Most of the world has been using ICD 10 for several years, but the United States is implementing its own version of it, ICD-10-CM, just as it has its own version of ICD-9, ICD-9-CM.
So how did we get here and where are we going? The history of the international classification of diseases is an interesting one.
An attempt at classifying diseases began with an international statistical congress in London in 1860. Florence Nightingale made a proposal that was to result in the development of the first model of systemic collection of hospital data. In 1893 French physician Jacques Bertillon introduced the Bertillon Classification of Causes of Death at a congress of the International Statistical Institute in Chicago.
A number of countries and cities adopted Bertillon's system, which was based on the principle of distinguishing between general diseases and those localized to a particular organ or anatomical site, as used by the City of Paris for classifying deaths. Subsequent revisions represented a synthesis of English, German, and Swiss classifications, expanding from the original 44 titles to 161 titles. In 1898, the American Public Health Association (APHA) recommended that the registrars of Canada, Mexico, and the United States also adopt it. The APHA also recommended revising the system every ten years to ensure the system remained current with medical practice advances. As a result, the first international conference to revise the International Classification of Causes of Death took place in 1900, with revisions occurring every ten years thereafter.
Prior to the sixth revision, responsibility for ICD revisions fell to the Mixed Commission, a group composed of representatives from the International Statistical Institute and the Health Organization of the League of Nations.
When diplomats met to form the United Nations in 1945, one of the things they discussed was setting up a global health organization.
WHO’s Constitution came into force on 7 April 1948 – a date we now celebrate every year as World Health Day. WHO also became the responsible body for ICD coding and their fist one, ICD 6, was a major expansion on the previous ones. Every 10 years there was an upgraded version,
The International Conference for the Ninth Revision of the International Classification of Diseases, convened by WHO, met in Geneva from 30 September to 6 October 1975. For the benefit of users wishing to produce statistics and indexes oriented towards medical care, the Ninth Revision included an optional alternative method of classifying diagnostic statements, including information about both an underlying general disease and a manifestation in a particular organ or site. International Classification of Diseases, Clinical Modification (ICD-9-CM) is an adaption created by the U.S. National Center for Health Statistics (NCHS) and used in assigning diagnostic and procedure codes associated with inpatient, outpatient, and physician office utilization in the United States. The ICD-9-CM is based on the ICD-9 but provides for additional morbidity detail. It was slightly updated annually on October 1, until this year, when ICD-10-CM will be implemented..
Work on ICD-10 began in 1983, and the new revision was endorsed by the Forty-third World Health Assembly in May 1990. The latest version came into use in WHO Member States starting in 1994. The classification system allows more than 155,000 different codes and permits tracking of many new diagnoses and procedures, a significant expansion on the 17,000 codes available in ICD-9. The numeric coding of diseases is entirely different in ICD-10 than in ICD-9. Despite this, adoption was relatively swift in most of the world. Several materials were made available online by WHO to facilitate its use, including a manual, training guidelines, a browser, and files for download. Many countries adapted their own version of the international standard, such as the "ICD-10-AM" published in Australia in 1998 (also used in New Zealand), and the "ICD-10-CA" introduced in Canada in 2000.
Adoption of ICD-10-CM has been slow in the United States. Since 1979, the USA had required ICD-9-CM codes for Medicare and Medicaid claims, and most of the rest of the American medical industry followed suit.
On August 21, 2008, the US Department of Health and Human Services (HHS) proposed new code sets to be used for reporting diagnoses and procedures on health care transactions. Under the proposal, the ICD-9-CM code sets would be replaced with the ICD-10-CM code sets, effective October 1, 2013. On April 17, 2012 the Department of Health and Human Services (HHS) published a proposed rule that would delay, from October 1, 2013 to October 1, 2014, the compliance date for the ICD-10-CM and PCS. Once again, Congress delayed implementation date to October 1, 2015, after it was inserted into "Doc Fix" Bill without debate but over objections of many.
I have been a health care provider for over 40 years, and have been using the ICD-9 codes all those years. I know the most used codes in my industry in my head. Thank goodness for Google, to give health care professionals a place to reference the old codes with the new ones. It would have been much more difficult to institute the massive changes in disease coding prior to computers and the internet.
What I worry about is how the various health insurance companies will process claims with the new ICD-10 coding. The new coding is more specific than the old coding. For example, ICD-9 code for regular astigmatism is 367.21. There is no specific code for the right eye or the left eye. With ICD-10 regular astigmatism can be coded H52.211 (regular astigmatism right eye, H52.212 (regular astigmatism, left eye), H52.213 (regular astigmatism both eyes) or H52.219 (regular astigmatism unspecified eye). In order for a claim to be paid will insurance companies require the eye to be specified or will they allow us to submit a claim without specifying the eye, or will some insurance companies require eye specified and some not. There is already huge diversity in what insurance companies allow and what insurance companies do not allow, and sometimes it seems to be aimed at ways, or excuses, for the insurers not to pay a claim which , except for some technicality contrived by the insurance company, they should pay.
Much time and money will be spent this year while the healthcare industry sorts out how they will use the newly required ICD-10-CM coding, and the United States catches up with the rest of world, which has been using ICD-10 for the past 2 decades.