Discussing How ICD Codes Work

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The ICD, or International Classification of Diseases (and related health conditions) is a catalog created by the World Health Organization, to classify all known diseases and health problems. Every disease is classified according to an alphanumeric code in the system, which makes it easier for people to look up and find out more about a specific condition. According to WHO, ICD codes make it easier for the healthcare industry to store and retrieve information required for diagnostics, as well as gathering and assessing morbidity and mortality statements.

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In the beginning, the ICD was known for a much more somber name. Its title was the International List for Causes of Death according to the data retrieved from 1893. Fortunately, the classification of the system has been changed over the years. However, in 1893, the system had already been in development for 40 years, tracing back to the work of a 17th-century demographer in London.

When WHO began in 1948, it took over the responsibility for the ICD in it’s sixth revision. Since that date, the system has been updated four times, with the most recent version being ICD 10, which was completed in 1992. According to experts, a revision is already under way for ICD 11.

What Is ICD-10?

When it comes to understanding the ICD codes, one of the first things you should know is that ICD-10 is the most current version of the system. It’s used throughout the world today in more than 100 countries for reporting deaths. There are also two dozen countries that use this system for resource allocation and reimbursement purposes. Early adopters – such as the Nordic Countries, which began using the system in 1994, and the United Kingdom which began using the system in 1995 have stuck with it for a number of years now.

The ICD 10 version of the code system contains around 22 chapters which contain a range of diseases and conditions. Many providers in the US currently use the ICD 10 to report information about deaths, but they were still using ICD 9 up until the point of 2015 for the reporting of Medicare claims.

Unfortunately, the US could not continue to use ICD 9 forever, because it was severely outdated.

It was found necessary to develop ICD 10 because the ICD 9 the standards were too rigid and not descriptive enough to be suitable for the current healthcare industry. Additionally, many of the codes are also obsolete. What’s more, the American Medical Association have also noted that chapters relating to complex systems within the body were filed somewhat quickly, meaning that new codes have been assigned in the wrong places.

What Are the Benefits of the ICD 10 Codes?

Importantly, there’s a huge difference between ICD 9 and ICD 10. While ICD 9 contains about 13,000 codes in total, which are made up of mostly three or five-digit numbers, the ICD 10 has around 68,000 codes made of seven alphanumeric characters. This means that ICD10 overall has the capacity to contain over 140,000 codes.

ICD 10 is far more detailed and advanced than its predecessor, and the move to ICD 10 for the United States was predicted to be an important process for improving the healthcare system and ensuring that health care providers could submit medical claims as efficiently as possible.

With the ICD 10, there is less need for supporting documents, fewer coding mistakes, and generally better activity in the claims world. Additionally, ICD 10 is also more sensitive when it comes to refining reimbursement and grouping methods along with improvements to public surveillance in the health industry.

Why Did the US Struggle with Shifting to ICD 10?

Since the ICD codes are now much more efficient than, it might be hard to imagine why switching was such a big deal for the United States. However, the new characters in the ICD 10 provide a lot of key information about root operations, body systems, and devices involved in procedures, which also means that data fields need to be expanded in all applications using ICD codes.

Because these codes need to be used in every transaction involving HIPAA protected data, including claims regarding dates of service and inpatient claims with discharge dates, they permeate a range of applications, including electronic healthcare recorded tech, billing software, and revenue management systems.

From the first of October 2015, US healthcare providers were told that their claims would be rejected if they didn’t include the right ICD Codes from ICD 10. This delay was sure to create a backlog for a lot of smaller organizations, particularly because time was tight when it came to making sure that they were ready for the new standard.

The only good news for the US when the ICD 10 Codes emerged, was that the annual update to the code set scheduled for the first of October on 2011 would be the last one to take place for three years. The updates were partially frozen for 2013 and 2014 to make sure that people had more time to capture and manage new diseases.

How Does ICD 10 Work?

Like the ICD 9 codes that came before them, the ICD 10 CM is based on the original classification of diseases, but uses alphanumeric codes, instead of numerical digits. According to WHO, all coders, physicians, health information managers, and other professionals can use the system to help them with the storage and retrieval of information for diagnostic purposes.

The structure of how an ICD code appears on paper or in digital format is easy enough to understand. The first character of the code has to be an alphabetic or alpha character – but it cannot be U. The third and second characters in the code, are numeric, and the remaining characters up to the seventh digit can be a combination of both alpha and numeric characters.

While the first three characters in the code are intended to draw attention to the injury category, the remaining characters are designed to outline the cause of the problem in greater detail, along with the location of the injury or disease, and the severity of the injury or illness. The final character is simply an extension digit intended to classify an initial, or subsequent encounter with treatment for the disease.

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