ICD-11: One Last Coding Update for the Road

The implementation date for the new code remains uncertain at this time.

EDITOR’S NOTE: Skurka, who is stepping down after 40 years of voluntary services to AHIMA and the World Health Organization, will make her public farewell appearance on Talk Ten Tuesdays today.

I’m sure a question on all your minds is this: when will we start coding with ICD-11 in the U.S.?

I have no idea, nor does anyone, really, in the U.S., to the best of my knowledge. Much must happen before that decision is made. As an active, current member of the National Committee on Vital and Health Statistics (NCVHS) in the U.S., I can report that it remains firmly on our agenda. We are an advisory committee that can make recommendations and observations, set goals and establish vision, and provide guidance and framework regarding implementation work – but we do not make policy decisions, or anything of the sort.

NCVHS did send an important follow-up letter to the first letter sent about ICD-11 in 2019. Our newest letter was issued in September of this year. We again made two recommendations:

  1. That HHS (the U.S. Department of Health and Human Services) should conduct research to evaluate the impact of different approaches to the transition to and implementation of ICD-11; and
  2. That HHS should conduct outreach and communicate regularly to the U.S. healthcare community industry about the ICD transition.

How long will this research and evaluation period last? I do not think any of us know. Last time it took us 25 years after it was endorsed by the WHO. No decisions have been made by either the U.S. or our colleagues in Canada and Australia whether various editions will be developed. Both Canada and Australia are saying “no” at this point, to the best of my knowledge, and I am in contact with my counterparts there regularly.

NCVHS recommended in its latest letter that the research be completed in 12 months. There have been only three studies, I believe, in the U.S. to date that directly compare ICD-11 with ICD-10-CM. NCVHS did develop an updated set of recommended research questions, and they were attached to the aforementioned letter sent. We also recommended that HHS execute a strategic communication plan as soon as possible, running parallel with the recommended research work over the next 12 months.

We believe that taking a proactive approach to ICD-11 is essential. This includes all the research and communications recommendations included in the most recent letter. The U.S. needs to identify a path forward that supports national healthcare priorities, optimizes benefits, and minimizes cost. Doesn’t that sound great! WHO continues to say that ICD-11 is so comprehensive that there will be no ICD-12. I hope that is true! I want to highlight an excellent publication that the International Federation of Health Information Management Associations (IFHIMA) released on Feb. 10 of this year, titled IFHIMA Fosters Planning for ICD-11 Adoption with Global Case Studies. It is available, free, of course, online at http://ifhima.org/whitepapers. Enjoy the read.

I have enjoyed all my 16 years as the IFHIMA rep to the WHO, and the sponsorship from AHIMA, but it is time for new blood. I’m proud to say that Mary Stanfill, RHIA, a well-known HIM professional in the U.S., replaced me a few weeks ago, after the WHO-FIC annual meeting. She will offer strong leadership for the IFHIMA and also can provide input regarding HIM activities in the U.S. Welcome, Mary, and thank you AHIMA for your sponsorship of me all these years at the international level. 

The very best to all who are reading today. Thank you.

Programming Note: Listen to Margaret Skurka’s live farewell address today on Talk Ten Tuesday, 10 Eastern.


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