The World Health Organization (WHO), based in Geneva, Switzerland, is the holder of the International Classification of Diseases (ICD). As you may know, there have been 10 versions of the ICD, and every member country of WHO is required to adopt the current version of the ICD.
The United States is currently using ICD-10. The actual name of the ICD-10 in the United States is the “ICD-10 CM” which stands for ICD-10 “Clinical Modification,” and the Centers for Disease Control and Prevention, along with the National Center for Health Statistics, are the two entities in the United States who oversee administration of the ICD-10 CM. Within the ICD-10 CM, Chapter 5 (Mental and Behavioral Disorders) contains many of the diagnoses we use in our industry. The other Chapters contain critical diagnoses as well, so we are also compelled to use X, R, T, Z, and other diagnostic codes when working with our clients.
For example, Suicidal Ideation, which is very common among our clients, is in Chapter 18, the “R-Chapter,” and the code is R45.851.
The challenges of diagnostic differences and classifications between the DSM and ICD are hopefully well-known by now, creating a confusing dilemma for practitioners. Further, diagnostic criteria for ICD-10 codes, contained in the ICD-10 Clinical Descriptions and Diagnostic Guidelines (CDDG), which is also called the “Bluebook,” needs to be updated.
There is good news on all fronts: WHO has published its ICD-11 Beta Version online for the whole world to see, and give feedback, participating in the process. Concurrent to this, the CDDG is also being updated. The ICD-11 is slated to be presented for approval in 2018. The goal is for the ICD-11 CDDG to be released with the final version of the ICD-11.
WHO has done an admiral job over the years at updating the ICD with its refreshing, collaborative, open, and transparent approach. We will finally have a free, open-source, standardized, technology/EHR-friendly, comprehensive diagnosing system along with up-to-date clinical guidelines to use and support our compliance efforts.
When the United States decides to adopt the ICD-11 is another matter. We were the last WHO-member country to adopt the ICD-10.
The changes from ICD-10 to ICD-11 should be minimal, all things considered. Regardless of when ICD-11 is adopted, approved, and utilized in the United States, it is imperative our technology solutions and educational institutions be ready to accommodate the change. Having the entire set of ICD-10 CM codes available in the EHR is critical to patient safety. Many times, vendors are behind in their enhancements. Graduate schools need a standardized curriculum as well.
The upshot: ICD-11 is eventually coming to the United States. Let your vendor know your expectations and your needs. Begin discussing utilization of the ICD-11 CDDG and how your organization will incorporate this into clinical practice. And hopefully, new graduates will be coming out of school prepared for the real-world of clinical practice!