ICD
Encyclopedia
The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) is a medical classification
that provides codes to classify disease
s and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Under this system, every health condition can be assigned to a unique category and given a code, up to six characters long. Such categories can include a set of similar diseases.
The International Classification of Diseases is published by the World Health Organization (WHO)
and used worldwide for morbidity and mortality statistics, reimbursement systems, and automated decision support in medicine
. This system is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics. The ICD is a core classification of the WHO Family of International Classifications (WHO-FIC).
The ICD is revised periodically and is currently in its tenth edition. The ICD-10
, as it is therefore known, was developed in 1992 to track mortality statistics. ICD-11 is planned for 2015 and will be revised using Web 2.0
principles. Annual minor updates and triennial major updates are published by the WHO. The ICD is part of a "family" of guides that can be used to complement each other, including also the International Classification of Functioning, Disability and Health
which focuses on the domains of functioning (disability) associated with health conditions, from both medical and social perspectives.
, introduced the Bertillon Classification of Causes of Death at a congress of the International Statistical Institute
in Chicago. A number of countries and cities adopted Dr. Bertillon’s system, which was based on the principle of
distinguishing between general diseases and those localized to a particular organ or anatomical site, as used by the City of Paris for classifying deaths. Subsequent revisions represented a synthesis of English, German and Swiss classifications, expanding from the original 44 titles to 161 titles. In 1898, the American Public Health Association
(APHA) recommended that the registrars of Canada, Mexico, and the United States also adopt it. The APHA also recommended revising the system every ten years to ensure the system remained current with medical practice advances. As a result, the first international conference to revise the International Classification of Causes of Death convened in 1900; with revisions occurring every ten years thereafter. At that time the classification system was contained in one book, which included an Alphabetic Index as well as a Tabular List. The book was small compared with current coding texts.
The revisions that followed contained minor changes, until the sixth revision of the classification system. With the sixth revision, the classification system expanded to two volumes. The sixth revision included morbidity and mortality conditions, and its title was modified to reflect the changes: International Statistical Classification of Diseases, Injuries and Causes of Death (ICD). Prior to the sixth revision, responsibility for ICD revisions fell to the Mixed Commission, a group composed of representatives from the International Statistical Institute
and the Health Organization of the League of Nations
. In 1948, the World Health Organization
(WHO) assumed responsibility for preparing and publishing the revisions to the ICD every ten years. WHO sponsored the seventh and eighth revisions in 1957 and 1968, respectively. It later become clear that the established ten-year interval between revisions was too short.
The ICD is currently the most widely used statistical classification system for diseases in the world. International health statistics using this system are available at the WHO Statistical Information System (WHOSIS).
In addition, some countries—including Australia, Canada and the United States—have developed their own adaptations of ICD, with more procedure codes
for classification of operative or diagnostic procedures.
(NCHS) and used in assigning diagnostic and procedure codes
associated with inpatient, outpatient, and physician office utilization in the United States. The ICD-9-CM is based on the ICD-9 but provides for additional morbidity detail. It is updated annually on October 1.
It consists of two or three volumes:
The NCHS and the Centers for Medicare and Medicaid Services are the U.S. governmental agencies responsible for overseeing all changes and modifications to the ICD-9-CM.
in May 1990. The latest version came into use in WHO Member States starting in 1994. The classification system allows more than 155,000 different codes and permits tracking of many new diagnoses and procedures, a significant expansion on the 17,000 codes available in ICD-9.
Adoption was relatively swift in most of the world. Several materials are made available online by WHO to facilitate its use, including a manual, training guidelines, a browser, and files for download. Some countries have adapted the international standard, such as the "ICD-10-AM" published in Australia in 1998 (also used in New Zealand), and the "ICD-10-CA" introduced in Canada in 2000.
and Medicaid
claims, and most of the rest of the American medical industry followed suit.
On 1 January 1999 the ICD-10 (without clinical extensions) was adopted for reporting mortality, but ICD-9-CM was still used for morbidity. Meanwhile, NCHS received permission from the WHO to create a clinical modification of the ICD-10, and has production of all these systems:
On August 21, 2008, the US Department of Health and Human Services (HHS) proposed new code sets to be used for reporting diagnoses and procedures on health care transactions. Under the proposal, the ICD-9-CM code sets would be replaced with the ICD-10-CM code sets, effective October 1, 2013.
s to health, such as occupational and environmental factors, lifestyle and psycho-social circumstances.
