ICD-11 Round up: April #1

ICD-11 Round up: April #1

Post #239 Shortlink: http://wp.me/pKrrB-2Qy

[PMID 23583019]

The Lancet, Early Online Publication, 11 April 2013

Proposals for mental disorders specifically associated with stress in the International Classification of Diseases-11

Maercker A, Brewin CR, Bryant RA, Cloitre M, Reed GM, Ommeren MV, Humayun A, Jones LM, Kagee SA, Llosa AE, Rousseau C, Somasundaram DJ, Souza R, Suzuki Y, Weissbecker I, Wessely SC, First MB, Saxena S.

Mental disorders specifically associated with stress are exceptional in needing external events to have caused psychiatric symptoms for a diagnosis to be made. The specialty of stress-associated disorders is characterised by lively debates, including about the extent to which human suffering should be medicalised, 1 and the purported overuse of the diagnosis of post-traumatic stress disorder (PTSD). 2 Most common mental disorders are potentiated or exacerbated by stress and childhood adversity…

AM, CRB, RAB, MC, GMR, MvO, SW, MBF, and SS were the core writing group. AH, LJ, SAK, AEL, CR, DS, RS, YS, and IW discussed the text and gave feedback to the core writing group.
Conflicts of interest
AM, CRB, RAB, MC, AH, LJ, SAK, CR, DS, SCW, and YS are members of the WHO ICD-11 Working Group on the Classification of Disorders Specifically Associated with Stress, reporting to the WHO International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders. GMR, MvO, and SS are members of the WHO Secretariat, Department of Mental Health and Substance Abuse. AEL, RS, IW, and MBF are special invitees to Working Group meetings. However, the views expressed in this article are those of the authors and, except as specifically noted, do not represent the official policies or positions of the International Advisory Group or WHO.
[Subscription required for full paper. A PDF may be available on authors’ personal websites or academic websites.]


According to CDC’s, Donna Picket, as reported by AHIMA (American Health Information Management Association), “ICD-11 would likely not be ready for implementation in the US until after 2020.”


Update: ICD-11 on Track For 2015

Melanie Endicott | AHIMA & ICD-10 & ICD-10/CAC Summit | April 23, 2013

While the United States is preparing to implement ICD-10-CM/PCS on October 1, 2014, the World Health Organization (WHO) is anticipating a 2015 release of ICD-11. Taking into account the need to then clinically modify the WHO version, ICD-11 would likely not be ready for implementation in the US until after 2020. Donna Pickett, MPH, RHIA, medical systems administrator at Centers for Disease Control and Prevention/National Center for Health Statistics, delivered an update on the progress of ICD-11 development in Monday’s presentation “ICD-11 Update” at the 2013 AHIMA ICD-10-CM/PCS and Computer-Assisted Coding Summit, taking place in Baltimore, MD this week...  Read on


Go here to view ICD-11 Beta drafting platform public version


ICD-11 Beta: Expectations, Concerns and Known Issues

Information for Beta Participants

ICD-11 Beta Phase started on 14 May 2012. The objective is to have a final ICD-11 version by 2015. This announcement clarifies that ICD-11 Beta version is not final, and will be enhanced by input from multiple stakeholders during the beta phase, which will last 3 years.

Problems and Issues
Concerns and Criticisms etc



Participate in ICD Revision
Video invitation to participate
Frequently Asked Questions About ICD-11
ICD Information Sheet
ICD Revision Information Notes
Register to become involved
Content Model
Definitions etc


Presentation | T Bedirhan Üstün

ICD Revision Summary presentation: Quality and Safety Topic Advisory Group meeting, New York, April 2-3, 2013.

ICD11 Quality and Safety TAG 2013 Presentation | Slideshare

According to this presentation, by WHO’s Bedirhan Üstün, all ICD-11 Topic Advisory Groups (TAGs) have finished their editing of the structure. A good deal of work remains for the population of content, in accordance with the ICD-11 Content Model, across all chapters and on compatibility of linearizations across primary care, specialty and detailed research versions.


Presentation [PDF Format, no PP viewer required]

Revising the ICD Definition of Intellectual Disability: Implications and Recommendations | March 19, 2013

Intellectual Disability’s Long Journey: George Jesien, Ph.D., Executive Director, Association for University Centers on Disabilities (AUCD)
Intellectual Disability and the Revision of ICD-10 Mental and Behavioural Disorders: Geoffrey M. Reed, Department of Mental Health and Substance Abuse, WHO
AAIDD Proposed Recommendations for ICD-11: Marc J. Tassé, Nisonger Center – UCEDD, The Ohio State University, Webinar

On Slides 17 and 18, Classification System Most Used and Classification Most Used by Country, graphics for data from WPA-WHO Survey of Practicing Psychiatrists* on global use of ICD-10, ICD-8/9, DSM-IV and Other diagnostic system(s).

