ICD-9 codes are used to classify diagnoses of patients around the world. They are usually denoted by a two-or three-digit number, sometimes followed by one or two digits after a dot. Sometimes they begin with an alpha character instead. This gives physicians the ability to not only show the primary diseases, but all other diseases and maladies that might have been a contributing factor.
The ICD-9 codes beginning with two digits denote what's known as surgical procedure codes. Hospitals and physicians are allowed to use these codes instead of using CPT-4, or regular procedure codes, though for Medicare they have to officially declare which way they'll be submitting the codes to get claims processed properly.
History of ICD
The history of ICD goes back to the 17th century. A statistician named John Graunt created what was called the London Bills of Mortuary to try to categorize how people were dying. It wasn't overly sophisticated, since he wasn't a physician, but it served his purpose.
It wasn't until William Farr in 1837 when the classifications of diseases started to take on a more formal look. Farr, a medical statistician, created the first principles of classification are based on today. Although they weren't fully agreed upon, they have remained as the base for the International List of Causes of Death.
In 1977, the ninth revision of ICD came out, and that's where we get the term ICD-9 from. It had been agreed up by the World Health Organization that there would be revisions every 10 years. A request was put through in 1985 to delay it to 1989, but there hasn't been universal agreement on its principles or setup. There is still no implementation date for ICD-10 in the United States, but most countries around the world are already using it.
Classifications
The first is the Classification of Diseases and Injuries. Every medical claim submitted must have at least one of these codes on it. For surgical and inpatient claims, it is expected that those bills will have multiple codes, listed in order of severity and complicity in diagnosing the patient's malady.
The second is the Classification of Procedures, what we referred to earlier as surgical procedure codes. If used, these codes need to be present on any surgical claims, or any claims where a surgical procedure might have taken place, such as an inpatient stay.
Classification of Diseases and Injuries
The list below is the general index of diseases, based on numerical order:
Infectious And Parasitic Diseases (001-139)
Neoplasms (140-239)
Endocrine, Nutritional And Metabolic Diseases, And Immunity Disorders (240-279)
Diseases Of The Blood And Blood-Forming Organs (280-289)
Mental Disorders (290-319)
Diseases Of The Nervous System And Sense Organs (320-389)
Diseases Of The Circulatory System (390-459)
Diseases Of The Respiratory System (460-519)
Diseases Of The Digestive System (520-579)
Diseases Of The Genitourinary System (580-629)
Complications Of Pregnancy, Childbirth, And The Puerperium (630-679)
Diseases Of The Skin And Subcutaneous Tissue (680-709)
Diseases Of The Musculoskeletal System And Connective Tissue (710-739)
Congenital Anomalies (740-759)
Certain Conditions Originating In The Perinatal Period (760-779)
Symptoms, Signs, And Ill-Defined Conditions (780-799)
Injury And Poisoning (800-999)
Supplementary Classification Of Factors Influencing Health Status And Contact With Health Services (V01-V89)
Supplementary Classification Of External Causes Of Injury And Poisoning (E800-E999)
Classification of Procedures
The list below is the general index of surgical procedures, based on numerical order:
Procedures And Interventions , Not Elsewhere Classified (00)
Operations On The Nervous System (01-05)
Operations On The Endocrine System (06-07)
Operations On The Eye (08-16)
Other Miscellaneous Diagnostic And Therapeutic Procedures (17)
Operations On The Ear (18-20)
Operations On The Nose, Mouth, And Pharynx (21-29)
Operations On The Respiratory System (30-34)
Operations On The Cardiovascular System (35-39)
Operations On The Hemic And Lymphatic System (40-41)
Operations On The Digestive System (42-54)
Operations On The Urinary System (55-59)
Operations On The Male Genital Organs (60-64)
Operations On The Female Genital Organs (65-71)
Obstetrical Procedures (72-75)
Operations On The Musculoskeletal System (76-84)
Operations On The Integumentary System (85-86)
Miscellaneous Diagnostic And Therapeutic Procedures (87-99)
Billing of ICD-9 Codes
There must be at least one ICD-9 code on every claim that goes out, whether bills are submitted on a UB-04, a an HFCA-1500 form, or electronically. Often, insurance companies require approval of procedures before they're performed. They require both ICD-9 and CPT-4 codes for their determination, and it's imperative for physicians to add as many codes for each to give them a better opportunity for getting these procedures approved.
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