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1<?xml version="1.0" encoding="ISO-8859-1"?>
2
3<HTML_CONTENT xmlns:ibis="http://www.ibisph.org">
4
5        <ibis:doc>
6                <name>home/ICDHelp</name>
7                <summary>General Public Health Topics Help Page</summary>
8                <description>
9                </description>
10
11                <author>Garth Braithwaite?</author>
12                <company>Utah Department of Health/Software Technology Group?</company>
13                <versions>
14                        <version><number>1.0</number><date>Oct 6, 2008</date><who>Maria</who>
15                                <description>initial release (adapted from ICD_Help page)</description></version>
16                </versions>
17        </ibis:doc>
18
19        <TITLE>ICD Help</TITLE>
20        <DESCRIPTION>This is the ICD Help page.</DESCRIPTION>
21
22
23        <CONTENT>
24                Click a bar below to expand or collapse its content.<br/><br/>
25                <ibis:ExpandableContent titleLevel="2"><SHOW/>
26                <TITLE>What is an ICD Code?</TITLE>
27                <CONTENT>
28                        <!--h1>What is an "ICD Code?"</h1-->
29                        The International Classification of Diseases (ICD) is a
30                        coding system maintained by the World Health Organization (WHO) and the
31                        National Center for Health Statistics and is used to classify causes of death
32                        on death certificates and diagnoses, injury causes, and medical
33                        procedures for hospital and emergency department visits. These codes are
34                        updated every decade or so to account for advances in medical
35                        technology. Currently, the U.S. is using the 10th revision of the ICD (ICD-10).<br/>
36                </CONTENT>
37                </ibis:ExpandableContent>
38
39                <ibis:ExpandableContent titleLevel="2"><HIDE/>
40                <TITLE>Validity of ICD Codes</TITLE>
41                <CONTENT>
42                        ICD codes are used on the death certificate primarily for surveillance
43                        purposes. There is a strong emphasis in the U.S. Vital Events protocols
44                        on correct classification of underlying cause of death and related
45                        causes of death on the death certificate, and the process is
46                        well-defined and regularly audited. The validity is excellent to the
47                        extent that the persons completing the death certificate record the
48                        causes of death accurately and legibly. (Sometimes death certificates
49                        are completed by the Office of the Medical Examiner, but they are also
50                        completed by physicians, funeral directors, and law enforcement.)<br/><br/>
51
52                        ICD codes that are used in the hospital discharge query system are the
53                        codes that were recorded on the UB92, a standard electronic billing form
54                        used across the country. The primary purpose of supplying codes to this
55                        form is to bill for hospital services. In general, it is believed that
56                        the ICD codes on the UB92 do an adequate job of accurately recording the
57                        reason (diagnosis) for each hospital visit.<br/>
58                </CONTENT>
59                </ibis:ExpandableContent>
60
61                <ibis:ExpandableContent titleLevel="2"><HIDE/>
62                <TITLE>Transition From ICD-9 to ICD-10</TITLE>
63                <CONTENT>
64                        The following material on this page was excerpted directly from
65                        <a href="ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/publications/guide2/document%20for%20the%20states.pdf">
66                        A Guide to State Implementation of ICD-10 for Mortality Part II: Applying
67                        Comparability Ratios</a>. (December 2000) National Center for Health
68                        Statistics, pp. 6-7.<br/><br/>
69
70                        <h2>ICD Revisions</h2>
71
72                        Since the beginning of the century the ICD for mortality has been
73                        modified about once every ten years, except for the twenty year interval
74                        between the last two revisions, ICD-9 and ICD-10, as shown below:<br/><br/>
75
76                        <h2>ICD Implementation Dates in the U.S.</h2>
77
78                        <table class="Info">
79                                <tr>
80                                        <th class="heading"><p align="center" style="font-weight:bold">Revision</p></th>
81                                        <th class="heading"><p align="center" style="font-weight:bold">Years in Effect</p></th>
82                                </tr>
83                                <tr>
84                                        <td class="help">First (ICD-1)</td>
85                                        <td class="help"><p align="center">1900 - 1909</p></td> 
