the structure of ICPC-2. posted 2018, may 05

• ·         Green represent all concepts that should be in Component 1 (codes 01-29 in each chapter): “Symptoms and complaints” (not RFEs as suggested by Marc below)

• ·         Grey: Components 2-6 are Process rubrics and their codes are standard across all chapters and can be used iin any chapter except the social chapter which does not have Components 2-6.

Process codes  include:

• ·         Component 2: Diagnostic &  preventive procedures (codes31-49)
• ·         Component 3: Medication, treatment , procedures (codes 50-59
• ·         Component 4: Test results (codes 60-61
• ·         Component 5: Administrative procedures (code 62)
• ·         Component 6: Referrals and other reasons for encounter (codes 63–69)

• ·         Component 7: Diagnosis/disease ( should be within the  code rang 70-99 in each chapter): is made up of sub-groups each with a different colour on the two pager:
  • ·         Yellow      -- Infections
  • ·         Light blue -- Neoplasms
  • ·         Red           -- Trauma
  • ·         Dark blue  --Congenital anomalies
  • ·         Mauve/purple -- Other diagnoses

A Patient’s reasons for encounter (RFE)  may often include:

• ·         symptoms or complaints ( i.e. component1) but it also may  include ( or be limited to)
• ·         a request for an action: e.g. I want a referral to a …..; I need some a prescription for more medication” etc
• ·         I’v come about my (e.g) ”diabetes”, or their ‘arthritis’, or any other diagnosed problem for which they are already under care.

So a patient RFE could fall into any of the components.

At the end of the consultation, the GP may not have any diagnosis. The GP may be investigating through tests, referral etc. So the “diagnosis” for that consultation  for that problem has to remain a symptom or complaint for the moment.

E.g. Patient presents with Rectal bleeding (RFE = rectal bleeding code D16).

This is the first time he/she has experienced this.

Until you do further investigations, you cannot diagnose this.

So the problem managed ( in the health record), remains the same as the RFE: rectal bleeding code D16. 
This is the beginning of an episode, which later will be diagnosed and have a diagnostic label (rubric) and its code.

Regarding the colours on the ICPC-2 Two pager:

You can see some that some colours are NOT in their correct place.

For example, if you look at chapter S (Skin),  (copied below my signature block):

• ·         In Component 1 ( symptoms & complaints) which should be GREEN we have quite a lot of YELLOW (Infections); and a block of RED (Injuries)

We are trying to fix these problems  in the development of ICPC-3.

How did this mix up of colours ( components) happen?

1. 1.       After ICPC-1 was developed and released in 1987, we used it in many countries and found that some things were missing, and other things were two infrequently managed in general practice in any of the countries using ICPC-1, to want having their own rubric and own code.

IN developing ICPC-2 WICC tried to solve these problems.

Some rubrics were removed because they were too infrequently used ( an merged with other rubrics such as ‘other diseases of ‘’’’’”. However you could not re-use  code for the rubric you just removed, because it would lead to confusion between data collected in ICPC-1 and that collectioed in ICPC-2.

So WICC used codes that had NOT been used in ICPC-1, and these were not always available in the correct component. But the new rubric  had to be put somewhere.

So,  you will see the two new infection rubrics in Chapter S  that are NOT with the other infections (S84, and S95), because there was no numerical space left to put them  in the correct place with the other infections.

There had been insufficient space in ICPC to place the skin injuries in the limited codes available, even in ICPC-2, and again in ICPC-2), so the injuries remained in Component 1.

1. 2.       The components were reviewed by a WICC working group in 2003-4. The groups reached agreement on the CORRECT component for each rubric, made them different colours and created the TWO PAGED.

Note that during this work, ( then some 15-16 years after the release of ICPC-2), the group used any additional understanding of the aetiology of the rubrics, that had grown over the 16 years, so some of the mixed colours you see are because  this improved knowledge assisted in more accurate placement of a rubric into a sub-component ( particularly in the Diagnosis Component (component 7).

I hope this information has helped to some degree.

Has anyone given you an electronic copy of the ICPC-2 BOOK?

If not, I think it would help you very much.

I do not have a copy to send you.

I believe Thomas has a copy he was planning to distribute. I will ask him.

Best wishes in your important work in the Ukraine,

Helena Britt

Dr Helena Britt

Hon. Professor of Primary Care Research

Sydney School of Public Health  |  Sydney Medical School

M +61 (0)411197938

E helena.britt@sydney.edu.au| W www.sydney.edu.au/medicine/fmrc