Definitions of ICD-9 & V Codes

Medical doctors, nurses, hospitals, clinicians and other health care professionals all use a series of codes for diagnostic and classification purposes. The ICD-9 and V-codes organize the injury, disease, injury or death of a patient into a classification that all health care professionals recognize. Insurance companies use these codes to determine payment for services to health care professionals and organizations. Worker’s compensation professionals use these same codes to classify injuries into the appropriate categories to ensure that treatment and payment is justified under the ICD-9 classification.

Definition

• The World Health Organization established the International Classification of Diseases in 1977 so that health care professionals, clinicians, statisticians, insurance entities, politicians and health planners would all speak the same language when discussing causes of death, injuries and diseases. The 6-digit coding system also allows statisticians and health care professionals to classify and code this data from death certificates around the world to track underlying causes of death and prevent potential problems.

ICD-9 V Codes

• The ICD-9 V-code refers to classifications other than a disease or injury that arise in one of three ways. This includes classification for donors of tissues or organs not related to their own disease or injury; treatment protocols for individuals with known diseases, such as kidney disease requiring dialysis or when a problem influences a person’s health but is not a current illness or injury. In the latter, the V-code is used as a supplementary code, such as treatment for a patient with an artificial heart valve.

Health Insurance Claims

• ICD-9 and V codes also are used in health insurance claims, payments, reimbursements, tracking fees, improving provider relations and projecting revenue. The U.S. Medicare and Medicaid programs require participating doctors to use these six-digit codes in all claims submitted.

Structure

• The ICD-9 codes use a six-digit structure to classify diseases, death and injury. The first three digits determine the area or affliction, and the subsequent numbers offer further detail. For instance, codes 001 to 139 deal with parasitic diseases, codes 290 to 319 pertain to mental disorders, while codes 320 to 359 relate to nervous disorders. Each affliction has an associated code; the United States adds a further classification, “Clinical Modification ” that lists the treatment protocols for the ICD-9 CM system.