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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:
           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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