ICD diseases decoding. I10 Essential (primary) hypertension. Z52 Organ and tissue donors

• A00-A09 Intestinal infections
• A15-A19 Tuberculosis
• A20-A28 Some bacterial zoonoses
• A30-A49 Other bacterial diseases
• A50-A64 Infections that are predominantly sexually transmitted
• A65-A69 Other diseases caused by spirochetes
• A70-A74 Other diseases caused by chlamydia
• A75-A79 Rickettsial diseases
• A80-A89 Viral infections of the central nervous system
• A90-A99 Arthropod-borne viral fevers and viral hemorrhagic fevers

• B00-B09 Viral infections characterized by lesions of the skin and mucous membranes
• B15-B19 Viral hepatitis
• B20-B24 Human immunodeficiency virus disease [HIV]
• B25-B34 Other viral diseases
• B35-B49 Mycoses
• B50-B64 Protozoan diseases
• B65-B83 Helminthiasis
• B85-B89 Pediculosis, acariasis and other infestations
• B90-B94 Consequences of infectious and parasitic diseases
• B95-B97 Bacterial, viral and other infectious agents
• B99 Other infectious diseases

• C00-C75 Malignant neoplasms of specified localizations, which are designated as primary or presumably primary, except for neoplasms of lymphoid, hematopoietic and related tissues
• C00-C14 Lips, mouth and pharynx
• C15-C26 Digestive organs
• S30-S39 Respiratory and chest organs
• S40-S41 Bones and articular cartilage
• S43-S44 Skin
• S45-S49 Mesothelial and soft tissues
• C50 Mammary gland
• S51-S58 Female genital organs
• S60-S63 Male genital organs
• С64-С68 Urinary tract
• S69-S72 Eyes, brain and other parts of the central nervous system
• S73-S75 Thyroid and other endocrine glands
• S76-S80 Malignant neoplasms, ill-defined, secondary and unspecified localizations
• S81-S96 Malignant neoplasms of lymphoid, hematopoietic and related tissues, which are designated as primary or presumably primary
• S97 Malignant neoplasms of independent (primary) multiple localizations
• D00-D09 In situ neoplasms
• D10-D36 Benign neoplasms
• D37-D48 Neoplasms of undetermined or unknown nature

• D50-D53 Diet-related anemias
• D55-D59 Hemolytic anemias
• D60-D64 Aplastic and other anemias
• D65-D69 Bleeding disorders, purpura and other hemorrhagic conditions
• D70-D77 Other diseases of the blood and hematopoietic organs
• D80-D89 Selected disorders involving the immune mechanism

• E00-E07 Thyroid diseases
• E10-E14 Diabetes
• E15-E16 Other disorders of glucose regulation and pancreatic endocrine
• E20-E35 Disorders of other endocrine glands
• E40-E46 Malnutrition
• E50-E64 Other types of malnutrition
• E65-E68 Obesity and other types of excess nutrition
• E70-E90 Metabolic disorders

• F00-F09 Organic, including symptomatic, mental disorders
• F10-F19 Mental and behavioral disorders associated with the use of psychoactive substances
• F20-F29 Schizophrenia, schizotypal and delusional disorders
• F30-F39 Mood disorders
• F40-F48 Neurotic, stress-related, and somatoform disorders
• F49-F50

• F51-F59 Behavioral syndromes associated with physiological disorders and physical factors
• F60-F69 Personality and behavior disorders in adulthood
• F70-F79 Mental retardation
• F80-F89 Psychological development disorders
• F90-F93

• F94-F98 Emotional disorders, behavioral disorders, usually beginning in childhood and adolescence
• F99 Unspecified mental disorders

• G00-G09 Inflammatory diseases of the central nervous system
• G10-G13 Systemic atrophies affecting primarily the central nervous system
• G20-G26 Extrapyramidal and other movement disorders
• G30-G32 Other degenerative diseases of the central nervous system
• G35-G37 Demyelinating diseases of the central nervous system
• G40-G47 Episodic and paroxysmal disorders

• G50-G59 Lesions of individual nerves, nerve roots and plexuses
• G60-G64 Polyneuropathies and other lesions of the peripheral nervous system
• G70-G73 Diseases of the neuromuscular junction and muscles
• G80-G83 Cerebral palsy and other paralytic syndromes
• G90-G99 Other nervous system disorders

• H00-H06 Diseases of the eyelids, tear ducts and orbits
• H10-H13 Diseases of the conjunctiva
• H15-H22 Diseases of the sclera, cornea, iris and ciliary body
• H25-H28 Lens diseases
• H30-H36 Diseases of the choroid and retina
• H40-H42 Glaucoma
• H43-H45 Diseases of the vitreous body and eyeball
• H46-H48 Diseases of the optic nerve and visual pathways
• H49-H52 Diseases of the eye muscles, disorders of concomitant eye movement, accommodation and refraction
• H53-H54 Visual impairment and blindness
• H55-H59 Other diseases of the eye and its adnexa

