Feasibility of replacing the ICD-10-CM with the ICD-11 for morbidity coding: A content analysis
Feasibility of replacing the ICD-10-CM with the ICD-11 for morbidity coding: A content analysis
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DOI：
10.1093/jamia/ocab156
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发表时间：
2021-08-12
影响因子：
6.4
通讯作者：
Bodenreider, Olivier
中科院分区：
文献类型：
--
作者：
Fung, Kin Wah;Xu, Julia;Bodenreider, Olivier
目的：该研究旨在评估的可行性，取代国际疾病分类第10次修订，临床修改（ICD-10-CM）与国际疾病分类第11次修订（ICD-11）的发病率编码的基础上的内容analysis.Materials和方法：最常用的ICD-10-CM代码从每一章，涵盖60%的患者被确定为医疗保险索赔和医院的数据。每个ICD-10-CM代码在ICD-11中重新编码，必要时使用后协调（代码组合）。重新编码由2名术语学家独立进行。失败的情况下，即使与postcoordination没有达到充分的代表性进行了分析。重新编码后，ICD-10-CM和ICD-11代码的编码指南（包括，排除，和索引）进行了审查的conflict.Results：总体而言，23.5%的943代码可以完全由ICD-11没有postcoordination代表。后协调是潜在的游戏规则改变者。它支持943个代码的8.6%的完整表示。此外，仅增加9个扩展代码，后协调支持943个代码的35.2%的完全表示。编码指南审查发现10%的代码存在潜在冲突，但大多数不影响重新编码。大多数的冲突是由于ICD-11和ICD-10-CM之间的粒度和默认编码假设的差异造成的。结论：随着一些轻微的增强后协调，ICD-11可以完全代表几乎60%的最常用的ICD-10-CM代码。即使没有后协调，23.5%的完全代表性与ICD-10-CM中完全匹配的ICD-9-CM代码的24.3%相当，因此从ICD-10-CM迁移到ICD-11并不一定比从国际疾病分类-第九版-临床修改到ICD-10-CM更具破坏性。因此，ICD-11（无CM）应被视为替代ICD-10-CM进行发病率编码的候选标准。
Objective: The study sought to assess the feasibility of replacing the International Classification of Diseases-Tenth Revision-Clinical Modification (ICD-10-CM) with the International Classification of Diseases-11th Revision (ICD-11) for morbidity coding based on content analysis.Materials and Methods: The most frequently used ICD-10-CM codes from each chapter covering 60% of patients were identified from Medicare claims and hospital data. Each ICD-10-CM code was recoded in the ICD-11, using postcoordination (combination of codes) if necessary. Recoding was performed by 2 terminologists independently. Failure analysis was done for cases where full representation was not achieved even with postcoordination. After recoding, the coding guidance (inclusions, exclusions, and index) of the ICD-10-CM and ICD-11 codes were reviewed for conflict.Results: Overall, 23.5% of 943 codes could be fully represented by the ICD-11 without postcoordination. Postcoordination is the potential game changer. It supports the full representation of 8.6% of 943 codes. Moreover, with the addition of only 9 extension codes, postcoordination supports the full representation of 35.2% of 943 codes. Coding guidance review identified potential conflicts in 10% of codes, but mostly not affecting recoding. The majority of the conflicts resulted from differences in granularity and default coding assumptions between the ICD-11 and ICD-10-CM.Conclusions: With some minor enhancements to postcoordination, the ICD-11 can fully represent almost 60% of the most frequently used ICD-10-CM codes. Even without postcoordination, 23.5% full representation is comparable to the 24.3% of ICD-9-CM codes with exact match in the ICD-10-CM, so migrating from the ICD-10-CM to the ICD-11 is not necessarily more disruptive than from the International Classification of Diseases-Ninth Revision-Clinical Modification to the ICD-10-CM. Therefore, the ICD-11 (without a CM) should be considered as a candidate to replace the ICD-10-CM for morbidity coding.