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{{Short description|International standard diagnostic tool
{{Redirect|ICD}}
The '''International Classification of Diseases''' ('''ICD''') is a globally used [[
The ICD is published by the WHO and used worldwide for [[morbidity]] and mortality statistics, [[reimbursement]] systems, and automated decision support in health care. This system is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics.
The ICD is revised periodically and is currently in its 11th revision. The [[ICD-11]], as it is therefore known, was accepted by WHO's [[World Health Assembly]] (WHA) on 25 May 2019 and officially came into effect on 1 January 2022.<ref>{{Cite news|url=https://www.who.int/news-room/detail/25-05-2019-world-health-assembly-update|title=World Health Assembly Update, 25 May 2019|date=25 May 2019}}</ref>
The ICD is part of [[Medical classification#WHO Family of International Classifications|a "family" of international classifications]] (WHOFIC) that complement each other, also including the [[International Classification of Functioning, Disability and Health]] (ICF) which focuses on the domains of functioning (disability) associated with health conditions, from both medical and social perspectives, and the [[International Classification of Health Interventions]] (ICHI) that classifies the whole range of medical, nursing, functioning and public health interventions.
The title of the ICD is formally the '''International Statistical Classification of Diseases and Related Health Problems''', although the original title, International Classification of Diseases, is still informally the name by which it is usually known.
In the United States and some other countries, the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' (DSM) is preferred for the classification of mental disorders for some purposes.
== Historical synopsis ==
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==Versions of ICD==
===ICD-6===
The ICD-6, published in 1949, was the first to be shaped to become suitable for morbidity reporting. Accordingly, the name changed from International List of Causes of Death to International Statistical Classification of Diseases. 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 .<ref name=Katsching>{{cite journal|last=Katsching|first=Heinz|title=Are psychiatrists an endangered species? Observations on internal and external challenges to the profession|journal=[[World Psychiatry]]|date=February 2010|volume=9|issue=1|pages=21–28|publisher=[[World Psychiatric Association]] |pmc=2816922 |pmid=20148149 |doi=10.1002/j.2051-5545.2010.tb00257.x}}</ref><ref name="volume2">ICD-10 Volume 2, online at [https://www.who.int/classifications Classifications] WHO.int</ref>
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The International Conference for the Seventh Revision of the International Classification of Diseases was held in Paris under the auspices of WHO in February 1955. In accordance with a recommendation of the WHO Expert Committee on Health Statistics, this revision was limited to essential changes and amendments of errors and inconsistencies.<ref name="volume2"/>
===ICD-
The 8th Revision Conference convened by WHO met in Geneva, from 6 to 12 July 1965. This revision was more radical than the Seventh but left unchanged the basic structure of the Classification and the general philosophy of classifying diseases, whenever possible, according to their [[etiology]] rather than a particular manifestation.
During the years that the Seventh and Eighth Revisions of the ICD were in force, the use of the ICD for indexing hospital medical records increased rapidly and some countries prepared national adaptations which provided the additional detail needed for this application of the ICD.
In the US, a group of consultants was asked to study the 8th revision of ICD (ICD-8a) for its applicability to various users in the United States. This group recommended that further detail be provided for coding hospital and morbidity data. The American Hospital Association's "Advisory Committee to the Central Office on ICDA" developed the needed adaptation proposals, resulting in the publication of the International Classification of Diseases, Adapted (ICDA). In 1968, the United States Public Health Service published the International Classification of Diseases, Adapted, 8th Revision for use in the United States (ICDA-8a). Beginning in 1968, ICDA-8a served as the basis for coding diagnostic data for both official morbidity [and mortality] statistics in the United States.<ref name="volume2"/><ref name="cdc">{{cite web|url=http://wonder.cdc.gov/wonder/sci_data/codes/icd9/type_txt/icd9cm.asp|title=International Classification Of Diseases - 9 - CM, (1979)|website=Wonder.cdc.gov|access-date=11 December 2017}}</ref>▼
==== ICDA-8 (United States) ====
▲In the US, a group of consultants was asked to study the
===ICD-9{{Anchor|ICDM 9|ICDM-9}}===
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The final proposals presented to and accepted by the Conference in 1978<ref>{{cite journal | pmc = 1361216 | pmid=16178999 | doi=10.1111/j.1475-6773.2005.00444.x | volume=40 | issue=5p2 | title=Measuring diagnoses: ICD code accuracy | year=2005 | journal=Health Serv Res | pages=1620–39 |vauthors=O'Malley KJ, Cook KF, Price MD, Wildes KR, Hurdle JF, Ashton CM }}</ref> retained the basic structure of the ICD, although with much additional detail at the level of the four digit subcategories, and some optional five digit subdivisions. For the benefit of users not requiring such detail, care was taken to ensure that the categories at the three digit level were appropriate.
