Updates on status of ICD-11 and changes to other classification and terminology systems

Well thanks, @InfiniteRubix but as you may have seen in my update in Post #398 and in my revised recent submission to ICD-11 (Post #388), the origin of this submission for a change for the WHO's international version of ICD-10 is a person who currently works for Canadian Institute for Health, who submitted for the change in March 2016 and had had it approved by the URC (the WHO-FIC Update and Revision Committee) in September 2016, for implementation from 1/2018.

So, its submission and approval pre-date the various submissions for ICD-11.

 

Yes, and corrective modesty notwithstanding, many thanks anyway

Apart from your specific effort, the overall effort is so foundational and one of the ways to achieve consequential policy trajectory 'nudges', in the long term behavioural sense that should compound over time. That's a very rare benefit that so many others'good work will increasingly benefit from increasingly IMO.

Sorry, the thanks to you both is spontaneously and enthuisastially compulsive.

 

England's NHS Digital currently mandates the use of ICD-10 5th Edition Version: 2016.

(There are now PDF copies of the 2016 version's Volume 1, 2 and 3 available for free from the WHO's IRIS platform, as well as an ICD-10 Browser for Version: 2016 and now Version: 2019.)


There is currently a question mark over whether NHS Digital will adopt Version: 2019 (and when) or whether it will skip adoption of Version: 2019 and migrate at some point in the future directly from Version: 2016 to ICD-11.

If NHS Digital does decide not to adopt Version: 2019, it may not be permitted to retrofit selected changes that have been implemented for a later version into an earlier version.

This is something which will need to be established.

 

Well, if WHO/MSAC/CSAC/Robert Jakob do accept my proposal for ICD-11 (which includes selected extracts from the joint proposal with Mary in March 2017) a couple of bunches of emoticon flowers and the chocolate cake will be graciously accepted.

 

For ICD-11, the electronic Coding Tool performs the role of the Alphabetical Index, as the starting point for coders.

Just to demonstrate what displays when myalgic encephalomyelitis (ie minus "Benign") is entered into the Coding Tool:







The terms under "Matching Terms" are listed in the Foundation and MMS Linearization under Synonyms/Index Terms. All 14 alternative and historical terms listed under Synonyms/Index Terms in the Foundation and MMS Linearization are coded to 8E49.

The search field database will respond to a search using only the initials, CFS, and offers a choice of two Destinations Entities from which the coder can select the appropriate disease, disorder or condition:

Destination Entities​

CA25.Z
Cystic fibrosis, unspecified

Matching Terms
CF - [cystic fibrosis]


8E49
Postviral fatigue syndrome

Inclusions
Benign myalgic encephalomyelitis
chronic fatigue syndrome

Exclusions
Fatigue (MG22)

Matching Terms
CFS - [chronic fatigue syndrome]​

A search in the Coding Tool using just the letters ME returns the following:

Destination Entities

1C80
Viral encephalitis not elsewhere classified
Encephalitis due to Me Tri virus


8E49
Postviral fatigue syndrome

Inclusions
Benign myalgic encephalomyelitis
chronic fatigue syndrome

Exclusions
Fatigue (MG22)

Matching Terms
ME - [myalgic encephalomyelitis]


​

So whichever term might be entered into the Coding Tool, whether it's the Concept Title term, one of the two specified inclusion terms, one of the 14 terms under Synonyms/Index terms (including just initials: ME; CFS; or PVFS), all terms will be returned details for and all terms are coded to 8E49.

 

Awesome, thanks so much for the heads up, this is great to know -- I'll take this to our team for action and keep you updated on how it goes.

 

Note that in the proposal of 2016 submitted for ICD-10 by Ms Mabon, deletion of the Index term "Benign myalgic encephalomyelitis" had also been requested for consideration.

However, it looks as though the URC rejected its removal as an Index Term, as the term does display in brown when searched for in the Version: 2019 search box. Brown indicates an Index Term and it displays like this:

Encephalomyelitis|myalgic, benign G93.3


It's reasonable that the URC rejected the removal of the Benign term from the Index, because not all member states are recording data using the same release of ICD-10, and some use national modifications which will still contain the term. So for the purpose of global data aggregation, backward compatibility and comparability over time, terms that have been retired from the Tabular List may sometimes be retained as Index Terms.

