The ICPC-3 is open for testing!
ICPC-3 Field Testing instructions:
- For the Field Testing of ICPC-3 you need a Username and a Password. This will be provided to you after registration. Registration by sending an e-mail with your name, profession and country to: email@example.com
- You will receive a Username and a Password after which you can log on to the ICPC-3 Browser website at: https://icpc3.eggbird.eu
- On the right upper-side of the ICPC-3 Browser there are a number of tags, under which: Manual – Install ICPC-3 App and Coding Fun. Install Coding Fun! explains how to install the ICPC-3 Browser as an App on your cellphone or tablet or desktop computer.
- In the ICPC-3 App you can select the Coding Fun to test the ICPC-3 content, but you can also toggle between the Coding Fun and the ICPC-3 Browser to find your way to the correct code)s).
BUT! before moving to the Coding Fun! via the ICPC-3 Browser website: Please read this information on ICPC-3 first. It will support the understanding of how ICPC-3 is composed, which is required to assign a phrase or expression to the correct classes within ICPC-3.
Introduction on ICPC-3
ICPC-3 is a classification tailored to Primary Health Care using primary care concepts based on the frequency of use of these concepts in daily practice and linked to other classifications (including ICD-11, ICD-10, ICF, ICHI and Snomed-CT). ICPC-3 is divided into 19 chapters.
There are five chapters for:
- reasons for visit, such as prevention, family planning, general examination, etc. – Chapter A1
- general and unspecified issues concerning symptoms, complaints and abnormal findings and diagnoses and diseases – Chapter A
- for social problems – Chapter Z
- for interventions – Chapter I
- and for functioning and functioning related issues – Chapter II
The possibility to capture prevention and family planning, unspecified issues, social problems and information about activities and participation is a prerequisite to understand what happens in primary care from a patient perspective point of view.
Fourteen chapters represent the localization of the problem and / or disease on a body or body-system level, the Chapters A to W. This makes it easy to use for healthcare providers.
In addition to the 19 chapters that belong to the core of the classification, there are three additional chapters:
- a chapter with regional extensions, codes based on the frequency of classes in national and regional primary care registrations – Chapter III,
- a chapter with codes for emergency use with epidemiological importance for risk of (national or international) spreading of infections – Chapter IV and,
- a chapter with extension codes – Chapter V. Extension Codes are provided as supplementary codes or additional positions to give more detail or meaning to the initial code, if so desired. The Extension Codes are not to be used without an initial code.
The choice of classes is based on the framework that combines RFEs with diseases / health problems, participation, activities, functions, interventions / procedures and environmental factors.
New chapters in more detail
Chapter A1. General/routine examination, family planning, prevention, and other reasons for visit
In some cases a patient has a contact which the provider cannot interpret as a complaint or diagnosis within the other chapters of ICPC-3. This contact is related to first contact, prevention, screening and case finding, certification, family planning or public health promotion. The classes in this chapter, like the organ/system chapters, are meant to define an episode of care (EoC). Interventions carried out in these episodes of care are to be coded with the Intervention Codes in Chapter I – Interventions and Processes, not by using the classes in Chapter A1!
Chapter II Functioning and functioning related
This chapter allows a description of the Functioning and Functioning related aspects of all persons (first and follow-up) contacts with the Health Care system in Primary- and Community Care settings. The Functioning and Functioning Related items are a for Primary Health Care selected subset of items from the WHO-International Classification of Functioning, Disability and Health (ICF), which provide an overview of a person in a person-in-context approach, on a certain moment in time. Where indicated in the references of the classes, a specific set of items is available in the form of self-administered tools for the assessment of functioning (and disability). These sets can be regarded as implementations of ICF within a specific UseCase.
For specific use in Primary Care health settings the Primary Care Functioning Scale (PCFS) has been developed with an intended population-age group 50+ with multimorbidity. Specially within multimorbidity the problems in Functioning is often the more important focus of care. The PCFS needs further testing.
Also for a specific use the “Arrêts de Travail en médecine générale à partir de la Classification Internationale de Fonctionnement” (ATCIF) has been developed for sick leave prescription. In many countries sick-leave prescriptions are frequently used in Primary Health Care/General Practices. Using the ICF for sick-leave prescription, instead of the traditional medical approach, supports and changes the way health professionals and patients communicate in the work-related context.
Finally there is the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) from WHO, which is available at www.psychiatry.org/dsm5.
The WHODAS 2.0 is a general applicable tool for the assessment of difficulties due to health/mental health conditions. This assessment tool is advised to be used for the collection of disability data on adults age 18 years and older.
The questions from these three questionnaires have been renamed with the original class-names they have been derived from and structured into two components, as shown below in Chapter II. These classes are encouraged to be used whenever relevant, as separate items or scored with the complete WHODAS 2.0, the PCFS, or the ATCIF.
If more detail on Functioning and Functioning related aspects is required than within the presented selection of items, the WHO ICF should be consulted.
Access to ICF classification: http://apps.who.int/classifications/icfbrowser/
Component 2F Functioning
Functioning of a person can be defined by the complexity of components such as the physiological functions of body systems (including psychological functions), anatomical features of parts of the body such as organs, limbs and their components and the execution of tasks or actions by an individual as such or the involvement of a person in a life situation.
Physiological functions of body systems (including psychological functions) are referred to as Body Functions (body and body-system level).
Anatomical features of parts of the body such as organs, limbs and their components are referred to as Body Structures (body-level). Not as such classified in ICPC-3. In ICPC-3 anatomical terms are harmonized with the Foundational Model of Anatomy (FMA), like in the ICD-11.
Execution of tasks or actions by an individual are referred to as Activities (person-level).
The involvement of a person in a life situation is referred to as Participation (person-in-social context level.
From the Primary Health Care point of view, Activities and Participation are the core part for shaping a person-centered approach. This means that in ICPC-3 the Activities and Participation Chapter comes first, followed by the Functions Chapter.
Component 2R Functioning related
Functioning related factors describe the context in which functioning takes place, and how functioning is executed. They are made up by the environmental factors the person lives in (the things outside the person) and the personality functions in which one person differs from another person. Personality Functions require the persons own perception and expression of, and as to which extent a personal characteristic plays a role in the context of the persons health.
Personality Functions should only be used if provided by the person her- or himself and with consent for use or re-use. It is not to express the health providers opinion about the person.
Chapter III Regional Extension
The regional Extension codes, provided here, are based on the frequency of classes and codes in national and regional primary care registrations. Also additional classes and codes from the Global Burden of Disease (GBD) list, needed to achieve the addressing of a world-wide coverage of health problems have been included in the Regional Extensions. There are presently Regional extensions for Africa, Europe and South America. Other Regions will be available where needed.
In principle these classes/codes are always a part of the Inclusions of the Core version of ICPC-3, where the 6-digit code is already presented.
Chapter IV Emergency codes
The Emergency codes (EM) are for emergency use with epidemiological importance for risk of (National or International) spreading of infections. The codes are updated and harmonized in accordance with the ICD10 and ICD11 emergency classes, whenever relevant.
Chapter V Extension Codes
Extension Codes are provided as supplementary codes or additional positions to give more detail or meaning to the initial code, if so desired. The Extension Codes are not to be used without an initial code.