*World Psychiatry. 2011 Jun;10(2):118-31.

The WPA-WHO Global Survey of Psychiatrists’ Attitudes Towards Mental Disorders Classification.

Reed GM, Mendonça Correia J, Esparza P, Saxena S, Maj M.


Full free paper



Schizophrenia Bulletin

Schizophr Bull.2012;38(5):895-898.

Status of Psychotic Disorders in ICD-11

Wolfgang Gaebel

Abstract and full report


ICD-11 Revision Beta drafting process: stakeholder participation

ICD-11 Revision Beta drafting process: stakeholder participation

Post #194 Shortlink: http://wp.me/pKrrB-2nw

Information in this report relates to the World Health Organization’s ICD-11, currently under development. It does not apply to the existing ICD-10 or to the forthcoming US specific “clinical modification” of ICD-10, known as ICD-10-CM.

Update at August 2, 2012:

ICD-11 Slide Presentation:     Harrison Slides 2011 PDF 3MB

Update at August 2, 2012:

Dr Robert J.G. Chalmers, co-chair and managing editor of ICD Revision Dermatology Topic Advisory Group put out a call, yesterday, on the website of the American Academy of Dermatology Association (AAD) for input into the Beta draft for Chapter 12 Diseases of the skin:

An invitation to contribute to the future of dermatology

ICD-11 Update

By Robert J.G. Chalmers

ICD-11 draft is ready for comments and criticism

By Robert J.G. Chalmers, MB, FRCP, August 01, 2012


When will ICD-11 be ready for dissemination?

Slipping targets

The revision of ICD-10 and development of the structure for ICD-11 began in 2007.

ICD-11 was originally planned to be ready for dissemination by 2012, with the timelines for the revisions of ICD-10 and DSM-IV running more or less in parallel. Source: Archive documents, References [1] [2].

Very early on in the revision process, the ICD-11 dissemination date was extended from 2012 to 2015. In 2009, launch of the Beta draft was timelined for May 2011, with the final draft scheduled for submission to World Health Assembly (WPA) for approval in 2014.

In order to be ready for global implementation in 2015, the technical work on ICD-11 would need to be completed by 2012. Source: Dr Geoffrey Reed, Ph.D., May 2009, via personal correspondence.


ICD-11 still at the Beta drafting stage

In early 2011, in response to slipping targets for content population and software development, ICD Revision and WHO-FIC were discussing the pros and cons of postponing the launch of a Beta drafting platform until later that year or until May 2012, and whether an interim solution might be to launch “a hybrid model of opening the revision process to public comment and suggestions at the same time not a full scale beta phase with field trials…”

Sources: Slide presentation: ICD Revision Paediatrics Meeting, Ankara, Turkey, February 28 – March 1, 2011;
Report: WHO-FIC Council conference call, February 16, 2011: Page 6: 
PDF for Report [3]


Launch of the Beta delayed

The decision was made to delay launching the Beta draft until May 2012. With the Alpha and Beta stages already running a year or more behind 2009 targets, it’s not clear how much time can be allocated for completing the Beta phase and two year field trials period – if the target for a final version for public viewing in 2014 is going to be reached.

According to the ICD-11 Timeline, presentation for World Health Assembly approval has been shifted to May 2015 and in this paper, published in March 2012 by Christopher Chute, MD, (Chair, ICD-11 Revision Steering Group) et al, publication of ICD-11 is now expected “around 2016.”

“…And just a small detail: who will do all this work?” [4]

ICD-11 is a very ambitious project.

The burden of drafting and liaison is being carried out largely via electronic means between individuals scattered across the globe and in addition to their clinical and academic responsibilities.

Given the scale of the undertaking, its technical complexity, limited funding and human resources, lack of an overall project manager, reported communication problems between WHO, Revision Steering Group, Topic Advisory Group managing editors and members and the amount of work that remains to be completed, I cannot see this vision of WHO’s Bedirhan Üstün reaching fruition by 2016.

There are some interesting comments in this Agenda Appendix (Page 6 of 10) on project funding, lack of resources, project management and lines of communication: ICD-11 April 11 Meeting Agenda

For make-up of the Revision Steering Group (RSG) and the various Topic Advisory Groups (TAGs) see links at end of post. Membership of the various sub working groups to Topic Advisory Groups and the names of external peer reviewers of proposals and content have not been published by ICD-11 Revision.


