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Philhealth ICD-10 Code

Philhelath assistance is largely dependent on the type of disease/s that the patient have. Understandably, the more severe have more financial assistance. It is therefore imperitave that the ICD 10 which is a universal code of diseases be accurate. Here are the common diseases in the pediatric age group in the Philippines and their corresponding ICD code. Hopefully, you can suggest some of these codes, in case the hospital fails to include one of them. This is based from the World Health Organization ICD - Version 10.

(photo: a seminar conducted to orient the health workers on Philhealth and the ICD code)

Pulmonary / Respiratory Diseases
Acute Respiratory Tract Infection J22
Acute Tonsillopharyngitis J06.8
Allergic Rhinitis J30.4
Aspiration Pneumonia J69.0
Asthma Severe J46
Asthma in Acute Exacerbation J44.1
Asthma, Unspecified J45.9
Atelectasis J98.1
Atypical Pneumonia J15.7
Bronchitis J20.9
Bronchiolitis J21.9
Bronchopneumonia J18.0
Bronchoscopy Z41.8 (1-620)
BPD P27.1 (Newborn)
Croup J05.0
Empyema Thoracis J86.9
Hyperactive Airway Disease J68.3
Laryngitis J04.0
Laryngomalacia J38.7
Laryngoscopy Z41.8
Pharyngitis J02.9
Post Intubation Subglottic Stenosis J34.2
Pneumonectomy Z41.8
Pneumonia, nonspecific J18.9
Pneumopyothorax, unspec J39.9
Pneumothorax J93.8
Primary Respiratory Tuberculosis (PKI) A16.7
PTB A16.2
Rhinitis J00
Sinusitis J32.9
Thoracotomy Z41.8
Tracheostomy Z93.0  Malfunction J95.0
URTI J06.9
Viral Pneumonia J12.9

Diseases of the Neonates
ABO Incompatibility P55.1
APCD D68.4
Asphyxia Neonatorum P21.9
Bilirubin Encephalopathy P59.8
Cholestasis P59.9
Hemolytic Disease P55.9
Hemorrhagic Disease P53
Hepatitis Viral P535.3
HMD P22.0
Ileus – Meconium E84.1+P75
Ileus – Transitory P76.1
LGA P08.2
Meconium Plug Syndrome P76.0
Omphalitis P38
Pneumonia P23.9
Pneumothorax P25.1
Post Maturity P08.2
Premature P07.3
RDS P22.0
Seizure P90
Sepsis P36.9
SGA P05.1
Transient Tachypnea P22.1
Well Baby Z38.0 Twin Z38.3

Dehydration E86.9 / Mild E86.0 / Mod E86.1 / Severe E 86.3
DKA E14.1
DM, unspecified E14.9
type1 E10.9
type2 E11.9
G6PD with anemia D55.0
G6PD – E740
Hypocalcemia E83.5, Dietary E58
Hypokalemia E87.6
Hyponatremia E87.1
Hypothyroidism,unspecified E03.9
Kwashior E40 / Marasmus E42
Lactose Intolerance E73.9
Malnutrition E46
Marasmus E42
Severe Stunting E45
Severe Wasting E43
Vit A Def E50.9

