Australia's journey towards ICD-11

Anne Elsworthy ^a

Introduction
The International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11) is the international standard for reporting diseases and health conditions. It reflects the latest advances in science and medicine in a completely electronic format.

Despite its advantages it is a daunting undertaking to replace a highly utilised and embedded classification such as the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) with ICD-11. Especially as taking advantage of modern digital capabilities means that ICD-11 has been completely restructured.

Despite these challenges the Independent Health and Aged Care Pricing Authority (IHACPA) recognises its advantages and is committed to the ICD-11 journey.

Background
IHACPA is responsible for the development of ICD-10-AM which captures admitted patient clinical activity and underpins casemix classifications such as the Australian Refined Diagnosis Related Groups (AR-DRGs).

These classifications are also licensed internationally.

Will Australia keep developing and modifying ICD-10?
The answer is, yes, but likely only in the short term while IHACPA and other stakeholders in Australia conduct work to assess ICD-11 and establish its fitness to replace ICD-10-AM.

Preparing for a future implementation of ICD-11

Limiting updates to ICD-10-AM
In recent editions of ICD-10-AM major updates have been aligned with ICD-11 where possible, and major refinements limited given ICD-10 is no longer being updated.

Implementing cluster coding
IHACPA considers that cluster coding has immediate and longer-term benefits that include aiding a transition to ICD-11, where cluster coding is a feature.

Cluster coding is a mechanism of linking related diagnosis codes through use of a diagnosis cluster identifier to enhance the value of coded data.

IHACPA is planning to implement cluster coding for ICD-10-AM Thirteenth Edition.

Mapping ICD-10-AM to ICD-11
In 2023 IHACPA commenced a project to map ICD-10-AM to ICD-11, with the goal to identify the gaps and new features of ICD-11.

This will provide a consistent foundation to compare the benefits and assess the impact of ICD-11 on morbidity reporting and other classifications. IHACPA considers this to be the most important step to inform a potential decision on whether ICD-11 is fit to replace ICD-10-AM.

Following completion of the mapping IHACPA will generate proposals for the ICD-11 platform to address identified gaps and commence work to ensure that ICD-10-AM indexed concepts are considered and the extension codes and Reference Guide are suitable.

Other ICD-11 considerations
IHACPA has bespoke software known as the 'ICD Toolkit' that generates ICD-10-AM outputs such as the electronic code lists and mapping tables.

Replacement of the 'ICD Toolkit' will commence in 2024 to minimise current manual processes that produce classification outputs and will also consider functionality to support ICD-11.

IHACPA is also planning a project to consult, develop and conduct a cost benefit analysis for a potential ICD-11 implementation.

Conclusions
The work to replace a highly utilised and embedded classification such as ICD-10-AM is not insignificant and will take time, however, the opportunities that ICD-11 present are exciting and IHACPA is committed to the ICD-11 journey.


^a Independent Health and Aged Care Pricing Authority, Australia

Original Version in PDF