As the World Health Organization explains: "For the benefit of users wishing to produce statistics and indexes oriented towards medical care, the 9th 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. This system became known as the 'dagger and asterisk system' and is retained in the Tenth Revision. A number of other technical innovations were included in the Ninth Revision, aimed at increasing its flexibility for use in a variety of situations."<ref>{{
It was eventually replaced by ICD-10, the version currently in use by the WHO and most countries. Given the widespread expansion in the tenth revision, it is not possible to convert ICD-9 data sets directly into ICD-10 data sets, although some tools are available to help guide users.<ref>World Health Organization. [https://www.who.int/classifications/help/icdfaq/en/ FAQ on ICD.] Accessed 12 July 2011.</ref>
Publication of ICD-9 without IP restrictions in a world with evolving electronic data systems led to a range of products based on ICD-9, such as MeDRA or the Read directory.<ref name="volume2"/><ref name="cdc"/>
====International Classification of Procedures in Medicine (ICPM)====
When ICD-9 was published by the World Health Organization (WHO), the [[International Classification of Procedures in Medicine]] (ICPM) was also developed (1975) and published (1978). The ICPM surgical procedures fascicle was originally created by the United States, based on its adaptations of ICD (called ICDA), which had contained a procedure classification since 1962. ICPM is published separately from the ICD disease classification as a series of supplementary documents called fascicles (bundles or groups of items). Each fascicle contains a classification of modes of laboratory, radiology, surgery, therapy, and other diagnostic procedures. Many countries have adapted and translated the ICPM in parts or as a whole and are using it with amendments since then.<ref name="volume2"/><ref name="cdc"/>
====ICD-9-CM (United States)====
The ''International Classification of Diseases, Clinical Modification'' (ICD-9-CM)
It consists three volumes:
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* [[ICD-9-CM Volume 3|Volume 3]] contains [[procedure code]]s for surgical, diagnostic, and therapeutic procedures.<ref>{{Cite web|title = ICD-9-CM Diagnosis Codes - International Classisfication of Diseases - Medical Diagnosis Codes|url = http://www.findacode.com/icd-9/icd-9-cm-code-set.html|website = www.findacode.com|access-date = 2015-12-30}}</ref> ICD-9-CM only
The NCHS and the Centers for Medicare and Medicaid Services are the
===ICD-10===
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Adoption was relatively swift in most of the world. Several materials are made available online by WHO to facilitate its use, including a manual, training guidelines, a browser, and files for download.<ref name="WHO-FIC"/> Some countries have adapted the international standard, such as the "ICD-10-AM" published in Australia in 1998 (also used in New Zealand),<ref>New Zealand Health Information Service. [http://www.nzhis.govt.nz/moh.nsf/pagesns/534 ''ICD-10-AM''.] Accessed 12 July 2011.</ref> and the "ICD-10-CA" introduced in Canada in 2000.<ref name="CIHI">Canadian Institute for Health Information. [http://www.cihi.ca/cihi-ext-portal/internet/en/document/standards+and+data+submission/standards/classification+and+coding/codingclass_icd10 ''ICD-10-CA''.] {{webarchive|url=https://web.archive.org/web/20150501034205/http://www.cihi.ca/CIHI-ext-portal/internet/en/document/standards+and+data+submission/standards/classification+and+coding/codingclass_icd10 |date=2015-05-01 }} Accessed 12 July 2011.</ref>
====ICD-10-CM (United States)====
{{main|ICD-10-CM}}
Adoption of ICD-10-CM was slow in the United States.
* [[ICD-10-CM]], for [[diagnosis code]]s, replaces volumes 1 and 2. Annual updates are provided.
* [[ICD-10-PCS]], for [[procedure codes]], replaces volume 3. Annual updates are provided.
On 21 August 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 1 October 2013. On 17 April 2012 the Department of Health and Human Services (HHS) published a proposed rule that would delay, from 1 October 2013 to 1 October 2014, the compliance date for the ICD-10-CM and PCS.<ref>{{cite web |url=https://www.cdc.gov/nchs/about/otheract/icd9/abticd10.htm |title=Classification of Diseases, Functioning, and Disability |publisher=[[
Revisions to ICD-10-CM Include:
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* Classification refinement for increased data granularity.
