Laws Icd 10 Volume 3 Pdf


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ICD Volume 2 Instruction manual - Fifth Edition to the users; Volume 3 → presents the Alphabetical index to the classification. WHO's ICD morbidity or mortality coding rules and guidelines in Volume. 2. The introductory pages of Volume 3 include general instructions about the. ICD Volume 1 - Tabular List - Ebook download as PDF File .pdf), Text File . txt) or III DD89 Diseases of the blood and blood-forming organs and certain.

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International statistical classification of diseases and related health problems. 10th revision. Volume 3. Alphabetical index. Fifth edition. VOLUME 3. Includes diabetic (acute)(any stage)(chronic)(See also EE14 with fourth character.2) E†. N* . cardioverter-defibrillator (ICD) Z ICD 2e Volume 3 (). SECTION I - Alphabetical index to diseases and nature of injury. A. Aarskog's syndrome. Q Abandonment T

C Malignant neoplasms C97 C Malignant neoplasms, stated or presumed to be primary, of specified C75 sites, except of lymphoid, haematopoietic and related tissue C Lip, oral cavity and pharynx C14 C Digestive organs C Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism DD D Aplastic and other anaemias D64 D Coagulation defects, purpura and other haemorrhagic conditions D69 D Other diseases of blood and blood-forming organs D77 D Certain disorders involving the immune mechanism D FF09 Organic, including symptomatic, mental disorders FF19 Mental and behavioural disorders due to psychoactive substance use FF29 Schizophrenia, schizotypal and delusional disorders FF39 Mood [affective] disorders FF48 Neurotic, stress-related and somatoform disorders FF59 Behavioural syndromes associated with physiological disturbances and physical factors FF69 Disorders of adult personality and behaviour FF79 Mental retardation FF89 Disorders of psychological development. FF98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence F99 Unspecified mental disorder. G Inflammatory diseases of the central nervous system G09 G Systemic atrophies primarily affecting the central nervous system G13 G Extrapyramidal and movement disorders G26 G Other degenerative diseases of the nervous system G32 G Demyelinating diseases of the central nervous system G37 G Episodic and paroxysmal disorders G47 G Nerve, nerve root and plexus disorders G59 G Polyneuropathies and other disorders of the peripheral nervous system G64 G Diseases of myoneural junction and muscle G73 G Cerebral palsy and other paralytic syndromes G83 G Other disorders of the nervous system G

As the term remained not retired and indicated replacement, it was deemed different. As CMS chose to re-develop a procedure classification, direct comparison with volume 3 is difficult. Outside of that loose comparison one can only note that the increase in size between the two classifications is In ICDCM they serve to limit the number of available codes due to previous choices as evidenced by the coding pattern nnn condition ; nnn.

The coding pattern appears in numerous places with no evidence that those concepts appearing in the nnn. The post-coordinated nature of ICDCM codes is evident from the gross construction pattern in many codes: For the non-disease sections the pattern remains where condition is replaced by injury or event and comorbidity is an equivalent modifier. Use of the formulaic pattern allows for the vast addition of post-coordinated terms to the classifications and may serve as a means to improve code selection through novel guidance tools, either on paper or built into the next-generation clinical and practice management systems required to service HIPAA version 2.

Classifications inherently have a hierarchy that differs from what is used in ontological construction. A classification hierarchy is needed for aggregation and not to define inheritance. Hence the hierarchical relationship is not parent—child but more member-of.

Subsumption now is more difficult. The second broad exclusion rule is not related to the logical structure but is a restriction on use. Basically, that rule prevents the co-reporting of codes for similar conditions that the patient has but are not related to the present incidence, and the logical relationship between the two remains.

ICDPCS has no hierarchical terms defined by the authors, although they do have an index in their released information. Lack of a formal relationship between the codes prevents logical determination of duplication in this vast assemblage of procedures. While many classifications grow as they are used, adding missing or new concepts, ICDPCS has contracted, indicating that automatic detection of duplication in versions is perhaps difficult.

ICDCM was essentially developed in the mids 30 and successfully field tested in 41 but has not been formally re-tested since that time. One example is diabetes coverage, which has expanded from 29 codes containing the phrase in ICDCM to in ICDCM, but with few codes, outside of gestational diabetes, indicating control level or the agent used.

Adding these types of concepts appears necessary and easy. Diseases of the musculoskeletal system and connective tissue chapter M comprise 8.

The international version uses a similar shorthand description for anatomical sites and provides more specific definitions for the regions encompassed. There is tension that is international in scope in coding between the provider incentives to use codes for payment versus the broader healthcare community's interest in having correct detail in the codes so they represent what the care encounter involves. An example of bad practice would be the conversion of the present ICDCM versions of the common superbill used in providers' offices, or their electronic system equivalence, that capture codes at the point of care as they contain ICDCM codes 48 or ICDCM codes that are not at the reporting detail level.

