The Conversion Between ICPC and ICD-10. Requirements for a Family of Classification Systems in the Next Decade

Abstract

The International Classification of Primary Care (ICPC) was developed to order medical concepts into classes that have been chosen for their relevance for family medicine. Family physicians use this to label the most prevalent conditions in their practice as well as their patients' symptoms and complaints. At the same time they do not want to be divorced from the needs of the medical community at large as these are reflected in the most recent medical nomenclature: the Tenth Revision of the International Classification of Diseases (ICD-10). A full conversion between all classes in the first and seventh component of ICPC (n = 646) with those of ICD-10 (n = 1983), with the exception of the chapter on external causes, has been prepared. It was concluded that ICD-10 at the three-digit level cannot function as a core classification for an international primary care system. Of the three-digit ICD-10 rubrics only 120 are compatible on a one to one basis with an ICPC rubric. A total of 114 three-digit ICD-10 rubrics have to be broken open into four-digit rubrics to allow at least one compatible conversion to one or more ICPC rubrics. On this basis only 25% of the diagnostic classes in ICPC can be converted to a single three- or four-digit ICD-10 rubric without lumping. The rest of ICD-10, either on the three- or on the four-digit level, has to be grouped into combinations of classes (lumping) to allow compatible conversion to the remaining rubrics of ICPC. Even though ICD-10 cannot serve as a core classification for primary care, a technical conversion between ICPC and ICD-10 is practically always possible which allows primary care physicians to implement ICD-10 as a contemporary nomenclature within the classification structure of ICPC.

Employees Sick-Listed with Mental Disorders: Who Returns to Work and When?

“…The ICPC was developed to order medical concepts into diagnostic classes relevant for family medicine, while ICD-10 classifies disorders according to the needs of the medical community at large. Although there are some differences, a technical conversion between the ICPC and ICD-10 codes is practically always possible for mental disorders [25][26][27]. Nystuen et al categorized feeling depressed (ICPC P03) as a depressive condition, while ICD-10 classifies ICPC P03 in the R45 category of symptoms and signs of emotional disturbance [26][27].…”

Diagnosing somatisation disorder (P75) in routine general practice using the International Classification of Primary Care

“…[14,[40][41][42][43]. By entering the diagnostic description, a list of thesaurus terms is offered in a dropdown menu and the clinician selects the best matching term.…”

ICPC-2-E: the electronic version of ICPC-2. Differences from the printed version and the consequences

“…In fact, ICD-10 thus serves as a terminology for ICPC because of the careful mapping of the clinical content rather than only the coding structure of both systems. 6 ICPC contains many 'rag-bag' rubrics, in most of which many ICD-10 classes are included: these contain specific disorders as well as ICD-10 'rag bags'. Obviously, in an electronic patient record, a patient should not be labelled with a 'rag-bag' diagnosis, but with a specific diagnosis attached to an ICPC code to structure the database, and an ICD-10 label for additional specification.…”