national prescription drug plan formulary supplement plan icd-9 diagnosis... · national...
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TABLE OF CONTENTS
PREFACE ............................................................................................... 3
Diagnosis Codes for Arthritis ............................................................... 4
Diagnosis Codes for Asthma ................................................................ 6
Diagnosis Codes for Benign Prostate Hypertrophy ............................. 7
Diagnosis Codes for Cancer - (Breast & Prostate) .............................. 8
Diagnosis Codes for Diabetes............................................................ 10
Diagnosis Codes for Epilepsy ............................................................. 12
Diagnosis Codes for Glaucoma ......................................................... 13
Diagnosis Codes for Hypercholesterolemia ...................................... 16
Diagnosis Codes for Hypertension .................................................... 17
Diagnosis Codes for Ischaemic Disease ........................................... 19
Diagnosis Codes for Sickle Cell Anemia ............................................ 41
Diagnosis Codes for Thyroid Disease ................................................ 42
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PREFACE
The National Prescription Drug Plan (NPDP) is committed to providing accountable and pertinent information to all health care providers in The Bahamas. This supplementary booklet serves as a reference guide for physicians, nurses and other relevant staff of health care facilities who may assist in completing the NPDP Registration Forms for patients. The information provided in this supplementary booklet is derived from the 2012 ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification). It details the recommended ICD-9-CM codes for the 2012-2013 NPDP Chronic Conditions which include: Arthritis, Asthma, Benign Prostate Cancer (BPH), Cancer (Breast and Prostate), Diabetes, Epilepsy, Glaucoma, Hypercholesterolemia, Hypertension, Ischaemic Disease, Psychiatric Illness, Sickle Cell Anemia and Thyroid Disease.
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Diagnosis Codes for Arthritis
Code Description
714.0 Rheumatoid arthritis (excludes juvenile arthritis) Requires *5th digit subclassification as noted in brackets: (e.g. 715.01) 0 - site unspecified 1 - shoulder region 2 - upper arm 3 - forearm 4 - hand 5 - pelvic region and thigh 6 - lower leg 7 - ankle and foot 8 - other specified sites 9 - multiple sites
714.1 Felty’s syndrome (rheumatoid arthritis w/ splenoadenomegaly & leukopenia)
714.2 Other rheumatoid arthritis with visceral of systemic involvement (rheumatoid carditis)
714.3 Juvenile chronic polyarthritis
714.30 Polyarticular juvenile rheumatoid arthritis, chronic or unspecified (Still’s disease)
714.31 Polyarticular juvenile rheumatoid arthritis, acute
714.32 Pauciarticular juvenile rheumatoid arthritis
714.33 Monoarticular juvenile rheumatoid arthritis
714.4 Chronic post-rheumatic arthropathy
714.8 Other specified inflammatory polyarthopathies
714.81 Rheumatoid lung (Caplan’s syndrome)
715 Osteoarthrosis and allied disorders
*715.0 (0,4,9)
Osteoarthrosis, generalized (Degenerative joint disease, involving multiple joints)
*715.1 (0-8)
Osteoarthrosis, localized, primary (Localized osteoarthropathy, idiopathic)
*715.2 (0-8)
Osteoarthrosis, localized, secondary (Coxae malum senilis)
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Code Description
*715.3 (0-8)
Osteoarthrosis, localized, not specified whether primary or secondary
*715.8 (0,9)
Osteoarthosis involving, or with mention of more than one site, but not specified as generalized
*715.9 (0-8)
Osteoarthosis, unspecified whether generalized or localized
*716.2 (0-9) Allergic arthritis
*716.3 (0-9) Climacteric arthritis (Menopausal arthritis)
*716.5 (0-9) Unspecified polyarthropathy or polyarthritis
*716.6 (0-8) Unspecified monoarthritis
*716.8 (0-9) Other specified arthropathy
*716.9 (0-9) Arthropathy, unspecified (acute, chronic,subacute)
274 Gout
274.0 Gouty arthropathy
274.00 Gouty arthropathy, unspecified
274.01 Acute gouty arthropathy
274.1 Gouty nephropathy
274.10 Gout nephropathy, unspecified
274.11 Uric acid nephrolithiasis
274.9 Gout, unspecified
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Diagnosis Codes for Asthma
