AMA Board: Skipping Directly to ICD-11 Codes 'Is Not Recommended'


The American Medical Association's board of trustees has released a report noting that although it still has several significant concerns about the shift to ICD-10 code sets, it does not recommend skipping directly to ICD-11 standards, Modern Physician reports.

The board plans to present its report -- titled, "Evaluation of ICD-11 as a New Diagnostic Coding System" -- during the AMA House of Delegates' June meeting in Chicago. The report will not be considered an official AMA position until it receives approval from the delegates (Robeznieks, Modern Physician, 5/10).

About ICD-10

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date until Oct. 1, 2014 (iHealthBeat, 1/14). The October compliance date comes a few months before the World Health Organization is expected to consider an update to ICD-11 in May 2015 (Modern Physician, 5/10).

In December 2012, AMA, 42 state medical organizations and 40 medical specialty groups sent a letter urging CMS to halt the implementation of ICD-10 code sets. The letter stated that the transition to ICD-10 code sets would impose an expensive burden on health care providers without improving patient care (iHealthBeat, 1/14).

Also in 2012, AMA's board of trustees said that it would work on a report to explore the feasibility of skipping to ICD-11 transaction codes (iHealthBeat, 11/14/12).

Details of Board of Trustees Report

According to the new board of trustees report, AMA has "serious concerns and reservations with the significant burden of the ICD-10 mandate and will continue to convey these points to policymakers."

However, the board added that it believes "skipping ICD-10 and moving directly to ICD-11 is fraught with its own pitfalls and therefore, based on current information available, is not recommended."

The board cited several concerns about skipping directly to ICD-11 code sets, including the fact that transitioning to a U.S. version of ICD-11 could take as long as 20 years.

In addition, the board noted that many health care organizations will need to update or replace certain electronic systems to implement either ICD-10 or ICD-11. The report stated, "The electronic system changes to implement ICD-11 will be more significant, but they will be significant from either ICD-10 or ICD-9" (Modern Physician, 5/10).

Jon Handler
The burden of the ICD-10 mandate is significant, as the AMA and many others have stated, and it’s prudent for all of us to look ahead and anticipate the next inevitable coding overhaul. Like the American College of Physicians and Texas Medical Association have recommended, we should wait for ICD-11 (which will be based on SNOMED-CT), and if the wait is long, use compositional SNOMED-CT in the interim. Perhaps better, we might abandon ICD altogether and just use compositional SNOMED-CT. I delve into this in much greater detail in my two-part blog post on mmodal(dot)com, “Let’s Abandon ICD-10! (and use SNOMED-CT instead).” – Jon Handler, MD and CMIO for M*Modal

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