philhealth circular no. 0035, s.2013 annex 8 list of medical conditions allowed for referral...

ICD CODE DESCRIPTION

A22.0Cutaneous anthrax due to Bacillus anthracis; Malignant carbuncle due to Bacillus anthracis;

Malignant pustule due to Bacillus anthracisA22.2 Gastrointestinal anthrax due to Bacillus anthracisA22.7 Anthrax septicaemia due to Bacillus anthracis

A27.0Leptospirosis icterohaemorrhagica; Leptospirosis due to Leptospira interrogans serovar

ictehaemorrhagiciaeA27.8 Other forms of leptospirosisA33 Tetanus NeonatorumA39.2 Acute meningococcaemiaA48.3 Toxic shock syndromeA52.1 Symptomatic neurosyphilis

A52.3Neurosyphilis, unspecified; Gumma (syphilitic) of the central nervous system NOS; Syphilis (late) of

the central nervous system NOS; Syphiloma of the central nervous systemA82.0 Sylvatic rabiesA82.1 Urban rabiesA82.9 Rabies, unspecifiedA83.0 Japanese encephalitisA83.2 Eastern equine encephalitisA83.5 California encephalitis; California meningoencephalitis; La Crosse encephalitisA83.8 Other mosquito-borne viral encephalitis

A83.9Mosquito-borne viral encephalitis, unspecified; mosquito-borne viral meningoencephalitis,

unspecifiedA85.2 Arthropod-borne viral encephalitis, unspecifiedA85.8 Other specified viral encephalitis; Encephalitis lethargica; Von Economo-Cruchet disease

A86UNSPECIFIED VIRAL ENCEPHALITIS; VIRAL ENCEPHALOMYELITIS NOS; VIRAL

MENINGOENCEPHALITIS NOSA87.8 Other viral meningitisA87.9 Viral meningitis, unspecifiedA91.3 Severe dengueA98.4 Ebola virus diseaseB15.0 Acute Hepatitis A with hepatic comaB16.0 Acute hepatitis B with delta-agent (coinfection) with hepatic comaB16.2 Acute hepatitis B without delta-agent with hepatic comaB19.0 Unspecified viral hepatitis hepatic with comaB20.1 HIV disease resulting in other bacterial infectionsB20.6 HIV disease resulting in Pneumocystis carinii pneumoniaB21.0 Human immunodeficiency virus [HIV] disease resulting in Kaposi's sarcomaB21.1 Human immunodeficiency virus [HIV] disease resulting in Burkitt's lymphoma

B21.2 Human immunodeficiency virus [HIV] disease resulting in other types of non-Hodgkin's lymphoma

B21.3Human immunodeficiency virus [HIV] disease resulting in other malignant neoplasms of lymphoid,

haematopoietic and related tissue

B22.0Human immunodeficiency virus [HIV] disease resulting in encephalopathy; Human

immunodeficiency virus [HIV] dementia

C77.0Secondary and unspecified malignant neoplasm of Lymph nodes of head, face and neck/

Supraclavicular lymph nodesC77.1 Secondary and unspecified malignant neoplasm of Intrathoracic lymph nodesC77.2 Secondary and unspecified malignant neoplasm of Intra-abdominal lymph nodes

C77.3Secondary and unspecified malignant neoplasm of Axillary and upper limb lymph nodes/ Pectoral

lymph nodes C77.9 Secondary and unspecified malignant neoplasm of Lymph node, unspecifiedC78.0 Secondary malignant neoplasm of lung

ANNEX 8. LIST OF MEDICAL CONDITIONS ALLOWED FOR REFERRAL PACKAGE

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C78.1 Secondary malignant neoplasm of mediastinumC78.2 Secondary malignant neoplasm of pleuraC78.3 Secondary malignant neoplasm of other and unspecified respiratory organsC78.4 Secondary malignant neoplasm of small intestineC78.5 Secondary malignant neoplasm of large intestine and rectum

C78.6 Secondary malignant neoplasm of retroperitoneum and peritoneum, Malignant ascites NOS

