ICD-10 4th Edition
HRG4 2012/13 Local
Payment Grouper
Changes
The NHS Information Centre
is England’s central, authoritative source
of health and social care information
The National Casemix Office designs and refines
classifications that are used by the NHS in
England to describe healthcare activity
The NHS Information Centre
www.ic.nhs.uk
0845 300 6016
enquiries@ic.nhs.uk
The National Casemix Office
www.ic.nhs.uk/casemix
Glossary of Terms
www.ic.nhs.uk/jargon-buster
Department of Health - Payment by Results
www.dh.gov.uk/pbr
NHS Connecting for Health
www.cfh.nhs.uk
106763789
ICD-10 4th Edition HRG4
2012/13 Local Payment
changes
Table of Contents
Purpose
4
Types of change affecting HRG4 design
4
Numbers
5
Implementation with the HRG4 2012/13 Local Payment Grouper
6
Other grouper outputs
6
Summary
7
Frequently Asked Questions
7
Further Information
8
Appendices
9
Appendix A – Code Additions
9
Appendix B – Code Deletions
12
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Purpose
This document outlines the changes to the HRG4 2012/13 Local Payment Grouper for use
from 1st April 2012 due to the underlying primary classification for diagnoses being updated to
ICD-10 4th Edition also mandated for use from 1st April 2012.
This paper does not consider changes to the HRG4 classification to be used in the HRG4
2012/13 Reference Costs Grouper, which is expected to support the updated ICD-10
classification in its entirety.
Background
ICD-10 is an NHS Information Standard implemented on 1 April 1995, with a subsequent
update implemented by the NHS on 1 April 2004 referred to as ICD-10 Reprinted (with
updates and with corrections) 2000.
In 2010 the Government published the White Paper – Equity and excellence: Liberating the
NHS which reports commitment to ICD-10 changes for NHS implementation on 1 April 2012
to support quality improvements. The ICD-10 4th Edition includes changes by the World
Health Organisation (WHO) and constitutes updates to the classification to provide improved
classification of medical conditions.
ICD-10 diagnosis codes are used solely in HRG4 grouping within the Admitted Patient Care
(APC) Commissioning Data set (CDS).
They can be used:




To derive HRGs for patient activity where a significant procedure is not recorded in the
patient record.
To qualify some procedures which can be used for a variety of conditions and for which
separate identification is a clinical requirement.
To recognise the presence of complications and comorbities [CCs] within a patient record
(where it is deemed clinically relevant to differentiate HRG activity by this variable) as a
direct consequence of the resource implications of care.
In other processes as trigger codes with the output via the HRG grouper. For example,
Best Practice Tariffs (BPTs), Specialised Service Codes (SSCs), Programme Budgeting
Codes (PBCs).
Types of change affecting HRG4 design
Codes added to ICD-10 classification
For the purpose of this document, and subsequent impact analysis, new codes are defined
as those 4 or 5 digit ICD-10 codes which do not exist in the HRG4 2011/12 Local Payment
Grouper, but will exist in the ICD-10 code set to be used by the NHS from April 2012.
Codes deleted from ICD-10 classification
Codes have been deleted from the ICD-10 4th Edition classification by the WHO to provide an
improved classification of medical conditions.
Historically released data files for ICD-10 codes have only included ICD-10 codes and titles
to 4 character level. HRG4 design and subsequent software requires the full code list
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including the ICD-10 codes to 5th character level where appropriate. Where a 5th character
ICD-10 code is expected, the HRG4 design includes this code within the ICD-10 code set
used for grouping purposes. The new codes and titles files released by NHS Connecting for
Health now contain all valid ICD-10 codes to 5th character level, where available
Therefore for the purpose of this paper, and subsequent impact analysis, deleted codes are
defined as those 4 or 5 digit ICD-10 codes which exist in the HRG4 2011/12 Local Payment
grouper, but will not exist in the ICD-10 code set to be used by the NHS from April 2012.
ICD-10 changes to the dagger - asterisk coding convention
This change is required as a direct result of the sequencing change to the current coding
rules for dagger (underlying disease) and asterisk (manifestation of the disease), which are
identified as “paired” in the ICD-10 classification.
Prior to the updated ICD-10 classification the coding rule states that the dagger code must
always be coded before the asterisk code. When grouping such dagger-asterisk pairs
previous groupers in a non-significant procedure episode/spell, and, where a mandated
dagger and asterisk are recorded in the primary and first secondary diagnosis fields, the
grouper reverses these and groups using the asterisk code. If a coder had recorded an
asterisk code in the primary position the grouper would invalidate the episode and generate
the UZ01Z Data Invalid for Grouping HRG.
The change in the ICD-10 4th Edition update is that if the manifestation (asterisk) is the
primary focus of care, then the dagger (underlying disease) and asterisk sequence may be
reversed thereby coders could record the asterisk code first and the dagger code second.
The grouper therefore no longer reverses the dagger/asterisk combination to group from the
asterisk, and groups from the ICD-10 code recorded in the primary diagnosis field, which
should always be recorded for the primary focus of care.
Changes to the ICD-10 alphabetical index and tabular list at sub-code level
The ICD-10 4th Edition update contain numerous changes to the ICD-10 alphabetical index
and tabular list at a sub code level, i.e. how a clinical coder arrives at 4 or 5 character ICD-10
codes to record against a patient record. As HRG4 requires the ICD-10 code, rather than
what diseases or conditions are contained within that code it is not possible to quantify the
impact of sub code level changes on HRG4.
Numbers
The following table attempts to illustrate the magnitude of the change. There are
approximately 15,000 ICD-10 codes in total
Count
New codes
160
Deleted codes
595
Dagger / asterisk
117 / 750
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Implementation with the HRG4 2012/13 Local Payment Grouper
ICD-10 code additions
Where a new code has been added to the ICD-10 classification, Expert Working Group
(EWG) advice has been sought as to the most appropriate HRGs to group to and whether the
new code should (or should not) be a member within certain lists (e.g. complication and
comorbities). The discussions centred on the ICD-10 code (or codes) that would have been
used prior to the introduction of the ICD-10 update in April 2012.
Accommodating the new ICD-10 codes within the design in this way preserves the base
2009/10 Reference Costs design, on which the underlying reference costs were collected, as
much as possible.
See Appendix A for the list of expected code additions
A list can be found with the Code to Group worksheet of where a new ICD-10 replicates the
grouping of another ICD-10 code with the HRG design this being either a current ICD-10
code or where the new ICD-10 has replaced a now deleted code.
ICD-10 code deletions
The HRG4 2012/13 Local Payment Grouper had implemented the code list as released by
NHS Connecting for Health. Therefore, codes that were present in previous payment
groupers but are not in the updated codes set will not be valid. If used these will cause the
episode (and spell) to generate HRG UZ01Z Data Invalid for Grouping.
For multi-episode spells an admission date prior to the 1st April 2012 and a discharge date
after 31st March 2012 (i.e. crossing the financial year) that contain a deleted ICD-10 code the
spell HRG generated will be UZ01Z Data Invalid for Grouping. The HRG4 2012/13 Local
Payment Grouper will not distinguish between the two different versions of the ICD-10
classification. From analysis undertaken based on HES data it is estimated this will affect no
more than 3,000 spells nationally (0.02%).