Code Description
493 Asthma (excludes wheezing) Requires *5th digit subclassification as noted in brackets: (e.g. 493.00) 0 - unspecified 1 - with status asthmaticus 2 - with (acute) exacerbation
*493.0 (0-2) Extrinsic asthma
*493.1 (0-2) Intrinsic asthma
*493.2 (0-2) Chronic obstructive asthma
493.8 Other forms of asthma
493.81 Exercise induced bronchospasm
493.82 Cough variant asthma
*493.9 (0-2) Asthma, unspecified
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Diagnosis Codes for Benign Prostate Hypertrophy (BPH)
Code Description
600 Hypertrophy (benign) of prostate
600.00 Hypertrophy (benign) of prostate without urinary obstruction and other lower tract symptoms (LUTS)
600.01 Hypertrophy (benign) of prostate with urinary obstruction and other lower tract symptoms (LUTS)
600.1 Nodular prostate
600.10 Nodular prostate without urinary obstruction
600.11 Nodular prostate with urinary obstruction
600.2 Benign localized hyperplasia of prostate
600.20 Benign localized hyperplasia of prostate without urinary obstruction and other lower urinary tract symptoms (LUTS)
600.21 Benign localized hyperplasia of prostate with urinary obstruction and other lower urinary tract symptoms (LUTS)
600.3 Cyst of prostate
600.9 Hyperplasia of prostate, unspecified
600.90 Hyperplasia of prostate, unspecified, without urinary obstruction and other lower urinary tract symptoms
600.91 Hyperplasia of prostate, unspecified, with urinary obstruction and other lower urinary tract symptoms
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Diagnosis Codes for Cancer - (Breast & Prostate)
Breast Cancer:
Code Description
174 Malignant neoplasm of female breast (excludes skin of breast)
174.0 • Nipple and areola
174.1 • Central portion
174.2 • Upper-inner quadrant
174.3 • Lower-inner quadrant
174.4 • Upper-outer quadrant
174.5 • Lower-outer quadrant
174.6 • Axillary tail
174.8 Other specified sites of female breast
174.9 Breast (female), unspecified
175 Malignant neoplasm of male breast (excludes skin of breast)
175.0 • Nipple and areola
175.9 • Other specified sites of male breast
233 Carcinoma in situ of breast and genitourinary system
233.0 Carcinoma in situ of breast
239.3 Neoplasm of breast
198.8 Other specified sites (secondary malignant)
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198.81 • Breast
Prostate Cancer:
Code Description
185 Malignant neoplasm of prostate
198.82 Secondary malignant neoplasm of genital organ (includes prostate)
222.2 Benign neoplasm of prostate
233 Carcinoma in situ of breast and genitourinary system (Breast)
233.4 Carcinoma in situ of prostate
236.5 Neoplasm of uncertain behavior of genitourinary organs (Prostate)
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Diagnosis Codes for Diabetes
Code Description
*249 Secondary diabetes mellitus
Requires *4th or *5th digit subclassification as noted in brackets: (e.g. 250.1 or 250.01) 1 - type 1 (juvenile type), not stated as uncontrolled 2 - type 2 or unspecified type, uncontrolled 3 - type 1 (juvenile type), uncontrolled
*249.0 (0-1) Secondary diabetes mellitus without mention of complication
*249.1 (0-1) Secondary diabetes mellitus with ketoacidosis
*249.2 (0-1) Secondary diabetes mellitus with hyperosmolarity
*249.3 (0-1) Secondary diabetes mellitus with other coma (excludes hyperosmolar coma)
*249.4 (0-1) Secondary diabetes mellitus with renal manifestations
*249.5 (0-1) Secondary diabetes mellitus with opthalmic manifestations
*249.6 (0-1) Secondary diabetes mellitus with neurological manifestations
*249.7 (0-1) Secondary diabetes mellitus with peripheral circulatory disorders
*249.8 (0-1) Secondary diabetes mellitus with other specified manifestations
*249.9 (0-1) Secondary diabetes mellitus with unspecified complication
*250 Diabetes mellitus
*250.0 Diabetes mellitus without mention of complication
*250.1 (0-3) Diabetes with ketoacidosis
*250.2 (0-3) Diabetes with hyperosmolarity
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Code Description
*250.3 (0-3) Diabetes with other coma (excludes diabetes with hyperosmolarity coma)
*250.4 (0-3) Diabetes with renal manifestations
*250.5 (0-3) Diabetes with ophthalmic manifestations
*250.6 (0-3) Diabetes with neurological manifestations
*250.7 (0-3) Diabetes with peripheral circulatory disorders
*250.8 (0-3) Diabetes with other specified manifestations
*250.9 (0-3) Diabetes with unspecified complication
251 Other disorders of pancreatic internal secretion
