As coders mark the third anniversary this October of the U.S. implementation of ICD-10, its newly minted successor is waiting in the wings, nearly ready for adoption.
That would be the International Classification of Diseases 11
th Revision, otherwise known as
ICD-11, which was released by the World Health Organization (WHO) in June after a decade in development. And U.S. officials are already considering a switch to the codes – for use on death certificates.
While ICD-11 is considered “implementation ready,” it still must be approved by the World Health Assembly, and that won’t occur until May 2019, according to Donna Pickett, who heads the
ICD-10-CM Coordination and Maintenance Committee offices at the National Center for Health Statistics, a branch of the Centers for Disease Control and Prevention (CDC).
The new code set comes with certain enhancements over ICD-10, such as built-in lengthy descriptions at the category level of the codes and how they are to be used. In addition, ICD-11 includes 26 chapters, compared with ICD-10’s 21. New chapters address areas including diseases of the blood or blood-forming organs, immune system diseases, sleep-wake disorders, conditions related to sexual health and the intriguing “traditional medicine conditions.” ICD-11 also includes new tools for training, crosswalking and code selection to ease coders’ transition to the new set.
The approved version of ICD-11 “will go into effect on 1 January 2022,” the WHO website states.
After that, the U.S. could decide to begin the adoption process for ICD-11 for mortality reporting (cause of death), which does not require formal rulemaking under the HIPAA statute, Pickett announced Sept. 12 at the Coordination and Maintenance Committee meeting in Baltimore. She noted that the U.S. began using the WHO’s version of ICD-10 for mortality reporting in 1999, seven years after WHO finalized that code set. U.S. adoption of ICD-10 for morbidity reporting – illness, injury and other conditions – did not begin for another 16 years.
If this country does decide to implement ICD-11 for mortality reporting, it would likely be on a timetable of “a minimum of five years – not sooner than 2023,” she explained.
No timetable yet for morbidity reporting
However, coders likely won’t have to worry about transitioning to ICD-11 to report illnesses and injuries on their insurance claims for quite a while. In fact, Pickett said it was too soon to set a timetable for it.
For one thing, “rulemaking will be in play for any implementation,” under HIPAA. And there are still many details to be ironed out before the U.S. could consider adopting ICD-11, Picket warned.
For example, there is the issue of clinical modification (CM). The U.S. and other countries including Australia and Germany created their own national modifications of both ICD-9 and ICD-10 diagnosis codes before activating those code sets. For ICD-10, the U.S. used the CM to expand the code set to include laterality, seventh characters and other additional details not in the original WHO code set.
But ICD-11 already contains those elements, and the WHO would like to discourage countries from creating their own modifications this time around, Pickett said. It is too soon to say whether the U.S. might still see a need for clinical modification, or whether WHO would permit one, she added.
There is also the matter of licensing. While WHO retained the copyright for the ICD-9 and ICD-10 code sets, it allowed countries to adapt and release the codes without charging a licensing fee.
For ICD-11, though, WHO wants to keep licensing restrictions in place so they can retain control of the codes, Pickett said. That raises “a whole host of issues we didn’t have to deal with for ICD-9 and ICD-10,” she pointed out - especially for book publishers and electronic products that incorporate diagnosis codes into their data systems.
“This is the beginning of the process,” she explained. “The WHO may have completed the content, but now it is up to each country to assess how to move forward.”