01 - Maltreatment as a cause of injury or death

Maltreatment as a cause of injury or death

Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural or Neurodevelopmental Disorders Maltreatment as a cause of injury or death Categories for maltreatment from Chapter 23 on external causes of morbidity or mortality are used when the purpose is to document the cause of an injury being treated or the cause of death. These categories are used along with a classification of the associated physical injury (e.g. fracture of nasal bones, burns of external body surface). Available maltreatment categories in Chapter 23 include: Physical maltreatment Sexual maltreatment Psychological maltreatment Other specified maltreatment Maltreatment, unspecified Unintentional neglect Assault by neglect Neglect with undetermined intent. The associated injury from Chapter 22 on injury, poisoning or certain other consequences of external causes is postcoordinated with the type of maltreatment presumed to have caused it. Mental, behavioural and neurodevelopmental disorders such as post-traumatic stress disorder and recurrent depressive disorder can clearly be the result of or be exacerbated by maltreatment, but they are not typically considered immediate causes of the types of injuries classified in Chapter 22. However, mental disorders are provided as postcoordination options for PJ22 Psychological maltreatment. For other maltreatment categories in Chapter 23, any applicable mental, behavioural and neurodevelopmental disorder diagnosis should be assigned separately. Additional dimensions of the maltreatment as a cause of injury can also be specified via postcoordination. These include activity when injured (e.g. paid work, educational activity), place of occurrence (e.g. home, school, education area), the perpetrator–victim relationship (e.g. spouse or partner, parent, stranger) and the gender of the perpetrator. As an illustration, below is a fully postcoordinated example of a Chapter 23 maltreatment code: • PJ20 Physical maltreatment • Associated with: NA02.3 Fracture of skull or facial bones • Activity when injured: XE9ME Unpaid cleaning, cooking or maintenance at own place of residence • Place of occurrence: XE266 Home • Perpetrator–victim relationship: XE454 Spouse or partner • Gender of perpetrator, male: XE5YG • Context of assault and maltreatment: XE0UM Altercation The full postcoordinated code is: PJ20&XE9ME&XE266&XE454&XE5YG&XE0UM/NA02.3. (See discussion of ICD-11 diagnostic coding, p. 30, in the introductory section on using the CDDR for ICD-11 mental, behavioural and neurodevelopmental disorders.) PJ20 PJ21 PJ22 PJ2Y PJ2Z PJ5B PF1B PH7B Relationship problems and maltreatment