What’s the Importance of the International Classifications of Diseases?

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The International Classifications of Diseases, or ICD, is set of alphanumeric codes that allow medical professionals to communicate universally about patient diagnoses and treatments. The codes represent every known symptom, condition, disease, injury, and procedure. They are used across the globe to document patient health conditions in medical records and to file insurance claims, but their importance goes far beyond billing and coding.

The ICD Codes Are a Universal Language

The World Health Organization publishes the ICD code to provide a standardized language for medical professionals around the globe that can transcend language barriers. The ICD provides a way to classify, record, and compare health data across nations and continents over time, which in turn, leads to effective data analysis and decision making by researchers and policy makers.

The ICD is Used to Update Medical Records

When a patient is diagnosed with a disease, treated for an illness, or displays unusual symptoms that require further investigation, that information is entered into their medical record via the ICD codes. This allows physicians and nurses to understand a patient’s particular case prior to their next visit. More importantly, it presents a means for accurate communication and consistent treatment among a team of doctors who might need to work together to treat a patient.

Insurance Companies Need the ICD Codes for Reimbursement

Once the medical records are updated, those same codes are put on the insurance claim that is filed by the medical biller. The insurance companies use the codes to check for policy coverage. If the illness or procedure is not covered by the policy, the claim will be rejected. If it is covered, the company will reimburse the medical facility for their services.

The ICD Helps Monitor Public Health

The ICD codes are also used to pull statistical data on diseases and health conditions. This information is crucial in times of public health crises, such as the pandemic, and can help save lives. The information can be used to monitor the long-term health of a population. It can also provide information that helps researchers and health professionals track the incidence and prevalence of diseases, monitor health trends, and identify the onset of an epidemic or pandemic. These kinds of data points are vital for public health planning and research.

Quality of Care Can Be Determined by the ICD Codes

Individuals and organizations that track the quality of medical care can also use the ICD codes in their work. The codes can reveal if there were accidental doses of the wrong medication, injuries from medical equipment, or near accidents. This information can help medical professionals implement better practices to improve the quality of care.

The ICD Codes Aid Medical Research

The ICD codes can also provide data that’s valuable to medical researchers. It can show them if there are spikes in certain types of illnesses, and where and when those spikes occurred. It can help them monitor patient outcomes and notice if a particular type of treatment is working. The codes can also help them track and identify patients who could be recruited for clinical trials.

ICD Code Structure

The ICD codes include a combination of three to seven letters and numbers that describe a particular disease, injury, allergen, symptom, or inpatient procedure. The first three characters represent the disease or injury and are followed by a decimal point. The final three characters provide greater detail about the severity of the health condition, the cause, or where it is located in the body. Here are a few examples:

G10. – Huntington’s Disease
G44.311 – Acute post-traumatic headache, intractable
E119 – Type II diabetes without complications
M80.021G — Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with delayed healing

Who Uses the ICD?

Physicians, nurses, health researchers, health information technology workers, and insurance agents all use the ICD in their daily work. Medical billers and coders use the ICD most frequently to update medical records and to file insurance claims. As a Medical Biller or Coder, you maintain and audit medical records for accuracy, file, track, and amend insurance claims, and process billing forms and payments. As a key member of the administration of a healthcare organization, you would ensure that your facility is properly paid for its services with the aid of the ICD.

Are you interested in Billing and Coding? Charter College offers an Associate of Applied Science in Medical Billing and Coding that can prepare you for entry-level work at a hospital, private practice, clinic, or insurance agency. The program is offered online and can be completed in as few as 15 months. Call 888-200-9942 or fill out the form for more information.

888.200.9942