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

April 2, 2012 by

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

Abstract

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

Filed under American Psychiatric Association (APA), Christopher Chute, Clinical Modification, ICD revision process, ICD-10, ICD-10-CM, ICD-10-CM compliance, ICD-11, ICD-11 Beta Draft, WHO (World Health Organization) Tagged with , , , , , , , , ,

AHIMA: Ten Reasons to Not Delay ICD-10 (ICD-10-CM)

February 23, 2012 by

AHIMA: Ten Reasons to Not Delay ICD-10 (ICD-10-CM)

Post #147 Shortlink: http://wp.me/pKrrB-1Xw

This material relates to the forthcoming US specific “clinical modification” of the WHO ICD-10, known as “ICD-10-CM.” It does not relate to other country specific clinical modifications of ICD-10.

Update @ February 27: There has been considerable coverage of HHS’s announcement to delay the compliance date for ICD-10-CM.

Further coverage:

Press release

HCPro

Industry Experts Respond to Announcement of ICD-10 Deadline Delay

February 27, 2012

Industry experts respond as HHS has confirmed its intent to delay the ICD-10 compliance deadline, according to its latest press release. HCPro contacted numerous industry experts for their thoughts on the recent announcement by CMS. Although reactions are mixed, experts agree that forward progress on ICD-10 readiness for providers is essential…

ICD-10 may not be postponed for everyone

Ken Kerry | February 20, 2012

One school of thought is that it will be delayed for a year or two; but CMS’ announcement mentioned that only “certain healthcare entities” would be granted a reprieve. Which entities? We don’t know yet.

On January 16, 2009, Department of Health and Human Services (HHS) published a Final Rule in the Federal Register mandating adoption of ICD-10-CM and ICD-10-PCS to replace ICD-9-CM in HIPAA transactions, with a compliance date of October 1, 2013.

Until implementation, codes in ICD-10-CM are not valid for any purpose or use. ICD-10-CM has been subject to partial code freeze since October 1, 2011.

The 2012 release of ICD-10-CM is now available from the CDC site and replaces the December 2011 release:

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

 

HHS announces delay for compliance

On February 16, HHS Secretary Kathleen Sebelius issued a press release announcing that HHS will initiate a process to postpone the date by which certain health care entities are required to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes.

HHS Secretary Kathleen Sebelius said, “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead.  We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”

HHS has yet to announce a new compliance date but it is speculated that the delay would be for at least one year, rather than for a few months.

Related content:

Post #142 | February 16, 2012

HHS Secretary Sebelius announces intent to delay ICD-10-CM compliance date

For background see: 

Could the U.S skip ICD-10 and leapfrog directly to ICD-11?

February 16, 2012 | Tom Sullivan, Government Health IT

HIMSS statement, February 17, 2012

HIMSS Calls for Maintaining October 1, 2013 ICD-10 Implementation Deadline for Most Healthcare Entities

Information Week report

ICD-10 Delay Worries Health IT Leaders

The train’s already left the station for organizations that have been prepping for an October 2013 ICD-10 deadline, say health IT organizations and CIOs.

Nicole Lewis | InformationWeek |February 22, 2012

Practice Fusion

HHS Asks for a Delay to the Start of ICD-10

Robert Rowley, MD | February 21, 2012

AHIMA issues statement and press release

Yesterday, American Health Information Management Association (AHIMA) issued a statement and press release in response to HHS Sebelius’ February 16 announcement to delay the ICD-10-CM compliance date.

AHIMA represents more than 64,000 Health Information Management professionals in the United States and around the world. www.ahima.org

American Health Information Management Association statement and press release

http://journal.ahima.org/2012/02/22/ten-reasons-to-not-delay-icd-10/

     AHIMA statement IDC-10 Delay 02.17.12

Ten Reasons to Not Delay ICD-10

Feb 22, 2012 01:12 pm | posted by Kevin Heubusch | ICD-10

This week AHIMA announced it will reach out to leaders at the Department of Health and Human Services and urge there be no delay in the implementation of ICD-10-CM and ICD-10-PCS.

