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316 Psychic factors associated with diseases classified elsewhere
Mental disturbances or psychic factors of any type thought to have played a
major part in the aetiology of physical conditions, usually involving tissue
damage, classified elsewhere. The mental disturbance is usually mild and
nonspecific and psychic factors [worry, fear, conflict, etc.] may be present
without any overt psychiatric disorder. Use an additional code to identify the
physical condition. In the rare instance that an overt psychiatric disorder
is thought to have caused a physical condition, use a second additional code
to record the psychiatric diagnosis.
Examples of the use of this category are:
psychogenic:
asthma (316 and 493.9)
dermatitis (316 and 692.-)
eczema (316 and 691.-, or 692.-)
gastric ulcer (316 and 531.-)
mucous colitis (316 and 564.1)
ulcerative colitis (316 and 556)
urticaria (316 and 708.-)
psychosocial dwarfism (316 and 259.4)
Excludes: physical symptoms and physiological malfunctions, not involving
tissue damage, of mental origin (306.-)
MENTAL RETARDATION (317-319)
A condition of arrested or incomplete development of mind which is especially
characterized by subnormality of intelligence. The coding should be made on
the individual's current level of functioning without regard to its nature or
causation such as psychosis, cultural deprivation, Down's syndrome etc.
Where there is a specific cognitive handicap, such as in speech, the
four-digit coding should be based on assessments of cognition outside the area
of specific handicap. The assessment of intellectual level should be based on
whatever information is available, including clinical evidence, adaptive
behavior and psychometric findings. The IQ levels given are based on a test
with a mean of 100 and a standard deviation of 15-such as the Wechsler scales.
They are provided only as a guide and should not be applied rigidly. Mental
retardation often involves psychiatric disturbances and may often develop as a
result of some physical disease or injury. In these cases, an additional code
or codes should be used to identify any associated condition, psychiatric or
physical. The Impairment and Handicap codes should also be consulted.
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