C78.7 Secondary malignant neoplasm of liverC78.8 Secondary malignant neoplasm of other and unspecified digestive organsC79.0 Secondary malignant neoplasm of kidney and renal pelvisC79.1 Secondary malignant neoplasm of bladder and other and unspecified urinary organsC79.3 Secondary malignant neoplasm of brain and cerebral meningesC79.4 Secondary malignant neoplasm of other and unspecified parts of nervous systemC79.5 Secondary malignant neoplasm of bone and bone marrowC79.6 Secondary malignant neoplasm of ovaryC79.7 Secondary malignant neoplasm of adrenal glandC79.8 Secondary malignant neoplasm of other specified sites

D65

Disseminated intravascular coagulation [defibrination syndrome]; Afabrinogenaemia, acquired;

Consumption of coagulopathy; Diffuse or disseminated intravascular coagulation [DIC]; Fibrinolytic

haemorrhage, acquired; Fibriinolytic purpura; Fulminans purpura

E03.5 Myxoedema coma

E10.0Insulin-dependent diabetes mellitus [Diabetes mellitus brittle; Diabetes mellitus juvenile-onset;

Diabetes mellitus ketosis-prone;Diabetes mellitus type I] with coma; Insulin-dependent diabetic

coma with ketoacidosis; Insulin-dependent diabetic coma witho

E10.1Insulin-dependent diabetes mellitus with ketoacidosis; Insulin-dependent diabetic acidosis with

mention of coma; Insulin-dependent diabetic ketoacidosis without mention of coma

E11.0Non-insulin-dependent diabetes mellitus [ Adult-onset] diabetes mellitus with coma; Maturity-

onset diabetes mellitus with coma; Nonketotic diabetes mellitus with coma; Stable diabetes

mellitus with coma; Diabetes mellitus type II with coma; Adult-onset no

E11.1Non-insulin-dependent diabetes mellitus with ketoacidosis; Non-insulin-dependent diabetic

acidosis with mention of coma; Non-insulin-dependent diabetic ketoacidosis without mention of

coma

E12.0Malnutrition-related diabetes mellitus [Non-insulin-dependent malnutrition-related diabetes

mellitus; Insulin-dependent malnutrition-related diabetes mellitus] with coma; Malnutrition-

related diabetes mellitus coma with ketoacidosis; Malnutrition-related

E13.0Other specified diabetes mellitus with coma; Other specified diabetes mellitus with coma with

ketoacidosis; Other specified diabetes mellitus with coma without ketoacidosis; Other specified

diabetes mellitus hyperosmolar coma; Other specified diabetes mel

E13.1Other specified diabetes mellitus with ketoacidosis; Other specified diabetes mellitus with

ketoacidosis with mention of coma; Other specified diabetes mellitus with ketoacidosis without

mention of coma

E14.0

Unspecified diabetes mellitus [Diabetes NOS] with coma; Unspecified diabetes mellitus with coma

with ketoacidosis; Unspecified diabetes mellitus with coma without ketoacidosis; Unspecified

diabetes mellitus hyperosmolar coma; Unspecified diabetes mellitus

E14.1Unspecified diabetes mellitus with ketoacidosis; Unspecified diabetes mellitus with ketoacidosis

with mention of coma; Unspecified diabetes mellitus with ketoacidosis without mention of coma

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E15Nondiabetic hypoglycaemic coma; Drug-induced insulin coma in nondiabetic; Hyperinsulinism with

hypoglycaemic coma; Hypoglycaemic coma NOS Use additional external cause code (Chapter XX),

if desired to identify drug, if drug-induced.E27.2 Addisonian crisis; Adrenal crisis; Adrenocortical crisis

G00.0Haemophilus meningitis; Meningitis/ arachnoiditis/ leptomeningitis/ pachymeningitis due to

Haemophilus influenzae

G00.1Pneumococcal meningitis; Meningitis/ arachnoiditis/ leptomeningitis/ pachymeningitis due to

Pneumococcus

G00.2Streptococcal meningitis; Meningitis/ arachnoiditis/ leptomeningitis/ pachymeningitis due to

Streptococcus

G00.3Staphylococcal meningitis; Meningitis/ arachnoiditis/ leptomeningitis/ pachymeningitis due to

Staphylococcus

G00.8 Other bacterial meningitis; Meningitis due to Escherichia coli; Friedlander bacillus; Klebsiella