• I00-I02 Acute rheumatic fever
• I05-I09 Chronic rheumatic heart disease
• I10-I15 Diseases characterized by high blood pressure
• I20-I25 Cardiac ischemia
• I26-I28 Pulmonary heart and pulmonary circulation disorders
• I30-I52 Other heart diseases
• I60-I69 Cerebrovascular diseases
• I70-I79 Diseases of arteries, arterioles and capillaries
• I80-I89 Diseases of the veins, lymphatic vessels and lymph nodes, not elsewhere classified
• I95-I99 Other and unspecified diseases of the circulatory system

• J00-J06 Acute respiratory infections of the upper respiratory tract
• J10-J18 Flu and pneumonia
• J20-J22 Other acute respiratory infections of the lower respiratory tract
• J30-J39 Other upper respiratory tract diseases
• J40-J47 Chronic diseases of the lower respiratory tract
• J60-J70 Lung diseases caused by external agents
• J80-J84 Other respiratory diseases affecting primarily interstitial tissue
• J85-J86 Purulent and necrotic conditions of the lower respiratory tract
• J90-J94 Other pleural diseases
• J95-J99 Other respiratory diseases

• K00-K04 Diseases of the mouth, salivary glands and jaws
• K20-K31 Diseases of the esophagus, stomach and duodenum
• K35-K38 Diseases of the appendix [vermiform appendix]
• K40-K46 Hernias
• K50-K52 Non-infectious enteritis and colitis
• K55-K63 Other bowel diseases
• K65-K67 Peritoneal diseases
• K70-K77 Liver diseases
• K80-K87 Diseases of the gallbladder, biliary tract and pancreas
• K90-K93 Other diseases of the digestive system

• L00-L04 Infections of the skin and subcutaneous tissue
• L10-L14 Bullous disorders
• L20-L30 Dermatitis and eczema
• L40-L45 Papulosquamous disorders
• L50-L54 Urticaria and erythema
• L55-L59 Diseases of the skin and subcutaneous tissue associated with radiation
• L60-L75 Skin appendage diseases
• L80-L99 Other diseases of the skin and subcutaneous tissue

• M00-M25 Arthropathy
• M00-M03 Infectious arthropathy
• M05-M14 Inflammatory polyarthropathy
• M15-M19 Arthrosis
• M20-M25 Other joint lesions

• M30-M36 Systemic connective tissue lesions
• M40-M54 Dorsopathies
• M40-M43 Deforming dorsopathies

• M50-M54 Other dorsopathies
• M60-M79 Soft tissue diseases
• M60-M63 Muscle lesions
• M65-M68 Lesions of synovial membranes and tendons
• M70-M79 Other soft tissue lesions
• M80-M94 Osteopathy and chondropathy
• M80-M85 Bone density and structure disorders
• M86-M90 Other osteopathies
• M91-M94 Chondropathy
• M95-M99 Other musculoskeletal and connective tissue disorders

• N00-N08 Glomerular diseases
• N10-N16 Tubulointerstitial kidney disease
• N17-N19 Kidney failure
• N20-N23 Urolithiasis disease
• N25-N29 Other diseases of the kidney and ureter
• N30-N39 Other diseases of the urinary system
• N40-N51 Diseases of the male genital organs
• N60-N64 Breast diseases
• N70-N77 Inflammatory diseases of the female pelvic organs
• N80-N98 Non-inflammatory diseases of the female genital organs
• N99 Other disorders of the genitourinary system

• O00-O08 Pregnancy with abortion outcome
• O10-O16 Edema, proteinuria and hypertensive disorders during pregnancy, childbirth and the puerperium
• O20-O29 Other maternal illnesses, mainly associated with pregnancy
• O30-O48 Medical care for the mother in connection with the condition of the fetus, the amniotic cavity and possible difficulties in delivery
• O60-O75 Complications of labor and delivery
• O38-O84 Delivery
• O85-O92 Complications associated primarily with the postpartum period
• O95-O99 Other obstetric conditions not elsewhere classified

• P00-P04 Damage to the fetus and newborn caused by maternal conditions, complications of pregnancy, labor and delivery
• P05-P08 Disorders associated with duration of pregnancy and fetal growth
• P10-P15 Birth injury
• P20-P29 Respiratory and cardiovascular disorders characteristic of the perinatal period
• P35-P39 Infectious diseases specific to the perinatal period
• P50-P61 Hemorrhagic and hematological disorders in the fetus and newborn
• P70-P74 Transient endocrine and metabolic disorders specific to the fetus and newborn
• P75-P78 Digestive system disorders in the fetus and newborn
• P80-P83 Conditions affecting the skin and thermoregulation in the fetus and newborn
• P90-P96 Other disorders arising in the perinatal period

