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INTERNATIONAL CLASSIFICATION OF DISEASES

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vertical line Table of Contents Alphabetical Index of Diseases and Injuries Explanation of Disease Classification

7. Diseases of the Circulatory System (390-459)




ACUTE RHEUMATIC FEVER (390-392)

390	Rheumatic fever without mention of heart involvement
Arthritis, rheumatic, acute or subacute
Rheumatic fever (active) (acute)
Rheumatism, articular, acute or subacute
Excludes:	that with heart involvement (391.0-391.9)
391	Rheumatic fever with heart involvement
Excludes:	chronic heart diseases of rheumatic origin (393.0-398.9) unless
 rheumatic fever is also present or there is evidence of recrudescence or activity
 of the rheumatic process
391.0	Acute rheumatic pericarditis
Rheumatic:
fever (active) (acute) with pericarditis
pericarditis (acute)
Any condition classifiable to 390 with pericarditis
Excludes:	that not specified as rheumatic (420.0-420.9)
391.1	Acute rheumatic endocarditis
Rheumatic:
endocarditis, acute
fever (active) (acute) with endocarditis or valvulitis
valvulitis acute
Any condition classifiable to 390 with endocarditis or valvulitis
391.2	Acute rheumatic myocarditis
Rheumatic fever (active) (acute) with myocarditis
Any condition classifiable to 390 with myocarditis
391.8	Other acute rheumatic heart disease
Rheumatic:
fever (active) (acute) with other or multiple types of heart involvement
pancarditis, acute
Any condition classifiable to 390 with other or multiple types of heart involvement
391.9	Acute rheumatic heart disease, unspecified
Rheumatic:
carditis, acute
fever (active) (acute) with unspecified type of heart involvement
heart disease, active or acute
Any condition classifiable to 390 with unspecified type of heart involvement
392	Rheumatic chorea
Includes:	Sydenham's chorea
Excludes:	chorea:
NOS (333.5)
Huntington's (333.4)
392.0	With heart involvement
Rheumatic chorea with heart involvement of any type classifiable to 391
392.9	Without mention of heart involvement

CHRONIC RHEUMATIC HEART DISEASE (393-398)

393	Chronic rheumatic pericarditis
Adherent pericardium, rheumatic
Chronic rheumatic:
mediastinopericarditis
myopericarditis
Excludes:	pericarditis NOS or not specified as rheumatic (423.0-423.9)
394	Diseases of mitral valve
Excludes:	that with aortic valve involvement (396.0-396.9)
394.0	Mitral stenosis
Mitral (valve):
obstruction (rheumatic)
stenosis NOS
394.1	Rheumatic mitral insufficiency
Rheumatic mitral:
incompetence
regurgitation
Excludes:	that not specified as rheumatic (424.0)
394.2	Mitral stenosis with insufficiency
Mitral stenosis with incompetence or regurgitation
394.9	Other and unspecified mitral valve diseases
Mitral (valve):
disease (chronic)
failure
395	Diseases of aortic valve
Excludes:	that not specified as rheumatic (424.1)
that with mitral valve involvement (396.0-396.9)
395.0	Rheumatic aortic stenosis
Rheumatic aortic (valve) obstruction
395.1	Rheumatic aortic insufficiency
Rheumatic aortic:
incompetence
regurgitation
395.2	Rheumatic aortic stenosis with insufficiency
Rheumatic aortic stenosis with incompetence or regurgitation
395.9	Other and unspecified rheumatic aortic diseases
Rheumatic aortic (valve) disease
396	Diseases of mitral and aortic valves
Includes:	involvement of both mitral and aortic valves, whether specified as
 rheumatic or not
396.0	Mitral valve stenosis and aortic valve stenosis
Atypical aortic (valve) stenosis
Mitral and aortic (valve) obstruction (rheumatic)
396.1	Mitral valve stenosis and aortic valve insufficiency
396.2	Mitral valve insufficiency and aortic valve stenosis
396.3	Mitral valve insufficiency and aortic valve insufficiency
Mitral and aortic (valve):
incompetence
regurgitation
396.8	Multiple involvement of mitral and aortic valves
Stenosis and insufficiency of mitral or aortic valve with stenosis or insufficiency,
 or both, of the other valve
396.9	Mitral and aortic valve diseases, unspecified
397	Diseases of other endocardial structures
397.0	Diseases of tricuspid valve
Tricuspid (valve) (rheumatic):
disease
insufficiency
obstruction
regurgitation
stenosis
397.1	Rheumatic diseases of pulmonary valve
Excludes:	that not specified as rheumatic (424.3)
397.9	Rheumatic diseases of endocardium, valve unspecified
Rheumatic:
endocarditis (chronic)
valvulitis (chronic)
Excludes:	that not specified as rheumatic (424.90-424.99)
398	Other rheumatic heart disease
398.0	Rheumatic myocarditis
Rheumatic degeneration of myocardium
Excludes:	myocarditis not specified as rheumatic (429.0)
398.9	Other and unspecified rheumatic heart diseases
398.90	Rheumatic heart disease, unspecified
Rheumatic:
carditis
heart disease NOS
Excludes:	carditis not specified as rheumatic (429.89)
heart disease NOS not specified as rheumatic (429.9)
398.91	Rheumatic heart failure (congestive)
Rheumatic left ventricular failure
398.99	Other

HYPERTENSIVE DISEASE (401-405)

Excludes:	that complicating pregnancy, childbirth, or the puerperium (642.0-642.9)
that involving coronary vessels (410.00-414.9)
401	Essential hypertension
Includes:	high blood pressure
hyperpiesia
hyperpiesis
hypertension (arterial) (essential) (primary) (systemic)
hypertensive vascular:
degeneration
disease
Excludes:	elevated blood pressure without diagnosis of hypertension (796.2)
pulmonary hypertension (416.0-416.9)
that involving vessels of:
brain (430-438)
eye (362.11)
401.0	Malignant
401.1	Benign
401.9	Unspecified
402	Hypertensive heart disease
Includes:	hypertensive:
cardiomegaly
cardiopathy
cardiovascular disease
heart (disease) (failure)
any condition classifiable to 429.0-429.3, 429.8, 429.9 due to hypertension
Use additional code to specify type of heart failure (428.0-428.43), if known
402.0	Malignant
402.00	Without heart failure
402.01	With heart failure
402.1	Benign
402.10	Without heart failure
402.11	With heart failure
402.9	Unspecified
402.90	Without heart failure
402.91	With heart failure
403	Hypertensive chronic kidney disease
Includes:	arteriolar nephritis
arteriosclerosis of:
kidney
renal arterioles
arteriosclerotic nephritis (chronic) (interstitial)
hypertensive:
nephropathy
renal failure
uremia (chronic)
nephrosclerosis
renal sclerosis with hypertension
any condition classifiable to 585, 586, or 587 with any condition classifiable to 401
Excludes:	acute renal failure (584.5-584.9)
renal disease stated as not due to hypertension
renovascular hypertension (405.0-405.9 with fifth-digit 1)
The following fifth-digit subclassification is for use with category 403:
0	with chronic kidney disease stage I through stage IV, or unspecified
Use additional code to identify the stage of chronic kidney disease (585.1-585.4, 585.9)
1	with chronic kidney disease stage V or end stage renal disease
Use additional code to identify the stage of chronic kidney disease (585.5, 585.6)
403.0	Malignant
403.1	Benign
403.9	Unspecified
404	Hypertensive heart and chronic kidney disease
Includes:	disease:
cardiorenal
cardiovascular renal
any condition classifiable to 402 with any condition classifiable to 403
Use additional code to specify type of heart failure (428.0-428.43), if known
The following fifth-digit subclassification is for use with category 404:
0	without heart failure and with chronic kidney disease stage I through stage IV,
 or unspecified
Use additional code to identify the stage of chronic kidney disease (585.1-585.4, 585.9)
1	with heart failure and with chronic kidney disease stage I through stage IV, or
 unspecified
Use additional code to identify the stage of chronic kidney disease (585.1-585.4, 585.9)
2	without heart failure and with chronic kidney disease stage V or end stage renal
 disease
Use additional code to identify the stage of chronic kidney disease (585.5, 585.6)
3	with heart failure and chronic kidney disease stage V or end stage renal disease
Use additional code to identify the stage of chronic kidney disease (585.5, 585.6)
404.0	Malignant
404.1	Benign
404.9	Unspecified
405	Secondary hypertension
405.0	Malignant
405.01	Renovascular
405.09	Other
405.1	Benign
405.11	Renovascular
405.19	Other
405.9	Unspecified
405.91	Renovascular
405.99	Other