Where can the Beta drafting platform be viewed?

ICD Revision Steering Group and the various Topic Advisory Groups that are developing the Beta draft are working on an electronic collaborative authoring platform, called the iCAT, on a password protected server accessible only by WHO classification experts, Revision Steering Group, Topic Advisory Group Managing Editors and revision process IT personnel and software developers. It looks similar to this:

For more views of the iCAT see Slides 20-25 and Slide 39 of this 2011 slide presentation:

ICD-11 Slide Presentation:     Harrison Slides 2011 PDF 3MB

The iCAT platform is more complex than the publicly viewable version of the Beta platform and has a mechanism for recording change histories which tracks additions, deletions and revisions to the draft as ICD chapters are reorganized and new content generated and populated.

Population of content is managed by the Topic Advisory Group (TAG) Managing Editors following review by the Revision Steering Group. Structural changes to the classification, eg changing parent/child relationships and editing the linearizations can only be done by TAG Managing Editors in liaison with WHO classification experts. Source: Drafting Workflow text and chart [MS Word]; Swim Lane Workflow chart [PDF].

The publicly viewable version of the Beta drafting platform, which was launched in May 2012, looks like this:

With no change histories displaying in the public version of the Beta it is difficult for stakeholders to track proposed hierarchical changes to existing categories, changes to the names of parent classes or child categories, proposed introduction of new category terms (and the rationales for these) or proposed retirement of ICD-10 categories.

In the absence of rationales, it cannot be determined whether the disappearance of a category or group of categories is due to error or oversight by Advisory Group Managing Editors or others with editor level access, a temporary absence while a specific chapter section is being reorganized or whether these no longer displaying categories are intended to be subsumed under existing or new categories.

For example, a number of ICD-10 F45 and F48 Somatoform Disorder categories were removed from the Beta draft in early July with no explanation of intention.

Whilst ICD Revision invites interaction with the drafting process, the lack of clear intent on the part of Advisory Group editors and lack of response to requests for clarifications hinder submission of meaningful stakeholder comment and productive interaction with the process.


When viewing the Beta draft, be mindful of the Caveats published by ICD Revision; the draft is in a state of flux.

The ICD-11 Beta drafting process is a work in progress over the next two to three years. The Beta draft is updated on a daily basis to reflect the work being carried out on the iCAT platform. Parent terms, category terms and sorting codes assigned to categories are subject to change as chapter reorganization progresses.

The Beta draft can be accessed here:

Beta draft Foundation Component (FC) view:


Beta draft Linearization Morbity (LM) view:


For definitions of Synonyms, Inclusions, Exclusions and ICD-11 terminology see the iCAT Glossary.


Who are the stakeholders in ICD?

government service providers
policy makers and policy implementation agencies
health care professionals and practitioners
physician groups, especially primary care physicians
researchers and clinician academics
lay health care workers (who deliver most of the primary and mental health care in some developing countries)
social workers
patients (aka service users/consumers of health services), their families and carers
advocacy and disability rights organizations
health information managers and coders
health information technology workers

On its Facebook page, in June, ICD Revision put out a specific call for professionals with backgrounds in the following fields:


Do you have a background in any of the following areas?

Health information management (coding, medical records)
Environmental and occupational health and hygiene
Physiotherapy or Physical therapy
Social Sciences
Social work and counseling
Health Policy
Traditional and complementary medicine

WHO is asking experts from all over the world to sign up today to participate in the ICD revision.



How can stakeholders participate in the Beta process?

The public version of the Beta platform can be viewed without registration.

Professional stakeholders and others who register an interest are able to interact with the drafting process and have access to additional content.

Interested stakeholders can register here

Registered stakeholders are permitted to:

• Add comments on and read other stakeholder comments on concepts; title terms; synonyms; inclusion terms, exclusions and other Content Model parameter terms;
• Comment on whether a category is in the right place;
• Comment on whether the category is useful for Primary Care; Research; Clinical;
• Suggest definitions (with source for definition) for a disease or disorder and comment on already populated draft definitions;
• Make proposals to change ICD categories;
• Offer to participate in field trials (for professionals);
• Offer to assist in translating ICD into other languages

Comments left by registered stakeholders are not visible to non registered viewers. Comments cannot be edited or deleted and appear immediately.

