A narrative review of the impact of the transition to ICD-10 and ICD-10-CM/PCS

Sheila V Kusnoor; Mallory N Blasingame; Annette M Williams; Spencer J DesAutels; Jing Su; Nunzia Bettinsoli Giuse

doi:10.1093/jamiaopen/ooz066

A narrative review of the impact of the transition to ICD-10 and ICD-10-CM/PCS

JAMIA Open. 2019 Dec 26;3(1):126-131. doi: 10.1093/jamiaopen/ooz066. eCollection 2020 Apr.

Authors

Sheila V Kusnoor¹, Mallory N Blasingame¹, Annette M Williams¹, Spencer J DesAutels¹, Jing Su¹, Nunzia Bettinsoli Giuse^{1

2

3}

Affiliations

¹ Center for Knowledge Management, Strategy and Innovation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
² Department of Biomedical Informatics, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
³ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Abstract

Objectives: The United States transitioned to the tenth version of the International Classification of Diseases (ICD) system (ICD-10) for mortality coding in 1999 and to the International Classification of Diseases, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) on October 1, 2015. The purpose of this study was to conduct a narrative literature review to better understand the impact of the implementation of ICD-10/ICD-10-CM/PCS.

Materials and methods: We searched English-language articles in PubMed, Web of Science, and Business Source Complete and reviewed websites of relevant professional associations, government agencies, research groups, and ICD-10 news aggregators to identify literature on the impact of the ICD-10/ICD-10-CM/PCS transition. We used Google to search for additional gray literature and used handsearching of the references of the most on-target articles to help ensure comprehensiveness.

Results: Impact areas reported in the literature include: productivity and staffing, costs, reimbursement, coding accuracy, mapping between ICD versions, morbidity and mortality surveillance, and patient care. With the exception of morbidity and mortality surveillance, quantitative studies describing the actual impact of the ICD-10/ICD-10-CM/PCS implementation were limited and much of the literature was based on the ICD-10-CM/PCS transition rather than the earlier conversion to ICD-10 for mortality coding.

Discussion: This study revealed several gaps in the literature that limit the ability to draw reliable conclusions about the overall impact, positive or negative, of moving to ICD-10/ICD-10-CM/PCS in the United States.

Conclusion: These knowledge gaps present an opportunity for future research and knowledge sharing and will be important to consider when planning for ICD-11.

Keywords: International Classification of Diseases; claims; clinical coding; diagnosis codes; population surveillance.