How are non-HIPAA and public health entities affected?
ICD-9-CM codes are currently the cornerstone of classifying diseases, injuries, health encounters and inpatient procedures in morbidity settings. U.S. public health officials at the federal, state, and local level rely on the receipt of ICD-9-CM coded data from HIPAA-covered entities to conduct many disease-related activities.
CDC programs use ICD-9-CM codes to conduct surveillance (e.g., chronic disease and injury surveillance, health care utilization, health care-associated adverse events), for case findings lists to identify cases of reportable cancers and certain birth defects and disabilities, and to provide public use data files for public analysis.
A few programs abstract information from patient medical records and assign codes, and one CDC program uses ICD-9-CM codes for claims reimbursement.
Primary and Secondary Users of ICD-9-CM Codes
A primary user of ICD codes includes health care personnel, such as physicians and nurses, as well as medical coders, who assign ICD-9-CM codes to verbatim or abstracted diagnosis or procedure information, and thus are originators of the ICD codes. ICD-9-CM codes are used for a variety of purposes, including:
- Statistics
- Billing and claims reimbursement
A secondary user of ICD-9-CM codes is someone who uses already coded data from hospitals, health care providers, or health plans to conduct surveillance and/or research activities. Public health is largely a secondary user of coded data.