Recent comments get aggregated here:


PDFs of Print Versions for the ICD-11 Beta Morbidity Linearization

Registered users can download individual chapters or the full linearization using the links on this page. These PDF files are updated every few days to reflect the daily revisions to the drafting platform:


For more information on how it is envisaged professional and lay stakeholders will interact with the drafting process see:

PowerPoint presentation slides in Posts #70 and #71:

ICD Revision Process Alpha Evaluation Meeting 11 – 14 April 2011: The Way Forward?

ICD Revision Process Alpha Evaluation Meeting documents and PowerPoint slide presentations

ICD-11 Revision Video invitation to participate here: Video invitation to participate

Press Release here announcing launch of Beta drafting platform. Further media coverage here

Specific call for comments from neurology professionals on The Lancet Neurology site here:



Recently issued documents around the Beta drafting process

Frequently Asked Questions About ICD-11

ICD-11 Beta: Expectations, Concerns and Known Issues: Information for Beta Participants


ICD-11 Known Concerns and Criticisms: Known concerns about the ICD-11 Beta phase


     ICD-11 Beta known concerns

ICD-11 Known Problems and Issues: General known issues


     ICD-11 General known issues


The ICD-11 Content Model

ICD Revision says that the most important difference between ICD-10 and ICD-11 will be the Content Model.

In ICD-10, other than Chapter V Mental and behavioral disorders, there are no definitions or other descriptive content associated with ICD categories – just hierarchical lists of diseases arranged by chapter and their ICD codes.

But content in ICD-11 is being populated in accordance with the Content Model Reference Guide and there will be the potential for considerably more content to be included for diseases, disorders and syndromes in ICD-11 than appears in ICD-10, across all chapters:

“Population of the Content Model and the subsequent review process will serve as the foundation for the creation of the ICD-11. The Content Model identifies the basic characteristics needed to define any ICD category through use of multiple parameters.”

The most recently published version of the Content Model Reference Guide is here:

Content Model Reference Guide January 2011  [MS Word]

There are currently 13 defined parameters in the content model to describe a category in ICD. All categories will have an ICD Entity Title, Classification Properties, Textual Definition, Terms and up to 13 parameters described.

Content Model Parameters

  • ICD Entity Title
  • Classification Properties
  • Textual Definitions
  • Terms
  • Body System/Structure Description
  • Temporal Properties
  • Severity of Subtypes Properties
  • Manifestation Properties
  • Causal Properties
  • Functioning Properties
  • Specific Condition Properties
  • Treatment Properties
  • Diagnostic Criteria

Some ICD-11 chapters are more advanced than others for reorganization of categories and population of proposed definitions and text for other parameters.

In setting itself the task of generating, peer reviewing, populating and approving this amount of detail across the entire ICD, one has to question how realistic a goal this is within current timeframes.

“Populating the Content Model is a critical task for the revision. Failure results in failure of delivery of ICD‑11.” [4]

It would not surprise me if at some point before the end of this year, ICD Revision Steering Group announces further delays for the Beta drafting and field trial stages and an extension to the projected dissemination date, or a scaling back of the project if completion of ICD-11 and its several, planned speciality publications, by 2016, is to be viable.


Will ICD-11 be implemented worldwide from 2015/16?

ICD-10 is used in over 100 countries, worldwide. Assuming ICD-11 does meet it schedules, it may still take several years before countries currently using ICD-10 are ready to adopt ICD-11.

Several countries have been authorized by WHO to develop their own “Clinical Modification (CM)” of ICD. Canada uses an adaptation called ICD-10-CA, with a version published for 2009. Germany uses a version called ICD-10-GM. Australia (ICD-10-AM) and Thailand (ICD-10-TM) also use country specific modifications of ICD-10.

The US lags behind the rest of the world and is still using a CM version of ICD based on the ICD-9, which is long since retired by the WHO.

Instead of moving onto ICD-11, once this is completed, the US had scheduled implementation of a clinical modification of ICD-10 called ICD-10-CM, for October 1, 2013. ICD-10-CM has been in development for a considerable number of years.

On April 17, 2012 the Secretary of HHS issued a proposed rule to delay the compliance date for ICD-10-CM and ICD-10-PCS codes sets from October 1, 2013 to October 1, 2014, in order to allow more time for clinical practices and the coding industry to prepare for transitioning from ICD-9-CM to ICD-10-CM.

The public comment period for the proposed rule to delay the compliance date is now closed and comments are in the process of being reviewed. A final rule has yet to be announced. Until a new compliance date has been ratified and the revised implementation date reached, codes in ICD-10-CM are not valid for any purpose or use but can be viewed for free on the CDC website together with other ICD-10-CM documentation.

The US might not anticipate moving on to a clinical modification of ICD-11 before 2020 and possibly later*.

