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ICD-9-CM Classification System

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In 1979, the use of the ICD-9-CM classification system for morbidity was implemented in the United States. As a result, it is one of the most well-known classification systems for patient health records. Furthermore, the ICD-9-CM is set by HIPAA for diagnostic coding. Though it has three volumes, only the first two are used by physicians. The CPT classification is used by physicians for medical and surgical procedures. Hospitals utilize the third volume of the ICD-9-CM. Since 2012, there have been very few changes to the ICD-9-CM classification system. No further changes are anticipated unless there are new diseases found or new technology developed. This lack of changes is one of the appealing aspects of this system.

SNOMED was the result of a merger in 1999. It is considered to be the most comprehensive classification system available, with over 311,000 active concepts available for physician use. Features of SNOMED include concept codes, descriptions, relationships, and reference sets. Furthermore, it is easily referenced due to various ways of searching for needed information. All of this information creates a lot more processing.

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Both classification systems have positive aspects. Since HIPAA set the ICD-9-CM, it is easier to ascertain that the proper information is followed. Furthermore, since ICD-9-CM is essentially codes, it is easier to aggregate. SNOMED contains many concepts that includes multiple descriptions and synonyms, making it harder for insurance providers to aggregate.

Although we can make the change to SNOMED, it is not advisable without additional staff. The previous EHRs will need to be changed as well. It is possible to transition to SNOMED with training and education provided. As the situation currently is, I do not advise changing the system as it would require extensive training for all involved, including physicians. Furthermore, such a change will be quite time consuming.