MANUAL OF THE INTERNATIONAL STATISTICAL CLASSIFICATION OF DISEASES, INJURIES

184 Pages·2012·6.92 MB·English

INTERNATIONAL CLASSIFICATION OF DISEASES
MANUAL
OF THE INTERNATIONAL
STATISTICAL CLASSIFICATION
OF DISEASES, INJURIES, AND
CAUSES OF DEATH
Based on the Recommendations
of the Seventh Revision Conference, 1955,
and Adopted by the Ninth World Health Assembly
under the WHO Nomenclature Regulations
Volume 2
ALPHABETICAL INDEX
WORLD HEALTH ORGANIZATION
PALAIS DES NATIONS
GENEVA
1957
TABLE OF CONTENTS
Page
Introduction . . v
Terms included in Index . . . . . . . IX
Coding of Sole and Multiple Diagnoses . X
Structure and Use of .Alphabetical Index. x
Criterion for assigning a Given Code Number. XI
How to use Index to find Code Numbers XII
Adjectival Forms and Modifiers XII
Neoplasms. . . . . . . . . . XIII
Eponyms . . . . . . . . . . XIII
Diphthongs and Other Variations in Spelling XIV
Other Special Arrangements . XIV
Indexing of Combination Terms . . xv
Special Use of Parentheses . XVI
Abbreviations, Symbols and other Devices used in
Index . . . . . XVIII
Age Abbreviations . . XIX
Four-digit Subcategories. . XXI
Disease-code Numbers XXI
Accident-code Numbers XXII
Injuries (N- and E-Codes) . XXIII
Definitions supplementing External-cause Index XXIV
Late Effects of Disease and Injury XXIV
Supplementary Classification (Y-Code) XXVI
Alphabetical Index
Section I ; .Alphabetical Index to Diseases and
Nature of Injury. . . . . . 1
Section II; .Alphabetical Index to External Causes
of Accidents, Poisonings, and Vio-
lence (E-Code) . . . . . . . . . . 477
Section III; Alphabetical Index to Causes of Stillbirth 513
INTRODUCTION
viii INTRODUCTION
of surgical operations.l In this index the inclusion of these surgical
terms serves only to classify what is really an incomplete statement
of a medical diagnosis. When there is doubt about the condition
for which the operation was performed, additional information
should be secured wherever possible.
The American and English spellings of many medical terms differ
somewhat because of the .American trend towards simplified spelling,
especially through the elimination of diphthongs. The present
index includes both .American and English spelling, in contrast to
the use of English spelling only in the List of Categories and the
Tabular List of Inclusions which appear in Volume 1. In many
instances the two spellings come near enough to the same place in
the alphabet for them to be entered on the same line, but if the
words begin with different letters each term appears in its own
alphabetical place.
The English Index includes some Latin medical terms which
are also part of English medical nomenclature, for instance, composite
terms such as : Pityriasis capitis, Folliculitis abscedens et suffodiens,
a.o.
The Alphabetical Index consists of three sections as follows:
Section I (pp. 1-476). Index to the disease section of the code
(categories 001-795) and to the section on the nature and anatomical
site of an injury in such terms as : fracture; dislocation; wound,
open; and burn (categories NSOO-N999). These types of term
were both included in Section I of the index because they are similar,
constituting the diagnosis for the case as it would be given by an
attending physician, a clinic, or a hospital.
Section II (pp. 477-512). Index to the external cause of injury
(categories ESOO-E999). These items are in no sense medical diag
noses, but are descriptions of the circumstances under which the
accident or violence occurred and of the means of injury. This
section includes such terms as motor-vehicle accident, railway
accident, machinery accident, fire, explosion, and animal injury.
It should be noted that the numbers are the same in the two
injury sections (SOO-999), which means that on a punchcard a
special field must be provided for either the N - or the E-code or
some other method be arranged to identify the two types of code.