• Q00-Q07 Congenital abnormalities of the nervous system
• Q10-Q18 Congenital anomalies of the eye, ear, face and neck
• Q20-Q28 Congenital anomalies of the circulatory system
• Q30-Q34 Congenital anomalies of the respiratory system
• Q35-Q37 Cleft lip and palate [cleft lip and cleft palate]
• Q38-Q45 Other congenital anomalies of the digestive system
• Q50-Q56 Congenital anomalies of the genital organs
• Q60-Q64 Congenital anomalies of the urinary system
• Q65-Q79 Congenital anomalies and deformations of the musculoskeletal system
• Q80-Q89 Other congenital anomalies
• Q90-Q99 Chromosomal disorders not elsewhere classified

• R00-R09 Symptoms and signs related to the circulatory and respiratory systems
• R10-R19 Symptoms and signs related to the digestive and abdominal systems

• R20-R23 Symptoms and signs related to the skin and subcutaneous tissue
• R25-R29 Symptoms and signs related to the nervous and musculoskeletal systems
• R30-R39 Symptoms and signs related to the urinary system
• R40-R46 Symptoms and signs related to cognition, perception, emotional state and behavior
• R47-R49 Symptoms and signs related to speech and voice

• R50-R69 General symptoms and signs
• R70-R79 Deviations from the norm identified during blood tests, in the absence of a diagnosis
• R80-R82 Deviations from the norm identified during urine examination, in the absence of a diagnosis
• R83-R89 Deviations from the norm identified during the study of other fluids, substances and tissues of the body, in the absence of a diagnosis
• R90-R94 Abnormalities identified during diagnostic imaging and functional studies in the absence of a diagnosis
• R95-R99 Ill-defined and unknown causes of death

• V01-V99 Transport accidents
• V01-V09 Pedestrian injured in a traffic accident
• V10-V19 Cyclist injured in a traffic accident
• V20-V29 Motorcyclist injured in a traffic accident
• V30-V39 Occupant of a three-wheeler injured in a traffic accident
• V40-V49 A person who was in a car and was injured as a result of a transport accident
• V50-V59 An occupant of a pickup truck or van who is injured in a transportation accident
• V60-V69 A person who was in a heavy truck and was injured as a result of a transport accident
• V70-V79 A person on a bus who was injured in a traffic accident
• V80-V89 Accidents involving other land vehicles
• V90-V94 Water transport accidents
• V95-V97 Accidents in air transport and space flights
• V98-V99 Other and unspecified transport accidents

• W01-X59 Other external causes of injury in accidents
• W00-W19 Falls
• W20-W49 Impact of non-living mechanical forces
• W50-W64 Impact of living mechanical forces
• W65-W74 Accidental drowning or submersion
• W75-W84 Other respiratory hazards
• W85-W99 Accidents caused by electrical current, radiation and extreme levels of ambient temperature and atmospheric pressure

• X00-X09 Exposure to smoke, fire and flames
• X10-X19 Contact with hot and incandescent substances (objects)
• X20-X29 Contact with poisonous animals and plants
• X30-X39 Impact of the forces of nature
• X40-X49 Accidental poisoning and exposure to toxic substances
• X50-X57 Overexertion, travel and hardship
• X58-X59 Incidental exposure to other and unspecified factors
• X60-X84 Deliberate self-harm
• X85-Y09 Attack

• Y10-Y34 Damage with undetermined intent
• Y35-Y36 Legal actions and military operations
• Y40-Y84 Complications of therapeutic and surgical interventions
• Y40-Y49 Medicines, medications and biological substances that cause adverse reactions during their therapeutic use
• Y60-Y69 Accidental harm to a patient during therapeutic (and surgical) interventions
• Y70-Y82 Medical devices and devices associated with accidents arising from their use for diagnostic and therapeutic purposes
• Y83-Y84 Surgical and other medical procedures as the cause of an abnormal response or late complication in a patient without mention of accidental harm during their performance
• Y85-Y89 Consequences of external causes of morbidity and mortality
• Y90-Y98 Additional factors relevant to morbidity and mortality classified elsewhere

• Z00-Z13 Visits to healthcare institutions for medical examination and examination
• Z20-Z29 Potential health hazards associated with infectious diseases
• Z30-Z39 Appeals to health care institutions in connection with circumstances related to reproductive function
• Z40-Z54 Appeals to healthcare institutions in connection with the need to carry out specific procedures and receive medical care
• Z55-Z65 Potential health hazards associated with socioeconomic and psychosocial circumstances
• Z70-Z76 Appeals to healthcare institutions due to other circumstances
• Z80-Z99 Potential health hazards related to personal or family history and certain health conditions

What does sick leave mean? With the help of a sick leave certificate, an illness, injury or other physiological problem of an employee is registered. The form is sometimes called differently - a sheet of temporary incapacity for work. It is allowed to be prescribed only by doctors who have passed a special check by the FSS. An employee can count on payments if the form was correctly filled out and submitted to the enterprise administration within the established time frame.

For a long time now, a single standardized form has been used to fill out sick leave. In 2011, a reform was carried out in this area, the forms began to look slightly different, and new rules for filling out were introduced. Disease codes have become strictly mandatory.