BMA Z12.8
>Albumin Z51.8
>Cryo Z51.8
>Factor Z51.8(8-814)
>PRBC Z51.8(8-805)
>Plasma Z51.8(8-810)
>PC Z51.8(8-806)
Chemo Z51.1
ALL C91.0(M9821/3)
AML C92.0(M9861/3)
>Aplastic D61.9
>Hemolytic D58.9
>IDA D50.9 (iron deficiency)
>Nutritional D53.9
>Unspecified D64.9
BMA Z12.0
Brainstem Glioma C71.7(M9380/3)
Burkitts Lymphoma C83.7(M9687/3)
CML C92.1(M9863/3)
CNS Leukemia C94.7(M980/3)
Craniopharyngioma D44.4(M9350/1)
Cystic Hygroma D18.1(M917310)
Cystostomy Z43.5
Dermoid Cyst D23.9(M9084/0)
Embryonal Carcinoma,Lung C34.9(M9070/3)
Ependymoma,posterior fossa C71.9(M9391/3)
Fibrosarcoma C49.9 (M8810/3)
Ganglioneuroblastoma C47.9 (M9490/3)
Germ Cell Tumor,Suprasellar C71.9(M9064/3)
Hemangioma D18.0 (M9120/0)
Hemophilia A D66
Hemophilia B D67
Hepatoblastoma C22.2(M8970/3)
Histiocytosis D76.3
Hodgkins Lymphoma C81.9 (M965013)
Hygroma D18.1(M9173/0)
ITP D69.3
Langerhans Cells Histiocytosis D76.0
Leukemia C95.9(M9801/3)
Lymphoma C85.9(M9590/3)
Medulloblastoma,Brain,Unspecified C71.0(M9470/3)
Medulloblastoma,Brainstem C71.7(M9470/3)
Medulloblastoma,Cerebellum C71.6(M9470/3)
Metastasis C79.3 (M800/6)
Mucositis D70.0
Myoma, Intramural D25.1
Myoma Uteri D25.9
Myoma Subserous D25.2
Nasopharyngeal Carcinoma C11.9(M8010/3)
Neuroblastoma,Unspecified C74.9(M9500/3)
Leukemia, Acute C95.0 (M9801/3)
Lymphoma,unspecified C85.9(M9591/3)
Oophorectomy Z41.8
Ovarian Cast Dermoid D27(M9084/0)
Optic Glioma C72.3(M9380/3)
Osteosarcoma C41.9(M9180/3)
Pure Red Cell Aplasia D60.9
Retinoblastoma C69.2(M9510/3)
>Thigh C49.2(M8900/3)
>Cheek C49.0(M8910/3)
>Orbit C69.6(M8900/3)
Spherocytosis D58.0
Teratoma Lung,
Mature D38.1(M9080/1)
Immature D34.9(M9080/3)
>Alpha D56.0
>Beta D56.1
>Unspecified D56.9
Thrombastenia D69.1
Wilms Tumor C64(M8960/3)
Yolk Sac Tumor
>Male C62.9(M9071/3)
>Female C56(M9071/3)

Hypersensitivity/Allergy Nonspecific T78.4
Atopic Dermatitis L20.9
>Unspecified L03.9
>Ear H60.1
>Head L03.8
>Neck L03.8
>Hip/Knee/Leg/Thigh/Hand L03.1
>Periorbital H05.0
Diaper Rash L22
Herpes Simplex B00.9
Herpes Zoster B02.9
Impetigo L01.0
Scrofula A18.2
Fungal Infection B49

>Alveolar K04.7
>Arm L02.4
>Cutaneous/Subcutaneous L02.9
>Dentoalveolar K04.7
>Eyebrow L02.0
>Eyelid H00.0
>Lung J85.2
>Perianal K61.0
>Peridental K05.2
>Peritonsillar J36
>Submandibular K12.2
>Temporal L02.0
>Thigh L02.4
>Toe L02.4
Amebiasis A06.9
Ascariasis B77.9
Conjunctivitis H10.9
Dengue Fever A90
Denge Hemorrhagic Fever
>Stage 1 A91.0
> Stage 2 A91.1
> Stage 3 A91.2
> Stage 4 A91.3
Diarrhea A09
 w/Dehydration E86
Food Poisoning A05.9
Giardiasis A07.1
HepaA B15.9
HepaB B16.9
Mumps B26.9
Oral Thrush B37.0
Parasitism B89 / Intestinal B82.9
Rubella B06.9 Congenital P35.0
Rubeola B05.9
Salmonellosis A02.0
Sepsis A41.9
Sepsis Neonatorum P36.9
Septic Shock A41.9
Shigellosis A03.9
Small Pox B03
SVI B34.9
Typhoid Fever A01.0
Varicella B01.9 / Congenital P35.8
Viral Exanthem B09
Viremia B34.9
Intestinal Amoebiasis A06.0