*Source: DHSS Office of Secretary Final Rule document“We estimated that the earliest projected date to begin rulemaking for implementation of a U.S. clinical modification of ICD–11 would be the year 2020.”

WHO-FIC meeting materials suggest no earlier than 2018 for Canada. Australia is discussing earlier adoption of ICD-11 (or a CM of ICD-11).

Harmonization between ICD-11 and DSM-5

There is already a degree of correspondence between DSM-IV categories and Chapter V of ICD-10. For the next editions, the APA and WHO have committed as far as possible:

“To facilitate the achievement of the highest possible extent of uniformity and harmonization between ICD-11 mental and behavioural disorders and DSM-V disorders and their diagnostic criteria.”

with the objective that

“The WHO and APA should make all attempts to ensure that in their core versions, the category names, glossary descriptions and criteria are identical for ICD and DSM.”

WHO acknowledges that there may be areas where congruency may not be achievable.

With the timelines for DSM-5 and ICD-11 running out of synch (DSM-5 slated for publication in May 2013; ICD-11 still at the Beta drafting stage with a two year period scheduled for completion of its field trials), this may present barriers to harmonization.

In a June 2011 presentation to the International Congress of the Royal College of Psychiatrists, APA President, John M. Oldham, MD, MS, spoke of “Negotiations in progress to ‘harmonize’ DSM-5 with ICD-11 and to ‘retro-fit’ these codes into ICD-10-CM” and that DSM-5 would need “to include ICD-10-CM ‘F-codes’ in order to process all insurance claims beginning October 1, 2011.”

With the three systems: DSM-5 (publication date May 2013), ICD-10-CM (subject to partial code freeze since October 1, 2011 until 2014+ with new compliance date t.b.a.) and ICD-11 (dissemination scheduled for 2015+) set to become potentially more closely aligned, proposals for ICD-11 may have implications for US health care professionals and patient populations who might also consider themselves stakeholders in the ICD-11 development process.


References and additional ICD-11 related links and documentation

According to documents [1] and [2], ICD-11 was originally planned for dissemination by 2012, with the timelines for revisions of ICD-10 and DSM-IV running more or less in parallel. By 2008, the completion date for ICD-11 had been extended to 2014. In December 2009, the American Psychiatric Association (APA) announced a shift in the publication date for DSM-5 to May 2013. APA News Release No. 09-65 

1] IUPsyS Mar 08 Agenda Item 25 ICD-10
International Union of Psychological Science COMMITTEE ON INTERNATIONAL RELATIONS ACTION, March 28–30, 2008, Agenda Item No. 25: Revision of the International Classification of Diseases (ICD-10) and Involvement of Psychology

2] Exhibit 1 WHO Letter Aug 07 
Letter Saxena, WHO, to Ritchie, IUPsyS (International Union for Psychological Science), August 2007
Source: http://www.apa.org/international/governance/cirp/s08agenda25-Exhibit1.pdf  

3] Pages 5-6: Report, WHO FIC Council conference call, 16 February 2011, PDF format

4] Closing remarks, PowerPoint presentation: “Proposal for the ICD Beta Platform”, Stanford team, 12.04.11, WHO, Geneva.

5] Key document: ICD Revision Project Plan version 2.1 9 July 2010

Key links

ICD-11 Beta drafting platform  |  Publicly viewable version

WHO ICD Revision  |  Main WHO website: Revision Steering Group and Topic Advisory Groups
ICD-11 Revision site  |  Revision resources [Google site currently unavailable]
ICD-11 Revision site Documents Page  |  Key revision documents and meeting materials  [Google site currently unavailable]

ICD-11 Revision Information  |
ICD-11 Timeline  |

ICD Information Sheet  |

Revision News  |
Steering Group  |
Topic Advisory Groups  |

ICD-11 YouTube Channel  |  Video reports
ICD-11 on Facebook  |
ICD-11 on Twitter  |
ICD-11 Blog  |  Not updated since October 2009

ICD-11 YouTubes collated on Dx Revision Watch ICD-11 YouTubes  |

WHO Publications

ICD-10 Tabular List online Version: 2010  |  International Statistical Classification of Diseases and Related Health Problems 10th Revision Version: 2010, Tabular List of inclusions and Chapter List

ICD-10 Volume 2: Instruction Manual  |  Volume 2 online Version: 2010 PDF Download

ICD-10 for Mental and Behavioural Disorders Diagnostic Criteria for Research  |  PDF download
ICD-10 for Mental and Behavioural Disorders Clinical Descriptions and Diagnostic Guidelines  |  PDF download

ICD-10 Volume 3: The Alphabetical Index  |  WHO does not make ICD-10 Volume 3: The Alphabetical Index available online

About the World Health Organization (WHO)

The WHO Family of International Classifications  

History of ICD

WHO releases ICD-11 Beta drafting platform

WHO releases ICD-11 Beta drafting platform

Post #170 Shortlink: http://wp.me/pKrrB-28K

Yesterday, May 14, the World Health Organization (WHO) announced the launch of the ICD-11 Beta drafting platform.

