level by the Tumor Registry in military services facilities. The comprehensive list by
anatomic sites is found in a Neoplasm Table under the main term "Neoplasm,
neoplastic." The table contains six columns : primary, secondary, and in situ if
diagnosed as malignant and benign, uncertain behavior, or unspecified.
2-16. ARRANGEMENT OF THE TABULAR LIST
a. As explained earlier, the Tabular List, Volume 1, is arranged in 17 main
sections (see figure 2 -1) which are in numerical order by three-digit numbers. The first
two digits indicate important or summary groups (e.g., 01 Tuberculosis, 40 Hypertensive
Heart Disease). The third-digit divides each group into categories representing specific
disease entities or the classification of the disease or condition, such as anatomical site
b. There are also fourth-digit numbers which appear after a decimal. (Military
services facilities disregard the decimal.) The fourth-digit provides more information
about the disease or condition (e.g., 157.1 Body of pancreas, 157.2 Tail of pancreas).
EXAMPLE: 157 Malignant neoplasm of pancreas
157.0 Head of pancreas
157.1 Body of pancreas
157.2 Tail of pancreas
157.3 Pancreatic duct
c. In some places, "optional" fifth-digit classifications are provided for even more
specificity (e.g., 715.01 Osteoarthrosis, generalized of the shoulder region, 714.02
Osteoarthrosis, generalized of the upper arm). Such classifications are usually at the
beginning of a chapter or at the beginning of a three-digit category. Although ICD-9-CM
states that these are optional, the Army requires that these classifications be used.
2-17. STEPS IN USING VOLUME 1
a. Verify that the code number selected from the Alphabetical Index (Volume 2)
is appropriate with the correct diagnostic classification.
b. Read all inclusions, exclusions, and notes under the selected code.
Remember that these may be at the beginning of a chapter or a three-digit category.
c. Disregard decimal points appearing in ICD-9-CM when coding a disease or
cause of injury diagnosis.