ICD

ICD refers to the International Statistical Classification of Diseases and Related Health Problems, a set of codes published by the World Health Organization (WHO) to classify diseases, symptoms, and other health problems. The most basic purpose of the coding system was to classify and quantify causes of mortality. ICD-9 has been used in the United States since 1977 for reporting statistics and billing to Medicare, Medicaid, and insurance companies.(1) The code set was developed before computers were widely used to process medical data aside from billing, indexing, and statistics. The World Health Organization has since published a revised set of codes called ICD-10 in 1992. The new scheme allows for 155,000 unique codes as opposed to the 17,000 of ICD-9-CM.

ICD-10 allows for greater granularity and specificity of reporting data. In addition, the system solves many of the problems of ICD-9, most notably the problem of expandability. Previously, newly classified diseases and procedures were simply added to the end of the current list of codes. In 1998, the National Center for Health Statistics released a modification of ICD-10 for the reporting of morbidity data and thus began the process of converting U.S. government departments to the new code set.(2) In 2008, CMS announced that all diagnosis data for claims processing would have to use ICD-10 beginning in October 2011.

The proposed implementation is being met with resistance by U.S. providers and insurers due to the cost of implementation and increased administrative complexity. One estimate puts the cost at $285,000 for a 10-physician practice over the 3-year implementation period between 2008 and 2011.(3) Although HHS's goal is to reduce improper or inaccurate charges, the transition is expected to result in two-to-threefold increases in rejected claims in the short-term. Some believe the timeframe for the changeover is unworkable, although the legislation by Congress in 2006 proposed the change be completed by 2009.(4)

References

1. AAFP Challenges Wisdom of Adopting ICD-10. American Academy of Family Physicians. [1]

2. Latour, Kathleen M and Eichenwald-Maki, Shirley, eds. Health Information Management: Concepts Principles, and Practice. 2nd Edition. Chicago: AHIMA, 2006.

3. Switch to ICD-10 codes could be costly: HHS proposal calls for ICD-10 implementation by 2011. Renal Business Today. [2]

4. Rushing ICD-10 Implementation Would Likely Cause Improper and Fraudulent Medicare Payments To Soar, New Report Finds. BlueCross BlueShield Association. [3]