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Donna Pickett, RHIA, MPHMedical Systems Administrator
AHRQ Annual Conference September 10, 2012
Overview of the WHO ICD Revision Process (ICD-11)
National Center for Health Statistics
Classifications and Public Health Data Standards
ICD Revision History
2
ICD Revision No. Year of Conference When Adopted
Year in Use in the U.S.
ICD, Clinical Modification
Year in Use in the U.S.
First 1900 1900-1909
Second 1909 1910-1920
Third 1920 1921-1929
Fourth 1929 1930-1938
Fifth 1938 1939-1948
Sixth 1948 1949-1957
Seventh 1955 1958-1967
Eighth 1965 1968-1978 ICDA-8H-ICDA-1H-ICDA-2
1968-19781968-19721973-1978
Ninth 1975 1979-1998 ICD-9-CM 1979
Tenth 1989 1999- ICD-10-CM Oct. 1, 2014
3
HIPAA Administrative Simplification:Modifications to Medical Data Code Set Standards
• Published August 2012 • Adopts ICD-10-CM and ICD10-PCS as
replacements for ICD-9-CM • October 1, 2014 – Compliance date for
implementation of ICD-10-CM and ICD-10-PCS• Single implementation date for all users
– Date of service for ambulatory and physician reporting
– Date of discharge for inpatient and other settings
The ICD Revision Process
–Background–Alpha–Beta–Timeline–Participation
ICD-11 Revision Goals1. Multi-purpose and coherent classification
– Mortality, morbidity, primary care, clinical care, research, public health…– Consistency & interoperability across different uses
2. International multilingual reference standard for – scientific comparability and – communication purposes
3. Fit for electronic health record environments– Link
• terminologies and • ontologies (e.g. SNOMED, GO, …)
– ICD Categories • “defined” by • "logical operational rules" on their associations and details
Definitions
• All ICD entities will have definitions:key descriptions of the meaning of the category
in human readable terms – to guide users
• Limited definition in Print Version – 100 words • Detailed definitions ONLINE
• Definitions will be compatible with:– the Content Model – Diagnostic Criteria– across the whole classification and the versions
Construction of ICD-11: Revision Process in the 21st Century
• Internet-based permanent platform – All year round – Open to all people in a structured way– Content experts focus
• Digital curation– Wiki enabled collaboration– Ontology based
• Enhanced discussion & peer review – TAGs serve as the editorial group
• Electronic copy print version • Work in multiple languages• Planned field tests
– Based on Use Cases
ICD Revision Organizational Structure
Gastroenterology WG
Cardiovascular WG
Hepatology & Pancreatobiliary WG
Nephrology WG
Endocrinology WG
Rheumatology WG
Cross-Sectional TAGs
Working Groups
Haematology WG
Respiratory WG
Dentistry TAG
Musculoskeletal TAG
Mental Health TAG
GURM
External Causes and Injuries TAG
Dermatology TAG
Internal Medicine TAG
Neurology TAG
Ophthalmology TAG
Paediatrics TAG
Functioning TAG
Mortality TAG
Morbidity TAG
Quality & Safety TAG
Rare Diseases TAG
Health Informatics and Modelling TAG (HIM TAG)
iCAT Software Team
Traditional Medicine TAG
Neoplasms TAG
WHO
Revision Steering Group
Genito-Urinary, Reproductive
and Maternal TAG
ICD11 beta http://www.who.int/classifications/icd/revision
• Beta – Browser & Print 10 look & feel + descriptions – code
structure !
• ICD-11 beta draft is INCOMPLETE • updated on a daily basis• NOT TO BE USED for CODING at this stage• not yet been approved by the TAGs, RSG or WHO
The ICD-11 Beta Phase
• New beta platform: ICD-11 Browser• WHO Web story• Twitter announcement• Facebook announcement• WHO website• FAQs and Fact Sheet about the revision to post on WHO
website• ADG Video Message calling on experts to get involved
• http://www.who.int/classifications/icd/revision/en/index.html
The ICD-11 Beta Phase
• Draft ICD-11 Content presented in web portal: www.who.int/classifications/icd11
• Daily Updates• Participants can:
– Make comments– Make proposals to change ICD Categories– Propose structured definitions of diseases– Participate in field testing– Assist in translating ICD into other languages
• Answer Single Assessment Questions – (e.g. Is this category in the right place? Is this scientifically
accurate?)
Work Program during Beta Phase
• Completion of chapters by end August 2012
• Standardized structured reviews by experts– Suggested by TAG and others
• Inter rater reliability• Bridge coding• WHO will draw a framework to ensure
standardization of beta testing
ICD-11 Timeline
2011 : Alpha version ( ICD 11 alpha draft) +1 YR : Commentaries and consultations
2012 : Beta version & Field Trials Version 14 May 2012 +2 YR : Field trials
2014 : Final version for public viewing
2015 : WHA Approval
2015+ implementation