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ICD-10 & OPCS-4



Practical Commissioning’s Jargon Buster explains the meaning of the term ‘ICD-10’ and ‘OPCS-4’.

ICD-10 and OPCS-4 are codes used by the Hospital Episode Statistics system to underpin tariff payments and Healthcare Resource Groups. ICD-10 stands for International Statistical Classification of Diseases and Related Health Problems – Tenth Revision. Each diagnosis, such as liver disease, will have its own code. OPCS-4 is the Office of Population Censuses and Surveys Classification of Interventions and Procedures V4.5. Drilling down to this level gives you a more detailed understanding of the episode of care, the eventual diagnosis and any procedures carried out.

There are more than 10,000 codes for ICD-10 and OPCS-4. They sit behind HRG-4, the latest update, which allows you to distinguish between routine and complex care. It introduces new services such as chemotherapy, renal dialyss and diagnostice imaging. There is more detail about the setting for care, distinguishing between inpatients, day cases, outpatients, emergency and critical care and you can now unbundle the patient pathway.

More information

See NHS Comparators at www.nhscomparators.nhs.uk
for local data. It’s also worth visiting www.hesonline.nhs.uk
for more detail.

To request data down to provider level, contact the NHS Information Centre at enquiries@ic.nhs.uk
or 0845 300 6016.