ASD Q21.1
AVSD Q21.2
Cardiomegaly I51.7 / Congenital Q24.8
Cardiomyopathy I42.9
Coarcatation Q25.1
CHD,unspecified Q24.9
CHF I50.0
Dextrocardia Q24.0
DOLeft Ventricle Q20.2
DORV Q20.1
Endocarditis Infective I33.0
Heart Block I45.9
Hypoplastic Left Heart Syndrome Q23.4
Hypoplastic Right Heart Syndrome Q22.6
Infarct I21.9
Kawasaki M30.3
Ligation of PDA Z41.8(5-387)
Myocarditis I51.4
MR Q23.3
PDA Q25.0
Pericarditis 131.9
Phlebotomy Z41.8(5-380)
Pulmonary Atresia Q25.5 (artery)
Rheumatic Carditis I09.9
Rheumatic Fever I00
Rheumatic Heart I09.9
TOF Q21.3
VSD Q21.0
Mitral Stenosis I05.0

Alveolar Ridge K06.8
Alveoloplasty Z41.8(5-244)
Cataract H26.9
Chalazion H00.1
Conjunctivitis H10.9
Dental Caries K02.9
Esotropia H50.0
Glaucoma, unspecified H40.9
Hordeoloum H00.0
Impacted Cerumen H61.2
Impacted Teeth KO1.1
Incision of Cataract Z41.8(5-145)
Incision of Chalazion Z41.8(5-090)
Mastoiditis H70.9 / Acute H70.0
Otitis Externa H60.9
Otitis Media H66.9
Polishing Z41.8(4-521)
Prophylaxis Z41.8(4-430)
Ptosis H02.4
ROP H35.1
Teething Syndrome K00.7
Tonsillectomy Z41.8(5-282)
Tooth Extraction Z41.8(5-231)
Tracheostomy Z43.0
Strabismus H50.9

Arthritis M13.9
Cri-Du-Chat Syndrome Q93.4
Down Syndrome (Tri 21)Q90.9
Edward’s (Tri 18) Q91.3
Haemarthrosis M25.0
HSP D69.0
Muscular Dystrophy G71.0
Multiple Congenital Anomalies Q89.7
Osteogenesis Imperfecta Q78.0
Peutz-Jehgers Q85.8
Rheumatoid M06.9
Scleroderma M34.9
Spinal Muscle Atrophy G12.9
SLE M32.9
Sturge Q85.8
Tuberous Sclerosis Q85.1

APCD D68.4
Autism F84.0
Bact Meningitis G00.9
Bell’s Palsy G51.0
BFC R56.8
CNSI G96.9
Cerebral Concussion S06.0
Dandy Walker Q03.1
Epilepsy Focal G40.1 General G40.2
GBS G61.0
Hydrancephaly Q04.3
Hydrocephalus G91.9
>Communicating G91.0
>Congenital Q03.9
>Obstructive G91.1
Hypoxic Ischemic Encephalopathy G93.1
Kassabach-Merrit D18.0
Malfunction of Shunt T85.0
Meningocoele Q05.9
Meningoencephalitis G04.9
Myasthenia Gravis G70.0
Myelomeningocoele Q05.4 / HydrocephQ05.4
NEM Q01.1
Psychosomatic F82
Schizencephaly Q04.6
Seizure Disorder R56.0
>Generalized,tonic,clonic,atonic G40.3
>Complex,partial G40.1
>Neonatal Sz P90
Sleep Apnea G47.3
Status Epilepticus G41.9
SSPE A81.1
TBM A17.0+G01
Tuberous Sclerosis Q85.1
Ventriculitis G04.9
Viral Enceph A86

Biliary Atresia Q44.2
Biopsy –hepatic surgical Z41.8(1-551) nonsurgical Z41.8(1-454)
Cholelithiasis K80.2
Choledocholithiasis K80.5
Duodenal Obstruction K31.5
Dyspepsia K30
Esophageal Atresia Q39.0
Ø  w/ fistula Q39.1
Esophageal Reflux K21.9
Ø  w/ esophagitis K21
Esophageal Stenosis K22.2
Ø  congenital Q39.3
Esophagoscopy K41.8
Esophagostomy Z41.8(5-421)
Gastritis, unspecified K29.7
Ø  acute K29.1
Gastroschisis Q79.3
Gastrostomy Z43.1
GI bleed K92.2
Hepatic Absceso K75.0
Hepatic Failure K72.9
>Acute K72.0
>Chronic K72.1
>Post Op K91.8
Hepatic Sclerosis K74.1
Hepatitis unspecified K75.9
Hepa A B15.9
Hepa B B16.9
Viral B19.9
Impaired Glucosa Intolerante E74.3
PUD K27.9

