General rules for use of the guidelines. They are incorporated within the ICD-10-CM as instructional notes.
ICD-10-CM Diagnosis codes are to be used and reported at their highest number of digits available. They are composed of codes with 3, 4, 5, 6 or 7 digits. Three digits are used as the heading of a category of codes that may be further subdivided by the use of fourth and/or fifth digits (preceded by a decimal, i.e. A00.1 Cholera due to Vibrio cholerae 01, biovar eltor), which provides greater detail. A code is invalid if it has not been coded to the full number of characters required for that code, including the 7th character, if applicable.
Seventh character and placeholders
Some codes require the use of a seventh character for codes in chapters M, O, R, S, T, V, W, X, Y. If there are fewer than six characters in the code (not counting the decimal point) the placeholder "x" is used to ensure that the seventh character is always in the seventh position. For example, "A" (for initial encounter) is in the seventh position in "S03.4xxA Sprain of jaw, initial encounter".
ICD-10-CM has two types of excludes notes.
Exclude 1 - Indicates that the code excluded should never be used at the same time as the code in this section
Exclude 2 - Indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time
CHAPTER I - Certain infectious and parasitic diseases (A00-B99)
This chapter contains the following blocks:
A00-A09 Intestinal infectious diseases
A15-A19 Tuberculosis
A20-A28 Certain zoonotic bacterial diseases
A30-A49 Other bacterial diseases
A50-A64 Infections with a predominantly sexual mode of transmission
A65-A69 Other spirochetal diseases
A70-A74 Other diseases caused by chlamydiae
A75-A79 Rickettsioses
A80-A89 Viral infections of the central nervous system
A90-A99 Arthropod-borne viral fevers and viral hemorrhagic fevers
B00-B09 Viral infections characterized by skin and mucous membrane lesions
B10 Other human herpes viruses
B15-B19 Viral hepatitis
B20 Human immunodeficiency virus [HIV] disease
B25-B34 Other viral diseases
B35-B49 Mycoses
B50-B64 Protozoal diseases
B65-B83 Helminthiases
B85-B89 Pediculosis, acariasis and other infestations
B90-B94 Sequelae of infectious and parasitic diseases
B95-B97 Bacterial, viral and other infectious agents
B99 Other infectious diseases
This chapter contains the following broad groups of neoplasms:
C00-C75 Malignant neoplasms, stated or presumed to be primary (of specified sites), and certain specified histologies, except neuroendocrine, and of lymphoid, hematopoietic and related tissue
C00-C14 Malignant neoplasms of lip, oral cavity and pharynx
C15-C26 Malignant neoplasms of digestive organs
C30-C39 Malignant neoplasms of respiratory and intrathoracic organs
C40-C41 Malignant neoplasms of bone and articular cartilage
C43-C44 Malignant neoplasms of skin
C45-C49 Malignant neoplasms of mesothelial and soft tissue
C50 Malignant neoplasms of breast
C51-C58 Malignant neoplasms of female genital organs
C60-C63 Malignant neoplasms of male genital organs
C64-C68 Malignant neoplasms of urinary tract
C69-C72 Malignant neoplasms of eye, brain and other parts of central nervous system
C73-C75 Malignant neoplasms of thyroid and other endocrine glands
C7a Malignant neuroendocrine tumors
C7b Secondary neuroendocrine tumors
C76-C80 Malignant neoplasms of ill-defined, other secondary and unspecified sites
C81-C96 Malignant neoplasms of lymphoid, hematopoietic and related tissue
D00-D09 In situ neoplasms
D10-D36 Benign neoplasms, except benign neuroendocrine tumors
D3a Benign neuroendocrine tumors
D37-D48 Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes
D49 Neoplasms of unspecified behavior
This chapter contains the following blocks:
D50-D53 Nutritional anemias
D55-D59 Hemolytic anemias
D60-D64 Aplastic and other anemias and other bone marrow failure syndromes
D65-D69 Coagulation defects, purpura and other hemorrhagic conditions
D70-D77 Other disorders of blood and blood-forming organs
D78 Intraoperative and postprocedural complications of spleen
D80-D89 Certain disorders involving the immune mechanism
This chapter contains the following blocks:
E00-E07 Disorders of thyroid gland
E08-E13 Diabetes mellitus
E15-E16 Other disorders of glucose regulation and pancreatic internal secretion
E20-E35 Disorders of other endocrine glands
E36 Intraoperative complications of endocrine system
E40-E46 Malnutrition
E50-E64 Other nutritional deficiencies
E65-E68 Overweight, obesity and other hyperalimentation
