ICD-10 Chapter XXI: Factors influencing health status and contact with health services
ICD-10 is an international statistical classification used in health care and related industries.
Chapter | Block | Title |
---|---|---|
I | A00–B99 | Certain infectious and parasitic diseases |
II | C00–D48 | Neoplasms |
III | D50–D89 | Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism |
IV | E00–E90 | Endocrine, nutritional and metabolic diseases |
V | F00–F99 | Mental and behavioural disorders |
VI | G00–G99 | Diseases of the nervous system |
VII | H00–H59 | Diseases of the eye and adnexa |
VIII | H60–H95 | Diseases of the ear and mastoid process |
IX | I00–I99 | Diseases of the circulatory system |
X | J00–J99 | Diseases of the respiratory system |
XI | K00–K93 | Diseases of the digestive system |
XII | L00–L99 | Diseases of the skin and subcutaneous tissue |
XIII | M00–M99 | Diseases of the musculoskeletal system and connective tissue |
XIV | N00–N99 | Diseases of the genitourinary system |
XV | O00–O99 | Pregnancy, childbirth and the puerperium |
XVI | P00–P96 | Certain conditions originating in the perinatal period |
XVII | Q00–Q99 | Congenital malformations, deformations and chromosomal abnormalities |
XVIII | R00–R99 | Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified |
XIX | S00–T98 | Injury, poisoning and certain other consequences of external causes |
XX | V01–Y98 | External causes of morbidity and mortality |
XXI | Z00–Z99 | Factors influencing health status and contact with health services |
XXII | U00–U99 | Codes for special purposes |
Produced by the World Health Organization, it is used in several countries around the world. Some have gone on to develop their own national enhancements, building off the international classification.
Chapter XXI of ICD-10 captures factors influencing health status and contact with health services.
During some health encounters it may not be appropriate to use a code from Chapters I-XIX. As such codes from this chapter can be used in the primary diagnosis field when they represent the reason for which the encounter has taken place. Situations where this may be appropriate include: when a patient receives limited care or service for an ongoing condition (for example a patient in remission undergoing maintenance chemotherapy); to donate an organ and/or tissue; to receive prophylactic immunization; to discuss a problem other than a disease or injury; and for a situation or problem that influences the person's health status (that is not currently an illness or injury).
Should local coding rules permit; codes from Chapter XXI can also be used in addition to codes from other chapters. Instances might include the capturing of statuses and previously resolved conditions impacting upon the current encounter. For example; a patient with a history of colorectal cancer treated with a colectomy, now presenting with abdominal adhesions.
(Z00–Z13) Persons encountering health services for examination and investigation
- (Z00) General examination and investigation of persons without complaint and reported diagnosis
- (Z01) Other special examinations and investigations of persons without complaint or reported diagnosis
- (Z02) Examination and encounter for administrative purposes
- (Z03) Medical observation and evaluation for suspected diseases and conditions
- (Z04) Examination and observation for other reasons
- (Z08) Follow-up examination after treatment for malignant neoplasms
- (Z09) Follow-up examination after treatment for conditions other than malignant neoplasms
- (Z10) Routine general health check-up of defined subpopulation
- (Z11) Special screening examination for infectious and parasitic diseases
- (Z12) Special screening examination for neoplasms
- (Z13) Special screening examination for other diseases and disorders
(Z20–Z29) Persons with potential health hazards related to communicable diseases
- (Z20) Contact with and exposure to communicable diseases
- (Z21) Asymptomatic human immunodeficiency virus (HIV) infection status
- (Z22) Carrier of infectious disease
- (Z23) Need for immunization against single bacterial diseases
- (Z24) Need for immunization against certain single viral diseases
- (Z25) Need for immunization against other single viral diseases
- (Z26) Need for immunization against other single infectious diseases
- (Z27) Need for immunization against combinations of infectious diseases
- (Z28) Immunization not carried out
- (Z29) Need for other prophylactic measures
(Z30–Z39) Persons encountering health services in circumstances related to reproduction
- (Z30) Contraceptive management
- Z30.0 General counselling and advice on contraception
- Z30.1 Insertion of (intrauterine) contraceptive device