86                                </tr>
87                                <tr>
88                                        <td class="help">Second (ICD-2)</td>
89                                        <td class="help"><p align="center">1910 - 1920</p></td> 
90                                </tr>
91                                <tr>
92                                        <td class="help">Third (ICD-3)</td>
93                                        <td class="help"><p align="center">1921 - 1929</p></td> 
94                                </tr>
95                                <tr>
96                                        <td class="help">Fourth (ICD-4)</td>
97                                        <td class="help"><p align="center">1930 - 1938</p></td> 
98                                </tr>
99                                <tr>
100                                        <td class="help">Fifth (ICD-5)</td>
101                                        <td class="help"><p align="center">1939 - 1948</p></td> 
102                                </tr>
103                                <tr>
104                                        <td class="help">Sixth (ICD-6)</td>
105                                        <td class="help"><p align="center">1949 - 1957</p></td> 
106                                </tr>
107                                <tr>
108                                        <td class="help">Seventh (ICD-7)</td>
109                                        <td class="help"><p align="center">1958 - 1967</p></td> 
110                                </tr>
111                                <tr>
112                                        <td class="help">Eighth, Adapted (ICDA-8)</td>
113                                        <td class="help"><p align="center">1968 - 1978</p></td> 
114                                </tr>
115                                <tr>
116                                        <td class="help">Ninth (ICD-9)</td>
117                                        <td class="help"><p align="center">1979 - 1998</p></td> 
118                                </tr>
119                                <tr>
120                                        <td class="help">Tenth (ICD-10)</td>
121                                        <td class="help"><p align="center">1999 - </p></td> 
122                                </tr>
123                        </table>       
124                        <br/>
125
126                        The rationale for the periodic revisions has been to reflect advances in
127                        medical science and changes in diagnostic terminology. Historically, the
128                        U.S. accepted the WHO versions of the ICD, except for the Eighth
129                        Revision, when the U.S. produced its own "adapted" version, which is
130                        symbolized by the "A" in ICDA-8. The U.S.'s rejection of the WHO version
131                        reflected principally disagreements on the content of the circulatory
132                        chapter. That changes in the ICD for mortality have been made only every
133                        ten to twenty years rather than annually promotes comparability over
134                        time in mortality trend data.<br/><br/>
135
136                        <h2>Differences between ICD-10 and ICD-9</h2>
137
138                        ICD-10 differs from ICD-9 in a number of respects: 1) ICD-10 is far more
139                        detailed than ICD-9; about 8,000 categories compared with 4,000
140                        categories. The expansion was mainly to provide more clinical detail for
141                        morbidity applications; 2) ICD-10 uses 4-digit alphanumeric codes
142                        compared with 4-digit numeric codes in ICD-9; 3) three additional
143                        chapters have been added and some chapters rearranged; 4) cause-of-death
144                        titles have been changed, and conditions have been regrouped; 5) some
145                        coding rules have been changed. 6) Finally, ICD-10 is published in three
146                        volumes compared with two volumes in ICD-9.<br/><br/>
147
148                        <h2>Statistical Impact and Comparability</h2>
149
150                        The introduction of a new revision of the ICD can create major
151                        discontinuities in trend data, as shown in <a href="ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/publications/guide2/document%20for%20the%20states.pdf">Figure 1</a>. Figure 1 shows
152                        trends in leading causes of death in the United States from 1950 to 1997
153                        in terms of age-adjusted death rates. The lines on the chart are not
154                        continuous, but rather are broken by vertical lines that represent the
155                        introduction of a new revision of the ICD. Thus, ICD-9 was introduced in
156                        1979. Further, the level of the rates is sometimes discontinuous between
157                        revisions. For example, a large discontinuity occurred between 1978 and
