficiencies; amino-acid, carbohydrates and other nutrient transport disorders; gout; and disorders involving the immune mechanism

199 Systemic diseases and disorders, n.e.c.

This nature group classifies systemic diseases and disorders that are not classified under any other group in this division.

2* INFECTIOUS AND PARASITIC DISEASES

3* NEOPLASMS, TUMORS, AND CANCER

This division classifies diseases or conditions related to tumors, or neoplasms: the new growth of tissue in which the multiplication of cells is uncontrolled and progressive. The behavior of tumors or neoplasms may be benign, cancerous, or of uncertain behavior at the time of diagnosis.

31* Malignant neoplasms and tumors (cancers, carcinomas, sarcomas)

This major group classifies cancers that are grouped by location or site. Malignant neoplasms, or tumors, are divided into two broad categories of carcinoma and sarcoma; both are included in this major group. These codes are not designed to capture information on whether a malignant neoplasm is restricted to the original body site or has metastasized.

310 Malignant neoplasms and tumors (cancers, carcinomas, and sarcomas), unspecified

311* Malignant neoplasms and tumors of bone or connective tissue

This nature group includes cancers of the bone and articular cartilage; and connective and other soft tissue.

Includes: malignant neoplasms of the periosteum, or covering of bones (3111); blood vessel, bursa, fascia, fat, ligament, muscle, nerves and ganglia, synova, tendon, and tendon sheath (3112)

Excludes: malignant neoplasm of hematopoietic tissue (313)

3110 Malignant neoplasms and tumors of bone or connective tissue, unspecified

3111 Bone, articular cartilage

3112 Connective and other soft tissue

3118 Multiple malignant neoplasms and tumors of bone or connective tissue

312* Malignant neoplasms and tumors of the skin

This nature group classifies melanocarcinoma, squamous, basal cell, and multiple malignant neoplasms and tumors of the skin.

Includes: malignant neoplasms and tumors of sebaceous glands, sudoriferous and sudoriparous glands, and sweat glands

3120 Malignant neoplasms and tumors of the skin, unspecified

3121 Melanoma of the skin (melanocarcinoma)

3122 Non-melanoma skin cancer (squamous and basal cell)

3128 Multiple malignant neoplasms and tumors of the skin

313* Malignant neoplasms and tumors of lymphatic and hematopoietic tissue

This nature group classifies cancers of the lymphatic and hematopoietic tissue.

3130 Malignant neoplasms and tumors of lymphatic and hematopoietic tissue, unspecified

3131 Lymphosarcoma and reticulosarcoma (lymphoma)

reticulum cell sarcoma

3132 Hodgkin's disease

nodular sclerosis

3133 Multiple myeloma

Kahler's disease, Myelomatosis

3134 Leukemias

lymphoid, myeloid

monocyctic, Di Guglielmo's disease

erythremic myelosis, Heilmeyer-Schoner disease

3138 Multiple malignant neoplasms and tumors of lymphatic and hematopoietic tissue

3139 Malignant neoplasms and tumors of lymphatic and hematopoietic tissue, n.e.c.

319 Malignant neoplasms and tumors of other sites

This nature group classifies malignant neoplasms and tumors located in other sites not included in any of the previous nature groups of this division.

Includes: malignant neoplasms and tumors of the digestive organs and peritoneum; respiratory and intrathoracic organs; genitourinary organs; brain; eyeball; endocrine glands, and oral cavity pharynx

32* Benign neoplasms and tumors

This major group classifies non-cancerous neoplasms and tumors of the bone, connective tissue, the skin, and internal organs.

320 Benign neoplasms and tumors, unspecified

321* Benign neoplasms of bone, connective tissue, and skin

This nature group classifies lipomas and other benign tumors of the bone, connective and soft tissue, and of the skin.

Includes: benign neoplasms of the periosteum, or covering of bones (3211); blood vessel, bursa, fascia, fat, ligament, muscle, nerves and ganglia, synova, tendon, and tendon sheath (3214)

Excludes: benign neoplasm of hematopoietic tissue (329)

3210 Benign neoplasms of bone, connective tissue, and skin, unspecified

3211 Benign neoplasms of bone and articular cartilage

3212 Lipoma (fatty tumor)

3213 Benign neoplasms of the skin

3214 Other benign neoplasms of connective and other soft tissue

3218 Multiple benign neoplasms of bone, connective tissue, and skin

329* Benign neoplasms and tumors of other sites

This group includes benign neoplasms and tumors located at sites other than those named in this major group.