Ascites R18
Bladder Extrophy Q64.1
>surgical K41.8(1-560)
>nonsurgical K41.8(1-460)
Double Ureter Q62.5
DUB N93.8
AGN N00.9
CGN N03.9
Crecentic N05.7
Dialysis Z49.1
Diffuse Proliferative N05.8
FSGS N18.9
FSGN N05.1
Glomerulosclerosis N26
RPGN N01.9
Haemoperitoneum K66.1
Hydrocoele N43.3
Hydronephrosis N13.3
Hydroureter N13.4
IgA Nephropathy N02.8
Methylprednisolone Pulse Z51.2
Nephrectomy Z93.6
Nephritis N04.9
Nephrostomy Z43.6
Nephrotic Syndrome N04.9
Neurogenic Bladder N31.9
Patent Urachus Q64.4
Peritoneal Dialysis Z49.2
Peritonitis K65.9
Phimosis N47
Pyelonephritis N12
Renal Failure N17.9 / RF N19
Renal Parenchymal Disease N28.8
RTA N25.8
SLE M32.1+N08.5
Ureter Pelvic Junction Obstruction N13.5
Ureterostomy Z43.6
Uretrocaliectasis N20.1
UTI,unspecified N39.0
Urolithiasis N20.9
Uterine Prolapse Q51.8
Urethara Prolapse Q64.7
VUR N13.7

Adhesion w/ intestinal obstruction K56.5
Anoplasty Z41.8(5-496)
Appendicitis K37
>Acute K35.9
>Ruptured K35.0
>Adhesion K38.8
Appendectomy Z41.8(5-470)
Barium Enema Z41.8(8-127)
Cheiloplasty Z41.8(5-898)
Cleft Lip Q36.9
>unilateral Q36.0
>bilateral Q36.9
Cleft Palate Q35.9
>unilateral Q35.9
>bilateral Q35.8
> w/ cleft lip Q37.9 / bilateral Q37.8
Cheiloplasty Z41.8(5-898)
Colostomy Prolapse K91.4
Colostomy TLDB Z43.3
Crypthorchidism Q53.9
Ø  unilateral Q53.1
Ø  bilalateral Q53.2
Debridement Z41.8(5-883)
Diaphragmatic Hernia
Ø  unspecified K44.0
Ø  congenital Q79.0
Dressing Z48.0
End to End Anastomosis Z41.8
Endorectal Pullthrough Z41.8(5-483)
Excision of Fistula Z41.8(5-884)
Exploratory Lap Z41.8(5-541)
Fistula in Ano K60.3
Gastrostomy Z43.1
Herniorrhapy Z41.8(5-530)
Hirchsprungs Q43.1
Hypospadia,unspecified Q54.9
>Repair Z41.8(5-643)
Ileal Atresia Q41.2
Ileus K56.7
Ileostomy Z43.2
Inguinal Hernia K40.9
Ø  strangulated K40.3
Ø  bilateral K40.2 w/ gangrene K40.1
Ø  unilateral K40.9 w/ gangrene K40.4
Intussusception K56.1
Ø  congenital Q43.8
Impacted Stool K56.4
Imperforate Anus Q42.3
>Strangulated K40.3
>Bilateral K40.2
>Unilateral K40.9
Jejunal Atresia Q41.0
Ligation Z30.2
Malrotation Q43.3
Meckels Q43.0
Nec Fascitis M72.5
Nephrostomy Z43.6
PSARP Z41.8(5-496)
Orchidopexy Z41.8(5-624)
Orchiectomy Z41.8(5-622)
Orchitis N45.9
Palatoplasty Z41.8(5-275)
Perineal Fistula N36.0
Persistent Cloaca Q43.7
Rectal Polyp K62.1
Sutures Z48.0
TEF Q39.2
Transanorectal Pullthrough Z41.8(5-483)
Umbilical Hernia K42.9
Undescended testes Q53.9
Ø  bilateral Q53.2
Ø  unilateral Q53.1


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