2004-02-10-世界卫生组织-ICD-10_Updates_2003_38页_309kb

报告摘要

ICD-10 Official Updates Summary

Core Content

This document outlines the official updates to the ICD-10 classification system, including changes to the tabular list, instruction manual, and alphabetical index. The updates were approved at the WHO-FIC Network annual meeting in Cologne, Germany in October 2003, and have been implemented or are scheduled for implementation in various regions with specific dates noted.

Major Updates

Volume 1 - Tabular List

Chapter XXII - Codes for special purposes (U00-U99):
- Added as a new chapter.
- Includes U00-U49 for provisional assignment of new diseases of uncertain etiology.
- Specifically added U04 Severe acute respiratory syndrome [SARS] and U04.9 SARS, unspecified.
New Code Addition:
- G90.4 Autonomic dysreflexia was added as a new code, effective January 2006.
Inclusion and Exclusion Terms:
- A04.7 Enterocolitis due to Clostridium difficile was added with an inclusion term for Pseudomembranous colitis.
- A04 Other bacterial intestinal infections had its excludes note modified to remove foodborne intoxications, bacterial (A05.) and include tuberculous enteritis (A18.3).
- M24.8 Other specific joint derangements, not elsewhere classified was added with an inclusion term for Irritable hip.
- D56.1 Beta thalassaemia Sickle-cell beta thalassaemia was deleted.
- D57 Sickle-cell disorders had its excludes note modified to include double heterozygous sickling disorders (D57.2).
- Z87.8 Personal history of other specified conditions was added with an excludes note for personal history of self harm (Z91.5).
Place of Occurrence Code:
- A new place of occurrence code was proposed for use with ICD categories W00-Y34, but the actual implementation was deferred until an electronic version of ICD-10 is available.
Activity Code:
- A new activity code was introduced for use with ICD categories V01-Y34, to indicate the activity of the injured person at the time of the event. Implementation was deferred until an electronic version is available.

Volume 2 - Instruction Manual

Embolism and Secondary Conditions:
- Any disease described as "embolic" is assumed to be a direct consequence of conditions such as venous thrombosis, valvular heart disease, and atrial fibrillation.
- Dementia without a specified cause is considered a consequence of conditions involving irreversible brain damage, and only conditions that may lead to such damage are accepted as causes.
- Secondary or unspecified anaemia, malnutrition, marasmus or cachexia is assumed to be a consequence of malignant neoplasms, paralytic diseases, or conditions limiting self-care, including dementia and degenerative nervous system diseases.
Linkage of Conditions:
- Pneumocystis carinii pneumonia is linked to B20.6 HIV.
- Respiratory failure is not linked to categories B20-B23.
- Alcoholic liver disease is linked to K70.-, K70.4, K70.1, K70.2, K70.3, and K70.9 based on the presence of specific conditions.
- Atherosclerosis is linked to various conditions, including hypertensive disease, ischaemic heart diseases, heart failure, myocarditis, and cerebrovascular diseases.
Code Modification:
- I08 Multiple valve diseases was modified to not be used for non-rheumatic valvular diseases and to apply the General Principle or Rules 1, 2, or 3 for selecting the underlying cause.
- I70.- Atherosclerosis includes additional linkages to I05-I09, I34-I38, I71-I78, and K55.-.
- I70.9 Generalised and unspecified atherosclerosis includes linkages to R02 (Gangrene), F01 (Vascular dementia), and G20 (Parkinson's disease).
Postprocedural Respiratory Disorders:
- J95.- Postprocedural respiratory disorders, not elsewhere classified is not used for underlying cause mortality coding.
Other Conditions:
- K72 Hepatic failure is linked to F10.- (Mental and behavioural disorders due to use of alcohol) as K70.4.
- K76.0 Fatty (change) of liver is linked to F10.- as K70.0.
- K76.9 Liver disease, unspecified is linked to F10.- as K70.9.

Minor Updates

I07 Rheumatic tricuspid valve diseases includes valvulitis (chronic) and excludes endocardial fibroelastosis (I42.4) when specified as rheumatic.
I34 Nonrheumatic mitral valve disorders excludes hypertrophic subaortic stenosis (I42.1) when of unspecified cause.
I35 Nonrheumatic aortic valve disorders excludes hypertrophic subaortic stenosis (I42.1) when of unspecified cause.
I36 Nonrheumatic tricuspid valve disorders excludes conditions of unspecified cause (I07.-) and congenital disorders (Q22.4, Q22.8, Q22.9).
I47 Paroxysmal tachycardia excludes event of undetermined intent (Y32-Y33), intentional self-harm (X82-X83), and transport accidents due to cataclysm (X34-X38).
I67.2 Cerebral atherosclerosis includes linkages to I60-I66 (cerebral haemorrhage, infarction, or stroke).
I60-I69 Cerebrovascular diseases includes linkages to F01-F03, G20, and G31.2.
J44.8 Other specified chronic obstructive pulmonary disease includes chronic bronchitis, asthmatic, emphysematous, and obstructive NOS, and excludes acute lower respiratory infections (J44.0) and acute exacerbations (J44.1).
J60 Coalworker's pneumoconiosis and J61 Pneumoconiosis due to asbestos and other mineral fibres were modified to exclude tuberculosis (A15-A16).
J62 Pneumoconiosis due to dust containing silica excludes tuberculosis (A15-A16).
J63 Pneumoconiosis due to other inorganic dusts excludes tuberculosis (A15-A16).
J64 Unspecified pneumoconiosis excludes tuberculosis (A15-A16).
M62.2 Ischaemic infarction of muscle includes compartment syndrome, non-traumatic.
M62.2 excludes compartment syndrome, traumatic (T79.6).

Key Information

Implementation Dates:
- Most updates were implemented in January 2005 or January 2006.
- Some updates were deferred until an electronic version of ICD-10 is available.
Sources:
- Updates were sourced from MRG (Medical Reference Group), Australia, United Kingdom, USA, and Germany.
Scope:
- The updates cover various areas including infectious diseases, cardiac conditions, respiratory disorders, liver diseases, neurological conditions, injuries and poisonings, and special purpose codes.
Purpose:
- The updates aim to improve the accuracy, clarity, and comprehensiveness of the ICD-10 system, ensuring that it reflects the latest medical knowledge and coding practices.