251.0 Hypoglycemic coma
251.1 Other specified hypoglycemia: Hyperinsulinism; Hyperplasia of pancreatic islet beta cells NOS
251.2 Hypoglycemia, unspecified
251.3 Postsurgical hypoinsulinemia
251.4 Abnormality of secretion of glucagon
251.5 Abnormality of secretion of gastrin
251.8 Other specified disorders of pancreatic internal secretion
251.9 Unspecified disorder of pancreatic internal secretion
253.5 Diabetes insipidus
271.4 Renal glycosuria (renal diabetes)
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Diagnosis Codes for Epilepsy
Code Description
345 Epilepsy and recurrent seizures
Requires * 4th or *5th digit subclassification as noted in brackets: (e.g. 345.1, 345.11) 0 – without mention of intractable epilepsy 1 - with intractable epilepsy
*345.0 (0,1) Generalized non-convulsive epilepsy
*345.1 (0,1) Generalized convulsive epilepsy
*345.2 (0,1) Petit mal status
*345.3 (0,1) Grand mal status
*345.4 (0,1) Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures
*345.5 (0,1) Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures
*345.6 (0,1) Infantile spasms
*345.7 (0,1) Epilepsia partialis continua
*345.8 (0,1) Other forms of epilepsy and recurrent seizures
*345.9 (0,1) Epilepsy, unspecified
780.3 Convulsions
780.31 Febrile convulsions (simple), unspecified
780.32 Complex febrile convulsions
780.33 Post traumatic seizures
780.39 Other convulsions (Fits NOS, Recurrent convulsions NOS, Seizures NOS, Convulsive disorder NOS)
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Diagnosis Codes for Glaucoma
Code Description
365 Glaucoma (excludes absolute glaucoma)
365.0 Borderline glaucoma (glaucoma suspect)
365.00 Pre-glaucoma, unspecified
365.01 Open angle with borderline findings
365.02 Anatomical narrow angle
365.03 Steroid responders
365.04 Ocular hypertension
365.1 Open angle glaucoma
365.10 Open angle glaucoma, unspecified
365.11 Primary open angle glaucoma
365.12 Low tension glaucoma
365.13 Pigmentary glaucoma
365.14 Glaucoma of childhood
365.15 Residual stage of open angle glaucoma
365.2 Primary angle-closure glaucoma
365.20 Primary angle-closure glaucoma, unspecified
365.21 Intermittent angle-closure glaucoma
365.22 Acute angle-closure glaucoma
365.23 Chronic angle-closure glaucoma
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Code Description
365.24 Residual stage of angle-closure glaucoma
365.3 Corticosteroid-induced glaucoma
365.31 • Glaucomatous stage
365.32 • Residual stage
365.4 Glaucoma associated with congenital anomalies, dystrophies, and systemic syndromes
365.41 Glaucoma associated with chamber angle anomalies
365.42 Glaucoma associated with anomalies of iris
365.43 Glaucoma associated with other anterior segment anomalies
(250.00) Glaucoma associated with systemic syndromes (diabetes)
365.44
365.5 Glaucoma associated with disorders of the lens
365.51 Phacolytic glaucoma
365.52 Pseudo-exfoliation glaucoma
365.59 Glaucoma associated with other lens disorders
365.6 Glaucoma associated with other ocular disorders
365.60 Glaucoma associated with unspecified ocular disorders
365.61 Glaucoma associated with pupillary block
365.62 Glaucoma associated with ocular inflammation
365.63 Glaucoma associated vascular disorders
365.64 Glaucoma associated with tumors or cysts
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Code Description
365.65 Glaucoma associated with ocular trauma
365.7 Glaucoma stage
365.70 Glaucoma stage, unspecified
365.71 Mild stage glaucoma
365.72 Moderate stage glaucoma
365.73 Severe stage glaucoma
365.74 Indeterminate stage glaucoma
365.8 Other specified forms of glaucoma
365.81 Hypersecretion of glaucoma
365.82 Glaucoma with increased episcleral venous pressure
365.83 Aqueous misdirection (malignant glaucoma)
365.89 Other specified glaucoma
365.9 Unspecified glaucoma
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Diagnosis Codes for Hypercholesterolemia
Code Description
272 Disorders of lipid metabolism
272.0 Pure hypercholesterolemia
272.1 Pure hyperglyeridemia
272.2 Mixed hyperlipidemia
272.3 Hyperchylomicronemia
272.4 Other and unspecified hyperlipidemia
272.5 Lipoprotein deficiencies
272.6 Lipodystrophy
272.7 Lipidoses
272.8 Other disorders of lipoid metabolism
272.9 Unspecified disorder of lipoid metabolism
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Diagnosis Codes for Hypertension
Code Description
401 Essential hypertension
