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ICD-9-CM classification coding in psychiatry.

P M Dingemans1

  • 1Dept. of Psychiatry, University of Amsterdam.

Journal of Clinical Psychology
|March 1, 1990
PubMed
Summary
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Mental health professionals showed poor agreement when translating diagnoses into International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. This suggests current mental health statistics based on ICD-9-CM lack scientific value.

Area of Science:

  • Psychiatry and Mental Health Statistics
  • Health Information Systems

Background:

  • Accurate diagnostic coding is crucial for mental health statistics.
  • The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) is widely used for this purpose.

Purpose of the Study:

  • To evaluate the reliability of translating mental health diagnostic formulations into ICD-9-CM codes.
  • To assess interrater agreement among mental health professionals using the ICD-9-CM system.

Main Methods:

  • Three distinct groups of coders assessed diagnostic formulations.
  • Coding accuracy and agreement were examined under two different conditions.

Main Results:

  • Insufficient interrater agreement was observed across all coder groups and conditions.

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  • The study identified significant variability in ICD-9-CM code assignment.

    • Conclusions:

    • The current ICD-9-CM system exhibits inadequacies for precise mental health diagnosis coding.
    • Mental health statistics derived from ICD-9-CM coding lack scientific validity due to poor reliability.