See Appendix B for the list of expected code deletions
Changes to the grouping algorithm due to changes in coding conventions
Due to the change to the dagger and asterisk coding convention used within ICD-10, the
HRG4 2012/13 Local Payment Grouper no longer groups using the code recorded in the first
secondary diagnosis field in non-significant procedure episode/spells. It will now group using
the primary diagnosis only. This results in the removal of code to Group type ‘Core2’ with
these rows replacing the equivalent row in Code to Group type ‘Core1’.
Members on list ‘Dagger’ and list ‘Asterisk’ have also been removed.
Other grouper outputs
Both Best Practice Tariffs (BPTs) and Specialised Service Codes (SSCs) code trigger lists
have been reviewed and updated as appropriate in line with the changers due to the use of
ICD-10 4th Edition.
Programme Budgeting Categories (PBCs) have also been updated to use the updated ICD10 4th Edition code set.
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Summary
The NHS CFH Classification Service are due to implement ICD-10 4th Edition on 01/04/12.
The HRG4 2012/13 Local Payment Grouper therefore supports this classification as it is
designed to be used with 2012/13 data.
As part of the ICD-10 update a number of ICD-10 codes will become invalid on 01/04/12.
Where spells span the year boundary and constituent 2011/12 episodes contain a deleted
code, these validly coded spells will U-Group. This approach was agreed with the
Department of Health (DH) due to the relatively small number of expected affected multiepisode spells containing a deleted code, the cost/difficulty of trying to deal with two versions
of ICD codes concurrently, and the short lived nature of the problem led to the design
encapsulated in the LP1213 grouper.
Further advice can be obtained from DH PbR via
http://www.dh.gov.uk/health/2012/02/confirmation-pbr-arrangements/
The dagger-asterisk switch has been implemented within the HRG4 design, with codes from
Code to Group Type ‘Core2’ replacing the equivalent code entry in Code to Group Type
‘Core1’ and the removal of the ‘Core2’ to allow for asterisk codes to be recorded in the
primary diagnosis field.
All 160 new ICD-10 codes have been accommodated within the HRG4 classification and are
present in the HRG4 2012/13 Local Payment Grouper. This means the new ICD-10 codes
will be valid and will play a part in grouping but the base 2009/10 Reference Costs design on
which the underlying Reference Costs were collected will be preserved as much as
practicable.
All 595 ICD-10 codes deleted as of 1st April 2012 so from the year of use of HRG4 2012/13
Local Payment Grouper onwards have been deleted from the HRG4 design. This means the
use of the old ICD-10 codes will cause the episode (and spell) to group to HRG UZ01Z Data
Invalid for Grouping. This will have an impact when grouping multi episode spells that span
the year-end boundary and contain one or more deleted ICD-10 codes.
Frequently Asked Questions
Q:
A:
Q:
A:
How can we group multi-episode spells that span 2011/12 and 2012/13 that have a
deleted ICD-10 code in the 2011/12 episode, to valid HRGs using the HRG4 2012/13
Local Payment Grouper?
For multi-episode spells that end in 2012/13, but contain episodes that finished in
2011/12 (and where the episode from 2011/12 contains one of the deleted ICD-10
codes), we would advise commissioners and providers discuss the activity and come
to an arrangement locally as to appropriate tariffs.
How can we group historic data for business planning purposes or calculation of the
marginal rate through the HRG4 2012/13 Local Payment Grouper?
Historic data will U-Group when run through the HRG4 2012/13 Local Payment
Grouper if it contains codes that were deleted in ICD-10 4th Edition. Where this causes
an issue for organisations locally they may wish to use the HRG4 2012/13 Road Test
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Grouper for their planning, however it should be noted that there were a small number
of changes made to the groupers between Road Test and Local Payment. Further
details on these changes can be found in the summary of changes document
http://www.ic.nhs.uk/webfiles/Services/casemix/HRG4_LP12_13_Summary_of_Chang
es_v1.1.
Q:
A:
What were the grouper changes between Road Test and Local Payment for 2012/13?
There were only a few changes to the grouper between Road Test and Local Payment
for 2012/13:

Uplift ICD codes to ICD-10 4th edition (including for SSCs and PBCs)

Update to BPT flags
(http://www.ic.nhs.uk/webfiles/Services/casemix/HRG4_LP1213_Identification_Fla
g_Code_Sets_2._0.xlsx)

OPCS-4 codes K575, K621 and K622 mapped from EA27Z to EA29Z (from simple
to complex ablation)

Update mapping for IVUS/pressure wires when also having a PCI, in line with
updated CFH coding guidance
Further details on these changes can be found in the summary of changes document
http://www.ic.nhs.uk/webfiles/Services/casemix/HRG4_LP12_13_Summary_of_Chang
es_v1.1.
Further Information
For further information please contact the NHS Information Centre helpdesk on 0845 300
6016 or via enquires@ic.nhs.uk.
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Appendices
Appendix A – Code Additions
Code additions – the following are ICD-10 have been accommodated within the HRG4
design for the HRG4 2012/13 Local Payment Grouper
Code
A090
A099
B179
B334
B980
B981
C799
C800
C809
C814
C823
C824
C825
C826
C846
C847
C848
C849
C852
C860
C861
C862
C863
C864
C865
C866
C884
C903
C916
C918
C926
C928
C933
C946
C964
C965
C966
C968
D465
D466
D474
D475
D685
D686
D893
E883
G14X
G214
G904
Code Title
Other and unspecified gastroenteritis and colitis of infectious origin
Gastroenteritis and colitis of unspecified origin
Acute viral hepatitis, unspecified
Hantavirus (cardio)-pulmonary syndrome [HPS] [HCPS] (J17.1*)
Helicobacter pylori [H.pylori] as the cause of diseases classified to other chapters
Vibrio vulnificus as the cause of diseases classified to other chapters
Secondary malignant neoplasm, unspecified site
Malignant neoplasm, primary site unknown, so stated
Malignant neoplasm, unspecified
Lymphocyte-rich classical Hodgkin lymphoma
Follicular lymphoma grade IIIa
Follicular lymphoma grade IIIb
Diffuse follicle centre lymphoma
Cutaneous follicle centre lymphoma
Anaplastic large cell lymphoma, ALK-positive
Anaplastic large cell lymphoma, ALK-negative
Cutaneous T-cell lymphoma, unspecified
Mature T/NK-cell lymphoma, unspecified
Mediastinal (thymic) large B-cell lymphoma
Extranodal NK/T-cell lymphoma, nasal type
Hepatosplenic T-cell lymphoma
Enteropathy-type (intestinal) T-cell lymphoma
Subcutaneous panniculitis-like T-cell lymphoma
Blastic NK-cell lymphoma
Angioimmunoblastic T-cell lymphoma
Primary cutaneous CD30-positive T-cell proliferations
Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma]
Solitary plasmacytoma
Prolymphocytic leukaemia of T-cell type
Mature B-cell leukaemia Burkitt-type
Acute myeloid leukaemia with 11q23-abnormality
Acute myeloid leukaemia with multilineage dysplasia
