ICD (International Classification of Diseases) codes are
medical diagnosis and procedure codes used for billing and health insurance
reimbursement, automated decision support and government statistical reports on
morbidity and mortality. In fact, they are used around the world – not a US creation,
the ICD coding system is published by WHO (the World Health Organization, a UN
agency) And they’ve been around a long time: Version 1 was created in 1900,
with precursors to the ICD codes existing as early as 1853.
ICD-10 is the latest revision. To the US healthcare IT industry, ICD-10
seems like the next big thing, but in fact it’s been in existence since 1990.
To date, 153 nations use the ICD-10 codes, though not all of them use the
coding system in its entirety. In the US,
ICD-10 codes are “not currently valid for any purpose or use,” according to the
National Center for Health Statistics, a division
of the CDC. The government does use the codes for mortality reporting,
according to the American Health Information Management Association, but that
is about all.
The US
still uses the old ICD-9 coding system. The limitations of this outdated system
are increasing as new diagnostic and treatment procedures become available,
because ICD-9 does not have the ability to add new codes for them. The same is
true for new diagnoses. The system also cannot provide granularity of sub-classifications
of diagnoses or related problems from socioeconomic or lifestyle issues.
Moreover, because one of the main uses of the ICD codes is in the medical
billing – health insurance payment transaction, and that transaction is now
almost universally done electronically, there is a need for the transaction to
be able to use the new HIPAA electronic transaction forms. ICD-9 codes are not
set up to do this.
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