HCI213 CODING

HCI213 CODING
Sample Answer for HCI213 CODING Included After Question
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I’m studying for my Health & Medical class and don’t understand how to answer this. Can you help me study?

Describe  the purpose of using ICD10 coding system?

ICD-10 International Statistical Classification of Diseases and Related Health Problems Tenth Revision Volume � Second Edition World Health Organization Geneva www.who.int/classifications WHO Library Cataloguing-in-Publication Data ICD-10 : international statistical classification of diseases and related health problems : tenth revision. — 2nd ed. 3 v. Contents: v. 1. Tabular list — v. 2. Instruction manual — v. 3. Alphabetical index. I.Disease – classification 2.Classification. 3.Manuals I.World Health Organization II.Title: International statistical classification of diseases : 10th revision III.Title: ICD-10. Second edition. ISBN 92 4 154649 2 (vol. 1) (NLM classification: WB 15) 92 4 154653 0 (vol. 2) 92 4 154654 9 (vol. 3) © World Health Organization 2004 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to Marketing and Dissemination, at the above address (fax: +41 22 791 4806; email: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The 43rd World Health Assembly in 1990 approved the Tenth Revision of the International Classification of Diseases (WHA 43.24) and endorsed the recommendation of the The International Conference for the Tenth Revision of the ICD held in Geneva from 26 September to 2 October 1989 concerning the establishment of an updating process within the 10-year revision cycle. This recommendation was put into motion at the annual meeting of WHO Collaborating Centres for the Family of International Classifications in Tokyo, Japan in 1996 and later a formal mechanism to guide the updating process was established. According to this updating mechanism minor updates are made each year while major updates are made, if required, every three years. For more information regarding the updating process and a cumulative list of the updates please see http://www.who.int/classifications/. Future updates will also be posted on this site. This Second Edition of ICD-10 includes the corrigenda to Volume 1 which appeared as an addendum to Volume 3 of the first edition, as well as the updates that came into effect between 1998 and 2003. Typeset by DIMDI in Germany and adapted for electronic use by WHO Print of this version is not permitted Contents 1. Introduction 1 2. Description of the International Statistical Classification of Diseases and Related Health Problems 3 2.1 Purpose and applicability 2.2 The concept of a “family” of disease and health-related classifications 2.2.1 Diagnosis-related classifications 6 2.2.2 Non-diagnostic classifications 8 2.2.3 Information support to primary health care 11 2.2.4 International Nomenclature of Diseases 12 2.2.5 The role of WHO 13 2.3 General principles of disease classification 2.4 The basic structure and principles of classification of the ICD 2.4.1 Volumes 2.4.2 Chapters 2.4.3 Blocks of categories 2.4.4 Three-character categories 2.4.5 Four-character subcategories 2.4.6 Supplementary subdivisions for use at the fifth or subsequent character level 2.4.7 The unused “U” codes 3. How to use the ICD 3.1 13 14 15 16 17 17 17 18 18 19 How to use Volume 1 3.1.1 Introduction 3.1.2 Use of the tabular list of inclusions and fourcharacter subcategories 3.1.3 Two codes for certain conditions 3.1.4 Conventions used in the tabular list 3.1.5 Categories with common characteristics 19 19 3.2 How to use Volume 3 3.2.1 Arrangement of the Alphabetical Index 3.2.2 Structure 3.2.3 Code numbers 3.2.4 Conventions 28 28 29 29 29 3.3 Basic coding guidelines 30 4. Rules and guidelines for mortality and morbidity coding 4.1 iii 3 Mortality: guidelines for certification and rules for coding 4.1.1 Causes of death 4.1.2 