Medical classification
A medical classification is used to transform descriptions of medical
- statistical analysis of diseases and therapeutic actions
- reimbursement (e.g., to process claims in medical billing based on diagnosis-related groups)
- knowledge-based and decision support systems
- direct surveillance of epidemic or pandemic outbreaks
There are country specific standards and international classification systems.
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 used by the
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
- Are used to determine diseases, disorders, and symptoms
- Can be used to measure morbidity and mortality
- Examples:
- Procedural codes
- They are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals.
- Examples: ICPM, ICHI
- Pharmaceutical codes
- Are used to identify medications
- Examples: NDC, ICD-11
- Topographical codes
- Are codes that indicate a specific location in the body
- Examples :SNOMED, ICD-11
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.[2] 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 various countries for national use.
Reference classifications
- International Statistical Classification of Diseases and Related Health Problems (ICD)[3]
- International Classification of Functioning, Disability and Health (ICF)
- International Classification of Health Interventions (ICHI)
Derived classifications
Derived classifications are based on the WHO reference classifications (i.e. ICD and ICF).[2] They include the following:
- International Classification of Diseases for Oncology, Third Edition (ICD-O-3)
- The ICD-10 Classification of Mental and Behavioural Disorders – This publication deals exclusively with Chapter V of ICD-10,[6] and is available as two variants;
- Application of the International Classification of Diseases to Dentistry and Stomatology, 3rd Edition (ICD-DA)[9]
- Application of the International Classification of Diseases to Neurology (ICD-10-NA)[10]
- congenital disorders.
National versions
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:
- Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), and has been in use in the US since October 2015 – replacing ICD-9-CM.[1]
- ICD-10-AM was published by Australia's National Centre for Classification in Health in 1998 and has since been adopted by a number of other countries.[12]
Related classifications
Related classifications in the WHO-FIC are those that partially refer to the reference classifications, e.g. only at specific levels.[2] They include:
- International Classification of Primary Care (ICPC)[13]
- Anatomical Therapeutic Chemical Classification System with Defined Daily Doses (ATC/DDD)
- Assistive products — Classification and terminology (ISO 9999:2022). WHO adopted ISO 9999 as a related classification in 2003,[14] however, the International Organization for Standardization (ISO) remains responsible for maintaining ISO 9999.
- International Classification for Nursing Practice (ICNP)[15]
Historic FIC classifications
ICD versions before ICD-9 are not in use anywhere.
The
Other medical classifications
Diagnosis
The categories in a diagnosis classification classify
- Diagnostic and Statistical Manual of Mental Disorders (DSM)
- DSM-IV Codes
- DSM-5
- International Classification of Headache Disorders 2nd Edition (ICHD-II)[22]
- International Classification of Sleep Disorders (ICSD)
- Online Mendelian Inheritance in Man, database of genetic codes
- Orchard Sports Injury and Illness Classification System (OSIICS)
- Read codes
- SNOMED CT
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 (CCI)[23]
- Current Procedural Terminology (CPT)
- Health Care Procedure Coding System(HCPCS)
- ICD-10 Procedure Coding System (ICD-10-PCS)
- OPCS Classification of Interventions and Procedures (OPCS-4)
Drugs
Drugs are often grouped into drug classes. Such classifications include:
- RxNorm
- Anatomical Therapeutic Chemical Classification System
- Medical Reference Terminology
- National Pharmaceutical Product Index
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
The United States Food and Drug Administration requires in its Manual of Policies and Procedures (MaPP) 7400.13 dated July 18, 2013 and updated on July 25, 2018, that MED-RT be used for selecting an established pharmacologic class (EPC) for the Highlights of Prescribing Information in drug labeling. Each EPC text phrase is associated with a term known as an EPC concept. EPC concepts use a standardized format derived from the U.S. Department of Veterans Affairs, Veterans Health Administration (VHA) Medication Reference Terminology (MED-RT). Each EPC concept also has a unique standardized alphanumeric identifier code, used as the machine-readable tag for the concept. These codes enable SPL indexing. The exact EPC text phrase used in INDICATIONS AND USAGE in Highlights might not be identical to the wording used to describe the EPC concept, because the standardized language used for the EPC concept might not be considered sufficiently clear to the readers of the labeling. Each active moiety also may be assigned MOA, PE, and CS standardized indexing concepts, which are also linked to unique standardized alphanumeric identifier codes. MOA, PE, and CS standardized indexing concepts may or may not be related to the therapeutic effect of the active moiety for a particular indication, but they should still be scientifically valid and clinically meaningful. Even if the MOA, PE, and CS standardized indexing concepts are not known with certainty to be related to the therapeutic effect, they may still be useful for identifying drug interactions and permitting other safety assessments for a moiety based upon appropriate and relevant considerations, such as enzyme inhibition and enzyme induction. MOA, PE, and CS concepts are maintained in a standardized format as part of the MED-RT hierarchy. https://www.fda.gov/media/86437/download