ISCHEMIC HEART DISEASE (410-414)

Includes:	that with mention of hypertension
Use additional code to identify presence of hypertension (401.0-405.9)
410	Acute myocardial infarction
Includes:	cardiac infarction
coronary (artery):
embolism
occlusion
rupture
thrombosis
infarction of heart, myocardium, or ventricle
rupture of heart, myocardium, or ventricle
ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction
any condition classifiable to 414.1-414.9 specified as acute or with a stated duration
 of 8 weeks or less
The following fifth-digit subclassification is for use with category 410:
0	episode of care unspecified
	Use when the source document does not contain sufficient information for the
 assignment of fifth-digit 1 or 2.
1	initial episode of care
	Use fifth-digit 1 to designate the first episode of care (regardless of facility
 site) for a newly diagnosed myocardial infarction.  The fifth-digit 1 is assigned
 regardless of the number of times a patient may be transferred during the initial
 episode of care.
2	subsequent episode of care
	Use fifth-digit 2 to designate an episode of care following the initial episode
 when the patient is admitted for further observation, evaluation or treatment for a
 myocardial infarction that has received initial treatment, but is still less than 8
 weeks old.
410.0	Of anterolateral wall
ST elevation myocardial infarction (STEMI) of anterolateral wall
410.1	Of other anterior wall
Infarction:
anterior (wall) NOS (with contiguous portion of intraventricular septum)
anteroapical (with contiguous portion of intraventricular septum)
anteroseptal (with contiguous portion of intraventricular septum)
ST elevation myocardial infarction (STEMI) of other anterior wall
410.2	Of inferolateral wall
ST elevation myocardial infarction (STEMI) of inferolateral wall
410.3	Of inferoposterior wall
ST elevation myocardial infarction (STEMI) of inferoposterior wall
410.4	Of other inferior wall
Infarction:
diaphragmatic wall NOS (with contiguous portion of intraventricular septum)
inferior (wall) NOS (with contiguous portion of intraventricular septum)
ST elevation myocardial infarction (STEMI) of other inferior wall
410.5	Of other lateral wall
Infarction:
apical-lateral
basal-lateral
high lateral
posterolateral
ST elevation myocardial infarction (STEMI) of other lateral wall
410.6	True posterior wall infarction
Infarction:
posterobasal
strictly posterior
ST elevation myocardial infarction (STEMI) of true posterior wall
410.7	Subendocardial infarction
Non-ST elevation myocardial infarction (NSTEMI)
Nontransmural infarction
410.8	Of other specified sites
Infarction of:
atrium
papillary muscle
septum alone
ST elevation myocardial infarction (STEMI) of other specified sites
410.9	Unspecified site
Acute myocardial infarction NOS
Coronary occlusion NOS
Myocardial infarction NOS
411	Other acute and subacute forms of ischemic heart disease
411.0	Postmyocardial infarction syndrome
Dressler's syndrome
411.1	Intermediate coronary syndrome
Impending infarction
Preinfarction angina
Preinfarction syndrome
Unstable angina
Excludes:	angina (pectoris) (413.9)
decubitus (413.0)
411.8	Other
411.81	Acute coronary occlusion without myocardial infarction
Acute coronary (artery):
embolism without or not resulting in myocardial infarction
obstruction without or not resulting in myocardial infarction
occlusion without or not resulting in myocardial infarction
thrombosis without or not resulting in myocardial infarction
Excludes:	obstruction without infarction due to atherosclerosis (414.00-414.07)
occlusion without infarction due to atherosclerosis (414.00-414.07)
411.89	Other
Coronary insufficiency (acute)
Subendocardial ischemia
412	Old myocardial infarction
Healed myocardial infarction
Past myocardial infarction diagnosed on ECG [EKG] or other special investigation, but
 currently presenting no symptoms
413	Angina pectoris
413.0	Angina decubitus
Nocturnal angina
413.1	Prinzmetal angina
Variant angina pectoris
413.9	Other and unspecified angina pectoris
Angina:
NOS
cardiac
of effort
Anginal syndrome
Status anginosus
Stenocardia
Syncope anginosa
Excludes:	preinfarction angina (411.1)
414	Other forms of chronic ischemic heart disease
Excludes:	arteriosclerotic cardiovascular disease [ASCVD] (429.2)
cardiovascular:
arteriosclerosis or sclerosis (429.2)
degeneration or disease (429.2)
414.0	Coronary atherosclerosis
Arteriosclerotic heart disease [ASHD]
Atherosclerotic heart disease
Coronary (artery):
arteriosclerosis
arteritis or endarteritis
atheroma
sclerosis
stricture
Use additional code, if applicable, to identify chronic total occlusion of coronary
 artery (414.2)
Excludes:	embolism of graft (996.72)
occlusion NOS of graft (996.72)
thrombus of graft (996.72)
414.00	Of unspecified type of vessel, native or graft
414.01	Of native coronary artery
414.02	Of autologous biological bypass graft
414.03	Of nonautologous biological bypass graft
414.04	Of artery bypass graft
Internal mammary artery
414.05	Of unspecified type of bypass graft
Bypass graft NOS
414.06	Of native coronary artery of transplanted heart
414.07	Of bypass graft (artery) (vein) of transplanted heart
414.1	Aneurysm and dissection of heart
414.10	Aneurysm of heart (wall)
Aneurysm (arteriovenous):
mural
ventricular
414.11	Aneurysm of coronary vessels
Aneurysm (arteriovenous) of coronary vessels
414.12	Dissection of coronary artery
414.19	Other aneurysm of heart
Arteriovenous fistula, acquired, of heart
414.2	Chronic total occlusion of coronary artery
Complete occlusion of coronary artery
Total occlusion of coronary artery
Code first	coronary atherosclerosis (414.00-414.07)
Excludes:	acute coronary occlusion with myocardial infarction (410.00-410.92)
acute coronary occlusion without myocardial infarction (411.81)
414.8	Other specified forms of chronic ischemic heart disease
Chronic coronary insufficiency
Ischemia, myocardial (chronic)
Any condition classifiable to 410 specified as chronic, or presenting with symptoms
 after 8 weeks from date of infarction
Excludes:	coronary insufficiency (acute) (411.89)
414.9	Chronic ischemic heart disease, unspecified
Ischemic heart disease NOS

DISEASES OF PULMONARY CIRCULATION (415-417)

