The International Classification of Disease [ICD] began its life as a cause of death classification [vital statistics] in the mid-19th century and as gradually incorporated other functions [indexing hospital records, reimbursements, etc.] over it’s development – retaining its function as a statistical tool to the present. It’s now in its 11th Revision process. For our purposes, the current US version is the ICD-9-CM first released in 1979. Most of the rest of the world uses the ICD-10. The date for the changover to ICD-10 in the US was 10/2013 until recently, but has been postponed until 10/2014 – so the ICD-9-CM will be with us for at least the next 2½ years. For the last several revisions, there have been yearly updates, so it changes more frequently that our DSM psychiatric classifications.
It is maintained by the
World Health Organization, but adapted for US use by the
National Center for Health Statistics [NCHS] housed at the CDC and the
Centers for Medicare and Medicaid Services. The current files are located
here on the CDC site for downloading. For those of us in Psychiatry used to using the DSM classification and manuals, the system has a different look and feel. The DSM is constructed like a textbook. The ICD is more a code book, and it encompasses all of medicine – not simply mental disorders [all of which are collected in chapter 5 of the ICD-9-cm]. Just to get a feel of the system, there are several interactive versions on the Internet that allow you to jump around:
In addition, I’ve extracted the most recent
ICD-9-CM Chapter 5 only [2012] as a Rich Text Format file for downloading and perusing. My idea here is to spend a little time looking at the
International Classification of Disease itself, getting familiar with its ins-and-outs, comparing it to our DSMs, before looking into the nuts-and-bolts of using it on a practical basis and the resources available…
There’s an obituary in the Washington Post today for a psychiatrist who died. I find it interesting that in the obituary, it says “For over five decades, he practiced psychiatry and psychotherapy where he remained committed to a psychoanalytic orientation even as the psychiatric profession itself turned increasingly to psychopharmacology.”
Many psychiatrists these days leave the psychotherapy to psychologists and counselors in favor of psycho-pharmacology so it is significant that a psychiatrist would stick to his roots and continue to provide psychoanalytic driven interventions. The main reason for this shift is that psychiatrist can bill for 15 minute medication check appointments but psychotherapy appointments tend to last at least 30 minutes.
Nah. . . therapy is the “50 minute hour.”
Those wise old therapy-oriented psychiatrists are dying off now.