Is the diagnosis written on the sick leave certificate? The diagnosis and cause of disability are now indicated using two special digital designations. The first is the national designation of the cause (01,02,03), the second is the international form of recording the disease according to the ICD-10 system.

First of all, the reform was carried out to avoid cases of fraud associated with sick leave payments. That's why there's honey in everything. Institutions forms are received directly through FSS branches. The sheets are marked with serial numbers, so it becomes much easier to track illegal fraud. In addition, new sheets of paper are protected with watermarks, micro-text and some other methods.

It is best to fill out the sheet using printed media, as well as a black pen. Entries must be placed exactly within the boundaries of the cells and frames. Such accuracy is necessary so that the form can be processed by a computer - electronic reading is quite sensitive and demanding. The physician must not cross out, sign, or otherwise change the completed form.

Sample of a completed sick leave certificate:

If you need to change information, you should take a new sheet. The employer has the right to make mistakes and make corrections to the records, but this is highly undesirable. Corrections are written on the back of the sheet, incorrect data is crossed out.

Then you should sign and date it, recording the fact of the corrections. We also recommend that you read the article, from which you will learn about inaccuracies that FSS employees will not pay attention to.

The form must be filled out by two people: the doctor and the employer. The doctor is responsible for completing sections 1 and 3. The employer, in turn, is for the second. It should be taken into account that the FSS carries out quality control and conducts random checks. In the future, the Foundation plans to switch completely to an electronic sick leave system, which will further simplify the control task.

When registering/using sick leave, you should rely on the Tax, Labor and Administrative Code. In addition, important documents are Federal Laws N212, N125, N255. In any unclear cases, you should contact the FSS department for advice.

On the back side of the sheet you can always find instructions for filling out, as well as a decoding of all codes.

Registration procedure

There are three people involved in registration: the doctor, the employer and the employee. An employee becomes ill and goes to a medical facility. The doctor must diagnose the patient's disease and health condition. Based on this, the doctor determines the duration of sick leave and enters it into the form. To do this, use the corresponding unified codes (detailed explanation below). Then he indicates the following information about the patient:

• Date of Birth;
• Name of the enterprise - according to the patient, no special documents are required. If the employer is an individual entrepreneur, then enter the full name of the individual. employer person.

The doctor must also indicate the name, address and registration number of his medical institution. After this, the sheet should be signed and stamped. If the attending physician is engaged in private practice, then he similarly indicates his full name and register. number.

The employee takes the form completed by the doctor to the administration at the place of work. The employer fills out information regarding payment calculations and information about his company:

• Name of organization - 29 cells are allocated, one empty cell must be left between words;
• Type of work (main or part-time);
• Registration number in the Social Insurance Fund (enterprise);
• Subordination code;
• Employee number (identification);
• Fear. number;
• Payment terms;
• Fear. employee experience;
• Avg. earnings;
• Full name of the head. accountant and company manager;
• Amount of payments - indicate three amounts: from the employer, from the Fund and the final amount (due to the employee).

In addition, the data necessary for the tax authorities is recorded. Every year, tax reports (2-NDFL) must be prepared for all employees. On sick leave, the tax code is always 2300. The benefit is not taxed, although formally it is classified as income. A 2-NDFL certificate is sometimes required for an employee to get a loan; it may be necessary in a new workplace. The employee always has the opportunity to check the correctness of payments.

Explanation of the fields on the sick leave:

The employee is also a participant in the registration process, but he practically does not fill out anything. All he needs to do is consult a doctor in a timely manner and obtain a certificate of incapacity for work. Then it is necessary (within compliance with the deadlines) to provide the completed form at the place of work.

Codes

Special digital codes are used to record information describing the nature (diagnosis, disease, cause) and duration of disability. Codes can be two-digit or three-digit (starting from zero). Using such a flexible system, all reasons for incapacity/sick leave are coded. There are 15 main causes of disability(diseases), let's figure out what the codes on the sick leave mean, what disease and diagnosis is hidden behind it, and let's start deciphering them:

• “01” - disease, the most common case, especially during influenza epidemics;
• “02” - domestic injury, that is, damage to the body received outside of work/workplace;
• “03” - quarantine, indicates the need for quarantine, typical for infectious diseases, for example, tuberculosis;
• “04” is a work injury, but the correct name would be “work accident”;
• “05” - the onset of disability due to pregnancy and childbirth;
• “06” - prosthetics, which (for medical reasons) can only be performed in a hospital;
• "07" - prof. disease, as well as exacerbation of prof. diseases, especially typical for industries with hazardous conditions;
• “08” - medical procedures in hospitals and sanatoriums;
• “09” - disability due to the need to care for a sick family member (for example, a disabled person);
• “10” - poisoning, as well as other conditions;
• “11” is a disease from the list of social services. significant diseases, the list is approved by Government Decree N715. These include, in particular, tuberculosis, hepatitis, HIV, diabetes, oncology;
• “12” - the reason is the illness of a child under 7 years old, the need for additional care;
• “13” - caring for a disabled child;
• “14” - cancer in a child or a post-vaccination complication;
• “15” – HIV infection in a child.

