Not otherwise specified
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Not Otherwise Specified
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In medicine, not otherwise specified (NOS) is a subcategory in systems of
symptoms presented were sufficient to make a general diagnosis, but where a specific diagnosis was not made. The DSM-IV, for example, "applies the term not otherwise specified (NOS) to a disorder or disturbance that does not meet the criteria for the specific disorders already discussed".[1] The term was introduced because "it is sometimes impossible for the practitioner completing the diagnostic assessment to categorize all the symptoms that a client is experiencing into one diagnostic category".[2] In the context of mental health
diagnoses, four situations have been outlined for which such a diagnosis may be considered appropriate:
- Client meets the general guidelines for a disorder, yet not all of the criteria are met, or the ones present are not considered
clinically significant.- Significant
presentationfor a disorder.- Uncertainty about
medical condition.- Insufficient information exists to fully support assigning behaviors to a particular mental disorder in the category, but the general criteria for the category of disorders are evident.[2]
It is noted, however, that the use of an NOS classification invites scrutiny when billing or seeking reimbursement for practitioners.[2]
Examples
This classification is commonly used in
psychiatric
diagnoses, such as in:
- depressive disorder
- ED-NOS, eating disorder
- MD-NOS, mood disorder
- PD-NOS, personality disorder
- PDD-NOS, pervasive developmental disorder
- Psychotic disorder not otherwise specified
It is also used in the conditions:
- PTCL-NOS, peripheral T-cell lymphomanot otherwise specified
- Adenocarcinoma not otherwise specified
The ICD-10 also uses this phrase for various things, such as:
- Fall from, out of or through building, not otherwise specified (W13.9)
The phrase is also used within the
List of UN numbers
, where it refers to a generic entry, e.g. "UN 1993: Flammable liquid, N.O.S.".