We need to study the coding requirements and develop easily used systems, both paper and computer, that help guide one to the correct detail code, especially when dealing with the vast increase in injury codes and the complexity associated with their use. As an example, consider the coding complexity of a person with osteoporosis falling and breaking a wrist. Most likely the person will be treated in an emergency department or other urgent care facility that has no knowledge of the person's underlying condition and has the encounter coded as S While the S codes provide for follow-up care, that person will most likely get that care from a specialist.

Current advice is for the specialist to use codes from the M chapter and most likely code subsequent encounters using M How can we coordinate both care locations to the correct sequence of codes and maintain the care model?

Does this sequence of codes provide the best information for this common occurrence? To allow the successful flow of clinical observation to administrative systems to healthcare decisions, the informatics community needs to help shape this dialogue as it represents a new role of health information exchange. Review for use-case dependent acceptance will show, as with the high-level match of the international version to ICDCM discussed under observations table 2 , that many will be acceptable.

ICDPCS can only be viewed as a work in progress that has great potential to solve the ever-changing world of new procedures but must solve the problem of identifying and preventing overlapping concepts.

ICDCM gains and suffers from its tie to the international version. The rigid structure of the international version, while much improved from ICD-9, forces an organization that may not be most flexible with respect to US health care. The inability to have true subsumption of like medical concepts is one indication of the problem. The way the structure forces complex coding choices is another. Despite these issues, ICDCM, with some careful review regarding missing concepts, especially in the area of quality, appears close to meeting the needs of healthcare reporting for reimbursement and many secondary uses, including the one it was designed for: Central coordination is essential and is needed to better direct the introduction and changes in classification that will soon replace that used by essentially all US healthcare providers for clinical decision-making.

Competing interests: Provenance and peer review: Not commissioned; externally peer reviewed. National Center for Biotechnology Information , U. J Am Med Inform Assoc. Steven J Steindel. Author information Article notes Copyright and License information Disclaimer.

Corresponding author. Received Oct 6; Accepted Mar 2. For permission to use where not already granted under a licence please go to http: This article has been cited by other articles in PMC. Open in a separate window. Concept counts for eye and ear were manually determined for this comparison. Figure 1. Figure 2. Table 2 Reasons for top-level concept differences.

Percentages are best on best matches between the two classification code contents. Member-of relationships Classifications inherently have a hierarchy that differs from what is used in ontological construction.

Validation of codes and testing ICDCM was essentially developed in the mids 30 and successfully field tested in 41 but has not been formally re-tested since that time.

Code reuse There is tension that is international in scope in coding between the provider incentives to use codes for payment versus the broader healthcare community's interest in having correct detail in the codes so they represent what the care encounter involves. Footnotes Competing interests: References 1. Executive order —incentives for the use of health information technology and establishing the position of the national health information technology coordinator.

Fed Regist ; US Public Law American recovery and reinvestment act of Public Law Office of the national coordinator H. S Meaningful use US Public Law Health insurance portability and accountability act of Proposed rule. Comparison of methodologies for calculating quality measures based on administrative data versus clinical data from an electronic health record system: J Am Med Inform Assoc ; Chute CG. Clinical classification and terminology: J Am Med Inform Assoc ; 7: A framework for comprehensive health terminology systems in the United States: ANSI healthcare informatics standards board vocabulary working group and the computer-based patient records institute working group on codes and structures.

J Am Med Inform Assoc ; 5: Coping with changing controlled vocabularies. Cimino JJ. Desiderata for controlled medical vocabularies in the twenty-first century. Methods Inf Med ; Stud Health Technol Inform ; Rector AL. Clinical terminology: Symbolic anatomic knowledge representation in the read codes version 3: J Am Med Inform Assoc ; 4: Snomed RT: Comput Methods Programs Biomed ; Validating clinical terminology structures: Jiang G, Chute CG.

Rector AL, Brandt S. Why do it the hard way? A06 Amoebiasis Includes: A07 Other protozoal intestinal diseases A In countries where any term listed in A09 without further specification can be assumed to be of noninfectious origin. Tuberculosis of: Verruga peruana A Hutchinson's triad A Early congenital syphilis: Dementia paralytica juvenilis Juvenile: Secondary syphilitic: Herpesviral infection of genital tract: Lyme disease A Venezuelan equine encephalitis A A89 Unspecified viral infection of central nervous system Processed on Ross River disease B A99 Unspecified viral haemorrhagic fever Processed on Chapter I Certain infectious and parasitic diseases AB99 Viral infections characterized by skin and mucous membrane lesions BB09 B00 Herpesviral [herpes simplex] infections Excludes: The classification is maintained for surveillance purposes.