Includes: benign neoplasms and tumors of the digestive organs and peritoneum; respiratory and intrathoracic organs; genitourinary organs; brain; eyeball; endocrine glands, and oral cavity pharynx

3290 Benign neoplasms and tumors of other sites, unspecified

3291 Hemangioma and lymphangioma--any site

3298 Multiple benign neoplasms and tumors of other sites

3299 Benign neoplasms and tumors of other sites, n.e.c.

33* Neoplasms and tumors of unknown properties

This major group classifies neoplasms and tumors of unkown properties, uncertain behavior, unspecified nature, or unspecified morphology.

Includes: "growth", tumor, "new growth", histiocytic cells and mast cells, and neurofibromatosis

330 Neoplasms and tumors of unknown properties, unspecified

331 Bone, articular cartilage neoplasms and tumors of unknown properties

This nature group classifies neoplasms and tumors of the bone and articular cartilage of unknown properties.

332 Connective and other soft tissue neoplasms and tumors of unknown properties

This nature group classifies neoplasms and tumors of connective and other soft tissue of unknown properties.

Includes: neoplasms and tumors of the peripheral, sympathetic, and parasympathetic nerves and ganglia

333 Skin neoplasms and tumors of unknown properties

This nature group classifies neoplasms and tumors of the skin of uncertain or unspecified morphology and behavior.

338 Multiple neoplasms and tumors of unknown properties

339 Neoplasms and tumors of other sites of unknown properties, n.e.c.

This nature group classifies neoplasms and tumors of unknown properties at body sites other than those named in this major group.

4* SYMPTOMS, SIGNS, AND ILL-DEFINED CONDITIONS

This division classifies symptoms, signs, or abnormal results from laboratory or investigative medical tests or procedures. It includes those ill-defined conditions that can not be classified elsewhere. Codes from this division should be used when no specific diagnosis is named and cannot be inferred from information found on the source document.

40 Symptoms, signs, and ill-defined conditions, unspecified

41* Symptoms

This major group classifies symptoms--conditions that accompany a disease or illness--where no other diagnosis is available and another classification cannot be inferred from the documentation.

410 Symptoms, unspecified

411* General symptoms

This nature group classifies symptoms that are general in nature and no other diagnosis is available.

Includes: hallucinations (4119), hyperhidrosis (4119), sleep disturbances (4119), excessive sweating (4119), chills (4119), and stupor (4119)

Excludes: Heat related loss of consciousness (0722)

4110 General symptoms, unspecified

4111 Loss of consciousness--not heat related

4112 Convulsions, seizures

4113 Malaise and fatigue

4114 Dizziness

4115 Non-specified allergic reaction

4118 Multiple general symptoms

4119 General symptoms, n.e.c.

412* Symptoms involving nervous and musculoskeletal systems

This nature group classifies symptoms which are specific to either the nervous or musculoskeletal systems.

Includes: abnormal involuntary movements (4121), abnormality of gait (4129), lack of coordination (4129), tetany (4129), and meningismus (4129)

4120 Symptoms involving nervous and musculoskeletal systems, unspecified

4121 Spasms or tremors, n.e.c.

4122 Earache

4123 Eye strain

4128 Multiple symptoms involving nervous and musculoskeletal systems

4129 Symptoms involving nervous and musculoskeletal systems, n.e.c.

413* Symptoms involving skin and other integumentary tissue

This nature group classifies symptoms which are specific to the integumentary system.

Includes: unspecified jaundice (4139), changes in skin texture (4139), and disturbances of skin sensation (4139)

4130 Symptoms involving skin and other integumentary tissue, unspecified

4131 Edema (including dropsy)

4132 Cyanosis

4133 Pallor and flushing

4138 Multiple symptoms involving skin and other integumentary tissue

4139 Symptoms involving skin and other integumentary tissue, n.e.c.

414* Symptoms involving head and neck

This nature group classifies symptoms which are specific to either the head or neck.

