Health Affairs: ICD-10 Delay Should Be Used to Prepare for ICD-11, SNOMED

Although ICD-10 may update healthcare coding compared with the "now-antiquated ICD-9-CM," ICD-10 is still based on an international version that was published more than two decades ago, and healthcare might be better off moving toward ICD-11 and the Systematized Nomenclature of Medicine-Clinical Terms, or SNOMED, according to a recent article in Health Affairs.

Five leading medical informatics experts penned the article: Christopher Chute, MD, professor of biomedical informatics at Rochester, Minn.-based Mayo Clinic; Stanley Huff, MD, CMIO of Murray, Utah-based Intermountain Healthcare; James Ferguson, vice president of health information technology strategy and policy for Oakland, Calif.-based Kaiser Permanente; James Walker, MD, chief health information officer of Danville, Pa.-based Geisinger Health System; and John Halamka, MD, CIO of Harvard Medical School and Beth Israel Deaconess Medical Center in Boston.

The authors acknowledge that in several areas, such as diabetes coding, ICD-10 is a major upgrade over ICD-9, which has "run out of room to create new codes." However, they contend that the "base knowledge structures" of ICD-10 do not reflect what healthcare has learned in the 21st century. For example, the authors said ICD-10 does not use any genomic information.

"When a woman receives a bilateral prophylactic mastectomy because of family history and the presence of the BRCA2 gene (a genomic variant that dramatically increases the risk of breast cancer), there is no mechanism for coding this genomic variant as an indication for surgery," they wrote.

In addition to electronic health records, meaningful use and the many other healthcare technology initiatives required of hospitals, providers and payors, the authors said full adoption of ICD-10 could impose an "unsustainable burden."

Instead, the healthcare sector should be moving toward ICD-11, which is closely linked with SNOMED. SNOMED also happens to be an integral part of phase two meaningful use, according to the article. The authors recommended that if ICD-10 is to be pursued, the ICD-10 compliance date should be delayed with a grace period, similar to what has happened with Version 5010, or the go-live delay should be changed by one to three years.

The authors said CMS and HHS need to handle the delay to both help those who have heavily invested in ICD-10 and to make the gradual shift to the more modern and internationally recognized ICD-11 system.

More Articles on ICD-10:

Survey Suggests ICD-10 Delay is Favorable for Providers

National Library of Medicine Releases SNOMED to ICD-10-CM Map

In the Fog of Delay: What's Next for ICD-10?

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