The International Classification of Disease (ICD) is a standard diagnostic tool created by the World Health Organization (WHO), for monitoring the incidence and prevalence of diseases and related conditions.
The ICD has diverse clinical applications, and is used not just by doctors but also by paramedic staff, insurance companies, researchers and policy makers. ICD is used to classify diseases and store diagnostic information for clinical, quality and epidemiological purposes and also for reimbursement of insurance claims.
What is ICD-10
The ICD tenth revision (ICD-10) is a code system that contains codes for diseases, signs and symptoms, abnormal findings, circumstances and external causes of diseases or injury.
The need for ICD-10
Created in 1992, ICD-10 code system is the successor of the previous version (ICD-9) and addresses several concerns. ICD-10 codes are updated on a yearly basis, allowing addition, deletion and modification of existing codes. Annual revision of codes and code systems is primarily driven by research, prevalence of new diseases, and insurance reimbursement needs. ICD-9 codes were not reimbursement-centric – a requirement that sprouted later in the course of implementation which paved way for a rational systematic foundation. In short, the ICD-10 code system has been introduced to match the pace of advanced healthcare and information technology industry.
How ICD-10 helps
ICD-10 contains more than 14,000 codes that can be sub-classified into 16,000 codes, catering to many new diagnoses. However, there are two main classifications used worldwide:
- ICD-10-CM (Clinical Modification) – Diagnostic codes
- ICD-10-PCS (Procedure Coding System) – Procedure Codes (for inpatients)
ICD-10-CM and ICD-10-PCS accommodate new procedures as well as new technology. Not only do these codes cater to a number of diagnoses, they also have the potential to provide better and updated data for improving overall patient and health care. The data obtained from the codes provides better understanding of complex disease conditions and allows designing of clinical algorithms to track patient care outcomes.
What an ICD-10 code looks like
ICD-10-CM Diagnoses Codes are 3-7 character codes. Character 1 is alphabetic, character 2 is numeric and characters 3–7 are alphabetic or numeric, with a decimal after 3rd digit.
Why ICD-10 codes are important
The significance of the ICD-10 code system can be assessed from its application in various realms of quality management, healthcare, information technology and public health.
- The ICD-10 code system offers accurate and up-to-date procedure codes to improve health care cost and ensure fair reimbursement policies. The current codes specifically help healthcare providers to identify patients in need of immediate disease management and to tailor effective disease management programs.
- ICD-10-CM has been adopted internationally to facilitate implementation of quality health care as well as its comparison on a global scale.
- Compared to the previous version (i.e. ICD-9-CM) ICD-10-CM is more specific and captures public health diseases, particularly diseases related to external injury, e.g. terrorism.
- ICD-10 codes hold particular significance in research since code-analysis is an essential component of research and development. Code system and logic allows for fewer coding errors that ultimately benefits in the research and development analyses.
- The upgrade version of the ICD code system enhances health policy decision making by providing better data for organizational monitoring and performance.
- The ICD-10 code system is more easily configurable and retrievable into electronic format offering better format than ICD-9, other codes such as SNOMED CT and CPT codes.
- ICD-10 codes have specifically been developed for reimbursement purposes to offer a rational foundation for payment procedures.
- Alphanumeric formats of the ICD-10 code system provide a better alternative than ICD-9-CM codes offering a more flexible and upgradable version e.g. diabetes mellitus – E10-E14
- Lastly, the ICD-10 coding system helps to:
- Reduce medication error
- Improve treatment options and disease outcomes
- Lower treatment and claim cost
- In the health policy and operational and strategic planning
- Improve payment systems through claims processing
- Decrease claim submissions
ICD-10 codes are thus shaping the future of clinical practice. The sooner doctors get started with including them in managing their practice, the better it is for them and their patients. For more on ICD-10, please get in touch with us and we will be happy to share information.