PRINCIPLE VI. SYMPTOMS, INCONCLUSIVE DIAGNOSES, COPD
1. Signs and symptoms that point rather definitely to a particular diagnosis are
assigned to the appropriate chapter of ICD -9-CM rather than chapter 16; for example,
hematuria is assigned to the chapter for Genitourinary System (Code 5997). Chapter
16 includes ill -defined conditions and symptoms that could be the result of two or more
conditions, or may involve two or more systems of the body, and are used in cases
where the necessary studies to determine a definitive diagnosis were not completed
prior to disposition; for example, transfer and death cases without an autopsy.
2. Chapter 16 includes Category Codes 780 -799. The paragraph on page 707 of
Volume 1, ICD-9-CM should be reviewed carefu lly prior to assigning codes from this
3. Diagnostic statements that may require use of codes from chapter 16 are:
a. When a specific diagnosis cannot be made at time of disposition.
b. Transient signs and symptoms whose etiology could not be determined.
c. Provisional diagnosis made for dispositioned patients (e.g., patients that are
d. A more precise diagnosis cannot be made for other reasons.
e. Certain signs and symptoms are important in rendering appropriate med ical
care; therefore, the appropriate code from chapter 16 will be used as an additional code
when the etiology is known.
4. The signs and symptoms found in Chapter 16 (Categories 780-799) of ICD-9-CM
may be used as the principal diagnosis only when:
a. No definite cause is identified.
b. The signs and symptoms are followed by comparative contrasting diagnoses.
c. The signs and symptoms are a residual of late effect.
d. The signs and symptoms are the result of an adverse reaction to medication.
5. Comparative/Contrasting Diagnoses:
a. If the differential diseases/conditions have a symptom(s) stated, the symptom
may be used as the principal diagnosis.
b. If the differential diseases/conditions have no symptom stated, assign codes for
the stated conditions and assign the first listed as the principal diagnosis.