G00.9Bacterial meningitis, unspecified; Purulent meningitis NOS; Pyogenic meningitis NOS; Suppurative

meningitis NOS

G03.0Nonpyogenic meningitis; Nonbacterial meningitis/ Arachnoiditis/ Leptomeningitis/

Pachymeningitis G03.1 Chronic meningitis/ Arachnoiditis/ Leptomeningitis/ Pachymeningitis

G03.8 Meningitis/ Arachnoiditis/ Leptomeningitis/ Pachymeningitis due to other specified causes

G03.9 Meningitis, unspecified; Spinal arachnoiditis NOS

G04.0Acute disseminated encephalitis; Encephalitis postimmunization; Encephalomyelitis

postimmunization; Myelitis complicating vaccinationG04.1 Tropical spastic paraplegiaG04.2 Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified

G04.8Other encephalitis, myelitis and encephalomyelitis; Postinfectious encephalitis and

encephalomyelitis NOS

G04.9Encephalitis, myelitis and encephalomyelitis, unspecified; Cerebral ventriculitis NOS; Acute

ascending myelitis; Meningoencephalitis; MeningomyelitisG05.8* Encephalitis, myelitis and encephalomyelitis in other diseases classified elsewhere

G06.0Intracranial abscess and granuloma; Embolic abscess of brain [any part]; Embolic abscess of

cerebellar; Embolic abscess of cerebral; Embolic abscess of otogenic; Epidural intracranial abscess

or granuloma; Extradural intracranial abscess or granuloma; Sub

G06.1Intraspinal abscess and granuloma; Embolic abscess of spinal cord [any part]; Epidural intraspinal

abscess or granuloma; Extradural intraspinal abscess or granuloma; Subdural intraspinal abscess or

granuloma G06.2 Extradural and subdural abscess, unspecified G07* Intracranial and intraspinal abscess and granuloma in diseases classified elsewhere

G08Intracranial and intraspinal phlebitis and thrombophlebitis; Septic embolism of intracranial or

intraspinal venous sinuses and veins; Septic endophlebitis of intracranial or intraspinal venous

sinuses and veins; Septic thrombophlebitis of intracranial or G09 Sequelae of inflammatory diseases of central nervous systemG93.5 Compression of brain; Compression of brain stem; Herniation of brain stemG95.0 Syringomyelia and syringobulbia

G95.1

Vascular myelopathies; Acute embolic infarction of spinal cord; Acute nonembolic infarction of

spinal cord; Arterial thrombosis of spinal cord; haematomyelia; Nonpyogenic intraspinal phlebitis

and thrombophlebitis; Oedema of spinal cord; Subacute necrotic

I11.0Hypertensive heart disease with (congestive) heart failure; Hypertensive heart failure; Heart failure

with mention of or due to hypertension; Myocarditis with mention of or due to hypertension with

CHF; Myocardial degeneration with mention of or due to hy

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I12.0Hypertensive renal disease with renal failure; Hypertensive renal failure; Chronic renal failure with

hypertension; Unspecified renal failure with hypertension; Unspecified contracted kidney with

hypertension and renal failure; Arteriosclerosis of kidney I13.0 Hypertensive heart and renal disease with (congestive) heart failureI13.1 Hypertensive heart and renal disease with renal failure

I13.2Hypertensive heart and renal disease with both (congestive) heart failure and renal failure;

Cardiorenal dropsy

I21.0Acute transmural myocardial infarction of anterior wall; acute transmural infarction of anterior

wall NOS; acute transmural infarction of anteroapical; acute transmural infarction of anterolateral;

acute transmural infarction of anteroseptal

I21.1Acute transmural myocardial infarction of inferior wall; acute transmural infarction of

diaphragmatic wall; acute transmural infarction of inferior wall NOS;acute transmural infarction of

inferolateral; acute transmural infarction of inferoposterior

I21.2Acute transmural myocardial infarction of other sites; apical-lateral; basal-lateral; high lateral;

lateral wall NOS; posterior (true); posterobasal; posterolateral; posteroseptal; septal NOS

I21.3 Acute transmural myocardial infarction of unspecified site; transmural myocardial infarction NOS

I21.4 Acute subendocardial myocardial infarction; nontransmural myocardial infarction NOS

