As part of the Academy’s collaboration with the Healthcare
Information Management and Systems Society (HIMSS),
we have the opportunity to provide content on-their-web site concerning health
IT. Enter the “ICD Playbook.” You likely have heard about the upgrade from
ICD-9 to ICD-10. “ICD” stands for International Classification
of Diseases. The ICD is a coding
system used to classify diseases, signs, symptoms, abnormal findings,
complaints, social circumstances and external causes of health conditions in
health records. It is copyrighted by the World Health Organization. It is used for reimbursement purposes for
in-patient health care in the U.S.
So why do dietitians
care about ICD-10?
Better documentation –via code sets –allows for better care. Nutrition care is an integral part of care
which has great potential to improve health care and the delivery of health
As health IT is adopted, the ability to compare historical digital
data will allow for a more efficient reimbursement models. It is critical to record nutrition diagnoses,
intervention and progress in order to clarify the effectiveness of nutrition
Ancillary pricing models, in particular have room for
improvement in reimbursement and outcomes based interventions. Nutrition care
needs to be integrated in all coding and vocabularies to best exemplify
improved nutrition care.
Why do hospitals and
health care providers need to upgrade from the version 9 to version 10?
The 30-year-old code set uses outdated terminology and is
not consistent with current medical practice.
Lack of detail in version 9 prevents data analysis for
health care utilization and performance measurement. The ICD-9 codes do not provide the level of detail necessary
for efficient processing of reimbursement claims. This adds additional complexity and denials
based upon incomplete information.
What is the
difference between the two versions?
In short, the ICD-10 version has about 5 times as many terms
(68,000 vs. 13,000 with ICD-9)Much greater is provided with ICD-10 (such as descriptions
of co-morbidities, manifestations, etiology/causation, complications, detailed
anatomical location, degree of functional impairment, biologic and chemical
agents, phase/stage, lateralization, age related or joint involvement)—which allows
greater potential for inclusion of nutrition related details.