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The International Classification of Diseases (ICD) is the standard diagnostic international classification system for mortality and morbidity data. The ICD is a structured classification system of disease and associated codes that has been designed to promote international compatibility in health data collecting and reporting. During the 1800s, several statisticians started to develop medical-based data reporting systems. The importance of creating a uniform system was realized and several medical statisticians commissioned the completion of this task. The International Statistical Institute adopted the first edition of the ICD in 1893. The first ICD edition was based on the Bertillon Classification of Causes of Death, developed by Jacques Bertillon (the chief of Statistical Services for the City of Paris). In 1898, the American Public Health Association recommended that several countries use this system and revisions be completed once every 10 years. The ICD is an extremely valuable system, allowing for international and national uniform data analysis for tasks such as disease surveillance and mortality analyses.

The Design

The ICD contains a description of all known diseases and injuries. Each disease is detailed with diagnostic characteristics and given a unique identifier that is used to code mortality data on death certificates and morbidity data from patient and clinical records. The core of the ICD uses one single list of three alphanumeric character codes starting from A00 to Z99. The first letter of the code designates a different chapter; there are 21 in total. Within each chapter, the three character codes are divided so that they specify different classification axes. The ICD has undergone many revisions as the needs of countries change.

Current Use

Every country subscribing to the ICD system uses it in varying degrees. Most countries subscribe to the entirety of the ICD system, while some countries use the ICD in hospitals only, some for morbidity only, and other countries have chosen to implement partial code use. The U.S. Department of Health and Human Services felt that the ICD needed to provide better clinical information and developed a system that is referred to as ICD 9th revision: Clinical Modification (ICD-9-CM). These CM codes are much more precise and allows for stronger analyses. The ICD-9-CM is used by hospitals and other healthcare facilities. The ICD-10, developed in 1992, is the most current version and was adopted for use in 1999. The ICD-10 is currently used to report mortality data, while the ICD-9-CM is still used for reporting morbidity.

The World Health Organization and International Statistics

The World Health Organization (WHO) assumed the responsibility of publishing the ICD in 1948 and currently collects all ICD international data for all general epidemiological surveillance and health management purposes. WHO reports international health statistics for those countries that use the ICD system. The ICD is a core classification of the WHO Family of International Classifications (WHO-FIC).

  • International Classification of Diseases
Sudha R.Raminani, M.S., The Fenway Institute

Bibliography

National Center for Health Statistics, “Classifications of Disease and Functioning & Disability,”http://www.cdc.gov/nchs/default.htm (cited July 2007)
World Health

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