“We recommend that HHS reach out to the full healthcare community and gather more information about the great strides many have achieved— in good faith—since the ICD-10 deadline was set in January 2009,” said AHIMA CEO Lynne Thomas Gordon, quoted in a statement.

Further, AHIMA encouraged the healthcare community to continue its implementation planning and not let up its efforts.

In a statement released today, AHIMA offered 10 reasons not to delay ICD-10 implementation.

Ten Reasons We Need ICD-10 Now

  1. It Enhances Quality Measures. Without ICD-10 data, serious gaps will remain in the healthcare community’s ability to extract important patient health information needed for physicians and others to measure quality care.
  2. Research Capabilities Will Improve Patient Care. Data could be used in a more meaningful way to enable better understanding of complications, better design of clinically robust algorithms, and better tracking of the outcomes of care. Greater detail offers the ability to discover previously-unrecognized relationships or uncover phenomenon such as incipient epidemics early.
  3. Significant Progress Has Already Been Made. For several years, hospitals and healthcare systems, health plans, vendors and academic institutions have been preparing in good faith to put systems in place to transition to ICD-10. A delay would cause an unnecessary setback.
  4. Education Programs Are Underway. To ready the next generation of HIM professionals, academic institutions have set their curriculum for two-year, four-year, and graduate programs to include ICD-10.
  5. Other Healthcare Initiatives Need ICD-10. ICD-10 is the foundation needed to support other national healthcare initiatives such as meaningful use, value-based purchasing, payment reform, quality reporting and accountable care organizations. Electronic health record systems being adopted today are ICD-10 compatible. Without ICD-10, the value of these other efforts is greatly diminished.
  6. It Reduces Fraud. With ICD-10, the detail of health procedures will be easier to track, reducing opportunities for unscrupulous practitioners to cheat the system.
  7. It Promotes Cost Effectiveness. More accurate information will reduce waste, lead to more accurate reimbursement and help ensure that healthcare dollars are used efficiently.

If ICD-10 Is Delayed:

  1. Resources Will Be Lost. For the last three years, the healthcare community has invested millions of dollars analyzing their systems, aligning resources and training staff for the ICD-10 transition.
  2. Costs Will Increase. A delay will cause increased implementation costs, as many healthcare providers and health plans will need to maintain two systems (ICD-9 and ICD-10). Delaying ICD-10 increases the cost of keeping personnel trained and prepared for the transition. Other systems, business processes, and operational elements also will need upgrading. More resources will be needed to repeat some implementation activities if ICD-10 is delayed.
  3. Jobs Will Be Lost.To prepare for the transition, many hospitals and healthcare providers have hired additional staff whose jobs will be affected if ICD-10 is delayed.

And Finally…

We Can’t Wait for ICD-11. The foundations of ICD-11 rest on ICD-10 and the foundation must be laid before a solid structure can be built. ICD-11 will require the development and integration of a new clinical modification system. Even under ideal circumstances, ICD-11 is still several years away from being ready for implementation in the United States.*

In the report by Tom Sullivan (Health Care Finance News, February 16, 2012), Christopher Chute, MD, who chairs the ICD-11 Revision Steering Group, warned of a possible further delay for completion of ICD-11, from 2015 to 2016.

Implementation of ICD-11 has already been shifted from 2012 to 2014, then last year, to 2015+. These are projections for pilot, then global implementation for ICD-11.

The DHHS Office of the Secretary Final Rule document, February 2009, stated:

“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.”

Canada uses a clinical modification of ICD-10 called ICD-10-CA. WHO-FIC meeting materials suggest that Canada might not move onto ICD-11 (or a modification of ICD-11) until 2018+.  Australia, which uses a clinical modification of ICD-10 called ICD-10-AM, is discussing potentially earlier adoption of ICD-11.

Filed under Clinical Modification, ICD-10, ICD-10-CM, ICD-10-CM compliance, ICD-11, ICD-11 in the media, WHO (World Health Organization) Tagged with , , , , , , , ,

“Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?

February 20, 2012 by

“Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?

Post #145 Shortlink: http://wp.me/pKrrB-1Vx

The information in this report relates only to proposals for the WHO’s forthcoming ICD-11; it does not relate to ICD-10 or to the forthcoming US specific “clinical modification” of ICD-10, known as ICD-10-CM.