In the 33rd World Health Assembly declared that smallpox had been eradicated. For use of this category. Epidemic polyarthritis and exanthema Ross River fever B Bayou and Black Creek Canal hantavirus aetiologies. Microsporum and Trichophyton tinea. Brazilian blastomycosis B Brazilian blastomycosis Lutz' disease B B48 Other mycoses. Most of the causal fungi are normally saprophytic in soil and decaying vegetation. B50 Plasmodium falciparum malaria Includes: B57 Chagas' disease Includes: American trypanosomiasis infection due to Trypanosoma cruzi B B60 Other protozoal diseases.

Infection due to Fasciola: B69 Cysticercosis Includes: B74 Filariasis Excludes: B88 Other infestations B These categories are to be used to indicate conditions in categories AB89 as the cause of sequelae. The "sequelae" include conditions specified as such.

For use of these categories. B90 Sequelae of tuberculosis B These categories should never be used in primary coding. B95 Streptococcus and staphylococcus as the cause of diseases classified to other chapters B They are provided for use as supplementary or additional codes when it is desired to identify the infectious agent s in diseases classified elsewhere. Male genital organs C63 C Mesothelial and soft tissue C49 C50 Breast C Bone and articular cartilage C41 C Malignant neoplasms C97 C Malignant neoplasms.

Digestive organs C26 C C96 haematopoietic and related tissue C97 Malignant neoplasms of independent primary multiple sites. Urinary tract C68 C Respiratory and intrathoracic organs C39 C Malignant neoplasms of ill-defined. Skin C44 C Female genital organs C58 C Thyroid and other endocrine glands C75 C Use of subcategories in Chapter II.

Morphology There are a number of major morphological histological groups ofmalignant neoplasms: Cancer is a generic term and may be used for any of the above groups.

In Chapter II neoplasms are classified predominantly by site within broad groupings for behaviour. For those wishing to identify the histological type of neoplasm. Morphology codes have six digits: Benign neoplasms D36 D Neoplasms of uncertain or unknown behaviour [see note before D37] D48 Notes 1. In situ neoplasms D09 D For example.

In a few exceptional cases morphology is indicated in the category and subcategory titles. Functional activity All neoplasms are classified in this chapter. In both cases the primary site is considered to be unknown. An additional code from Chapter IV may be used. Sometimes a neoplasm overlaps the boundaries of three-character categories within certain systems.

Attention is drawn to the special use of subcategory. A neoplasm that overlaps two or more contiguous sites within a three-character category and whose point of origin cannot be determined should be classified to the subcategory. Many three- character categories are further divided into named parts or subcategories of the organ in question. Numerically consecutive subcategories are frequently anatomically contiguous. Malignant neoplasms overlapping site boundaries and the use of sub. On the other hand.

To take care of this the following subcategories have been designated: Use of the Alphabetical Index in coding neoplasms In addition to site. The specific instructions and examples pertaining to neoplasms should be consulted to ensure correct use of the.

The introductory pages of Volume 3 include general instructions about the correct use of the Alphabetical Index. Where it has been necessary to provide subcategories for "other". Malignant neoplasms of ectopic tissue Malignant neoplasms of ectopic tissue are to be coded to the site mentioned. It is therefore recommended that agencies interested in identifying both the site and morphology of tumours.

Chapter II provides a rather restricted topographical classification. The topography codes of ICD-O use for all neoplasms essentially the same three. C11 Malignant neoplasm of nasopharynx C Two alternative subclassifications are given: Cardiac orifice Cardio-oesophageal junction Gastro-oesophageal junction Oesophagus and stomach C Hodgkin's disease C C30 Malignant neoplasm of nasal cavity and middle ear C C31 Malignant neoplasm of accessory sinuses C C40 Malignant neoplasm of bone and articular cartilage of limbs C C44 Other malignant neoplasms of skin Includes: Kaposi's sarcoma C C47 Malignant neoplasm of peripheral nerves and autonomic nervous system Includes: C58 Tubo-ovarian Utero-ovarian C C54 Malignant neoplasm of corpus uteri C C63 Malignant neoplasm of other and unspecified male genital organs C If the sites of multiple involvement are known.