Points “14” and “15” are noted on the form only with the consent of the insured person (employee).

After the code “15”, three-digit designations begin (the first is “017”), they are indicated next to the above two-digit ones. They are incremental in nature, giving more detail if needed, and they start with the number “0.” There are five such designations in total:

• “017” - indicate if the treatment took place in a special facility. sanatoriums;
• “018” - undergoing sanatorium-resort treatment due to an industrial injury;
• “019” – treatment in a clinic at a university/institute;
• "020" - additional holiday for labor and finance;
• “021” - noted if the disease/injury was caused by alcohol and drug use.

Thus, correlating the reason with the established list, the doctor enters the reason on the form. For example, if a woman is on sick leave due to BiR and has received additional leave for this reason, the form will indicate the codes “05” and “017”.

Then, in the lines “Other” and , the code again becomes two-digit. Let's figure out what some of the codes in the "Other" section mean:

• “31” - noted if the employee continues to be sick;
• “32” - the employee was assigned a disability;
• “34” — death (in this case: the reason for the end of sick leave);
• “36” - the patient arrived (at the appointment) healthy and able to work.

In addition to codes for causes of disability, there are so-called ICD (International Classification of Diseases) codes. The latest version is ICD-10, the tenth edition of this classification. The doctor on sick leave also notes the disease according to the ICD system. There are 22 classes of diseases in total. They are designated from "A00" to "Z100". The ICD is already completely medical information.

If the doctor made a mistake when filling out the codes, then he must take a new, blank form. He is not allowed to cross out, sign or make changes.

Conclusion

A sick leave certificate is required when registering an employee’s temporary disability. In 2011, in order to optimize document flow and reduce FSS costs, a reform was carried out. Causes and diseases are recorded using digital symbols called codes.

Information is indicated using two designations - the first is the national designation of the cause of disability (for example, injury, disease), the second is the international designation of the disease according to the ICD-10 system, it provides more detailed medical information.

How to read a diagnosis if there is a suspicion of a cancerous tumor is an important issue for the patient and his relatives. The article discusses, firstly, the structure of an oncological diagnosis, as well as the rules for reading and understanding it. Let's start with the structure. Oncological diagnosis consists of several components:

1. Characteristics of the pathological process.
2. Characteristics of the clinical and morphological variant of the disease.
3. Process localization.
4. The stage of the disease, characterizing the prevalence of the process.
5. Characteristics of the therapeutic effect (indicated in the diagnosis after treatment).

It is imperative to remember that the final diagnosis in oncology it is placed only after histological examination of tissue from the neoplasm (biopsy). In other words, only after examining a piece of patient tissue under a microscope from the area where, according to the doctor’s assumption, there is cancer tumor.

Histological examination makes it possible to determine the nature of growth (benign or malignant) and the actual morphology of the tumor (i.e. from which tissue the growth comes), depending on the morphology, and tumors are divided into cancer - tumors from epithelial tissue, sarcoma - tumors of connective tissue, etc. .P.

The morphology of the neoplasm must be known to determine the correct tactics of treatment and management of the patient, for the prognosis of the disease, because Tumors that differ in morphology metastasize, germinate, etc. differently. Before moving on to examples and explanations of oncological diagnoses, let’s consider its main components.

So, first of all, what do the Latin letters mean in diagnosis? TNM classification, adopted to describe the anatomical extent of the tumor, it operates in three main categories: T (tumor) - from lat. tumor - characterizes the prevalence of the primary tumor, N (nodus) - from lat. node - reflects the state of regional lymph nodes, M (metastasis) - indicates the presence or absence of distant metastases.

The primary tumor (T) within the clinical classification is characterized by the symbols TX, T0, Tis, T1, T2, T3, T4.

TX is used when the size and local spread of the tumor cannot be assessed.
T0 - the primary tumor is not determined.
Tis - preinvasive carcinoma, carcinoma in situ (cancer in place), intraepithelial form of cancer, the initial stage of development of a malignant tumor without signs of germination of more than 1 layer.

T1, T2, T3, T4 - designations of size, growth pattern, relationship with border tissues and (or) primary organs tumors. The criteria by which the digital symbols of category T are determined depend on the location of the primary tumor, and for certain organs, not only the size, but also the degree of its invasiveness (sprouting).

State of regional lymph nodes(N) are designated by the categories NX, N0, N1, 2, 3. These are the lymph nodes where metastases will “go” first. Eg. for breast cancer regional lymph nodes are axillary on the corresponding side.

NX - there is insufficient data to assess the involvement of regional lymph nodes.

N0 - there are no clinical signs of metastases in regional lymph nodes. Category 0, determined before surgery based on clinical signs or after surgery based on a visual assessment of the removed specimen, is clarified by the results of histological examination.