Codes assigned to ICD-11 Beta draft categories are subject to change as chapter reorganization progresses. Images and text in this posting may not reflect the most recently assigned codes. This post has been updated to reflect the launch of the Beta drafting platform and revisions to codes assigned during the drafting process as they stand at June 24, 2012.

Part One

 

This report contains an important update on proposals for ICD-11 Chapter 5: Mental and behavioural disorders.

In a February 16, 2012 report by Tom Sullivan for Health Care Finance News, Christopher Chute, MD, who chairs the ICD Revision Steering Group, warned of a possible delay for completion of ICD-11 from 2015 to 2016.

The ICD-11 Beta drafting platform was launched in May 2012.

The Beta drafting platform is a publicly viewable browser similar to the Alpha drafting platform that had been in the public domain since May, 2011.

You can view the Beta Drafting Browser here:

Foundation Component view:

http://apps.who.int/classifications/icd11/browse/f/en

Morbidity Linearization view:

http://apps.who.int/classifications/icd11/browse/l-m/en

The Morbidity Linearization is the view that includes (what may be temporarily assigned) sorting codes. These codes are likely to change as chapter organization progresses. Click on the small grey arrows next to the chapters and categories to display parent > child > grandchildren hierarchies. Click on individual terms to display descriptive content in the right hand frame of the Beta Browser.

Textual content for ICD-11 is in the process of being drafted and the population of content for some chapters is more advanced than others. Content for some of the “ICD-11 Content Model” parameters may display: ID legacy code from ICD-10 (where applicable); Parent(s); Definition; Synonyms; Inclusions; Narrower Terms; Exclusions; Body Site; Causal Mechanism; Signs and Symptoms.

(For ICD-11, entities will be defined across all chapters through up to 13 “Content Model” parameters – considerably more descriptive content than in ICD-10 and a significant workload for the Topic Advisory Group members and managers who are generating the content for ICD-11.)

The Beta Browser User Guide is here:

http://apps.who.int/classifications/icd11/browse/Help/en

This page of the User Guide sets out differences between Foundation view and Morbidity Linearization view.

The various ICD Revision Topic Advisory Groups (TAGs) are carrying out their work on a separate, more complex, multi-author drafting platform. On their platform, editing histories and “Category and Discussion Notes” are recorded so the progress of proposals and reorganization of ICD entities can be tracked, as the draft evolves.

For the Beta drafting platform, interested stakeholders may register for increased access and interaction with the drafting process by submitting comments and suggestions on draft content and proposals.

For those registered for increased access, it is possible to download PDFs of drafts for the “Print Versions for the ICD-11 Beta Morbidity Linearization” for all 25 chapters of ICD-11. These are obtainable, once registered and logged in, from the Linearization > Print Versions tab.

Caveats

I’m going to reiterate the ICD-11 Alpha Browser Caveats because it’s important to understand that the ICD-11 Beta draft is a work in progress – not a static document – and is subject to change.

The draft is updated on a (usually) daily basis; when you view the Beta Browser, you are viewing a “snapshot” of how the publicly viewable draft stood at the end of the previous day; not all chapters are as advanced as others for reorganization or population of content; the draft is incomplete and may contain errors and omissions.

The codes and “sorting labels” assigned to ICD parent classes, child and grandchildren terms are subject to change as reorganization of the chapters progresses. The Beta draft has not yet been approved by the Topic Advisory Groups, Revision Steering Group or WHO and proposals for, and content in the draft may not progress to the Beta drafting stage; field trials have not yet been completed – so be mindful of the fact that the draft is in a state of flux.

As it currently stands, the Beta draft lacks clarity; not all textual content will have been generated and uploaded for terms imported from ICD-10 and there may be no definitions or other textual content displaying for proposed new terms.

Two chapters that are a focus of this site are Chapter 5: Mental and behavioural disorders and Chapter 6: Disorders of the nervous system (the Neurology chapter). (ICD-11 is dropping the use of Roman numerals.)

