In 2015, the United States belatedly joined the rest of the world in implementing the most updated version of the World Health Organization’s coding system for medical diagnoses, the International Classification of Diseases, Tenth Revision, usually referred to as the ICD-10.
Although nearly every other country in the world had been using the system since 1994, the process was delayed in this country because of the far more complicated health care system here.
The WHO’s ICD coding is used around the world for health diagnoses to ensure that every country is in sync with the most up-to-date research and medical knowledge.
It is also used by the WHO to track illness in order to focus resources according to need. The US version, known as the ICD-10-CM (for “clinical modification”), is used for diagnosis coding by healthcare providers in the U.S.
Most U.S. mental health providers are more likely to turn to the Diagnostic and Statistical Manual of Medical Disorders (DSM) put out by the American Psychiatric Association for coding information.
What many clinicians do not realize is that the DSM uses the ICD codes for diagnoses. The difference in the two documents is that the ICD is a list of codes and the DSM includes diagnostic criteria. (Although the WHO has begun to publish its own book of diagnostic criteria as a supplement to the ICD).
Another reason for the delay for the last update centered around the immense increase in the number of new codes, up to 68,000 from 13,000 in the ICD-9.
Because of the increase, the numbering system was also changed to alphanumeric codes that concerned the Center for Disease Control, the federal agency tasked with managing the implementation of the updates. The deadline for using the new codes in insurance billing was pushed back several times as insurance agencies and health care organizations worked to adjust billing practices.
At the time, there was discussion about the possibility of merely skipping the ICD-10 and moving directly into the ICD-11, which was first scheduled to be released in 2011.
However, the date for that release had already been moved to 2012, and then to 2015 and then 2017. It was recently announced that the ICD-11 release date will now be some time in 2018.
“My understanding is that the chapters related to psychology are fairly far along,” said Lynn Bufka, Ph.D, associate executive director of practice research and policy at the American Psychological Association, “and there is a beta version available on the WHO site. But other chapters are more complicated and the WHO will only release the whole document at once.”
Once the new version is published, the U.S. will still need to create its own version for release, which could take time.
“I understand that if there are key changes in the ICD-11 that people want to see enacted before the wholescale update, they will change aspects of the ICD-10-CM prior to the full release of 11,” said Bufka.
It is also possible that the federal government will impose a deadline for the changeover to the new codes. However, with electronic updates available easily, the changeover to ICD-11-CM should be a smoother transition than past updates.