For my proposal, I have said: "It is recommended to retain the entity "Benign myalgic encephalomyelitis" under the Synonyms/Index Terms list for continuity with ICD-10 and the various national modifications of ICD-10."

and: "(It is recommended to retain the entity "Benign myalgic encephalomyelitis" under the Synonyms/Index Terms list for backward compatibility and comparability over time.)"

 

Brilliant, Scott, thanks, and do keep me posted.

 

@ScottTriGuy

In one of the posts above, Suzy suggested going to the Canadian Institute for Health or to the North American WHO-FIC Collaborating Center to get the ICD-10-CA updated. The North American WHO-FIC Collaborating Center covers both Canada and the US and we need to implement the same change here as well. Might be worth submitting a joint proposal to the North American WHO-FIC collaborating Center on top of individual proposals to our respective countries. Let me know if you are interested in doing that

 

For sure - I'll DM you.

 

I am intending to contact Lynn Bracewell, lead NHS Digital, in the next day or so. I had discussions with her in 2016/17. She participates in WHO-FIC Network committees and oversees the implementation of ICD and SNOMED CT within the NHS.

I shall be discussing whether NHS Digital would be able to incorporate the change in Version: 2019 into Version: 2016 (which they currently mandate for use in the NHS), if it is decided that at a future date, they will move straight from Version: 2016 to ICD-11 and skip Version: 2019.

 

I have today contacted Ms Lynn Bracewell, NHS Digital to discuss what might be possible, if NHS Digital is not intending to adopt ICD-10: Version 2019 in preference for skipping from Version: 2016 straight to ICD-11 (some years down the line).

 

Tentative Agenda for March NCHS/CDC ICD-10-CM ICD-10 Coordination and Maintenance (C&M) Committee Meeting:


From the U.S. Federal Register:

https://www.federalregister.gov/doc...-coordination-and-maintenance-candm-committee

Tentative Agenda (Full Topic Packets are posted a day or so before Meeting Day One)

National Center for Health Statistics (NCHS), ICD-10 Coordination and Maintenance (C&M) Committee Meeting

A Notice by the Centers for Disease Control and Prevention on 01/30/2020

AGENCY:
Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS).

ACTION:
Notice of meeting.

SUMMARY:
The Centers for Disease Control and Prevention, National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, announces the following meeting of the ICD-10 Coordination and Maintenance (C&M) Committee meeting. This meeting is open to the public, limited only by the space available. The meeting room accommodates approximately 240 people. We will be broadcasting the meeting live via Webcast at http://www.cms.gov/live/.

DATES:
The meeting will be held on March 17, 2020, 9:00 a.m. to 5:00 p.m., EDT and March 18,2020, 9:00 a.m. to 5:00 p.m., EDT.

ADDRESSES:
Centers for Medicare and Medicaid Services (CMS) Auditorium, 7500 Security Boulevard, Baltimore, Maryland 21244.

FOR FURTHER INFORMATION CONTACT:
Traci Ramirez, Program Specialist, CDC, 3311 Toledo Road, Hyattsville, Maryland 20782; telephone: (301) 458-4454; TRamirez@cdc.gov.

SUPPLEMENTARY INFORMATION:


Purpose: The ICD-10 Coordination and Maintenance (C&M) Committee is a public forum for the presentation of proposed modifications to the International Classification of Diseases, Tenth Revision, Clinical Modification and ICD-10 Procedure Coding System.

Matters to be Considered: The tentative agenda will include discussions on ICD-10-CM and ICD-10-PCS topics listed below. Agenda items are subject to change as priorities dictate.

Please refer to the posted agenda for updates one month prior to the meeting.