C81 Hodgkin's disease Includes: The terms used in categories CC85 for non-Hodgkin's lymphomas are those of the Working Formulation.. The terms used in these schemes are not given in the Tabular List but appear in the Alphabetical Index. If B-cell lineage or involvement is mentioned in conjunction with a specific lymphoma. C85 Other and unspecified types of non-Hodgkin's lymphoma Includes: If T-cell lineage or involvement is mentioned in conjunction with a specific lymphoma.

C83 Diffuse non-Hodgkin's lymphoma Includes: C92 Myeloid leukaemia Includes: This system of grading has been extended to other organs.. Many in situ neoplasms are regarded as being located within a continuum of morphological change between dysplasia and invasive cancer. Descriptions of grade III intraepithelial neoplasia. D06 Carcinoma in situ of cervix uteri Includes: Pharyngeal tonsil Posterior margin of septum and choanae D D37 Neoplasm of uncertain or unknown behaviour of oral cavity and digestive organs D Categories DD48 classify by site neoplasms of uncertain or unknown behaviour.

Chorioadenoma destruens Hydatidiform mole: Di Guglielmo's disease C Lesch-Nyhan syndrome E Evans' syndrome D Chapter III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism DD89 Aplastic and other anaemias DD64 D60 Acquired pure red cell aplasia [erythroblastopenia] Includes: Blackfan-Diamond syndrome D Chapter III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism DD89 Coagulation defects.

Chapter III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism DD89 Other diseases of blood and blood-forming organs DD77 D70 Agranulocytosis Agranulocytic angina Infantile genetic agranulocytosis Kostmann's disease Neutropenia: Anomaly granulation granulocyte or syndrome: Chediak -Steinbrinck -Higashi syndrome E Letterer-Siwe disease C Basophilia D Chapter III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism DD89 Certain disorders involving the immune mechanism DD89 Includes: D84 Other immunodeficiencies D Disorders of thyroid gland E07 E Diabetes mellitus E14 E Metabolic disorders E90 Asterisk categories for this chapter are provided as follows: Chapter IV Endocrine.

Appropriate codes in this chapter i. All neoplasms. Other disorders of glucose regulation and pancreatic internal secretion E16 E Other nutritional deficiencies E64 E Malnutrition E46 E Disorders of other endocrine glands E35 E Obesity and other hyperalimentation E68 E Some of the conditions have no current hypothyroidism but are the consequence of inadequate thyroid hormone secretion in the developing fetus.

Use additional code FF Environmental goitrogens may be associated. E02 Subclinical iodine-deficiency hypothyroidism E03 Other hypothyroidism Excludes: The following fourth-character subdivisions are for use with categories EE E16 Other disorders of pancreatic internal secretion E Di George's syndrome D Nelson's syndrome E E22 Hyperfunction of pituitary gland Excludes: Cushing's syndrome E Prader-Willi syndrome Q Use additional external cause code Chapter XX.

E28 Ovarian dysfunction Excludes: Albright -McCune -Sternberg syndrome Q May be used as an additional code. E30 Disorders of puberty. The degree of malnutrition is usually measured in terms of weight. In the exceptional circumstances that no measurement of weight is available. If an observed weight is below the mean value of the reference population. When only one measurement is available.. When one or more previous measurements are available. When only one measurement is available. E45 Retarded development following protein-energy malnutrition Nutritional: E42 Marasmic kwashiorkor Severe protein-energy malnutrition [as in E43]: Starvation oedema E44 Protein-energy malnutrition of moderate and mild degree E E52 Niacin deficiency [pellagra] Deficiency: Marfan's syndrome Q Chapter IV Endocrine..

Schilder's disease G Refsum's disease G II E II Non-ketotic hyperglycinaemia Sarcosinaemia E Glucose-galactose malabsorption Sucrase deficiency Excludes: VII Syndrome: Acrodermatitis enteropathica E Alzheimer's disease G Syndrome of inappropriate secretion of antidiuretic hormone E Whipple's disease K Mental retardation F79 F Mental and behavioural disorders due to psychoactive substance use F19 F Disorders of adult personality and behaviour F69 F Disorders of psychological development F89 F Behavioural and emotional disorders with onset usually occurring in childhood F98 and adolescence F99 Unspecified mental disorder Asterisk categories for this chapter are provided as follows: Mood [affective] disorders F39 F Behavioural syndromes associated with physiological disturbances and physical F59 factors F The impairments of cognitive function are commonly accompanied.

Alzheimer's type Primary degenerative dementia of the Alzheimer's type. Alzheimer's disease. This syndrome occurs in Alzheimer's disease. Dementia FF03 is a syndrome due to disease of the brain. Use additional code. The dysfunction may be primary. The disorder is usually insidious in onset and develops slowly but steadily over a period of several years. Consciousness is not clouded. Onset is usually in middle or later life. Onset may be at any time in life.