I won’t be reporting on specific categories in Chapter 6 in this post but will do a follow up post for Chapter 6 in a forthcoming post; again, there is a lack of clarity for Chapter 6 and requests for specific clarifications, last year, from the chair of Topic Advisory Group Neurology and the lead WHO Secretariat for TAG Neurology have met with no response.

Continued on Page 2: Somatoform Disorders in ICD-10; Somatoform Disorders to Bodily Distress Disorders for ICD-11?

Filed under DSM-5 draft proposals, Functional Somatic Syndrome (FSS), ICD-10, ICD-11, ICD-11 Alpha Draft, ICD-11 Beta Draft, ICD-11 consultation, MUS, Somatic Symptom Disorder, Somatoform Disorders, WHO (World Health Organization) Tagged with , , , , , , , ,

HHS Secretary Sebelius announces intent to delay ICD-10-CM compliance date

February 16, 2012 by

HHS Secretary Sebelius announces intent to delay ICD-10-CM compliance date

Post #142 Shortlink: http://wp.me/pKrrB-1Ux

Coverage today of the announcement by Health and Human Services (HHS) Secretary Kathleen G. Sebelius of intent to delay ICD-10-CM compliance date.

Will American Psychiatric Association Board of Trustees take this opportunity to delay its DSM-5 timeline, take a breathing space, and reconsider its controversial proposals for DSM-5, or submit them to independent scientific scrutiny?

Link to report at end of post also quotes Chris Chute, Chair, ICD-11 Revision Steering Group, on possible delay for completion of ICD-11 from 2015 to 2016 – no surprise that ICD Revision may be considering another shift of timeline given the technical ambitiousness of the revision project, the lack of resources and slipping targets for the Alpha and Beta drafts.

Tom Sullivan reports:

Should the U.S. delay the ICD-10 compliance deadline just one year, until 2014, then the WHO will have a beta of ICD-11 ready. And if Sisko’s gut is correct, and the new ICD-10 deadline flows into 2015, well, then a final version of ICD-11 will be fast-approaching.

When it arrives, currently slated for 2015 (but Chute said it could be 2016), the underlying structure of ICD-11 will be profoundly different than any anterior ICD.

“ICD-11 will be significantly more sophisticated, both from a computer science perspective and from a medical content and description perspective,” Chute explains. “Each rubric in ICD-11 will have a fairly rich information space and metadata around it. It will have an English language definition, it will have logical linkages with attributes to SNOMED, it will have applicable genomic information and underpinnings linked to HUGO, human genome standard representations.”

ICD-10, as a point of contrast, provides a title, a string, a number, inclusion terms and an index. No definitions. No linkages because it was created before the Internet, let alone the semantic web. No rich information space.”

 

HHS Secretary Kathleen Sebelius announces intent to delay ICD-10 compliance date

February 16, 2012 | Carl Natale, Editor, ICD10Watch

Health and Human Services (HHS) Secretary Kathleen G. Sebelius confirmed Wednesday that they will change the ICD-10 timeline.

A HHS press release stated they “will initiate the rulemaking process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).”

On Tuesday, Marilyn Tavenner, the acting administrator of the Centers for Medicare and Medicaid Services (CMS), said the agency will examine the ICD-10-CM/PCS timeline. Tavenner made the statement at a conference of the American Medical Association (AMA) National Advocacy Conference. The AMA has declared vigorous opposition to the medical coding system citing the cost, complexity and lack of perceived benefit to patients… Read on

 

CMS Public Affairs Press Release:

http://www.dhhs.gov/news/press/2012pres/02/20120216a.html

News Release
Contact: CMS Public Affairs
(202) 690-6145

FOR IMMEDIATE RELEASE
February 16, 2012

HHS announces intent to delay ICD-10 compliance date

As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).

The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 – a delay of two years from the compliance date initially specified in the 2008 proposed rule. HHS will announce a new compliance date moving forward.

“ICD-10 codes are important to many positive improvements in our health care system,” said HHS Secretary Kathleen Sebelius. “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead. We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system.”

ICD-10 codes provide more robust and specific data that will help improve patient care and enable the exchange of our health care data with that of the rest of the world that has long been using ICD-10. Entities covered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be required to use the ICD-10 diagnostic and procedure codes.

