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

ICD-11 Proposal Mechanism:

A change of Definition/Description proposal for 6C20 Bodily distress disorder was submitted to the ICD-11 Proposal Mechanism by the WHO's Dr Geoffrey Reed on February 29, 2020:

https://icd.who.int/dev11/proposals...lGroupId=41ee2f01-05cf-4883-82f3-db2a553f5258

Content Enhancement Proposal
Originator: Geoffrey Reed #2A1H

Bodily distress disorder

Current text:

Bodily distress disorder is characterized by the presence of bodily symptoms that are distressing to the individual and excessive attention directed toward the symptoms, which may be manifest by repeated contact with health care providers. If another health condition is causing or contributing to the symptoms, the degree of attention is clearly excessive in relation to its nature and progression. Excessive attention is not alleviated by appropriate clinical examination and investigations and appropriate reassurance. Bodily symptoms are persistent, being present on most days for at least several months. Typically, bodily distress disorder involves multiple bodily symptoms that may vary over time. Occasionally there is a single symptom—usually pain or fatigue—that is associated with the other features of the disorder.

Proposed addition (in brown):

Bodily distress disorder is characterized by the presence of bodily symptoms that are distressing to the individual and excessive attention directed toward the symptoms, which may be manifest by repeated contact with health care providers. If another health condition is causing or contributing to the symptoms, the degree of attention is clearly excessive in relation to its nature and progression. Excessive attention is not alleviated by appropriate clinical examination and investigations and appropriate reassurance. Bodily symptoms are persistent, being present on most days for at least several months. Typically, bodily distress disorder involves multiple bodily symptoms that may vary over time. Occasionally there is a single symptom—usually pain or fatigue—that is associated with the other features of the disorder. The symptoms and associated distress and preoccupation have at least some impact on the individual’s functioning (e.g., strain in relationships, less effective academic or occupational functioning, abandonment of specific leisure activities).

Proposal status: Submitted

Rationale:

These are minor changes to be more consistent with the expanded diagnostic guidance for mental disorders. Name of chapter was corrected. The necessary impact on functioning has been made clearer.

References

There are no references attached for this proposal item

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It is unclear what "Name of chapter was corrected." refers to. I have asked for clarification. (I suspect it may have been included due to a pasting error inherited as a result of using part of the Rationale text for other disorders submitted in that batch.)

Note: The "expanded diagnostic guidance for mental disorders" is a reference to the Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD‐11 Mental, Behavioural and Neurodevelopmental Disorders (an equivalent publication to ICD-10's "Blue Book").

The CDDG provides expanded clinical descriptions, essential (required) features, boundaries with other disorders and normality, differential diagnoses, additional features, culture-related features and codes for all mental and behavioural disorders commonly encountered in clinical psychiatry. This companion publication is intended for use by mental health professionals and for general clinical, educational and service use. The WHO has said it planned to release the CDDG "as soon as possible" after WHA's adoption of ICD-11. But it remains unclear whether the CDDG has been finalised and when it is planned to be released.​



This proposal for additional text to be added to the BDD Definition/Description text is one of around 40 submissions that were batch submitted on February 29 for various disorders in the Mental, behavioural, and neurodevelopmental disorders chapter.

These include revisions to the texts for:

Hypochondriasis (Substantive changes to the Definition/Description text)

Current text:

Hypochondriasis is characterized by persistent preoccupation with or fear about the possibility of having one or more serious, progressive or life-threatening diseases. The preoccupation is associated with catastrophic misinterpretation of bodily signs or symptoms, including normal or commonplace sensations, and is manifest either in repetitive and excessive health-related behaviours or in maladaptive avoidance behaviours related to health. The preoccupation or fear is not simply a reasonable concern related to a specific context of the patient, and persists or reoccurs despite appropriate medical evaluation and reassurance. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Proposed change:

Hypochondriasis is characterized by persistent preoccupation or fear about the possibility of having one or more serious, progressive or life-threatening illnesses. The preoccupation is accompanied by either: 1) repetitive and excessive health-related behaviours such as repeatedly checking of the body for evidence of illness, spending inordinate amounts of time searching for information about the feared illness, repeatedly seeking reassurance (e.g., arranging multiple medical consultations); or 2) maladaptive avoidance behaviour related to health (e.g., avoids medical appointments). The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.


