icd revision (ustun) 2014
DESCRIPTION
This is the current status of ICD Revision Process. A stable computer infrastructure is built; 24 Expert Advisory Groups in different segments have given their proposals. Crosswalks between ICD 10 and ICD 11 have been built using 5 different sources. Proposals can NOW be made by interested stakeholders and the PUBLIC. A scientific peer review for the current and future proposals is set up. YOU can comment, make proposals, review or translate the ICD11 BETA NOW...TRANSCRIPT
World Health Organization Classifications, Terminologies, Standards
ICD Revision: Where Are We?
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
Linearizations:Zoom-in Zoom-Out
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-11 Browser
Visualization
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.
Frozen Diff Files
Frozen Diff Files
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.
Mapping Tool
Transcoding tables ICD-10 to ICD-11 in excel
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
Translation Platform
World Health Organization Classifications, Terminologies, Standards
ICD Revision: Where Are We?