The course is subacute. The cerebral cortex is usually preserved and this contrasts with the clinical picture which may closely resemble that of dementia in Alzheimer's disease.

Alzheimer's type F Predominantly cortical dementia F The infarcts are usually small but cumulative in their effect. In rare cases. Onset is usually in later life. Progression is slow. The disorder is transmitted by a single autosomal dominant gene. Dementia in Huntington's chorea F A dementia occurring as part of a widespread degeneration of the brain. Dementia in: Symptoms typically emerge in the third and fourth decade. No particular distinguishing clinical features have yet been demonstrated.

The duration is variable and the degree of severity ranges from mild to very severe. Korsakov's psychosis or syndrome. Confabulation may be a marked feature. The prognosis depends on the course of the underlying lesion. F04 Organic amnesic syndrome.

The extremes of psychomotor disturbance may alternate. Organic hallucinatory state nonalcoholic Excludes: Delusional elaboration of the hallucinations may occur..

Paranoid and paranoid-hallucinatory organic states Schizophrenia-like psychosis in epilepsy Excludes: Some features suggestive of schizophrenia. The delusions may be accompanied by hallucinations. None of these symptoms is so severe that a diagnosis of either dementia FF03 or delirium F It can be differentiated from postencephalitic syndrome F The disorder may precede.

This diagnosis should be made only in association with a specified physical disorder. Impairment of cognitive and thought functions. A disorder characterized by a partial or complete loss of the normal integration between memories of the past. There is often a marked feeling of mental fatigue when mental tasks are attempted. The principal difference between this disorder and the organic personality disorders is that it is reversible.

Postcontusional syndrome encephalopathy Post-traumatic brain syndrome. Chapter V Mental and behavioural disorders FF99 Mental and behavioural disorders due to psychoactive substance use FF19 This block contains a wide variety of disorders that differ in severity and clinical form but that are all attributable to the use of one or more psychoactive substances.

Other diagnoses should be coded when other psychoactive substances have been taken in intoxicating amounts common fourth character. Identification of the psychoactive substance should be based on as many sources of information as possible. The third character of the code identifies the substance involved.

Many drug users take more than one type of psychoactive substance. These include self-report data. Complications may include trauma. The codes should be used. The disturbances are directly related to the acute pharmacological effects of the substance and resolve with time.

Only in cases in which patterns of psychoactive substance-taking are chaotic and indiscriminate. The nature of these complications depends on the pharmacological class of substance and mode of administration. The main diagnosis should be classified. Psychoactive substance abuse. Convulsions may also occur. When organic factors are also considered to play a role in the etiology.

The onset and course of the withdrawal state are time-limited and are related to the type of psychoactive substance and dose being used immediately before cessation or reduction of use. The dependence syndrome may be present for a specific psychoactive substance e.

The withdrawal state may be complicated by convulsions. Delirium tremens alcohol-induced. Chronic alcoholism Dipsomania Drug addiction. The damage may be physical as in cases of hepatitis from the self- administration of injected psychoactive substances or mental e. Acute drunkenness in alcoholism "Bad trips" drugs Drunkenness NOS Pathological intoxication Trance and possession disorders in psychoactive substance intoxication Excludes: The disorder is characterized by hallucinations typically auditory.

Alcoholic dementia NOS Chronic alcoholic brain syndrome Dementia and other milder forms of persisting impairment of cognitive functions Flashbacks Late-onset psychoactive substance-induced psychotic disorder Posthallucinogen perception disorder Residual: Other cognitive functions are usually relatively well preserved and amnesic defects are out of proportion to other disturbances.

Disturbances of time sense and ordering of events are usually evident. The sensorium is usually clear but some degree of clouding of consciousness. Flashbacks may be distinguished from psychotic state partly by their episodic nature.

A cluster of psychotic phenomena that occur during or following psychoactive substance use but that are not explained on the basis of acute intoxication alone and do not form part of a withdrawal state. Cases in which initial onset of the state occurs later than episode s of such substance use should be coded here only where clear and strong evidence is available to attribute the state to the residual effect of the psychoactive substance.

Immediate recall is usually preserved and recent memory is characteristically more disturbed than remote memory. Onset of the disorder should be directly related to the use of the psychoactive substance. Amnestic disorder. Confabulation may be marked but is not invariably present.

F19 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances [See before F10 for subdivisions ] This category should be used when two or more psychoactive substances are known to be involved. It should also be used when the exact identity of some or even all the psychoactive substances being used is uncertain or unknown.