158                        1979 in mortality for the 11th leading cause of death, "Nephritis,
159                        nephrotic syndrome, and nephrosis." The rate for this cause in 1979 was
160                        over 70 percent higher than in the previous year, because of the
161                        introduction of ICD-9.<br/><br/>
162
163                        The extent of the discontinuity is measured using a "comparability
164                        ratio," which results from double-coding a large sample of the national
165                        mortality file, once by the old revision (ICDA-8), and again by the new
166                        revision (ICD-9), and expressing the results of the comparison as a
167                        ratio of deaths for a cause of death by the later revision divided by
168                        the number of that cause of death coded and classified by the earlier
169                        revision. The national Comparability Study for ICD-9 was carried out
170                        using a sample of 137,000 deaths (and a special sample of 13,000 deaths
171                        for infants) occurring in 1976 (3). The ratios for 1976 were considered
172                        applicable to deaths occurring in 1978, and represent the break in trend
173                        resulting from introducing the new coding and classification system. The
174                        ratio for Nephritis is 1.74 indicating that 74 percent more deaths
175                        occurred from this cause in 1979 compared with 1978 only because of the
176                        introduction of ICD-9. The comparability ratio for Septicemia of 0.85
177                        indicates that about 15 percent fewer deaths occurred in 1979 compared
178                        with 1978, because of the introduction of the new revision of the ICD.<br/><br/>
179
180                        For ICD-10, two sets of comparability ratios are being prepared: a
181                        preliminary set scheduled for early release based on a very large sample
182                        of deaths (in excess of 1.8 million records) occurring in 1996 that will
183                        accompany the publication of preliminary national mortality data for
184                        1999, and a final set of comparability ratios based on the entire
185                        national mortality file of 1996 (over 2.3 million records) that will be
186                        published one year later. The final comparability ratios are expected to
187                        differ little from the preliminary ratios, but will permit calculation
188                        of state-specific ratios, cross tabulation by age and sex, and the use
189                        of more detailed tabulation lists than the standard ICD-10 tabulation
190                        list of 113 Selected Causes of Death (see <a href="ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/publications/guide2/document%20for%20the%20states.pdf">Appendix I</a>). Preliminary
191                        comparability ratios for ICD-10 are shown in a companion document to
192                        this Guide.<br/><br/>
193                </CONTENT>
194                </ibis:ExpandableContent>
195
196<h2>ICD Code Links</h2>
197<br/>
198
199<b>ICD-10 and ICD-10-CM</b>
200        <ul>
201                <li>ICD-10 is used for Mortality data (1999-present)</li>
202                <li><a href="http://apps.who.int/classifications/icd10/browse/" target="_blank">ICD-10 online code look-up</a></li>
203                <li><a href="https://www.cdc.gov/nchs/icd/icd10.htm" target="_blank">ICD-10 information</a></li>
204                <li>ICD-10-CM is used for Hospitalization data (2016-present)*</li>
205                <li><a href="https://www.cms.gov/Medicare/Coding/ICD10/index.html" target="_blank"> ICD-10-CM diagnosis and procedure codes and transition information</a></li>
206                <li><a href="https://www.cdc.gov/nchs/icd/icd10cm.htm" target="_blank">ICD-10-CM information</a></li>
207         </ul>
208         <br/>
209         
210<b>ICD-9-CM</b>
211        <ul>
212                <li>ICD-9-CM was used for Hospitalization data (2008-2015)*</li>
213                <li><a href="https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/codes.html" target="_blank">ICD-9-CM diagnosis and procedure codes</a></li>
214                <li><a href="https://icd.codes/icd9cm" target="_blank">ICD-9-CM online code look-up</a></li>
215                <li><a href="https://www.cdc.gov/nchs/icd/icd9cm.htm" target="_blank">ICD-9-CM information</a></li>
216        </ul>
217        <br/>
218       
219*ICD-10-CM was implemented nationwide on October 1, 2015.  New Jersey hospital records for October 1, 2015 through December 31, 2015 were back-coded to ICD-9-CM so the entire data year would be coded the same way.
220<br/><br/>
221
222          <div class="Note">
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226        </div>
227        <br/>
228        </CONTENT>
229</HTML_CONTENT>
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