ICD-10

ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.

The code set allows more than 14,400 different codes and permits the tracking of many new diagnoses. The codes can be expanded to over 16,000 codes by using optional sub-classifications.

The WHO provides detailed information about ICD online, and makes available a set of materials online, such as an ICD-10 online browser, ICD-10 Training, ICD-10 online training, ICD-10 online training support, and study guide materials for download.

The International version of ICD should not be confused with national modifications of ICD that frequently include much more detail, and sometimes have separate sections for procedures. The US ICD-10 Clinical Modification (ICD-10-CM), for instance, has some 68,000 codes. The US also has the ICD-10 Procedure Coding System (ICD-10-PCS), a coding system that contains 76,000 procedure codes that is not used by other countries.

Work on ICD-10 began in 1983 and was completed in 1992.

List
The following is a list of ICD-10 codes.

National adoption for clinical use
Some 27 countries use ICD-10 for reimbursement and resource allocation in their health system. A few of them have made modifications to ICD to better accommodate this use of ICD-10. The article below makes reference to some of these modifications. The unchanged international version of ICD-10 is used in about 110 countries for performing cause of death reporting and statistics.

Brazil
Brazil introduced ICD-10 in 1996.

Canada
Canada introduced ICD-10-CA in 2000. Canada implemented ICD-10 in a staggered fashion across nine of the 10 provinces between the years of 2001 and 2004. As data was returned, comparison was undertaken of information classified by ICD-9 and ICD-10, beginning with volumes and length of stay within major diagnostic groups.

The large scale realignment of individual diagnostic and procedural codes demanded close analysis of the impacts to existing indicators of healthcare delivery. Using data reported in 2001 and 2002,the Canadian Institute for Health Information, an independent organization that works with the federal government, tabulated the input. Rigorous statistical analysis was conducted to evaluate the comparability of ICD-9 codes to ICD-10 codes as they pertained to the Canadian version of diagnostic groups, Case Mix Groups (CMGs), which are used in the patient classification system to group together patients with similar characteristics.

China
China adopted ICD-10 in 2002.

Czech Republic
The Czech Republic adopted ICD-10 in 1994, one year after official release from WHO. The Czech Republic uses the international version without any local modifications. The Czech Republic adopted all updates to the international version (namely in 2004,2010,2011,2012).

France
France introduced a clinical addendum to ICD-10 in 2005. See also website of the ATIH.

Germany
Germany: ICD-10-GM (German Modification)

Korea
A Korean modification has existed since 2008.

Netherlands
The Dutch translation of ICD-10 is ICD10-nl, which was created by the WHO-FIC Network in 1994. There is an online dictionary.

Russia
The ministry of health of Russia ordered in 1997 to transfer all health organizations to ICD-10.

South Africa
ICD-10 was implemented in July 2005 under the auspice of the National ICD-10 Implementation Task Team which is a joint task team between the National Department of Health and the Council for Medical Schemes.

Sweden
The current Swedish translation of ICD-10 was created in 1997. A clinical modification has added more detail and omits codes of the international version in the context of clinical use of ICD:

The codes F64.1 (Dual-role transvestism), F64.2 (Gender identity disorder of childhood), F65.0 (Fetishism), F65.1 (Fetishistic transvestism), F65.5 (Sadomasochism), F65.6 (Multiple disorders of sexual preference) are not used in Sweden since 1 January 2009 according to a decision by the present Director General of The National Board of Health and Welfare, Sweden. The code O60.0 (Preterm labor without delivery) is not used in Sweden; instead, since 1 January 2009, the Swedish extension codes to O47 (False labor) are recommended for use.

Thailand
A Thai modification has existed since 2007; the Ministry of Public Health has ICD 10 TM. and 1 of 3 first used ICD-10 Code with Czechoslovakia and Denmark in 1994

United Kingdom
ICD-10 was first mandated for use in the UK in 1995. In 2010 the UK Government made a commitment to update the UK version of ICD-10 every three years. On 1 April 2016, following a year's delay, ICD-10 5th Edition replaced the 4th Edition as the mandated diagnostic classification within the UK.

United States
The US has used ICD-10-CM since October 1, 2015. This national variant of ICD-10 was provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), and the use of ICD-10-CM codes are now mandated for all inpatient medical reporting requirements. There are over 70,000 ICD-10-CM codes, which is up from around 14,000 ICD-9-CM codes.

The use of ICD-10 for coding of death certificates and mortality data was mandated in the United States beginning in 1999.

The deadline for the United States to begin using Clinical Modification ICD-10-CM for diagnosis coding and Procedure Coding System ICD-10-PCS for inpatient hospital procedure coding was set at October 1, 2015, which is a year later than a previous 2014 deadline. Before that 2014 deadline, the previous deadline has been a year before that on October 1, 2013. All HIPAA "covered entities" must make the change; a pre-requisite to ICD-10-CM is the adoption of EDI Version 5010 by January 1, 2012. Enforcement of 5010 transition by the Centers for Medicare & Medicaid Services (CMS), however, was postponed by CMS until March 31, 2012, with the federal agency citing numerous factors, including slow software upgrades. The implementation of ICD-10-CM has been subject to previous delays. In January 2009, the date was pushed back by two years, to October 1, 2013, rather than an earlier proposal of October 1, 2011.

The most recent pushback of the implementation date has inspired a mixed reaction from the healthcare community. Even though the deadline for ICD-10 was pushed back repeatedly, CMS recommended that medical practices take several years to prepare for implementation of the new code set. The basic structure of the ICD-10-CM code is the following: Characters 1–3 (the category of disease); 4 (etiology of disease); 5 (body part affected); 6 (severity of illness); and 7 (placeholder for extension of the code to increase specificity). Not only must new software be installed and tested, but medical practices must provide training for physicians, staff members, and administrators. They will also need to develop new practice policies and guidelines, and update paperwork and forms. For convenience, practices may also create "crosswalks" that will convert their most frequently used ICD-9-CM codes to the ICD-10-CM equivalents.

Two of the most common reasons for pushback are 1) the long list of potentially relevant codes for a given condition (such as rheumatoid arthritis) which can be confusing and reduce efficiency and 2) the seemingly absurd conditions assigned codes (such as W55.22XA:  Struck by cow, initial encounter and V91.07XA:  Burn due to water-skis on fire, initial encounter)