Report:

http://www.healthcarefinancenews.com/news/could-us-skip-icd-10-and-leapfrog-directly-icd-11

Could the U.S skip ICD-10 and leapfrog directly to ICD-11?

February 16, 2012 | Tom Sullivan, Government Health IT

Filed under ICD revision process, ICD-10, ICD-10-CM, ICD-11, ICD-11 Beta Draft, ICD-11 in the media, WHO (World Health Organization) Tagged with , , , , , , ,

ICD-11 Beta drafting platform for release in May 2012

February 11, 2012 by

ICD-11 Beta drafting platform for release in May 2012

Post #139 Shortlink: http://wp.me/pKrrB-1SE

ICD-11 Beta drafting platform

ICD Revision on Facebook has announced that a ‎4th Face to Face meeting of the ICD Revision Topic Advisory Group for Internal Medicine (TAG IM) was held recently, in Tokyo.

No agenda, meeting materials or documents have been posted on the ICD-11 Revision Google site but a PowerPoint presentation prepared by WHO’s, Dr Bedirhan Üstün, is viewable here on the “Slideshare” platform.

Dr Bedirhan Üstün is Coordinator, Classifications, Terminology and Standards, Department of Health Statistics and Information, WHO, Geneva.

You won’t need a PowerPoint .pptx format viewer to view this presentation on the Slideshare site, but you will need a .pptx viewer if you want to download and view the file. (A free .pptx viewer can be downloaded for free from the Microsoft site.)

In order to download the file, you will first need to register with Slideshare or use a Facebook membership as Sign in. If you do agree to download through a Facebook membership, please read and digest the T & C before you agree to Slideshare accessing your Facebook profile data.

View the presentation here:

http://www.slideshare.net/ustunb/tokyo-2012-ustun-show

Tokyo 2012 ustun (show) by Bedirhan Ustun on Feb 10, 2012

for which it states:

“WHO is revising the ICD to be completed by 2015. It is going to enter into a Beta phase by 2012 May during which all stakeholders could see and comment on the ICD as well as propose changes, test in practice.”

Slide #7 states:

• 2011  : Alpha version (ICD 11 alpha draft)

– + 1 YR  : Commentaries and consultations

• 2012  : Beta version & Field Trials Version

– + 2 YR Field Trials

• 2014   : Final version for public viewing

– 2015  : WHA Approval

• 2015+  implementation

Slides #11 and #12, set out the thirteen parameters of the ICD-11 “Content Model”.

 

The “Content Model”

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

Content in ICD-11 will be populated in accordance with the ICD-11 Content Model Reference Guide. There is 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 (e.g. Body Systems, Body Parts, Signs and Symptoms, Diagnostic Findings, Causal Agents, Mechanisms, Temporal Patterns, Severity, Functional Impact, Treatment interventions, Diagnostic Rules).”

This is the most recent available version of the Content Model Reference Guide January 2011

This iCAT Glossary page gives an overview of the 13 Content Model parameters.

See also Post #62: ICD-11 Content Model Reference Guide: version for December 2010

 

New Beta drafting browser

In May 2011, a publicly viewable ICD-11 Alpha Browser platform was launched.

In July 2011, this platform was opened up to professionals and other interested stakeholders who can register via the site for fuller access and for reading and submitting comments. See the ICD-11 Alpha Browser User Guide for information on how the Browser functions and how to register for increased access. (This is the Alpha/Beta “hybrid” referred to in the WHO-FIC Council conference call report, February 16, 2011: Page 6: PDF for Report)

ICD-11 Revision and Topic Advisory Groups are continuing to use a separate platform for drafting purposes.

Stakeholder participation at the Beta stage

In preparation for the Beta drafting stage, another publicly viewable platform is being developed. According to ICD Revision presentations, this platform will invite and support a higher level of professional and public interaction with the drafting process, with various levels of input and editing authority for interested stakeholders who register for participation. According to editing status, registered stakeholders would be permitted to:

Make comments
Make proposals to change ICD categories
Participate in field trials
Assist in translating

See presentation slides in Dx Revision Watch 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

 

Slides #15 and #16 of Dr Üstün’s presentation show the methods via which interested stakeholders will be able to register for interaction with the platform.