E70-E88 Metabolic disorders
E89 Postprocedural endocrine and metabolic complications and disorders, not elsewhere classified
CHAPTER V - Mental and behavioral disorders (F01-F99)
This chapter contains the following blocks:
F01-F09 Mental disorders due to known physiological conditions
F10-F19 Mental and behavioral disorders due to psychoactive substance use
F20-F29 Schizophrenia, schizotypal and delusional, and other non-mood psychotic disorders
F30-F39 Mood [affective] disorders
F40-F48 Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders
F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors
F60-F69 Disorders of adult personality and behavior
F70-F79 Mental retardation
F80-F89 Pervasive and specific developmental disorders
F90-F98 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence
F99 Unspecified mental disorder
This chapter contains the following blocks:
G00-G09 Inflammatory diseases of the central nervous system
G10-G14 Systemic atrophies primarily affecting the central nervous system
G20-G26 Extrapyramidal and movement disorders
G30-G32 Other degenerative diseases of the nervous system
G35-G37 Demyelinating diseases of the central nervous system
G40-G47 Episodic and paroxysmal disorders
G50-G59 Nerve, nerve root and plexus disorders
G60-G64 Polyneuropathies and other disorders of the peripheral nervous system
G70-G73 Diseases of myoneural junction and muscle
G80-G83 Cerebral palsy and other paralytic syndromes
G89-G99 Other disorders of the nervous system
CHAPTER VII - Diseases of the eye and adnexa (H00-H59)
This chapter contains the following blocks:
H00-H05 Disorders of eyelid, lacrimal system and orbit
H10-H11 Disorders of conjunctiva
H15-H22 Disorders of sclera, cornea, iris and ciliary body
H25-H28 Disorders of lens
H30-H36 Disorders of choroid and retina
H40-H42 Glaucoma
H43-H44 Disorders of vitreous body and globe
H46-H47 Disorders of optic nerve and visual pathways
H49-H52 Disorders of ocular muscles, binocular movement, accommodation and refraction
H53-H54 Visual disturbances and blindness
H55-H57 Other disorders of eye and adnexa
H59 Intraoperative and postprocedural complications and disorders of eye and adnexa, not elsewhere classified
CHAPTER VIII - Diseases of the ear and mastoid process (H60-H95)
This chapter contains the following blocks:
H60-H62 Diseases of external ear
H65-H75 Diseases of middle ear and mastoid
H80-H83 Diseases of inner ear
H90-H94 Other disorders of ear
H95 Intraoperative and postprocedural complications and disorders of ear and mastoid process, not elsewhere classified
This chapter contains the following blocks:
I00-I02 Acute rheumatic fever
I05-I09 Chronic rheumatic heart diseases
I10-I15 Hypertensive diseases
I20-I25 Ischemic heart diseases
I26-I28 Pulmonary heart disease and diseases of pulmonary circulation
I30-I52 Other forms of heart disease
I60-I69 Cerebrovascular diseases
I70-I79 Diseases of arteries, arterioles and capillaries
I80-I89 Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified
I95-I99 Other and unspecified disorders of the circulatory system
This chapter contains the following blocks:
J00-J06 Acute upper respiratory infections
J09-J18 Influenza and pneumonia
J20-J22 Other acute lower respiratory infections
J30-J39 Other diseases of upper respiratory tract
J40-J47 Chronic lower respiratory diseases
J60-J70 Lung diseases due to external agents
J80-J84 Other respiratory diseases principally affecting the interstitium
J85-J86 Suppurative and necrotic conditions of the lower respiratory tract
J90-J94 Other diseases of the pleura
J95 Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified
J96-J99 Other diseases of the respiratory system
This chapter contains the following blocks:
K00-K14 Diseases of oral cavity and salivary glands
K20-K31 Diseases of esophagus, stomach and duodenum
K35-K38 Diseases of appendix
K40-K46 Hernia
K50-K52 Noninfective enteritis and colitis
K55-K63 Other diseases of intestines
K65-K68 Diseases of peritoneum and retroperitoneum
K70-K77 Diseases of liver
K80-K87 Disorders of gallbladder, biliary tract and pancreas
K90-K94 Other diseases of the digestive system
CHAPTER XII - Diseases of the skin and subcutaneous tissue (L00-L99)
This chapter contains the following blocks:
L00-L08 Infections of the skin and subcutaneous tissue
L10-L14 Bullous disorders
L20-L30 Dermatitis and eczema
L40-L45 Papulosquamous disorders
L49-L54 Urticaria and erythema
L55-L59 Radiation-related disorders of the skin and subcutaneous tissue
L60-L75 Disorders of skin appendages