Includes: throat pain (4149), aphasia (4149), and epistaxis/nosebleed (4149)

4140 Symptoms involving head and neck, unspecified

4141 Headache, except migraine

4142 Loss of voice, voice disturbances

4148 Multiple symptoms involving head and neck

4149 Symptoms involving head and neck, n.e.c.

415* Symptoms involving cardiovascular system

This nature group classifies symptoms which are specific to the cardiovascular--heart and blood vessels--system.

Includes: palpitations (4159), cardiac murmurs (4159), and abnormal heart sounds (4159)

4150 Symptoms involving cardiovascular system, unspecified

4151 Unspecified tachycardia (rapid heart beat)

4152 Gangrene

4153 Enlargement of lymph nodes

4158 Multiple symptoms involving cardiovascular system

4159 Symptoms involving cardiovascular system, n.e.c.

416* Symptoms involving respiratory system and chest

This nature group classifies symptoms which are specific to the respiratory system.

Includes: orthopnea (4169), stridor (4169), tachypnea (4169), wheezing (4169), and shortness of breath (4169)

4160 Symptoms involving respiratory system and chest, unspecified

4161 Hyperventilation

4162 Hemoptysis (cough with hemorrhage)

4163 Abnormal sputum

4164 Chest pain

4168 Multiple symptoms involving respiratory system and chest

4169 Symptoms involving respiratory system and chest, n.e.c.

417* Symptoms involving digestive and urinary system

This nature group classifies symptoms which are specific to the digestive and urinary systems.

Includes: dysphagia/difficulty in swallowing (4179), peristalsis (4179), renal colic (4179), dysuria (4179), and tenesmus (4179)

4170 Symptoms involving digestive and urinary system, unspecified

4171 Nausea and vomiting

4172 Heartburn

4173 Frequency of urination and polyuria

4174 Oliguria and anuria

4175 Abdominal pain, unspecified

4178 Multiple symptoms involving digestive or urinary system

4179 Symptoms involving digestive and urinary system, n.e.c.

418 Multiple symptoms

This group contains multiple symptoms from more than one subgroup within the major group 41. For example, abdominal pain, dizziness and a headache, all of equal severity.

419 Other symptoms, n.e.c.

This nature group classifies the residual symptoms that cannot be classified under any other three digit member of the major group.

Includes: hepatomegaly, splenomegaly, and ascites

42* Abnormal findings

This major group contains classifications for abnormal results from laboratory or investigative medical testing or procedure. These codes should be used when only test results and no specific diagnosis or symptoms are reported on the source documents.

420 Abnormal findings, unspecified

421* Abnormal findings from examination of blood

This nature group classifies abnormal results stemming from examination of the blood.

Includes: abnormal blood-gas level (4212), unspecified bacteremia and viremia (4219), anisocytosis and poikilocytosis (4219)

4210 Abnormal findings from examination of blood, unspecified

4211 Abnormal blood level of lead

4212 Abnormal blood level of substances, except. lead

4219 Abnormal findings from examination of blood, n.e.c.

422 Abnormal findings from examination of urine

This nature group classifies abnormal results stemming from examination of the urine.

Includes: acetonuria, biliuria, chyluria, crystalluria, hemoglobinuria, and myoglobinuria

423 Abnormal findings from other body substances

This nature group classifies abnormal results stemming from examination of other body substances. Body substances include amniotic fluid, cerebrospinal fluid, saliva, and semen.

424 Abnormal findings from radiological and other examination of body structure

This nature group classifies abnormal results stemming from examination of other body structures and from radiological testing. Findings of thermography, ultrasound (echogram) and x-ray examinations are included.

Includes: coin lesion or shadow of lung, abnormal mammogram results

425 Abnormal findings from function studies

This nature group classifies abnormal results as determined from function studies.

Includes: abnormal electrocardiogram (ECG, EKG), electroencephalogram (EEG), electroretinogram (ERG)

426 Abnormal findings from histological and immunological studies

This nature group classifies abnormal results as determined from histological and immunological studies.