The United States Food and Drug Administration Study Data Technical Conformance Guide dated July 2020 states, "6.5 Pharmacologic Class 6.5.1 Medication Reference Terminology 6.5.1.1 General Considerations The Veterans Administration's Medication Reference Terminology (MED-RT) should be used to identify the pharmacologic class(es) of all active investigational substances that are used in a study (either clinical or nonclinical). This information should be provided in the SDTM TS domain when a full TS is indicated. The information should be provided as one or more records in TS, where TSPARMCD= PCLAS. Pharmacologic class is a complex concept that is made up of one or more component concepts: mechanism of action (MOA), physiologic effect (PE), and chemical structure (CS).51 The established pharmacologic class is generally the MOA, PE, or CS term that is considered the most scientifically valid and clinically meaningful. Sponsors should include in TS (the full TS) the established pharmacologic class of all active moieties of investigational products used in a study. FDA maintains a list of established pharmacologic classes of approved moieties.52 If the established pharmacologic class is not available for an active moiety, then the sponsor should discuss the appropriate MOA, PE, and CS terms with the review division. For unapproved investigational active moieties where the pharmacologic class is unknown, the PCLAS record may not be available." https://www.fda.gov/media/136460/download
The United States Food and Drug Administration publishes a Data Standards Catalog that lists the data standards and terminologies that FDA supports for use in regulatory submissions to better enable the evaluation of safety, effectiveness, and quality of FDA-regulated products. In addition, the FDA has the statutory and regulatory authority to require certain standards and terminologies and these are identified in the Catalog with the date the requirement begins and, as needed, the date the requirement ends, and information sources. The submission of data using standards or terminologies not listed in the Catalog should be discussed with the Agency in advance. Where the Catalog expresses support for more than one standard or terminology for a specific use, the sponsor or applicant may select one to use or can discuss, as appropriate, with their review division. Version 7.0 of the FDA Data Standards Catalog dated 03-15-2021, specifies that MED-RT was a required terminology by the White House Consolidated Health Informatics Initiative in various Federal Register Notices beginning as early as May 6, 2004, for NDAs, ANDAs, and certain BLAs beginning on December 17, 2016, and for certain IND's beginning on December 17, 2017. https://www.fda.gov/media/85137/download
Medical Devices
- Global Medical Device Nomenclature (GMDN), the standard international naming system for medical devices.[26]
Other
- Classification of Pharmaco-Therapeutic Referrals (CPR)
- Logical Observation Identifiers Names and Codes (LOINC), standard for identifying medical laboratory observations
- MEDCIN, point-of-care terminology, intended for use in Electronic Health Record (EHR) systems
- Medical Dictionary for Regulatory Activities(MedDRA)
- Medical Subject Headings (MeSH)
- 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]
Library classification that have medical components
- Dewey Decimal Classification and Universal Decimal Classification (section 610–620)
- National Library of Medicine classification
ICD, SNOMED and Electronic Health Record (EHR)
SNOMED
The Systematized Nomenclature of Medicine (
ICD
The International Classification of Disease (
Comparison
Data Mapping
Veterinary medical coding
This section needs expansion. You can help by adding to it. (September 2016) |
Veterinary medical codes include the VeNom Coding Group, the U.S. Animal Hospital Codes, and the Veterinary Extension to SNOMED CT (VetSCT).[citation needed]
See also
- Acronyms in healthcare
- Ambulatory Payment Classification, US billing system for outpatient services
- Biological database
- Classification of mental disorders
- Clinical coder
- German Institute for Medical Documentation and Information
- Health information management
- Health informatics
- Human resources for health information system
- List of international common standards
- Medical dictionary
- North American Nursing Diagnosis Association(professional organization)
- Nosology
- Pathology Messaging Implementation Project
References
- ^ a b c "ICD - ICD-10-CM - International Classification of Diseases, Tenth Revision, Clinical Modification". Centers for Disease Control and Prevention. 2020-07-17. Retrieved 2020-11-04.
