Feasibility of replacing the ICD-10-CM with the ICD-11 for morbidity coding: A content analysis. (12th August 2021)

• Record Type: Journal Article
• Authors: Fung, Kin Wah; Xu, Julia; McConnell-Lamptey, Shannon; Pickett, Donna; Bodenreider, Olivier
• Is Part Of: Journal of the American Medical Informatics Association. Volume 28:Number 11(2021)
• Page Start: 2404
• Page End: 2411
• Publication Date: 2021-08-12
• Subjects: ICD-11 -- ICD-10 -- ICD-10-CM -- controlled medical vocabularies -- medical terminologies; Medical informatics -- Periodicals; Information Services -- Periodicals; Medical Informatics -- Periodicals; Médecine -- Informatique -- Périodiques; Informatica; Geneeskunde; Informatique médicale; Computer network resources; Electronic journals; 610.285
• DOI: 10.1093/jamia/ocab156
• Languages: English
• ISSNs: 1067-5027

Abstract

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 and Methods: 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.