Feasibility of replacing the ICD-10-CM with the ICD-11 for morbidity coding: A content analysis.
J Am Med Inform Assoc
; 28(11): 2404-2411, 2021 10 12.
Article
in En
| MEDLINE
| ID: mdl-34383897
ABSTRACT
OBJECTIVE:
The study sought to assess the feasibility of replacing the International Classification of Diseases-Tenth Revision-Clinical Modification (ICD-10-CM) with the International Classification of Diseases-11th Revision (ICD-11) for morbidity coding based on content analysis. MATERIALS ANDMETHODS:
The most frequently used ICD-10-CM codes from each chapter covering 60% of patients were identified from Medicare claims and hospital data. Each ICD-10-CM code was recoded in the ICD-11, using postcoordination (combination of codes) if necessary. Recoding was performed by 2 terminologists independently. Failure analysis was done for cases where full representation was not achieved even with postcoordination. After recoding, the coding guidance (inclusions, exclusions, and index) of the ICD-10-CM and ICD-11 codes were reviewed for conflict.RESULTS:
Overall, 23.5% of 943 codes could be fully represented by the ICD-11 without postcoordination. Postcoordination is the potential game changer. It supports the full representation of 8.6% of 943 codes. Moreover, with the addition of only 9 extension codes, postcoordination supports the full representation of 35.2% of 943 codes. Coding guidance review identified potential conflicts in 10% of codes, but mostly not affecting recoding. The majority of the conflicts resulted from differences in granularity and default coding assumptions between the ICD-11 and ICD-10-CM.CONCLUSIONS:
With some minor enhancements to postcoordination, the ICD-11 can fully represent almost 60% of the most frequently used ICD-10-CM codes. Even without postcoordination, 23.5% full representation is comparable to the 24.3% of ICD-9-CM codes with exact match in the ICD-10-CM, so migrating from the ICD-10-CM to the ICD-11 is not necessarily more disruptive than from the International Classification of Diseases-Ninth Revision-Clinical Modification to the ICD-10-CM. Therefore, the ICD-11 (without a CM) should be considered as a candidate to replace the ICD-10-CM for morbidity coding.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
International Classification of Diseases
/
Medicare
Type of study:
Guideline
Limits:
Aged
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
J Am Med Inform Assoc
Journal subject:
INFORMATICA MEDICA
Year:
2021
Document type:
Article
Affiliation country:
United States