Includes: reaction to tuberculin test, positive culture findings, raised level of immunoglobulins, and abnormal karyotype

427 Multiple abnormal findings

This nature group classifies abnormal results as determined from multiple tests or studies.

429 Other abnormal findings

This nature group classifies abnormal test or study results that are named but are not included in any other section of major group 42.

Includes: elevated blood pressure reading without diagnosis of hypertension, low blood pressure reading, and abnormal reflex

48* Multiple symptoms, signs, and ill-defined conditions

480 Multiple symptoms, signs, and ill-defined conditions, unspecified

481 Multiple chemical sensitivity

This major section classifies multiple signs and symptoms that are associated with exposure to multiple chemicals.

489 Multiple symptoms, signs, and ill-defined conditions, n.e.c.

This major section classifies multiple signs, symptoms and ill-defined conditions which can be individually found throughout Division 4.

49 Symptoms, signs, and ill-defined conditions, n.e.c.

This major group classifies other symptoms, signs, and ill-defined conditions, the details of which are known, but can not be assigned to another code category within Division 4.

5* OTHER DISEASES, CONDITIONS, AND DISORDERS

This division classifies physical characteristics for which there is sufficient information for coding purposes, but no specific code exists in previous divisions of the nature of injury or illness structure.

51 Damage to prosthetic devices

This major group classifies injuries or illnesses sustained to a prosthetic device only. If the incident involves a part of the body, code for the specific injury or illness named.

52* Mental disorders or syndromes

This major group is comprised of neurotic, psychotic and organic mental disorders or syndromes. See Appendix B, Volume 1 of the ICD-9-CM for a glossary of mental disorders.

When mental disorders or syndromes are described as sequelae or aftereffect of a traumatic injury or disorder, the initial or underlying condition should be coded. For example, if the individual is experiencing acute depression as a result of chronic pain from a back injury, code the back injury. However, if a mental disorder is secondary to a traumatic incident--witnessing a traumatic amputation of another person--code the mental disorder.

520 Mental disorder or syndrome, unspecified

521* Anxiety, stress, neurotic disorders

This nature group classifies neurotic disorders associated with acute and chronic post-traumatic anxiety; reaction to stress; panic disorders; and other specified neurotic disorders not elsewhere classified.

Includes: job-related stress (5214)

5210 Anxiety, stress, neurotic disorders, unspecified

5211 Post-traumatic anxiety--acute

5212 Post-traumatic anxiety--chronic

5213 Panic disorder

5214 Neurotic reaction to stress

5218 Multiple anxiety, stress, neurotic disorders

5219 Neurotic disorders, n.e.c.

522* Organic mental disorders--neurotic or psychotic

This nature group classifies neurotic and psychotic disorders organic in nature such as substance-induced mental disorders; organic affective syndrome; and other mental disorders not elsewhere classified.

5220 Organic mental disorders--neurotic or psychotic, unspecified

5221 Substance-induced mental disorder

5222 Organic affective syndrome

5228 Multiple organic mental disorders--neurotic or psychotic

5229 Organic mental disorders--neurotic or psychotic, n.e.c.

529 Mental disorders or syndromes, n.e.c.

This group classifies other mental disorders or syndromes not specified as either neurotic or organic mental disorders; or a combination of neurotic and organic mental disorders.

59 Other diseases, conditions, and disorders, n.e.c.

8 MULTIPLE DISEASES, CONDITIONS, AND DISORDERS

This division classifies multiple physical characteristics whose individual codes are found in two or more of the following divisions: Systemic Diseases and Disorders, Infectious and Parasitic Diseases, Neoplasms, Symptoms, Signs and Ill-defined Conditions, and Other Diseases, Conditions, and Disorders.

9999 Nonclassifiable

SECTION 2.2

Part of Body Affected

2.2.1 Definition, Rules of Selection

2.2.2 Titles and Descriptions

2.2.2 Part of Body Affected--Titles and Descriptions

The Part of Body Affected code structure is arranged in order from the top of the body (Division 0, Head) to the bottom of the body (Division 4, Lower Extremities). Division 5 classifies body systems. Division 8 classifies multiple body parts from two or more divisions. Division 9 classifies Prosthetic devices and any human parts of the body which are not classified or listed under any of the other divisions.