- Z30.2 Sterilization
- Z30.3 Menstrual extraction
- Z30.4 Surveillance of contraceptive drugs
- Z30.5 Surveillance of (intrauterine) contraceptive device
- Z30.8 Other contraceptive management
- Z30.9 Contraceptive management, unspecified
- (Z31) Procreative management
- (Z32) Pregnancy examination and test
- (Z33) Pregnant state, incidental
- (Z34) Supervision of normal pregnancy
- (Z35) Supervision of high-risk pregnancy
- (Z36) Antenatal screening
- (Z36.0) Antenatal screening for chromosomal anomalies
- (Z36.1) Antenatal screening for raised alphafetoprotein level
- (Z36.2) Other antenatal screening based on amniocentesis
- (Z36.3) Antenatal screening for malformations using ultrasound and other physical methods
- (Z36.4) Antenatal screening for fetal growth retardation using ultrasound and other physical methods
- (Z36.5) Antenatal screening for isoimmunization
- (Z36.8) Other antenatal screening
- (Z36.9) Antenatal screening, unspecified
- (Z37) Outcome of delivery
- (Z38) Liveborn infants according to place of birth
- (Z39) Postpartum care and examination
(Z40–Z54) Persons encountering health services for specific procedures and health care
- (Z40) Prophylactic surgery
- (Z41) Procedures for purposes other than remedying health state
- (Z42) Follow-up care involving plastic surgery
- (Z43) Attention to artificial openings
- (Z44) Fitting and adjustment of external prosthetic device
- (Z45) Adjustment and management of implanted device
- (Z46) Fitting and adjustment of other devices
- (Z47) Other orthopaedic follow-up care
- (Z48) Other surgical follow-up care
- (Z49) Care involving dialysis
- (Z50) Care involving use of rehabilitation procedures
- (Z51) Other medical care
- (Z52) Donors of organs and tissues
- (Z53) Persons encountering health services for specific procedures, not carried out
- (Z54) Convalescence
(Z55–Z65) Persons with potential health hazards related to socioeconomic and psychosocial circumstances
- (Z55) Problems related to education and literacy
- (Z56) Problems related to employment and unemployment
- (Z57) Occupational exposure to risk-factors
- (Z58) Problems related to physical environment
- (Z59) Problems related to housing and economic circumstances
- (Z60) Problems related to social environment
- (Z61) Problems related to negative life events in childhood
- (Z62) Other problems related to upbringing
- (Z63) Other problems related to primary support group, including family circumstances
- (Z64) Problems related to certain psychosocial circumstances
- (Z65) Problems related to other psychosocial circumstances
(Z70–Z76) Persons encountering health services in other circumstances
- (Z70) Counselling related to sexual attitude, behaviour and orientation.
- (Z71) Persons encountering health services for other counselling and medical advice, not elsewhere classified.
- (Z72) Problems related to lifestyle.
- (Z73) Problems related to life-management difficulty.
- (Z74) Problems related to care-provider dependency.
- (Z75) Problems related to medical facilities and other health care.
- (Z76) Persons encountering health services in other circumstances.
(Z80–Z99) Persons with potential health hazards related to family and personal history and certain conditions influencing health status
- (Z80) Family history of malignant neoplasm
- (Z81) Family history of mental and behavioural disorders
- (Z82) Family history of certain disabilities and chronic diseases leading to disablement
- (Z83) Family history of other specific disorders
- (Z84) Family history of other conditions
- (Z85) Personal history of malignant neoplasm
- (Z86) Personal history of certain other diseases
- (Z87) Personal history of other diseases and conditions
- (Z88) Personal history of allergy to drugs, medicaments and biological substances
- (Z89) Acquired absence of limb
- (Z90) Acquired absence of organs, not elsewhere classified
- (Z91) Personal history of risk-factors, not elsewhere classified
- (Z92) Personal history of medical treatment
- (Z93) Artificial opening status
- (Z93.0) Tracheostomy status
- (Z93.1) Gastrostomy status
- (Z93.2) Ileostomy status
- (Z93.3) Colostomy status
- (Z93.4) Other artificial openings of gastrointestinal tract status
- (Z93.5) Cystostomy status
- (Z93.6) Other artificial openings of urinary tract status
- (Z93.8) Other artificial opening status
- (Z93.9) Artificial opening status, unspecified
- (Z94) Transplanted organ and tissue status
- (Z95) Presence of cardiac and vascular implants and grafts
- (Z96) Presence of other functional implants
- (Z97) Presence of other devices
- (Z98) Other postsurgical states
- (Z99) Dependence on enabling machines and devices, not elsewhere classified