ICD coding for rare diseases
The International Classification of Diseases (ICD) is the code used for the purpose of documenting a person's medical condition. It is usually important for health insurance reimbursement, administration, epidemiology, and research. Of the approximately 7,000 rare diseases, only about 500 have a specific code. An ICD code is needed for a person's medical records—it is important for health insurance reimbursement, administration, epidemiology, and research. Finding the best ICD code for a patient who has a rare disease can be a challenge.[1]
Different versions of the ICD code exist worldwide. The United States currently uses the ICD-10-CM, a Clinical Modification of the WHO standard for diagnoses adapted for insurance reimbursement and billing purposes. This version allows for further breakdown of a code, which increases diagnosis specificity. Currently, published material that reference ICD-9-CM codes, which were used before October 1, 2015; however, not every code in the ICD-9-CM has a corresponding code in ICD-10-CM. Europe and other parts of the world use the ICD-10. The root codes for ICD-10 and ICD-10-CM are the same, making it helpful for locating codes for general body systems and disease processes.[1]
A good place to start is to contact an advocacy organization for the rare disease. These organizations are often aware of how the condition has been coded for other patients with the same diagnosis and may be able to recommend one or more codes to use. Many disease advocacy organizations also have medical advisory boards or physician directories, which can help to find someone with experience coding for that particular condition. A search can be done on the GARD website for a list of disease advocacy organizations. A GARD Information Specialist can be contacted directly for assistance.[1]
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Orphanet outlines the ICD-10 coding rules for rare diseases included in their database. The Orphanet database also often includes coding information for the Online Mendelian Inheritance in Man (OMIM), the Unified Medical Language System (UMLS), and more. When a diagnosis has not been established, or when a code does not exist for a specific rare disease, general coding guidelines indicate that it is acceptable to use codes that describe signs and symptoms.[1]
Other versions
Several online resources can help locate ICD codes:
- WHO ICD-10 Version: 2016 – A searchable online version of ICD-10 that allows users to search by hierarchy or by entering the disease name.[2]
- List of Official ICD-10 Updates - ICD-10 updates endorsed by the WHO.[3]
- ICD10Data.com – A website created to make it easier to quickly find medical coding information. The website is also smartphone- and tablet-friendly.[4]
- Orphanet – A European reference portal for information on rare diseases and orphan drugs that includes ICD-10 codes, disease summaries, prevalence data, and more. Some of the ICD-10 codes given to a disease are assigned by Orphanet and not the WHO.[5][1]
See also
Wikisource has original text related to this article: |
References
- 1 2 3 4 5 "ICD Coding for Rare Disease". 24 June 2016. Retrieved 25 July 2017.
This article incorporates text from this source, which is in the public domain. - ↑ "ICD-10 Version:2016". apps.who.int.
- ↑ "List of Official ICD-10 Updates". World Health Organization.
- ↑ "The Web's Free 2017 ICD-10-CM/PCS Medical Coding Reference". www.icd10data.com.
- ↑ RESERVED, INSERM US14 -- ALL RIGHTS. "Orphanet: Search a disease". www.orpha.net.
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Diagnostic codes |
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Procedural codes | |||||
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Outcomes codes |
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CNS |
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PNS |
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Surgery and IC |
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Diagnostic tests and procedures |
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Function tests | |||||||
Pacing |
Vascular and Endovascular surgery |
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Medical imaging |
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Other diagnostic |
Operations/surgeries and other procedures of the blood and lymphatic system (ICD-9-CM V3 40–41, ICD-10-PCS 07) | |
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Bone marrow | |
Thymus | |
Spleen | |
Lymph nodes | |
Tonsils |
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Imaging |
Outer ear | |
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Middle ear | |
Inner ear | |
Diagnosis |
Mouth |
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Oropharynx |
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Tests, surgery and other procedures involving the respiratory system (ICD-9-CM V3 21–22, 30–34, ICD-10-PCS 0B) | |
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Upper RT | |
Lower RT | |
Chest wall, pleura, mediastinum, and diaphragm | |
Medical imaging | |
CPRs | |
Lung function test | |
Cytology | |
Respiratory therapy/ intubation |
Digestive tract |
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Accessory |
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Abdominopelvic |
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CPRs |
Pancreas |
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Pituitary | |
Thyroid | |
Adrenal gland | |
Pineal gland |
Operations/surgeries and other procedures of the skin and subcutaneous tissue (ICD-9-CM V3 86, ICD-10-PCS 0H) | |||||||
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Skin | |||||||
Hair |
Orthopedic surgery, operations/surgeries and other procedures on muscle/soft tissue (ICD-9-CM V3 82–84, ICD-10-PCS 0K–L) | |||||||||
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Muscle, tendon, fascia, and bursa |
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Other |
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Orthopedic surgery, operations/surgeries and other procedures on bones and joints (ICD-9-CM V3 76–81, ICD-10-PCS 0P–S) | |||||||||||
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Bones |
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Cartilage | |||||||||||
Joints |
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Kidney | |||||
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Ureter | |||||
Urinary bladder | |||||
Urethra | |||||
General |
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Female genital surgical and other procedures (gynecological surgery) (ICD-9-CM V3 65–71, ICD-10-PCS 0U) | |||||||||||
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Adnexa |
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Uterus |
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Vagina | |||||||||||
Vulva | |||||||||||
Medical imaging |
Internal |
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External |
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Tests |
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Diagnostic |
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Intervention | |||||||||||||
Delivery |
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Medical placement and administration procedures (ICD-9-CM V3 96, ICD-10-PCS 2-3) | |
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Intubation | |
Therapeutic irrigation |
Extracorporeal assistance, performance, and therapy (ICD-9-CM V3 99, ICD-10-PCS 5-6) | |
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Ultraviolet light therapy | |
Other |
Chiropractic | |
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Techniques | |
Education | |
Accrediting bodies | |
International organizations | |
People | |
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X-ray/ Radiography |
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MRI | |||||||||||||||
Ultrasound | |||||||||||||||
Radionuclide |
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Thermography |
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Specific therapies |
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Conditions | |||||||||||||||
Features and equipment |
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Physical therapy and rehabilitation (ICD-9-CM V3 93, ICD-10-PCS F) | |
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Physical rehabilitation disciplines | |
Education | |
Intervention techniques |
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Professional associations and regulatory agencies |
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Other related articles |
Schools |
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Approaches | |||||||||||
Research | |||||||||||
Techniques |
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People |
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