I22.0

Acute subsequent/recurrent myocardial infarction of anterior wall; Acute subsequent/recurrent

infarction of anterior wall NOS; Acute subsequent/recurrent anteroapical infarction; Acute

subsequent/recurrent anterolateral infarction; Acute subsequent/recurr

I22.1

Acute subsequent/recurrent myocardial infarction of inferior wall; Acute subsequent/recurrent

infarction of diaphragmatic wall; Acute subsequent/recurrent infarction of inferior wall NOS;

Acute subsequent/recurrent inferolateral infarction; Acute subseque

I22.8Subsequent/recurrent myocardial infarction of other sites; Acute subsequent/recurrent

myocardial apical-lateral infarction; Acute subsequent/recurrent myocardial basal-lateral

infarction; Acute subsequent/recurrent myocardial high lateral infarction; AcutI22.9 Subsequent/recurrent myocardial infarction of unspecified siteI23.0 Haemopericardium as current complication following acute myocardial infarctionI23.1 Atrial septal defect as current complication following acute myocardial infarctionI23.2 Ventricular septal defect as current complication following acute myocardial infarction

I23.3Rupture of cardiac wall without haemopericardium as current complication following acute

myocardial infarction

I23.4 Rupture of chordae tendineae as current complication following acute myocardial infarction

I23.5 Rupture of papillary muscle as current complication following acute myocardial infarction

I23.8 Other current complications following acute myocardial infarction

I26.0

Pulmonary embolism with mention of acute cor pulmonale; Acute cor pulmonale NOS; Pulmonary

artery infarction with mention of acute cor pulmonale; Pulmonary vein infarction with mention of

acute cor pulmonale; Pulmonary artery thromboembolism with mention

I30.1Infective pericarditis; Pneumococcal pericarditis; Purulent pericarditis; Staphylococcal pericarditis;

Viral pericarditis; Pyopericarditis; Infective pericardial effusion

I50.0Congestive heart failure; Congestive heart disease; Right ventricular failure (secondary to left heart

failure); Biventricular failure

I50.1Left ventricular failure; Acute oedema of lung with mention of heart disease NOS or heart failure;

Acute pulmonary oedema with mention of heart disease NOS or heart failure; Cardiac asthma; Left

heart failure

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I60.0 Subarachnoid haemorrhage from carotid siphon and bifurcationI60.1 Subarachnoid haemorrhage from middle cerebral arteryI60.2 Subarachnoid haemorrhage from anterior communicating arteryI60.3 Subarachnoid haemorrhage from posterior communicating arteryI60.4 Subarachnoid haemorrhage from basilar arteryI60.5 Subarachnoid haemorrhage from vertebral artery

I60.6Subarachnoid haemorrhage from other intracranial arteries; Multiple involvement of intracranial

arteries

I60.7Subarachnoid haemorrhage from intracranial artery, unspecified; Ruptured (congenital) berry

aneurysm NOS; Subarachnoid haemorrhage from cerebral artery NOS; Subarachnoid haemorrhage

from communicating artery NOS

I60.8Other subarachnoid haemorrhage; Meningeal haemorrhage; Rupture of cerebral arteriovenous

malformationI60.9 Subarachnoid haemorrhage, unspecified; Ruptured (congenital) cerebral aneurysm NOSI61.0 Intracerebral haemorrhage in hemisphere, subcortical; Deep intracerebral haemorrhage

I61.1Intracerebral haemorrhage in hemisphere, cortical; Cerebral lobe haemorrhage;. Superficial

intracerebral haemorrhageI61.2 Intracerebral haemorrhage in hemisphere, unspecifiedI61.3 Intracerebral haemorrhage in brain stemI61.4 Intracerebral haemorrhage in cerebellumI61.5 Intracerebral haemorrhage, intraventricularI61.6 Intracerebral haemorrhage, multiple localizedI61.8 Other intracerebral haemorrhageI61.9 Intracerebral haemorrhage, unspecifiedI62.0 Subdural haemorrhage (acute)(nontraumatic)I62.1 Nontraumatic extradural haemorrhage; Nontraumatic epidural haemorrhageI62.9 Intracranial haemorrhage (nontraumatic), unspecifiedI63.0 Cerebral infarction due to thrombosis of precerebral arteriesI63.1 Cerebral infarction due to embolism of precerebral arteriesI63.2 Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteriesI63.3 Cerebral infarction due to thrombosis of cerebral arteriesI63.4 Cerebral infarction due to embolism of cerebral arteriesI63.5 Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteriesI63.6 Cerebral infarction due to cerebral venous thrombosis, nonpyogenicI63.8 Other cerebral infarctionI63.9 Cerebral infarction, unspecified

