Medical classification

Medical classification, or medical coding, is the process of transforming descriptions of

medical diagnoses and procedures into universal medical code numbers. The diagnoses and
procedures are usually taken from a variety of sources within the health care record, such as the
transcription of the physician's notes, laboratory results, radiologic results, and other sources.
Diagnosis codes are used to track diseases and other health conditions, whether they are chronic
diseases such as diabetes mellitus and heart disease, to contagious diseases such asnorovirus,
the flu, and athlete's foot. These diagnosis and procedure codes are used by government health
programs, private health insurance companies, workers' compensation carriers and others.
Medical classification systems are used for a variety of applications in medicine, public
health and medical informatics, including:

statistical analysis of diseases and therapeutic actions

knowledge-based and decision support systems

direct surveillance of epidemic or pandemic outbreaks

reimbursement; e.g., based on diagnosis-related groups

Classification types
Many different medical classifications exist, though they occur into two main
groupings: Statistical classifications and Nomenclatures.
A statistical classification brings together similar clinical concepts and groups them into
categories. The number of categories is limited so that the classification does not become too
big. An example of this is the International Statistical Classification of Diseases and Related
Health Problems (known as ICD). It groups diseases of the circulatory system into one "chapter"
(known as Chapter IX, covering codes I00I99). Within this chapter, there is for instance, code
I47.1. The code title (rubric) is Supraventricular tachycardia. However, there are several other
clinical concepts that are also classified here. Among them are paroxysmal atrial tachycardia,
paroxysmal junctional tachycardia, auricular tachycardia and nodal tachycardia.
Another feature of statistical classifications is the provision of residual categories for "other" and
"unspecified" conditions that do not have a specific category in the particular classification.
In a nomenclature there is a separate listing and code for every clinical concept. So, in the
previous example, each of the tachycardia listed would have its own code. This makes
nomenclatures unwieldy for compiling health statistics.
Types of coding systems specific to health care include:

Diagnostic codes

Pharmaceutical codes

Topographical codes

Procedural codes

[edit]WHO Family of International Classifications

The World Health Organization (WHO) maintains several internationally endorsed classifications
designed to facilitate the comparison of health related data within and across populations and
over time as well as the compilation of nationally consistent data.[1] This "Family of International
Classifications" (FIC) include three main (or reference) classifications on basic parameters

of health prepared by the organization and approved by the World Health Assembly for
international use, as well as a number of derived and related classifications providing additional
details. Some of these international standards have been revised and adapted by countries for
national use.

[edit]Reference classifications

International Statistical Classification of Diseases and Related Health

Problems (ICD)[2]

ICD-9 (9th revision, published in 1977)

ICD-9-CM (Clinical Modification, used in the US)

ICD-10 (10th revision, in use by WHO since 1994)

ICD-10-CM (Clinical Modification, used in the US)

ICD-10-PCS (Procedure Coding System, used in the US)

ICD-10-CA (used for morbidity classification in Canada).[3]

ICD-10-AM (used in Australia and New Zealand)[4]

EUROCAT - an extension of the ICD-10 Q chapter for congenital disorders

International Classification of Functioning, Disability and Health (ICF)

International Classification of Health Interventions (ICHI) (previously known as
International Classification of Procedures in Medicine)[5]

[edit]Derived classifications
Derived classifications are based on the WHO reference classifications (i.e. ICD and ICF).[1] They
include:

International Classification of Diseases for Oncology, Third Edition (ICD-O-3)

ICD-10 for Mental and Behavioural Disorders[6]

Application of the International Classification of Diseases to Dentistry and Stomatology,

3rd Edition (ICD-DA)[7]

Application of the International Classification of Diseases to Neurology (ICD-10-NA)[8]

[edit]Related classifications
Related classifications in the WHO-FIC are those that partially refer to the reference
classifications, e.g. only at specific levels.[1] They include:

International Classification of Primary Care (ICPC)[9]

ICPC-2 PLUS
International Classification of External Causes of Injury (ICECI)[10]

Anatomical Therapeutic Chemical Classification System with Defined Daily Doses

(ATC/DDD)

Technical aids for persons with disabilities: Classification and terminology (ISO9999)[11]

International Classification for Nursing Practice (ICNP)[12]

[edit]Other medical classifications

[edit]Diagnosis
The categories in a diagnosis classification classify [ and medical signs. In addition to the ICD and
its national variants, they include:

Diagnostic and Statistical Manual of Mental Disorders (DSM)

DSM-IV Codes

International Classification of Headache Disorders 2nd Edition (ICHD-II)[13]

International Classification of Sleep Disorders (ICSD)

Online Mendelian Inheritance in Man, database of genetic codes

Read codes

Systematized Nomenclature of Medicine - Clinical Terms (SNoMed-CT)

[edit]Procedure
The categories in a procedure classification classify specific health interventions undertaken
by health professionals. In addition to the ICHI and ICPC, they include:

Australian Classification of Health Interventions (ACHI)

Canadian Classification of Health Interventions (CCHI)

Canadian Classification of Health Interventions (CCI)

Chinese Classification of Heath Interventions (CCHI)

Current Procedural Terminology (CPT)

Health Care Procedure Coding System (HCPCS)

ICD-10 Procedure Coding System (ICD-10-PCS)

[14]

Office of Population, Censuses and Surveys Classification of Surgical Operations and

Procedures (OPCS-4)

[edit]Other

Classification of Pharmaco-Therapeutic Referrals (CPR)

Logical Observation Identifiers Names and Codes (LOINC), standard for identifying medical
laboratory observations
Medical Dictionary for Regulatory Activities (MedDRA)

Medical Subject Headings (MeSH)

List of MeSH codes

Nursing Interventions Classification (NIC)

Nursing Outcomes Classification (NOC)

TIME-ITEM, ontology of topics in medical education

TNM Classification of Malignant Tumors

Unified Medical Language System (UMLS)

Victoria Ambulatory Coding System (VACS) / Queensland Ambulatory Coding System

(QACS), Australia[citation needed