ICD-10-PCS Topics

Microbial Testing

Insertion of Subcutaneous Pump System for Ascites Drainage

Insertion of Carotid Baroceptor Stimulator Pulse Generator

Infectious Disease Testing

Administration of BREYANZI® (lisocabtagene maraleucel)

Administration of FETROJA® (cefiderocol)

CT Angiogram with Computer-Aided Triage and Notification

Endoscopic Gastrointestinal Hemostat

Administration of IMFINZI® (durvalumab)

Intramedullary Joint Fusion System

Peripheral Intravascular Lithotripsy (IVL)

Administration of KTE-X19

Administration of NUZYRA® (omadacycline)

Administration of OTL-101

Administration of Sivextro (tedizolid phosphate)

Administration of Soliris® (eculizumab)

Transcarotid Arterial Revascularization with Embolic

Neuroprotection

Implantable Fracture Reduction System

Administration of TECENTRIQ® (atezolizumab)

Administration of TERLIVAZ® (terlipressin)

Administration of XENLETA® (lefamulin)

Administration of ZERBAXA® (ceftolozane and tazobactam)

Addenda


ICD-10-CM Topics

Anaplasmosis

Breast implant illness

Cough

Electronic nicotine delivery devices

Endometriosis

Non-ischemic heart disease

Non-radiographic axial spondyloarthritis

Synthetic cannabinoids

Addenda

Security Considerations: Due to increased security requirements, CMS has instituted stringent procedures for entrance into the building by non-government employees. Attendees will need to present valid government-issued picture identification, and sign-in at the security desk upon entering the building.

Attendees who wish to attend the March 17-18, 2020, ICD-10-CM C&M meeting must submit their name and organization by March 6, 2020, for inclusion on the visitor list. This visitor list will be maintained at the front desk of the CMS building and used by security to admit visitors to the meeting. To request reasonable accommodation, please contact the CMS Reasonable Accommodation Program at Email reasonableaccommodationprogram@cms.hhs.gov.

Participants who attended previous Coordination and Maintenance meetings will no longer be automatically added to the visitor list. You must request inclusion of your name prior to each meeting you wish attend.

Please register to attend the meeting on-line at: http://www.cms.hhs.gov/apps/events/.

Please contact Mady Hue (410-786-4510) or Marilu.hue@cms.hhs.gov for questions about the registration process.

Note: CMS and NCHS no longer provide paper copies of handouts for the meeting. Electronic copies of all meeting materials will be posted on the CMS and NCHS websites prior to the meeting at http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/03_meetings.asp#TopOfPage and https://www.cdc.gov/nchs/icd/icd10cm_maintenance.htm.

The Director, Strategic Business Initiatives Unit, Office of the Chief Operating Officer, Centers for Disease Control and Prevention, has been delegated the authority to sign Federal Register notices pertaining to announcements of meetings and other committee management activities, for both the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry.

Kalwant Smagh,

Director, Strategic Business Initiatives Unit, Office of the Chief Operating Officer, Centers for Disease Control and Prevention.

[FR Doc. 2020-01756 Filed 1-29-20; 8:45 am]

BILLING CODE 4163-18-P

 

New post on http://DxRevisionWatch.com

WHO retires "Benign" from "Benign myalgic encephalomyelitis" for final ICD-10 release

https://dxrevisionwatch.com/2020/02...c-encephalomyelitis-for-final-icd-10-release/

or

https://wp.me/pKrrB-56g

A version of this report is scheduled for publication in the March edition of the ME Global Chronicle.

 

New post on http://DxRevisionWatch.com

WHO approves exclusions for PVFS, ME and CFS under ICD-11’s Bodily distress disorder

https://dxrevisionwatch.com/2020/02...d-cfs-under-icd-11s-bodily-distress-disorder/

or

https://wp.me/pKrrB-555

A version of this report is scheduled for publication in the March edition of the ME Global Chronicle.

 

[Australia]

The Australian Institute of Health and Welfare (AIHW) is scheduled to release ICD-11 Review stakeholder consultation report on March 12, 2020

https://www.aihw.gov.au/news-media/forthcoming-releases

 

A little graphic if anyone wanted one for Facebook:


World Health Organization retires "Benign" from "Benign myalgic encephalomyelitis" for its final update to ICD-10

https://icd.who.int/browse10/2019/en#/G93.3

Dx Revision Watch report: https://wp.me/pKrrB-56g

This decision by the WHO-FIC ICD-10 Update and Revision Committee (URC) sets a precedent for ICD-11 and the national modifications of the WHO's international edition of ICD-10.