Underlying cause of death 20 21 24 27 31 31 31 31 4 lNTERNATlONAL CLASSIFICATION OF DISEASES 4.1.3 International form of medical certificate of cause of death 4.1.4 Procedures for selection of the underlying cause of death for mortality tabulation 4.1.5 Rules for selection of the originating antecedent cause 4.1.6 Some considerations on selection rules 4.1.7 Examples of the General Principle and selection rules 4.1.8 Modification of the selected cause 4.1.9 The modification rules 4.1.10 Examples of the modification rules 4.1.11 Notes for use in underlying cause mortality coding 4.1.12 Summary of linkages by code number 4.2 4.3 4.4 Notes for interpretation of entries of causes of death 4.2.1 Assumption of intervening cause 4.2.2 Interpretation of “highly improbable” 4.2.3 Effect of duration on classification 4.2.4 Sequelae 4.2.5 Consistency between sex of patient and diagnosis 4.2.6 Operations 4.2.7 Malignant neoplasms 4.2.8 Rheumatic fever with heart involvement 4.2.9 Congenital malformations, deformations and chromosomal abnormalities 4.2.10 Nature of injury 4.2.11 Poisoning by drugs, medicaments and biological substances 4.2.12 External causes 4.2.13 Expressions indicating doubtful diagnosis 4.2.14 Human Immunodeficiency Virus (HIV) Perinatal mortality: guidelines for certification and rules for coding 4.3.1 Certification of perinatal deaths 4.3.2 Statement of causes of death 4.3.3 Tabulation of perinatal mortality by cause 4.3.4 Coding of causes of death 4.3.5 Coding rules Morbidity 4.4.1 Guidelines for recording diagnostic information for single-condition analysis of morbidity data 4.4.2 Guidelines for coding “main condition” and “other conditions” 4.4.3 Rules for reselection when the main condition is incorrectly recorded 4.4.4 Chapter-specific notes 5. Statistical presentation iv 32 34 34 36 37 43 43 45 51 64 69 69 69 72 72 74 74 74 89 89 90 91 91 92 92 92 92 94 97 97 98 101 102 104 111 117 129 5.1 Introduction 129 5.2 Source of data 129 5.3 Level of detail of cause in tabulations 129 5.4 The recommended special tabulation lists for mortality 130 CONTENTS 5.4.1 5.4.2 5.4.3 5.4.4 The condensed lists The selected lists Use of prefixes to identify the mortality lists Locally designed lists 5.5 The special tabulation list for morbidity 131 5.5.1 Description 131 5.5.2 Modification of the special tabulation list for morbidity according to national requirements 132 5.6 Recommendations in relation to statistical tables for international comparison 5.6.1 Statistical tables 132 5.6.2 Tabulation of causes of death 133 5.7 Standards and reporting requirements related to fetal, perinatal, neonatal and infant mortality 134 5.7.1 Definitions 134 5.7.2 Reporting criteria 136 5.7.3 Statistics for international comparison 136 5.7.4 Presentation of causes of perinatal mortality 138 5.8 Standards and reporting requirements related to maternal mortality 5.8.1 Definitions 5.8.2 International reporting 5.8.3 Published maternal mortality rates 5.8.4 Denominators for maternal mortality 139 139 140 140 141 Proportion of deaths classified to ill-defined causes 141 5.9 5.10 Morbidity 141 5.11 Precautions needed when tabulation lists include subtotals 142 5.12 Problems of a small population 142 5.13 “Empty cells” and cells with low frequencies 143 6. History of the development of the ICD v 130 130 131 131 145 6.1 Early history 145 6.2 Adoption of the International List of Causes of Death 147 6.3 The Fifth Decennial Revision Conference 149 6.4 Previous classifications of diseases for morbidity statistics 150 6.5 United States Committee on Joint Causes of Death 152 6.6 Sixth Revision of the International Lists 153 6.7 The Seventh and Eighth Revisions 155 6.8 The Ninth Revision 155 132 INTERNATIONAL CLASSIFICATION OF DISEASES 6.9 Preparations for the Tenth Revision 7. Appendices 7.1 List of conditions unlikely to cause death 156 159 159 References 167 Index 169 vi 1.