Rationale

These are minor changes to be more consistent with the expanded diagnostic guidance for mental disorders. Substantive meaning of description is the same, but language has been clarified.

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For the following Dissociative neurological symptom disorder terms, the change is described as: "These are minor changes to be more consistent with the expanded diagnostic guidance for mental disorders. Name of chapter was corrected. The term 'health condition' has been changed to 'medical condition' as this is the term that the TAG decided to use throughout.

"or neurodevelopmental disorder" has also been inserted for some of the following, minor typographical errors corrected and in one disorder, an exclusion revised:


Dissociative neurological symptom disorder
Dissociative neurological symptom disorder, with Parkinsonism
Dissociative neurological symptom disorder, with facial spasm
Dissociative neurological symptom disorder, with dystonia
Dissociative neurological symptom disorder, with tremor
Dissociative neurological symptom disorder, with myoclonus
Dissociative neurological symptom disorder, with chorea
Dissociative neurological symptom disorder, with movement disturbance
Dissociative neurological symptom disorder, with gait disturbance
Dissociative neurological symptom disorder, with paresis or weakness
Dissociative neurological symptom disorder, with speech disturbance
Dissociative neurological symptom disorder, with non-epileptic seizures
Dissociative neurological symptom disorder, with other sensory disturbance
Dissociative neurological symptom disorder, with vertigo or dizziness
Dissociative neurological symptom disorder, with auditory disturbance
Dissociative neurological symptom disorder, with visual disturbance
Dissociative neurological symptom disorder, with cognitive symptoms

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As these changes are being submitted by the WHO's lead Managing Editor for the Mental disorder chapter in order to align with the texts in the draft CDDG, I anticipate they will be marked as approved and implemented within the next few days.

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Edited to add: This batch of 40 proposals for minor changes to align description texts with the draft CDDG are now marked as Implemented.
 
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Posted on behalf of Suzy Chapman (Dx Revision Watch)


NHS Digital requests addition of SEID to SNOMED CT

The UK Edition of SNOMED CT terminology system is managed by NHS Digital.

Authorized users of the SNOMED CT system can register to submit requests for changes or additions to the content via NHS Digital's submission portal.

Members of the public can access a database of all requests submitted since late 2008 and monitor their progress through the review process and their outcome.

Last Thursday, I was poking around in the submission portal search engine to get a feel for how long it takes requests to be processed, how many are referred on to the terminology leads at SNOMED International for their input, or have been referred on for consideration for inclusion in the International Edition.

I stumbled by chance on a request submitted in November, last year, for adding the term "Systemic exertion intolerance disease" to SNOMED CT.

The request is for adding "Systemic exertion intolerance disease" as an additional Synonym term under SNOMED CT Concept: 52702003 Chronic fatigue syndrome.



On Friday, a senior member of SNOMED International's staff contacted me and confirmed that this request has been submitted for consideration for addition to the July release of the International Edition.

If the request is approved for adding to the International Edition, the term "Systemic exertion intolerance disease" would then be absorbed by all the various national editions when they release their next updates.

My concerns about the potential addition of the (unadopted) SEID term to SNOMED CT have been discussed and passed back to SNOMED International's terminology specialists.

They also have a copy of the report below which I've prepared for the March edition of The ME Global Chronicle.

You can read my report, here:

PDF: NHS Digital requests addition of SEID to SNOMED CT

SNOMED CT Report One | March 2020

https://dxrevisionwatch.files.wordp...-requests-addition-of-seid-to-snomed-ct-1.pdf

I will update on any developments with the processing of this request.