N1, N2, N3 reflect different degrees of damage to regional lymph nodes by metastases. The criteria that determine the category numeric symbols depend on the location of the primary tumor.

Distant metastases (M) are those metastases that appear in other organs and tissues, and not just in regional lymph nodes (when a tumor grows and the tumor destroys blood vessels, cancer cells enter the bloodstream and can “spread” to almost any organ). They are characterized by the categories MX, M0, M1.

MX - insufficient data to determine distant metastases.
M0 - no signs of distant metastases. This category may be clarified and changed if distant metastases are identified during surgical exploration or during postmortem examination.

M1 - there are distant metastases. Depending on the location of metastases, category M1 can be supplemented with symbols specifying the target of metastasis: PUL. - lungs, OSS - bones, NEP - liver, BRA - brain, LYM - lymph nodes, MAR - bone marrow, PLE - pleura, PER - peritoneum, SKI - skin, ATN - other organs.

Second, what does stage mean in diagnosis? There are 4 stages of the oncological process:

Stage 1 - the oncological process affects one layer of an organ, for example, the mucous membrane. This stage is also called “cancer in situ” or “cancer in situ”. At this stage, there is no damage to regional lymph nodes. There are no metastases.

Stage 2 - the oncological process affects 2 or more layers of the organ. There is no involvement of regional lymph nodes, and there are no distant metastases.

Stage 3 - the tumor grows through all the walls of the organ, regional lymph nodes are affected, and there are no distant metastases.

Stage 4 - a large tumor that affects the entire organ, there is damage to regional and distant lymph nodes and metastases to other organs. (In some pathological processes, only 3 stages are distinguished, some stages can be divided into substages, this depends on the classification of the oncological process adopted for a given organ).

Third, what does it mean? clinical group in the diagnosis? Clinical group(in oncology) - a classification unit for dispensary registration of the population in relation to cancer diseases.

1st clinical group - persons with precancerous diseases, actually healthy:

1a - patients with a disease suspicious for a malignant neoplasm (as the final diagnosis is established, they are removed from the register or transferred to other groups);

1b - patients with precancerous diseases;

Clinical group 2 - persons with proven malignant tumors that are subject to radical treatment;

Clinical group 3 - persons with proven malignant tumors who have completed radical treatment and are in remission.

Clinical group 4 - persons with proven malignant tumors, which for one reason or another are not subject to radical treatment, but are subject to palliative (symptomatic) treatment.

Clinical group must be indicated in the patient’s diagnosis. Over time, the same patient, depending on the degree of progression of the process and the treatment provided, can move from one clinical group to another. Clinical group in no way corresponds to the stage of the disease.

So, now we can say with confidence that the structure of the diagnosis adopted in oncology allows us to understand the situation quite accurately. To understand this more clearly, consider the following examples:

1) Diagnosed with breast cancer. How will this diagnosis appear in the medical records?

DS: Cancer of the right breast T4N2M0 Stage III. 2nd class. group.

T4- tells us that this is a large tumor with invasion into nearby organs;

N2- indicates that there are metastases in the internal lymph nodes of the mammary gland on the affected side, fixed to each other;

M0- indicates that there are currently no signs of distant metastases.

Stage III - tells us that the tumor has invaded all the walls of the organ, regional lymph nodes are affected, and there are no distant metastases;

2 classes group - tells us that the malignancy of the neoplasm has been proven histologically (100%) and the tumor is subject to radical (i.e. complete) surgical removal.

2) A diagnosis of left kidney cancer with metastases to the lungs was made. How will this diagnosis appear in the medical records?

DS: Left kidney cancer T3cN2M1 (PUL) stage III. 4kl. group. T3c - due to the significant size of the tumor, the tumor spreads to the inferior vena cava above the diaphragm or grows into its wall;

N2- metastases in more than one regional lymph node;

M1 (PUL) - there are distant metastases in the lungs.

Stage III - the tumor penetrates the lymph nodes or spreads to the renal vein or inferior vena cava;

4 clinical group

3) A diagnosis of cancer of the right ovary with metastases to the peritoneum was made. What will the diagnosis look like in the medical documentation?

DS: Cancer of the right ovary T3N2M1 (PER) IIIA stage 4 class. group

T3- A tumor is present in one or both ovaries, and cancer cells are present outside the pelvic area.

N2- metastases in more than one regional lymph node;

M1 (PER) - distant metastases into the peritoneum;

Stage IIIA - spread within the pelvis, with seeding of the peritoneum (many small metastases are scattered throughout the peritoneum);

4 clinical group- a proven malignant tumor, which for one reason or another is not subject to radical treatment, but is subject to palliative (symptomatic) treatment.

4) A diagnosis of sarcoma of the left leg was made. What will the diagnosis look like in the medical documentation?

DS: Osteogenic sarcoma of the lower third of the left fibula T2 Nx M0 IIB stage 2 class group.