Press Release here and below.

This publicly viewable platform replaces the Alpha drafting platform that has been viewable since mid 2011. ICD-11 Revision Topic Advisory Groups are using a separate drafting platform with greater functionality than the platform launched yesterday.

Interested stakeholders can register for increased access and to interact with the Beta drafting platform.

In terms of functionality, the Beta platform does not appear to incorporate any additional features over the Alpha. 

In terms of population of content, some entities have text populated for Definitions, others are still waiting for provisional definitions. Some entities have very few “Content Model” parameters listed, others have the following: Parents; Definition; Synonyms; Exclusions; Narrower Terms; Causal Mechanisms; Body Site.

It’s not evident how many of the proposed 13 “Content Model” parameters that describe an ICD-11 entity term will eventually be populated for any given entity. The original list of 13 “Content Model” parameters has been modified since early 2011, but no new documentation has been publicly released that sets out the new parameters.

More information on the Beta drafting platform here:


The International Classification of Diseases 11th Revision is due by 2015

Participate in the ICD Revision

Beta phase participants will have the opportunity to:

• Make Comments
• Make Proposals
• Propose definitions of diseases in a structured way
• Participate in Field Trials
• Assist in translating ICD into other languages

Video invitation to participate
Frequently Asked Questions About ICD-11
ICD Information Sheet

WHO video invitation from Dr Marie-Paule Kieny on ICD-11

For the first time, experts in the public health community who work with patient diagnosis and treatment have an opportunity to contribute to the development of the next version of the ICD. This is WHO’s publication that ensures all aspects of the health community refer to diseases and health conditions in a consistent way.

WHO is calling on experts, health providers and stakeholders from around the world to participate in the 11th revision process. The final ICD-11 will be released in 2015.

With your help, this classification will be more comprehensive than ever before.


The Beta drafting platform can be found here:



Foundation Component:


User Guide:


Listing for Chronic fatigue syndrome:


WHO Press Release

May 2102


WHO seeks health experts’ input for 11th International Classification of Diseases

For the first time, experts in the public health community who work with patient diagnosis and treatment have an opportunity to contribute to the development of the next version of the International Classification of Diseases (ICD), which is WHO’s publication that ensures all members of the health community refer to diseases and health conditions in a consistent way.

WHO/Jim Holmes

WHO is releasing the beta version of what will be ICD-11 on a wiki-type platform that allows stakeholder comments to be added after peer review. The final ICD-11 will be released in 2015.

WHO encourages anyone interested to comment to develop a more comprehensive classification.

Foundation for reliable health data

The ICD is the foundation for the identification of health trends and statistics globally. Receiving input from health experts will greatly improve the representation from current medical practice and create insight from a broader diversity of medicine.

“Literally this is what doctors use to diagnose a patient,” says Tevfik Bedirhan Ustun, coordinator in the Department of Health Statistics and Information Systems. “It is how we define the cause of death when a person dies. In research, it is how we classify health problems based on evidence.”

The ICD is the gold standard for defining and reporting diseases and health conditions. It allows the world to compare and share health information using a common language.

In addition to health providers, the ICD is a key tool used by epidemiologists to study disease patterns, insurers, national health programme managers, data collection specialists, and others who track global health progress and how health resources are spent.

ICD-11 innovations

Using advances in information technology, this ICD revision will allow users to collect data on cause of death, advances in science and medicine, emerging diseases and health conditions, and compare information across the globe with more ease and diversity in the service of public health and clinical reporting.

Some of the key new features of the 11th version will include:

• a new chapter on traditional medicine, which constitutes a significant part of health care in many parts of the world;
• it will be ready to use with electronic health records and applications;
• it will updated through the development phase to reflect new knowledge as it is added to the classification; and
• it will be produced in multiple languages through the development phase.

Further coverage:


WHO seeks inputs for key disease database

Tuesday, 15 May 2012 00:29
Pioneer News Service | New Delhi

The World Health Organisation (WHO) in a maiden initiative has invited experts and users to contribute online to the development of its next version of the International Classification of Diseases (ICD) capturing mortality and morbidity data.