A Sample Answer For the Assignment: HCI213 CODING
Title: HCI213 CODING

Introduction This volume of the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) contains guidelines for recording and coding, together with much new material on practical aspects of the classification’s use, as well as an outline of the historical background to the classification. This material is presented as a separate volume for ease of handling when reference needs to be made at the same time to the classification (Volume 1) and the instructions for its use. Detailed instructions on the use of the Alphabetical Index are contained in the introduction to Volume 3. This manual provides a basic description of the ICD, together with practical instructions for mortality and morbidity coders, and guidelines for the presentation and interpretation of data. It is not intended to provide detailed training in the use of the ICD. The material included here needs to be augmented by formal courses of instruction allowing extensive practice on sample records and discussion of problems. If problems arising from the use of the ICD cannot be resolved either locally or with the help of national statistical offices, advice is available from the WHO Collaborating Centres for the Family of International Classifications (see Volume 1). 1 2. Description of the International Statistical Classification of Diseases and Related Health Problems 2.1 Purpose and applicability A classification of diseases can be defined as a system of categories to which morbid entities are assigned according to established criteria. The purpose of the ICD is to permit the systematic recording analysis, interpretation and comparison of mortality and morbidity data collected in different countries or areas and at different times. The ICD is used to translate diagnoses of diseases and other health problems from words into an alphanumeric code, which permits easy storage, retrieval and analysis of the data. In practice, the ICD has become the international standard diagnostic classification for all general epidemiological and many health management purposes. These include the analysis of the general health situation of population groups and the monitoring of the incidence and prevalence of diseases and other health problems in relation to other variables, such as the characteristics and circumstances of the individuals affected. The ICD is neither intended nor suitable for indexing of distinct clinical entities. There are also some constraints on the use of the ICD for studies of financial aspects, such as billing or resource allocation. The ICD can be used to classify diseases and other health problems recorded on many types of health and vital records. Its original use was to classify causes of mortality as recorded at the registration of death. Later, its scope was extended to include diagnoses in morbidity. It is important to note that, although the ICD is primarily designed for the classification of diseases and injuries with a formal diagnosis, not every problem or reason for coming into contact with health services can be categorized in this way. Consequently, the ICD provides for a wide variety of signs, symptoms, abnormal findings, complaints, and social circumstances that may stand in place of a diagnosis on health-related records (see Volume 1, Chapters XVIII and XXI). It can therefore be used to classify data recorded under headings such as “diagnosis”, “reason for admission”, “conditions treated” and “reason for consultation”, which appear on a wide variety of health records from which statistics and other healthsituation information are derived. 2.2 The concept of a “family” of disease and health-related classifications Although the ICD is suitable for many different applications, it does not always allow the inclusion of sufficient detail for some specialties, and sometimes information on different attributes of the classified conditions may be needed. It has also been suggested that the ICD should include classifications of additional information related to health status or health care. It was felt that the main ICD (the three- and four-character classification), covered by the three volumes of ICD-10, could not incorporate all this additional information and remain accessible and relevant to its traditional users, so the idea arose of a “family” of disease and health-related classifications, including volumes published separately from the main ICD, to be used as required. The “core” classification of ICD-10 is the three-character code, which is the mandatory level of coding for international reporting to the WHO mortality database and for general international comparisons. The four-character subcategories, while not mandatory for reporting at the international level, are recommended for many purposes and form an integral part of the ICD, as do the special tabulation lists. 3 INTERNATIONAL CLASSIFICATION OF DISEASES There are two main types of classification. Those in the first group cover data related to diagnoses and health status, and are derived directly from the ICD by either condensation or expansion of the tabular list. The condensed lists can be used for many kinds of data presentation, for summary statistical tables, and potentially for information support in the development of primary health care (see 2.2.3), while the expanded lists are used to obtain increased clinical detail as in the specialty-based adaptations (see 2.2.1). This group also includes classifications complementary to the tabular list, that allow the allocation of diagnoses using a different axis of classification, such as the morphology of tumours. The second group of classifications covers aspects related to health problems generally outside the formal diagnoses of current conditions, as well as other classifications related