The one exception is the title "Hypertrophy of tonsils and adenoids
1
with tonsillectomy or adenoidectomy" (510.1), which was included in the
code because tonsillectomy constitutes in many places the most frequent
cause of admission to general hospitals.
INTRODUCTION ix
Section III (pp. 513-540). Index to the causes of stillbirth (cate
gories Y30-Y39). Since the causes of stillbirth are tabulated sepa
rately from the causes of death of liveborn infants, and also sepa
rately from the illnesses and deaths of mothers during pregnancy,
childbirth, and the puerperium, it would be confusing to have the
stillbirth index combined with any other index. As arranged, the
stillbirth code can be used to classify the causes of early as well as
intermediate and late fretal deaths.
It should be remembered that the " Y " symbol of this code can
be dropped when the stillbirth code is used apart from the main code
for illness and death. Thus with a special punchcard or in a separate
hand tabulation of stillbirths, the stillbirth code can be used as a
three-digit code.
Terms included in Index
The terms included in this English edition of the Alphabetical
Index to the International Statistical Classification of Diseases,
Injuries, and Causes of Death come from a variety of sources in
various English-speaking countries.
The terms in the Index to the 1948 Classification were collected
from national manuals of the International Lists of Diseases and
Causes of Death, from classifications used in coding morbidity data
of diverse origin and from lists of diagnoses serving as diagnostic
indexes to hospital case histories. The 1948 Index also included
all terms in two Nomenclatures, namely, the Standard Nomenclature
of Diseases and of Operations of the American Medical Association
and the Nomenclature of Diseases of the Royal College of Physicians
of London.
Apart from changes consequential to the seventh_revision of the
Classification, the 1955 Index contains a number of additional
terms frequently encountered on death certificates and other medical
records but hitherto missing from the Index.
Thus terms in the index represent those in actual use by physi
cians and various kinds of clinics and hospitals and in morbidity
surveys. Since the diagnosis coder will encounter both good and poor
terms, no attempt was made to exclude poor terms from the Alpha
betical Index. Generally, the terms in the Tabular List (Volume 1)
are the more acceptable or more commonly used medical terms.
All the latter terms are included in the index along with many
others which are less desirable.
xii INTRODUCTION
absence does not change the code number. Further explanation
of this special use of parentheses is included in a later section.
If the exact terminology cannot be found in the index by the
coding clerk, the matter should be referred to someone whose tech
nical medical knowledge and familiarity with the classification are
sufficient to determine the correct code number.
How to use index to find code numbers. The index is prepared
on the principle that the user will normally look up the noun portion
of a diagnostic term or pathological condition. Space limitations
made it impossible to list in the first alphabetical position of the
index the anatomical sites of specific diseases or injuries. However,
each of the important anatomical sites is listed once in its proper
alphabetical sequence with the reminder "see condition"; this
means that the coder should look at the place in the alphabet indi
cated by the disease or pathological condition and under this disease
name look for the anatomical site and other modifiers. For example,
under" tuberculosis" appear the various anatomical sites (in their
alphabetical order) with their code numbers, but since there are so
many sites to be covered the cross-indexing of anatomical sites has
not been included. Therefore, to find "tuberculosis of the hip",
look under T for "tuberculosis " and not under H for "hip ". To
find" stomach ulcer" look under U for" ulcer, stomach" and not
under S for " stomach ".
This principle is carried even to indefinite common expressions,
such as "heart disease", which is listed under D as "disease,
heart"; and "chest inflammation ", which is listed under I as
"inflammation, chest". In general, the anatomical site will follow
in the index immediately under the pathological condition, with any
further descriptive adjective in the third indention.
Adjectival forms and modifiers. .As a further aid to the coder,
adjectival forms of the disease name have frequently been placed
on the same line as the noun form, indicating that the noun or
adjectival form may appear interchangeably in medical terminology.
For example, the leading term" Rheumatism, rheumatic" will be
followed by terms in which one or the other of these two words
would be appropriate.