The world’s standard tool provides a picture of the general health of countries and populations and its 11th version is now being developed through an innovative, collaborative process to be released in 2015.

“This is for the first time WHO is calling on experts and users to participate in the revision process through a web-based platform. The outcome will be a classification that is based on user input and needs,” a WHO official said.

Users include physicians, nurses, other providers, researchers, health information managers and coders, health information technology workers, policy-makers, insurers and patient organisations.

WHO will soon be releasing the beta version of what will be ICD-11 on a wiki-type platform that allows stakeholder comments to be added after peer review.

All Member States are expected to use the most current version of the ICD for reporting death and disease statistics (according to the WHO Nomenclature Regulations adopted by the World Health Assembly in 1967), the official added.

Regarding the steps for participating, he elaborated that experts and stakeholders will have to register for a participant account on the web portal which will be open for comments over the next three years and accepted changes will be reflected immediately.

Some of the key new features of the 11th version will include a new chapter on traditional medicine, which constitutes a significant part of health care in many parts of the world and ready to use with electronic health records and applications.

The ICD is translated into 43 languages and is used by all 117 member countries. The ICD holds importance as it provides a common language for reporting and monitoring diseases. This allows the world to compare and share data in a consistent and standard way – between hospitals, regions and countries and over periods of time. It facilitates the collection and storage of data for analysis and evidence-based decision-making, the official said.

CMS expected to announce proposal for new ICD-10 implementation date sometime in April

CMS expected to announce proposal for new ICD-10 implementation date sometime in April

Post #153 Shortlink: http://wp.me/pKrrB-218

In a press release on February 16, Health and Human Services Secretary, Kathleen G. Sebelius, announced HHS’s intent to initiate a process to postpone the date by which certain health care entities have to comply with ICD-10-CM diagnosis and procedure codes.

The final rule adopting ICD-10-CM as a standard was published in January 2009, when a compliance date of October 1, 2013 had been set – a delay of two years from the compliance date initially specified in the 2008 proposed rule.

Several sites covering CMS’s intention to delay implementation are citing April as the month in which a new timeline for ICD-10-CM is expected to be announced:

HC Pro

New ICD-10 implementation date expected in April

ICD-10 Trainer | March 21, 2012

CMS plans to announce a new ICD-10 implementation date sometime in April, according to representatives of CMS and MassHealth, a public health insurance program for low and medium-income residents in Massachusetts.

Renee Washington, director of customer system integration at MassHealth, revealed the time frame for the much anticipated announcement during the Massachusetts Health Data Consortium’s March 9 conference call. Renee Richard from the CMS Regional Office in Boston confirmed this information during the call…

HC Pro Just Coding

Healthcare News: CMS targets April for release of new ICD-10-CM/PCS implementation date

March 20, 2012

CMS expects to release a new ICD-10-CM/PCS implementation date sometime in April. That date will be the same for payers and providers. (Excerpt from a member only article.)

ICD-10 Watch (no connection with this site which was formerly known as “DSM-5 and ICD-11 Watch”)

It’s about time for an ICD-10 delay announcement

Carl Natale | March 30, 2012

It looks like next week is when the Centers for Medicare and Medicaid (CMS) will announce their proposals for a new ICD-10 timeline.

Which should mean they will publish it in the Federal Register and take public comment for 60 days. Then they will consider the feedback and issue a final rule. Who knows when that will be…

Read full round up by Carl Natale


Christopher Chute, MD, (Chair, ICD-11 Revision Steering Group) et al set out the case for delaying implementation, in this paper published at Health Affairs:

Health Affairs

At the Intersection of Health, Health Care, and Policy

There Are Important Reasons For Delaying Implementation Of The New ICD-10 Coding System

Abstract: http://content.healthaffairs.org/content/early/2012/03/21/hlthaff.2011.1258.abstract

Full free text: http://content.healthaffairs.org/content/early/2012/03/21/hlthaff.2011.1258.full

PDF: http://content.healthaffairs.org/content/early/2012/03/21/hlthaff.2011.1258.full.pdf+html

Published online before print March 2012, doi: Health Aff March 2012 10.1377/hlthaff.2011.1258

There Are Important Reasons For Delaying Implementation Of The New ICD-10 Coding System

Christopher G. Chute 1,*, Stanley M. Huff 2, James A. Ferguson 3, James M. Walker 4 and John D. Halamka 5