to health care. This group includes classifications of disablement, of medical and surgical procedures, and of reasons for contact with health care providers. The ICD family also covers a conceptual framework of definitions, standards, and methods that, although they are not classifications in themselves, have been closely linked to the ICD for a long time. One of these concepts is the development of methods to support the local collection and use of information for primary health care. Another publication related to, but not derived from, the ICD is the International Nomenclature of Diseases (IND). The difference between a classification and a nomenclature is discussed at 2.3. The figure below shows the content and interrelationships of the various members of the family of classifications. Family of disease and health-related classifications 4 DESCRIPTION OF THE ICD 2.2.1 Diagnosis-related classifications Special tabulation lists The special tabulation lists are derived directly from the core classification, for use in data presentation and to facilitate analysis of health status and trends at the international, national and subnational levels. The special tabulation lists recommended for international comparisons and publications are included in Volume 1. There are five such lists, four for mortality and one for morbidity (for further details, see sections 5.4. and 5.5.). Specialty-based adaptations Specialty-based adaptations usually bring together in a single, compact volume the sections or categories of the ICD that are relevant to a particular specialty. The four-character subcategories of the ICD are retained, but more detail is often given by means of fifth-character or sometimes sixthcharacter subdivisions, and there is an alphabetical index of relevant terms. Other adaptations may give glossary definitions of categories and subcategories within the specialty. The adaptations have often been developed by international groups of specialists, but national groups have sometimes published adaptations that have later been used in other countries. The following list includes some of the major specialty adaptations to date. Oncology The third edition of the International Classification of Diseases for Oncology (ICD-O), published by WHO in 2000, is intended for use in cancer registries, and in pathology and other departments specializing in cancer (1). ICD-O is a dual-axis classification with coding systems for both topography and morphology. The topography code uses, for most neoplasms, the same three-character and fourcharacter categories used in ICD-10 for malignant neoplasms (categories C00-C80). ICD-O thus allows greater specificity of site for non-malignant neoplasms than is possible in ICD-10. The morphology code for neoplasms is identical to that in the Systematized nomenclature of medicine (SNOMED) (2), which was derived from the 1968 edition of the Manual of tumor nomenclature and coding (MOTNAC) (3) and the Systematized nomenclature of pathology (SNOP) (4). The morphology code has five digits; the first four digits identify the histological type and the fifth the behaviour of the neoplasm (malignant, in situ, benign, etc.). The ICD-O morphology code also appear in Volume 1 of ICD-10 and are added to the relevant entries in Volume 3, the Alphabetical Index. Tables are available for the conversion of the ICD-O third edition codes to ICD-10. Dermatology In 1978, the British Association of Dermatologists published the International Coding Index for Dermatology compatible with the Ninth Revision of the ICD. The Association has also published an adaptation of ICD-10 to dermatology, under the auspices of the International League of Dermatological Societies. Dentistry and stomatology The third edition of the Application of the International Classification of Diseases to Dentistry and Stomatology (ICD-DA), based on ICD-10, was published by WHO in 1995. It brings together ICD categories for diseases or conditions that occur in, have manifestations in, or have associations with the oral cavity and adjacent structures. It provides greater detail than ICD-10 by means of a fifth digit, but the numbering system is organized so that the relationship between an ICD-DA code and the ICD code from which it is derived is immediately obvious, and so that data from ICD-DA categories can be readily incorporated into ICD categories. Neurology In 1997 WHO published an adaptation of ICD-10 to neurology (ICD-NA), which retains the classification and coding systems of ICD-10 but is further subdivided at the fifth-character level and beyond to allow neurological diseases to be classified with greater precision. 5 INTERNATIONAL CLASSIFICATION OF DISEASES Rheumatology and orthopaedics The International League of Associations of Rheumatology is working on a revision of the Application of the International Classification of Diseases to Rheumatology and Orthopaedics (ICDR&O), including the International Classification of Musculoskeletal Disorders (ICMSD), to be compatible with ICD-10. The ICD-R&O provides detailed specification of conditions through the use of additional digits, which allow for extra detail while retaining compatibility with ICD-10. The ICMSD is designed to clarify and standardize the use of terms and is supported by a glossary of generic descriptors for groups of conditions, such as the inflammatory polyarthropathies. Paediatrics Under the auspices of the International Pediatric Association, the British Paediatric Association (BPA) has published an application of ICD-10 to paediatrics, which uses a fifth digit to provide greater specificity. This follows similar applications prepared by BPA for ICD-8 and ICD-9. Mental disorders The ICD-10 Classification of Mental and Behavioural Disorders: clinical descriptions and diagnostic guidelines. This volume, published in 1992, provides for each category in Chapter V of ICD-10 (Mental and behavioural disorders) a general description and guidelines concerning the diagnosis, as well as comments about differential diagnosis and a listing of synonyms and exclusion terms (5). Where more detail is required, the guidelines give further subdivisions at the fifth and sixth digit levels. A second publication relating to Chapter V, Diagnostic criteria for research, was published in 1993. A version of the classification for use in primary health care, and another version that uses a rearrangement of categories of childhood mental disorders in a multiaxial system, to allow simultaneous assessment of the clinical state, relevant environmental factors, and the degree of disability linked to the disease have also been developed. 