====ICD-10-CA (Canada)====
ICD-10-CA is a clinical modification of ICD-10 developed by the [[Canadian Institute for Health Information]] for morbidity classification in Canada. ICD-10-CA applies beyond acute hospital care, and includes conditions and situations that are not diseases but represent [[risk factor]]s to health, such as occupational and environmental factors, lifestyle and psycho-social circumstances.<ref name="CIHI"/>
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[[File:ICD-11 Beta browser icon.png|frameless|right]]
The eleventh revision of the International Classification of Diseases, or the [[ICD-11]], is almost five times as big as the ICD-10.<ref>{{Cite journal | author=Editorial | date=2019 | title=ICD-11 | journal=[[The Lancet]] | volume=393 | issue=10188 | page=2275 | doi=10.1016/S0140-6736(19)31205-X| pmid=31180012 | doi-access=free }}</ref> It was created following a decade of development involving over 300 specialists from 55 countries.<ref>{{Cite report | first=Azza | last=Badr | title=Fifth regional steering group meeting Bangkok | url=http://getinthepicture.org/system/files/ICD-11%20-%20WHO.pdf | date=17–19 September 2019}} [[WHO]]/[http://www.emro.who.int/ EMRO].</ref><ref>{{Cite report | first1=Donna | last1=Pickett | first2=Robert N. | last2=Anderson | title=Status on ICD-11: The WHO Launch | url=https://ncvhs.hhs.gov/wp-content/uploads/2018/08/ICD-11_WHO-v_7-17-2018.pdf | date=18 July 2018 | publisher=[[Centers for Disease Control and Prevention|CDC]]/[[National Center for Health Statistics|NCHS]]}}</ref><ref>{{Cite news | first=Arlin | last=Cuncic | title=Overview of the ICD-11 for Mental Health | url=https://www.google.com/search?q=How+Does+the+ICD-11+Compare+to+the+DSM-5%3F+Verywell | date=23 March 2020 | work=[[Verywell Mind]] | archive-url=https://archive.today/
For the ICD-11, the WHO decided to differentiate between the core of the system and its derived specialty versions, such as the [[ICD-O]] for [[oncology]]. As such, the collection of all ICD entities is called the Foundation Component. From this common core, subsets can be derived. The primary derivative of the Foundation is called the ICD-11 MMS, and it is this system that is commonly referred to and recognized as "the ICD-11".<ref>{{Cite journal | first=Christopher G. | last=Chute | date=2018 | title=The rendering of human phenotype and rare diseases in ICD-11 | journal=[[Journal of Inherited Metabolic Disease]] | volume=41 | issue=3 | pages=563–569 | doi=10.1007/s10545-018-0172-5 | pmid=29600497 | pmc=5959961 | quote=<small>The primary linearization, and the one most users will recognize and likely believe is "the ICD-11", is the Mortality and Morbidity Statistics (MMS) linearization.</small>| doi-access=free }}</ref> MMS stands for Mortality and Morbidity Statistics.
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== Usage in the United States ==
In the United States, the [[
| author =CMS Office of Public Affairs
| author-link =Centers for Medicare and Medicaid Services
| title =HHS Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards
| publisher =[[
| date =February 11, 2008
| url =https://www.cdc.gov/nchs/about/otheract/icd9/abticd10.htm
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* ICD-6: 1949
* ICD-7: 1958
*
* ICD-9-CM: 1979
* ICD-10-CM: 1999
{{Div col end}}
Cause of death on United States death certificates, statistically compiled by the [[Centers for Disease Control and Prevention]] (CDC), are coded in the ICD, which does not include codes for human and system factors commonly called [[medical errors]].<ref>{{cite journal|last1=Makary|first1=MA|last2=Daniel|first2=M|title=Medical error—the third leading cause of death in the US|journal=BMJ|volume=353|date=3 May 2016|pages=i2139|doi=10.1136/bmj.i2139|pmid=27143499|s2cid=206910205|url=http://www.bmj.com/content/353/bmj.i2139}}</ref><ref>{{cite book|last1=Moriyama|first1=IM|last2=Loy|first2=RM|last3=Robb-Smith|first3=AHT|editor1-last=Rosenberg|editor1-first=HM|editor2-last=Hoyert|editor2-first=DL|title=History of the Statistical Classification of Diseases and Causes of Death|date=2011|publisher=
