Diagnosis (ICD-9 and ICD-10)

Update: MLN (Medicare Learning Network) published this pdf on ICD-10 on June 22, 2010

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The diagnosis is the identification of a patient’s disease or medical condition and is currently (2010) described by a six place numeric identifier (5 digits and one decimal) called the International Classification of Diseases, Ninth Revision or the ICD-9 code.  On October 1, 2013, the United States will move to ICD-10.  The International version of ICD should not be confused with national Clinical Modifications of ICD that include frequently much more detail, and sometimes have separate sections for procedures, so the new US ICD-10 CM has more than 150,000 codes.

The differences are:

ICD-9 codes consist of 3-5 digits:
Ӣ Chapters 1-7 are numeric
”¢ Supplemental chapters: the first digit is alpha (E or V) and the rest are numeric

ICD-10-CM codes consist of 3-7 alphanumeric characters:
Ӣ Digit 1 is alpha
Ӣ Digit 2 is numeric
Ӣ Digits 3-7 are alpha or numeric

2009 totals, according to the U.S. Department of Health and Human Services:
ICD-9-CM: 17,000
Diagnosis: 13,000
Procedure: 4,000

ICD-10: 140,694
Diagnosis (ICD-10-CM): 68,105
Procedure (ICD-10-PCS): 72,589

Healthcare Information Management, Inc. states:

The ICD-10-CM is divided into an index. The first is the alphabetical list of terms and their corresponding code. The second is the Tabular List, a chronological list of codes divided into chapters that represent different conditions or body systems. There are also two parts to the Index ”“ the Index to External Causes of Injury and the Index for Diseases and Injury. The Index and Tabular portions of the ICD-10-CM include the conventions and structural notes.

The Tabular List contains alphanumeric categories, subcategories, and codes. When a three character category has no more subdivisions, it is considered a code. Each level of subdivision after the category is a subcategory. The ”˜code’ is considered complete once there are no more subcategories. A code indicated to have a 7^th character is considered incomplete without the missing character.

In order to be reportable, only a complete ”˜code’ can be used. Subcategories or diagnoses that are not complete cannot be used for reporting. When there is an unknown subcategory, the place holder X is allowable in either the 5^th or 6^th position. This placeholder allows for the future addition of characters, thereby accommodating expansion when needed. The notes in the Tabular List will indicate categories where a 7^th character is required.

ICD-9 codes are arranged thusly:

• List of ICD-9 codes 001-139: Infectious and parasitic diseases
• List of ICD-9 codes 140-239: Neoplasms
• List of ICD-9 codes 240-279: Endocrine, nutritional and metabolic diseases, and immunity disorders
• List of ICD-9 codes 280-289: Diseases of the blood and blood-forming organs
• List of ICD-9 codes 290-319: Mental disorders
• List of ICD-9 codes 320-359: Diseases of the nervous system
• List of ICD-9 codes 360-389: Diseases of the sense organs
• List of ICD-9 codes 390-459: Diseases of the circulatory system
• List of ICD-9 codes 460-519: Diseases of the respiratory system
• List of ICD-9 codes 520-579: Diseases of the digestive system
• List of ICD-9 codes 580-629: Diseases of the genitourinary system
• List of ICD-9 codes 630-676: Complications of pregnancy, childbirth, and the puerperium
• List of ICD-9 codes 680-709: Diseases of the skin and subcutaneous tissue
• List of ICD-9 codes 710-739: Diseases of the musculoskeletal system and connective tissue
• List of ICD-9 codes 740-759: Congenital anomalies
• List of ICD-9 codes 760-779: Certain conditions originating in the perinatal period
• List of ICD-9 codes 780-799: Symptoms, signs, and ill-defined conditions
• List of ICD-9 codes 800-999: Injury and poisoning
• List of ICD-9 codes E and V codes: external causes of injury and supplemental classification

And, the ICD-10 is arranged like this: