PRODUCED BY THE WORLD HEALTH ORGANIZATION

The ICD has been evolving for more than 100 years as a

SYSTEMATIC CODING SYSTEM.

-it is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems commonly known as ICD - 10

-it is used in clinical coding

-it is the translation of diseases, health related problems and procedural concepts from text to alphabetic/numeric codes for storage, retrieval and analysis

-it is a system of categories or groupings to which diseases, injuries, conditions and procedures are assigned according to established criteria

ICD-10 is a statistical classification, which means that it contains limited number of mutually exclusive code categories describing all disease concepts.

To allow easy storage, retrieval and analysis of data

To allow comparison of data between hospitals, provinces, regions and countries

Consistent use of ICD-10 codes allows comparative/accurate statistics – quality statistics to be produced...

INDIAPHILIPPINES

HOSP. A HOSP. B Region 2

CAR

ICD-10 codes are used to generate

statistics for Morbidity and Mortality.

HOW?• provides clues for causes of

disease• evaluation of previous

treatments• review of previous public health

initiatives or programs• aid health services planning

decisions

Epidemiology

Medical Care Management

1. There are three (3) Volumes

Volume 1 (Tabular List)

It is an alphanumeric listing of diseases and disease groups along with inclusion and exclusion notes and other coding conventions

Volume 2

It provides:1. an introduction and instructions on

the use of Volumes 1 and 3

2. Guidelines in morbidity and mortality coding

Volume 3

It is a comprehensive Alphabetical Index of diseases and conditions found in the Tabular List

2. There are 21 Chapters

The number of categories assigned

to a Chapter is influenced by the number of diseases and conditions that fall within the scope of the Chapter

3. The structure of the ICD-10 code is alphanumeric:

The first character of the code is an alpha character followed by 2 , 3 or 4 numeric characters

Examples: A90 A00.0 M79.09

The ICD-10 follows certain conventions in order to provide information in a consistent manner. These conventions fall into several categories namely:

Instructional Notes: Inclusion, Exclusion Glossary descriptions Dual coding Use of additional code/s

Punctuation marks Abbreviations Relational terms

“And” “With”, “Without” “Due to”, “Resulting in”

1. Review diagnostic statements and case notes to identify main condition and other conditions

2. Locate the lead term and modifiers in Volume 3 (Alphabetical Index)

3. Follow cross reference terms such as “see” and “see also”

4. Refer to Volume 1 (Tabular List) to verify the code given by the Alphabetical Index

5. Follow all applicable coding conventions found in the Tabular List

6. Finally, ASSIGN THE CODE

In 1998, the Department of Health (DOH) resolved to adopt the ICD-10 in Philippine hospitals and registries to improve existing health statistics

DOH Administrative Order No. 47 s. 2000 mandates all hospitals to implement ICD-

10 coding beginning January 01, 2001.

To complement this Administrative Order, PhilHealth issued Circular No. 04 s. 2001

mandating all accredited providers to code their claims beginning July 01, 2001.

In 1997, WHO sponsored an ICD-10 Train the Trainors seminar/workshop. A workshop on the development of the Student Manual was also conducted.

The DOH started to conduct ICD-10 Trainings

The National Epidemiology Center together with the Bureau of Health Facilities and

Services, National Center for Health Facility Development of the DOH and PhilHealth, have been tasked to provide intensive

training courses on ICD-10 Coding to all concerned.

Two Training Modules were developed by the National ICD-10 Program:

• Non-Coders Training (3 days)• Coders Training (5 days)

ICD-10 Coding Guidelines were developed by the ICD-10 National Technical Working

Group in consultation with the concerned Medical Specialty Societies

Department Circular No. 33, s. 2004 was signed by then Health Secretary Manuel M.