I65.2Occlusion and stenosis of carotid artery; Embolism of carotid artery not resulting in cerebral

infarction; Narrowing of carotid artery not resulting in cerebral infarction; Complete obstruction of

carotid artery not resulting in cerebral infarction; Parti

I67.1 Cerebral aneurysm, nonruptured; Cerebral aneurysm NOS; Acquired cerebral arteriovenous fistula

I67.3 Progressive vascular leukoencephalopathy; Binswanger's diseaseI67.4 Hypertensive encephalopathyI67.5 Moyamoya disease

I67.6Nonpyogenic thrombosis of intracranial venous system; Nonpyogenic thrombosis of cerebral vein;

Nonpyogenic thrombosis of intracranial venous sinusI67.7 Cerebral arteritis, not elsewhere classified

I71.0Dissection of aorta [any part]; Ruptured dissecting aneurysm of aorta; Dissecting aneurysm of

aorta [any part]J80 Adult respiratory distress syndrome; Adult hyaline membrane diseaseJ96.0 Acute respiratory failure

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K70.4Alcoholic hepatic failure; Alcoholic hepatic failure NOS; Acute alcoholic hepatic failure; Chronic

alcoholic hepatic failure; Subacute alcoholic hepatic failure; Alcoholic hepatic failure with or

without hepatic comaK72.0 Acute and subacute hepatic failureK72.1 Chronic hepatic failure

K72.9Hepatic failure, unspecified; Hepatic failure, not elsewhere classified; Hepatic coma NOS; Hepatic

encephalopathy NOS; Acute hepatitis NEC; with hepatic failure; Fulminant hepatitis NEC, with

hepatic failure; Malignant hepatitis NEC, with hepatic failure;M31.2 Lethal midline granulomaM31.3 Wegener's granulomatosis; Necrotizing respiratory granulomatosisM34.0 Progressive systemic sclerosis

N17.0Acute renal failure with tubular necrosis; Tubular necrosis NOS; Acute tubular necrosis; Renal

tubular necrosis

N17.1Acute renal failure with acute cortical necrosis; Cortical necrosis NOS; Acute cortical necrosis;

Renal cortical necrosis

N17.2Acute renal failure with medullary necrosis; Medullary [papillary] necrosis NOS; Acute medullary

[papillary] necrosis; Renal medullary [papillary] necrosisN18.0 End-stage renal disease; ESRDN18.8 Other chronic renal failureN18.9 Chronic renal failure, unspecified; Chronic uremia; Diffuse sclerosing glomrulonephritisN99.0 Postprocedural renal failure

O08.3Shock or Circulatory collapse or Postoperative shock following abortion and ectopic and molar

pregnancy

O08.4Renal failure or Oliguria or Acute renal failure or Renal shutdown or Renal tubular necrosis or

Uraemia following abortion and ectopic and molar pregnancy

O15.0Eclampsia in pregnancy; Convulsions in pregnancy following Pre-existing hypertensive disorder or

Gestational oedema with or without proteinuria or Pre-eclampsia or Unspecified maternal

hypertension

O15.1Eclampsia in labour; Convulsions in labour following Pre-existing hypertensive disorder or

Gestational oedema with or without proteinuria or Pre-eclampsia or Unspecified maternal

hypertension

O15.2Eclampsia in the puerperium; Convulsions in the puerperium following Pre-existing hypertensive

disorder or Gestational oedema with or without proteinuria or Pre-eclampsia or Unspecified

maternal hypertension

O15.9Eclampsia with pregnancy-induced or pre-existing hypertension, unspecified as to time period;

Eclampsia NOSO75.1 Shock during or following labour and delivery; Obstetric shock