415	Acute pulmonary heart disease
415.0	Acute cor pulmonale
Excludes:	cor pulmonale NOS (416.9)
415.1	Pulmonary embolism and infarction
Pulmonary (artery) (vein):
apoplexy
embolism
infarction (hemorrhagic)
thrombosis
Excludes:	that complicating:
abortion (634-638 with .6, 639.6)
ectopic or molar pregnancy (639.6)
pregnancy, childbirth, or the puerperium (673.0-673.8)
415.11	Iatrogenic pulmonary embolism and infarction
415.12	Septic pulmonary embolism
Septic embolism NOS
Code first underlying infection, such as:
septicemia (038.0-038.9)
Excludes:	septic arterial embolism (449)
415.19	Other
416	Chronic pulmonary heart disease
416.0	Primary pulmonary hypertension
Idiopathic pulmonary arteriosclerosis
Pulmonary hypertension (essential) (idiopathic) (primary)
416.1	Kyphoscoliotic heart disease
416.8	Other chronic pulmonary heart diseases
Pulmonary hypertension, secondary
416.9	Chronic pulmonary heart disease, unspecified
Chronic cardiopulmonary disease
Cor pulmonale (chronic) NOS
417	Other diseases of pulmonary circulation
417.0	Arteriovenous fistula of pulmonary vessels
Excludes:	congenital arteriovenous fistula (747.3)
417.1	Aneurysm of pulmonary artery
Excludes:	congenital aneurysm (747.3)
417.8	Other specified diseases of pulmonary circulation
Pulmonary:
arteritis
endarteritis
Rupture of pulmonary vessel
Stricture of pulmonary vessel
417.9	Unspecified disease of pulmonary circulation

OTHER FORMS OF HEART DISEASE (420-429)

