US ICD-10 Market size and forecast, 2016-2026

International Classification of Diseases (ICD) -10 is a new system, launched in October 2015 by the World Health Organization (WHO). It classifies and monitors diseases, their symptoms, and track causes of injury and abnormal findings. ICD-10 uses codes to classify the diseases. These codes are used to provide better information of diseases thus helping in improving the quality of patient care. For instance, data captured by ICD-10 can help to provide betterunderstanding of complications and help to frame clinically robust algorithms.

The applications of ICD-10 include noting diseases on health records, tracking the trends in epidemiology, and assisting in decisions made for medical reimbursement. The WHO develops and publishes these ICD-10 codes, and institutions such as governments and regulating bodies adopt it.

In the U.S., ICD-10 has been split into two systems. This includes ICD-10-CM (Clinical Modification) which is used for diagnostic coding. Second is ICD-10-PCS (Procedure Coding System) which is used for inpatient hospital procedure coding. The U.S.-specific ICD-10 conform to WHO’s ICD-10 layout as well as allowing the addition of other details found in U.S. healthcare.

Before ICD-10 was adopted on October 1st 2015, ICD-9 was in use in the U.S. However, the need for more elaborate listings of diseases and conformity to modern healthcare practices gave rise to the implementation of ICD-10. ICD-10 codes offer more number of classification options as compared ICD-9.

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Global ICD-10 Market: Drivers and Restraints

Need for quality measurement and medical error reduction for the safety of patients led to the improvisation of ICD-9 and creation of ICD-10. ICD-10-CM contains 69,000 diagnosis codes as compared to 14,000 codes of ICD-9-CM. This captures the specificity of the problem more accurately. ICD-10 also provides a large number of combination codes in comparison to ICD-9 which had limited combination codes.

Secondly, need for a large amount of medical data for the purpose of clinical research also drives the demand for ICD-10. With the availability of all the information at one place, it becomes easy to extract information for clinical research.

However, the implementation of ICD-10 across the country by healthcare providers proves to be very costly. This is because each healthcare provider has a minimum of 100 physicians under it along with other entities in the chain. Therefore, implementing it across the chain becomes very expensive for the providers.

Global ICD-10 Market: Market Segmentation

Segmentation on basis of type:

The major types of ICD-10 include:

  • ICD-10-CM (Clinical Modification)
  • ICD-10-PCS (Procedure Coding System)

ICD-10-CM diagnosis coding is for use in all the U.S. healthcare settings while ICD-10-PCS inpatient procedure coding is for use in the U.S. hospital settings.

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Segmentation on basis of End-user:

The major segments of End-user in this market include (within the healthcare industry):

  • Healthcare providers
  • Coders
  • IT professionals
  • Insurance carriers
  • Government agencies

Global ICD-10 Market: Key Players

The World Health Organization (WHO) is the sole developer and publisher of ICD-10 codes, while the system is adopted by government agencies and other regulating bodies.

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