Historically, ICD-9-CM was developed as a classification system for statistical compilation of data in inpatient settings. Unfortunately, it has proven to be inadequate for use in other healthcare settings and even for reimbursement purposes. The cornerstone of DRGs, RUGs, and other prospective payment groups is the ICD-9-CM code. Even non-PPS payment methodologies require complete, accurate, and detailed coding in order to calculate appropriate reimbursement rates, determine coverage, and establish medical necessity.
Keeping all of the problems encountered with ICD-9 in mind, it becomes quite clear that a classification system that provides greater coding accuracy and specificity is greatly needed. Several other organizations have called for Congress to adopt ICD-10-CM, including the American Hospital Association, the Advanced Medical Technology Association, the American Psychiatric Association, and the Federation of American Hospitals.
In 1994, WHO developed the tenth revision of the ICD system. The purpose of the revision was to expand the content, purpose, and scope of the system and to include ambulatory care services, increase clinical detail, capture risk factors in primary care, include emergent diseases, and group diagnoses for epidemiological purposes.
In 1997, the National Center for Health Statistics began the first round of testing following the development of ICD-10-CM. A timetable for the implementation of ICD-10-CM has not been determined. Many of the problems with ICD-9-CM have been addressed in ICD-10-CM. It provides better information for nonacute care or nonhospital encounters, clinical decisionmaking, and outcomes research. Terminology and disease classification have been updated to be consistent with current usage and medical advances.
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