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Overview• ICD Revision progress
– Current status – Stability: how similar to ICD10 – ICD10AM
– Next Steps: • Collaborative Authoring Tool improvements• Proposals • Peer Review• Field Trials• Other Products• …
ICD-11 Revision Goals1. Evolve a multi-purpose and coherent classification
– Mortality, morbidity, primary care, clinical care, research, public health…
– Consistency & interoperability across different uses
2. Serve as an international and multilingual reference standard for scientific comparability and communication purposes
3. Ensure that ICD-11 will function in an electronic environment.• ICD-11 will be a digital product• Support electronic health records and information systems
• Link ICD logically to underpinning terminologies and ontologies (e.g. SNOMED, GO, …)• ICD Categories “defined” by "logical operational rules" on their associations and details
Current Status
• Frozen September 30– iCAT continues real time– JLMMS is frozen for review – A new freeze is expected in Dec 2014.
• Definitions – Top level > 75 % > 10,000 definitions
• Linearization errors < 465 (from 10K) • Duplicates < 105 (from 3K)
The ICD Foundation Component
• is a collection of ALL ICD entities like diseases, disorders...
• It represents the whole ICD universe.
• In a simple way, the foundation component is similar to a “store” of books or songs.
The ICD Linearizations• A linearization is a subset of the
foundation component, that is: • Fit for a particular purpose: reporting mortality,
morbidity, or other uses• Jointly Exhaustive of ICD Universe (Foundation
Component) • Composed of entities that are Mutually Exclusive of
each other• Each entity is given a single parent
Skin
Neoplasms
ICD11 Components: Linearizations
Foundation: ICD categories with
- Definitions, synonyms- Clinical descriptions- Diagnostic criteria- Causal mechanism- Functional Properties
Find Term
SNOMED-CT, International Classification of Functioning, Disability and Health (ICF)…
Linearizations
Mortality
Morbidity
Primary Care
Title Primary C. Joint Lin. Ophthalm.Cataract code code code
Age-related cataract code code codeCortical age-related cataract other other codeNuclear age-related cataract other other codeCataracta brunescens other other codeNuclear sclerosis cataract other other codeCapsular and Subcapsular age-related cataract other other codeCapsular age-related cataract other other codeAnterior subcapsular polar age-related cataract other other codePosterior subcapsular polar age-related cataract other other codeIncipient age-related cataract other other code
Coronary age-related cataract other code codePunctate age-related cataract other code code
Water clefts other other codeAdvanced or mature age-related cataract other other code
Mature age-related cataract other code code Subtotal advanced or mature age-related cataract other other code
Advanced or mature age-related cataract, total cataract other other codeMorgagnian age-related cataract other other codeCalcified age-related cataract other other codeCombined forms of age-related cataract other other code
Example of Telescope
• Pre-coordination - fixed names
V12.24 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities
ICD Organization
• Post- Coordination - extensions• Bicycle Accident
• Hit • Role• Context• Activity
X – Chapter: Extension Codes
Type 1 Type 2 Type 3
Severity Main Condition (types) History of
Temporality (course of the condition)
Reason for encounter/admission
Family History of
Temporality (Time in Life)
Main Resource Condition Screening/Evaluation
Etiology Present on Admission
Anatomic detail TopologySpecific Anatomic Location
Provisional diagnosis
Histopathology Diagnosis confirmed by
Biological Indicators Rule out / Differential
Consciousness
External Causes (detail)
Injury Specific (detail)
POST COORDINATION MECHANISM
• Extension codes are implemented in iCAT• Sanctioning tables are being generated
– REQUIRED– ALLOWED– DISALLOWED
• First target group is the REQUIREDa. ICD-10 categories which have equivalence with
ICD11 STEM + X codes (around 1000 codes) b. other
• 2014 : Beta version & Field Trials Version – +2 YR : Field trials
• 2017 : Final version for WHA Approval– 2018+ implementation– Continuous Annual Cycles
• ICD 2018 • ICD 2019• ICD 2020
ICD-11 Timeline
ICD11 βetahttp://www.who.int/classifications/icd/revision
Beta – Browser & Print 10 look & feel + descriptions – code structure !
• ICD-11 Beta draft is NOT FINAL
• updated on a daily basis
•NOT TO BE USED for CODING except for agreed FIELD TRIALS
βeta
ICD 2014 September release
• Print version release includes:• Frozen “Joint Linearization for Mortality and
Morbidity Statistics” ( Vol. 1 Equivalent). • The ongoing work on iCAT will go ahead in further
completing the ICD definitions and improvements. • A future release is also planned in December.
Thereafter the releases will be made whenever necessary.
• Incremental changes from August Release are given in a separate document to enable tracking which parts remained stable – which parts changed.
Taxonomic Check• Taxonomic check includes the aggregation equivalence:
• with the Primary Care versions– PC Intermediate Resource version renamed: Intermediate Version– PC Low Resource version renamed: Short Version
• With Specialty Versions– see whether the specialty extensions roll up to JLMMS ( if this was the chosen option)
Annotation Document & Reviews
• An updated Annotation Document identifies the architecture, principles and known issues.
• Reviews by Mortality and Morbidity TAGs included for common reference and guiding future work
STABILITY ANALYSIS
• A Foundation based equivalence programme identifies equivalences between ICD-10 and ICD-11.
• a TRANSCODING table between ICD-10 and ICD-11 in
excel format• A CROSSWALK gives the detailed output in excel
format
• The ICD11 Beta Browser will display the ICD-10 equivalents accordingly.
ICD-10 ICD-11 correspondence
• 3 character – 1183 (w/o ECI & Residuals)– 951 Equivalent– 191 mapped to a larger entity in 11
• with post coordination many have equivalent maps– 41 not mapped
• 4 character - 6635– 4343 Equivalent– 2207 mapped to a larger entity in 11
• with post coordination many have equivalent maps– 85 not mapped
ICD Index
• Print Index is about 1900 pages with some lead terms running several pages.
• About 3000 ICD10 Index terms are “missing”. A human judgement is being made as to whether they are necessary and once included they point to the right code.
• Sublead terms missing• Improvements planned
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