IAPT and SSD:

For an update on the status of IAPT's request for addition of the DSM-5 term "Somatic symptom disorder" to the UK Edition of SNOMED CT, see Post #66 in this S4ME forum thread:

IAPT requests addition of DSM-5's Somatic symptom disorder (SSD) to SNOMED CT for use in Data Set v2.0 to replace "MUS - not otherwise specified"

https://www.s4me.info/threads/iapt-...-otherwise-specified.13691/page-4#post-243950

Suzy Chapman, Dx Revision Watch
 
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I've returned to this forum, briefly, to provide a series of updates over the next two or three weeks concerning SNOMED CT and ICD-11.


Update 1: Outcome of request for adding the term "Systemic exertion intolerance disease" as a Synonym term under existing SNOMED CT Concept: 52702003 Chronic fatigue syndrome

In the previous post (#423), Trish kindly posted a report on my behalf concerning a request submitted in November 2019 for addition of the term "Systemic exertion intolerance disease" to the SNOMED CT terminology system.

SNOMED CT UK Edition is the mandatory terminology system for use across all NHS England primary and secondary care settings, at the point of care.

Request #30104 had been submitted on November 30, 2019. It appeared to originate from within the NHS (or other authorised SNOMED CT end user) as no other class of stakeholder is referenced as the original requester.

The request was for adding the term "Systemic exertion intolerance disease" as a Synonym under the existing SNOMED CT Concept: 52702003 Chronic fatigue syndrome.

The "Brief summary" for the request had been given as "Synonym request due to renaming in some international health services".

The full rationale text for this request can be read here on the NHS Digital Request Submission Portal:
https://isd.hscic.gov.uk/rsp-snomed/user/guest/request/view.jsf?request_id=30104

The request had been referred on to SNOMED International's terminology leads for their consideration.


After drawing attention to this request on Twitter, I was contacted on March 12 by a senior member of SNOMED International’s team who confirmed that this request had been submitted for consideration for addition to the SNOMED CT International Edition. I was advised that the request had already been processed and pending any further changes, would be implemented in the International Edition's July 2020 release.

(If the request were approved for adding to the International Edition, the term "Systemic exertion intolerance disease" would then be absorbed by all the various national editions, when they released their next updates.)


I outlined my concerns about the potential addition of the (unadopted) SEID term to SNOMED CT and these were passed back to SNOMED International's terminology specialists for their consideration. They were also given a copy of a report I had prepared for the March edition of The ME Global Chronicle.

Report here: PDF: NHS Digital requests addition of SEID to SNOMED CT


On June 2, I was advised that the information I had provided had been passed on for review by the terminology team; that it was now considered that adding "Systemic exertion intolerance disease" as a synonym is premature; that approval of this request had been retracted and the term would not be included in the July 2020 release.

This was further confirmed on this SNOMED CT internal production page (last entry under heading: Concepts to be removed completely from the Alpha release content): https://jira.ihtsdotools.org/browse/ISRS-810?src=confmacro


The July 31, 2020 release has been published, today, on the public browser:

https://browser.ihtsdotools.org/?perspective=full&conceptId1=404684003&edition=MAIN/2020-07-31&release=&languages=en


I can confirm that the two synonyms terms that had been added under 52702003 |Chronic fatigue syndrome (disorder)| for the Alpha production release:
  • 3902795018 - SEID - systemic exertion intolerance disease
  • 3902796017 - Systemic exertion intolerance disease

have been removed for the July 2020 release.

--------------------------

Edited to add: An edited version of this report has been prepared for the next issue of the ME Global Chronicle.

Edited to add: An expanded version of this report is available on Dx Revision Watch:

Update on NHS Digital’s request for addition of SEID to SNOMED CT terminology system

https://dxrevisionwatch.com/2020/08...tion-of-seid-to-snomed-ct-terminology-system/

https://wp.me/pKrrB-58W

https://bit.ly/31aAca8
 
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Dx Revision Watch said:
I've returned to this forum, briefly, to provide a series of updates over the next two or three weeks concerning SNOMED CT and ICD-11.

