ICD-10-CM Instructional Notes · Tabular List · FY 2027 180 Notes

ICD-10-CM General Notes ICD-10-CM

General notes in the Tabular List explain how a chapter, block or code is to be used. The FY 2027 Tabular List has 180 General Notes; 56 of them name other codes, with 76 references to 72 distinct codes, categories and ranges. All of them are listed below, by the code that carries the note or by the code it names.

✓ From the official FY 2027 ICD-10-CM Tabular ListDefinitions follow the Official Guidelines, Section I.A
180
General Notes
56
Notes Naming Codes
76
Code References
72
Codes Referenced
What the Official Guidelines say about General Notes

General notes appear in the Tabular List at the chapter, block and code level. They explain the scope of a group of codes, define terms used in it, or give usage instructions that are not one of the named conventions.

Read the ICD-10-CM Official Guidelines →

ICD-10-CM

General Notes by the code that carries the note

33 of 33 shown
  • Block note Block B90-B94 Sequelae of infectious and parasitic diseases applies to 12 codes
    • Categories B90-B94 are to be used to indicate conditions in categories A00-B89 as the cause of sequelae, which are themselves classified elsewhere. The 'sequelae' include conditions specified as such; they also include residuals of diseases classifiable to the above categories if there is evidence that the disease itself is no longer present. Codes from these categories are not to be used for chronic infections. Code chronic current infections to active infectious disease as appropriate.
  • Chapter note Chapter 2 (C00-D49) Neoplasms applies to 1,730 codes
    • Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified (C25.9).
  • C91.0 Acute lymphoblastic leukemia [ALL] applies to 3 codes
    • Codes in subcategory C91.0- should only be used for T-cell and B-cell precursor leukemia
  • Block note Block D37-D48 Neoplasms of uncertain behavior, polycythemia vera and myelodysplastic syndromes applies to 137 codes
    • Categories D37-D44, and D48 classify by site neoplasms of uncertain behavior, i.e., histologic confirmation whether the neoplasm is malignant or benign cannot be made.
  • D49 Neoplasms of unspecified behavior applies to 14 codes
    • Category D49 classifies by site neoplasms of unspecified morphology and behavior. The term 'mass', unless otherwise stated, is not to be regarded as a neoplastic growth.
  • Chapter note Chapter 4 (E00-E89) Endocrine, nutritional and metabolic diseases applies to 973 codes
    • All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
  • E64 Sequelae of malnutrition and other nutritional deficiencies applies to 6 codes
    • This category is to be used to indicate conditions in categories E43, E44, E46, E50-E63 as the cause of sequelae, which are themselves classified elsewhere. The 'sequelae' include conditions specified as such; they also include the late effects of diseases classifiable to the above categories if the disease itself is no longer present
  • Block note Block F90-F98 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence applies to 33 codes
    • Codes within categories F90-F98 may be used regardless of the age of a patient. These disorders generally have onset within the childhood or adolescent years, but may continue throughout life or not be diagnosed until adulthood
  • G09 Sequelae of inflammatory diseases of central nervous system
    • Category G09 is to be used to indicate conditions whose primary classification is to G00-G08 as the cause of sequelae, themselves classifiable elsewhere. The 'sequelae' include conditions specified as residuals.
  • H54.8 Legal blindness, as defined in USA
    • The term 'low vision' in category H54 comprises categories 1 and 2 of the table, the term 'blindness' categories 3, 4 and 5, and the term 'unqualified visual loss' category 9.
  • I69 Sequelae of cerebrovascular disease applies to 240 codes
    • Category I69 is to be used to indicate conditions in I60-I67 as the cause of sequelae. The 'sequelae' include conditions specified as such or as residuals which may occur at any time after the onset of the causal condition
  • Chapter note Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
    • When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
  • O94 Sequelae of complication of pregnancy, childbirth, and the puerperium
    • This category is to be used to indicate conditions in O00-O77.-, O85-O94 and O98-O9A.- as the cause of late effects. The sequelae include conditions specified as such, or as late effects, which may occur at any time after the puerperium
  • Chapter note Chapter 18 (R00-R99) Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified applies to 774 codes
    • The conditions and signs or symptoms included in categories R00-R94 consist of:
  • R40.2 Coma applies to 97 codes
    • One code from each subcategory, R40.21-R40.23, is required to complete the coma scale
  • R40.24 Glasgow coma scale, total score applies to 20 codes
    • Assign a code from subcategory R40.24, when only the total coma score is documented
  • S06 Intracranial injury applies to 569 codes
    • 7th characters D and S do not apply to codes in category S06 with 6th character 7 - death due to brain injury prior to regaining consciousness, or 8 - death due to other cause prior to regaining consciousness.
  • S24 Injury of nerves and spinal cord at thorax level applies to 93 codes
    • Injuries to the spinal cord (S24.0 and S24.1) refer to the cord level and not bone level injury, and can affect nerve roots at and below the level given.
  • S34 Injury of lumbar and sacral spinal cord and nerves at abdomen, lower back and pelvis level applies to 93 codes
    • Injuries to the spinal cord (S34.0 and S34.1) refer to the cord level and not bone level injury, and can affect nerve roots at and below the level given.
  • T31 Burns classified according to extent of body surface involved applies to 55 codes
    • This category is to be used as the primary code only when the site of the burn is unspecified. It should be used as a supplementary code with categories T20-T25 when the site is specified.
  • T32 Corrosions classified according to extent of body surface involved applies to 55 codes
    • This category is to be used as the primary code only when the site of the corrosion is unspecified. It may be used as a supplementary code with categories T20-T25 when the site is specified.
  • Block note Block T36-T50 Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances applies to 3,186 codes
    • The drug giving rise to the adverse effect should be identified by use of codes from categories T36-T50 with fifth or sixth character 5.
  • Chapter note Chapter 20 (V00-Y99) External causes of morbidity and mortality applies to 7,461 codes
    • This chapter permits the classification of environmental events and circumstances as the cause of injury, and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used secondary to a code from another chapter of the Classification indicating the nature of the condition. Most often, the condition will be classifiable to Chapter 19, Injury, poisoning and certain other consequences of external causes (S00-T88). Other conditions that may be stated to be due to external causes are classified in Chapters I to XVIII. For these conditions, codes from Chapter 20 should be used to provide additional information as to the cause of the condition.
  • Block note Block V00-V99 Transport accidents applies to 4,086 codes
    • This section is structured in 12 groups. Those relating to land transport accidents (V00-V89) reflect the victim's mode of transport and are subdivided to identify the victim's 'counterpart' or the type of event. The vehicle of which the injured person is an occupant is identified in the first two characters since it is seen as the most important factor to identify for prevention purposes. A transport accident is one in which the vehicle involved must be moving or running or in use for transport purposes at the time of the accident.
    • (a) A transport accident (V00-V99) is any accident involving a device designed primarily for, or used at the time primarily for, conveying persons or good from one place to another.
  • Y07 Perpetrator of assault, maltreatment and neglect applies to 45 codes
    • Codes from this category are for use only in cases of confirmed abuse (T74.-)
  • Y93 Activity codes applies to 109 codes
    • Category Y93 is provided for use to indicate the activity of the person seeking healthcare for an injury or health condition, such as a heart attack while shoveling snow, which resulted from, or was contributed to, by the activity. These codes are appropriate for use for both acute injuries, such as those from chapter 19, and conditions that are due to the long-term, cumulative effects of an activity, such as those from chapter 13. They are also appropriate for use with external cause codes for cause and intent if identifying the activity provides additional information on the event. These codes should be used in conjunction with codes for external cause status (Y99) and place of occurrence (Y92).
    • Y93.0 Activities involving walking and running
    • Y93.1 Activities involving water and water craft
    • Y93.2 Activities involving ice and snow
    • Y93.3 Activities involving climbing, rappelling, and jumping off
    • Y93.4 Activities involving dancing and other rhythmic movement
    • Y93.5 Activities involving other sports and athletics played individually
    • Y93.6 Activities involving other sports and athletics played as a team or group
    • Y93.7 Activities involving other specified sports and athletics
    • Y93.A Activities involving other cardiorespiratory exercise
    • Y93.B Activities involving other muscle strengthening exercises
    • Y93.C Activities involving computer technology and electronic devices
    • Y93.D Activities involving arts and handcrafts
    • Y93.E Activities involving personal hygiene and interior property and clothing maintenance
    • Y93.F Activities involving caregiving
    • Y93.G Activities involving food preparation, cooking and grilling
    • Y93.H Activities involving exterior property and land maintenance, building and construction
    • Y93.I Activities involving roller coasters and other types of external motion
    • Y93.J Activities involving playing musical instrument
    • Y93.K Activities involving animal care
    • Y93.L Other outdoor activity
    • Y93.8 Activities, other specified
    • Y93.9 Activity, unspecified
  • Y99 External cause status applies to 5 codes
    • A single code from category Y99 should be used in conjunction with the external cause code(s) assigned to a record to indicate the status of the person at the time the event occurred.
  • Chapter note Chapter 21 (Z00-Z99) Factors influencing health status and contact with health services applies to 1,425 codes
    • Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
  • Block note Block Z00-Z13 Persons encountering health services for examinations applies to 156 codes
    • Nonspecific abnormal findings disclosed at the time of these examinations are classified to categories R70-R94.
  • Z01 Encounter for other special examination without complaint, suspected or reported diagnosis applies to 23 codes
    • Codes from category Z01 represent the reason for the encounter. A separate procedure code is required to identify any examinations or procedures performed
  • Z17 Estrogen, and other hormones and factors receptor status applies to 10 codes
  • Z17.4 Combined receptor status applies to 4 codes
    • Assign a code from subcategory Z17.4- when only a combined receptor status is documented
  • Z3A Weeks of gestation applies to 38 codes
    • Codes from category Z3A are for use, only on the maternal record, to indicate the weeks of gestation of the pregnancy, if known.