The various ICD editions include sections that classify mental and behavioural disorders. The ''ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines'' – also known as the "blue book" – is derived from Chapter {{rn|V}} of ICD-10 and gives the diagnostic criteria for the conditions listed at each [[Diagnosis code|category]] therein. The blue book was developed separately to, but coexists with, the [[Diagnostic and Statistical Manual of Mental Disorders]] (DSM) of the [[American Psychiatric Association]]—though both seek to use the same diagnostic [[Nosology#Types of classification|classifications]]. A survey of psychiatrists in 66 countries comparing use of the ICD-10 and DSM-IV found that the former was more often used for clinical diagnosis while the latter was more valued for research.<ref>{{cite journal|last=Juan E. Mezzich|year=2002|title=International Surveys on the Use of ICD-10 and Related Diagnostic Systems|url=https://books.google.com/books?id=EE-YRUki3LEC&pg=PA72|format=guest editorial, abstract|journal=Psychopathology|volume=35|issue=2–3|pages=72–75|doi=10.1159/000065122|pmid=12145487|isbn=9783805574617|s2cid=35857872}}</ref>
As part of the development of the ICD-11, WHO established an "International Advisory Group" to guide what would become the chapter on "Mental, behavioural or neurodevelopmental disorders".<ref name="Cochran-2014">{{cite journal|title = Proposed declassification of disease categories related to sexual orientation in the ''International Statistical Classification of Diseases and Related Health Problems'' (ICD-11)|first1 = Susan D.|last1 = Cochran|first2 = Jack|last2 = Drescher|author-link2 = Jack Drescher|first3 = Eszter|last3 = Kismödi|first4 = Alain|last4 = Giami|first5 = Claudia|last5 = García-Moreno|first6 = Elham|last6 = Atalla|first7 = Adele|last7 = Marais|first8 = Elisabeth|last8 = Meloni Vieira|first9 = Geoffrey M.|last9 = Reed|journal = [[Bulletin of the World Health Organization]]|year = 2014|volume = 92|issue = 9|pages = 672–679|doi = 10.2471/BLT.14.135541|pmid = 25378758|pmc = 4208576}}</ref><ref>{{cite web |title=ICD-11 for Mortality and Morbidity Statistics {{!}} Chapter 06 Mental, behavioural or neurodevelopmental disorders |url=https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f334423054 |website=icd.who.int |access-date=14 September 2023}}</ref> The working group proposed that ICD-11 should declassify the categories within ICD-10 at "F66 Psychological and behavioural disorders that are associated with sexual development and orientation".<ref name="Cochran-2014" /><ref>{{cite web |title=ICD-10 Version:2019 |url=https://icd.who.int/browse10/2019/en#/F66.2 |website=icd.who.int |access-date=14 September 2023}}</ref> The group reported to WHO that there was "no evidence" these classifications were clinically useful, as they do not "contribute to health service delivery or treatment selection nor provide essential information for public health surveillance."<ref name="Cochran-2014" /> Adding that; despite ICD-10 explicitly stating "sexual orientation by itself is not to be considered a disorder", the inclusion of such categories "suggest that mental disorders exist that are uniquely linked to sexual orientation and gender expression." A position already recognised by the DSM, as well as other classification systems.
The ICD is actually the official system for the US,{{Citation needed|date=March 2023}} although many mental health professionals do not realize this due to the dominance of the DSM.
▲==Mental health issues==
==See also==
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** [[Research Domain Criteria]] (RDoC), a framework being developed by the National Institute of Mental Health
* [[Medical diagnosis]]
** [[Diagnosis-related group]] (DRG)
* [[Medical terminology]]
** [[Current Procedural Terminology]]
** [[MedDRA]] (Medical Dictionary for Regulatory Activities)
** [[SNOMED CT]]
* [[WHO Family of International Classifications]]
** [[International Classification of Functioning, Disability and Health]]
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Note: Since adoption of ICD-10 CM in the US, several online tools have been mushrooming. They all refer to that particular modification and thus are not linked here.
* {{Official website|http://www.who.int/classifications/icd/en/}} at World Health Organization (WHO)
* [
* [http://apps.who.int/classifications/apps/icd/ICD10Training ICD-10 online training direct access] (WHO)
* [https://www.cdc.gov/nchs/icd/icd10cm.htm ICD-10-CM] (USA – modification) at Centers for Disease Control and Prevention (CDC)
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[[Category:Classification of mental disorders]]
[[Category:Data coding framework]]
[[Category:Diagnosis
[[Category:Statistical data coding]]
[[Category:World Health Organization]]
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