2.2.2 Non-diagnostic classifications Procedures in medicine The International Classification of Procedures in Medicine (ICPM) was published in two volumes by WHO in 1978 (6). It includes procedures for medical diagnosis, prevention, therapy, radiology, drugs, and surgical and laboratory procedures. The classification has been adopted by some countries, while others have used it as a basis for developing their own national classifications of surgical operations. The Heads of WHO Collaborating Centres for Classification of Diseases recognized that the process of consultation that had to be followed before finalization and publication was inappropriate in such a wide and rapidly advancing field. They therefore recommended that there should be no revision of the ICPM in conjunction with the Tenth Revision of the ICD. In 1987, the Expert Committee on the International Classification of Diseases asked WHO to consider updating at least the outline for surgical procedures (Chapter 5) of the ICPM for the Tenth Revision. In response to this request and the needs expressed by a number of countries, the Secretariat prepared a tabulation list for procedures. 6 DESCRIPTION OF THE ICD At their meeting in 1989, the Heads of the Collaborating Centres agreed that the list could serve as a guide for the national publication of statistics on surgical procedures and could also facilitate intercountry comparisons. The list could also be used as a basis for the development of comparable national classifications of surgical procedures. Work on the list will continue, but any publication will follow the issue of ICD-10. In the meantime, other approaches to this subject are being explored. Some of these have common characteristics, such as a fixed field for specific items (organ, technique, approach, etc.), the possibility of being automatically updated, and the flexibility of being used for more than one purpose. The International Classification of Functioning, Disability and Health The International Classification of Functioning, Disability and Health (ICF) was published by WHO in all six WHO official languages in 2001, after its official endorsement by the Fifty-fourth World Health Assembly on 22 May 2001. It has subsequently been translated into over 25 languages. ICF classifies health and health-related states in two parts. Part 1 classifies functioning and disability. Part 2 comprises environmental and personal contextual factors. Functioning and disability in Part 1 are described from the perspectives of the body, the individual, and society, formulated in two components: (1) body functions and structures, and (2) activities and participation. Since an individual’s functioning and disability occur in a context, the ICF also includes a list of environmental factors. The ICF has superseded the International Classification of Impairments, Disabilities and Handicaps (ICIDH). As a consequence the old ICIDH terms and definitions have been replaced by the following new ICF terms and definitions: Functioning is a generic term for body functions, body structures, activities and participation. It denotes the positive aspects of the interaction between an individual (with a health condition) and that individual’s contextual factors (environmental and personal factors). Disability is an umbrella term for impairments, activity limitations and participation restrictions. It denotes the negative aspects of the interaction between an individual (with a health condition) and that individual’s contextual factors (environmental and personal factors). Body functions are the physiological functions of body systems (including psychological functions). Body structures are anatomical parts of the body such as organs, limbs and their components. Impairments are problems in body function or structure such as a significant deviation or loss. Activity is the execution of a task or action by an individual. Activity limitations are difficulties an individual may have in executing activities. Participation is involvement in a life situation. Participation restrictions are problems an individual may experience in involvement in life situations. Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives. ICF uses an alphanumeric system in which the letters b, s, d and e are used to denote Body Functions, Body Structures, Activities and Participation, and Environmental Factors. These letters are followed by a numeric code that starts with the chapter number (one digit), followed by the second level (two digits), and the third and fourth levels (one digit each). ICF categories are “nested” so that broader categories are defined to include more detailed subcategories of the parent category. Any individual may have a range of codes at each level. These may be independent or interrelated. 