Requires *4th or *5th digit sub-classification as noted in brackets: (e.g. 404.2, 404.91) 0 - without heart failure and with chronic kidney disease stage 1 thru 4 or specified 1 - with heart failure and with chronic kidney disease stage 1 thru 4 or specified
401.0 • Malignant (Severe high arterial BP possibly resulting in necrosis)
401.1 • Benign (Mildly elevated arterial blood pressure)
402 Hypertensive heart disease
402.0 • Malignant
402.00 >> without heart failure
402.01 >> with heart failure
402.1 • Benign
402.10 >> without heart failure
402.11 >> with heart failure
402.9 Unspecified hypertension (Cardiomegaly, cardiopathy, CV disease, heart disease failure)
402.90 >> without heart failure
402.91 >> with heart failure
*403 Hypertensive chronic kidney disease
*403.0 (0,1) Malignant chronic kidney disease
*403.1 (0,1) Benign chronic kidney disease
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Code Description
*403.9 (0,1) Unspecified chronic kidney disease
*404 (0-3) Hypertensive heart and chronic kidney disease
*404.0 (0-3) • Malignant
*404.1 (0-3) • Benign
*404.9 (0-3) • Unspecified
405 Secondary hypertension (High arterial BP due to primary diseases eg. Renal disorders)
405.0 Malignant secondary hypertension
405.01 • Renovascular
405.09 • Other
405.1 Benign secondary hypertension
405.11 • Renovascular
405.19 • Other
405.9 Unspecified secondary hypertension
405.91 • Renovascular
405.99 • Other
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Diagnosis Codes for Ischaemic Disease
Code Description
*410 Acute myocardial infarction
*Requires 5th digit classification as noted in brackets: (e.g. 410.02, 410.61)* 0 – episode of care unspecified 1 – initial episode of care 2 – subsequent episode of care
*410.0 • Of anterolateral wall
*410.1 • Of other anterior wall
*410.2 • Of inferolateral wall
*410.3 • Of inferoposterior wall
*410.4 • Of other inferior wall (diagphragmatic wall NOS)
*410.5 • Of other lateral wall (apical-lateral; basal lateral; high lateral; posterolateral)
*410.6 True posterior wall infarction
*410.7 Subendocardial infarction
*410.8 Of other specified sites (atrium, papillary muscle, septum alone)
*410.9 Unspecified site (acute myocardial infarction NOS, coronary occlusion NOS, myocardial infarction NOS)
411 Other acute and subacute forms of ischemic heart disease
411.0 Postmyocardial infarction syndrome
411.1 Intermediate coronary syndrome (impending infarction, pre-infarction angina, pre-infarction syndrome, unstable angina)
411.81 Acute coronary occlusion without myocardial infarction
411.89 Other (coronary insufficiency (acute)); subendocardial ischaemia
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Code Description
412 Old myocardial infarction
413 Angina pectoris
413.0 Angina decubitus (nocturnal angina)
413.1 Prinzmetal angina (variant angina pectoris)
413.9 Other and unspecified angina pectoris (angina syndrome, status anginosus, stenocardia, syncope anginosa)
414 Other forms of chronic ischemic heart disease
414.0 Coronary atherosclerosis
414.00 Of unspecified type of vessel, native or graft
414.01 Of native coronary artery
414.02 Of autologous vein bypass graft
414.03 Of nonautologous biological bypass graft
414.04 Of artery bypass graft
414.05 Of unspecified type of bypass graft
414.06 Of native coronary artery of transplanted heart
414.07 Of bypass graft (artery) (vein) of transplanted heart
414.1 Aneurysm and dissection of heart
414.10 Aneurysm of heart (wall)
414.11 Aneurysm of coronary vessels
414.12 Dissection of coronary artery
414.19 Other aneurysm of heart
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Code Description
414.2 Chronic total occlusion of coronary artery
414.3 Coronary atherosclerosis due to lipid rich plaque
414.8 Other specified forms of chronic ischemic heart disease
414.9 Chronic ischemic heart disease, unspecified
415 Acute pulmonary heart disease
415.0 Acute cor pulmonale
415.1 Pulmonary embolism and infarction
415.11 Iatrogenic pulmonary embolism and infarction
415.12 Septic pulmonary embolism
415.13 Saddle embolus of pulmonary artery
416 Chronic pulmonary heart disease
416.0 Primary pulmonary hypertension
416.1 Kyphoscoliotic heart disease
416.2 Chronic pulmonary embolism
416.8 Other chronic pulmonary heart disease
416.9 Chronic pulmonary heart disease, unspecified
417 Other diseases of pulmonary circulation
417.0 Arteriovenous fistula of pulmonary vessels
417.1 Aneurysm of pulmonary artery
417.8 Other specified diseases of pulmonary circulation