(WHA) for official endorsement by 2015. The first (alpha) draft was made available online in July 2011 for initial consultation and commenting.
The WHO is using Web 2.0
principles for the first time to revise ICD via a multi-author drafting platform known as the Initial ICD-11 Collaborative Authoring Tool (iCAT). New features to ICD-11 include electronic health record
readiness.
s. The U.S. Public Health Service later published the Eighth Revision, International Classification of Diseases, Adapted for Use in the United States, commonly referred to as ICDA-8, for official national morbidity and mortality statistics. This was followed by the ICD, 9th Revision, Clinical Modification, known as ICD-9-CM, published by the U.S. Department of Health and Human Services and used by hospitals and other healthcare facilities to better describe the clinical picture of the patient
. The diagnosis component of ICD-9-CM is completely consistent with ICD-9 codes, and remains the data standard for reporting morbidity. National adaptations of the ICD-10 progressed to incorporate both clinical code (ICD-10-CM) and procedure code (ICD-10-PCS) with the revisions completed in 2003. In 2009, the U.S. Centers for Medicare and Medicaid Services
announced that it would begin using ICD-10 on April 1, 2010, with full compliance by all involved parties by 2013.
The years for which causes of death in the United States have been classified by each revision as follows:
's Diagnostic and Statistical Manual of Mental Disorders
(DSM) and the two manuals seek to use the same codes. There are significant differences, however, such as the ICD including personality disorders on the same axis as other mental disorders, unlike the DSM. The WHO is revising their classifications in these sections as part the development of the ICD-11 (scheduled for 2015), and an "International Advisory Group" has been established to guide this. An international survey of psychiatrists in 66 countries comparing use of the ICD-10 and DSM-IV found that the former was more often used for clinical diagnosis while the latter was more valued for research.
Medical classification
Medical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers...
that provides codes to classify disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
s and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Under this system, every health condition can be assigned to a unique category and given a code, up to six characters long. Such categories can include a set of similar diseases.
The International Classification of Diseases is published by the World Health Organization (WHO)
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
and used worldwide for morbidity and mortality statistics, reimbursement systems, and automated decision support in medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
. This system is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics. The ICD is a core classification of the WHO Family of International Classifications (WHO-FIC).
The ICD is revised periodically and is currently in its tenth edition. The ICD-10
ICD-10
The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...
, as it is therefore known, was developed in 1992 to track mortality statistics. ICD-11 is planned for 2015 and will be revised using Web 2.0
Web 2.0
The term Web 2.0 is associated with web applications that facilitate participatory information sharing, interoperability, user-centered design, and collaboration on the World Wide Web...
principles. Annual minor updates and triennial major updates are published by the WHO. The ICD is part of a "family" of guides that can be used to complement each other, including also the International Classification of Functioning, Disability and Health
International Classification of Functioning, Disability and Health
International Classification of Functioning, Disability and Health, also known as ICF, is a classification of the health components of functioning and disability....
which focuses on the domains of functioning (disability) associated with health conditions, from both medical and social perspectives.
Historical synopsis
In 1893, a French physician, Jacques BertillonJacques Bertillon
Jacques Bertillon was a French statistician and demographer.Born in Paris, Bertillon was the son of statistician Louis Bertillon and the older brother of Alphonse Bertillon. He was educated as a physician but turned to statistical analysis. In 1880 he wrote La Statistique humaine en France...
, introduced the Bertillon Classification of Causes of Death at a congress of the International Statistical Institute
International Statistical Institute
The International Statistical Institute is a professional association of statisticians. The Institut International de Statistique or International Statistical Institute was founded in 1885 although there had been international congresses from 1853.. The Institute publishes a variety of books and...
in Chicago. A number of countries and cities adopted Dr. Bertillon’s system, which was based on the principle of
distinguishing between general diseases and those localized to a particular organ or anatomical site, as used by the City of Paris for classifying deaths. Subsequent revisions represented a synthesis of English, German and Swiss classifications, expanding from the original 44 titles to 161 titles. In 1898, the American Public Health Association
American Public Health Association
The American Public Health Association is Washington, D.C.-based professional organization for public health professionals in the United States. Founded in 1872 by Dr. Stephen Smith, APHA has more than 30,000 members worldwide...
