Donna Pickett, RHIA, MPH Medical Systems Administrator AHRQ Annual Conference September 10, 2012 Overview of the WHO ICD Revision Process (ICD-11) National.

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

Questions?

Donna Pickett - [email protected]