The Tyranny of the Diagnosis Code

Dr. Vergil Slee and associates nicely summarize the core problems with ICD-9-CM and ICD-10-CM, and why the upgrade to ICD-10-CM is only a marginal improvement:

Slee VN, Slee D, and Schmidt HJ. The Tyranny of the Diagnosis Code. North Carolina Medical Journal, 2005;66(5):331-7.

Lest you think that this paper is unimportant, no less an authority than Dr. David Kibbe gave his approval in a commentary published in the same issue as Slee et al.'s paper (available via the same link above).

Dr. Kibbe is Director, Center for Health Information Technology of the venerable American Academy of Family Physicians (AAFP). The AAFP is the premier specialty society for family physicians in the United States, and represents 95,000 physicians.

Dr. Kibbe also shudders at the thought of using ICD-9-CM and ICD-10-CM as the foundation of the information we use to improve the quality of health care in America.

However, he stops short of endorsing a course of action to adopt an alternative to diagnosis coding that is vastly improved over ICD-9-CM and ICD-10-CM, citing a lack of political and "economic" will in America to do so.

That's a shame. The opposition of the AAFP to ICD-10-CM might have helped reverse that situation.

And if you are wondering what authority Dr. Slee may have to comment on these matters, the following is a brief biography, taken from additional commentary he made with a colleague to the House Ways and Means Committee on the issue of the switch to ICD-10-CM:

Vergil Slee, MD, MPH, FACP, FACHE (Hon) was responsible for the first deployment of ICD in hospitals as a tool for diagnosis indexing, a task for which ICD was admirably suited at that time (1955). In 1975 he represented the U. S. at the WHO conference which designed ICD-9. In 1976 he became President of the Council on Clinical Classifications which, in collaboration with the U. S. National Center for Health Statistics, developed ICD-9-CM (1978). He has analyzed ICD-10-CM (Reference 6) and has written extensively on the expanding demands on medical record information (Reference 7), demands which have destroyed ICD’s suitability for diagnosis input.