L76 Intraoperative and postprocedural complications of skin and subcutaneous tissue
L80-L99 Other disorders of the skin and subcutaneous tissue
CHAPTER XIII - Diseases of the musculoskeletal system and connective tissue (M00-M99)
This chapter contains the following blocks:
M00-M02 Infectious arthropathies
M05-M14 Inflammatory polyarthropathies
M15-M19 Osteoarthritis
M20-M25 Other joint disorders
M26-M27 Dentofacial anomalies [including malocclusion] and other disorders of jaw
M30-M36 Systemic connective tissue disorders
M40-M43 Deforming dorsopathies
M45-M49 Spondylopathies
M50-M54 Other dorsopathies
M60-M63 Disorders of muscles
M65-M67 Disorders of synovium and tendon
M70-M79 Other soft tissue disorders
M80-M85 Disorders of bone density and structure
M86-M90 Other osteopathies
M91-M94 Chondropathies
M95 Other disorders of the musculoskeletal system and connective tissue
M96 Intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified
M99 Biomechanical lesions, not elsewhere classified
This chapter contains the following blocks:
N00-N08 Glomerular diseases
N10-N16 Renal tubulo-interstitial diseases
N17-N19 Acute kidney failure and chronic kidney disease
N20-N23 Urolithiasis
N25-N29 Other disorders of kidney and ureter
N30-N39 Other diseases of the urinary system
N40-N51 Diseases of male genital organs
N60-N65 Disorders of breast
N70-N77 Inflammatory diseases of female pelvic organs
N80-N98 Noninflammatory disorders of female genital tract
N90.810 Female genital mutilation status, unspecified
N90.811 Female genital mutilation Type I status
N90.812 Female genital mutilation Type II status
N90.813 Female genital mutilation Type III status
N90.818 Other female genital mutilation status
N99 Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified
CHAPTER XV - Pregnancy, childbirth and the puerperium (O00-O99)
Note: CODES FROM THIS CHAPTER ARE FOR USE ONLY ON MATERNAL RECORDS, NEVER ON NEWBORN RECORDS This chapter contains the following blocks:
O00-O08 Pregnancy with abortive outcome
O09 Supervision of high risk pregnancy
O10-O16 Edema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium
O20-O29 Other maternal disorders predominantly related to pregnancy
O30-O48 Maternal care related to the fetus and amniotic cavity and possible delivery problems
O60-O77 Complications of labor and delivery
O80, O82 Encounter for delivery
O85-O92 Complications predominantly related to the puerperium
O94-O9A Other obstetric conditions, not elsewhere classified
NOTE: CODES FROM THIS CHAPTER ARE FOR USE ON NEWBORN RECORDS ONLY, NEVER ON MATERNAL RECORDS This chapter contains the following blocks:
P00-P04 Newborn affected by maternal factors and by complications of pregnancy, labor, and delivery
P05-P08 Disorders related to length of gestation and fetal growth
P09 Abnormal findings on neonatal screening
P10-P15 Birth trauma
P19-P29 Respiratory and cardiovascular disorders specific to the perinatal period
P35-P39 Infections specific to the perinatal period
P50-P61 Hemorrhagic and hematological disorders of newborn
P70-P74 Transitory endocrine and metabolic disorders specific to newborn
P76-P78 Digestive system disorders of newborn
P80-P83 Conditions involving the integument and temperature regulation of newborn
P84 Other problems with newborn
P90-P96 Other disorders originating in the perinatal period
Note: CODES FROM THIS CHAPTER ARE NOT FOR USE ON MATERNAL OR FETAL RECORDS
Q00-Q07 Congenital malformations of the nervous system
Q10-Q18 Congenital malformations of eye, ear, face and neck
Q20-Q28 Congenital malformations of the circulatory system
Q30-Q34 Congenital malformations of the respiratory system
Q35-Q37 Cleft lip and cleft palate
Q38-Q45 Other congenital malformations of the digestive system
Q50-Q56 Congenital malformations of genital organs
Q60-Q64 Congenital malformations of the urinary system
Q65-Q79 Congenital malformations and deformations of the musculoskeletal system
Q80-Q89 Other congenital malformations
Q90-Q99 Chromosomal abnormalities, not elsewhere classified
CHAPTER XVIII - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
This chapter contains the following blocks:
R00-R09 Symptoms and signs involving the circulatory and respiratory systems
R10-R19 Symptoms and signs involving the digestive system and abdomen
R20-R23 Symptoms and signs involving the skin and subcutaneous tissue
R25-R29 Symptoms and signs involving the nervous and musculoskeletal systems
R30-R39 Symptoms and signs involving the urinary system
