While the United States is preparing to implement ICD-10-CM/PCS on October 1, 2014, the World Health Organization (WHO) is anticipating a 2015 release of ICD-11. Taking into account the need to then clinically modify the WHO version, ICD-11 would likely not be ready for implementation in the US until after 2020. Donna Pickett, MPH, RHIA, medical systems administrator at Centers for Disease Control and Prevention/National Center for Health Statistics, delivered an update on the progress of ICD-11 development in Monday’s presentation “ICD-11 Update” at the 2013 AHIMA ICD-10-CM/PCS and Computer-Assisted Coding Summit, taking place in Baltimore, MD this week.
The WHO version of ICD-10 was initially approved in 1989 and is becoming outdated in many respects. The planning of ICD-11 began in 2007 with some very specific goals to improve upon ICD-10, including:
- Ensure that ICD-11 will function in an electronic environment
- Multipurpose and coherent classification
- International multilingual reference standard for scientific comparability
ICD-11 will be a digital product that will link with terminologies (i.e., SNOMED CT) and support electronic health records and information systems. The ICD-11 categories will be defined by “logical operational rules” based on their associations and detail.
The foundation of ICD-11 will be comprehensive enough to classify mortality, morbidity, primary care, clinical care, research, public health, and more. Considerations are being made to ensure that ICD-11 is consistent and interoperable across different users. “There are a dozen countries that have developed their own clinical modifications of ICD,” Pickett said. These various clinical modifications are being reviewed during the development of ICD-11.
The development process of ICD-11 involves numerous Topic Advisory Groups (TAGs) that are comprised of scientific peers of various specialties, as well as cross-sectional TAGs focusing on mortality, morbidity, functioning, quality, and safety. One of the parameters in the development process is that all ICD entities will have key descriptions of the meaning of the category in “human-readable” words to guide users. These descriptions will include 100 words in the print version and a more detailed definition online.
ICD-11 is currently in Beta version, the draft content available via a web portal that is open to the public. “The WHO has not approved this Beta version. It is highly interactive and being updated daily,” says Pickett. Participants can make comments, make proposals to change ICD categories, propose structured definitions of diseases, participate in field testing, or assist in translating ICD into other languages. “The process is intended to be open and transparent,” Pickett said.
Once the TAGs complete the construction and review of the ICD-11 codes, there will be field trial protocols that will test the fitness of ICD-11, review comparability between ICD-10 and ICD-11, increase consistency, and reduce errors. This review process will also evaluate ICD-11 for scientific accuracy and internal consistency of definitions as well as completeness, utility, and relevance of each unit (chapter, section, block, etc.).
“ICD-10-CM is keeping pace with ICD-11,” Pickett noted in closing. Many of the new concepts that are included in ICD-11 are found in ICD-10-CM. Both ICD-11 and ICD-10-CM are fluid systems that will continue enhancement over the upcoming years.