420	Acute pericarditis
Includes:	acute:
mediastinopericarditis
myopericarditis
pericardial effusion
pleuropericarditis
pneumopericarditis
Excludes:	acute rheumatic pericarditis (391.0)
postmyocardial infarction syndrome [Dressler's] (411.0)
420.0	Acute pericarditis in diseases classified elsewhere
Code first underlying disease, as:
actinomycosis (039.8)
amebiasis (006.8)
chronic uremia (585.9)
nocardiosis (039.8)
tuberculosis (017.9)
uremia NOS (586)
Excludes:	pericarditis (acute) (in):
Coxsackie (virus) (074.21)
gonococcal (098.83)
histoplasmosis (115.0-115.9 with fifth-digit 3)
meningococcal infection (036.41)
syphilitic (093.81)
420.9	Other and unspecified acute pericarditis
420.90	Acute pericarditis, unspecified
Pericarditis (acute):
NOS
infective NOS
sicca
420.91	Acute idiopathic pericarditis
Pericarditis, acute:
benign
nonspecific
viral
420.99	Other
Pericarditis (acute):
pneumococcal
purulent
staphylococcal
streptococcal
suppurative
Pneumopyopericardium
Pyopericardium
Excludes:	pericarditis in diseases classified elsewhere (420.0)
421	Acute and subacute endocarditis
421.0	Acute and subacute bacterial endocarditis
Endocarditis (acute) (chronic) (subacute):
bacterial
infective NOS
lenta
malignant
purulent
septic
ulcerative
vegetative
Infective aneurysm
Subacute bacterial endocarditis [SBE]
Use additional code, if desired, to identify infectious organism
 [e.g., Streptococcus 041.0, Staphylococcus 041.1]
421.1	Acute and subacute infective endocarditis in diseases classified elsewhere
Code first underlying disease, as:
blastomycosis (116.0)
Q fever (083.0)
typhoid (fever) (002.0)
Excludes:	endocarditis (in):
Coxsackie (virus) (074.22)
gonococcal (098.84)
histoplasmosis (115.0-115.9 with fifth-digit 4)
meningococcal infection (036.42)
monilial (112.81)
421.9	Acute endocarditis, unspecified
Endocarditis, acute or subacute
Myoendocarditis, acute or subacute
Periendocarditis, acute or subacute
Excludes:	acute rheumatic endocarditis (391.1)
422	Acute myocarditis
Excludes:	acute rheumatic myocarditis (391.2)
422.0	Acute myocarditis in diseases classified elsewhere
Code first underlying disease, as:
myocarditis (acute):
influenzal (487.8)
tuberculous (017.9)
Excludes:	myocarditis (acute) (due to):
aseptic, of newborn (074.23)
Coxsackie (virus) (074.23)
diphtheritic (032.82)
meningococcal infection (036.43)
syphilitic (093.82)
toxoplasmosis (130.3)
422.9	Other and unspecified acute myocarditis
422.90	Acute myocarditis, unspecified
Acute or subacute (interstitial) myocarditis
422.91	Idiopathic myocarditis
Myocarditis (acute or subacute):
Fiedler's
giant cell
isolated (diffuse) (granulomatous)
nonspecific granulomatous
422.92	Septic myocarditis
Myocarditis, acute or subacute:
pneumococcal
staphylococcal
Use additional code to identify infectious organism [e.g., Staphylococcus 041.1]
Excludes:	myocarditis, acute or subacute:
in bacterial diseases classified elsewhere (422.0)
streptococcal (391.2)
422.93	Toxic myocarditis
422.99	Other
423	Other diseases of pericardium
Excludes:	that specified as rheumatic (393)
423.0	Hemopericardium
423.1	Adhesive pericarditis
Adherent pericardium
Fibrosis of pericardium
Milk spots
Pericarditis:
adhesive
obliterative
Soldiers' patches
423.2	Constrictive pericarditis
Concato's disease
Pick's disease of heart (and liver)
423.3	Cardiac tamponade
Code first the underlying cause
423.8	Other specified diseases of pericardium
Calcification of pericardium
Fistula of pericardium
423.9	Unspecified disease of pericardium
424	Other diseases of endocardium
Excludes:	bacterial endocarditis (421.0-421.9)
rheumatic endocarditis (391.1, 394.0-397.9)
syphilitic endocarditis (093.20-093.24)
424.0	Mitral valve disorders
Mitral (valve):
incompetence NOS of specified cause, except rheumatic
insufficiency NOS of specified cause, except rheumatic
regurgitation NOS of specified cause, except rheumatic
Excludes:	mitral (valve):
disease (394.9)
failure (394.9)
stenosis (394.0)
the listed conditions:
specified as rheumatic (394.1)
unspecified as to cause but with mention of:
diseases of aortic valve (396.0-396.9)
mitral stenosis or obstruction (394.2)
424.1	Aortic valve disorders
Aortic (valve):
incompetence NOS of specified cause, except rheumatic
insufficiency NOS of specified cause, except rheumatic
regurgitation NOS of specified cause, except rheumatic
stenosis NOS of specified cause, except rheumatic
Excludes:	hypertrophic subaortic stenosis (425.1)
that specified as rheumatic (395.0-395.9)
that of unspecified cause but with mention of diseases of mitral valve (396.0-396.9)
424.2	Tricuspid valve disorders, specified as nonrheumatic
Tricuspid valve:
incompetence of specified cause, except rheumatic
insufficiency of specified cause, except rheumatic
regurgitation of specified cause, except rheumatic
stenosis of specified cause, except rheumatic
Excludes:	rheumatic or of unspecified cause (397.0)
424.3	Pulmonary valve disorders
Pulmonic:
incompetence NOS
insufficiency NOS
regurgitation NOS
stenosis NOS
Excludes:	that specified as rheumatic (397.1)
424.9	Endocarditis, valve unspecified
424.90	Endocarditis, valve unspecified, unspecified cause
Endocarditis (chronic):
NOS
nonbacterial thrombotic
Valvular:
incompetence of unspecified valve,unspecified cause
insufficiency of unspecified valve,unspecified cause
regurgitation of unspecified valve,unspecified cause
stenosis of unspecified valve,unspecified cause
Valvulitis (chronic)
424.91	Endocarditis in diseases classified elsewhere
Code first underlying disease, as:
atypical verrucous endocarditis [Libman-Sacks] (710.0)
disseminated lupus erythematosus (710.0)
tuberculosis (017.9)
Excludes:	syphilitic (093.20-093.24)
424.99	Other
Any condition classifiable to 424.90 with specified cause, except rheumatic
Excludes:	endocardial fibroelastosis (425.3)
that specified as rheumatic (397.9)
425	Cardiomyopathy
Includes:	myocardiopathy
425.0	Endomyocardial fibrosis
425.1	Hypertrophic obstructive cardiomyopathy
Hypertrophic subaortic stenosis (idiopathic)
425.2	Obscure cardiomyopathy of Africa
Becker's disease
Idiopathic mural endomyocardial disease
425.3	Endocardial fibroelastosis
Elastomyofibrosis
425.4	Other primary cardiomyopathies
Cardiomyopathy:
NOS
congestive
constrictive
familial
hypertrophic
idiopathic
nonobstructive
obstructive
restrictive
Cardiovascular collagenosis
425.5	Alcoholic cardiomyopathy
425.7	Nutritional and metabolic cardiomyopathy
Code first underlying disease, as:
amyloidosis (277.30-277.39)
beriberi (265.0)
cardiac glycogenosis (271.0)
mucopolysaccharidosis (277.5)
thyrotoxicosis (242.0-242.9)
Excludes:	gouty tophi of heart (274.82)
425.8	Cardiomyopathy in other diseases classified elsewhere
Code first underlying disease, as:
Friedreich's ataxia (334.0)
myotonia atrophica (359.21)
progressive muscular dystrophy (359.1)
sarcoidosis (135)
Excludes:	cardiomyopathy in Chagas' disease (086.0)
425.9	Secondary cardiomyopathy, unspecified
426	Conduction disorders
426.0	Atrioventricular block, complete
Third degree atrioventricular block
426.1	Atrioventricular block, other and unspecified
426.10	Atrioventricular block, unspecified
Atrioventricular [AV] block (incomplete) (partial)
426.11	First degree atrioventricular block
Incomplete atrioventricular block, first degree
Prolonged P-R interval NOS
426.12	Mobitz (type) II atrioventricular block
Incomplete atrioventricular block:
Mobitz (type) II