Juvenile myelomonocytic leukaemia
Myelodysplastic and myeloproliferative disease, not elsewhere classified
Sarcoma of dendritic cells (accessory cells)
Multifocal and unisystemic Langerhans-cell histiocytosis
Unifocal Langerhans-cell histiocytosis
Histiocytic sarcoma
Refractory anaemia with multi-lineage dysplasia
Myelodysplastic syndrome with isolated del(5q) chromosomal abnormality
Osteomyelofibrosis
Chronic eosinophilic leukaemia [hypereosinophilic syndrome]
Primary Thrombophilia
Other Thrombophilia
Immune reconstitution syndrome
Tumour lysis syndrome
Postpolio syndrome
Vascular parkinsonism
Autonomic dysreflexia
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Code
H549
I272
I7000
I7001
I7010
I7011
I7020
I7021
I7080
I7081
I7090
I7091
I725
I983
J09X
J123
J211
K123
K227
K352
K353
K358
K523
K850
K851
K852
K853
K858
K859
L890
L891
L892
L893
L899
M317
M726
M7260
M7261
M7262
M7263
M7264
M7265
M7266
M7267
M7268
M7269
M797
M7970
M7971
M7972
M7973
M7974
M7975
M7976
M7977
M7978
M7979
N181
N182
Code Title
Unspecified visual impairment (binocular)
Other secondary pulmonary hypertension
Atherosclerosis of aorta, without gangrene
Atherosclerosis of aorta, with gangrene
Atherosclerosis of renal artery, without gangrene
Atherosclerosis of renal artery, with gangrene
Atherosclerosis of arteries of extremities, without gangrene
Atherosclerosis of arteries of extremities, with gangrene
Atherosclerosis of other arteries, without gangrene
Atherosclerosis of other arteries, with gangrene
Generalized and unspecified atherosclerosis, without gangrene
Generalized and unspecified atherosclerosis, with gangrene
Aneurysm and dissection of precerebral arteries
Oesophageal varices with bleeding in diseases classified elsewhere
Influenza due to identified Avian influenza virus
Human metapneumovirus pneumonia
Acute bronchiolitis due to human metapneumovirus
Oral mucositis (ulcerative)
Barrett's esophagus
Acute appendicitis with generalized peritonitis
Acute appendicitis with localized peritonitis
Acute appendicitis, other and unspecified
Indeterminate colitis
Idiopathic acute pancreatitis
Biliary acute pancreatitis
Alcohol-induced acute pancreatitis
Drug-induced acute pancreatitis
Other acute pancreatitis
Acute pancreatitis, unspecified
Stage l decubitus ulcer and pressure area
Stage ll decubitus ulcer
Stage lll decubitus ulcer
Stage lV decubitus ulcer
Decubitus ulcer and pressure area, unspecified
Microscopic polyangiitis
Necrotising fasciitis
Necrotising fasciitis, Multiple sites
Necrotising fasciitis, Shoulder region
Necrotising fasciitis, Upper arm
Necrotising fasciitis, Forearm
Necrotising fasciitis, Hand
Necrotising fasciitis, Pelvic region and thigh
Necrotising fasciitis, Lower leg
Necrotising fasciitis, Ankle and foot
Necrotising fasciitis, Other
Necrotising fasciitis, Site unspecified
Fibromyalgia
Fibromyalgia, Multiple sites
Fibromyalgia, Shoulder region
Fibromyalgia, Upper arm
Fibromyalgia, Forearm
Fibromyalgia, Hand
Fibromyalgia, Pelvic region and thigh
Fibromyalgia, Lower leg
Fibromyalgia, Ankle and foot
Fibromyalgia, Other
Fibromyalgia, Site unspecified
Chronic kidney disease, stage 1
Chronic kidney disease, stage 2
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Code
N183
N184
N185
N423
O142
O432
O600
O601
O602
O603
O94X
O960
O961
O969
O970
O971
O979
O987
P916
Q315
R263
R296
R502
R508
R572
R636
R650
R651
R652
R653
R659
W460
W461
W462
W463
W464
W465
W466
W467
W468
W469
Z587
Z926
U049
U800
U801
U808
U810
U818
U88X
U898
U899
Code Title
Chronic kidney disease, stage 3
Chronic kidney disease, stage 4
Chronic kidney disease, stage 5
Dysplasia of prostate
HELLP syndrome
Morbidly adherent placenta
Preterm labour and delivery
Preterm spontaneous labour with preterm delivery
Preterm spontaneous labour with term delivery
Preterm delivery without spontaneous labour
Sequelae of complication of pregnancy, childbirth and the puerperium
Death from direct obstetric cause
Death from indirect obstetric causes
Death from unspecified obstetric cause
Death from sequelae of direct obstetric cause
Death from sequelae of indirect obstetric cause
Death from sequelae of obstetric cause, unspecified
Human immunodeficiency [HIV] disease complicating pregnancy, childbirth and the puerperium
Hypoxic ischaemic encephalopathy of newborn
Congenital laryngomalacia
Immobility
Tendency to fall, nor elsewhere classified
Drug-induced fever
Other specified fever
Septic shock
Insufficient intake of food and water due to self neglect
Systemic Inflammatory Response Syndrome of infectious origin without organ failure
Systemic Inflammatory Response Syndrome of infectious origin with organ failure
Systemic Inflammatory Response Syndrome of non-infectious origin without organ failure
Systemic Inflammatory Response Syndrome of non-infectious origin with organ failure
Systemic Inflammatory Response Syndrome, unspecified
Contact with hypodermic needle - Occurrence at home
Contact with hypodermic needle - Occurrence in residential institution
Contact with hypodermic needle - Occurrence at school other instit'n / pub admin area
Contact with hypodermic needle - Occurrence at sports / athletics area
Contact with hypodermic needle - Occurrence on street / highway
Contact with hypodermic needle - Occurrence at trade / service area
Contact with hypodermic needle - Occurrence at industrial / construction area
Contact with hypodermic needle - Occurrence on farm
Contact with hypodermic needle - Occurrence at other specified place
Contact with hypodermic needle - Occurrence at unspecified place
Exposure to tobacco smoke
Personal history of chemotherapy for neoplastic disease
Severe acute respiratory syndrome [SARS], unspecified
Penicillin resistant agent
Methicillin resistant agent
Agent resistant to other penicillin-related antibiotic
Vancomycin resistant agent
Agent resistant to other vancomycin-related antibiotic
Agent resistant to multiple antibiotics
Agent resistant to other single specified antibiotic
Agent resistant to unspecified antibiotic
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Appendix B – Code Deletions
Code deletions – the following are ICD-10 have been deleted from the HRG4 design for the
HRG4 2012/13 Local Payment Grouper
Code
A09X
C80X
C832
C834
C836
C842
C843
C850
C881
C912
C932
C941
C945
C952
C961
C963
D463
D752
D760
H547
K350
K351
K359
K511
K85X
L89X
M0701
M0702
M0703
M0705
M0706
M0708
M1906
M1916
M1926
M1996
M2131
M2132
M2135
M2136
M2138
M2139
M2140
M2141
M2142
M2143
M2144
M2145
Code Title
Diarrhoea and gastroenteritis of presumed infectious origin
Malignant neoplasm without specification of site
Diffuse non-Hodgkin mixed sml & lge cell (diffuse) lymphoma
Diffuse non-Hodgkin's immunoblastic (diffuse) lymphoma
Diffuse non-Hodgkin's lymphoma undifferentiated (diffuse)
Peripheral and cutaneous T-cell lymphomas, T-zone lymphoma
Periph & cutan T-cell lymphomas, lymphoepithelioid lymphoma
Oth & unspec types of non-Hodgkin's lymphoma, lymphosarcoma
Alpha heavy chain disease
Subacute lymphocytic leukaemia
Subacute monocytic leukaemia
Chronic erythraemia
Acute myelofibrosis
