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International Classification of Diseases (ICD)

The International Classification of Diseases (ICD) is the official coding system used by all the world's nations for recording the causes of morbidity and mortality. The ICD is periodically revised, published, and disseminated by the World Health Organization (WHO). Specifically, the WHO, working with 10 Collaboration Centers, produces the ICD. The purpose of the ICD is to permit valid and reliable comparisons of morbidity and mortality data across time and nations. The ICD plays an important role in reducing the complexities of thousands of diagnoses of diseases and medical procedures to a smaller, more manageable set of standardized diagnostic and procedural codes. It is widely used by public health departments, healthcare organizations, and health services researchers to analyze the general health of population groups; monitor the incidence and prevalence of diseases; and compare other health problems in relation to the access, cost, and quality of healthcare.

History

The origins of the ICD can be traced back to the 1850s, when William Farr (1807–1883), the founder of medical statistics, and others developed standardized classifications of diseases for comparative and statistical purposes. Farr, for example, classified diseases into five broad groups: (1) epidemic diseases, (2) constitutional (general) diseases, (3) local diseases arranged according to anatomical site, (4) developmental diseases, and (5) diseases that are the direct result of violence. Although Farr's structure has been modified over the years, it still forms the basis of the ICD.

Over the past 100 years, the ICD has been revised 10 times approximately each decade to incorporate changes in medicine. The 1st edition of the ICD, known as the International List of Causes of Death, was adopted by the International Statistical Institute in 1893. Until the 5th revision of the ICD, the Government of France convened the international conferences that developed the various revisions. After World War II, however, the newly created World Health Organization took over the responsibility for the ICD. In 1948, the WHO issued the 6th revision (ICD-6), and it has developed and published all succeeding revisions. In 1955, it published the 7th revision (ICD-7). This revision was changed in the United States in 1959 to include various clinical modifications. In 1965, the WHO published the 8th revision (ICD-8), which also was modified in the United States in 1968. The WHO published the 9th revision (ICD-9) in 1977, and it also was modified, this time by the National Center for Health Statistics (NCHS), to include more morbidity data and medical procedure codes. This extension resulted in the ICD-9-CM, with the CM standing for clinical modification. The United States currently requires all the nation's hospitals to use ICD-9-CM diagnosis codes for Medicare and Medicaid claims. In 1994, the WHO released the 10th revision of the ICD (ICD-10). This revision has been adopted for reporting mortality by the NCHS and the state and local public health departments; however ICD-9-CM is still used by hospitals and other healthcare organizations for recording morbidity and for billing purposes.

Key Differences between ICD-9-CM and ICD-10

The ICD-9-CM contains 17 chapters and two supplementary classifications. The E-Codes classify the external causes of injury and poisoning, and the V-Codes organize factors influencing health status and contact with health services. These two chapters now form part of the main classification in the 10th revision (ICD-10). Although the overall content is similar and the format and conventions of the classification remain unchanged, the ICD-10 is different from its predecessor in many ways.

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