second degree, Mobitz (type) II
426.13	Other second degree atrioventricular block
Incomplete atrioventricular block:
Mobitz (type) I [Wenckebach's]
second degree:
NOS
Mobitz (type) I
with 2:1 atrioventricular response [block]
Wenckebach's phenomenon
426.2	Left bundle branch hemiblock
Block:
left anterior fascicular
left posterior fascicular
426.3	Other left bundle branch block
Left bundle branch block:
NOS
anterior fascicular with posterior fascicular
complete
main stem
426.4	Right bundle branch block
426.5	Bundle branch block, other and unspecified
426.50	Bundle branch block, unspecified
426.51	Right bundle branch block and left posterior fascicular block
426.52	Right bundle branch block and left anterior fascicular block
426.53	Other bilateral bundle branch block
Bifascicular block NOS
Bilateral bundle branch block NOS
Right bundle branch with left bundle branch block (incomplete) (main stem)
426.54	Trifascicular block
426.6	Other heart block
Intraventricular block:
NOS
diffuse
myofibrillar
Sinoatrial block
Sinoauricular block
426.7	Anomalous atrioventricular excitation
Atrioventricular conduction:
accelerated
accessory
pre-excitation
Ventricular pre-excitation
Wolff-Parkinson-White syndrome
426.8	Other specified conduction disorders
426.81	Lown-Ganong-Levine syndrome
Syndrome of short P-R interval, normal QRS complexes, and supraventricular tachycardias
426.82	Long QT syndrome
426.89	Other
Dissociation:
atrioventricular [AV]
interference
isorhythmic
Nonparoxysmal AV nodal tachycardia
426.9	Conduction disorder, unspecified
Heart block NOS
Stokes-Adams syndrome
427	Cardiac dysrhythmias
Excludes:	that complicating:
abortion (634-638 with .7, 639.8)
ectopic or molar pregnancy (639.8)
labor or delivery (668.1, 669.4)
427.0	Paroxysmal supraventricular tachycardia
Paroxysmal tachycardia:
atrial [PAT]
atrioventricular [AV]
junctional
nodal
427.1	Paroxysmal ventricular tachycardia
Ventricular tachycardia (paroxysmal)
427.2	Paroxysmal tachycardia, unspecified
Bouveret-Hoffmann syndrome
Paroxysmal tachycardia:
NOS
essential
427.3	Atrial fibrillation and flutter
427.31	Atrial fibrillation
427.32	Atrial flutter
427.4	Ventricular fibrillation and flutter
427.41	Ventricular fibrillation
427.42	Ventricular flutter
427.5	Cardiac arrest
Cardiorespiratory arrest
427.6	Premature beats
427.60	Premature beats, unspecified
Ectopic beats
Extrasystoles
Extrasystolic arrhythmia
Premature contractions or systoles NOS
427.61	Supraventricular premature beats
Atrial premature beats, contractions, or systoles
427.69	Other
Ventricular premature beats, contractions, or systoles
427.8	Other specified cardiac dysrhythmias
427.81	Sinoatrial node dysfunction
Sinus bradycardia:
persistent
severe
Syndrome:
sick sinus
tachycardia-bradycardia
Excludes:	sinus bradycardia NOS (427.89)
427.89	Other
Rhythm disorder:
coronary sinus
ectopic
nodal
Wandering (atrial) pacemaker
Excludes:	carotid sinus syncope (337.0)
neonatal bradycardia (779.81)
neonatal tachycardia (779.82)
reflex bradycardia (337.0)
tachycardia NOS (785.0)
427.9	Cardiac dysrhythmia, unspecified
Arrhythmia (cardiac) NOS
428	Heart failure
Code, if applicable, heart failure due to hypertension first (402.0-402.9, with fifth-digit
 1 or 404.0-404.9 with fifth-digit 1 or 3)
Excludes:	rheumatic (398.91)
that complicating:
abortion (634-638 with .7, 639.8)
ectopic or molar pregnancy (639.8)
labor or delivery (668.1, 669.4)
428.0	Congestive heart failure, unspecified
Congestive heart disease
Right heart failure (secondary to left heart failure)
Excludes:	fluid overload NOS (276.6)
428.1	Left heart failure
Acute edema of lung with heart disease NOS or heart failure
Acute pulmonary edema with heart disease NOS or heart failure
Cardiac asthma
Left ventricular failure
428.2	Systolic heart failure
Excludes:	combined systolic and diastolic heart failure (428.40-428.43)
428.20	Unspecified
428.21	Acute
428.22	Chronic
428.23	Acute on chronic
428.3	Diastolic heart failure
Excludes:	combined systolic and diastolic heart failure (428.40-428.43)
428.30	Unspecified
428.31	Acute
428.32	Chronic
428.33	Acute on chronic
428.4	Combined systolic and diastolic heart failure
428.40	Unspecified
428.41	Acute
428.42	Chronic
428.43	Acute on chronic
428.9	Heart failure, unspecified
Cardiac failure NOS
Heart failure NOS
Myocardial failure NOS
Weak heart
429	Ill-defined descriptions and complications of heart disease
429.0	Myocarditis, unspecified
Myocarditis (with mention of arteriosclerosis):
NOS (with mention of arteriosclerosis)
chronic (interstitial) (with mention of arteriosclerosis)
fibroid (with mention of arteriosclerosis)
senile (with mention of arteriosclerosis)
Use additional code to identify presence of arteriosclerosis
Excludes:	acute or subacute (422.0-422.9)
rheumatic (398.0)
acute (391.2)
that due to hypertension (402.0-402.9)
429.1	Myocardial degeneration
Degeneration of heart or myocardium (with mention of arteriosclerosis):
fatty (with mention of arteriosclerosis)
mural (with mention of arteriosclerosis)
muscular (with mention of arteriosclerosis)
Myocardial (with mention of arteriosclerosis):
degeneration (with mention of arteriosclerosis)
disease (with mention of arteriosclerosis)
Use additional code to identify presence of arteriosclerosis
Excludes:	that due to hypertension (402.0-402.9)
429.2	Cardiovascular disease, unspecified
Arteriosclerotic cardiovascular disease [ASCVD]
Cardiovascular arteriosclerosis
Cardiovascular:
degeneration (with mention of arteriosclerosis)
disease (with mention of arteriosclerosis)
sclerosis (with mention of arteriosclerosis)
Use additional code to identify presence of arteriosclerosis
Excludes:	that due to hypertension (402.0-402.9)
429.3	Cardiomegaly
Cardiac:
dilatation
hypertrophy
Ventricular dilatation
Excludes:	that due to hypertension (402.0-402.9)
429.4	Functional disturbances following cardiac surgery
Cardiac insufficiency following cardiac surgery or due to prosthesis
Heart failure following cardiac surgery or due to prosthesis
Postcardiotomy syndrome
Postvalvulotomy syndrome
Excludes:	cardiac failure in the immediate postoperative period (997.1)
429.5	Rupture of chordae tendineae
429.6	Rupture of papillary muscle
429.7	Certain sequelae of myocardial infarction, not elsewhere classified
Use additional code to identify the associated myocardial infarction:
with onset of 8 weeks or less (410.00-410.92)
with onset of more than 8 weeks (414.8)
Excludes:	congenital defects of heart (745, 746)
coronary aneurysm (414.11)
disorders of papillary muscle (429.6, 429.81)
postmyocardial infarction syndrome (411.0)
rupture of chordae tendineae (429.5)
429.71	Acquired cardiac septal defect
Excludes:	acute septal infarction (410.00-410.92)
429.79	Other
Mural thrombus (atrial) (ventricular) acquired, following myocardial infarction
429.8	Other ill-defined heart diseases
429.81	Other disorders of papillary muscle
Papillary muscle:
atrophy
degeneration
dysfunction
incompetence
incoordination
scarring
429.82	Hyperkinetic heart disease
429.83	Takotsubo syndrome
Broken heart syndrome
Reversible left ventricular dysfunction following sudden emotional stress
Stress induced cardiomyopathy
Transient left ventricular apical ballooning syndrome
429.89	Other
Carditis
Excludes:	that due to hypertension (402.0-402.9)
429.9	Heart disease, unspecified
Heart disease (organic) NOS
Morbus cordis NOS
Excludes:	that due to hypertension (402.0-402.9)