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Code Description
417.9 Unspecified disease of pulmonary circulation
427 Cardiac disrhythmias
427.0 Paroxysmal supraventricular tachycardia
427.1 Paroxysmal ventricular tachycardia
427.2 Paroxysmal tachycardia, unspecified
427.3 Atrial fibrillation and flutter
427.31 Atrial fibrillation
427.32 Atrial flutter
427.4 Ventricular fibrillation and flutter
427.41 Ventricular fibrillation
427.42 Ventricular flutter
427.5 Cardiac arrest
427.6 Premature beats
427.60 Premature beats, unspecified
427.61 Supraventricula premature beats
427.69 Other (Ventricular premature beats, contractions or systoles)
427.8 Other specified cardiac dysrhythmias
427.81 Sinoatrial node dysfunction
427.89 Other (Rhythm disorder: coronary sinus, ectopic or nodal; wandering (atrial) pacemaker)
427.9 Cardiac dysrhythmia, unspecified
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Code Description
428 Heart failure
428.0 Congestive heart failure, unspecified
428.1 Left heart failure
428.2 Systolic heart failure
428.20 • Unspecified
428.21 • Acute
428.22 • Chronic
428.23 • Acute on chronic
428.3 Diastolic heart failure
428.30 • Unspecified
428.31 • Acute
428.32 • Chronic
428.33 • Acute on chronic
428.4 Combined systolic and diastolic heart failure
428.40 • Unspecified
428.41 • Acute
428.42 • Chronic
428.43 • Acute on chronic
428.9 Heart failure, unspecified
429 Ill-defined descriptions and complications of heart disease
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Code Description
429.0 Myocarditis, unspecified
429.1 Myocardial degeneration
429.2 Cardiovascular disease, unspecified
429.3 Cardiomegaly
429.4 Functional disturbances following cardiac surgery
429.5 Rupture of chordae tendineae
429.6 Rupture of papillary muscle
429.7 Certain sequelae of myocardial infarction, not elsewhere classified
429.71 Acquired cardiac septal defect
429.79 Other (Mural thrombus (atrial) (ventricular) acquired following myocardial infarction)
429.8 Other ill-defined heart diseases
429.81 Other disorders of papillary muscle
429.82 Hyperkinetic heart disease
429.83 Takotsubo syndrome
429.89 Other (Carditis)
429.9 Heart disease, unspecified
*433 Occlusion and stenosis precerebral arteries
*433.0 Basilar artery
*433.1 Carotid artery
*433.2 Vertebral artery
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Code Description
*433.3 Multiple and bilateral *Requires 4th or 5th digit classification as noted in brackets: (eg. 433.31, 433.00, etc.) 0 – without mention of cerebral infarction 1 – with cerebral infarction
*433.8 Other specified precerebral artery
*433.9 Unspecified precerebral artery
*434 Occlusion of cerebral arteries
*434.0 Cerebral thrombosis
*434.1 Cerebral embolism
*434.9 Cerebral artery occlusion, unspecified
435 Transient cerebral ischemia
435.0 Basilar artery syndrome
435.1 Vertebral artery syndrome
435.2 Subclavian steal syndrome
435.3 Vertebrobasilar artery syndrome
435.8 Other specified transient cerebral ischemias
435.9 Unspecified transient cerebral ischemia
437 Cerebral atherosclerosis
437.1 Other generalized ischemic cerebrovascular disease
440 Atherosclerosis
440.0 • Of aorta
440.1 • Of renal artery
440.2 • Of native arteries of the extremities
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Code Description
440.20 Atherosclerosis of the extremities, unspecified
440.21 Atherosclerosis of the extremities with intermittent claudication
440.22 Atherosclerosis of the extremities with rest pain
440.23 Atherosclerosis of the extremities with ulceration
440.24 Atherosclerosis of the extremities with gangrene
440.29 Other
440.3 Of bypass graft of the extremities
440.30 • Of unspecified graft
440.31 • Of autologous vein bypass graft
440.32 • Of nonautologous vein bypass graft
440.4 Chronis total occlusion of artery of the extremities
440.8 Of other specified arteries
440.9 Generalized and unspecified atherosclerosis
443 Other peripheral vascular disease
443.0 Raynaud’s syndrome
443.9 Peripheral vascular disease, unspecified
444 Arterial embolism and thrombosis
444.0 • Of abdominal aorta
440.09 Other arterial embolism and thrombosis of abdominal aorta
444.1 • Of thoracic aorta
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Code Description
444.2 • Of arteries of the extremities
444.21 Upper extremity
444.22 Lower extremity
444.8 • Of other specified artery
444.81 Iliac artery
444.89 Other
445 Atheroembolism
445.0 • Of extremities
