Max Rady College of Medicine

Concept: International Classification of Disease (ICD) Coding in MCHP Data

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Concept Description

Last Updated: 2019-01-17

Introduction
1 - Diagnoses Codes on Medical Services (Physician Claims)
    This includes medical, reciprocal and non-statistical.

    Time Frame ICD Version Captured Notes
    1970/01/01 to 1972/02/28 ICD-7 * captured using 3-digit code, but Manitoba Health added 3-digit ICDA-8 code using a crosswalk table.
    * the ICD-7 code is present in the field later used for National Grouping Code (NGC).
    1972/03/01 to 1979/02/28 ICDA-8 * captured using 3-digit code.
    1979/03/01 to present ICD-9-CM * captured using 3-digit code.
    * In December 2018, a 5-digit diagnosis code variable was added to the Medical Services data. If recorded, the first 3-digits of both the 3-digit and 5-digit diagnosis code variables will match exactly. The 5-digit diagnosis code variable applies to records from 2015/16 forward.
    Comments:
    • Dates refer to when a claim was processed not the service date.
    • In Manitoba, diagnosis codes also include the series "Ann","Bnn" or "Cnn" which are unique to Manitoba Health (prosthetics, Chiropractors, etc).
    • No current plan exists for changing to ICD-10-CA. Some jurisdictions, including CIHI, are seriously considering changing to a comprehensive clinical terminology system called SNOMED (Systematized NOmenclature of MEDicine). See Wikipedia - https://en.wikipedia.org/wiki/Systematized_Nomenclature_of_Medicine for more information on SNOMED.

2 - Diagnoses and Procedure Codes on Hospital Discharge Abstracts
    Time Frame ICD Version Captured Notes
    1970/01/01 to 1979/03/31 ICDA-8 * 1-3 diagnoses and 1 separate external cause of injury codes (E-Codes) .
    * All coded using 4-digit ICDA-8.
    * DX01 is primary diagnosis.
    * 0-3 procedures coded using 4-digit ICDA-8.
    * Out-of-province and out-patient claims have 0-3 diagnoses and 0-1 procedure. 60% of claims in this era are Outpatient Department claims.
    1979/04/01 to 1987/03/31 ICD-9-CM * 1-16 diagnoses coded using 5-digit ICD-9-CM.
    * DX01 is primary diagnosis.
    * external cause of injury codes (E-Codes) not captured.
    * 0-12 procedures coded using 4-digit ICD-9-CM.
    * Out-of-province admissions and non-budget out-patient claims have 0-3 diagnoses and 0-1 procedure.
    1987/04/01 to 2004/03/31 ICD-9-CM * 1-16 diagnoses coded using 5-digit ICD-9-CM.
    * DX01 is most responsible diagnosis.
    * DXTYPE01-DXTYPE16 now exist.
    * Diagnosis #2 thru 16 can be external cause of injury codes (E-Codes) .
    * 0-12 procedures coded using 4-digit ICD-9-CM.
    * Out-of-province admissions and non-budget out-patient claims have 0-3 diagnoses and 0-1 procedure.
    2004/04/01 to present ICD-10-CA For hospital admissions and day surgery in Manitoba Facilities:
    * 1-25 diagnoses coded using ICD-10-CA.
    * DX01 is most responsible diagnosis.
    * CIHI-based conversion to ICD-9-CM is also present for the 25 diagnoses but unreliable.
    * 0-20 procedures coded using Canadian Classification of Health Interventions (CCI).
    2004/04/01 to present ICD-9-CM For admissions out of province (Reciprocal or not) and non-budget outpatient contacts:
    * 1-3 diagnoses coded using 5-digit ICD-9-CM.
    * DX01 is most responsible diagnosis.
    * DX02 and DX03 can be external cause of injury codes (E-Codes) .
    * 0-1 procedures coded using ICD-9-CM.
    Comments:
    • Dates refer to when a claim was processed not the service date.

3 - Diagnoses Codes on Long Term Care (LTC)
    This includes admissions or separations.

    Time Frame ICD Version Captured Notes
    1973/04/01 to 1979/03/31 ICDA-8 * 1-3 Admit and 1-3 Separation diagnoses using 4-digit ICDA-8 code.
    1979/04/01 to 2004/06/01 ICD-9-CM * data collects 1-3 Admit and 1-3 Separation diagnoses using 5-digit ICD9-CM.
    * existing ICDA-8 diagnoses were retained and modified by adding a trailing "$" symbol in the 5th digit.
    2004/06/01 to present ICD-9-CM or
    ICD-10-CA
    * same as above plus new information may be recorded using ICD-10-CA diagnoses codes.
    Comments:
    • In the LTC system, diagnoses are captured using the prevalent ICD system in use at a facility at the time. Typically, LTC facilities attached to a hospital use the same ICD version in use at the hospital.
    • The LTC system at MCHP, at any given point, contains ALL information for 1973 through to the most recent fiscal year.
    • A text variable for each diagnosis filed contains an ICD version qualifier: either "ICD-9-CM" or "ICD-10-CA".
    • Some facility data may not follow the time frames outlined above because they did not begin using a different version until later in the time frame window.

4. Diagnoses Codes on Mental Health Management Information system (MHMIS)
    Time Frame ICD Version Captured Notes
    1990/04/01 to 2001/01/19 ICD-9-CM * 1-3 diagnoses coded using 5-digit ICD-9-CM.
    * 1-5 diagnoses coded using DSM-III Axis codes.
    * data collected at registration and on status changes.
    2001/01/20 to present ICD-9-CM * 1-3 diagnoses coded using 5-digit ICD-9-CM.
    * 1-5 diagnoses coded using DSM-IV Axis codes.
    * data collected at registration and on status changes.


    Comments:

    • DSM-III = Diagnostic and Statistical Manual of Mental Disorders, version 3
    • DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, version 4
5 - Diagnoses Codes on Vital Statistics Cause of Death
    Time Frame ICD Version Captured Notes
    1970/01/01 to 1978/12/31 ICDA-8 * cause of death and nature of injury are coded in ICDA-8.
    1979/01/01 to 1999/12/31 ICD-9 * cause of death and nature of injury are coded in 4-digit ICD-9 (not the same as ICD-9-CM).
    2000/01/01 to present ICD-10 * W.H.O. standard coding for cause of death.
    * W.H.O. ICD-10 is not entirely compatible with ICD-10-CA.
    Comments:
    • Vital Statistics collects only one diagnosis for reporting cause of death.
    • Vital Statistics reporting is based on the calendar year, not the fiscal year.
MORE INFORMATION
  • Information for this concept was extracted from an e-mail from Pat Nicol to Souradet Shaw - August 29, 2006

Related concepts 

Related terms 

Keywords 

  • diagnosis
  • International Classification of Diseases
  • surgical procedures


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Manitoba Centre for Health Policy
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Rady Faculty of Health Sciences,
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University of Manitoba
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