Elucidating challenges and opportunities in the transition to ICD-10-CM.

Abstract

* Abbreviations: EHR — : electronic health record ICD-9-CM — : International Classification of Disease, Ninth Revision Clinical Modification ICD-10 — : International Classification of Disease, Tenth Revision International Classification of Disease — : Tenth Revision ICD-10-CM — : International Classification of Disease Tenth Revision, Clinical Modification QI — : quality improvement Throughout the history of medicine, clinicians have worked to classify disease. As early as 1662, John Graunt studied the London Bills of Mortality to report death rates by condition.1 Originally created for epidemiologic purposes, systems of disease terminology became useful for other purposes, including billing. Since 1979, the International Classification of Diseases, Ninth Revision with Clinical Modifications (ICD-9-CM) has been used for third-party payment in the United States. Worldwide, the 10th revision of the ICD (ICD-10) has been used with local modifications in numerous countries for a decade or more. Now, all US entities covered by the Health Insurance Portability Accountability Act will be required to use ICD-10-CM on or after October 1, 2015. ICD-10-CM has about 5 times as many codes as ICD-9-CM. It is hoped the new codes will be better aligned with current medical terminology, characterize health information that could not be described with ICD-9-CM (eg, Glasgow coma score, blood type), and provide greater detail about health conditions (eg, severity of disease, laterality of anatomic location). The transition to ICD-10-CM should also facilitate comparisons of health outcomes between the United States and other nations.2 The … Address correspondence to Alexander G. Fiks, MD, MSCE, The Children’s Hospital of Philadelphia, 3535 Market Suite, Room 1546, Philadelphia, PA 19104. E-mail: fiks{at}email.chop.edu