Subacute leukaemia unsp cell type
Malignant histiocytosis
True histiocyt lymphoma
Refractory anaemia with excess of blasts with transformation
Essential thrombocytosis
Langerhans' cell histiocytosis, not elsewhere classified
Unspecified visual loss
Acute appendicitis with generalized peritonitis
Acute appendicitis with peritoneal abscess
Acute appendicitis, unspecified
Ulcerative (chronic) ileocolitis
Acute pancreatitis
Decubitus ulcer
Distal interphalangeal proriatic arthropathy-Shldr region
Distal interphalangeal proriatic arthropathy-Upper arm
Distal interphalangeal proriatic arthropathy-Forearm
Distal interphalangeal proriatic arthropathy-Pelvic/thigh
Distal interphalangeal proriatic arthropathy-Lower leg
Distal interphalangeal proriatic arthropathy-Other
Primary arthrosis of other joints-Lower leg
Post-traumatic arthrosis of other joints-Lower leg
Other secondary arthrosis of other joints-Lower leg
Arthrosis, unspecified-Lower leg
Wrist or foot drop (acquired)-Shldr region
Wrist or foot drop (acquired)-Upper arm
Wrist or foot drop (acquired)-Pelvic/thigh
Wrist or foot drop (acquired)-Lower leg
Wrist or foot drop (acquired)-Other
Wrist or foot drop (acquired)-Site unspec
Flat foot [pes planus] (acquired)-Mult sites
Flat foot [pes planus] (acquired)-Shldr region
Flat foot [pes planus] (acquired)-Upper arm
Flat foot [pes planus] (acquired)-Forearm
Flat foot [pes planus] (acquired)-Hand
Flat foot [pes planus] (acquired)-Pelvic/thigh
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Code
M2146
M2147
M2148
M2149
M2151
M2152
M2153
M2155
M2156
M2158
M2159
M2160
M2161
M2162
M2163
M2164
M2165
M2166
M2167
M2168
M2169
M2171
M2178
M2188
M2198
M2307
M2317
M2327
M2337
M2340
M2341
M2342
M2343
M2344
M2345
M2346
M2347
M2349
M2365
M2366
M2406
M2470
M2471
M2472
M2473
M2474
M2475
M2476
M2477
M2478
M2479
M4131
M4132
Code Title
Flat foot [pes planus] (acquired)-Lower leg
Flat foot [pes planus] (acquired)-Ankle/foot
Flat foot [pes planus] (acquired)-Other
Flat foot [pes planus] (acquired)-Site unspec
Acquired clawhand, clubhand, clawfoot and clubfoot-Shldr re
Acquired clawhand, clubhand, clawfoot and clubfoot-Upper ar
Acquired clawhand, clubhand, clawfoot and clubfoot-Forearm
Acquired clawhand, clubhand, clawfoot and clubfoot-Pelvic/t
Acquired clawhand, clubhand, clawfoot and clubfoot-Lower le
Acquired clawhand, clubhand, clawfoot and clubfoot-Other
Acquired clawhand, clubhand, clawfoot and clubfoot-Site uns
Other acquired deformities of ankle and foot-Mult sites
Other acquired deformities of ankle and foot-Shldr region
Other acquired deformities of ankle and foot-Upper arm
Other acquired deformities of ankle and foot-Forearm
Other acquired deformities of ankle and foot-Hand
Other acquired deformities of ankle and foot-Pelvic/thigh
Other acquired deformities of ankle and foot-Lower leg
Other acquired deformities of ankle and foot-Ankle/foot
Other acquired deformities of ankle and foot-Other
Other acquired deformities of ankle and foot-Site unspec
Unequal limb length (acquired)-Shldr region
Unequal limb length (acquired)-Other
Other specified acquired deformities of limbs-Other
Acquired deformity of limb, unspecified-Other
Cystic meniscus-Capsular lig
Discoid meniscus (congenital)-Capsular lig
Derangement of meniscus due to old tear or injury-Capsular
Other meniscus derangements-Capsular lig
Loose body in knee-Mult sites
Loose body in knee-Ant lig/hrn men
Loose body in knee-Pst lig/hrn men
Loose body in knee-Med lig/oth men
Loose body in knee-Lat lig/ant men
Loose body in knee-Pst hrn lat men
Loose body in knee-O/unsp lat men
Loose body in knee-Capsular lig
Loose body in knee-Unspec lig/men
Other spontaneous disruption of ligament(s) of knee-Pst hrn
Other spontaneous disruption of ligament(s) of knee-O/unsp
Loose body in joint-Lower leg
Protrusio acetabuli-Mult sites
Protrusio acetabuli-Shldr region
Protrusio acetabuli-Upper arm
Protrusio acetabuli-Forearm
Protrusio acetabuli-Hand
Protrusio acetabuli-Pelvic/thigh
Protrusio acetabuli-Lower leg
Protrusio acetabuli-Ankle/foot
Protrusio acetabuli-Other
Protrusio acetabuli-Site unspec
Thoracogenic scoliosis-Occipit-atl-axl
Thoracogenic scoliosis-Cervical
Copyright © 2011, The Health and Social Care Information Centre. All Rights Reserved.
The NHS Information Centre (NHSIC) will in future be known as Health and Social Care Information Centre (HSCIC)
13
106763789
Code
M4136
M4137
M4138
M4139
M4340
M4341
M4342
M4343
M4344
M4345
M4346
M4347
M4348
M4349
M4351
M4360
M4361
M4362
M4363
M4364
M4365
M4366
M4367
M4368
M4369
M4610
M4611
M4612
M4613
M4614
M4615
M4616
M4617
M4618
M4619
M5304
M5305
M5306
M5307
M5308
M5309
M5314
M5315
M5316
M5317
M5318
M5319
M5330
M5331
M5332
M5333
M5334
M5335
Code Title
Thoracogenic scoliosis-Lumbar
Thoracogenic scoliosis-Lumbosacral
Thoracogenic scoliosis-Sacral/sacrococ
Thoracogenic scoliosis-Site unspe
Other recurrent atlantoaxial subluxation-Mult site
Other recurrent atlantoaxial subluxation-Occipit-atl-axl
Other recurrent atlantoaxial subluxation-Cervical
Other recurrent atlantoaxial subluxation-Cervicothoracic
Other recurrent atlantoaxial subluxation-Thoracic
Other recurrent atlantoaxial subluxation-Thoracolumbar
Other recurrent atlantoaxial subluxation-Lumbar
Other recurrent atlantoaxial subluxation-Lumbosacral
Other recurrent atlantoaxial subluxation-Sacral/sacrococ
Other recurrent atlantoaxial subluxation-Site unspe
Other recurrent vertebral subluxation-Occipit-atl-axl
Torticollis-Mult site
Torticollis-Occipit-atl-axl
Torticollis-Cervical
Torticollis-Cervicothoracic
Torticollis-Thoracic
Torticollis-Thoracolumbar
Torticollis-Lumbar
Torticollis-Lumbosacral
Torticollis-Sacral/sacrococ
Torticollis-Site unspe
Sacroiliitis, not elsewhere classified-Mult site
Sacroiliitis, not elsewhere classified-Occipit-atl-axl
Sacroiliitis, not elsewhere classified-Cervical
Sacroiliitis, not elsewhere classified-Cervicothoracic
Sacroiliitis, not elsewhere classified-Thoracic
Sacroiliitis, not elsewhere classified-Thoracolumbar
Sacroiliitis, not elsewhere classified-Lumbar
Sacroiliitis, not elsewhere classified-Lumbosacral
Sacroiliitis, not elsewhere classified-Sacral/sacrococ
Sacroiliitis, not elsewhere classified-Site unspe
Cervicocranial syndrome-Thoracic
Cervicocranial syndrome-Thoracolumbar
Cervicocranial syndrome-Lumbar
Cervicocranial syndrome-Lumbosacral
Cervicocranial syndrome-Sacral/sacrococ
Cervicocranial syndrome-Site unspe
Cervicobrachial syndrome-Thoracic
Cervicobrachial syndrome-Thoracolumbar
Cervicobrachial syndrome-Lumbar
Cervicobrachial syndrome-Lumbosacral
Cervicobrachial syndrome-Sacral/sacrococ
Cervicobrachial syndrome-Site unspe
Sacrococcygeal disorders, not elsewhere classified-Mult sit
Sacrococcygeal disorders, not elsewhere classified-OccipitSacrococcygeal disorders, not elsewhere classified-Cervical
Sacrococcygeal disorders, not elsewhere classified-Cervicot
Sacrococcygeal disorders, not elsewhere classified-Thoracic
Sacrococcygeal disorders, not elsewhere classified-Thoracol
Copyright © 2011, The Health and Social Care Information Centre. All Rights Reserved.
