US gets the ball rolling on ICD-11

The National Committee on Vital and Health Statistics (NCVHS) met with several industry experts in preparation for the implementation of the ICD-11 code set in the US market. Committee members and industry stakeholders used the two-day assembly to reach a shared understanding of the critical lessons learned from the transition to ICD-10 and what needs to be done to move forward to ICD-11. Together they developed a series of documents calling government leaders to action. These compelling arguments will be prefaced by a letter to be presented to the Secretary of the Department of Health and Human Services. Included in the material are vital research questions that the committee  press need to be answered to inform of the costs and benefits of transition to ICD-11 for both mortality and morbidity.

Experts lack concrete information on many key aspects including: ICD-10 vs ICD-11 comparisons to identify what is missing in ICD-11, mechanisms of covering content gaps, how to develop computer tools to support implementation, costs of switching for both mortality and morbidity, and the costs of training. These research questions will help to fill knowledge gaps in pivotal data required to make informed decisions about implementation and will be used to determine everything from timeline, legislation, budgeting and funding, as well as the impact on public health and the industry. Many other research topics considered vital to the implementation process were included in the letter to the Secretary; including the feasibility of implementing ICD-11 for morbidity without a US Clinical Modification.

The committee states implementation of ICD-11 is inevitable, as the version given to the World Health Assembly in 2019 will go into effect January 1st, 2022. As of that date, all mortality data and statistics transmitted to the World Health Organization (WHO) are desired to be in ICD-11 format, though the WHO recognizes implementation will not happen overnight. Coders may remember that ICD-10 was used to report mortality in the US as early as 1999, 16 years before an implementation of a Clinical Modification (CM) version we know and use today for daily coding went into effect. Experts at the NCVHS meeting tentatively predict the US to report ICD-11 for mortality as soon as six years from this meetings date. The committee sees implementation and required use of ICD-11 for reporting morbidity in the US, without a CM version, as early as 2025; and if a CM version is determined to be needed, 2027. Though the committee was able to propose a timeline for research, development, legislation and implementation in its letter to the Secretary, they understand that extensive research is needed before the government and stakeholders can expect concrete dates.

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