Update 1: Outcome of request for adding the term "Systemic exertion intolerance disease" as a Synonym term under existing SNOMED CT Concept: 52702003 Chronic fatigue syndrome etc
Click to expand...


Edited to insert: In the event of a request for a change or addition to SNOMED CT not being accepted by the terminology team there is a formal appeals process and the submitter may request a further review of the decision.

I have received a message this afternoon from SNOMED International's Rory Davidson to say that there was no appeal from NHS Digital against the decision to retract approval of the addition of SEID to the July release.
 
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Update 2: Some updates on ICD-11

1. Updating the blue ICD-11 "Version for preparing implementation" platform:

It was anticipated that the ICD-11 Blue platform would continue to be updated annually to incorporate all the changes and additions approved and implemented in the Orange Maintenance platform since the last update of the Blue platform was released.

There hasn't been a new release of the Blue platform since April 2019.

So, for example, the Exclusions for 8E49 PVFS; BME; and CFS under 6C20 Bodily distress disorder which were approved in January, this year, and implemented in the Orange Maintenance platform don't yet display in the Blue platform.

A couple of weeks ago, I contacted the WHO's Dr John Grove to enquire when the next update of the Blue platform was anticipated to be published and when the Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders is now expected to be finalised and released.

I have, today, received a response from the WHO's Dr Robert Jakob who advises that the 2020 release of the ICD-11 Blue platform will be posted in a few weeks.


2. My proposal for deprecation of the prefix "Benign":

On February 9, 2020 I submitted a new proposal for removal of the prefix "Benign" from "Benign myalgic encephalomyelitis" citing, inter alia, the precedent of the removal of "Benign" for the last update of ICD-10 (Version: 2019).

My proposal and rationale can be read here in PDF format: https://dxrevisionwatch.files.wordpress.com/2020/02/new-proposal-for-icd-11-remove-benign-1.pdf

This proposal has not yet been processed. I am hoping it might be reviewed and accepted in time for inclusion in the 2020 release of the Blue platform.


3. Publication of the CDDG:

The Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders has been developed by the WHO Department of Mental Health and Substance Abuse. It is the equivalent of the ICD-10 "Blue Book".

The content of the core version of ICD-11 is intended as a basis for statistical reporting and its descriptive texts intended for use by coders and clerical workers.

The CDDG is a more comprehensive version of Chapter 06: Mental, behavioural or neurodevelopmental disorders that provides clinicians with detailed clinical guidance for diagnosing mental disorders in clinical settings.

It provides expanded clinical descriptions, essential (required) features, boundaries with other disorders and normality, differential diagnoses, additional features, culture-related features and codes for mental and behavioural disorders commonly encountered in clinical psychiatry and is intended for use by mental health professionals and for general clinical, educational and service use.

It will contain, for example, expanded description texts and diagnostic guidelines for 6C20 Bodily distress disorder and 6B60 Dissociative neurological symptom disorder.

The draft texts for the CDDG have not been made accessible for public review and comment, though clinicians have been able to register to review and provide feedback throughout its development via a dedicated GCP.Network platform.

Last year, the WHO stated that the CDDG would be published "as soon as possible" after the May 2019 adoption of ICD-11 at the 72nd World Health Assembly.

I have been advised by Dr Robert Jakob, today, that the CDDG is still being amended based on feedback from the field and that the mental health team hasn’t provided a clear deadline [for its finalisation and release].


4. New version of my report: Update on classification and coding of PVFS, ME and CFS for ICD-11 (v4 August 2020):

On February 10, 2020, the WHO stated: "The ICD-11 codes are now frozen. Proposed changes to the classification that would result in a code change are not permitted."

Changes that would not disrupt the structure of the now frozen code hierarchies, for example, additions to the Index, addition/deletion of synonym terms or exclusion terms, edits to Description texts, correction of typos are permissible.

But relocating an existing Concept Title to another chapter (which would entail a code change) or changing a term's Primary parent location (and hence its code) within its existing chapter could not be considered.