- ^ a b c "Family of International Classifications". World Health Organization. World Health Organization. Archived from the original on October 3, 2004. Retrieved 12 July 2011.
- ^ "International Classification of Diseases (ICD)". World Health Organization. World Health Organization.
- ^ "WHO | International Classification of Diseases, 11th Revision (ICD-11)". WHO. Retrieved 2022-06-02.
- ^ "ICD-11 tools".
- ^ a b c "ICD-10-CM Release for 2014 now available". Dx Revision Watch. 2013-07-12. Retrieved 30 May 2015.
- ^ "The ICD-10 Classification of Mental and Behavioural Disorders, Clinical descriptions and diagnostic guidelines" (PDF). World Health Organization.
- ^ "The ICD-10 Classification of Mental and Behavioural Disorders, Diagnostic criteria for research" (PDF). World Health Organization.
- PMID 282953.
- S2CID 12754467.
- ^ "Get ready for the end of ICD-10 'flexibilities'". Modern Healthcare. Retrieved 2016-10-16.
- ISBN 9780123822017. Retrieved 3 December 2018.
- ^ "ICPC-2". World Health Organization.
- ISBN 9780539089127. Retrieved 2 June 2022.
- ^ "International Classification for Nursing Practice (ICNP)". World Health Organization.
- ^ "ICD - ICD-9 - International Classification of Diseases, Ninth Revision". Centers for Disease Control and Prevention. 2019-03-01. Retrieved 2020-11-04.
- ^ a b "WHO releases new International Classification of Diseases (ICD 11)". World Health Organization. Retrieved 9 May 2020.
- ^ "ICD-11 2022 release". World Health Organization. Retrieved 2 June 2022.
- ^ "International Classification of Health Interventions (ICHI)". World Health Organization. World Health Organization. Retrieved 8 September 2015.
- ^ "OPS – German Procedure Classification". Archived from the original on 13 October 2015. Retrieved 8 September 2015.
- ^ "ICECI". World Health Organization.
- S2CID 208214505.
- ^ Canadian Classification of Health Interventions. CCI.
- ^ "National Drug File – Reference Terminology (NDF-RT™) Documentation" (PDF). U.S. Veterans Health Administration.
- ^ "Introduction to MED-RT as the Replacement for NDF-RT" (PDF). U.S. Veterans Health Administration.
- ^ IMDRF UDI Guidance Unique Device Identification (UDI) of Medical Devices 9.2.8.
- ^ a b "SNOMED International". ihtsdo.org. Retrieved 17 January 2017.
- ^ a b c "FAQs: Inclusion of SNOMED CT in the UMLS". nih.gov. Retrieved 17 January 2017.
- ^ Office, Publications. "SNOMED CT – Systematized Nomenclature of Medicine". sydney.edu.au. Retrieved 17 January 2017.
- ^ a b c Margret K. Amatayakul, MBA, RHIA, CHPS, CPHIT, CPEHR&FHIMSS.(2009).Electronic Health Records: A Practical Guide for Professionals and Organizations.Chicago, America:AHIMA
- ^ "Why SNOMED cannot replace the ICD-10-CM/PCS code sets". icd10watch.com. Retrieved 17 January 2017.
- ^ "ICD-11 | Implementation or Transition Guide" (PDF). World Health Organization. p. 14. Retrieved 1 June 2022.
Certain countries currently use automated coding
- ^ "WHO – SNOMED CT to ICD-10 Cross-Map Technology Preview Release". who.int. Archived from the original on October 23, 2012. Retrieved 17 January 2017.