ICD-10 Strikes Back

by Thomas JornoICD-10-strikes-back

Believe it or not, there is a method to the madness of ICD-10. The system was developed by the World Health Organization (WHO) as a means of standardizing the categorization of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.

Officially known as the International Statistical Classification of Diseases and Related Health Problems, ICD is the standard international diagnostic tool for epidemiology, health management and clinical purposes. This system is designed to map health conditions to corresponding generic categories together with specific variations, assigning for these a designated code, up to six characters long. Thus, major categories are designed to include a set of similar diseases.

ICD-6, adopted in 1949, was the first version of ICD that was deemed suitable for morbidity reporting. The combined code section for injuries and their associated accidents was split into two: a chapter for injuries, and a chapter for their external causes. With use for morbidity there was a need for coding mental conditions, and for the first time a section on mental disorders was added.

Work on ICD-10 — the tenth revision of the system — began in 1983. It was officially copyrighted by WHO in 1990, though it wasn’t actually completed until 1992. It was then adopted relatively quickly by many countries of the world, starting with Australia in 1998. Today, ICD-10 is the most widely used statistical classification system for diseases in the world.

For numerous reasons, but particularly due to the special interest groups that affect policy, the United States wasn’t able to get on board until August 2008. At that time, the Department of Health and Human Services proposed that ICD-10 be adopted in America — a move that was formalized in January 2009, establishing ICD-10 as the new national coding standard, with an implementation date of October 1, 2013.

And if the prospect of changing over to ICD-10 wasn’t imposing enough, ICD-11 is scheduled to become the new standard in 2017 — though with the numerous delays in getting ICD-10 onto the books, it’s likely that ICD-11 will be pushed back for at least a few years.

How will ICD-10 benefit practices?

4 replies
  1. Andrew Kropff
    Andrew Kropff says:

    ICD-10 is an improvement for coding with specificity. The problem is that payers will take advantage of the new codes and use them to deny claims to providers who have already done the work! ICD-10 provides insurance companies with a new arsenal that they will use on physical therapists. But PTs aren’t alone, and the more that join a network of providers the more protected they’ll be from an audit.

  2. Reuven Lirov, M.A.
    Reuven Lirov, M.A. says:

    Asking how ICD-10 will benefit practices is definitely a shorter list than how it doesn’t. It’s always important to improve the way we track medical necessity, but ICD-10 presents a potential for fewer visits because of extra admin time. This means, more private PT practices are going to close their doors. That means patients not getting care. Not OK. ICD-10 may help practices standardize diagnostics across multiple specialties to help with multi-location care, but in the short term, it presents a tremendous headache that practices need to start preparing for now.

  3. Christine
    Christine says:

    Yes, icd-10 is a big headache that won’t go away but that’s why practices need to start preparing for it NOW! Any attempt to decrease the administrative burden and simplify the process is worth the investment in the end.

  4. Yuval Lirov
    Yuval Lirov says:

    I understand the need for transition to ICD-10 but do not understand why does it have to be so expensive?

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