CEREBROVASCULAR DISEASE (430-438)

Includes:	with mention of hypertension (conditions classifiable to 401-405)
Use additional code to identify presence of hypertension
Excludes:	any condition classifiable to 430-434, 436, 437 occurring during pregnancy,
 childbirth, or the puerperium, or specified as puerperal (674.0)
iatrogenic cerebrovascular infarction or hemorrhage (997.02)
430	Subarachnoid hemorrhage
Meningeal hemorrhage
Ruptured:
berry aneurysm
(congenital) cerebral aneurysm NOS
Excludes:	syphilitic ruptured cerebral aneurysm (094.87)
431	Intracerebral hemorrhage
Hemorrhage (of):
basilar
bulbar
cerebellar
cerebral
cerebromeningeal
cortical
internal capsule
intrapontine
pontine
subcortical
ventricular
Rupture of blood vessel in brain
432	Other and unspecified intracranial hemorrhage
432.0	Nontraumatic extradural hemorrhage
Nontraumatic epidural hemorrhage
432.1	Subdural hemorrhage
Subdural hematoma, nontraumatic
432.9	Unspecified intracranial hemorrhage
Intracranial hemorrhage NOS
433	Occlusion and stenosis of precerebral arteries
The following fifth-digit subclassification is for use with category 433:
0	without mention of cerebral infarction
1	with cerebral infarction
Includes:	embolism of basilar, carotid, and vertebral arteries
narrowing of basilar, carotid, and vertebral arteries
obstruction of basilar, carotid, and vertebral arteries
thrombosis of basilar, carotid, and vertebral arteries
Excludes:	insufficiency NOS of precerebral arteries (435.0-435.9)
433.0	Basilar artery
433.1	Carotid artery
433.2	Vertebral artery
433.3	Multiple and bilateral
433.8	Other specified precerebral artery
433.9	Unspecified precerebral artery
Precerebral artery NOS
434	Occlusion of cerebral arteries
The following fifth-digit subclassification is for use with category 434:
0	without mention of cerebral infarction
1	with cerebral infarction
434.0	Cerebral thrombosis
Thrombosis of cerebral arteries
434.1	Cerebral embolism
434.9	Cerebral artery occlusion, unspecified
435	Transient cerebral ischemia
Includes:	cerebrovascular insufficiency (acute) with transient focal neurological
 signs and symptoms
insufficiency of basilar, carotid, and vertebral arteries
spasm of cerebral arteries
Excludes:	acute cerebrovascular insufficiency NOS (437.1)
that due to any condition classifiable to 433 (433.0-433.9)
435.0	Basilar artery syndrome
435.1	Vertebral artery syndrome
435.2	Subclavian steal syndrome
435.3	Vertebrobasilar artery syndrome
435.8	Other specified transient cerebral ischemias
435.9	Unspecified transient cerebral ischemia
Impending cerebrovascular accident
Intermittent cerebral ischemia
Transient ischemic attack [TIA]
436	Acute, but ill-defined, cerebrovascular disease
Apoplexy, apoplectic:
NOS
attack
cerebral
seizure
Cerebral seizure
Excludes:	any condition classifiable to categories 430-435
cerebrovascular accident (434.91)
CVA (ischemic) (434.91)
embolic (434.11)
hemorrhagic (430, 431, 432.0-432.9)
thrombotic (434.01)
postoperative cerebrovascular accident (997.02)
stroke (ischemic) (434.91)
embolic (434.11)
hemorrhagic (430, 431, 432.0-432.9)
thrombotic (434.01)
437	Other and ill-defined cerebrovascular disease
437.0	Cerebral atherosclerosis
Atheroma of cerebral arteries
Cerebral arteriosclerosis
437.1	Other generalized ischemic cerebrovascular disease
Acute cerebrovascular insufficiency NOS
Cerebral ischemia (chronic)
437.2	Hypertensive encephalopathy
437.3	Cerebral aneurysm, nonruptured
Internal carotid artery, intracranial portion
Internal carotid artery NOS
Excludes:	congenital cerebral aneurysm, nonruptured (747.81)
internal carotid artery, extracranial portion (442.81)
437.4	Cerebral arteritis
437.5	Moyamoya disease
437.6	Nonpyogenic thrombosis of intracranial venous sinus
Excludes:	pyogenic (325)
437.7	Transient global amnesia
437.8	Other
437.9	Unspecified
Cerebrovascular disease or lesion NOS
438	Late effects of cerebrovascular disease
Note:	This category is to be used to indicate conditions in 430-437 as the cause of
 late effects.  The "late effects" include conditions specified as such, or as sequelae,
 which may occur at any time after the onset of the causal condition.
Excludes:	personal history of:
cerebral infarction without residual deficits (V12.54)
PRIND (Prolonged reversible ischemic neurologic deficit) (V12.54)
RIND (Reversible ischemic neurological deficit) (V12.54)
transient ischemic attack (TIA) (V12.54)
438.0	Cognitive deficits
	438.1	Speech and language deficits
438.10	Speech and language deficit, unspecified
438.11	Aphasia
438.12	Dysphasia
438.19	Other speech and language deficits
438.2	Hemiplegia/hemiparesis
438.20	Hemiplegia affecting unspecified side
438.21	Hemiplegia affecting dominant side
438.22	Hemiplegia affecting nondominant side
438.3	Monoplegia of upper limb
438.30	Monoplegia of upper limb affecting unspecified side
438.31	Monoplegia of upper limb affecting dominant side
438.32	Monoplegia of upper limb affecting nondominant side
438.4	Monoplegia of lower limb
438.40	Monoplegia of lower limb affecting unspecified side
438.41	Monoplegia of lower limb affecting dominant side
438.42	Monoplegia of lower limb affecting nondominant side
438.5	Other paralytic syndrome
Use additional code to identify type of paralytic syndrome, such as:
locked-in state (344.81)
quadriplegia (344.00-344.09)
Excludes:	late effects of cerebrovascular accident with:
hemiplegia/hemiparesis (438.20-438.22)
monoplegia of lower limb (438.40-438.42)
monoplegia of upper limb (438.40-438.42)
438.50	Other paralytic syndrome affecting unspecified side
438.51	Other paralytic syndrome affecting dominant side
438.52	Other paralytic syndrome affecting nondominant side
438.53	Other paralytic syndrome, bilateral
438.6	Alterations of sensations
Use additional code to identify the altered sensation
438.7	Disturbances of vision
Use additional code to identify the visual disturbance
438.8	Other late effects of cerebrovascular disease
438.81	Apraxia
438.82	Dysphagia
Use additional code to identify the type of dysphagia, if known (787.20-787.29)
438.83	Facial weakness
Facial droop
438.84	Ataxia
438.85	Vertigo
438.89	Other late effects of cerebrovascular disease
Use additional code to identify the late effect
438.9	Unspecified late effects of cerebrovascular disease