The NHS Information Centre (NHSIC) will in future be known as Health and Social Care Information Centre (HSCIC)
14
106763789
Code
M5336
M5337
M5338
M5339
M5420
M5424
M5425
M5426
M5427
M5428
M5429
M5431
M5432
M5433
M5434
M5441
M5442
M5443
M5444
M5451
M5452
M5453
M5454
M5461
M5462
M5466
M5467
M5468
M5469
M6530
M6531
M6532
M6533
M6534
M6535
M6536
M6537
M6538
M6539
M6541
M6542
M6545
M6546
M6547
M6548
M6549
M6600
M6601
M6602
M6603
M6604
M6605
M6606
Code Title
Sacrococcygeal disorders, not elsewhere classified-Lumbar
Sacrococcygeal disorders, not elsewhere classified-Lumbosac
Sacrococcygeal disorders, not elsewhere classified-Sacral/s
Sacrococcygeal disorders, not elsewhere classified-Site uns
Cervicalgia-Mult site
Cervicalgia-Thoracic
Cervicalgia-Thoracolumbar
Cervicalgia-Lumbar
Cervicalgia-Lumbosacral
Cervicalgia-Sacral/sacrococ
Cervicalgia-Site unspe
Sciatica-Occipit-atl-axl
Sciatica-Cervical
Sciatica-Cervicothoracic
Sciatica-Thoracic
Lumbago with sciatica-Occipit-atl-axl
Lumbago with sciatica-Cervical
Lumbago with sciatica-Cervicothoracic
Lumbago with sciatica-Thoracic
Low back pain-Occipit-atl-axl
Low back pain-Cervical
Low back pain-Cervicothoracic
Low back pain-Thoracic
Pain in thoracic spine-Occipit-atl-axl
Pain in thoracic spine-Cervical
Pain in thoracic spine-Lumbar
Pain in thoracic spine-Lumbosacral
Pain in thoracic spine-Sacral/sacrococ
Pain in thoracic spine-Site unspe
Trigger finger-Mult sites
Trigger finger-Shldr region
Trigger finger-Upper arm
Trigger finger-Forearm
Trigger finger-Hand
Trigger finger-Pelvic/thigh
Trigger finger-Lower leg
Trigger finger-Ankle/foot
Trigger finger-Other
Trigger finger-Site unspec
Radial styloid tenosynovitis [de Quervain]-Shldr region
Radial styloid tenosynovitis [de Quervain]-Upper arm
Radial styloid tenosynovitis [de Quervain]-Pelvic/thigh
Radial styloid tenosynovitis [de Quervain]-Lower leg
Radial styloid tenosynovitis [de Quervain]-Ankle/foot
Radial styloid tenosynovitis [de Quervain]-Other
Radial styloid tenosynovitis [de Quervain]-Site unspec
Rupture of popliteal cyst-Mult sites
Rupture of popliteal cyst-Shldr region
Rupture of popliteal cyst-Upper arm
Rupture of popliteal cyst-Forearm
Rupture of popliteal cyst-Hand
Rupture of popliteal cyst-Pelvic/thigh
Rupture of popliteal cyst-Lower leg
Copyright © 2011, The Health and Social Care Information Centre. All Rights Reserved.
The NHS Information Centre (NHSIC) will in future be known as Health and Social Care Information Centre (HSCIC)
15
106763789
Code
M6607
M6608
M6609
M6628
M7001
M7002
M7005
M7006
M7007
M7008
M7009
M7010
M7011
M7012
M7013
M7014
M7015
M7016
M7017
M7018
M7019
M7020
M7021
M7022
M7023
M7024
M7025
M7026
M7027
M7028
M7029
M7030
M7031
M7032
M7033
M7034
M7035
M7036
M7037
M7038
M7039
M7040
M7041
M7042
M7043
M7044
M7045
M7046
M7047
M7048
M7049
M7050
M7051
Code Title
Rupture of popliteal cyst-Ankle/foot
Rupture of popliteal cyst-Other
Rupture of popliteal cyst-Site unspec
Spontaneous rupture of extensor tendons-Other
Chronic crepitant synovitis of hand and wrist-Shldr region
Chronic crepitant synovitis of hand and wrist-Upper arm
Chronic crepitant synovitis of hand and wrist-Pelvic/Thigh
Chronic crepitant synovitis of hand and wrist-Lower Leg
Chronic crepitant synovitis of hand and wrist-Ankle/Foot
Chronic crepitant synovitis of hand and wrist-Other
Chronic crepitant synovitis of hand and wrist-Site unspec
Bursitis of hand-Mult sites
Bursitis of hand-Shldr region
Bursitis of hand-Upper arm
Bursitis of hand-Forearm
Bursitis of hand-Hand
Bursitis of hand-Pelvic/Thigh
Bursitis of hand-Lower Leg
Bursitis of hand-Ankle/Foot
Bursitis of hand-Other
Bursitis of hand-Site unspec
Olecranon bursitis-Mult sites
Olecranon bursitis-Shldr region
Olecranon bursitis-Upper arm
Olecranon bursitis-Forearm
Olecranon bursitis-Hand
Olecranon bursitis-Pelvic/Thigh
Olecranon bursitis-Lower Leg
Olecranon bursitis-Ankle/Foot
Olecranon bursitis-Other
Olecranon bursitis-Site unspec
Other bursitis of elbow-Mult sites
Other bursitis of elbow-Shldr region
Other bursitis of elbow-Upper arm
Other bursitis of elbow-Forearm
Other bursitis of elbow-Hand
Other bursitis of elbow-Pelvic/Thigh
Other bursitis of elbow-Lower Leg
Other bursitis of elbow-Ankle/Foot
Other bursitis of elbow-Other
Other bursitis of elbow-Site unspec
Prepatellar bursitis-Mult sites
Prepatellar bursitis-Shldr region
Prepatellar bursitis-Upper arm
Prepatellar bursitis-Forearm
Prepatellar bursitis-Hand
Prepatellar bursitis-Pelvic/Thigh
Prepatellar bursitis-Lower Leg
Prepatellar bursitis-Ankle/Foot
Prepatellar bursitis-Other
Prepatellar bursitis-Site unspec
Other bursitis of knee-Mult sites
Other bursitis of knee-Shldr region
Copyright © 2011, The Health and Social Care Information Centre. All Rights Reserved.
