Medical classification

From Vero - Wikipedia
Jump to navigation Jump to search

Template:Short description A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. Diagnosis classifications list diagnosis codes, which are used to track diseases and other health conditions, inclusive of chronic diseases such as diabetes mellitus and heart disease, and infectious diseases such as norovirus, the flu, and athlete's foot. Procedure classifications list procedure codes, which are used to capture interventional data. These diagnosis and procedure codes are used by health care providers, government health programs, private health insurance companies, workers' compensation carriers, software developers, and others for a variety of applications in medicine, public health and medical informatics, including:

There are country specific standards and international classification systems.

Classification types

Many different medical classifications exist, though they occur in 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 used by the International Statistical Classification of Diseases and Related Health Problems (known as ICD). ICD-10 groups diseases of the circulatory system into one "chapter", known as Chapter Template:Rn, covering codes I00–I99. One of the codes in this chapter (I47.1) has the code title (rubric) 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 listed tachycardias would have its own code. This makes nomenclatures unwieldy for compiling health statistics.

Types of coding systems specific to health care include:

  • Diagnostic codes
    • Are used to determine diseases, disorders, and symptoms
    • Can be used to measure morbidity and mortality
    • Examples: ICD-9-CM, ICD-10, ICD-11<ref name=":0">{{#invoke:citation/CS1|citation

|CitationClass=web }}</ref>

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.<ref name="WHO-FIC">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> This "Family of International Classifications" (FIC) includes 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 various countries for national use.

Reference classifications

|CitationClass=web }}</ref>

    • ICD-10 (International classification of diseases, 10th revision) – effective from 1 January 1993.<ref>{{#invoke:citation/CS1|citation

|CitationClass=web }}</ref> Although Version:2019 was the last update, and ICD-11 is now available, the World Health Organization is still accepting data reported using ICD-10 from member states yet to make the switch to ICD-11.

    • ICD-11 (International classification of diseases, 11th revision) – available for reporting data to WHO since 1 January 2022<ref>{{#invoke:citation/CS1|citation

|CitationClass=web }}</ref>

Derived classifications

Derived classifications are based on the WHO reference classifications (i.e., ICD and ICF).<ref name="WHO-FIC"/> They include the following:

|CitationClass=web }}</ref> and is available as two variants;

    • Clinical descriptions and diagnostic guidelines,<ref>{{#invoke:citation/CS1|citation

|CitationClass=web }}</ref> also known as the blue book.<ref name="bluegreen" />

    • Diagnostic criteria for research,<ref>{{#invoke:citation/CS1|citation

|CitationClass=web }}</ref> also known as the green book.<ref name="bluegreen" />

National versions

Template:See also Several countries have developed their own version of WHO-FIC publications, which go beyond a local language translation. Many of these are based on the ICD:

Related classifications in the WHO-FIC are those that partially refer to the reference classifications, e.g., only at specific levels.<ref name="WHO-FIC"/> They include:

|CitationClass=web }}</ref>

|CitationClass=web }}</ref>

Historic FIC classifications

ICD versions before ICD-9 are not in use anywhere.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> ICD-9 was published in 1977, and superseded by ICD-10 in 1994. The last version of ICD-10 was published in 2019, and it was replaced by ICD-11 on 1 January 2022.<ref name=WHO-FIC_ICD11 /> Template:As of 35 of the 194 member states have made the transition to the latest version of the ICD.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

The International Classification of Procedures in Medicine (ICPM) is a procedural classification that has not updated since 1989, and will be replaced by ICHI.<ref name=WHO-FIC-ICHI>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> National adaptions of the ICPM includes OPS-301, which is the official German procedural classification.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

International Classification of External Causes of Injury (ICECI) was last updated in 2003 and, with the development ICD-11, is no longer maintained.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> The concepts of ICECI are represented within ICD-11 as extension codes.

Other medical classifications

Diagnosis

{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} The categories in a diagnosis classification classify diseases, disorders, symptoms and medical signs. In addition to the ICD and its national variants, they include:

Procedure

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

Drugs

Drugs are often grouped into drug classes. Such classifications include:

National Drug File-Reference Terminology (NDF-RT)

National Drug File-Reference Terminology was a terminology maintained by the Veterans Health Administration (VHA). It groups drug concepts into classes. It was part of RxNorm until March 2018.