A revised version of my report (v4 August 2020):

Update on classification and coding of PVFS, ME and CFS for ICD-11 v4 August 2020

can be downloaded from:

https://dxrevisionwatch.files.wordp...ion-of-pvfs-me-cfs-for-icd-11-august-2020.pdf

or

https://bit.ly/ICD118E49


I have also attached a copy to this post.

[Thumbnails pages 1 and 4]

thumbnail2-reporticd-11-august-2020.png



Edited to add:

An expanded version of this post has been published on Dx Revision Watch:

A round up of updates on ICD-11

https://wp.me/pKrrB-59G
 

Attachments

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Upcoming Meeting: ICD-10-CM Coordination and Maintenance Committee September 8-9, 2020

Tentative Agenda*

https://cdc.gov/nchs/data/icd/Tentative-Agenda-Sept-2020.pdf

*This updated list of tentative agenda of topics is not final.

The final topics material will be available electronically from the NCHS and CMS web sites prior to the meeting. NCHS and CMS no longer provide paper copies of handouts for the meeting.

The NCHS web site for ICD-10-CM Coordination and Maintenance Committee is available at the URL below. http://www.cdc.gov/nchs/icd/icd10cm_maintenance.htm

The CMS website for Meeting materials is available below. https://www.cms.gov/Medicare/Coding/ICD10/C-and-M-Meeting-Materials

------------

The full Topic Packets and meeting materials are usually posted on the CDC C & M Meeting page a day or two before meeting Day One. So the full agenda would be expected to be available by September 7.
 
Brief update on a change of personnel at the WHO:

Dévora Kestel has replaced Dr Shekhar Saxena as Director of the WHO Department of Mental Health and Substance Abuse - the WHO Division that is also responsible for neurological diseases and disorders.

Ms Kestel appears to have held this position since at least October 2019.


https://www.paho.org/hq/index.php?o...-de-sustancias-de-la-oms&Itemid=42050&lang=en

Dévora Kestel to direct WHO Department of Mental Health and Substance Abuse
 
Second update on a change of personnel at the WHO:

Dr John Grove, who was Director of Information, Evidence and Research, is now Director of Quality Assurance for Norms and Standards at WHO HQ, Geneva.

I have not yet established who currently holds the post of Director of Information, Evidence and Research.


This morning, Dr Tedros Ghebreyesus, Director-General, has announced that WHO is establishing a new Science Council to support the delivery of health for all and keeping the world safe through advances in science and technology.

I have asked whether WHO will be transparent about the membership and affiliations of its Science Council once assembled. Currently WHO does not publish membership lists for its ICD advisory committees: the Classifications and Statistics Advisory Committee (CSAC) and Medical Scientific Advisory Committee (MSAC).


Edited to add update:

Dr John Grove (responding on behalf of Dr Tedros Ghebreyesus, Director-General) has said that WHO does intend to publish a list of the membership of the new Science Council, once assembled.

Also, that the concern about the [non publication of the members of the ICD MSAC and CSAC committees] will be reviewed.
 
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The next meeting of the NCHS/CDC ICD-10-CM Coordination and Maintenance Committee is scheduled for September 8-9, 2020

A PDF of the Diagnosis Agenda has been posted on the CDC's C & M meeting page:

https://www.cdc.gov/nchs/data/icd/Topic-packet-September-8-9.2020.pdf


The September 2020 ICD-10 Coordination and Maintenance Committee Meeting will be held fully virtual, with no in-person audience.

Those who wish to attend must participate via Zoom Webinar or by dialing in.