The NHS Information Centre (NHSIC) will in future be known as Health and Social Care Information Centre (HSCIC)
16
106763789
Code
M7052
M7053
M7054
M7055
M7056
M7057
M7058
M7059
M7060
M7061
M7062
M7063
M7064
M7065
M7066
M7067
M7068
M7069
M7070
M7071
M7072
M7073
M7074
M7075
M7076
M7077
M7078
M7079
M7120
M7121
M7122
M7123
M7124
M7125
M7126
M7127
M7128
M7129
M7200
M7201
M7202
M7203
M7204
M7205
M7206
M7207
M7208
M7209
M7211
M7212
M7213
M7215
M7216
Code Title
Other bursitis of knee-Upper arm
Other bursitis of knee-Forearm
Other bursitis of knee-Hand
Other bursitis of knee-Pelvic/Thigh
Other bursitis of knee-Lower Leg
Other bursitis of knee-Ankle/Foot
Other bursitis of knee-Other
Other bursitis of knee-Site unspec
Trochanteric bursitis-Mult sites
Trochanteric bursitis-Shldr region
Trochanteric bursitis-Upper arm
Trochanteric bursitis-Forearm
Trochanteric bursitis-Hand
Trochanteric bursitis-Pelvic/Thigh
Trochanteric bursitis-Lower Leg
Trochanteric bursitis-Ankle/Foot
Trochanteric bursitis-Other
Trochanteric bursitis-Site unspec
Other bursitis of hip-Mult sites
Other bursitis of hip-Shldr region
Other bursitis of hip-Upper arm
Other bursitis of hip-Forearm
Other bursitis of hip-Hand
Other bursitis of hip-Pelvic/Thigh
Other bursitis of hip-Lower Leg
Other bursitis of hip-Ankle/Foot
Other bursitis of hip-Other
Other bursitis of hip-Site unspec
Synovial cyst of popliteal space [Baker]-Mult sites
Synovial cyst of popliteal space [Baker]-Shldr region
Synovial cyst of popliteal space [Baker]-Upper arm
Synovial cyst of popliteal space [Baker]-Forearm
Synovial cyst of popliteal space [Baker]-Hand
Synovial cyst of popliteal space [Baker]-Pelvic/Thigh
Synovial cyst of popliteal space [Baker]-Lower Leg
Synovial cyst of popliteal space [Baker]-Ankle/Foot
Synovial cyst of popliteal space [Baker]-Other
Synovial cyst of popliteal space [Baker]-Site unspec
Palmar fascial fibromatosis [Dupuytren]-Mult sites
Palmar fascial fibromatosis [Dupuytren]-Shldr region
Palmar fascial fibromatosis [Dupuytren]-Upper arm
Palmar fascial fibromatosis [Dupuytren]-Forearm
Palmar fascial fibromatosis [Dupuytren]-Hand
Palmar fascial fibromatosis [Dupuytren]-Pelvic/Thigh
Palmar fascial fibromatosis [Dupuytren]-Lower Leg
Palmar fascial fibromatosis [Dupuytren]-Ankle/Foot
Palmar fascial fibromatosis [Dupuytren]-Other
Palmar fascial fibromatosis [Dupuytren]-Site unspec
Knuckle pads-Shldr region
Knuckle pads-Upper arm
Knuckle pads-Forearm
Knuckle pads-Pelvic/Thigh
Knuckle pads-Lower Leg
Copyright © 2011, The Health and Social Care Information Centre. All Rights Reserved.
The NHS Information Centre (NHSIC) will in future be known as Health and Social Care Information Centre (HSCIC)
17
106763789
Code
M7218
M7220
M7221
M7222
M7223
M7224
M7225
M7226
M7227
M7228
M7229
M723
M7230
M7231
M7232
M7233
M7234
M7235
M7236
M7237
M7238
M7239
M725
M7250
M7251
M7252
M7253
M7254
M7255
M7256
M7257
M7258
M7259
M7601
M7602
M7603
M7604
M7606
M7607
M7608
M7609
M7611
M7612
M7613
M7614
M7616
M7617
M7618
M7619
M7620
M7621
M7622
M7623
Code Title
Knuckle pads-Other
Plantar fascial fibromatosis-Mult sites
Plantar fascial fibromatosis-Shldr region
Plantar fascial fibromatosis-Upper arm
Plantar fascial fibromatosis-Forearm
Plantar fascial fibromatosis-Hand
Plantar fascial fibromatosis-Pelvic/Thigh
Plantar fascial fibromatosis-Lower Leg
Plantar fascial fibromatosis-Ankle/Foot
Plantar fascial fibromatosis-Other
Plantar fascial fibromatosis-Site unspec
Nodular fasciitis
Nodular fasciitis-Mult sites
Nodular fasciitis-Shldr region
Nodular fasciitis-Upper arm
Nodular fasciitis-Forearm
Nodular fasciitis-Hand
Nodular fasciitis-Pelvic/Thigh
Nodular fasciitis-Lower Leg
Nodular fasciitis-Ankle/Foot
Nodular fasciitis-Other
Nodular fasciitis-Site unspec
Fasciitis, not elsewhere classified
Fasciitis, not elsewhere classified-Mult sites
Fasciitis, not elsewhere classified-Shldr region
Fasciitis, not elsewhere classified-Upper arm
Fasciitis, not elsewhere classified-Forearm
Fasciitis, not elsewhere classified-Hand
Fasciitis, not elsewhere classified-Pelvic/Thigh
Fasciitis, not elsewhere classified-Lower Leg
Fasciitis, not elsewhere classified-Ankle/Foot
Fasciitis, not elsewhere classified-Other
Fasciitis, not elsewhere classified-Site unspec
Gluteal tendinitis-Shldr region
Gluteal tendinitis-Upper arm
Gluteal tendinitis-Forearm
Gluteal tendinitis-Hand
Gluteal tendinitis-Lower Leg
Gluteal tendinitis-Ankle/Foot
Gluteal tendinitis-Other
Gluteal tendinitis-Site unspec
Psoas tendinitis-Shldr region
Psoas tendinitis-Upper arm
Psoas tendinitis-Forearm
Psoas tendinitis-Hand
Psoas tendinitis-Lower Leg
Psoas tendinitis-Ankle/Foot
Psoas tendinitis-Other
Psoas tendinitis-Site unspec
Iliac crest spur-Mult sites
Iliac crest spur-Shldr region
Iliac crest spur-Upper arm
Iliac crest spur-Forearm
Copyright © 2011, The Health and Social Care Information Centre. All Rights Reserved.