On February 14, I submitted a new proposal and rationale for dropping "Benign" for ICD-11: http://bit.ly/BenignICD11

I am hoping WHO will decide to approve the retirement of "Benign" in time for incorporation into the next release of the Blue ICD-11 MMS Implementation browser. A new release is anticipated at some point in 2020:



Image source: https://dxrevisionwatch.files.wordpress.com/2020/02/benign4.png

 

[Canada] Canadian Institute for Health Information (CIHI)

ICD-11 Frequently Asked Questions

https://www.cihi.ca/en/icd-11-frequently-asked-questions

According to the FAQ page, no decision has been made regarding the implementation of ICD-11 in Canada.

CIHI is in the process of assessing clinical, business and statistical implications of implementing ICD-11 for morbidity statistics in Canada. The decision to adopt ICD-11 will not reside with CIHI. Provincial and territorial governments will decide whether and when to adopt and implement the new edition.

 

I continue to be concerned by the number of errors I find on MEpedia pages regarding terminology and classification.

Why are authors of these pages not fact checking before they add content? Why are they attempting to author content if they are not equipped to do so ? What is the point of MEpedia when it is so unreliable? It's all very well having an alert on the page which says:


This article needs cleanup to meet MEpedia's guidelines.
The reason given is:
Overly long, repeated points
Please help improve this page if you can. (Mar 2019)

The reason given is:

• This page does not maintain a neutral point of view, or
• This page has questionable factual accuracy.

But how are the platform's potential visitors to know what can be relied upon and what has been waiting to be rewritten since March 2019?

Here is a good example (my comments in brown). I have left a comment on the Talk page pointing out the lack of clarity in this section. I do not have the time nor the inclination to edit the page.


https://www.me-pedia.org/wiki/Medically_unexplained_physical_symptoms

Medically unexplained physical symptoms

(...)

Classification and alternative names[edit | edit source]
Patients with MUS or MUPS are sometimes referred to as having Functional Somatic Symptoms (FSS) or diagnosed as Bodily Distress Disorder (BDD) - both of which are mental illnesses - despite being classified as physical illnesses under the World Health Organization's current ICD-10 classification, and the latest ICD-11 classification.

Comment: There is no term "Functional Somatic Symptoms" in ICD-10. ICD-10 has a Somatoform disorders category block (F45.0-F45.9). The various ICD-10 Somatoform disorders categories are not classified as "physical illnesses" in ICD-10 - they are classified as mental disorders in ICD-10 Chapter V: Mental and behavioural disorders.

"Bodily distress disorder" is an ICD-11 category, but again it is not classified as a "physical illness" in ICD-11. "Bodily distress disorder" is classified as a mental disorder in ICD-11 Chapter 06 Mental, behavioural and neurodevelopmental disorders.


Possibly the author had intended to write:

Patients with MUS or MUPS are sometimes referred to as having Functional Somatic Symptoms (FSS) or diagnosed as Bodily Distress Disorder (BDD) - both of which are mental illnesses [- despite having diseases or conditions that are] classified as physical illnesses under the World Health Organization's current ICD-10 classification, and the latest ICD-11 classification.

But it's not clear what they intended.


Somatoform disorders, Somatic symptom disorders, Conversion disorder, and Functional Neurological Disorder (FND) are also regarded as medically unexplained symptom and classified as purely psychological symptoms conditions only in the DSM psychiatric manual.[4][5]

Comment: There are no Somatoform disorders in DSM-5. The DSM-IV and DSM-IV TR Somatoform disorders are obsolete and were replaced with Somatic symptom disorder for DSM-5.

DSM-IV and DSM-IV TR included a category "Conversion disorder". This term was replaced for DSM-5 with the term, "Conversion disorder (functional neurological symptom disorder)".