(APHA) recommended that the registrars of Canada, Mexico, and the United States also adopt it. The APHA also recommended revising the system every ten years to ensure the system remained current with medical practice advances. As a result, the first international conference to revise the International Classification of Causes of Death convened in 1900; with revisions occurring every ten years thereafter. At that time the classification system was contained in one book, which included an Alphabetic Index as well as a Tabular List. The book was small compared with current coding texts.
The revisions that followed contained minor changes, until the sixth revision of the classification system. With the sixth revision, the classification system expanded to two volumes. The sixth revision included morbidity and mortality conditions, and its title was modified to reflect the changes: International Statistical Classification of Diseases, Injuries and Causes of Death (ICD). Prior to the sixth revision, responsibility for ICD revisions fell to the Mixed Commission, a group composed of representatives from the International Statistical Institute
International Statistical Institute
The International Statistical Institute is a professional association of statisticians. The Institut International de Statistique or International Statistical Institute was founded in 1885 although there had been international congresses from 1853.. The Institute publishes a variety of books and...
and the Health Organization of the League of Nations
League of Nations
The League of Nations was an intergovernmental organization founded as a result of the Paris Peace Conference that ended the First World War. It was the first permanent international organization whose principal mission was to maintain world peace...
. In 1948, the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) assumed responsibility for preparing and publishing the revisions to the ICD every ten years. WHO sponsored the seventh and eighth revisions in 1957 and 1968, respectively. It later become clear that the established ten-year interval between revisions was too short.
The ICD is currently the most widely used statistical classification system for diseases in the world. International health statistics using this system are available at the WHO Statistical Information System (WHOSIS).
In addition, some countries—including Australia, Canada and the United States—have developed their own adaptations of ICD, with more procedure codes
Procedure codes
Procedure codes are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals.-International:...
for classification of operative or diagnostic procedures.
ICD-9
The ICD-9 was finalized at the Conference for the Ninth Revision of the ICD in 1975 and published by the World Health Organization in 1977. It was eventually replaced by ICD-10, the version currently in use by the WHO and most countries. Given the widespread expansion in the tenth revision, it is not possible to convert ICD-9 data sets directly into ICD-10 data sets, although some tools are available to help guide users.ICD-9-CM
International Classification of Diseases, Clinical Modification (ICD-9-CM) is an adaption created by the U.S. National Center for Health StatisticsNational Center for Health Statistics
National Center for Health Statistics is a division of the United States federal agency the Centers for Disease Control and Prevention . As such, NCHS is under the United States Department of Health and Human Services...
(NCHS) and used in assigning diagnostic and procedure codes
Procedure codes
Procedure codes are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals.-International:...
associated with inpatient, outpatient, and physician office utilization in the United States. The ICD-9-CM is based on the ICD-9 but provides for additional morbidity detail. It is updated annually on October 1.
It consists of two or three volumes:
- Volumes 1 and 2 contain diagnosis codesDiagnosis codesIn healthcare, diagnostic codes are used to group and identify diseases, disorders, symptoms, human response patterns, and medical signs, and are used to measure morbidity and mortality...
. (Volume 1 is a tabular listing, and volume 2 is an index.) Extended for ICD-9-CM - Volume 3ICD-9-CM Volume 3ICD-9-CM Volume 3 is a system of procedural codes. It is a subset of ICD-9-CM - Procedures and interventions, not elsewhere classified :* Procedures and interventions, not elsewhere classified...
contains procedure codesProcedure codesProcedure codes are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals.-International:...
. ICD-9-CM only
The NCHS and the Centers for Medicare and Medicaid Services are the U.S. governmental agencies responsible for overseeing all changes and modifications to the ICD-9-CM.
ICD-10
Work on ICD-10 began in 1983, and the new revision was endorsed by the Forty-third World Health AssemblyWorld Health Assembly
The World Health Assembly is the forum through which the World Health Organization is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states....
in May 1990. The latest version came into use in WHO Member States starting in 1994. The classification system allows more than 155,000 different codes and permits tracking of many new diagnoses and procedures, a significant expansion on the 17,000 codes available in ICD-9.
