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Disease ClassificationDr. Shaikh Balan Mahetab

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Learning Objectives

DefinitionsBackgroundClassification TypesICD – 10Problems faced

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Definitions

Disease –

Deviation from the state of complete physical, mental and social well-being

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ClassificationThe process of putting things into groups based on ways that they

are alike.

Classification of diseases: Arrangement of diseases into groups having common characteristics.

Medical classification is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers.

E.g. : ICD, ICF, ICHI, NDC

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Background Earliest evidence of classifications appear as some groupings of diseases in the early

writings of the Greeks and Romans.

John Graunt (1620 – 1674) arranged the diseases in alphabetical order in his work Bills of Mortality.

Francois Bossier de Lacroix (1706-1777) conceived the idea of classification of diseases and published it under the title Nosologia methodica.

William Farr (1807-1883)- the First medical statistician who spelt out principles that should govern a statistical classification of disease and urged the adoption of a uniform classification internationally.

The first version of ICD was adopted in 1893 chicogo , in 1898 recommended the revisions of the classification every ten years.

First starting in 1900 – The First Revision (ICD–1) Presently ICD 10 since 1993

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•On various approach diseases are classified as .. 1. Topographical or Systemic , by bodily region or

system, gastrointestinal disease, vascular disease, abdominal

disease, and chest disease etc 2. Anatomical, by organ or tissue, cardiac disease, hepatic disease, and pulmonary

disease etc 3. Physiological, by function affect, respiratory and metabolic syndrome, DM , gout,

hyperacidity 4. Pathological, by the nature of the disease process, Neoplastic and inflammatory disease

Types

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5. Etiological (causal), • communicable ..bacterial, viral, parasitic ,vector

born ,water born zoonotic , STDs etc • non communicable .. Hereditary , Life style related ,

accidental, injuries , nutritional 6. Juristic, Medicolegal,7. Epidemiological, Sporadic , outbreak , epidemic

pandemic endemic etc

•Any single disease may fall within several of these classifications.

Types

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•Work on ICD-10 began in 1983 and was completed in 1992 and is in use from 1994 to present day.

•The ICD - 10 allows more than 14,400 different codes and permits the tracking of many new diagnoses. The codes can be expanded to over 16,000 codes by using optional sub-classifications.

•ICD – 10 is arranged in 21 major chapters.

International Classification of Diseases (ICD – 10)

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Chapter Blocks Title

I A00–B99 Certain infectious and parasitic diseases

II C00–D48 Neoplasms

III D50–D89Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism

IV E00–E90 Endocrine, nutritional and metabolic diseases

V F00–F99 Mental and behavioural disorders

VI G00–G99 Diseases of the nervous system

VII H00–H59 Diseases of the eye and adnexa

VIII H60–H95 Diseases of the ear and mastoid process

IX I00–I99 Diseases of the circulatory system

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Chapter Blocks Title

X J00–J99 Diseases of the respiratory system

XI K00–K93 Diseases of the digestive system

XII L00–L99 Diseases of the skin and subcutaneous tissue

XIII M00–M99Diseases of the musculoskeletal system and connective tissue

XIV N00–N99 Diseases of the genitourinary system

XV O00–O99 Pregnancy, childbirth and the puerperium

XVI P00–P96Certain conditions originating in the perinatal period

XVII Q00–Q99Congenital malformations, deformations and chromosomal abnormalities

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Chapter Blocks Title

XVIII R00–R99Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

XIX S00–T98Injury, poisoning and certain other consequences of external causes

XX V01–Y98 External causes of morbidity and mortality

XXI Z00–Z99Factors influencing health status and contact with health services

XXII U00–U99 Codes for special purposes

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Coding SystemA N N . N

1. First character is associated with the particular chapter.2. D is used in chapters II and III and letter H is used in

chapter VII and VIII.3. Chapters I, II, XIX and XX use more than one letters in

their first position of the codes.4. Each chapter have three character categories to cover its

contents. A fourth numeric character is added after decimal for sub categories.

5. Unused U codes are to be used for provisional assignment of new diseases of uncertain aetiology.

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Arrangement of Volumes of ICD-10•Volume 1: Main classifications •Volume 2: Instruction/ Guidance to users •Volume 3: Alphabetical Index

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Purpose and use of ICD•To identify health trends and statistics globally•  It is the international standard for defining and

reporting diseases •  Comprehensive compilation •Global uniformity •  It is the diagnostic classification standard for all clinical

and research purposes•easy storage, retrieval, analysis and comparison of the

data collected in different countries or areas and at different times.

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Problems encountered•Size of the Classification•No formal training•No user-friendly software to guide•No Online Help-line system

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Summary Definitions disease and classification Classification of diseases is the Arrangement of

diseases into groups having common characteristics. History Type Of classification .. Based on different

approaches ICD 10 ICD maintained and revised under WHO every 10

years. The purpose of the ICD is to permit the systematic

recording, analysis, interpretation and comparison of mortality and morbidity data collected.

ICD – 10 has 21 chapters, 3 volumes.

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Questions ?

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Which of the following is true about ICD 101. Unique alphabet is used for each chapter2. Consists of 10 chapters3. Arranged in 3 volumes 4. Was produced by UNICEF

Answer: 3 i.e. Arranged in 3 volumes

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ICD 10 has how many chapters1. 52. 123. 214. 23

Answer : 3 i.e. 21

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Further Reading•History of the Statistical Classification of Diseases and

Causes of Death at http://www.cdc.gov/nchs/data/misc/classification_diseases2011.pdf

•International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) at http://www.cdc.gov/nchs/icd/icd10cm.htm

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References1. Park’s Textbook of Preventive and Social Medicine, 23rd

Edition.2. WHO (1993) International Statistical Classification of

Diseases and Related Health Problems, Tenth Revision, Vol. 2 .

3. A Dictionary of Epidemiology by J. Last, 5th Edition4. Accessed http://www.who.int/classifications/icd/en/5. Accessed http://www.cdc.gov/nchs/icd/icd10.htm

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THANKS