Schizoaffective disorders have been retained here in spite of their controversial nature. The most important psychopathological phenomena include thought echo. The course of schizophrenic disorders can be either continuous. F20 Schizophrenia The schizophrenic disorders are characterized in general by fundamental and characteristic distortions of thinking and perception. Nor should schizophrenia be diagnosed in the presence of overt brain disease or during states of drug intoxication or withdrawal.

Clear consciousness and intellectual capacity are usually maintained although certain cognitive deficits may evolve in the course of time. The diagnosis of schizophrenia should not be made in the presence of extensive depressive or manic symptoms unless it is clear that schizophrenic symptoms antedate the affective disturbance. Similar disorders developing in the presence of epilepsy or other brain disease should be classified under F The mood is shallow and inappropriate.

These depressive states are associated with an increased risk of suicide. Some schizophrenic symptoms. Paraphrenic schizophrenia Excludes: Hebephrenia should normally be diagnosed only in adolescents or young adults. Catatonic stupor Schizophrenic: The catatonic phenomena may be combined with a dream-like oneiroid state with vivid scenic hallucinations. Constrained attitudes and postures may be maintained for long periods. Episodes of violent excitement may be a striking feature of the condition.

Disturbances of affect.

ICD-10 Volume 1 - Tabular List

Disorganized schizophrenia Hebephrenia F If schizophrenic symptoms are still florid and prominent. Usually the prognosis is poor because of the rapid development of "negative" symptoms. There is a tendency to social isolation. Atypical schizophrenia Excludes: If the patient no longer has any schizophrenic symptoms. Paranoid schizophrenia is dominated by relatively stable. Chronic undifferentiated schizophrenia Restzustand schizophrenic Schizophrenic residual state F The symptoms may include a cold or inappropriate affect.

Latent schizophrenic reaction Schizophrenia: Asperger's syndrome F The characteristic negative features of residual schizophrenia e. There is no definite onset and evolution and course are usually those of a personality disorder. A chronic stage in the development of a schizophrenic illness in which there has been a clear progression from an early stage to a later stage characterized by long.

Clear and persistent auditory hallucinations voices. Paranoia Paranoid: F22 Persistent delusional disorders Includes a variety of disorders in which long-standing delusions constitute the only. Delusional dysmorphophobia Involutional paranoid state Paranoia querulans F The content of the delusion or delusions is very variable. Delusional disorders that have lasted for less than a few months should be classified.

The polymorphism and instability are characteristic for the overall clinical picture and the psychotic features do not justify a diagnosis of schizophrenia F Perplexity and puzzlement are often present but disorientation for time. Acute onset is defined as a crescendo development of a clearly abnormal clinical picture in about two weeks or less. A heterogeneous group of disorders characterized by the acute onset of psychotic symptoms such as delusions.

The disorder may or may not be associated with acute stress. Emotional turmoil with intense transient feelings of happiness or ecstasy. Complete recovery usually occurs within a few months. Acute undifferentiated schizophrenia Brief schizophreniform: These disorders often have an abrupt onset.

If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia F If the disorder persists. For these disorders there is no evidence of organic causation. If the symptoms persist the diagnosis should be changed to persistent delusional disorder F Mood-incongruent psychotic symptoms in affective disorders do not justify a diagnosis of schizoaffective disorder. Only one of the people suffers from a genuine psychotic disorder.

Paranoid reaction Psychogenic paranoid psychosis F This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective. Other conditions in which affective symptoms are superimposed on a pre-existing schizophrenic illness.

Acute psychotic disorders in which comparatively stable delusions or hallucinations are the main clinical features.

If the delusions persist the diagnosis should be changed to persistent delusional disorder F Schizoaffective psychosis. F30 Manic episode All the subdivisions of this category should be used only for a single episode. Loss of normal social inhibitions may result in behaviour that is reckless.

The disturbances of mood and behaviour are not accompanied by hallucinations or delusions. Self-esteem is often inflated with grandiose ideas and overconfidence. Increased sociability. Most of these disorders tend to be recurrent and the onset of individual episodes can often be related to stressful events or situations.

Hypomanic or manic episodes in individuals who have had one or more previous affective episodes depressive. Attention cannot be sustained. Elation is accompanied by increased energy. The mood change is usually accompanied by a change in the overall level of activity. Chapter V Mental and behavioural disorders FF99 Mood [affective] disorders FF39 This block contains disorders in which the fundamental disturbance is a change in affect or mood to depression with or without associated anxiety or to elation.

Repeated episodes of hypomania or mania only are classified as bipolar. In addition to the clinical picture described in F Mania with: Sleep is usually disturbed and appetite diminished. Capacity for enjoyment. The lowered mood varies little from day to day.

