The ICD: What Therapists Need to Know

Earlier this week, Congress passed a measure to delay the implementation of ICD-10 from October 1, 2014 until at least October 1, 2015. The good news for therapists is we do not need to do anything new nor different with regard to diagnosis and insurance claim coding any time in the immediate future. So, relax and carry on as usual—for now.

Yet, many therapists are uncertain what the ICD is and the history behind it all. If this describes you—keep reading because I wrote this post with you in mind.

An Introduction to ICD

The International Classification of Diseases (ICD) is produced by the World Health Organization (WHO) to serve as a common language for governments, healthcare providers and consumers. The ICD is the global standard for reporting and categorizing disease, health-related conditions, and the prevention and cause of disease and injury. Beyond it’s use in clinical diagnosis—the ICD supports the development of health programs, facilitates insurance reimbursement, and guides treatment planning. Governments use the ICD to compile health statistics and monitor health spending. Researchers use the ICD to compare health statuses across populations.

While the WHO owns the ICD, in the United States it’s the National Center for Health Services (NCHS), a part of the Centers for Medicare and Medicaid Services (CMS), who oversees implementation and modification of the ICD within the United States.

A Brief History of ICD

The first attempt to classify disease by grouping items according to their purpose, and codifying them with a numerical identification following to certain principles, is credited to French physician and botanist François Boissier de Sauvages de Lacroix(1706-1777).

Yet, it was not until the First World Health Assembly in 1948 that the International Classification of Disease was adopted—marking a new era in international vital statistics.

The United States was a late adoptee to the system, waiting until 1968 to accept what became known as ICD-8. In 1977 the United States secured permission from the WHO to modify its 1975 published ICD-9 to include additional morbidity detail. This modification became known as ICD-9-CM—the version used in the United States today.

A more thorough history of the ICD can be found here.

Adoption of ICD-10

The WHO published ICD-10 in 1994. Soon after, the international community adopted ICD-10 to report both morbidity and mortality. The United States began using ICD-10 to report mortality only in 1999. It was not until 2009 that George W. Bush signed a law making full ICD-10 implementation mandatory in the U.S. by October 1, 2011.

Following pressure from providers and insurance companies, full ICD-10 implementation in the United States was delayed until October 1, 2013. Then, another delay pushed implementation back to October 1, 2014. As we learned earlier this week, Congress has again pushed the full ICD-10 implementation date—now scheduled for October 1, 2015.

The United States’ full adoption of ICD-10 lags behind other countries. For example, Australia adopted ICD-10 starting in 1998; Canada adopted ICD-10 in 2000 with its unique Provence-by-Provence rollout approach; and China has been using ICD-10 since 2002. Yet, other countries like Dubai only just adopted ICD-10 in 2012.

A more detailed history of ICD-10 adoption by country can be found here.

In the Wings: ICD-11

According to the World Health Organization, the mission of ICD-11 is “To produce an international disease classification that is ready for electronic health records that will serve as a standard for scientific comparability and communication.” This will no doubt represent a huge leap towards helping us better understand the health of our world.

The WHO began developing ICD-11 in 2007 with an initial expected publication date of 2012. Publication has been delayed until 2015 with a final revision expected in 2017. If you are interested in following the development of ICD-11 you can do so here.

I hope this helps you make sense of the ICD and the history behind its development and adoption. If you now find yourself curious about the relationship between ICD and the Diagnostic and Statistical Manual of Mental Disorders (DSM)—stay tuned for my next blog post. In the interim, I welcome your feedback and questions below.

Thanks all!

Karen Gorrin is a psychotherapist and clinical consultant from Seattle, Washington.

This article is part of a series that will be contributed by various guest bloggers for SimplePractice. If you are interested in blogging with us, please email


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