General adjectives such as "acute", "chronic", "epidemic",
" thermic ", and "tropical" usually appear in their alphabetical
sequence in the index with the instruction" see condition ", which
INTRODUCTION xiii
means that the disease name is to be looked up rather than the
adjectival modifier. For example, to find "chronic bronchitis ",
look under B for " bronchitis, chronic" and not under C for" chro
nic "; similarly, look for" bronchitis, acute" and not for" acute
bronchitis". "Acute" and "chronic" may be omitted even as
second or later words in the disease name as listed in the index, unless
the two forms of the disease have different code numbers. Important
modifiers of a medical nature such as " streptococcal", " gonococcal",
" puerperal ", and " septic ", however, are listed in the first position
in the index with code numbers for the specific conditions so modified.
Neoplasms. A comprehensive list of the sites of neoplasms is
found in the index under" neoplasm" where code numbers appear
in three columns for" malignant ", "benign ", and" unspecified ",
respectively. Terms such as "carcinoma ", "sarcoma" and" epi
thelioma ", however, appear in their own alphabetical places in
the index with a few frequent sites and their code numbers, but
with instructions to "(see also Neoplasm, malignant) ", where the
complete listing of anatomical sites appears with code numbers.
Types of benign tumour such as "adenomyoma" are indexed in
a similar way except that they have the reference" (see also Neo
plasm, benign) ". Thus the coder is directed to the correct column
of the three columns of code numbers for neoplasms according to
malignancy and anatomical site. If the type of tumour listed in its
own alphabetical position occurs in only one site, the code number is
given with no reference to "neoplasm", for instance "Thymoma
224 " or " Seminoma 178 ".
A list of types of neoplasms classified as " malignant ", " benign ",
and" unspecified" is given in the Tabular List of Inclusions (Vol. 1,
pp. 75-78).
Eponyms. Eponyms are listed under "Disease" followed by
the name of the physician or the locality that is associated with the
disease. In most instances the name appears also in first position
in the index with code numbers. The best practice is to look under
D for" disease" ; thus for" Addison's disease ", look under D for
"disease, Addison's". A physician's name associated with a
" syndrome" is indexed in the same manner as eponyms associated
with diseases. Thus for " Korsakoff's syndrome", look under S for
" syndrome, Korsakoff's ".
xvi INTRODUCTION
will be found under " Arteriosclerosis ", where they are listed under
an indent" underlying cause of ".
These special arrangements of the terms for assigning code
numbers to combinations of diagnoses complicate the index consider
ably. Moreover, it makes it necessary to refer a considerable
number of synonyms or equivalent terms to some one term, to
avoid including practically the same dual coding arrangements
in many different 'places in the index. For example, "arthritis,
acute, rheumatic" is referred to "Fever, rheumatic ", under which
are included not only rheumatic fever, but the various combinations
of rheumatic fever with heart disease which take separate code
numbers. Although such references from one part of the index to
another are inconvenient to the coder, any other scheme would
make the index so voluminous that it would be cumbersome
to use.
There are some provisions in the Tabular List which have not
been carried out in the Alphabetical Index, since consultation of the
Tabular List appeared more convenient than complex arrangements
in the Index. Examples are: the combination of pulmonary tuber
culosis with tuberculosis of some other sites, depending on statements
about the respective durations of the conditions; the notes to ery
sipelas, septicmmia and pymmia, and tetanus, concerning their
relationship to certain types of injury; the combination of malignant
neoplasms of sites in different subcategories of the same three-digit
category, assignment being to the "multiple" subcategory; the
exclusion from primary death classification of acute nasopharyngitis
and acute upper respiratory infection unspecified when stated as the
starting point of a morbid sequence involving more s~rious condi
tions.
In all cases, except when diagnoses are a part of these combined
or dual categories, only one condition is listed on a given line in the
index; this is done on the assumption that if a second condition
appears on the medical record or death certificate it will be looked
up independently in the index and given another code number if
multiple causes are coded.
Special Use of Parentheses
In this Alphabetical Index and in the Tabular List (Vol. 1, pp.
