U.S. healthcare system finally catches up

On Oct. 1, 2015, the American healthcare system as we know it changed.

The replacement of Version 9 of the International Classification of Diseases (ICD-9), with its successor, Version 10 (ICD-10), is a pretty big deal, at least for healthcare professionals and insurance companies. It has even been called “healthcare’s Y2K moment.” For anyone too young to remember, Y2K happened over 15 years ago, when people feared that computer systems would crash because of shortcuts programmers had taken. Instead of using four digits to represent a date, e.g. 1999, they would only use the last two digits, i.e. 99. When the year rolled over to 2000, people feared that the computers would not be able to handle it. Unlike Y2K, most people might not even know about the recent shift from ICD-9 to ICD-10.

So what is ICD-10 exactly? It is the 10th version of the International Classification of Diseases, the “standard diagnostic tool” for health providers. It is a standardized system for diagnosing patients that insurance companies use to process claims, as well as by nurses, researchers and policy-makers. In the world of healthcare, changing such a system is a big deal.

So why is the change happening now? It turns out that the United States is embarrassingly behind the times. We’ve been using ICD-9 since 1979. And ICD-10 has been in use around the world since 1994. In fact, the United States is pretty much the only developed country that hasn’t adopted ICD-10 yet. That is pretty pathetic, especially considering the fact that the next version, ICD-11, is due for release in 2018 — only three years away.

But unlike updating the operating system on your iPhone, which only requires a decent Wi-Fi connection and a simple tap, updating the system used nationally for healthcare diagnoses takes a lot more time and effort. The ICD-10 system has 68,000 codes for diagnoses, five times as many as the ICD-9’s 14,000 codes. Each one describes a unique diagnosis. It might seem excessive, but with the number of developments in our understanding of human health in the past 30 years — from fine-tuning autism diagnoses to redefining mental health disorders — a new system is necessary.

With 68,000 codes, there are some pretty arcane diagnoses, including “toxic effect of contact with other jellyfish, intentional self-harm, initial encounter” (code T63.622A), which is different from “toxic effect of contact with other jellyfish, assault, initial encounter” (code T63.623A). It might seem like a nuance, but whether or not you got stung by a jellyfish on purpose or by accident matters to medical providers and insurance companies (although I’m not sure exactly why one would get stung on purpose). There really is a code for everything, which is part of what makes updating the system such a pain.

Despite the hassle for healthcare providers and health insurance companies, switching from ICD-9 to ICD-10 is long overdue. The new system could help doctors and insurance companies work better together to provide the best possible care to patients. And that’s definitely worth it.