Adoption was relatively swift in most of the world. Several materials are made available online by WHO to facilitate its use, including a manual, training guidelines, a browser, and files for download. Some countries have adapted the international standard, such as the "ICD-10-AM" published in Australia in 1998 (also used in New Zealand), and the "ICD-10-CA" introduced in Canada in 2000.
ICD-10-CM
Adoption of ICD-10 has been slow in the United States. Since 1979, the USA had required ICD-9-CM codes for MedicareMedicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
and Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
claims, and most of the rest of the American medical industry followed suit.
On 1 January 1999 the ICD-10 (without clinical extensions) was adopted for reporting mortality, but ICD-9-CM was still used for morbidity. Meanwhile, NCHS received permission from the WHO to create a clinical modification of the ICD-10, and has production of all these systems:
- ICD-10-CM, for diagnosis codesDiagnosis codesIn healthcare, diagnostic codes are used to group and identify diseases, disorders, symptoms, human response patterns, and medical signs, and are used to measure morbidity and mortality...
, is intended to replace volumes 1 and 2. Annual updates are provided. - ICD-10-PCS, for procedure codesProcedure codesProcedure codes are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals.-International:...
, is intended to replace volume 3. Annual updates are provided.
On August 21, 2008, the US Department of Health and Human Services (HHS) proposed new code sets to be used for reporting diagnoses and procedures on health care transactions. Under the proposal, the ICD-9-CM code sets would be replaced with the ICD-10-CM code sets, effective October 1, 2013.
ICD-10-CA
ICD-10-CA is an enhanced version of ICD-10 developed by the Canadian Institute for Health Information for morbidity classification in Canada. ICD-10-CA applies beyond acute hospital care, and includes conditions and situations that are not diseases but represent risk factorRisk factor
In epidemiology, a risk factor is a variable associated with an increased risk of disease or infection. Sometimes, determinant is also used, being a variable associated with either increased or decreased risk.-Correlation vs causation:...
s to health, such as occupational and environmental factors, lifestyle and psycho-social circumstances.
ICD-11
The final draft of the ICD-11 system is expected to be submitted to WHO's World Health AssemblyWorld Health Assembly
The World Health Assembly is the forum through which the World Health Organization is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states....
(WHA) for official endorsement by 2015. The first (alpha) draft was made available online in July 2011 for initial consultation and commenting.
The WHO is using Web 2.0
Web 2.0
The term Web 2.0 is associated with web applications that facilitate participatory information sharing, interoperability, user-centered design, and collaboration on the World Wide Web...
principles for the first time to revise ICD via a multi-author drafting platform known as the Initial ICD-11 Collaborative Authoring Tool (iCAT). New features to ICD-11 include electronic health record
Electronic Health Record
An electronic health record is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations...
readiness.
History and usage in the United States
In the United States, the U.S. Public Health Service published The International Classification of Diseases, Adapted for Indexing of Hospital Records and Operation Classification (ICDA), completed in 1962 and expanding the ICD-7 in a number of areas to more completely meet the indexing needs of hospitalHospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
s. The U.S. Public Health Service later published the Eighth Revision, International Classification of Diseases, Adapted for Use in the United States, commonly referred to as ICDA-8, for official national morbidity and mortality statistics. This was followed by the ICD, 9th Revision, Clinical Modification, known as ICD-9-CM, published by the U.S. Department of Health and Human Services and used by hospitals and other healthcare facilities to better describe the clinical picture of the patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
. The diagnosis component of ICD-9-CM is completely consistent with ICD-9 codes, and remains the data standard for reporting morbidity. National adaptations of the ICD-10 progressed to incorporate both clinical code (ICD-10-CM) and procedure code (ICD-10-PCS) with the revisions completed in 2003. In 2009, the U.S. Centers for Medicare and Medicaid Services
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
announced that it would begin using ICD-10 on April 1, 2010, with full compliance by all involved parties by 2013.