Medication Reference Terminology (MED-RT)

Medication Reference Terminology (MED-RT) is a terminology created and maintained by Veterans Health Administration in the United States.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> In 2018, it replaced NDF-RT that was used during 2005–2017. Med-RT is not included in RxNorm but is included in National Library of Medicine's UMLS Metathesaurus. Prior 2017, NDF-RT was included in RxNorm. The first release of MED-RT was in the spring of 2018.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>[1]</ref><ref>https://www.fda.gov/media/136460/download</ref><ref>[2]</ref>

Medical Devices

Other

Library classification that have medical components

ICD, SNOMED and Electronic Health Record (EHR)

SNOMED

The Systematized Nomenclature of Medicine (SNOMED) is the most widely recognised nomenclature in healthcare.<ref name="ihtsdo.org">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Its current version, SNOMED Clinical Terms (SNOMED CT), is intended to provide a set of concepts and relationships that offers a common reference point for comparison and aggregation of data about the health care process.<ref name="nih.gov">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> SNOMED CT is often described as a reference terminology.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> SNOMED CT contains more than 311,000 active concepts with unique meanings and formal logic-based definitions organised into hierarchies.<ref name="nih.gov"/> SNOMED CT can be used by anyone with an Affiliate License, 40 low income countries defined by the World Bank or qualifying research, humanitarian and charitable projects.<ref name="nih.gov"/> SNOMED CT is designed to be managed by computer, and it is a complex relationship concepts.<ref name="ihtsdo.org"/>

ICD

The International Classification of Disease (ICD) is the most widely recognized medical classification. Maintained by the World Health Organization (WHO),<ref name="Electronic Health Records: A Practical Guide for Professionals and Organizations.">Margret K. Amatayakul, MBA, RHIA, CHPS, CPHIT, CPEHR&FHIMSS.(2009).Electronic Health Records: A Practical Guide for Professionals and Organizations.Chicago, America:AHIMA</ref> its primary purpose is to categorise diseases for morbidity and mortality reporting. However the coded data is often used for other purposes too; including reimbursement practices such as medical billing. ICD has a hierarchical structure, and coding in this context, is the term applied when representations are assigned to the words they represent.<ref name="Electronic Health Records: A Practical Guide for Professionals and Organizations."/> Coding diagnoses and procedures is the assignment of codes from a code set that follows the rules of the underlying classification or other coding guidelines. The current version of the ICD, ICD-10, was endorsed by WHO in 1990. WHO Member states began using the ICD-10 classification system from 1994 for both morbidity and mortality reporting. The exception was the US, who only began using it for reporting mortality in 1999 whilst continuing to use ICD-9-CM for morbidity reporting. The US only adopted its version of ICD-10 in October 2015. The delay meant it was unable to compare US morbidity data with the rest of the world during this period. The next major version of the ICD, ICD-11, was ratified by the 72nd World Health Assembly on 25 May 2019, and member countries have been able to report data using ICD-11 codes since 1 January 2022.<ref name=WHO-FIC_ICD11>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> ICD-11 is a fully digital product with integration of clinical terminology and classification. It allows documentation at any level of detail. It includes extension codes, a terminology system, with medicaments, chemicals, infections agents, histopathology, anatomy and mechanisms, objects and animals, and other elements that serve to describe sources of injury or harm.

Comparison

SNOMED CT and ICD were originally designed for different purposes and each should be used for the purposes for which they were designed.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> As a core terminology for the EHR, SNOMED CT and ICD-11 provide a common language that enables a consistent way of capturing, and sharing health data across specialities and sites of care. SNOMED is a highly detailed terminology designed for input not reporting, without a specific use case. ICD-11 and SNOMED, are clinically based, and document whatever is needed for patient care. In contrast to SNOMED, ICD-11 allows full clinical documentation while permitting internationally agreed statistical aggregation for specific use cases. The foundation of ICD-11 together with the WHO Classification of Health Interventions (ICHI) and the WHO Classification for Functioning, Disability and Health (ICF), comprising also the WHO lists of anatomy, substances and more, are a complete ecosystem for lossless documentation in digital records and at the same time they address specific usecases for data aggregation in a multilingual, freely usable way. SNOMED CT and ICD are used directly by healthcare providers during the process of care,<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> in addition, ICD can be also used for coding after the episode of care, in lower technology environments. SNOMED CT has multiple hierarchy, whereas there is single primary hierarchy for ICD-11 with alternative multiple hierarchies. SNOMED CT concepts are defined logically by their attributes, as is the case in ICD-11, that in addition has textual rules and definitions.

Data Mapping

SNOMED and ICD can be coordinated. The National Library of Medicine (NLM) maps ICD-9-CM, ICD-10-CM, ICD-10-PCS, and other classification systems to SNOMED.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Data Mapping is the process of identifying relationships between two distinct data models.<ref name="Electronic Health Records: A Practical Guide for Professionals and Organizations."/>

Veterinary medical coding

Template:Expand section Veterinary medical codes include the VeNom Coding Group, the U.S. Animal Hospital Codes, and the Veterinary Extension to SNOMED CT (VetSCT).Template:Citation needed

See also

Template:Col div

Template:Colend

References

Template:Reflist

Template:Sister project

Template:Medical classification Template:Health informatics

Retrieved from "https://wiki.sarg.dev/index.php?title=Medical_classification&oldid=629939"