The Part of Body Affected divisions are arranged as follows:

DIVISION & TITLE

0 Head

1 Neck, Including Throat

2 Trunk

3 Upper Extremities

4 Lower Extremities

5 Body Systems

8 Multiple Body Parts

9 Other Body Parts

9999 Nonclassifiable

0* HEAD

This division classifies the uppermost parts of the body. This region consists of the skull, its contents, and related external structures.

If the nature of injury or illness named is amputation--decapitation, select Head, n.e.c., code 09.

00 Head, unspecified

01* Cranial region, including skull

This major group classifies the region that is bordered by the face in front and the neck below.

Select code 011 when concussion or other intracranial injuries is named as the nature of the injury. Select code 013 when a nonfatal fracture is the nature of injury.

Includes: brain and brain stem (011), hair (012), occipital, parietal, and temporal bones (013), skin (012), subcutaneous connective tissue, cartilage, and muscles (019)

010 Cranial region, unspecified

011 Brain

012 Scalp

013 Skull

018 Multiple cranial region locations

019 Cranial region, n.e.c.

02 Ear(s)

This major group classifies the sense or receptor organs located on either side of the head. The code can be used when either one or both ears are affected.

Includes: anvil, auditory nerve, auricle or pinna, cochlea, concha, eardrum, eustachian tube, hammer, helix, lobule, middle ear or tympanic cavity, outer ear canal, scapha, semicircular canals, stirrup (stapes), and tragus

03* Face

This major group classifies the anterior or frontal portion of the head, which is bounded by the cranial region to the top and back (hairline) and by the neck below.

Includes: bony structures, cartilage, muscle, skin, subcutaneous tissue, underside of the jaw/chin, and veins and arteries

030 Face, unspecified

031 Forehead

Includes: eyebrow(s)

032 Eye(s)

This part of body group classifies the sense organs of sight located in the frontal portion of the head. The code can be used for either one or both eyes and when loss or impairment of sight is involved.

Includes: conjunctiva, cornea, eyeball, inside and outside of the eyelids, iris, lacrimal glands, lens, optic nerve, orbit, retina, and upper and lower eyelashes

033* Nose, nasal cavity

This part of body group classifies the prominent sensory organ in the center of the face that functions as the organ of smell and as a part of the respiratory system.

Generally, select code 0330 when the nature of injury or illness named is from Traumatic Injuries or Disorders, Nature of Injury or Illness Division 0, such as fracture or contusion.

0330 Nose, except internal location of diseases or disorders

Internal Nasal Location of Diseases or Disorders:

Generally, select codes 0331-0339 when the nature of injury or illness named is found in Division 1 through 5 of the Nature of Injury or Illness structure.

0331 Internal nasal location, unspecified

0332 Nasopharynx

0333 Nasal passages

0334 Sinuses

0338 Multiple internal nasal locations

0339 Internal nasal location, n.e.c.

034 Cheek(s)

035 Jaw/chin

036* Mouth

This nature group classifies the opening of the alimentary canal which is bounded by the lips and includes the cavity which houses the tongue and teeth.

Select code 0369 if loss of taste has been named as the nature of injury or illness.

0360 Mouth, unspecified

0361 Lip(s)

0362 Tongue

0363 Tooth(teeth)

0364 Gum

0368 Multiple mouth locations

0369 Mouth, n.e.c.

038 Multiple face locations

039 Face, n.e.c.

08 Multiple head locations

09 Head, n.e.c.

Select Head, n.e.c. if the nature of injury or illness named is amputation--decapitation.

1* NECK, INCLUDING THROAT

This division classifies that portion of the body that connects the head to the torso or trunk. This region is bounded by the jaw/chin and cranial region to the top and the shoulder to the bottom.

If the nature of injury or illness named is amputation, and the point of amputation is neck, select Head, n.e.c., code 09.

10 Neck, except internal location of diseases or disorders

This major group classifies the external portion of the neck including the uppermost portion of the vertebra. Generally, select this code when the nature of injury or illness named is a member of Division 0 of the Nature of Injury or Illness structure.