445.01 Upper extremity
445.02 Lower extremity
445.8 • Of other sites
445.81 Kidney
445.89 Other site
785.51 Cardiogenic shock
786.5 Chest pain, unspecified
786.52 Precordial pain
786.59 Other chest pain (exhibiting discomfort, pressure and tightness)
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Diagnosis Codes for Psychiatric Illness
Code Description
290 Dementias
290.0 Senile dementia, uncomplicated
290.1 Presenile dementia
290.10 Presenile dementia, unspecified
290.11 Presenile dementia with delirium
290.12 Presenile dementia with delusional features
290.13 Presenile dementia with delusional or depressive features
290.2 Senile dementia with delusional or depressive features
290.20 Senile dementia with delusional features
290.21 Senile dementia with depressive features
290.3 Senile dementia with delirium
290.4 Vascular dementia
290.40 Vascular dementia, uncomplicated
290.41 Vascular dementia, with delirium
290.42 Vascular dementia, with delusions
290.43 Vascular dementia, with depressed mood
290.8 Other specified senile psychotic condition
290.9 Unspecified senile psychotic condition
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Code Description
293 Transient mental disorders due to condition classified elsewhere
293.0 Delirium due to conditions classified elsewhere
293.1 Subacute delirium
293.8 Other specified transient mental disorders due to conditions classified elsewhere
293.81 Psychotic disorder with delusions in conditions classified elsewhere
293.82 Psychotic disorder with hallucinations in conditions classified elsewhere
293.83 Mood disorder in conditions classified elsewhere
293.84 Anxiety disorder in conditions classified elsewhere
293.89 • Other
293.9 Unspecified transient mental disorder in conditions classified elsewhere
294 Persistent mental disorders due to conditions classified elsewhere
294.2 Dementia, unspecified
294.20 Dementia, unspecified, without behavioral disturbance
294.21 Dementia, unspecified, with behavioral disturbance
294.8
Other persistent mental disorders due to conditions classified elsewhere (Amnestic disorder NOS, Dementia NOS, Epileptic psychosis NOS, Mixed paranoid and affective organic psychotic states)
294.9 Unspecified persistent mental disorder mental disorders due to conditions classified elsewhere (Cognitive disorder NOS)
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Code Description
*295 (0-5) Schizophrenia disorders
*Requires 4th or 5th digit classification as noted in brackets: (295.04, 295.65, etc.) 0 – unspecified 1 – subchronic 2 – chronic 3 – chronic with acute exacerbation 4 – chronic with acute exacerbation 5 – in remission
*295.0 (0-5) • Simple type
*295.1 (0-5) • Disorganized type
295.2 (0-5) • Catatonic type
*295.3 (0-5) • Paranoid type
*295.5 (0-5) • Latent schizophrenia
*295.6 (0-5) • Residual type
*295.7 (0-5) • Schizoaffective disorder
*295.8 (0-5) • Other specified types of schizophrenia (acute, atypical or cenesthopathic schizophrenia)
*296 Episodic mood disorders *Requires 4th or 5th digit classification as noted in brackets: (296.36, 296.61) 0 – unspecified 1 – mild 2 – moderate 3 – severe, without mention of psychotic behavior 4 – severe, specified as with psychotic behavior 5 – in partial or unspecified remission 6 – in full remission
*296.0 (0-6) Bipolar 1 disorder, single manic episode
*296.1 (0-6) Manic disorder, recurrent episode
*296.2 (0-6) Major depressive disorder, single episode
*296.3 (0-6) Major depressive disorder, recurrent episode
*296.4 (0-6) Bipolar 1 disorder, most recent episode (or current) manic
*296.5 (0-6) Bipolar 1 disorder, most recent episode (or current) depressed
*296.6 (0-6) Bipolar 1 disorder, most recent episode (or current) mixed
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Code Description
296.7 Bipolar 1 disorder, most recent episode (or current) unspecified
296.8 Other and unspecified bipolar disorders
296.80 • Bipolar disorder, unspecified
296.81 • Atypical manic disorder
296.82 • Atypical depressive order
296.89 • Other
296.9 Other and unspecified episodic mood disorder
296.90 • Unspecified episodic mood disorder
296.99 • Other specified mood disorder
297 Delusional disorders
297.0 Paranoid state, simple
297.1 Delusional disorder
297.2 Paraphrenia
297.3 Shared psychotic disorder
297.8 Other specified paranoid states
297.9 Unspecified paranoid state
298 Other nonorganic psychoses (emotional stress or environmental factors as major part of etiology)