The years for which causes of death in the United States have been classified by each revision as follows:
- ICD-1 – 1900
- ICD-2 – 1910
- ICD-3 – 1921
- ICD-4 – 1930
- ICD-5 – 1939
- ICD-6 – 1949
- ICD-7 – 1958
- ICD-8A – 1968
- ICD-9 – 1979
- ICD-10 – 1999
Mental and behavioral disorders
The ICD includes a section classifying mental and behavioral disorders (Chapter V). This has developed alongside the American Psychiatric AssociationAmerican Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...
's Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
(DSM) and the two manuals seek to use the same codes. There are significant differences, however, such as the ICD including personality disorders on the same axis as other mental disorders, unlike the DSM. The WHO is revising their classifications in these sections as part the development of the ICD-11 (scheduled for 2015), and an "International Advisory Group" has been established to guide this. An international survey of psychiatrists in 66 countries comparing use of the ICD-10 and DSM-IV found that the former was more often used for clinical diagnosis while the latter was more valued for research.
See also
- Clinical coderClinical coderA clinical coder – also known as diagnostic coder, medical coder or medical records technician – is a health care professional whose main duties are to analyse clinical statements and assign standard codes using a classification system...
- Medical classificationMedical classificationMedical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers...
s- Classification of mental disordersClassification of mental disordersThe classification of mental disorders, also known as psychiatric nosology or taxonomy, is a key aspect of psychiatry and other mental health professions and an important issue for consumers and providers of mental health services...
- Classification of Pharmaco-Therapeutic ReferralsClassification of Pharmaco-Therapeutic ReferralsThe Classification of Pharmaco-Therapeutic Referrals is a taxonomy focused to define and group together situations requiring a referral from pharmacists to physicians regarding the pharmacotherapy used by the patients. It has been published in 2008...
- Diagnostic and Statistical Manual of Mental DisordersDiagnostic and Statistical Manual of Mental DisordersThe Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
- DSM-IV CodesDSM-IV CodesDiagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association that includes all currently recognized mental health disorders...
/ DSM-IV Codes (alphabetical)DSM-IV Codes (alphabetical)- A :* V62.3 Academic Problem* V62.4 Acculturation Problem* 308.3 Acute Stress Disorder* Adjustment Disorders** 309.9 Unspecified** 309.24 With Anxiety** 309.0 With Depressed Mood** 309.3 With Disturbance of Conduct...
- DSM-IV Codes
- International Classification of Primary CareInternational Classification of Primary CareThe International Classification of Primary Care is a classification method for primary care encounters. It allows for the classification of the patient’s reason for encounter , the problems/diagnosis managed, primary or general health care interventions, and the ordering of the data of the...
(ICPC)
- Classification of mental disorders
- Medical diagnosisMedical diagnosisMedical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
- Diagnosis-related groupDiagnosis-related groupDiagnosis-related group is a system to classify hospital cases into one of originally 467 groups. The 467th was "Ungroupable." The system of classification was developed as a collaborative project by Robert B Fetter, PhD of the Yale School of Management, and John D Thompson, MPH of the Yale...
- Diagnosis-related group
- Medical terminologyMedical terminologyMedical terminology is a vocabulary for accurately describing the human body and associated components, conditions, processes and process in a science-based manner. Some examples are: R.I.C.E., trapezius, and latissimus dorsi. It is to be used in the medical and nursing fields...
- Current Procedural TerminologyCurrent Procedural TerminologyThe Current Procedural Terminology code set is maintained by the American Medical Association through the CPT Editorial Panel. The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among...
- MedDRAMedDRAMedDRA or Medical Dictionary for Regulatory Activities is a clinically validated international medical terminology used by regulatory authorities and the regulated biopharmaceutical industry throughout the entire regulatory process, from pre-marketing to post-marketing activities, and for data...
(Medical Dictionary for Regulatory Activities) - Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT)
- Current Procedural Terminology
External links
- ICD Homepage at World Health OrganizationWorld Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO) - ICD-10 online browser (WHO)
- ICD-10 online training direct access (WHO)
- ICD-10 online training support (WHO)
- ICD-10-CM (USA – modification) at Centers for Disease Control and PreventionCenters for Disease Control and PreventionThe Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
- ICD-11 Revision (WHO)
- ICD-9-CM to ICD-10-CM code conversions
- ICD-9-CM and DRG on-line coding engine
- Free ICD-9-CM Code search
- ICD-9-CM