O88.1Amniotic fluid embolism; Pulmonary amniotic fluid emboli in pregnancy, childbirth or the

puerperium

O88.2Obstetric blood-clot embolism; Obstetric pulmonary embolism NOS; Puerperal pulmonary

embolism NOSO90.4 Postpartum acute renal failure; Hepatorenal syndrome following labour and deliveryP10.1 Cerebral haemorrhage due to birth injuryP10.2 Intraventricular haemorrhage due to birth injuryP10.3 Subarachnoid haemorrhage due to birth injury

P21.0Severe birth asphyxia; Pulse less than 100 per minute at birth and falling or steady, respiration

absent or gasping, colour poor, tone absent; Asphyxia with 1-minute Apgar score 0-3; White

asphyxia

P21.9Birth asphyxia, unspecified; Anoxia NOS; Asphyxia NOS; Hypoxia NOS This category

cannot be used for low APGAR score without mention of asphyxia or other respiratory problems.

P26.0 Tracheobronchial haemorrhage originating in the perinatal period

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P26.1 Massive pulmonary haemorrhage originating in the perinatal periodP26.8 Other pulmonary haemorrhages originating in the perinatal periodP28.5 Respiratory failure of newbornP29.0 Neonatal cardiac failure

P52.0Intraventricular (nontraumatic) haemorrhage, grade 1, of fetus and newborn; Subependymal

haemorrhage without intraventricular extension

P52.1Intraventricular (nontraumatic) haemorrhage, grade 2, of fetus and newborn; Subependymal

haemorrhage with intraventricular extensionP52.3 Unspecified intraventricular (nontraumatic) haemorrhage of fetus and newbornP52.4 Intracerebral (nontraumatic) haemorrhage of fetus and newbornP52.5 Subarachnoid (nontraumatic) haemorrhage of fetus and newbornP52.6 Cerebellar (nontraumatic) and posterior fossa haemorrhage of fetus and newbornP52.8 Other intracranial (nontraumatic) haemorrhages of fetus and newbornP52.9 Intracranial (nontraumatic) haemorrhage of fetus and newborn, unspecifiedP56.0 Hydrops fetalis due to isoimmunizationP56.9 Hydrops fetalis due to other and unspecified haemolytic disease

P60Disseminated intravascular coagulation of fetus and newborn; Defibrination syndrome of fetus or

newbornP77 Necrotizing enterocolitis of fetus and newbornQ00.0 Anencephaly; Acephaly; Acrania; Amyelencephaly; Hemianencephaly; HemicephalyQ06.0 AmyeliaQ06.2 DiastematomyeliaQ06.4 Hydromyelia; HydrorachisQ06.8 Other specified congenital malformations of spinal cordQ22.0 Pulmonary valve atresiaQ22.4 Congenital tricuspid stenosis; Tricuspid atresiaQ23.0 Congenital stenosis of aortic valve; Congenital aortic atresia; Congenital aortic stenosisQ23.2 Congenital mitral stenosis; Congenital mitral atresia; Duroziez' disease

Q23.4Hypoplastic left heart syndrome; Atresia, or marked hypolplasia aortic orifice or valve, with

hypoplasia of ascending aorta and defective development of left ventricle with mitral valve

stenosis or atresiaQ25.2 Atresia of aortaQ25.5 Atresia of pulmonary arteryQ33.3 Agenesis of lung; Absence of lobe of lung; Absence of lungR57.0 Cardiogenic shockR57.1 Hypovolaemic shockR57.8 Other shock; Endotoxic shockR57.9 Shock, unspecified; Failure of peripheral circulation NOST31.6 Burns involving 60-69% of body surfaceT31.7 Burns involving 70-79% of body surfaceT31.8 Burns involving 80-89% of body surfaceT31.9 Burns involving 90% or more of body surfaceT32.9 Corrosions involving 90% or more of body surfaceT79.4 Traumatic shock; Immediate shock following unjury; Delayed shock following injuryT79.5 Traumatic anuria; Crush syndrome; Renal failure following crushing

T81.1Shock during or resulting from a procedure, not elsewhere classified; Collapse NOS during or

following a procedure; Endotoxic shock during or following a procedure; Hypovolaemic shock

during or following a procedure; Septic hock during or following a proc

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philhealth circular no. 0035, s.2013 annex 8 list of medical conditions allowed for referral...

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