Power Point Presentation OnICD 10 by Prof. Lutful Kabir

ICD-10

Prof. Dr. Lutful Kabir

SSMU

What is ICD-10: Introduction

• ICD stands for International Classification of Disease

• ICD contains only diagnosis codes • Developed by the World Health

Organization (WHO)• The current version of ICD-10 was

adopted by WHO in May 1990• WHO revises the ICD code-set periodically

ICD-10: Introduction cont’d

• There are three volumes of ICDVolume I: providing a tabular list of ICDVolume II: instruction manual on how to use

ICDVolume III: Alphabetical list of ICD• There are more than 14,400 different

codes in ICD-10. using optional sub-classifications, the codes can be expanded to over 16,000 codes.

ICD-10: Introduction cont’d

• 138 countries have implemented the ICD-10 code for mortality and 99 countries have also implemented ICD-10 code set for morbidity

• Individual country, on permission from WHO, may make modification to ICD-10 to meet individual country specific needs.

Why ICD ?

• ICD is used world-wide for morbidity and mortality statistics, reimbursement systems and automated decision support in medicine

• It promotes international comparability in the collection, processing, classification and presentation of these statistics

Why ICD cont’d ?

• Implementation of ICD will impact the entire chain of healthcare including patient registration, service delivery, patient care, scheduling, customer service, insurance, revenue and reimbursement management, network management and risk management

Advantages of implementing ICD-10

• Measuring the quality, safety and efficacy of care

• Making clinical decisions based on output from multiple systems

• Conducting research, epidemiological studies and clinical trials

• Comparability between health facilities, regions and countries

• Setting health policy• Designing health care delivery systems

Advantages of implementing ICD-10 cont’d• Monitoring resource mobilization

• Improving clinical, financial and administrative performance

• Identifying fraudulant or abusive practices

• Managing care and disease process

• Tracking public health and risks

• Providing data to consumers regarding costs and outcomes of treatment options

Why to write the ICD-10 code?

• ICD-10 codes will soon be introduced in the Bangladeshi hospitals both public and private

• Initially, ICD-10 codes will need to be reported for indoor patients

• The MIS-Health will ask respective hospitals for patient by patient reporting on indoor patients

• Use of ICD-10 codes will be integral part of patient care management

How to use ICD-10?

• It is easy to use a computer software to find ICD codes

• Those who will not be using computer software, the following are some tips to understand ICD

• The ICD code is sub-divided into :

chapters blocks 3-digit codes 4-digit codes

There are 22 chapters: -Chapters I to XVII list different diagnoses.-Chapters XVIII lists symptpms, signs and abnormal

laboratory findings that are not mentioned elsewhere-Chapter XIX lists injury, poisoning and certain other

consequences of external causes-Chapter XX lists external causes of morbidity and mortality-Chapter XXI lists factors influencing health status and

contact with health services-Chapter XXII keeps provision for inclusion of new codes

which are unavailable in the existing ICD

How to use ICD-10: Chapters

ICD-10: Examples of Chapters

Chapter I: Certain infectious and parasitic diseases

A00-A09 Intestinal infectious diseases

A15-A19 Tuberculosis

B15-B19 Viral hepatitis

B65-B83 Helminthiasis

How each ICD block is constituted?

• The block is an alphaneumeric character block

• The first character is a CAPITAL LETTER

• The next two characters are neumeric

Examples of ICD block codes

Blocks Diseases

A00 Cholera

A01 Typhoid and paratyphoid fevers

A03 Shigellosis

A06 Amoebiasis

A09 Diarrhoea and gastrointeritis of presumed infectious origin

ICD-10 Chapters, block and diseases: Examples

Chapter Block Title

I A00-B99 Certain infectious and parasitic diseases

X J00-J99 Diseases of the respiratory system

XV O00-O99 Pregnancy, child birth and the puerperium

3-digit code

• Block denotes the group of disease without specificity

3-digit code Name of the disease

A00 Cholera

A01 Typhoid and paratyphoid fevers

A02 Other salmonella infections

A06 Amoebiasis

3-digit Vs 4-digit codes • 3-digit codes are broadened into 4-digit code to

enhance the specificity• 4-digit code adds with the 3-digit code a dot (.)

