ICD-10 codes · South Africa
The South African ICD-10 table. Searchable, by code or condition.
Every code valid on a South African account, from the National Department of Health’s ICD-10 Master Industry Table. Each code shows whether it may be used, whether it may stand first as the main diagnosis, and whether it is a Prescribed Minimum Benefit or Chronic Disease List condition.
Try , , , , or . Everyday terms and American spellings are understood.
- Codes
41 008, of which 35 345 valid for clinical use
- Structure
2 291 categories in 313 blocks, 22 chapters and the morphology codes
- Benefits marked
7 361 PMB codes and 407 CDL codes
- Table
MIT 2021, published 16 March 2021
Browse
Twenty-two chapters, and the morphology codes.
Open a chapter for its blocks and categories, and a category for every code under it with its markers.
Which ICD-10
The national table, not the American one.
South Africa codes to the WHO’s ICD-10, with a small number of national additions, as published in the National Department of Health’s Master Industry Table (MIT). The Ministerial ICD-10 Task Team compiles the table, and funders and practice systems load it. This lookup reproduces the MIT 2021 as published.
Most ICD-10 pages online are the United States’ ICD-10-CM, which has far more codes, different fourth to seventh characters, and no standing with South African schemes. A code such as M54.50 is valid in the US and rejected here; the South African code is M54.5.
Regulation 5 of the General Regulations under the Medical Schemes Act requires the relevant diagnostic code on every account, and schemes reject a claim without one. The code also decides whether the claim is paid as a Prescribed Minimum Benefit. Coding the diagnosis is the first step towards being paid; our guide to the BHF practice number covers the other number every claim needs.
Reading the table
What each column tells you.
The flags are the Department’s own, from the table’s clinical-use, primary, dagger, asterisk and status columns, plus the Council for Medical Schemes’ benefit lists.
| Marker | Meaning |
|---|---|
| Valid | The code is at its most specific level in the Master Industry Table and may be put on an account. "May be primary" means it can stand first, as the main diagnosis; "not as primary" means it must follow another code. |
| Heading only | A three-character category with more specific codes beneath it. Code to one of those; the heading is not accepted on its own. |
| Discontinued | Removed from use by WHO or the Department on the date shown. Kept in the table for old records only. |
| † and * | A dagger code gives the underlying cause and an asterisk code the manifestation in a particular organ. They are coded together, dagger first. |
| PMB | A Prescribed Minimum Benefit condition in the Council for Medical Schemes’ PMB Coded List, with the PMB code and treatment component the list gives. The scheme decides whether a claim qualifies. |
| CDL | A Chronic Disease List condition: one of the 26 chronic conditions every scheme must cover under the PMBs. |
| Age and sex | Where WHO limits a code to an age range or a sex, the table says so under the description. |
Questions
About the codes. Straight answers.
Is this the same ICD-10 as the codes I find on Google?
Usually not. Most ICD-10 results online are the United States’ ICD-10-CM, a different and much longer code set that South African medical schemes do not accept. This lookup uses the South African ICD-10 Master Industry Table (MIT) published by the National Department of Health, which is the only list of codes valid on an account in South Africa.
What does "valid for clinical use" mean?
The MIT flags a code as valid for clinical use when it is at its most specific level: a three-character code like K29 is a heading when four-character codes such as K29.7 exist beneath it, and only the four-character code goes on the account. Codes marked heading only are not accepted on their own.
What is a primary code?
A code the MIT allows in the first (primary) position on an account, that is, as the main reason for the visit. Codes that cannot be primary, such as most external-cause codes in Chapter XX and asterisk manifestation codes, must follow another diagnosis.
What do the PMB and CDL markers mean?
PMB marks a Prescribed Minimum Benefit condition and CDL a Chronic Disease List condition, as listed in the Council for Medical Schemes’ PMB Coded List. Schemes must fund the diagnosis, treatment and care of PMB conditions in full, subject to their rules, so coding a PMB condition correctly matters for your patient’s cover. Whether a specific claim is paid as a PMB is the scheme’s decision.
How current is this table?
The codes are the National Department of Health’s ICD-10 Master Industry Table 2021, published 16 March 2021, which is the latest version the Department has released. It includes the COVID-19 codes U07.1, U07.2, U08, U09 and U10. The page footer names the exact file and its checksum.
Why are codes required on my accounts?
Regulation 5 of the General Regulations under the Medical Schemes Act requires the relevant diagnostic code for every service on an account, and medical schemes reject claims without a valid code. The codes also decide whether a claim is paid from a Prescribed Minimum Benefit.
What are dagger and asterisk codes?
WHO’s dual classification for some conditions: the dagger (†) code gives the underlying cause and the asterisk (*) code the manifestation in a particular organ. They are coded together, with the dagger code first. The MIT marks both in the table.
Why can I not find a code for my condition?
The table uses WHO’s wording, which can differ from everyday terms: osteoarthritis is "arthrosis", eczema is "dermatitis", a stroke is "cerebral infarction" or "stroke, not specified as haemorrhage or infarction". The search knows the most common of these, and British spellings are used throughout (anaemia, oedema). Try the start of a word, fewer words, or browse the chapter.
Source and terms
Reproduced from the national table, unaltered.
The Department publishes the table for the industry to load. The ICD-10 Master Industry Table page
Codes and descriptions: ICD-10 Master Industry Table (MIT) 2021, published 16 March 2021 by the National Department of Health, Republic of South Africa. ® National Department of Health: all rights reserved. Reproduced for reference without alteration.
ICD-10 is the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, © World Health Organization. The WHO ICD-10 descriptions appear as published in the MIT.
Prescribed Minimum Benefit (PMB) and Chronic Disease List (CDL) markers: Council for Medical Schemes, PMB Coded List, as read by GreenNotes. Benefit decisions rest with each medical scheme.
Source file: ICD-10_MIT_2021_Excel_16-March_2021.xlsx. Found an error in a code or description? Write to help@greennotes.co.za.
In GreenNotes
Code the consultation once. The invoice and the claim pick it up.
GreenNotes looks codes up from this same table while you write the consultation. The codes you record there, including any the clinical AI included for your review, carry into the invoice and the medical-aid claim.