7 INTERNATIONAL CLASSIFICATION OF DISEASES The ICF codes are only complete with the presence of a qualifier, which denotes a magnitude of the level of health (e.g. severity of the problem). Qualifiers are coded as one, two or more numbers after a point (or separator). Use of any code should be accompanied by at least one qualifier. Without qualifiers, codes have no inherent meaning. The first qualifier for Body Functions and Structures, the performance and capacity qualifiers for Activities and Participation, and the first qualifier for Environmental Factors all describe the extent of problems in the respective component. The ICF puts the notions of ‘health’ and ‘disability’ in a new light. It acknowledges that every human being can experience a decrement in health and thereby experience some disability. This is not something that happens to only a minority of people. ICF thus ‘mainstreams’ the experience of disability and recognizes it as a universal human experience. By shifting the focus from cause to impact it places all health conditions on an equal footing allowing them to be compared using a common metric – the ruler of health and disability. Furthermore ICF takes into account the social aspects of disability and does not see disability only as a ‘medical’ or ‘biological’ dysfunction. By including Contextual Factors, in which environmental factors are listed, ICF allows the recording of the impact of the environment on the person’s functioning. The ICF is WHO’s framework for measuring health and disability at both individual and population levels. While the International Classification of Diseases classifies diseases and causes of death, the ICF classifies health domains. The ICD and ICF constitute the two major building blocks of WHO’s Family of International Classifications. Together, they provide exceptionally broad yet accurate tools to capture the full picture of health. 2.2.3 Information support to primary health care One of the challenges of the Global Strategy for Health for All by the Year 2000 is to provide information support to primary health care (PHC). In countries without complete information or with only poor-quality data, a variety of approaches need to be adopted to supplement or replace the conventional use of the ICD. Since the late 1970’s, various countries have experimented with the collection of information by lay personnel. Lay reporting has subsequently been extended to a broader concept called “nonconventional methods”. These methods, covering a variety of approaches, have evolved in different countries as a means of obtaining information on health status where conventional methods (censuses, surveys, vital or institutional morbidity and mortality statistics) have been found to be inadequate. One of these approaches, “community-based information”, involves community participation in the definition, collection and use of health-related data. The degree of community participation ranges from involvement only in data collection to the design, analysis and utilization of information. Experience in several countries has shown that this approach is more than a theoretical framework. The International Conference for the Tenth Revision of the International Classification of Diseases (see Volume 1) noted in its report: The Conference was informed about the experience of countries in developing and applying communitybased health information that covered health problems and needs, related risk factors and resources. It supported the concept of developing non-conventional methods at the community level as a method of filling information gaps in individual countries and strengthening their information systems. It was stressed that, for both developed and developing countries, such methods or systems should be developed locally and that, because of factors such as morbidity patterns as well as language and cultural variations, transfer to other areas or countries should not be attempted. Given the encouraging results of this approach in many countries, the Conference agreed that WHO should continue to give guidance on the development of local schemes and to support the progress of the methodology. 2.2.4 International Nomenclature of Diseases In 1970, the Council for International Organizations of Medical Sciences (CIOMS) began the preparation of an International Nomenclature of Diseases (IND), with the assistance of its member organizations, and five volumes of provisional nomenclature were issued during 1972-1974. It was soon realized, however, that the compilation of such a nomenclature, were it to be truly international, 8 DESCRIPTION OF THE ICD would need much wider consultation than was possible through the members of CIOMS alone. In 1975, the IND became a joint project of CIOMS and WHO, guided by a Technical Steering Committee of representatives from both organizations. The principal objective of the IND is to provide, for each morbid entity, a single recommended name. The main criteria for selection of this name are that it should be specific (applicable to one and only one disease), unambiguous, as self-descriptive as possible, as simple as possible, and (whenever feasible) based on cause. However, many widely used names that do not fully meet the above criteria are being retained as synonyms, provided they are not inappropriate, misleading, or contrary to the recommendations of international specialist organizations. Eponymous terms are avoided since they are not self-descriptive; however, many of these names are in such widespread use (e.g. Hodgkin disease, Parkinson disease and Addison disease) that they must be retained. Each disease or syndrome for which a name is recommended is defined as unambiguously and as briefly as possible. A list of synonyms appears after each definition. These comprehensive lists are supplemented, if necessary, by explanations about why certain synonyms have been rejected or why an alleged synonym is not a true synonym. The IND is intended to be complementary to the ICD. The differences between a nomenclature an