plus another numeric character . The (.) mark is not a character

Example: A00 is Cholera• A00.0 is Cholera classical• A00.1 is Cholera el tor

4-digit code

3-digit code 4-digit code Name of the disease

A01 Typhoid and paratyphoid fevers

A01.0 Typhoid fever

Infection due to Salmonella typhi

A01.1 Paratyphoid fever A

A01.2 Paratyphoid fever B

A01.3 Paratyphoid fever C

Who is responsible to write ICD-10 code

• The immediate doctor in-charge of the patient will have the primary responsibility to write the ICD-10 code

• Otherwise, the doctor who is writing the discharge, referral or death certificate of the patient will have to write or complete the ICD-10 code

• The overall responsibility of writing ICD-10 codes in all case sheets will be the responsibility of the unit head

ICD-10 code documentation:

Accountability and use • The doctor writing the ICD-10 code should write

his/her name legibly so that s/he can be traced for clarification or completing the incomplete write up

• The complete case-sheet on discharge, referral or death of the patient will go to the medical record room for entry into national data base.

• In time, this will be done through hospital wards where the patient will receive the treatment

ICD-10: How to write ?

• It is advisable that each hospital ward will make a seal with the following information from hospital’s own local fund

• Simple clear and legible hand writing will also be allowed

ICD-10 code seal

Chapter No.

Block No.

3-digit code

Name of the disease

4-digit code

Name of the disease

Name of the doctor

Bronchiolitis : ICD-10

Chapter No. J

Block No. 21

3-digit code J21

Name of the disease Acute bronchiolitis

4-digit code J21.9

Name of the disease Acute bronchiolitis, unspecified

Name of the doctor DR ARM Luthful Kabir

ICD-10 code: Guide book and references

• One handbook accommodating only ICD-3 digit and 4-digit codes will be supplied

• The codes are mentioned in order of block, 3-digit codes and 4-digit codes (vide appendix)

• Websites: DGHS (www.dghs.gov.bd>document>icd10)

• WHO (http://int/classification/apps/icd/icd10online)

Writing medical certification of death

• It is now a necessity that Bangladeshi Hospitals will conform to the international standards of death certifications and

• Meet international obligation of death reporting for statistical purposes

• An Internationally Standard Medical Certification of Death Form needs to be filled up and to be enclosed with the deaseased’s case sheet in case of any death event

• The doctor writing the death certificate will have to complete the standard medical certificate form

How to complete the Standard Medical Certification of Death

• In most of the cases death depends on a chain of events that would follow the exact underlying cause gradually to immediate cause.

So, a Standard Medical Certification of Death may have 3 important sections

Part I: Statement on causes of death having direct relationSection 1: Disease or conditions directly leading to deathSection 2: Antecedent causes, morbid conditions, if any, giving rise to above

causePart II (Section 3) : Statement of conditions that may contribute to death but not

directly related to factors causing death

The cause of death will be the last line of Part I, and this will be translated into ICD-10

Please see an example of International Form of Medical Certification of Death In the page overleaf…………….

International Form of Medical Certification of Death

Causes of death Approx. interval between onset and death

I. Disease or conditions directly leading to death* Due to or as a consequence of

Minutes______

Antecedent causes

Morbid conditions, if any, giving rise to the abobe causes, stating the underlying condition last

(b)

Due to or as a consequence of

days________

II. Other significant conditions contributing to death, but not related to diseases or conditions causing it

___________________________

* This does not mean the mode of dying. e,g. heart failure, respiratory failure, injury or complications that caused death

Main diagnosis Other diagnosisPlease put tick appropriately

International Form of Medical Certification of Death

Causes of death Approx. interval between onset and death

I. Disease or conditions directly leading to death*

(a) Hyperkalemia

Due to or as a consequence of

Minutes______

Antecedent causes

Morbid conditions, if any, giving rise to the abobe causes, stating the underlying condition last

(b) Acute glomerulonephritis

Due to or as a consequence of

2 days________

II. Other significant conditions contributing to death, but not related to diseases or conditions causing it

___________________________

* This does not mean the mode of dying. e,g. heart failure, respiratory failure, injury or complications that caused death

Main diagnosis Other diagnosisPlease put tick appropriately

ICD-10 coding of cause of death

Chapter No. XIV

Block No. N00-N99

3-digit code N00

Name of the disease Acute nephritic syndrome

4-digit code N00.9

Name of the disease Acute nephritic syndrome, unspecified

Name of the doctor DR ARM Luthful Kabir