Includes: bony structures (cervical vertebrae), cartilage, muscle, skin, subcutaneous tissue, and veins and arteries

Internal Neck Location of Diseases or Disorders:

These major groups classify the underlying visceral structures of the neck. Generally, these codes should be chosen when the nature of injury or illness named is a member of Division 1 through 5 of the Nature of Injury or Illness structure.

11 Internal neck location, unspecified

Select this code when an irritated or sore throat is the nature of injury or illness.

12 Vocal cord(s)

This major group classifies either of two pairs of folds projecting in the larynx cavity.

13 Larynx

This major group classifies the organ of the voice, located between the trachea and the base of the tongue.

14 Laryngopharynx

This major group classifies the inferior portion of the pharynx which is also known as hypopharynx or laryngeal pharynx.

15 Pharynx

This major group classifies the musculomembranous tube in the back of the nose, mouth, and larynx. It extends from the skull to the esophagus.

16 Trachea

This major group classifies the cartilaginous and membranous tube that extends from the bottom of the larynx to the bronchi, which is also known as the windpipe.

18 Multiple internal neck locations

19 Internal neck location, n.e.c.

2* TRUNK

This division classifies the main part of the body, where the head and limbs are attached. The area is bounded by the neck, arms, and legs.

Select a code from this division when the nature of injury or illness is localized to a specific organ(s) and does not affect the entire system, otherwise, select a code from Division 5 of this structure.

Includes: bones, cartilage, internal organs and structures,muscles, nerves, skin, subcutaneous tissue, tendons, veins and arteries, and internal organs and structures

20 Trunk, unspecified

21 Shoulder, including clavicle, scapula

This major group classifies the region where the arm(s) join the trunk.

If the nature of injury or illness named is amputation, and the point of amputation is shoulder, select Upper arm(s), code 311.

Includes: clavicle/collar bone, humerus, scapula/shoulder blade, and shoulder girdle

22* Chest, including ribs, internal organs

This major group classifies the frontal region of the body or thorax. It is bounded by the respiratory diaphragm or abdomen below, the shoulder above, and the back in the rear.

220 Chest, except internal location of diseases or disorders

Internal Chest Location of Diseases or Disorders:

These part groups classify the underlying visceral structures of the chest. Generally, these codes should be chosen when the nature of injury or illness named is a member of Division 1 through 5 of the Nature of Injury or Illness structure.

221 Internal chest location, unspecified

222 Esophagus

223 Heart

224 Bronchus

225 Lung(s), pleura

226 Breast(s)--internal

228 Multiple internal chest locations

229 Internal chest location, n.e.c.

23* Back, including spine, spinal cord

This major group classifies the posterior part of the trunk that is bounded by the neck and the pelvis.

Includes: cartilage, muscles, nerves, and neuroglia, spine, spinal cord, tendons, veins and arteries, vertebra (backbone)

230 Back, including spine, spinal cord, unspecified

231 Lumbar region

This major group classifies the region of the back which includes 5 vertebrae on the spinal column and is located in the lower portion of the back.

Select this code when low back pain or lumbago is named as the nature of injury or illness.

232 Thoracic region

This major group classifies the region of the back which includes 12 vertebrae on the spinal column and is located just below the cervical vertebrae of the neck.

233 Sacral region

This major group classifies the region of the back which is located just below the thoracic region.

Includes: sacrum

234 Coccygeal region

This major group classifies the region of the back which is bounded by the lower extremities.

Includes: coccyx

238 Multiple back regions

239 Back, including spine, spinal cord, n.e.c.

24* Abdomen

This major group classifies that portion of the body which lies between the thorax and the pelvis.

240 Abdomen, except internal location of diseases or disorders

Internal Abdominal Location of Diseases or Disorders:

These major groups classify the underlying visceral structures of the abdomen. Generally, these codes should be chosen when the nature of injury or illness named is a member of Division 1 through 5 of the Nature of Injury or Illness structure.