298.0 Depressive type psychosis
298.1 Excitative type psychosis 298.2 Reactive confusion
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Code Description
298.3 Acute paranoid reaction
298.4 Psychogenic paranoid psychosis
298.8 Other and unspecified reactive psychosis
298.9 Unspecified psychosis
*299.0 (0,1) Autistic disorder
*Requires 5th digit classification as noted in brackets: (e.g. 299.01, etc) 0 – current or active state 1 – residual state
*299.8 (0,1) Other specified pervasive developmental disorders
*299.9 (0,1) Unspecified pervasive developmental disorder
300 Anxiety, dissociative and somatoform disorders
300.0 • Anxiety states
300.00 Anxiety state, unspecified
300.01 Panic disorder without agoraphobia
300.02 Generalized anxiety disorder
300.09 Other
300.1 Dissociative, conversion and factitious disorders
300.10 Hysteria, unspecified
300.11 Conversion disorder
300.12 Dissociative amnesia
300.13 Dissociative fugue
300.14 Dissociative identity disorder
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Code Description
300.15 Dissociative disorder with predominantly psychological signs and symptoms
300.16 Factitious disorder with predominantly psychological signs and symptoms
300.19 Other and unspecified factitious illness
300.2 Phobic disorders
300.2 Phobia, unspecified
300.21 Agoraphobia with panic disorder
300.22 Agoraphobia without mention of panic attacks
300.23 Social phobia
300.29 Other isolated or specified phobias
300.3 Obsessive-compulsive disorders
300.4 Dysthymic disorder
300.5 Neurasthenia
300.6 Depersonalization disorder
300.7 Hypochondriasis
300.8 Somatoform disorders
300.81 • Somatization disorder
300.82 • Undifferentiated somatoform disorders
300.89 • Other somatoform disorders
300.9 Unspecified nonpsychotic mental disorder 301 Paranoid personality disorders
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Code Description
301.1 Affective personality disorder
301.10 • Unspecified
301.11 Chronic hypomanic personality disorder
301.12 Chronic depressive personality disorder
301.13 Cyclothymic disorder
301.2 Schizoid personality disorder
301.20 • Unspecified
301.21 Introvert personality
301.22 Schizotypal personality disorder
301.3 Explosive personality disorder
301.5 Histrionic personality disorder
301.50 • Unspecified
301.51 Chronic factitious illness with physical symptoms
301.59 Other histrionic personality disorder
301.6 Dependent personality disorder
301.7 Antisocial personality disorder
301.8 Other personality disorders
301.81 Narcissistic personality disorder
301.82 Avoidant personality disorder
301.83 Borderline personality disorder
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Code Description
301.84 Passive-aggressive personality
301.89 • Other
301.9 Unspecified personality disorder
*303 Alcohol dependence syndrome *Requires 4th or 5th digit classification as noted in brackets: (e.g. 303.2, 303.01) 0 – unspecified 1 – continuous 2 – episodic 3 – in remission
*303.0 (0-3) Acute alcoholic intoxication
*303.9 (0-3) Other and specified alcohol dependence
*304 Drug dependence
*304.0 (0-3) Opoid type dependence
*304.1 (0-3) Sedative, hypnotic or anxiolytic dependence
*304.2 (0-3) Cocaine dependence
*304.3 (0-3) Cannabis dependence
*304.4 (0-3) Amphetamine and other psychostimulant dependence
*304.5 (0-3) Hallucinogen dependence
*304.6 (0-3) Other specified drug dependence
*304.7 (0-3) Combination of opoid type drug with any other
*304.8 (0-3) Combinations of drug dependence excluding opoid type drug
*304.9 (0-3) Unspecified drug dependence
*305 (0-3) Nondependent abuse of drugs
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Code Description
*305.0 (0-3) Alcohol abuse
305.1 Tobacco use disorder
*305.2 (0-3) Cannabis abuse
*305.3 (0-3) Hallucinogen abuse
*305.4 (0-3) Sedative, hypnotic or anxiolytic abuse
*305.6 (0-3) Cocaine abuse
*305.7 (0-3) Amphetamine or related acting sympathomimetic abuse
*305.8 (0-3) Antidepressant type abuse
*305.9 (0-3) Other, mixed, or unspecified drug abuse
*306 (0-3) Physiological malfunction arising from mental factors
306.0 • Musculoskeletal (psychogenic paralysis; psychogenic torticollis)
306.1 • Respiratory (air hunger; hiccough, cough, hyperventilation, etc.)
306.2 • Cardiovascular (cardiac neurosis;
neurocirculatory asthenia; psychogenic cardiovascular disorder)
306.3 • Skin (psychogenic pruritus)
306.4 • Gastrointestinal (aerophagy; cyclical vomiting; nervous gastritis, etc.)