Self-esteem and self-confidence are almost always reduced and. Periods of remission during prophylactic treatment should be coded here.. Depending upon the number and severity of the symptoms. The patient is currently depressed. The more severe forms of recurrent depressive disorder F Suicidal thoughts and acts are common and a number of "somatic" symptoms are usually present.

If such an episode does occur. The first episode may occur at any age from childhood to old age. Single episodes of: The patient is usually distressed by these but will probably be able to continue with most activities. The risk that a patient with recurrent depressive disorder will have an episode of mania never disappears completely.

The hallucinations and delusions may or may not be mood-congruent. There may. Two or three of the above symptoms are usually present. Endogenous depression with psychotic symptoms Manic-depressive psychosis.

Endogenous depression without psychotic symptoms Major depression. This disorder is frequently found in the relatives of patients with bipolar affective disorder.

Some patients with cyclothymia eventually develop bipolar affective disorder. In some instances. Affective personality disorder Cycloid personality Cyclothymic personality F Because they last for many years. Persistent and usually fluctuating disorders of mood in which the majority of the individual episodes are not sufficiently severe to warrant being described as hypomanic or mild depressive episodes. Depressive and obsessional symptoms and social phobias are also commonly present as subsidiary features.

As a result these situations are characteristically avoided or endured with dread.

ICD - ICDCM - International Classification of Diseases, Tenth Revision, Clinical Modification

Contemplating entry to the phobic situation usually generates anticipatory anxiety. Whether two diagnoses. Anthropophobia Social neurosis F Symptoms may progress to panic attacks. Phobic anxiety and depression often coexist. More pervasive social phobias are usually associated with low self-esteem and fear of criticism.

They may present as a complaint of blushing. Agoraphobia without history of panic disorder Panic disorder with agoraphobia F Avoidance of the phobic situation is often prominent. The patient's concern may be focused on individual symptoms like palpitations or feeling faint and is often associated with secondary fears of dying.

Panic disorder is a frequent feature of both present and past episodes. Acrophobia Animal phobias Claustrophobia Simple phobia Excludes: As with other anxiety disorders.

The dominant symptoms are variable but include complaints of persistent nervousness. Fears that the patient or a relative will shortly become ill or have an accident are often expressed. Panic disorder should not be given as the main diagnosis if the patient has a depressive disorder at the time the attacks start. Though the triggering situation is discrete.

Phobias restricted to highly specific situations such as proximity to particular animals. Depressive and obsessional symptoms. There is often also a secondary fear of dying. Neither type of symptom is severe enough to justify a diagnosis if considered separately. Sometimes the ideas are an indecisive. They are almost invariably distressing and the patient often tries. Anxiety depression mild or not persistent F They are not inherently enjoyable.

If compulsive acts are resisted the anxiety gets worse. The relationship between obsessional ruminations and depression is particularly close and a diagnosis of obsessive-compulsive disorder should be preferred only if ruminations arise or persist in the absence of a depressive episode.

When both anxiety and depressive symptoms are present and severe enough to justify individual diagnoses. Anxiety is almost invariably present. Compulsive acts or rituals are stereotyped behaviours that are repeated again and again.

They are. Obsessional thoughts are ideas. Their function is to prevent some objectively unlikely event. The majority of compulsive acts are concerned with cleaning particularly handwashing. The disorders in this section can thus be regarded as maladaptive responses to severe or continued stress. The stressful events or the continuing unpleasant circumstances are the primary and overriding causal factor and the disorder would not have occurred without their impact.

This state may be followed either by further withdrawal from the surrounding situation to the extent of a dissociative stupor. The symptoms show a typically mixed and changing picture and include an initial state of "daze" with some constriction of the field of consciousness and narrowing of attention. Partial or complete amnesia F Individual vulnerability and coping capacity play a role in the occurrence and severity of acute stress reactions.

The symptoms usually appear within minutes of the impact of the stressful stimulus or event. Autonomic signs of panic anxiety tachycardia. In contrast.

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

Although less severe psychosocial stress "life events" may precipitate the onset or contribute to the presentation of a very wide range of disorders classified elsewhere in this chapter.

Underlying the overt behaviour is a fear. If the symptoms persist. Individual predisposition or vulnerability plays an important role in the risk of occurrence and the shaping of the manifestations of adjustment disorders.

The predominant feature may be a brief or prolonged depressive reaction. Typical features include episodes of repeated reliving of the trauma in intrusive memories "flashbacks". Traumatic neurosis F The onset follows the trauma with a latency period that may range from a few weeks to months. The course is fluctuating but recovery can be expected in the majority of cases. The manifestations vary and include depressed mood. Conduct disorders may be an associated feature.