DISEASES OF ARTERIES, ARTERIOLES, AND CAPILLARIES (440-449)

440	Atherosclerosis
Includes:	arteriolosclerosis
arteriosclerosis (obliterans) (senile)
arteriosclerotic vascular disease
atheroma
degeneration:
arterial
arteriovascular
vascular
endarteritis deformans or obliterans
senile:
arteritis
endarteritis
Excludes:	atheroembolism (445.01-445.89)
atherosclerosis of bypass graft of the extremities (440.30-440.32)
440.0	Of aorta
440.1	Of renal artery
Excludes:	atherosclerosis of renal arterioles (403.00-403.91)
440.2	Of native arteries of the extremities
Use additional code, if applicable, to identify chronic total occlusion of artery of
 the extremities (440.4)
Excludes:	atherosclerosis of bypass graft of the extremities (440.30-440.32)
440.20	Atherosclerosis of the extremities, unspecified
440.21	Atherosclerosis of the extremities with intermittent claudication
440.22	Atherosclerosis of the extremities with rest pain
Any condition classifiable to 440.21
440.23	Atherosclerosis of the extremities with ulceration
Any condition classifiable to 440.21-440.22
Use additional code for any associated ulceration (707.10-707.9)
440.24	Atherosclerosis of the extremities with gangrene
Any condition classifiable to 440.21, 440.22, and 440.23 with ischemic gangrene 785.4
Use additional code for any associated ulceration (707.10-707.9)
Excludes:	gas gangrene 040.0
440.29	Other
440.3	Of bypass graft of the extremities
Excludes:	atherosclerosis of native artery of the extremity (440.21-440.24)
embolism [occlusion NOS] [thrombus] of graft (996.74)
440.30	Of unspecified graft
440.31	Of autologous vein bypass graft
440.32	Of nonautologous vein bypass graft
440.4	Chronic total occlusion of artery of the extremities
Complete occlusion of artery of the extremities
Total occlusion of artery of the extremities
Code first atherosclerosis of arteries of the extremities (440.20-440.29, 440.30-440.32)
Excludes:	acute occlusion of artery of extremity (444.21- 444.22)
440.8	Of other specified arteries
Excludes:	basilar (433.0)
carotid (433.1)
cerebral (437.0)
coronary (414.00-414.07)
mesenteric (557.1)
precerebral (433.0-433.9)
pulmonary (416.0)
vertebral (433.2)
440.9	Generalized and unspecified atherosclerosis
Arteriosclerotic vascular disease NOS
Excludes:	arteriosclerotic cardiovascular disease [ASCVD] (429.2)
441	Aortic aneurysm and dissection
Excludes:	syphilitic aortic aneurysm (093.0)
traumatic aortic aneurysm (901.0, 902.0)
441.0	Dissection of aorta
441.00	Unspecified site
441.01	Thoracic
441.02	Abdominal
441.03	Thoracoabdominal
441.1	Thoracic aneurysm, ruptured
441.2	Thoracic aneurysm without mention of rupture
441.3	Abdominal aneurysm, ruptured
441.4	Abdominal aneurysm without mention of rupture
441.5	Aortic aneurysm of unspecified site, ruptured
Rupture of aorta NOS
441.6	Thoracoabdominal aneurysm, ruptured
441.7	Thoracoabdominal aneurysm, without mention of rupture
441.9	Aortic aneurysm of unspecified site without mention of rupture
Aneurysm
Dilatation of aorta
Hyaline necrosis of aorta
442	Other aneurysm
Includes:	aneurysm (ruptured) (cirsoid) (false) (varicose)
aneurysmal varix
Excludes:	arteriovenous aneurysm or fistula:
acquired (447.0)
congenital (747.60-747.69)
traumatic (900.0-904.9)
442.0	Of artery of upper extremity
442.1	Of renal artery
442.2	Of iliac artery
442.3	Of artery of lower extremity
Aneurysm:
femoral artery
popliteal artery
442.8	Of other specified artery
442.81	Artery of neck
Aneurysm of carotid artery (common) (external) (internal, extracranial portion)
Excludes:	internal carotid artery, intracranial portion (437.3)
442.82	Subclavian artery
442.83	Splenic artery
442.84	Other visceral artery
Aneurysm:
celiac artery
gastroduodenal artery
gastroepiploic artery
hepatic artery
pancreaticoduodenal artery
superior mesenteric artery
442.89	Other
Aneurysm:
mediastinal artery
spinal artery
Excludes:	cerebral (nonruptured) (437.3)
congenital (747.81)
ruptured (430)
coronary (414.11)
heart (414.10)
pulmonary (417.1)
442.9	Of unspecified site
443	Other peripheral vascular disease
443.0	Raynaud's syndrome
Raynaud's:
disease
phenomenon (secondary)
Use additional code to identify gangrene (785.4)
443.1	Thromboangiitis obliterans [Buerger's disease]
Presenile gangrene
443.2	Other arterial dissection
Excludes:	dissection of aorta (441.00-441.03)
dissection of coronary arteries (414.12)
443.21	Dissection of carotid artery
443.22	Dissection of iliac artery
443.23	Dissection of renal artery
443.24	Dissection of vertebral artery
443.29	Dissection of other artery
443.8	Other specified peripheral vascular diseases
443.81	Peripheral angiopathy in diseases classified elsewhere
Code first underlying disease, as:
diabetes mellitus (250.7)
443.82	Erythromelalgia
443.89	Other
Acrocyanosis
Acroparesthesia:
simple [Schultze's type]
vasomotor [Nothnagel's type]
Erythrocyanosis
Excludes:	chilblains (991.5)
frostbite (991.0-991.3)
immersion foot (991.4)
443.9	Peripheral vascular disease, unspecified
Intermittent claudication NOS
Peripheral:
angiopathy NOS
vascular disease NOS
Spasm of artery
Excludes:	atherosclerosis of the arteries of the extremities (440.20-440.22)
spasm of cerebral artery (435.0-435.9)
444	Arterial embolism and thrombosis
Includes:	infarction:
embolic
thrombotic
occlusion
Excludes:	atheroembolism (445.01-445.89)
septic arterial embolism (449)
that complicating:
abortion (634-638 with .6, 639.6)
ectopic or molar pregnancy (639.6)
pregnancy, childbirth, or the puerperium (673.0-673.8)
444.0	Of abdominal aorta
Aortic bifurcation syndrome
Aortoiliac obstruction
Leriche's syndrome
Saddle embolus
444.1	Of thoracic aorta
Embolism or thrombosis of aorta (thoracic)
444.2	Of arteries of the extremities
444.21	Upper extremity
444.22	Lower extremity
Arterial embolism or thrombosis:
femoral
peripheral NOS
popliteal
Excludes:	iliofemoral (444.81)
444.8	Of other specified artery
444.81	Iliac artery
444.89	Other
Excludes:	basilar (433.0)
carotid (433.1)
cerebral (434.0-434.9)
coronary (410.00-410.92)
mesenteric (557.0)
ophthalmic (362.30-362.34)
precerebral (433.0-433.9)
pulmonary (415.19)
renal (593.81)
retinal (362.30-362.34)
vertebral (433.2)
444.9	Of unspecified artery
445	Atheroembolism
Includes:	Atherothrombotic microembolism
Cholesterol embolism
445.0	Of extremities
445.01	Upper extremity
445.02	Lower extremity
445.8	Of other sites
445.81	Kidney
Use additional code for any associated acute renal failure or chronic
 kidney disease (584, 585)
445.89	Other site
446	Polyarteritis nodosa and allied conditions
446.0	Polyarteritis nodosa
Disseminated necrotizing periarteritis
Necrotizing angiitis
Panarteritis (nodosa)
Periarteritis (nodosa)
446.1	Acute febrile mucocutaneous lymph node syndrome [MCLS]
Kawasaki disease
446.2	Hypersensitivity angiitis
Excludes: antiglomerular basement membrane disease without pulmonary hemorrhage (583.89)
446.20	Hypersensitivity angiitis, unspecified
446.21	Goodpasture's syndrome
Antiglomerular basement membrane antibody-mediated nephritis with pulmonary hemorrhage
Use additional code to identify renal disease (583.81)
446.29	Other specified hypersensitivity angiitis
446.3	Lethal midline granuloma
Malignant granuloma of face
446.4	Wegener's granulomatosis
Necrotizing respiratory granulomatosis
Wegener's syndrome
446.5	Giant cell arteritis
Cranial arteritis
Horton's disease
Temporal arteritis
446.6	Thrombotic microangiopathy
Moschcowitz's syndrome
Thrombotic thrombocytopenic purpura
446.7	Takayasu's disease
Aortic arch arteritis
Pulseless disease
447	Other disorders of arteries and arterioles
447.0	Arteriovenous fistula, acquired
Arteriovenous aneurysm, acquired
Excludes:	cerebrovascular (437.3)
coronary (414.19)
pulmonary (417.0)
surgically created arteriovenous shunt or fistula:
complication (996.1, 996.61-996.62)
status or presence (V45.1)
traumatic (900.0-904.9)
447.1	Stricture of artery
447.2	Rupture of artery
Erosion of artery
Fistula, except arteriovenous of artery
Ulcer of artery
Excludes:	traumatic rupture of artery (900.0-904.9)
447.3	Hyperplasia of renal artery
Fibromuscular hyperplasia of renal artery
447.4	Celiac artery compression syndrome
Celiac axis syndrome
Marable's syndrome
447.5	Necrosis of artery
447.6	Arteritis, unspecified
Aortitis NOS
Endarteritis NOS
Excludes:	arteritis, endarteritis:
aortic arch (446.7)
cerebral (437.4)
coronary (414.00-414.07)
deformans (440.0-440.9)
obliterans (440.0-440.9)
pulmonary (417.8)
senile (440.0-440.9)
polyarteritis NOS (446.0)
syphilitic aortitis (093.1)
447.8	Other specified disorders of arteries and arterioles
Fibromuscular hyperplasia of arteries, except renal
447.9	Unspecified disorders of arteries and arterioles
448	Disease of capillaries
448.0	Hereditary hemorrhagic telangiectasia
Rendu-Osler-Weber disease
448.1	Nevus, non-neoplastic
Nevus:
araneus
senile
spider
stellar
Excludes:	neoplastic (216.0-216.9)
port wine (757.32)
strawberry (757.32)
448.9	Other and unspecified capillary diseases
Capillary:
hemorrhage
hyperpermeability
thrombosis
Excludes:	capillary fragility (hereditary) (287.8)
449	Septic arterial embolism
Code first underlying infection, such as: 
infective endocarditis (421.0)
lung abscess (513.0)
Use additional code to identify the site of the embolism (433.0-433.9, 444.0-444.9)
Excludes:	septic pulmonary embolism (415.12)