Author Affiliations

1 Christopher G. Chute (chute@mayo.edu) is a professor of biomedical informatics at Mayo Clinic, in Rochester, Minnesota.
2 Stanley M. Huff is a professor of biomedical informatics at the University of Utah, in [please provide city], and chief medical informatics officer at Intermountain Healthcare, in Murray, Utah.
3 James A. Ferguson is a fellow at the Kaiser Permanente Institute for Health Policy and vice president of health information technology strategy and policy for Kaiser Permanente, in Oakland, California.
4 James M. Walker is chief health information officer of Geisinger Health System, in Danville, Pennsylvania.
5 John D. Halamka is a professor of medicine at Harvard Medical School, chief information officer at Beth Israel Deaconess Medical Center, and chief information officer at Harvard Medical School, in Boston, Massachusetts.
*Corresponding author


Federal authorities have recently signaled that they would consider delaying some aspects of implementation of the newest version of the International Classification of Diseases, known as ICD-10-CM, a coding system used to define health care charges and diagnoses. Some industry groups have reacted with dismay, and many providers with relief. We are concerned that adopting this new classification system for reimbursement will be disruptive and costly and will offer no material improvement over the current system. Because the health care community is also working to integrate health information technology and federal meaningful-use specifications that require the adoption of other complex coding standardization systems (such as the system called SNOMED CT), we recommend that the Centers for Medicare and Medicaid Services consider delaying the adoption of ICD-10-CM. Policy makers should also begin planning now for ways to make the coming transition to ICD-11 as tolerable as possible for the health care and payment community.

Full free text

Tom Sullivan, for Health Care IT News, asks Chute, “Why not just skip right to ICD-11?”

Why not just skip right to ICD-11?

Tom Sullivan, Government Health IT| March 13, 2012

…While industry associations battle over the code set’s future, and HHS figures out when the new compliance deadline will be, the World Health Organization (WHO) is already moving toward ICD-11, promising a beta in 2014 to be followed by the final version in 2015. Should that slip until 2016, U.S. health entities will still be settling into ICD-10 when ICD-11 arrives – meaning that shortly thereafter, we will be right back where we are now: Behind the times, on the previous ICD incarnation.

Are we repeating our own faulty history?

“That almost assuredly will be the case,” said Chris Chute, MD, DrPH, who spearheads the Mayo Clinic’s bioinformatics division and chairs the WHO’s ICD-11 Revision Steering Group…

Read full article by Tom Sullivan

Rhonda Butler argues why US health care providers and industry can’t just ditch ICD-10-CM and wait for ICD-11 in 2015/16:

3M Health Information

We Can’t Skip ICD-10 and Go Straight to ICD-11

Rhonda Butler | March 26, 2012

Since the recent announcement by CMS that ICD-10 implementation will be delayed for certain healthcare entities, some industry pundits have argued, “Let’s just skip ICD-10 and go straight to ICD-11.”

Skipping ICD-10 assumes that we haven’t started implementing ICD-10. Well, the U.S. did start—19 years ago.

What have we been doing for the last 19 years…

Read full article

Letter from Justine M. Carr, MD, Chairperson, National Committee on Vital and Health Statistics to The Honorable Kathleen Sebelius, Secretary, Department of Health and Human Services, March 2, 2012

Contains ICD-10-CM timeline

    Re: Possible Delay of Deadline for Implementation of ICD-10 Code Sets

James Phillips asks Michael First (Editor of DSM-IV-TR, Consultant to WHO ICD-11 Revision) how DSM-5 relates to ICD:

Psychiatric Times

DSM-5 In the Homestretch—1. Integrating the Coding Systems

James Phillips, MD | 07 March 2012

With DSM-5 scheduled for publication a little more than a year from now, we may safely assume that, barring unannounced surprises from, say, the APA Scientific Review Committee, what we will see on the DSM-5 Web site is what we will get. With that in mind it’s time to review what we will indeed get. But before moving to significant changes in the major disorder categories, we should remind ourselves where DSM-5 fits into the larger picture of coding mental illnesses.

There are, in case you have forgotten, two classificatory systems of mental disorders—the International Classification of Diseases (ICD), produced by the World Health Organization (WHO), and the Diagnostic and Statistical Manual (DSM), produced by the American Psychiatric Association. How are they related? It is a question that has confused me, and I assume, some of my psychiatric colleagues as well as others—other mental health professionals, and still others. For an answer to this question I asked Michael First, MD, Editor of DSM-IV-TR, Consultant on the WHO ICD-11 revision…

Read full commentary


Related posts:

HHS Secretary Sebelius announces intent to delay ICD-10-CM compliance date  February 16, 2012

AHIMA: Ten Reasons to Not Delay ICD-10 (ICD-10-CM)  February 23, 2012

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