I will update when more information becomes available on the launch of the Beta platform.

Filed under ICD revision process, ICD-10, ICD-11, ICD-11 Alpha Draft, ICD-11 Beta Draft, ICD-11 consultation, ICD-11 revision docs, WHO (World Health Organization) Tagged with , , , , , , , , ,

CFSAC November 8-9, 2011 meeting: Minutes and Recommendations to HHS posted

January 14, 2012 by

CFSAC November 8-9, 2011 meeting: Minutes and Recommendations to HHS posted

Shortlink Post #129: http://wp.me/pKrrB-1Fn

The fall meeting of the Chronic Fatigue Syndrome Advisory Committee (CFSAC) took place on November 8-9, 2011.

Minutes and Committee’s Recommendations to HHS have now been posted on the CFSAC website.

Chronic Fatigue Syndrome Advisory Committee (CFSAC) 

The Chronic Fatigue Syndrome Advisory Committee (CFSAC) provides advice and recommendations to the Secretary of Health and Human Services via the Assistant Secretary for Health of the U.S. Department of Health and Human Services on issues related to chronic fatigue syndrome (CFS). These include:

• factors affecting access and care for persons with CFS;
• the science and definition of CFS; and
• broader public health, clinical, research and educational issues related to CFS.

Administrative and management support for CFSAC activities is provided by the Office of the Assistant Secretary for Health (OASH). However, staffing will continue to be provided primarily from the Office on Women’s Health, which is part of OASH.

Dr. Nancy C. Lee, Deputy Assistant Secretary for Health – Women’s Health, is the Designated Federal Officer for CFSAC.

The Meetings page is here

               Minutes Day One CFSAC Fall 2011 meeting

               Minutes Day Two CFSAC Fall 2011 meeting

Presentations, Public Testimony and links for Videos for Day One and Day Two

 

The Agenda item with the most relevance for this site was the issue of the current proposals for chapter placement and coding for Chronic fatigue syndrome in the forthcoming US specific ICD-10-CM, the proposals presented for consideration at the September meeting of the ICD-9-CM Coordination and Maintenance Committee on behalf of the Coalition for ME/CFS, and an alternative proposal presented by NCHS.

See this Dx Revision Watch post (Post #118, December 27, 2011) for a report on the Fall 2012 Meeting presentation by Donna Pickett (NCHS) and discussions of proposals for ICD-10-CM:

CFSAC November 2011 meeting: videos, presentations and Day One Agenda item:

International Classification of Diseases – Clinical Modification (ICD-CM): Presentation by Donna Pickett, RHIA, MPH, National Center for Health Statistics (NCHS)

 

Recommendations out of the Fall 2011 CFSAC Meeting

CFSAC Recommendations – November 8-9, 2011

The specific recommendations articulated by the Committee are:

1. This recommendation addresses the process by which CFSAC transmits recommendations to the Secretary and the Secretary communicates back to CFSAC whether or not a recommendation was acted upon. CFSAC recommends that this process be transparent and clearly articulated to include regular feedback on the status of the committee’s  recommendations. This communication could originate directly from the Office of the Secretary or be transmitted via the relevant agency or agencies.

2. CFSAC recommends to the Secretary that the NIH or other appropriate agency issue a Request for Applications (RFA) for clinical trials research on chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).

3. CFSAC would like to encourage and support the creation of the DHHS Interagency Working Group on Chronic Fatigue Syndrome and ask this group to work together to pool resources that would put into place the “Centers of Excellence” concept that has been recommended repeatedly by this advisory committee. Specifically, CFSAC encourages utilizing HHS agency programs and demonstration projects, available through the various agencies, to develop and coordinate an effort supporting innovative platforms that facilitate evaluation and treatment, research, and public and provider education. These could take the form of appropriately staffed physical locations, or be virtual networks comprising groups of qualified individuals who interact through a variety of electronic media. Outreach and availability to underserved populations, including people who do not have access to expert care, should be a priority in this effort.

