Health Language Blog

Health Language (June) “Did You Know?”

Posted on 06/30/13



We are excited to announce the launch of a new blog series called “Did You Know?” that will include one post each month on an interesting fact that you might not know about clinical terminology management, standardized vocabularies, industry regulations and more!

Health Language's first post in the series is inspired by the current push toward ICD-10 implementation among providers and payers: we go back in time to take a closer look at the history of disease classification. ICD-10 represents the tenth revision of the International Classification of Diseases whose origins go back to the first International Statistical Congress, held in Brussels in 1853.

According to “History of the Development of the ICD,” it was at this congress that William Farr of England, and Marc d’Espine of Geneva presented internationally applicable, uniform classifications of causes of death. The two men subscribed to different principles for classifications and at a subsequent congress, proposed separate lists. The Congress accepted a list that combined both approaches, and it was revised four times. While not universally acknowledged, Farr’s classification, based on the principle of classifying diseases by anatomical site, ultimately served as a model for the International List of Causes of Death.

Additionally, many of the driving forces for the creation of the ICD go back to the need to capture reasons for death by tuberculosis, and this is why a large number of codes in ICD-9 relate to this particular disease. With the transition to ICD-10, there will be fewer codes associated with tuberculosis because it is no longer a significant epidemiological issue.

As described in a 2011 report from the National Center for Health Statistics, the official resolution for the International List of Causes of Death was passed at the 1899 International Statistical Institute (ISI) session held in Christiania and was based on the cause of death nomenclature presented in 1893 by Jacques Bertillon, Chief of Statistical Services of the City of Paris.

From there, it was determined that the list would be examined and revised every ten years, though it was later decided that this interval between revisions was too short. This pattern of revisions established in 1899 has led us to the tenth revision and the current overhaul of the ICD code set scheduled for October 1, 2014.

While ICD has undergone many changes throughout its history, its intent to provide a universal naming and classification system remains just as important for healthcare today as it was in the 19th century. However, its role in the United States has certainly evolved to be more relevant for billing rather than epidemiology, especially as we enter into a new era of healthcare where granularity will be essential for value-based reimbursement.

*Background materials for this post included “History of the Development of the ICD” by the World Health Organization and “History of the Statistical Classification of Diseases and Causes of Death” by the National Center for Health Statistics.

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Topics: ICD-10, Medical vocabulary, ICD-10 Transition, ICD-9 to ICD-10, clinical terminology management, ICD-10 implementation, Standardized vocabularies, Dr. Brian Levy

About the Author

Dr. Brian Levy, MD is Vice President and Chief Medical Officer with Health Language, part of Wolters Kluwer Health. He holds an MD and BS from the University of Michigan. Go Blue!