T2 - The lesion extends beyond the natural barrier;

Nx, M0 - no metastases;

Stage IIB - Poorly differentiated (very malignant) tumor. The outbreak spreads beyond the natural barrier. No metastases;

2nd class group - persons with proven malignancy of the tumor, which are subject to radical (complete removal of the tumor by surgery) treatment.

5) A diagnosis of cancer of the right lung with metastases to the brain was made. What will the diagnosis look like in the medical documentation?

DS: Bronchoalveolar adenocarcinoma of the right lung T3N2M1 (BRA) stage III. 4kl. group

T3 - a tumor of any size extending to the chest wall, diaphragm, mediastinal pleura (the inner layer of the pleura that is adjacent to the lungs), pericardium (the outer lining of the heart); a tumor that does not reach the carina (this is a small protrusion at the site of the division of the trachea into 2 main bronchi) by less than 2 cm, but without involving the carina, or a tumor with concomitant atelectasis (collapse) or obstructive pneumonia (blockage) of the entire lung;

N2- there is damage to the mediastinal lymph nodes on the affected side or bifurcation lymph nodes
(bifurcation is the place where the trachea divides into 2 main bronchi);

M1 (BRA) - there are distant metastases to the brain.

Stage III - a tumor larger than 6 cm with transition to the adjacent lobe of the lung or invasion of the neighboring bronchus or main bronchus. Metastases are found in bifurcation, tracheobronchial, paratracheal lymph nodes;

4kl. group - a proven malignant tumor, which for one reason or another is not subject to radical treatment, but is subject to palliative (symptomatic) treatment.

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The International Classification of Diseases is a generally accepted coding system for medical diagnoses developed by WHO. The classification includes 21 sections, each of which contains disease codes and. Currently, the ICD 10 system is used in the healthcare system and serves as a regulatory document.

The largest part of the document is devoted to describing the diagnoses of diseases. Through the use of a general classification in the medical field of different countries, a general statistical calculation is carried out, the degree of mortality and the incidence rate of individual diseases are noted.

Diseases according to ICD 10:

Thus, diagnosis codes according to ICD 10 are an element of the general classification used in the medical field.

Other diseases in the ICD

The international classification describes a number of diseases associated with disorders of the excretory system, lesions of the skin, bone and muscle tissue. The presented groups of pathologies have their own coding in the ICD.

Low lower pressure: what to do and how to treat the disease

These include the following:

The International Classification of Diagnoses contains codes for all types of pathological phenomena and processes that can occur in the human body.

Pathologies of pregnancy and childbirth in the ICD

The ICD 10 classification, in addition to diseases of certain groups of organs and systems, includes conditions associated with pregnancy and childbirth. A pathological or non-pathological process during the period of bearing a child is a medical diagnosis, which is noted accordingly in the classification.

Codes in the ICD:

• Pathologies during pregnancy. In the classification they are designated by code values ​​O00-O99. The group includes pathologies that provoke miscarriage, diseases of the mother during pregnancy, and birth complications.
• Perinatal pathologies. Includes disorders associated with disturbances in the gestation process. The group includes the consequences of injuries during childbirth, damage to the respiratory organs, heart, endocrine system associated with childbirth, and digestive disorders of the newborn. In the ICD they are designated by the values ​​P00-P96.
• Congenital defects. They are included in the classification under the code Q00-Q99. The group describes genetic abnormalities and diseases of organ systems, limb deformities, and chromosomal abnormalities.

Dyscirculatory encephalopathy is an extremely common disease that affects almost every person with arterial hypertension.

Decoding scary words is quite simple. The word “dyscirculatory” means disorders of blood circulation through the vessels of the brain, while the word “encephalopathy” literally means suffering from the head. Thus, discirculatory encephalopathy is a term that refers to any problems and disturbances of any functions due to impaired blood circulation through the vessels.

Information for doctors: the code for dyscirculatory encephalopathy according to ICD 10 is most often code I 67.8.

Causes

There are not many reasons for the development of dyscirculatory encephalopathy. The main ones are hypertension and atherosclerosis. Discirculatory encephalopathy is less often spoken of when there is a tendency to lower blood pressure.

Constant changes in blood pressure and the presence of a mechanical barrier to blood flow in the form of atherosclerotic plaques create the preconditions for chronic insufficiency of blood flow to various structures of the brain. Lack of blood flow means insufficient nutrition, untimely elimination of metabolic products of brain cells, which gradually leads to disruption of various functions.

It should be said that frequent changes in pressure lead to encephalopathy most quickly, while constantly high or constantly low pressure levels will lead to encephalopathy over a longer period of time.

A synonym for discirculatory encephalopathy is chronic cerebral circulatory failure, which, in turn, means the long-term formation of persistent disorders of the brain. Thus, the presence of the disease should be discussed only if vascular diseases are reliably present for many months and even years. Otherwise, you should look for another reason for the existing violations.

