Resolution in Support of Education and Implementation of the International Classification of Diseases (ICD)
Adopted by the Council of Representatives, February 2015. (Suggested citation is included with references.)
WHEREAS the World Health Organization (WHO) constitution mandates the production of international classifications on health so that there is a consensual, meaningful and useful framework which governments, providers and consumers can use as a common language;
WHEREAS internationally endorsed classifications facilitate the storage, retrieval, analysis, and interpretation of data, facilitating the comparison of data within populations over time and between populations at the same point in time as well as the compilation of nationally consistent data;
WHEREAS the purpose of the WHO Family of International Classifications (WHO-FIC) is to promote the appropriate selection of classifications in the range of settings in the health field across the world (WHO, WHO-FIC Network);
WHEREAS the International Classification of Diseases (ICD) is the global standard diagnostic tool for epidemiology, health management and clinical purposes, includes the analysis of the general health circumstances of population groups, is used throughout the world to monitor the incidence and prevalence of diseases and other health problems (WHO, ICD, 2001);
WHEREAS the International Classification of Diseases (ICD) is used to classify diseases and other health problems recorded on many types of health and vital records including death certificates and health records, enabling the storage and retrieval of diagnostic information for clinical, epidemiological and quality purposes, and providing the basis for the compilation of national mortality and morbidity statistics by WHO Member States (WHO, ICD, 2001);
WHEREAS the International Classification of Diseases (ICD) is used for reimbursement and resource allocation decision-making by countries (WHO, ICD, 2001);
WHEREAS the U.S. government has published adaptations of ICD as the framework for official morbidity and mortality statistics in the U.S. for more than 50 years. The current U.S. version, called ICD-9-CM (Clinical Modification) was adapted from the ninth revision of the ICD by the National Center for Health Statistics (NCHS) and the Health Care Financing Administration (now the Center for Medicare and Medicaid Services)(U.S. Government Printing Office (GPO), ICD);
WHEREAS the primary federal agency funding mental health research in the US, the National Institute of Mental Health (NIMH) is working with WHO to develop a work plan for integrating ICD-11, including its own project to re-conceptualize diagnostic criteria for research;
WHEREAS the Health Insurance Portability and Accountability Act (HIPAA) of 1996 required the use of ICD-9 CM codes on all electronic transactions for billing and reimbursement and transition to ICD-10-CM at a specified date (U.S. Government Printing Office (GPO), HIPAA, 1996);
WHEREAS psychologists who submit claims for billing and reimbursement are almost certainly using the ICD-9-CM given that "parallel codes" in the DSM-IV-TR/DSM-5 are actually taken from the ICD-9-CM, which are in turn taken from WHO's ICD-9;
WHEREAS the official code set for U.S. government purposes is the ICD, and HIPAA standard transactions as of October 1, 2015 require only use of ICD-10-CM codes which is already freely available from the U.S. government (see https://www.cdc.gov/nchs/icd/icd10cm.htm );
WHEREAS the WHO Department of Mental Health and Substance Abuse is responsible for directing the technical work associated with the revision of two chapters of the ICD-10: the chapter on Mental and Behavioural Disorders and the Chapter on Diseases of the Nervous System, as well as portions of the chapter on Symptoms, Signs and Abnormal Clinical and Laboratory Findings and the chapter on Factors Influencing Health Status and Contact with Health Services that relate to psychological, behavioral, emotional, and relational phenomena (WHO, 2012);
WHEREAS the major goals of the Department of Mental Health and Substance Abuse for the ICD-10 include incorporating new scientific knowledge and changes in clinical practice that have developed over the past two decades, improving the ICD-11's effectiveness as a tool for reducing global disease burden and disability, improving the classification's clinical utility (e.g., to improve the ICD as a diagnostic tool) in daily clinical practice throughout the world, including in global primary care settings, and making the ICD-11 compatible with new health information system technology;
WHEREAS since 2008, APA, among other national psychological associations, have supported the revision of the World Health Organization's ICD-10 Mental and Behavioural Disorders chapter through an agreement between APA and the International Union of Psychological Sciences (IUPsyS) to provide technical assistance to the World Health Organization (APA, 2014; APA, 2009); Reed, 2010, Reed et al, 2013; Ritchie, 2012; WHO, 2012);
WHEREAS the American Psychological Association (APA) in its mission and vision statements and in its ethical code of conduct asserts that psychologists are committed to creating, applying, and communicating our knowledge to improving individual and societal conditions and facilitating the resolution of global challenges (APA, 2014; APA, 2010(a); APA, 2009);
WHEREAS psychology as a discipline and profession is well-suited to monitor and participate in the present and future revisions of the ICD, as well as track its implications and implementation for psychologists through its governance structure;
WHEREAS APA is committed to education and training in psychology, and to the dissemination and application of sound psychological science;
THEREFORE BE IT RESOLVED that APA reaffirms its recognition of the importance of the WHO Family of International Classifications (WHO-FIC) and, specifically, the implementation of the International Classification of Diseases (ICD) as national health care adopts global standards, electronic record keeping and integrated care;
BE IT FURTHER RESOLVED that APA supports psychologists' utilization of the International Classification of Diseases as a step to improve standards of diagnosis, intervention and care and psychologists' contributions to global and national epidemiological, public health and health policy research and practices.