The NHS Information Centre (NHSIC) will in future be known as Health and Social Care Information Centre (HSCIC)
18
106763789
Code
M7624
M7625
M7626
M7627
M7628
M7629
M7631
M7632
M7633
M7634
M7637
M7638
M7639
M7640
M7641
M7642
M7643
M7644
M7645
M7646
M7647
M7648
M7649
M7650
M7651
M7652
M7653
M7654
M7655
M7656
M7657
M7658
M7659
M7661
M7662
M7663
M7664
M7665
M7668
M7669
M7671
M7672
M7673
M7674
M7675
M7678
M7679
M7681
M7682
M7683
M7684
M7688
M7689
Code Title
Iliac crest spur-Hand
Iliac crest spur-Pelvic/Thigh
Iliac crest spur-Lower Leg
Iliac crest spur-Ankle/Foot
Iliac crest spur-Other
Iliac crest spur-Site unspec
Iliotibial band syndrome-Shldr region
Iliotibial band syndrome-Upper arm
Iliotibial band syndrome-Forearm
Iliotibial band syndrome-Hand
Iliotibial band syndrome-Ankle/Foot
Iliotibial band syndrome-Other
Iliotibial band syndrome-Site unspec
Tibial collateral bursitis [Pellegrini-Stieda]-Mult sites
Tibial collateral bursitis [Pellegrini-Stieda]-Shldr region
Tibial collateral bursitis [Pellegrini-Stieda]-Upper arm
Tibial collateral bursitis [Pellegrini-Stieda]-Forearm
Tibial collateral bursitis [Pellegrini-Stieda]-Hand
Tibial collateral bursitis [Pellegrini-Stieda]-Pelvic/Thigh
Tibial collateral bursitis [Pellegrini-Stieda]-Lower Leg
Tibial collateral bursitis [Pellegrini-Stieda]-Ankle/Foot
Tibial collateral bursitis [Pellegrini-Stieda]-Other
Tibial collateral bursitis [Pellegrini-Stieda]-Site unspec
Patellar tendinitis-Mult sites
Patellar tendinitis-Shldr region
Patellar tendinitis-Upper arm
Patellar tendinitis-Forearm
Patellar tendinitis-Hand
Patellar tendinitis-Pelvic/Thigh
Patellar tendinitis-Lower Leg
Patellar tendinitis-Ankle/Foot
Patellar tendinitis-Other
Patellar tendinitis-Site unspec
Achilles tendinitis-Shldr region
Achilles tendinitis-Upper arm
Achilles tendinitis-Forearm
Achilles tendinitis-Hand
Achilles tendinitis-Pelvic/Thigh
Achilles tendinitis-Other
Achilles tendinitis-Site unspec
Peroneal tendinitis-Shldr region
Peroneal tendinitis-Upper arm
Peroneal tendinitis-Forearm
Peroneal tendinitis-Hand
Peroneal tendinitis-Pelvic/Thigh
Peroneal tendinitis-Other
Peroneal tendinitis-Site unspec
Other enthesopathies of lower limb, excluding foot-Shldr re
Other enthesopathies of lower limb, excluding foot-Upper ar
Other enthesopathies of lower limb, excluding foot-Forearm
Other enthesopathies of lower limb, excluding foot-Hand
Other enthesopathies of lower limb, excluding foot-Other
Other enthesopathies of lower limb, excluding foot-Site uns
Copyright © 2011, The Health and Social Care Information Centre. All Rights Reserved.
The NHS Information Centre (NHSIC) will in future be known as Health and Social Care Information Centre (HSCIC)
19
106763789
Code
M7691
M7692
M7693
M7694
M7701
M7703
M7704
M7707
M7708
M7711
M7713
M7714
M7717
M7718
M7720
M7721
M7722
M7723
M7724
M7725
M7726
M7727
M7728
M7729
M7730
M7731
M7732
M7733
M7734
M7735
M7736
M7737
M7738
M7739
M7740
M7741
M7742
M7743
M7744
M7745
M7746
M7747
M7748
M7749
M7750
M7751
M7752
M7753
M7754
M7755
M7756
M7757
M7758
Code Title
Enthesopathy of lower limb, unspecified-Shldr region
Enthesopathy of lower limb, unspecified-Upper arm
Enthesopathy of lower limb, unspecified-Forearm
Enthesopathy of lower limb, unspecified-Hand
Medial epicondylitis-Shldr region
Medial epicondylitis-Forearm
Medial epicondylitis-Hand
Medial epicondylitis-Ankle/Foot
Medial epicondylitis-Other
Lateral epicondylitis-Shldr region
Lateral epicondylitis-Forearm
Lateral epicondylitis-Hand
Lateral epicondylitis-Ankle/Foot
Lateral epicondylitis-Other
Periarthritis of wrist-Mult sites
Periarthritis of wrist-Shldr region
Periarthritis of wrist-Upper arm
Periarthritis of wrist-Forearm
Periarthritis of wrist-Hand
Periarthritis of wrist-Pelvic/Thigh
Periarthritis of wrist-Lower Leg
Periarthritis of wrist-Ankle/Foot
Periarthritis of wrist-Other
Periarthritis of wrist-Site unspec
Calcaneal spur-Mult sites
Calcaneal spur-Shldr region
Calcaneal spur-Upper arm
Calcaneal spur-Forearm
Calcaneal spur-Hand
Calcaneal spur-Pelvic/Thigh
Calcaneal spur-Lower Leg
Calcaneal spur-Ankle/Foot
Calcaneal spur-Other
Calcaneal spur-Site unspec
Metatarsalgia-Mult sites
Metatarsalgia-Shldr region
Metatarsalgia-Upper arm
Metatarsalgia-Forearm
Metatarsalgia-Hand
Metatarsalgia-Pelvic/Thigh
Metatarsalgia-Lower Leg
Metatarsalgia-Ankle/Foot
Metatarsalgia-Other
Metatarsalgia-Site unspec
Other enthesopathy of foot-Mult sites
Other enthesopathy of foot-Shldr region
Other enthesopathy of foot-Upper arm
Other enthesopathy of foot-Forearm
Other enthesopathy of foot-Hand
Other enthesopathy of foot-Pelvic/Thigh
Other enthesopathy of foot-Lower Leg
Other enthesopathy of foot-Ankle/Foot
Other enthesopathy of foot-Other
Copyright © 2011, The Health and Social Care Information Centre. All Rights Reserved.
