Life after ICD-10: ICD-11 is coming
Feeling better about ICD-10? Getting accustomed to all of those new codes? Starting to get a handle on the new process and waiting for those reimbursements to come rolling in?
Not so much? Well, there's always ICD-11.
That's right: Even as healthcare practices in the U.S. finish adopting the massive new healthcare coding system that rolled out in October, there's an updated version waiting on the horizon to be finalized, approved, customized, and implemented.
With so much of the American healthcare industry having just gone through a very long and complex transition just to get to ICD-10, the concept of a new set of codes is sure to elicit some groans. But the good news is the next iteration won't be coming for awhile, and the change should be significantly less complex.
"One thing that's going to help us going forward and changing versions is just the fact that we've done it once and [we've learned] the world's not going to end," Sue Bowman, senior director of coding policy and compliance at AHIMA, told Healthcare Dive.
Another reality is it's still relatively early in the ICD-11 process, with adoption in the U.S. years, if not more than a decade, away.
The World Health Organization is intensifying its work on ICD-11 now, with a goal of approving it in 2017 -- which would be 10 years after its development began. There's a public ever-changing beta draft, although it's hard to say at this point how much resemblance this document will bear to the final product.
Even after ICD-11 clears that hurdle, its adoption in the U.S. will likely take years. Two decades passed between the time WHO adopted ICD-10 and the U.S. implemented its customized version, and those years were filled with plenty of political and professional debates and delays. Earlier this year, the American Medical Association remained vocally opposed to ICD-10, dropping its opposition only after CMS promised not to delay reimbursements to providers in the case of improper coding.
Bowman said she doesn't expect the same level of angst when ICD-11 does get rolled out. She noted many of the fears that had arisen around ICD-10's implementation have so far proven unfounded.
That development isn't a surprise to many people in healthcare IT, she said. Despite CMS' well-documented struggles in implementing ACA -- which was a unique and very different challenge -- ICD-10's implementation followed some well-worn ground, as will ICD-11.
"If there's one thing CMS knows how to do, it's process[ing] claims, and moving to a new claims processing methodology is something they know how to do," she said.
ICD codes -- an acronym for "International Classification of Disease" -- have roots that date back to the late 1800s and have gone through 10 major revisions (hence, ICD-10). According to WHO, ICD-11 will "better reflect progress in health sciences and medical practice. In line with advances in information technology, ICD-11 will be used with electronic health applications and information systems."
In other words, ICD-11 is designed to be EHR-friendly, becoming the first update to be designed with that goal in mind.
"It's kind of like Windows and all the other things out there. Things change," Bowman said.
So when will ICD-11 become a reality in the U.S.? Opinions vary from the mid-2020s until...well, later. And it isn't just politics -- far from it.
The current fee-for-service healthcare system (in which ICD codes are intertwined) and making sure HIPAA requirements are met make adopting a new coding system in the U.S. more complex, Bowman noted. And few countries adopt ICD codes right away.
On the other hand, some healthcare providers already are complaining the current codes are out of date.
"I recently had a patient who was hit by a drone. I was excited (not for the patient) that I would be able to use a new ICD-10 code. But, alas, there is no code for drone injury," Dr. Lawrence Adler of Beverly Hills, CA wrote in a recent letter to The Wall Street Journal. "I hope to be retired by the time ICD-11 is in place."
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