BE IT FURTHER RESOLVED that APA supports psychologists' utilization of ICD for research that furthers the understanding and classification of diseases, variations in population data, and the means for better and culturally appropriate interventions.
BE IT FURTHER RESOLVED that APA reaffirms its advocacy that further modifications and developments of the ICD align with the conclusions of substantive bodies of research on any particular diagnostic category therein.
BE IT FURTHER RESOLVED that APA supports psychologists' acquisition of appropriate knowledge, skills and practices in their transition from ICD-9 to this revised classification tool, the ICD-10-CM, as it is implemented in the U.S. in October 2015, and of ICD-11 when it is subsequently adapted.
Suggested Citation
References
American Psychological Association. (2014). World Health Organization (WHO) ICD-10 Revision. Retrieved from https://www.apa.org/international/outreach/who-icd-revision.
American Psychological Association (2010a). Ethical principles of psychologists and code of conduct (2002, as amended June 1, 2010). Retrieved from https://www.apa.org/ethics/code/index.
American Psychological Association. (2009). APA Strategic Plan. Retrieved from https://www.apa.org/about/apa/strategic-plan/default.
Centers for Disease Control and Prevention (2013). ICD-10-CM official guidelines for coding and reporting. Retrieved from https://www.cdc.gov/nchs/data/icd9/icd10cm_guidelines_2014.pdfopens in new window.
Goodheart, Carol D. (2014) A primer for ICD-10-CM users: Psychological and behavioral conditions. Washington, DC, US: American Psychological Association. vii 171 pp. doi: 10.1037/14379-000
Health Insurance Portability and Accountability Act of 1996 (1996). (US Government Printing Office 1996). Print.
National Research Council. U.S. Health in International Perspective: Shorter Lives, Poorer Health. Washington, DC: The National Academies Press, 2013.
Reed, G. M. (2010). Toward ICD-11: Improving the clinical utility of WHO's international classification of mental disorders. Professional Psychology: Research and Practice, 41, 457-464. doi: 10.1037/a0021701
Reed, G. M. Roberts , M. C. Keeley , J. W. Hooppell , C. Matsumoto , C. Sharan , P. Medina-Mora , M. E. (2013). Mental health professionals' natural taxonomies of mental disorders: Implications for the clinical utility of the ICD-11 and the DSM-5. Journal of Clinical Psychology. Advanced online publication.doi:10.1002/jclp.22031.
Ritchie, Pierre L.J. 2012 Annual Report of the International Union of Psychological Science to the American Psychological Association on Revision of World Health Organization's ICD-10 Mental and Behavioural Disorders. (2013) International Union of Psychological Science, January, 2013.
US Government Printing Office, The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).
World Health Organization (1992). International classification of diseases and related health problems (10th rev., ICD-10). Geneva, Switzerland: Author.
World Health Organization. International Classification of Functioning, Disability and Health. Geneva, WHO, 2001.
World Health Organization. "The WHO-FIC Network." Retrieved from https://www.who.int/classifications/network/en/opens in new window.
World Health Organization (2012). World Health Assembly Resolution 65.4: Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country levelGeneva, Switzerland: Author.