43-353), parentheses have a special meaning which must be kept
in mind by the coder whenever the index is used. Any words or
INTRODUCTION xvii
phrases in the diagnosis or cause of death which are listed in the
index in parentheses do not change the code assignment. The
advantage of this special meaning of parentheses is evident when it
is remembered that, in coding a medical diagnosis or cause of death,
it is necessary to find in the index the exact terms that appear on
the medical record, although not necessarily in the order in which
they appear. Many of thc adjective modifiers on such medical
records do not change the code number to be assigned to the diag
nosis term or cause of death. For this reason such modifiers appear
in the index in p~rentheses, usually following the leading terms.
Examples of such listings follow:
Abscess (infectional) (metastatic) (multiple) (pyogenic) (septic) 692.6
with
diabetes (mellitus) 260
lymphangitis-see Abscess, lymphangitic
adrenal (capsule) (gland) 274
bile, biliary, duct or tract 585
with calculus 584
buccal cavity 538
Cirrhosis
liver (portal) (atrophic) (biliary) (chronic) (congenital) (congestive)
(fatty) (hypertrophic) (interstitIal) (malignant) (nodular)
(obstructive) (passive) (xanthomatous) 581.0
with alcoholism 581.1
Thus "abscess" unqualified or qualified by any of the five
terms in parentheses after the leading term " .Abscess" is assigned
to 692.6; moreover, "adrenal abscess", unqualified o!' qualified
by any of these five terms in parentheses on the leading term or
by either of the two terms in parentheses following" adrenal ", is
assigned to 274. Without this special usc of parentheses, the many
terms in parentheses after "Oirrhosis, liver" would have to be
listed separately, but all with the same code number, and would
have to be repeated under the subhead" with alcoholism ".
Thus this special method of using parentheses avoids the repe
tition of many terms and the index is shortened without impairing
the ability of the coder to find in it the exact terminology on the
medical record or death certificate. It is, however, a system which
must be learned and kept in mind by the coder or medical record
librarian.
2
xviii INTRODUCTION
Abbreviations, Symbols and other Devices used in Index
Abbreviations have been eliminated from the index wherever
possible. However, a few terms that occur frequently are abbre
viated. Following is an explanation of the abbreviations and symbols
used.
NEe = not elsewhere classifiable: This symbol is added to
terms such as "Tuberculosis, respiratory, of specified site NEe ".
In this instance it would cover a case of respiratory tuberculosis of
a site not listed in the index and would presumably be coded 007.
However, this code number should be assigned only after referring
to the Tabular List and a medical dictionary to be sure the site or
other adjective modifier is not a synonym of a site or other term
included in the index, presumably under the leading term involved.
This abbreviation has not been used extensively; the chief places
where NEe is used are: specified organism, NEe; specified site,
NEe; and specified type of a disease, NEe.
NOS (= not otherwise specified; unspecified; unqualified),
frequently used in the Tabular List in Volume 1, is not used in the
index because terms listed without qualification are all assumed to
be NOS in the sense that any other words modifying the term may
change the code number.
SAl = sine altera indicatione = without other qualification:
These letters follow some medical-Latin terms and have the same
meaning as NOS. The Latin terms are not cross-indexed.
See --: A term followed by "see --" without a code
number indicates one of several things: (a) This term may be a
part of a dual or combined diagnosis and under the term to which
it is referred there is an arrangement to show how to code this term
in conjunction with other terms. For example, " Abscess, mastoid
(process) (subperiosteal) " is followed by "see Mastoiditis" where
there is an arrangement for coding acute and chronic mastoiditis
with and without mention of otitis media. (b) The term may be
different but may be coded like some other term for which the
alphabetical arrangement is complicated in some way, making it
impracticable to repeat this arrangement in several places.
Terms followed by "see --" are so important in combined
or dual diagnoses that no number is given-just the reference to
the proper complete arrangement with code numbers. The term
"(see also --)" followed by a code number means that this