Includes: abdominal cavity

241 Internal abdominal location, unspecified

242 Stomach organ

243 Spleen

244* Urinary organs

2440 Urinary organs, unspecified

2441 Bladder

2442 Kidney(s)

2448 Multiple urinary organs

2449 Urinary organs, n.e.c.

245* Intestines, peritoneum

2450 Intestines, peritoneum, unspecified

2451 Peritoneum

2452 Small intestine

2453 Large intestine/colon, rectum

2458 Multiple intestinal locations

2459 Intestines, n.e.c.

246* Other digestive structures

2460 Other digestive structures, unspecified

2461 Liver

2462 Gallbladder

2463 Pancreas

2468 Multiple other digestive structures

2469 Other digestive structures, n.e.c.

248 Multiple internal abdominal locations

249 Internal abdominal location, n.e.c.

25* Pelvic region

This major group classifies the lower portion of the trunk or torso that supports the lower extremities. This region is bounded by the coccyx of the vertebral column, the abdomen and the legs.

When inguinal hernia is the nature of injury or illness listed, select code 254, Groin. If the nature of injury or illness named is amputation, and the point of amputation is hip, select Thigh, code 411.

Includes: sacroiliac (259)

Excludes: intestines (245)

250 Pelvic region, unspecified

251 Hip(s)

252 Pelvis

253 Buttock(s)

254 Groin

255* External reproductive tract structures

2550 External reproductive tract structures, unspecified

2551 Scrotum

2552 Penis

2553 External female genital region

2558 Multiple external reproductive tract structures

2559 External reproductive tract structures, n.e.c.

256* Internal reproductive tract structures

2560 Internal reproductive tract structures, unspecified

2561 Prostate

2562 Testis(testes)

2563 Ovary(ies)

2564 Uterus

2565 Female genitals, n.e.c.

2568 Multiple internal reproductive tract structures

2569 Internal reproductive tract structures, n.e.c.

258 Multiple pelvic region locations

259 Pelvic region, n.e.c.

28 Multiple trunk locations

29 Trunk, n.e.c.

3* UPPER EXTREMITIES

This division classifies the extremities that are bounded by the shoulder at the top with the fingers as the lowermost part included.

Includes: bones, cartilage, muscles, skin, subcutaneous tissue, veins and arteries (See the alphabetical listing for specific muscle and bone names.)

30 Upper extremities, unspecified

31* Arm(s)

This major group classifies the upper extremities from the area above the wrist up to the shoulder.

If the injury or illness involves the same part of the left, right, or both arms, select a code from this major group.

If the nature of injury named is amputation, and the point of amputation is elbow, select Forearm(s), code 313.

310 Arm(s), unspecified

311 Upper arm(s)

312 Elbow(s)

313 Forearm(s)

318 Multiple arm(s) locations

319 Arm(s), n.e.c.

32 Wrist(s)

This major group classifies the region between the forearm and the hand.

When the nature of injury or illness named is carpal tunnel syndrome, select this code. Select this code whether the injury or illness involves wrist(s) from the right, left, or both arms.

If the nature of injury or illness named is amputation, and the point of amputation is the wrist, select Hand(s), except finger(s) , code 33.

33 Hand(s), except finger(s)

This major group classifies the part of the upper extremity at the end of the forearm. Select this code whether the injury or illness involves hand(s) from the right, left, or both arms.

If the nature of injury or illness named is amputation, and the point of amputation is the wrist or hand, select this code. If the only information on the source document is hand, with no mention of fingers being included or excluded, select this code.

Includes: knuckles and the areas between the fingers

Excludes: fingers (34) and wrist (32)

34 Finger(s), fingernail(s)

This major group classifies the digits of the hand.

Select this code whether the injury or illness involves finger(s) from the right, left, or both hand(s).

Includes: distal phalanx (phalanges), medial phalanx (phalanges), proximal phalanx (phalanges), thumb

38* Multiple upper extremities locations

This major group classifies combinations of differing parts of the body within this division.

380 Multiple upper extremities locations, unspecified

381 Hand(s) and finger(s)

Includes: combinations of at least one hand and one finger

382 Hand(s) and wrist(s)

Includes: combinations of at least one hand and one wrist

383 Hand(s) and arm(s)

Includes: combinations of at least one hand and one arm

389 Multiple upper extremities locations, n.e.c.

39 Upper extremities, n.e.c.

4* LOWER EXTREMITIES

This division classifies the appendages that are bounded by the hip to the top with the toes as the lowermost part included.

Includes: bones, cartilage, muscles, skin, subcutaneous t