R40-R46 Symptoms and signs involving cognition, perception, emotional state and behavior
R47-R49 Symptoms and signs involving speech and voice
R50-R69 General symptoms and signs
R70-R79 Abnormal findings on examination of blood, without diagnosis
R80-R82 Abnormal findings on examination of urine, without diagnosis
R83-R89 Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis
R90-R94 Abnormal findings on diagnostic imaging and in function studies, without diagnosis
R97 Abnormal tumor markers
R99 Ill-defined and unknown cause of mortality
This chapter contains the following blocks:
Z00-Z13 Persons encountering health services for examination and investigation
Z14-Z15 Genetic carrier and genetic susceptibility to disease
Z16 Infection with drug resistant microorganisms
Z17 Estrogen receptor status
Z20-Z28 Persons with potential health hazards related to communicable diseases
Z30-Z39 Persons encountering health services in circumstances related to reproduction
Z40-Z53 Persons encountering health services for specific procedures and health care
Z55-Z65 Persons with potential health hazards related to socioeconomic and psychosocial circumstances
Z66 Do not resuscitate [DNR] status
Z67 Blood type
Z68 Body mass index (BMI)
Z69-Z76 Persons encountering health services in other circumstances
Z77-Z99 Persons with potential health hazards related to family and personal history and certain conditions influencing health status
The appropriate 7th character is to be added to each code from category.
0 without tophus (tophi)
1 with tophus (tophi)
A initial encounter for fracture
D subsequent encounter for fracture with routine healing
G subsequent encounter for fracture with delayed healing
S sequela of fracture
A initial encounter for fracture
D subsequent encounter for fracture with routine healing
G subsequent encounter for fracture with delayed healing
K subsequent encounter for fracture with nonunion
P subsequent encounter for fracture with malunion
S sequela
7th character 0 is for single gestations and multiple gestations where the fetus is unspecified. 7th characters 1 through 9 are for cases of multiple gestations to identify the fetus for which the code applies.
0 not applicable or unspecified
1 fetus 1
2 fetus 2
3 fetus 3
4 fetus 4
5 fetus 5
9 other fetus
0 unspecified time
1 in the field [EMT or ambulance]
2 at arrival to emergency department
3 at hospital admission
4 24 hours or more after hospital admission
A initial encounter
D subsequent encounter
S sequela
A fracture not designated as open or closed should be coded to closed
A initial encounter for closed fracture
D subsequent encounter for fracture with routine healing
G subsequent encounter for fracture with delayed healing
K subsequent encounter for fracture with nonunion
P subsequent encounter for fracture with malunion
S sequela
A initial encounter
D subsequent encounter
S sequela
A fracture not designated as open or closed should be coded to closed The open fracture designations are based on the Gustilo open fracture classification
A initial encounter for closed fracture
B initial encounter for open fracture type I or II initial encounter for open fracture NOS
C initial encounter for open fracture type IIIA, IIIB, or IIIC
D subsequent encounter for closed fracture with routine healing
E subsequent encounter for open fracture type I or II with routine healing
F subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing
G subsequent encounter for closed fracture with delayed healing
H subsequent encounter for open fracture type I or II with delayed healing
J subsequent encounter for open fracture type IIIA, IIIB, or IIIC with delayed healing
K subsequent encounter for closed fracture with nonunion
M subsequent encounter for open fracture type I or II with nonunion
N subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion
P subsequent encounter for closed fracture with malunion
Q subsequent encounter for open fracture type I or II with malunion
R subsequent encounter for open fracture type IIIA, IIIB, or IIIC with malunion
S sequela
A fracture not designated as open or closed should be coded to closed
A initial encounter for closed fracture
D subsequent encounter for fracture with routine healing
G subsequent encounter for fracture with delayed healing
K subsequent encounter for fracture with nonunion
P subsequent encounter for fracture with malunion
S sequela
A initial encounter
D subsequent encounter
S sequela
A initial encounter
D subsequent encounter
S sequela
