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The History of ICD-10 Codes

Forbes, and others, are reporting that Medicare’s October 1, 2015 rollout of the new ICD-10 medical codes is going smoothly for large insurers. Also, from everything I have heard, the Medicare Secondary Payer compliance industry, which has been preparing for this for years, is experiencing few problems switching from ICD-9 to ICD 10.

Much has been written about the much-anticipated switch to ICD-10, but very little about the origin and purpose of the ICD medical coding system. So, this piqued my curiosity and here is what I found out.

In 1763, the first attempt to classify diseases is credited to a French physician, François Boissier de Sauvages de Lacroix, who identified 2,400 individual diseases. Many physicians updated the list to add diseases as more were discovered. In 1855, the first revision of standards for classification was published in Paris, which established a model for how the coding process should work. In 1948, the United Nation’s World Health Organization (WHO) created a Sixth Revision International Classification list. By 1955, the seventh revision of this list was called, the “International Classification of Diseases (ICD)”.

ICD is the WHO’s standard diagnostic tool for classifying diseases and other health problems. It is used for many types of health records, death certificates, mortality and morbidity statistics and for reimbursement and resource allocation decision making.

ICD-9, the 9th revision, uses 3-5 digits and has been used in the United States and internationally since about 1979. ICD-9-CM Volume 3 was added in the United States for procedural codes for hospitals.

ICD-10 codes, which use a 3-7 digit alphanumeric scheme, came into use by the WHO countries in 1994. The United States is one of the last developed countries to adopt ICD-10. After several delays, the U.S. finally begin using ICD-10 codes on October 1, 2015. ICD-10 will expand the number of diagnostic codes, more than fivefold, from the previous 13,500 found in ICD-9 to about 69,000 codes IN ICD-10.

In addition, the Centers for Medicare and Medicaid Services (CMS) has developed a completely new procedural coding system for reporting hospital inpatient procedural services to Medicare called ICD-10-PCS which will expand the number of hospital inpatient procedure codes from 4,000 to 71,000, bringing the total new ICD-10 codes to about 144,000.

Work on ICD-11 is well underway and a final draft is expected in 2018.

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