Just as many US healthcare organizations are hitting their stride in ICD-10 implementation, more changes are on the horizon. This past June, the World Health Organization (WHO) released the first complete draft of the next iteration in its International Statistical Classification of Diseases and Related Health Problems, ICD-11.
This version is very different from the 9th and 10th versions that the United States modified to create the ICD-9-CM and ICD-10-CM standard codes, with which coding and HIM professionals have become so familiar.
ICD-11 will be presented to the World Health Assembly next spring. Worldwide, it’s slated to go into effect on January 1, 2022 for mortality reporting. You can browse the code set here.
Among the highlights:
- This edition includes 55,000 codes, up from 14,440 in ICD-10.
- There are new chapters covering sleep-wake disorders, traditional medicine and sexual health (which was previously covered in other chapters). The addictive disorders chapter has been updated with gaming disorders.
- Introduces a new coding approach: “cluster” coding, which provides a mechanism to use more than one code, in a cluster, to fully represent a concept.
- Other new methods that are covered include pre-coordination, post-coordination, sanctioning rules, multiple parenting and linearization.
- Healthcare safety data can also be captured, which may help hospitals prevent unnecessary incidents.
With so many changes and new diagnosis codes to parse through, hospitals and health systems should examine their resources, bolster their internal expertise and, in many cases, seek outside help.
Created Specifically for Electronic Medical Records (EMRs)
ICD-11 is the first standardized coding system to have been built entirely on an electronic infrastructure. This, WHO and coding experts hope, will make it easier for organizations to integrate with their EMRs and other digital health applications.
As you’ll recall, the initial rollout of ICD-10 seemed to industry watchers to go more smoothly than expected. But many US healthcare entities encountered unforeseen difficulties over the course of their implementation cycles.
One of the most common problems was incorrect code mapping — instances in which EMRs or applications were found to still be mapping back to select ICD-9-CM codes even after ICD-10-CM protocols were loaded in.
Usually, these concerned isolated codes that, once discovered, could be easily remapped. But, as with any large-scale modification to an existing computer system, such “bugs” often manifested at the least convenient moments.
In ICD-10-CM’s case, some of those errors may have been attributable to the fact that its development began in the early 1990s, before EMRs became the gold standard. With ICD-11, many of these issues will hopefully be avoided.
ICD-11’s Collaborative Development May Bode Well for Easier Implementation
Unlike ICD-10’s long, fitful development, ICD-11’s was a collaborative, transparent and publicly accessible affair. This time around, for example, SNOMED International was included in the process.
As a result, ICD-11 and SNOMED Clinical Terms (SNOMED CT) are more synergistic. That should lead to improved post-rollout interoperability, which is most welcome news for healthcare organizations. In addition, there are new tools for mapping ICD-10 to ICD-11, as well as for coding, browsing and translation.
Still, issues will crop up even for the organizations that prepare diligently for ICD-11 implementation.
Implementation Timelines Will Be Regulated and the Process Will Be Long
There’s typically a lag time of three years for countries to start implementing a new ICD version. It can be even longer in countries with highly complex, integrated health information systems, like the United States. As with ICD-10-CM, fully evaluating ICD-11 and its implications for morbidity reporting on healthcare claims will take years. A mandatory implementation date will be determined by regulators, but it’s clear that implementation will be a long-term process.
Stay Tuned for More News about ICD-11
We’ll be keeping an eye on developments and preparing ourselves to help healthcare systems like yours accomplish smooth and efficient ICD-11 implementations.
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