The NHS Information Centre (NHSIC) will in future be known as Health and Social Care Information Centre (HSCIC)
20
106763789
Code
M7759
M7949
M8520
M8521
M8522
M8523
M8524
M8525
M8526
M8527
M8528
M8529
M8800
M8801
M8802
M8803
M8804
M8805
M8806
M8807
M8808
M8809
M9100
M9101
M9102
M9103
M9104
M9105
M9106
M9107
M9108
M9109
M9110
M9111
M9112
M9113
M9114
M9115
M9116
M9117
M9118
M9119
M9120
M9121
M9122
M9123
M9124
M9125
M9126
M9127
M9128
M9129
M9130
Code Title
Other enthesopathy of foot-Site unspec
Hypertrophy of (infrapatellar) fat pad-Site unspec
Hyperostosis of skull-Mult sites
Hyperostosis of skull-Shldr region
Hyperostosis of skull-Upper arm
Hyperostosis of skull-Forearm
Hyperostosis of skull-Hand
Hyperostosis of skull-Pelvic/Thigh
Hyperostosis of skull-Lower Leg
Hyperostosis of skull-Ankle/Foot
Hyperostosis of skull-Other
Hyperostosis of skull-Site unspec
Paget's disease of skull-Mult sites
Paget's disease of skull-Shldr region
Paget's disease of skull-Upper arm
Paget's disease of skull-Forearm
Paget's disease of skull-Hand
Paget's disease of skull-Pelvic/Thigh
Paget's disease of skull-Lower Leg
Paget's disease of skull-Ankle/Foot
Paget's disease of skull-Other
Paget's disease of skull-Site unspec
Juvenile osteochondrosis of pelvis-Mult sites
Juvenile osteochondrosis of pelvis-Shldr region
Juvenile osteochondrosis of pelvis-Upper arm
Juvenile osteochondrosis of pelvis-Forearm
Juvenile osteochondrosis of pelvis-Hand
Juvenile osteochondrosis of pelvis-Pelvic/Thigh
Juvenile osteochondrosis of pelvis-Lower Leg
Juvenile osteochondrosis of pelvis-Ankle/Foot
Juvenile osteochondrosis of pelvis-Other
Juvenile osteochondrosis of pelvis-Site unspec
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Mult
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Shld
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Uppe
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Fore
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Hand
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Pelv
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Lowe
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Ankl
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Othe
Juv osteochondrosis head of femur [Legg-Calve-Perthes]-Site
Coxa plana-Mult sites
Coxa plana-Shldr region
Coxa plana-Upper arm
Coxa plana-Forearm
Coxa plana-Hand
Coxa plana-Pelvic/Thigh
Coxa plana-Lower Leg
Coxa plana-Ankle/Foot
Coxa plana-Other
Coxa plana-Site unspec
Pseudocoxalgia-Mult sites
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106763789
Code
M9131
M9132
M9133
M9134
M9135
M9136
M9137
M9138
M9139
M9181
M9182
M9183
M9184
M9185
M9186
M9187
M9188
M9189
M9191
M9192
M9193
M9194
M9195
M9196
M9197
M9198
M9199
M9400
M9401
M9402
M9403
M9404
M9405
M9406
M9407
M9408
M9409
M9926
M9927
M9928
M9929
M9936
M9937
M9938
M9939
M9946
M9947
M9948
M9949
M9956
M9957
M9958
M9959
Code Title
Pseudocoxalgia-Shldr region
Pseudocoxalgia-Upper arm
Pseudocoxalgia-Forearm
Pseudocoxalgia-Hand
Pseudocoxalgia-Pelvic/Thigh
Pseudocoxalgia-Lower Leg
Pseudocoxalgia-Ankle/Foot
Pseudocoxalgia-Other
Pseudocoxalgia-Site unspec
Other juvenile osteochondrosis of hip and pelvis-Shldr regi
Other juvenile osteochondrosis of hip and pelvis-Upper arm
Other juvenile osteochondrosis of hip and pelvis-Forearm
Other juvenile osteochondrosis of hip and pelvis-Hand
Other juvenile osteochondrosis of hip and pelvis-Pelvic/Thi
Other juvenile osteochondrosis of hip and pelvis-Lower Leg
Other juvenile osteochondrosis of hip and pelvis-Ankle/Foot
Other juvenile osteochondrosis of hip and pelvis-Other
Other juvenile osteochondrosis of hip and pelvis-Site unspe
Juvenile osteochondrosis of hip and pelvis, unspecified-Shl
Juvenile osteochondrosis of hip and pelvis, unspecified-Upp
Juvenile osteochondrosis of hip and pelvis, unspecified-For
Juvenile osteochondrosis of hip and pelvis, unspecified-Han
Juvenile osteochondrosis of hip and pelvis, unspecified-Pel
Juvenile osteochondrosis of hip and pelvis, unspecified-Low
Juvenile osteochondrosis of hip and pelvis, unspecified-Ank
Juvenile osteochondrosis of hip and pelvis, unspecified-Oth
Juvenile osteochondrosis of hip and pelvis, unspecified-Sit
Chondrocostal junction syndrome [Tietze]-Mult sites
Chondrocostal junction syndrome [Tietze]-Shldr region
Chondrocostal junction syndrome [Tietze]-Upper arm
Chondrocostal junction syndrome [Tietze]-Forearm
Chondrocostal junction syndrome [Tietze]-Hand
Chondrocostal junction syndrome [Tietze]-Pelvic/thigh
Chondrocostal junction syndrome [Tietze]-Lower leg
Chondrocostal junction syndrome [Tietze]-Ankle/foot
Chondrocostal junction syndrome [Tietze]-Other
Chondrocostal junction syndrome [Tietze]-Site unspec
Subluxation stenosis of neural canal-Lower extremity
Subluxation stenosis of neural canal-Upper extremity
Subluxation stenosis of neural canal-Rib cage
Subluxation stenosis of neural canal-Abdomen/other
Osseous stenosis of neural canal-Lower extremity
Osseous stenosis of neural canal-Upper extremity
Osseous stenosis of neural canal-Rib cage
Osseous stenosis of neural canal-Abdomen/other
Connective tissue stenosis of neural canal-Lower extremity
Connective tissue stenosis of neural canal-Upper extremity
Connective tissue stenosis of neural canal-Rib cage
Connective tissue stenosis of neural canal-Abdomen/other
Intervertebral disc stenosis of neural canal-Lower extremit
Intervertebral disc stenosis of neural canal-Upper extremit
Intervertebral disc stenosis of neural canal-Rib cage
Intervertebral disc stenosis of neural canal-Abdomen/other
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106763789
Code
M9966
M9967
M9968
M9969
M9976
M9977
M9978
M9979
N180
N188
O60X
O96X
O97X
Q314
Q356
R500
R501
Code Title
Osseous and subluxation stenosis of intervertebral foramina
Osseous and subluxation stenosis of intervertebral foramina
Osseous and subluxation stenosis of intervertebral foramina
Osseous and subluxation stenosis of intervertebral foramina
Connective tis and disc stenosis of intervertebral foramina
Connective tis and disc stenosis of intervertebral foramina
Connective tis and disc stenosis of intervertebral foramina
Connective tis and disc stenosis of intervertebral foramina
End-stage renal disease
Other chronic renal failure
Preterm delivery
Death obst cse occur more 42 day less than one yr aft deliv
Death from sequelae of direct obstetric causes
Congenital laryngeal stridor
Cleft palate, medial
Fever with chills
Persistent fever
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106763789
The HRG4 Documentation Suite
The HRG4 Documentation Suite is a comprehensive resource of supporting materials,
designed to assist users in understanding the design concepts, logic and practical use of a
particular HRG4 Grouper. Below is a list of the various HRG4 documents which are available
to download from The National Casemix Office website www.ic.nhs.uk/casemix
HRG4 Companion is a starting point and general reference for new and existing
users, providing an introduction to HRGs, groupers, HRG4 design concepts and
grouping logic and useful links to further information.
Casemix Design Framework defines the rules and criteria followed when designing
Casemix classification systems.
HRG4 Grouper Reference Manual provides full instructions on how to prepare and
group data using the HRG4 Grouper software application.
HRG4 Summary of Changes provides an overview of the main changes between
the current HRG4 grouper design and its predecessor.
HRG4 Roots workbook identifies new HRGs, deleted HRGs and changes to existing
HRG Labels between designs using colour-coding.
HRG4 Chapter Summaries provide an overview of the scope, composition and
grouping logic of individual subchapters along with illustrative worked examples.
They also include updates on the changes within subchapters.
HRG4 Code to Group workbook provides details on all mappings between primary
classification codes and HRGs. Also detailed within the workbook are the logic
conditions required to generate the HRGs.
HRG4 Code to Group User Manual serves as an introduction to using the Code to
Group workbook to perform manual grouping. It also details some basic design
concepts and provides worked examples of a variety of different grouping scenarios.
HRG4 Chapter Listings provide details, listed by HRG, of the codes that can map to
those groups, along with details of flags, lists and complications and comorbidities
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