Dayrit for the dissemination of the said guidelines

ICD-10 Coding Guidelines:• No. 001- Pregnancy, Childbirth and the

Puerperium• No. 002- Cataract and Disorders of Lens• No. 003- Influenza• No. 004- Pneumonia• No. 005- Pulmonary Tuberculosis• No. 006- Conditions with No Direct Index

This year , the “ICD-10 Philippine Modification” will be launched to assist coder in the coding certain conditions/diseases common in the country

2. Incomplete Translation• Outcome of Delivery not coded• Missing fourth and fifth digit category• No Morphology and Behaviour Code

1. Unfamiliarity of the ICD-10 Philippine Modifications

3. Failure to follow the ICD-10 Conventions.(site of musculo-skeletal involvement, laterality, exclusions, etc.)

4. Requiring the Physicians to adopt the ICD-10 category titles as diagnostic statements

Note: ICD is a classification, therefore, category title may represent a specific diagnosis or it may also appear as a general terminology for a group of related conditions/diseases/circumstances.

Example: Dengue Fever

Other Disorders of the Lung

1.Always write the complete and correct diagnoses for the main condition and

other conditions or the correct sequence of events for mortality cases to enable the coder (medical records officer) to apply the appropriate rule/s and arrive at the correct set of codes.

2. In diagnosing injuries, provide the nature of the injury, the circumstances that caused the injury including the place of occurrence, and the activity of the injured. Follow the guidance in coding injury and poisoning.

3. In diagnosing neoplasms, provide the site, morphology and behaviour of the cancer.

4. In diagnosing infections, provide the etiologic

agent, if possible.5. Specify if the condition is a late effect or a

sequelae of another condition.

6. Specify the offending agent (chemical or drug) when diagnosing poisoning or adverse reactions.

CONDITIONSICD-10 CODE

A90 dengue, dengue fever, dengue fever syndrome

A91.0 dengue hemorrhagic fever stage 1, DHF I, dengue stage I

A91.1 dengue hemorrhagic fever stage 2, DHF II, dengue stage II

A91.2 dengue hemorrhagic fever stage 3, DHF III, dengue stage III

A91.3 dengue hemorrhagic fever stage 4, DSS, dengue stage IV

A91.9 dengue hemorrhagic fever stage unspecified, dengue hemorrhagic fever

CONDITIONSICD-10 CODE

A09.9 AGE; AGE with DHN; acute gastroenteritis with DHN

A09.1 AGE with moderate/marked dehydration

A09.2 AGE with severe dehydration

A09.3 AGE with no signs dehydration

A09.0 AGE with some/mild dehydration

CONDITIONSICD-10 CODE

I10.9 Hypertension, HPN, HTN

I10.0 Stage I

I10.1 Stage II

I10.2 Stage III

I10.3 Stage IV

CONDITIONSICD-10 CODE

Pulmonary Tuberculosis [PTB] Class 1,2

Z20.1

Pulmonary Tuberculosis [PTB] Class 3 by sputum confirmation

A15.0

Pulmonary Tuberculosis [PTB]Pulmonary Tuberculosis [PTB] Class 2,3,5 by x-ray confirmation

A16.2

Pulmonary Tuberculosis [PTB] Class 5

Z03.0

Systemic Viral Infection (SVI)

B 34.9

Typhoid FeverA01.0

Acid Peptic DiseaseK31.8

Bronchial Asthma in Acute Exacerbation (BAIAE)

J45.9

Community Acquired Pneumonia (CAP)

J18.9

ChostocondritisM94.88

Diagnoses/Conditions ICD-10 CodeChronic Respiratory Insufficiency R06.8

Diabetic Gastropathy E14.4

Diabetic Hypermotility E14.4

Diabetic Macrovascular Disease E14.7, I21.9, I63.9

Gastropathy K31.9

Metabolic Encephalopathy G93.4† E90*

Multiple Organ Failure R68.8

NSAID Gastropathy K31.9, Y56.0

Renal Scar N28.9

Soft Tissue Mass M35.9

Soft Tissue Rheumatism M79.09