With ICD-11 on the Horizon, What Will Happen to ICD-10 Then?

Posted on Posted in Medical Coding Blog

If you think you’ve just started to be more confident on your ICD-10-CM coding skills, here comes an interesting development: revisions are being done on the next-generation product ICD-11.

The World Health Organization, with the help of the Joint Task Force (JTF) coordinates the implementation of ICD-11. It is not fully complete but the WHO has set its launch and implementation in 2018.

Does this mean that all the training you went through learning ICD-10-CM would be put to waste?

The answer is not quite. According to Sue Bowman, senior director for coding policy and compliance at the American Health Information Management Association, it won’t be logical to leapfrog from ICD-10 to ICD-11 without familiarizing with the former first. She calls ICD-10 as “the path” to get to ICD-11 if only for their similarity (both use alphanumeric coding and coding based on laterality). Centers for Medicare and Medicaid Services (CMS) describes ICD-10 as the foundation building block prior to moving to ICD- 11.

Many industry experts also think that the medical coding sector will have ICD-10 for a good 15-20 years, at least. As case in point, the WHO adopted ICD-10 in 1990 and it was only in October 2015 that the US adopted it – replacing ICD-9 – based on the final rule set by the CMS.

In short, even if the WHO release date pushes through in 2018, your coding using ICD-10 would be safe for a good few years, and you would not have to abandon it to learn a revised coding system because the probability that the US would stick to the tenth revision is high.

ICD-10-CM explained

ICD-10-CM stands for Internation Classification of Diseases, Tenth Revision, Clinical Modification and is a system used by physicians and other healthcare providers to classify and code all diagnoses and symptoms recorded in hospital and physician care in the US. The codes are also used by public health workers to see trends in health, and track morbidity and mortality.

The transition from ICD-9 to ICD-10 reflected a five-fold increase in diagnosis codes, from 13,000 to about 69,000. These codes are required for anyone covered by Health Insurance Portability Accountability Act (HIPAA) including doctors, hospitals and health insurance companies, all of whom rely on these codes for diagnosing patients and billing for services.

If a medical practice or insurance payer didn’t comply with the transition, say from ICD-9 to ICD-10, they could be facing difficulties processing claims and could not be getting payments accurately.