Notes on a category or block apply to every code beneath it; “applies to N codes” counts the billable codes covered. Switch to “By referenced code” to see, for any code, every General Note that names it.

Questions About General Notes

What are general notes in the ICD-10-CM Tabular List?

General notes are free-text instructions printed under a chapter, block or code. They explain how the codes there are to be used, for example which circumstances a block is limited to, or where related conditions are classified. The FY 2027 Tabular List has 180 of them; 56 name other codes, with 76 references to 72 distinct codes, categories and ranges.

Do general notes apply to the codes below them?

Yes. A note under a chapter or block heading applies to every code in it; ICD List code pages show such notes on each code, marked as inherited from the chapter or block.

Official Sources & Methodology

Every note on these pages is loaded verbatim from the FY 2027 ICD-10-CM Tabular List. Code references inside the notes are matched against the FY 2027 code set, so every link opens a valid code; scope counts (“applies to N codes”) count the billable codes under the note’s chapter, block or category.

ICD List is not affiliated with CMS or NCHS. These pages are a coding reference; the Tabular List and the Official Guidelines remain the authority.

Related References

ICD-10-CM Official GuidelinesICD-10-CM Code LookupICD-10-CM Codes ListCode Lists by Tag

Source: FY 2027 ICD-10-CM Tabular List (CMS and NCHS) and the ICD-10-CM Official Guidelines for Coding and Reporting FY 2027, Section I.A. ICD List is not affiliated with CMS or NCHS.