In a press release today, Kathleen Sebelius, Health and Human Services Secretary, announced that the ICD-10 implementation timeline would be postponed from its current October 1, 2013 deadline. This is a disheartening turn of events and is clearly related to the American Medical Association kvetching that started in November 2011. It is unlikely that the ICD-10 deadline would be pushed forward less than a year since it is tied to the MS-DRG system so integrally, and these systems must be maintained and developed in tandem.

Could the new deadline be October 1, 2014? But wait, now there are some pushes, since ICD-11 is due out from the World Health Organization in 2015, that perhaps we’d skip ICD-10, which was released in 1990. Reported on ModernHealthcare.com, Dr. Joseph Schneider, chief medical information officer and medical director of clinical information at Baylor Health Care System in Dallas, said “There are other, better ways to do this other than to go to a system that’s 30 years old coming up shortly.”

How would it be possible to implement an ICD-11 system that would necessarily have to be modified to fit US healthcare needs? It would take years of research to develop the system and create the general equivalency mappings that were just created for ICD-10. Additionally, the MS-DRG system would have to be reauthored as well. All of this work is essentially finished given the partial code freezes that were set to take place:

• On October 1, 2012, there will be only limited code updates to both the ICD-9-CM and ICD-10 code sets to capture new technologies and diseases as required by section 503(a) of Pub. L. 108-173.
• On October 1, 2013, there will be only limited code updates to ICD-10 code sets to capture new technologies and diagnoses as required by section 503(a) of Pub. L. 108-173.  There will be no updates to ICD-9-CM, as it will no longer be used for reporting.

Who could even begin to imagine how difficult that would be given that ICD-11 is going to be even more different than ICD-10?  In fact, the US National Center for Health Statistics has already envisioned how the US would transition to ICD-11, which would be through ICD-10-CM!

“NCHS will work closely with the ICD-11 Revision Committee to ensure the gradual evolution of ICD-10-CM to ICD-11 content through the regular updating of ICD-10-CM; this will avoid a disruptive transition to ICD-11 some time after 2015.”

I can only imagine that trying to jump to a newly released WHO ICD-11, which will likely have its own early problems, could take anywhere from 3-5 years after the release of the system. Can we possibly use ICD-9-CM for 8 more years to implement ICD-11 in 2020? The answer is clearly no. However, since there are several great things that ICD-11 has going for it, maybe this time, the US will not wait 24 years from the release of a new WHO coding system to implement it.