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.

ICD-10 chapters
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) 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

(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) 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) 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
    • (Z88.0) Personal history of allergy to penicillin
    • (Z88.1) Personal history of allergy to other antibiotic agents
    • (Z88.2) Personal history of allergy to sulfonamides
  • (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
  • (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

See also

References

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