Symptoms

What should you pay attention to in order to suspect the presence of dyscirculatory encephalopathy? All symptoms of the disease are quite nonspecific and usually include “ordinary” symptoms that can also occur in a healthy person. That is why patients do not seek medical help immediately, only when the severity of symptoms begins to interfere with a normal life.

According to the classification of dyscirculatory encephalopathy, several syndromes that combine the main symptoms should be distinguished. When making a diagnosis, the doctor also determines the presence of all syndromes, indicating their severity.

• Cephalgic syndrome. Includes complaints such as headaches (mainly in the occipital and temporal regions), pressure on the eyes, nausea with headaches, and tinnitus. Any discomfort associated with the head should also be included in this syndrome.
• Vestibulo-coordinating disorders. They include dizziness, throwing up when walking, a feeling of instability when changing body position, blurred vision with sudden movements.
• Astheno-neurotic syndrome. Includes mood swings, persistently low mood, tearfulness, and feelings of distress. In case of pronounced changes, it should be differentiated from more serious psychiatric diseases.
• Dissomnia syndrome, including any sleep disorders (including light sleep, “insomnia”, etc.).
• Cognitive impairment. They combine memory impairment, decreased concentration, absent-mindedness, etc. If the impairment is severe and other symptoms are absent, dementia of various etiologies (including) should be excluded.

Discirculatory encephalopathy grades 1, 2 and 3 (description)

Also, in addition to the syndromic classification, there is a gradation according to the degree of encephalopathy. So, there are three degrees. Discirculatory encephalopathy of the 1st degree means the most initial, transient changes in brain function. Discirculatory encephalopathy of the 2nd degree indicates persistent disorders, which, however, only affect the quality of life, usually not leading to a severe decrease in ability to work and self-care. Discirculatory encephalopathy of the 3rd degree means persistent gross disorders, often leading to disability of a person.

According to statistical data, the diagnosis of grade 2 dyscirculatory encephalopathy is one of the most common neurological diagnoses.

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Diagnostics

Only a neurologist can diagnose the disease. To make a diagnosis, an examination of the neurological status requires the presence of revived reflexes, the presence of pathological reflexes, changes in performance, and signs of disturbance of the vestibular apparatus. You should also pay attention to the presence of nystagmus, deviation of the tongue away from the midline and some other specific signs that indicate the suffering of the cerebral cortex and a decrease in its inhibitory effect on the spinal cord and reflex sphere.

Only in addition to the neurological examination are additional research methods - and others. Rheoencephalography can reveal disturbances in vascular tone and asymmetry of blood flow. MRI signs of encephalopathy include the presence of calcifications (atherosclerotic plaques), hydrocephalus, and scattered vascular hypodense inclusions. Typically, MRI signs are detected in the presence of grade 2 or 3 dyscirculatory encephalopathy.

Treatment

Treatment must be comprehensive. The main factor in successful therapy is the normalization of the causes that caused the development of the disease. It is necessary to normalize blood pressure and stabilize lipid metabolism. Standards for the treatment of dyscirculatory encephalopathy also include the use of drugs that normalize the metabolism of brain cells and vascular tone. The drugs in this group include sermion.

The choice of other medications depends on the presence and severity of certain syndromes:

• In case of severe cephalgic syndrome and existing hydrocephalus, they resort to specific diuretics (diacarb, glycerin mixture), venotonics (detralex, phlebodia).
• Vestibular-coordinating disorders should be eliminated with drugs that normalize blood flow in the vestibular structures (cerebellum, inner ear). The most commonly used are betahistine (, vestibo, tagista), vinpocetine ().
• Astheno-neurotic syndrome, as well as sleep disorders, are eliminated by prescribing mild sedatives (glycine, tenoten, etc.). In case of severe manifestations, antidepressants are prescribed. You should also adhere to proper sleep hygiene, normalize the work-rest regime, and limit psycho-emotional stress.
• For cognitive impairment, nootropic drugs are used. The most commonly used drugs are piracetam, including in combination with a vascular component (fezam), as well as more modern drugs such as phenotropil, pantogam. In case of existing severe concomitant diseases, preference should be given to safe herbal-based drugs (for example, tanakan).

Treatment with folk remedies for dyscirculatory encephalopathy usually does not pay off, although it can lead to a subjective improvement in well-being. This is especially true for patients who are distrustful of taking medications. In advanced cases, such patients should be oriented to at least take constant antihypertensive therapy, and during treatment, use parenteral methods of treatment, which, in the opinion of such patients, have a better effect than tablet forms of drugs.

Prevention

There are not many methods for preventing the disease, but standard treatment cannot do without prevention. To prevent the development of dyscirculatory encephalopathy, as well as to reduce its manifestations, you should constantly monitor the level of blood pressure, the content of cholesterol and its fractions. Psycho-emotional overload should also be avoided.

If you have dyscirculatory encephalopathy, you should also regularly (1-2 times a year) undergo a full course of vasoactive, neuroprotective, nootropic therapy in a day or round-the-clock hospital to prevent progression of the disease. Be healthy!