DISEASES OF VEINS AND LYMPHATICS,
  AND OTHER DISEASES OF CIRCULATORY SYSTEM (451-459)

451	Phlebitis and thrombophlebitis
Includes:	endophlebitis
inflammation, vein
periphlebitis
suppurative phlebitis
Use additional E code to identify drug if drug-induced
Excludes:	that complicating:
abortion (634-638 with .7, 639.8)
ectopic or molar pregnancy (639.8)
pregnancy, childbirth, or the puerperium (671.0-671.9)
that due to or following:
implant or catheter device (996.61-996.62)
infusion, perfusion, or transfusion (999.2)
451.0	Of superficial vessels of lower extremities
Saphenous vein (greater) (lesser)
451.1	Of deep vessels of lower extremities
451.11	Femoral vein (deep) (superficial)
451.19	Other
Femoropopliteal vein
Popliteal vein
Tibial vein
451.2	Of lower extremities, unspecified
451.8	Of other sites
Excludes:	intracranial venous sinus (325)
nonpyogenic (437.6)
portal (vein) (572.1)
451.81	Iliac vein
451.82	Of superficial veins of upper extremities
Antecubital vein
Basilic vein
Cephalic vein
451.83	Of deep veins of upper extremities
Brachial vein
Radial vein
Ulnar vein
451.84	Of upper extremities, unspecified
451.89	Other
Axillary vein
Jugular vein
Subclavian vein
Thrombophlebitis of breast (Mondor's disease)
451.9	Of unspecified site
452	Portal vein thrombosis
Portal (vein) obstruction
Excludes:	hepatic vein thrombosis (453.0)
phlebitis of portal vein (572.1)
453	Other venous embolism and thrombosis
Excludes:
that complicating:
abortion (634-638 with .7, 639.8)
ectopic or molar pregnancy (639.8)
pregnancy, childbirth, or the puerperium (671.0-671.9)
that with inflammation, phlebitis, and thrombophlebitis (451.0-451.9)
453.0	Budd-Chiari syndrome
Hepatic vein thrombosis
453.1	Thrombophlebitis migrans
453.2	Of vena cava
453.3	Of renal vein
453.4	Venous embolism and thrombosis of deep vessels of lower extremity
453.40	Venous embolism and thrombosis of unspecified deep vessels of lower extremity
Deep vein thrombosis NOS
DVT NOS
453.41	Venous embolism and thrombosis of deep vessels of proximal lower extremity
Femoral
Iliac
Popliteal
Thigh
Upper leg NOS
453.42	Venous embolism and thrombosis of deep vessels of distal lower extremity
Calf
Lower leg NOS
Peroneal
Tibial
453.8	Of other specified veins
Excludes:	cerebral (434.0-434.9)
coronary (410.00-410.92)
intracranial venous sinus (325)
nonpyogenic (437.6)
mesenteric (557.0)
portal (452)
precerebral (433.0-433.9)
pulmonary (415.19)
453.9	Of unspecified site
Embolism of vein
Thrombosis (vein)
454	Varicose veins of lower extremities
Excludes:	that complicating pregnancy, childbirth, or the puerperium (671.0)
454.0	With ulcer
Varicose ulcer (lower extremity, any part)
Varicose veins with ulcer of lower extremity [any part] or of unspecified site
Any condition classifiable to 454.9 with ulcer or specified as ulcerated
454.1	With inflammation
Stasis dermatitis
Varicose veins with inflammation of lower extremity [any part] or of unspecified site
Any condition classifiable to 454.9 with inflammation or specified as inflamed
454.2	With ulcer and inflammation
Varicose veins with ulcer and inflammation of lower extremity [any part] or of
 unspecified site
Any condition classifiable to 454.9 with ulcer and inflammation
454.8	With other complications
Edema
Pain
Swelling
454.9	Asymptomatic varicose veins
Phlebectasia of lower extremity [any part] or of unspecified site
Varicose veins NOS
Varicose veins of lower extremity [any part] or of unspecified site
Varix of lower extremity [any part] or of unspecified site
455	Hemorrhoids
Includes:	hemorrhoids (anus) (rectum)
piles
varicose veins, anus or rectum
Excludes:	that complicating pregnancy, childbirth, or the puerperium (671.8)
455.0	Internal hemorrhoids without mention of complication
455.1	Internal thrombosed hemorrhoids
455.2	Internal hemorrhoids with other complication
Internal hemorrhoids:
bleeding
prolapsed
strangulated
ulcerated
455.3	External hemorrhoids without mention of complication
455.4	External thrombosed hemorrhoids
455.5	External hemorrhoids with other complication
External hemorrhoids:
bleeding
prolapsed
strangulated
ulcerated
455.6	Unspecified hemorrhoids without mention of complication
Hemorrhoids NOS
455.7	Unspecified thrombosed hemorrhoids
Thrombosed hemorrhoids, unspecified whether internal or external
455.8	Unspecified hemorrhoids with other complication
Hemorrhoids, unspecified whether internal or external:
bleeding
prolapsed
strangulated
ulcerated
455.9	Residual hemorrhoidal skin tags
Skin tags, anus or rectum
456	Varicose veins of other sites
456.0	Esophageal varices with bleeding
456.1	Esophageal varices without mention of bleeding
456.2	Esophageal varices in diseases classified elsewhere
Code first underlying disease, as:
cirrhosis of liver (571.0-571.9)
portal hypertension (572.3)
456.20	With bleeding
456.21	Without mention of bleeding
456.3	Sublingual varices
456.4	Scrotal varices
Varicocele
456.5	Pelvic varices
Varices of broad ligament
456.6	Vulval varices
Varices of perineum
Excludes:	that complicating pregnancy, childbirth, or the puerperium (671.1)
456.8	Varices of other sites
Varicose veins of nasal septum (with ulcer)
Excludes:	placental varices (656.7)
retinal varices (362.17)
varicose ulcer of unspecified site (454.0)
varicose veins of unspecified site (454.9)
457	Noninfectious disorders of lymphatic channels
457.0	Postmastectomy lymphedema syndrome
Elephantiasis due to mastectomy
Obliteration of lymphatic vessel due to mastectomy
457.1	Other lymphedema
Elephantiasis (nonfilarial) NOS
Lymphangiectasis
Lymphedema:
acquired (chronic)
praecox
secondary
Obliteration, lymphatic vessel
Excludes:	elephantiasis (nonfilarial):
congenital (757.0)
eyelid (374.83)
vulva (624.8)
457.2	Lymphangitis
Lymphangitis:
NOS
chronic
subacute
Excludes:	acute lymphangitis (682.0-682.9)
457.8	Other noninfectious disorders of lymphatic channels
Chylocele (nonfilarial)
Chylous:
ascites
cyst
Lymph node or vessel:
fistula
infarction
rupture
Excludes:	chylocele:
filarial (125.0-125.9)
tunica vaginalis (nonfilarial) (608.84)
457.9	Unspecified noninfectious disorder of lymphatic channels
458	Hypotension
Includes:	hypopiesis
Excludes:	cardiovascular collapse (785.50)
maternal hypotension syndrome (669.2)
shock (785.50-785.59)
Shy-Drager syndrome (333.0)
458.0	Orthostatic hypotension
Hypotension:
orthostatic (chronic)
postural
458.1	Chronic hypotension
Permanent idiopathic hypotension
458.2	Iatrogenic hypotension
458.21	Hypotension of hemodialysis
Intra-dialytic hypotension 
458.29	Other iatrogenic hypotension
Postoperative hypotension
458.8	Other specified hypotension
458.9	Hypotension, unspecified
Hypotension (arterial) NOS
459	Other disorders of circulatory system
459.0	Hemorrhage, unspecified
Rupture of blood vessel NOS
Spontaneous hemorrhage NEC
Excludes:	hemorrhage:
gastrointestinal NOS (578.9)
in newborn NOS (772.9)
secondary or recurrent following trauma (958.2)
traumatic rupture of blood vessel (900.0-904.9)
459.1	Postphlebitic syndrome
Chronic venous hypertension due to deep vein thrombosis
Excludes:	chronic venous hypertension without deep vein thrombosis (459.30-459.39)
459.10	Postphlebitic syndrome without complications
Asymptomatic postphlebitic syndrome
Postphlebitic syndrome NOS
459.11	Postphlebitic syndrome with ulcer
459.12	Postphlebitic syndrome with inflammation
459.13	Postphlebitic syndrome with ulcer and inflammation
459.19	Postphlebitic syndrome with other complication
459.2	Compression of vein
Stricture of vein
Vena cava syndrome (inferior) (superior)
459.3	Chronic venous hypertension (idiopathic)
Stasis edema
Excludes:	chronic venous hypertension due to deep vein thrombosis (459.10-459.19)
varicose veins (454.0-454.9)
459.30	Chronic venous hypertension without complications
Asymptomatic chronic venous hypertension
Chronic venous hypertension NOS
459.31	Chronic venous hypertension with ulcer
459.32	Chronic venous hypertension with inflammation
459.33	Chronic venous hypertension with ulcer and inflammation
459.39	Chronic venous hypertension with other complication
459.8	Other specified disorders of circulatory system
459.81	Venous (peripheral) insufficiency, unspecified
Chronic venous insufficiency NOS
Use additional code for any associated ulceration (707.10-707.9)
459.89	Other
Collateral circulation (venous), any site
Phlebosclerosis
Venofibrosis
459.9	Unspecified circulatory system disorder








TABLE OF CONTENTS

Preface

Acknowledgments

Introduction

The ICD-9-CM Coordination and Maintenance Committee

Characteristics of the ICD-9-CM

The Disease Classification

Alphabetical Index of Diseases

Table of Drugs and Chemicals

Index To External Causes of Injury (E Code)

Classification of Procedures

Index to Procedures

Appendix A:
Morphology of Neoplasms


Appendix C:
Classification of Drugs by American Hospital Formulary Services List Number and their ICD-9-CM Equivalents


Appendix D:
Classification of Industrial Accidents According to Agency


Appendix E:
List of Three-Digit Categories






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