4. This multi‐part recommendation pertains to classification of CFS in ICD classification systems:

a) CFSAC considers CFS to be a multi‐system disease and rejects any proposal to classify CFS as a psychiatric condition in the U.S. disease classification systems.

b) CFSAC rejects the current classification of CFS in Chapter 18 of ICD‐9‐CM under R53.82, chronic fatigue unspecified, chronic fatigue syndrome, not otherwise specified.

c) CFSAC continues to recommend that CFS should be classified in ICD‐10‐CM in Chapter 6 under Diseases of the Nervous System at G93.3 in line with ICD‐10, the World Health Organization, and ICD‐10‐CA, the Canadian Clinical Modification and in accordance with CFSAC’s recommendations of August 2005 and May 2011. CFSAC rejects CDC’s National Center for Health Statistics Option 2 and recommends that CFS remain in the same code and the same subcode as myalgic encephalomyelitis because CFS includes both viral and non‐viral triggers.

d) CFSAC recommends that an “excludes one” [sic *] be added to G93.3 for chronic fatigue, R53.82, and neurasthenia, F48.8. CFSAC recommends that these changes be made in ICD‐10‐CM prior to its rollout in 2013.

This final recommendation was also provided to the National Center for Statistics at the CDC prior to the November 18, 2011 deadline for comments along with the following rationale:

We feel that the interests of patients, the scientific and medical communities, continuity and logic are best served by keeping CFS, (B)ME (Benign Myalgic Encephalomyelitis) and PVFS (Post Viral Fatigue Syndrome) in the same broad grouping category. Current scientific evidence would indicate there are more similarities between the three entities than there are differences. Whether they are synonyms for the same underlying concept, disease entities and sub‐entities, or merely the best coding guess is unclear. In reality, any or all of the above may be correct. While the  relationship between CFS, B(ME) and PVFS is not stated, that they are grouped together in ICD 10 (WHO) would indicate some rationale for a connection. Our understanding is that this association will be maintained in the ICD 11, which may also include further description of the relationship. Exclusions specific to chronic fatigue (a symptom present in many illnesses) and neurasthenia (not a current diagnosis) also seem to be under consideration for ICD 11.

*Ed: Should be “Excludes1”. For definitions for “Excludes1” and “Excludes2” see Post #118

               November 2011 Recommendations Letter to the Secretary (PDF 31 KB)

               November 2011 CFSAC Recommendations Chart (PDF 138 KB)

The Minute for Ms Pickett’s presentation “International Classification of Diseases—Clinical Modification (ICD‐CM) Donna Pickett, National Center for Health Statistics (NCHS/Centers for Disease Control and Prevention)” and Committee discussions in response to that presentation can be found on Pages 4-10 of the PDF for Minutes Day One (November 8, 2011).

Video of presentation in Post #118. Ms Pickett’s presentation slides here in PDF format.

The Minute for the proposal and unanimous approval of a revised and expanded Recommendation to HHS on the coding of CFS in ICD-10-CM can be found on Pages 43-44 of the PDF for Minutes Day Two (November 9, 2011). Video in Post #118.

As reported in Post #118, following the September 14 meeting of the ICD-9-CM Coordination and Maintenance Committee, NCHS had invited comments from stakeholders on the proposals in Option 1 (presented by the Coalition for ME/CFS) and Option 2 (alternative proposals by NCHS).

The closing date for comments was November 18, 2011.

A decision was expected before the end of December but since any decision that might have been reached on these proposals has yet to be announced, I have raised some queries with Ms Pickett around the decision making process (see Post #118). I will update when a response has been received from Ms Pickett’s office or a public announcement made.

 

Related post

CFSAC November 2011 meeting: videos, presentations and Day One Agenda item: 

International Classification of Diseases – Clinical Modification (ICD-CM): Presentation by Donna Pickett, RHIA, MPH, National Center for Health Statistics (NCHS), November 27, 2011

Filed under CFSAC meetings, Clinical Modification, Coalition4ME/CFS, ICD-10, ICD-10-CM, ICD-11, ICD-11 Alpha Draft, ICD-11 revision docs, WHO (World Health Organization) Tagged with , , , , , , , , ,

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