306.5 • Genitourinary
306.50 Psychogenic genitourinary malfunction, unspecified
306.51 Psychogenic vaginismus
306.52 Psychogenic dysmenorrhea
306.53 Psychogenic dysuria
37
Code Description
306.6 • Endocrine
306.7 • Organs of special sense
306.8 • Other specified psychophysiological malfunction
306.9 • Unspecified psychophysiological malfunction
307.5 Other and unspecified disorders of eating
307.50 Eating disorder, unspecified
307.51 Bulimia nervosa
307.52 Pica
307.53 Rumination disorder
307.54 Psychogenic vomiting
307.59 Other
307.6 Enuresis
307.7 Encopresis
307.9 Other and unspecified symptoms or syndromes not elsewhere classified
308 Acute reaction to stress
308.0 Predominant disturbance of emotions
308.1 Predominant disturbance of consciousness
308.2 Predominant psychomotor disturbance
308.3 Other acute reactions to stress
308.4 Mixed disorders as reactions to stress
38
Code Description
308.9 Unspecified acute reaction to stress
309 Adjustment reaction
309.0 Adjustment disorder with depressed mood
309.1 Prolonged depressive reaction
309.2 With predominant disturbance of other emotions
309.21 Separation anxiety disorder
309.22 Emancipation disorder of adolescence and early adult life
309.23 Specific academic or work inhibition
309.24 Adjustment disorder with anxiety
309.28 Adjustment disorder with mixed anxiety and depressed mood
309.29 • Other
309.3 Adjustment disorder with disturbance of conduct
309.4 Adjustment disorder with mixed disturbance of emotions
309.8 Other specified adjustment reactions
309.81 Post-traumatic stress disorder
309.82 Adjustment reaction with physical symptoms
309.83 Adjustment reaction with withdrawal
309.9 Unspecified adjustment reaction
310 Specific non-psychotic mental disorders due to brain damage
310.0 Frontal lobe syndrome
39
Code Description
310.1 Personality change due to conditions classified elsewhere
310.2 Post-concussion syndrome
310.8 Other specific non-psychotic mental disorders following organic brain damage
310.81 • Pseudobulbar affect
310.89 • Other specified non-psychotic mental disorders
310.9 Unspecified non-psychotic mental disorder following organic brain damage
311 Depressive disorder, not elsewhere classified
*312 Disturbance of conduct, not elsewhere classified
*Requires 4th or 5th digit classification as noted in brackets: (e.g. 312.23, 312.01, etc) 0 – unspecified 1 – mild 2 – moderate 3 - severe
*312.0 (0-3) Under-socialized conduct disorder, aggressive type
*312.1(0-3) Under-socialized conduct disorder, unaggressive type
*312.2 (0-3) Socialized conduct disorder
312.3 Disorders of impulse control, not elsewhere classified
312.30 Impulse control disorder, unspecified
312.31 Pathological gambling
312.32 Kleptomania
312.33 Pyromania
312.34 Intermittent explosive disorder
312.35 Isolated explosive disorder
40
Code Description
312.39 • Other
312.4 Mixed disturbance of conduct and emotions
312.8 Other specified disturbances of conduct, not elsewhere classified
312.81 Conduct disorder, childhood onset type
312.82 Conduct disorder, adolescent onset type
312.89 Other conduct disorder
312.9 Unspecified disturbance of conduct
314 Hyperkinetic syndrome childhood
314.0 Attention deficit disorder
314.00 • Without mention of hyperactivity
314.01 • With hyperactivity
314.1 Hyperkinesis with development delay
314.2 Hyperkinetic conduct disorder
314.8 Other specified manifestations of hyperkinetic syndrome
314.9 Unspecified hyperkinetic syndrome
41
Diagnosis Codes for Sickle Cell Anemia
Code Description
282.6 Sickle-cell disease
282.6 Sickle-cell disease, unspecified
282.61 Hb-SS disease without crisis
282.62 Hb-SS disease with crisis
282.63 Sickle-cell/Hb-C disease without crisis
282.64 Sickle-cell/Hb-C disease with crisis
282.68 Other sickle-cell disease without crisis
282.69 Other sickle-cell disease with crisis
42
Diagnosis Codes for Thyroid Disease
Code Description
240 Simple and unspecified goiter
240.0 Goiter, specified as simple
240.9 Goiter, unspecified
241 Nontoxic nodular goiter
241.0 Nontoxic uninodular goiter
241.1 Nontoxic multinodular goiter
241.9 Unspecified nontoxic with or without goiter
*242 Thyrotoxicosis with or without goiter
242.0 (0,1) Toxic diffuse goiter
*242.1 (0,1) Toxic uninodular goiter
*242.2 (0,1) Toxic multinodular goiter
*242.3 (0,1) Toxic nodular goiter, unspecified
*242.4 (0,1) Thyrotoxicosis from ectopic thyroid nodule
*242.8 (0,1) Thyrotoxicosis of other specified origin
*242.9 (0,1) Thyrotoxicosis without mention of goiter or other cause
243 Congenital hypothyroidism
244 Acquired hypothyroidism
244.0 Postsurgical hypothyroidism
43
Code Description
244.1 Other postablative hypothyroidism
244.2 Iodine hypothyroidism
244.3 Other iatrogenic hypothyroidism
244.8 Other specified acquired hypothyroidism
244.9 Unspecified hypothyroidism
245 Thyroiditis
245.0 Acute thyroiditis
245.1 Subacute thyroiditis
245.2 Chronic lymphocytic thyroiditis
245.3 Chronic fibrous thyroiditis
245.4 Iatrogenic thyroiditis
245.8 Other and unspecified chronic thyroiditis
245.9 Thyroiditis, unspecified
246 Other disorders of thyroid
246.0 Disorders of thyrocalcitonin secretion
246.1 Dyshormonogenic goiter
246.2 Cyst of thyroid
246.3 Hemorrhage and infarction of thyroid
246.8 Other specified disorders of thyroid