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ICD codes - ambulatory care sensitive hospitalisations

>Report of the Chief Health Officer >Contents >Disease and Procedure codes >ICD codes - ambulatory care sensitive hospitalisations


Table 4. Codes for disease groups used to calculate ambulatory care sensitive (ACS) hospitalisations
Group ICD-9-CM codes (NSW Health) ICD-10-AM codes (NSW Health) Further selection information
Vaccine-preventable      
Influenza and pneumonia 481, 482.2, 482.3, 482.9, 483, 487.0, 487.1, 487.8 J10, J11, J13, J14, J15.3, J15.4, J15.7, J15.9, J16.8, J18.1, J18.8 In any diagnosis field; exclude people under 2 months; ICD-9-CM: exclude cases with secondary diagnosis of 282.6; ICD-10-AM: exclude cases with secondary diagnosis of D57
Other vaccine preventable 032, 033.0, 033.1, 033.8, 033.9, 037, 045, 055, 056, 070.3, 072, 320.0 A35, A36, A37, A80, B05, B06, B16.1, B16.9, B18.0, B18.1, B26, G00.0, M01.4 In any diagnosis field
Chronic      
Diabetes complications 250.1-250.9 E10.0-E10.8, E11.0-E11.8, E12.0- E12.8, E13.0-E13.8, E14.0-E14.8 Principal diagnosis only
Nutritional deficiencies 260, 261, 262, 268.0, 268.1 E40-E43, E55.0, E64.3 Principal diagnosis only
Iron deficiency anaemia 280.1, 280.8, 280.9 D50.1-D50.9 Principal diagnosis only
Hypertension 401.0, 401.9, 402.00, 402.10, 402.90 I10, I11.9 Principal diagnosis only; ICD-9-CM: exclude cases with procedure code of 35, 36, 37.5, 37.6, 37.7, 37.8; ICD-10-AM: exclude cases with procedures in blocks 600-693, 705-707, 717 and procedure codes 38721-00, 38721-01, 90226-00
Congestive heart failure 402.01, 402.11, 402.91, 428, 518.4 I11.0, I50, J81 Principal diagnosis only; ICD-9-CM: exclude cases with procedure code of 35, 36, 37.5, 37.6, 37.7, 37.8; ICD-10-AM: exclude cases with procedures in blocks 600-693, 705-707, 717 and procedure codes 38721-00, 38721-01, 90226-00
Angina 411.1, 411.8, 413 I20, I24.0, I24.8, I24.9 Principal diagnosis only; ICD-9-CM: exclude cases with procedure codes 01 to 86.99; ICD-10-AM: exclude cases with procedure codes in blocks 1-1779
Chronic obstructive pulmonary disease 491, 492, 494, 496, (466.0) J41-J44, J47, (J20) Principal diagnosis only; ICD-9-CM: 466.0 only with secondary diagnosis of 491, 492, 494, 496; ICD-10-AM: J20 only with secondary diagnosis of J41, J42, J43, J44, J47
Asthma 493 J45, J46 Principal diagnosis only
Acute      
Dehydration and gastroenteritis 276.5, 558.9 E86, K52.2, K52.8, K52.9 Principal diagnosis only
Convulsions and epilepsy 345, 642.6, 780.3 G40, G41, O15, R56 Principal diagnosis only
Ear, nose and throat infections 382, 462, 463, 465, 472.1 H66, H67, J02, J03, J06, J31.2 Principal diagnosis only
Dental conditions 521, 522, 523, 525, 528 A69.0, K02-K06, K08, K09.8, K09.9, K12, K13 Principal diagnosis only
Perforated/bleeding ulcer 531.0-531.2, 531.4-531.6, 532.0-532.2, 532.4-532.6, 533.0-533.2, 533.4-533.6, 534.0-534.2, 534.4-534.6 K25.0- K25.2, K25.4-K25.6, K26.0-K26.2, K26.4-K26.6, K27.0-K27.2, K27.4-K27.6, K28.0-K28.2, K28.4-K28.6 Principal diagnosis only
Ruptured appendix 540 K35.0 In any diagnosis field
Pyelonephritis 590.0, 590.1, 590.8 N10, N11, N12, N13.6 Principal diagnosis only
Pelvic inflammatory disease 614 N70.0, N70.1, N70.9, N73, N74.0-N74.1, N74.2-N74.8 Principal diagnosis only
Cellulitis 681, 682, 683, 686 L03, L04, L08.0, L08.8, L08.9, L88, L98.0, L98.3 Principal diagnosis only; ICD-9-CM: exclude cases with procedure codes 01 to 86.99 except 86.0 where it is the only listed procedure; ICD-10-AM: exclude cases when any procedure performed from blocks 1-1779 except when the following procedures done as the only ones: blocks: 1604-1606, 1608 and procedures: 90660-00, 30207-00, 30676-00, 30679-00, 34530-01 and 47912-00.
Gangrene 785.4 R02 In any diagnosis field
For more information: National Centre for Classification in Health. ICD-10-AM, 3rd edition. Sydney: National Centre for Classification in Health, 2002.
National Coding Centre. The Australian version of the International Classification of Diseases, 9th revision, clinical modification (ICD-9-CM). Sydney: University of Sydney, 1996.
World Health Organization. International Classification of Diseases, 9th revision. Geneva: WHO, 1977.
World Health Organization. International Statistical Classification of Diseases and Related Health Problems, 10th revision. Geneva: WHO, 1992.
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Suggested citation: Population Health Division. The health of the people of New South Wales - Report of the Chief Health Officer. Sydney: NSW Department of Health. Available at: http://www.health.nsw.gov.au/public-health/chorep/toc/app_icd_acs.htm. Accessed (insert date of access).
Produced by: Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.
Last updated on: 27 November 2006
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