There is usually a state of autonomic hyperarousal with hypervigilance. Culture shock Grief reaction Hospitalism in children Excludes: The stressor may have affected the integrity of an individual's social network bereavement. Anxiety and depression are commonly associated with the above symptoms and signs.

Predisposing factors. In a small proportion of cases the condition may follow a chronic course over many years. The symptoms may develop in close relationship to psychological stress. The diagnosis should not be made in the presence of organic brain disorders. The possibility of the later appearance of serious physical or psychiatric disorders should always be kept in mind.

More chronic disorders. The amnesia is usually centred on traumatic events. If this is the case. These disorders have previously been classified as various types of "conversion hysteria".

The symptoms often represent the patient's concept of how a physical illness would be manifest. Medical examination and investigation do not reveal the presence of any known physical or neurological disorder.

In addition. All types of dissociative disorders tend to remit after a few weeks or months. Disorders involving pain and other complex physical sensations mediated by the autonomic nervous system are classified under somatization disorder F They are presumed to be psychogenic in origin.

Complete and generalized amnesia is rare. Only disorders of physical functions normally under voluntary control and loss of sensations are included here. Dissociative fugue has all the features of dissociative amnesia.. Include here only trance states that are involuntary or unwanted. There may be close resemblance to almost any variety of ataxia. Although there is amnesia for the period of the fugue.

Loss of vision and hearing are rarely total in dissociative disorders. The course of the disorder is chronic and fluctuating. Tourette's syndrome F Psychogenic deafness F There may be differential loss between the sensory modalities which cannot be due to a neurological lesion.

Most patients have a long and complicated history of contact with both primary and specialist medical care services. Short-lived less than two years and less striking symptom patterns should be classified under undifferentiated somatoform disorder F Anaesthetic areas of skin often have boundaries that make it clear that they are associated with the patient's ideas about bodily functions.

Sensory loss may be accompanied by complaints of paraesthesia. Symptoms may be referred to any part or system of the body. If any physical disorders are present.

Marked depression and anxiety are often present. Body dysmorphic disorder Dysmorphophobia nondelusional Hypochondriacal neurosis Hypochondriasis Nosophobia Excludes: The symptoms are usually of two types. Undifferentiated psychosomatic disorder F Patients manifest persistent somatic complaints or a persistent preoccupation with their physical appearance.

Briquet's disorder Multiple psychosomatic disorder Excludes: Normal or commonplace sensations and appearances are often interpreted by patients as abnormal and distressing. Pain presumed to be of psychogenic origin occurring during the course of depressive disorders or schizophrenia should not be included here.

The result is usually a marked increase in support and attention. Psychalgia Psychogenic: Cardiac neurosis Da Costa's syndrome Gastric neurosis Neurocirculatory asthenia Psychogenic forms of: In the other type. In one type. The mental fatiguability is typically described as an unpleasant intrusion of distracting associations or recollections. The sensorium is normal and the capacity for emotional expression intact. In both types a variety of other unpleasant physical feelings is common.

Fatigue syndrome Use additional code. In spite of the dramatic nature of the experience. Sleep is often disturbed in its initial and middle phases but hypersomnia may also be prominent.

In such cases the diagnosis should be that of the main disorder. Among the varied phenomena of the syndrome. Depersonalization-derealization symptoms may occur as part of a diagnosable schizophrenic. Worry about decreasing mental and bodily well-being. It occurs most commonly in adolescent girls and young women.

For instance. The symptoms include restricted dietary choice. Repeated vomiting is likely to give rise to disturbances of body electrolytes and physical complications. This disorder shares many psychological features with anorexia nervosa. There is usually undernutrition of varying severity with secondary endocrine and metabolic changes and disturbances of bodily function.

There is often. This diagnosis should not be made in the presence of known physical disorders associated with weight loss. The disorder is associated with a specific psychopathology whereby a dread of fatness and flabbiness of body contour persists as an intrusive overvalued idea. This subcategory may also be used in addition to O This category includes only those sleep disorders in which emotional causes are considered to be a primary factor.

Whether a sleep disorder in a given patient is an independent condition or simply one of the features of another disorder classified elsewhere. Psychogenic overeating Excludes: Psychogenic vomiting Excludes: Psychogenic inversion of: Quite often he or she rushes to the door as if trying to escape. Upon awakening the individual rapidly becomes alert and oriented.

In the absence of an organic factor for the occurrence of hypersomnia.

There is very detailed recall of the dream content. Upon awakening. During a typical episode there is a degree of autonomic discharge but no appreciable vocalization or body motility. The dream experience is very vivid and usually includes themes involving threats to survival.

Dream anxiety disorder F

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