INTERNATIONAL CLASSIFICATION OF DISEASE

Understanding ICD Codes in Healthcare

Understanding diseases in ways that enable prevention, treatment, and the allocation of resources requires measurement. To be useful, measurement must be reliable, allow valid comparisons between places and over time, and enable coherent summarization of large volumes of data. Classification of diseases and related things is essential for such measurement.

For more than a century, the International Classification of Diseases (ICD) has been the primary basis for comparable statistics on causes of death and non-fatal disease. The 10th revision (ICD-10) was released nearly 30?years ago. It serves a variety of functions in much of the world—at least 120 countries—and has been translated into 43 languages.?

As a healthcare professional, you probably know the importance of accurate medical billing and records coding. One crucial component of this is the International Classification of Diseases (ICD) codes. These codes classify diseases, injuries, and other health conditions and are used worldwide to standardize diagnoses and help track public health trends. ICD serves a broad range of uses globally and provides critical knowledge on the extent, causes, and consequences of human disease and death worldwide via data that is reported and coded with the ICD. Clinical terms coded with ICD are the primary basis for health recording and statistics on disease in primary, secondary, and tertiary care, as well as on cause of death certificates. These data and statistics support payment systems, service planning, administration of quality and safety, and health services research. Diagnostic guidance linked to categories of ICD also standardizes data collection and enables large-scale analysis.

Clinical terms coded with ICD are the primary basis for health recording and statistics on disease in primary, secondary, and tertiary care, as well as on cause of death certificates.

The International Classification of Diseases (ICD) has long been the main basis for the comparability of statistics on causes of mortality and morbidity between places and over time. This paper provides an overview of the recently completed 11th revision of the ICD, focusing on the main innovations and their implications.

The 11th revision, adopted by the 72nd World Health Assembly in May 2019 after extensive consultation and deliberation, addresses these shortcomings of ICD-10 and more. In aggregate, the changes are substantial: ICD-11 is not just ICD-10 with some new categories. Rather, ICD-11 is a different and more powerful health information system, based on formal ontology, designed to be implemented in modern information technology infrastructures, and flexible enough for future modification and use with other classifications and terminologies. It is better able to capture clinically relevant characteristics of cases and to permit summarization of information for various purposes, has flexibility allowing use in more and less elaborate modes, and has integrated support for multiple languages. It is also designed to ensure that data coded according to ICD-11 will be comparable with data coded to ICD-10.

Things to know

ICD codes are updated regularly. The World Health Organization (WHO) releases a new version of the ICD codes every few years to reflect changes in medical knowledge and treatment methods. In 2022, the most recent version of ICD codes (ICD-11) was released.

ICD codes are used for different purposes. They are used for medical billing purposes, as well as for research and public health surveillance.

There are two main versions of ICD codes: ICD-9 (legacy version) and ICD-10 (currently in use in most countries).

Accurate and up-to-date use of ICD codes is critical for effective patient care, accurate billing and reimbursement, and tracking and monitoring disease patterns and public health trends.

This essential infrastructure for health information has now been revised for the 11th time. The 11th revision was more extensive and has greater implications for what can be done with the ICD, and how, than any revision since the 6th, in 1948.

Properties of ICD coding

• ICD codes provide a standardized, internationally recognized system for classifying diseases and conditions. This allows for consistent documentation and data collection across different healthcare providers and settings.
• ICD codes are periodically updated to reflect advances in medical knowledge and changes in healthcare.
• ICD codes cover a wide range of conditions, from common illnesses to rare diseases, and include codes for both medical and psychiatric conditions.
• ICD codes are available in multiple languages, making it easier for healthcare providers in different countries to use and understand them.
• ICD codes provide a reliable way to track disease patterns and public health trends and monitor the effectiveness of healthcare interventions.
• ICD codes are used in medical billing and reimbursement processes.

Changes in content reflect knowledge and perspectives on diseases and their causes that have emerged since ICD-10 was developed about 30?years ago. Changes in design and structure reflect the arrival of the networked digital era, for which ICD-11 has been prepared. ICD-11’s information framework comprises a semantic knowledge base (the Foundation), a biomedical ontology linked to the Foundation, and classifications derived from the Foundation. ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS) is the primary derived variety and the main successor to ICD-10. Innovations enabled by the new architecture include an online coding tool (replacing the index and providing additional functions), an application program interface to enable remote access to ICD-11 content and services, enhanced capability to capture and combine clinically relevant characteristics of cases, and integrated support for multiple languages.

ICD-11 Coding key features

• The eleventh revision contains around 17,000 unique codes,?and more than 1,20,000 codable terms and is now entirely digital.
• Smart coding algorithm: Now interprets more than 1.6 million terms.
• State-of-the-art Coding tool: Easily codes all detail.
• Digital reference guide.
• Multilingual integrated API.
• Multilingual Browser and Coding tool.
• Offline functionality.
• Local deployment options for ICD-API: Docker, Windows, or Linux service.
• A technical content model reference guide to defining and explaining the content model used for the?WHO Family of Classifications?(ICD-11, ICHI,?and ICF).?
• Implementation package to facilitate the transition from outdated ICD-10 to ICD-11. This package can be found on?the ICD-11 and includes the?Transition and Implementation Guide,?ICD-11 Fact Sheet, information on?ICD-API?web services,?ICD-11 self-learning training package, training platform, cause of death analysis tool (ANACoD-3),?ICD-11 license?and more.?

Author: @Preetham Poojary, @IIHMRB Scholar, Intern at #GCFORCB Organisation.