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{{Short description|International standard diagnostic tool for epidemiology, health management and clinical purposes}}
{{Redirect|ICD}}
 
The '''International Classification of Diseases''' ('''ICD''') is a globally used [[Diagnosis|diagnosticmedical classification]] toolused forin [[epidemiology]], [[health management]] and for [[diagnostics|clinical purposes]]. The ICD is maintained by the [[World Health Organization]] (WHO), which is the directing and coordinating authority for health within the [[United Nations System]].<ref>{{cite web|url=https://www.who.int/about/en |title=About WHO |access-date=14 March 2014 |url-status=live |publisher=World Health Organization |archive-date=9 February 2014 |archive-url=https://web.archive.org/web/20140209050225/http://www.who.int/about/en}}</ref> The ICD is originally designed as a [[health care]] classification system, providing a system of diagnostic codes for classifying [[disease]]s, including nuanced classifications of a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. 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.
 
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 a major project to statistically classify all health disorders, and provide diagnostic assistance. The ICD is a core statistically based classificatory diagnostic system for health care related issues of the [[Medical classification#WHO Family of International Classifications|WHO Family of International Classifications]] (WHO-FIC).<ref name="WHO-FIC">{{cite web|url=https://www.who.int/classifications/en |title=The WHO Family of International Classifications |publisher=World Health Organization |access-date=14 March 2014 |url-status=live |archive-date=22 December 2013 |archive-url=https://web.archive.org/web/20131222042324/http://www.who.int/classifications/en}}</ref>
 
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> On 11 February 2022, the WHO stated that 35 countries were using the ICD-11.<ref>{{cite web | author=WHO | title=ICD-11 2022 release | url=https://www.who.int/news/item/11-02-2022-icd-11-2022-release | date=11 February 2022 | website=www.who.int | archive-url=https://web.archive.org/web/20220210221848/https://www.who.int/news/item/11-02-2022-icd-11-2022-release | archive-date=10 February 2022 | url-status=live}}</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.
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==Versions of ICD==
===ICD 1-5===
{{Expand section|date=February 2023}}
 
===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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==== ICDA-8 (United States) ====
In the US, a group of consultants was asked to study the ICD-8 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-8). Beginning in 1968, ICDA-8 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=WonderCDC WONDER|access-date=11 December 2017 |url-status=dead |archive-url=https://web.archive.org/web/20171212193143/http://wonder.cdc.gov/wonder/sci_data/codes/icd9/type_txt/icd9cm.asp |accessarchive-date=11 DecemberDec 12, 2017 }}</ref>
 
===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>{{citationCite web needed|author-link=World Health Organization |title=History of ICD |url=https://cdn.who.int/media/docs/default-source/classification/icd/historyoficd.pdf |access-date=FebruaryDecember 201619, 2023 |website=WHO}}</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>
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{{main|ICD-10-CM}}
 
Adoption of ICD-10-CM was slow in the United States. Since 1979, the US had required ICD-9-CM codes<ref>[http://wonder.cdc.gov/wonder/sci_data/codes/icd9/type_txt/icd9cm.asp International Classification Of Diseases - 9 - CM, (1979)]. Wonder.name="cdc.gov. Retrieved on 2014-06-20.<"/ref> for [[Medicare (United States)|Medicare]] and [[Medicaid]] claims, and most of the rest of the American medical industry followed suit. On 1 January 1999 the ICD-10 (without clinical extensions) was adopted for reporting mortality, but ICD-9-CM was still used for [[morbidity]]. Meanwhile, NCHS received permission from the WHO to create a clinical modification of the ICD-10, and has production of all these systems:
* [[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.
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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/7sKGo20200405194700/https://www.verywellmind.com/overview-of-the-icd-11-4589392 |archive-date=5 April 2020 | url-status=live}}</ref> Following an [[alpha version]] in May 2011 and a [[Beta version|beta draft]] in May 2012, a stable version of the ICD-11 was released on 18 June 2018,<ref>{{Cite web | title=ICD-11 Timeline | url=https://www.who.int/classifications/icd/revision/timeline/en/ | website=who.int | archive-url=https://web.archive.org/web/20190505082818/https://www.who.int/classifications/icd/revision/timeline/en/ | archive-date=5 May 2019 | url-status=live}}</ref> and officially endorsed by all WHO members during the 72nd [[World Health Assembly]] on 25 May 2019.<ref>{{Cite press release | title=World Health Assembly Update, 25 May 2019 | url=https://www.who.int/news-room/detail/25-05-2019-world-health-assembly-update | publisher=WHO | location=Geneva, Switzerland | date=25 May 2019 | archive-url=https://web.archive.org/web/20190730052948/https://www.who.int/news-room/detail/25-05-2019-world-health-assembly-update | archive-date=30 July 2019 | url-status=live}}</ref>
 
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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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=US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics|location=Hyattsville, MD|isbn=978-0-8406-0644-0|url=https://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf}}</ref>
 
==Mental health issuesconditions==
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>
The ICD includes a section classifying mental and behavioral disorders (Chapter V). This has developed alongside the [[Diagnostic and Statistical Manual of Mental Disorders]] (DSM) of the [[American Psychiatric Association]] and the two manuals seek to use the same classifications. The WHO is revising their classifications in these sections as part the development of the ICD-11, and an "International Advisory Group" has been established to guide this.<ref>[https://www.who.int/mental_health/evidence/en/ Who | Mental Health Evidence And Research (Mer)]. Who.int. Retrieved on 2014-06-20.</ref> Section F66 of the ICD-10 deals with classifications of psychological and behavioural disorders that are associated with sexual development and orientation. It explicitly states that "sexual orientation by itself is not to be considered a disorder," in line with the DSM and other classifications that recognise homosexuality as a normal variation in human sexuality. The Working Group has reported that there is "no evidence that [these classifications] are clinically useful" and recommended that section F66 be deleted for the ICD-11.<ref>{{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>
 
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.
 
An international 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> 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. A psychologist has stated: "Serious problems with the clinical utility of both the ICD and the DSM are widely acknowledged."<ref>{{cite journal|last=Geoffrey M. Reed|year=2010|title=Toward ICD-11: Improving the clinical utility of WHO's International Classification of mental disorders|url=http://www.apa.org/international/outreach/icd-reed.pdf|journal=Professional Psychology: Research and Practice|volume=41|issue=6|pages=457–464|doi=10.1037/a0021701}}</ref>
 
==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]]
** [[Systematized Nomenclature of Medicine Clinical Terms]] (SNOMED CT)
* [[WHO Family of International Classifications]]
** [[International Classification of Functioning, Disability and Health]]