Recordings and slide presentations of the September 8-9, 2020 ICD-10 Coordination and Maintenance Committee Meeting will be posted on the following web pages:

Diagnosis code portion of the recording and related materials – https://www.cdc.gov/nchs/icd/icd10cm_maintenance.htm
Procedure code portion of the recording and related materials – https://www.cms.gov/Medicare/Coding/ICD10/C-and-M-MeetingMaterials.html
 
Follow up to my ICD-11 proposal (submitted 14/02/20) which remains unprocessed, requesting deprecation of "Benign" prefix from 8E49 inclusion term: Benign myalgic encephalomyelitis


Copy of Proposal and rationale here, in PDF format for ease of access: New proposal for ICD-11: Deprecate "Benign" February 14 2020


Follow up Comment, uploaded today, on the ICD-11 Orange Maintenance platform's Comment facility (registration required for access, so I am including an image):

https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/569175314

(Most recent Comment under "Generic Comments on the Category")

comment060920.png



I've also left a brief comment under the Proposal, itself, requesting that this submission is reviewed and processed in time for inclusion in the annual update of the Blue ICD-11 MMS.
 
NHS Digital National Clinical Coding Standards ICD-10 5th Edition (April 2020)

PDF: https://tinyurl.com/y4ogxxu6

WHO also refer to the ICD-10 5th Edition as the 2016 Edition. It includes updates that came into effect between 2011 and 2016.

Page 84:

This note for coders has been included in the NHS Digital Clinical Coding Standards for a number of years.

clinical-standards-5th-edition.png


These national clinical coding standards are for use with the Tenth Revision 5th Edition (ICD-10) when translating diagnoses and other health related problems recorded in a patient’s medical record for morbidity coding.

The classification of diagnoses using ICD-10 is a mandatory national requirement for the NHS Admitted Patient Care (APC) Commissioning Data Set (which includes day cases) and other data sets as outlined in the section below.

(...)

Clinical coding

Clinical coding is the translation of medical terminology that describes a patient’s complaint, problem, diagnosis, treatment or other reason for seeking medical attention into codes that can then be easily tabulated, aggregated and sorted for statistical analysis in an efficient and meaningful manner.

(...)

Background

The WHO states that ICD is to permit the systematic recording, analysis, interpretation and comparison of mortality and morbidity data collected in different countries or areas and at different times. The ICD is used to translate diagnoses and other health problems from words into alphanumeric codes, which permits easy storage, retrieval and analysis of data’1.

1 World Health Organisation International Classification of Diseases and Related Health Problems’ ICD-10 Volume 2, 2.1 Purpose and applicability


ICD-10 is a vital component of national data sets, such as Hospital Episodes Statistics (HES) in England, Hospital In-patient Statistics (HIS) in Northern Ireland, Patient Episode Data for Wales (PEDW), Scottish Morbidity Records (SMR), Cancer Registries, National Service Frameworks, Care Pathways, Performance Indicators, Commissioning Data Sets (CDS) and other Central Returns.

The statistical classification underpins key information initiatives that support the monitoring of morbidity and health trends. NHS managers and health care professionals use it locally to support operational/strategic planning and performance management.

For example:

• Statistical uses include study of aetiology (cause or origin) and incidence of diseases, health care planning and casemix.

• Epidemiologists use statistical data to study frequency and occurrence of disease. The aggregation of coded data enables health professionals to identify at risk populations based on demographic, diagnostic or environmental factors.

• Planners and managers use statistical data to review caseloads to: determine specialty needs, inform staffing levels, patient admissions and clinic schedules in hospitals.

• Clinical audit uses coded data to compare patient care and measure outcomes within specialities. Doctors may use extracts of local information for research purposes. The United Kingdom has a mandatory obligation to collect and submit ICD-10 data to the World Health Organisation (WHO) for the production of international statistical and epidemiological data...

PDF (250 pages): https://tinyurl.com/y4ogxxu6​

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The most recent update of ICD-10 is Version: 2019 which was published in January 2020. WHO has stated that this will be the final update of ICD-10, apart from correction of errors, typos and addition of important viruses.

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

G93.3 Postviral fatigue syndrome
Myalgic encephalomyelitis


As reported in this thread in January, for the final update of ICD-10, removal of the "Benign" prefix from "Benign myalgic encephalomyelitis" was implemented.

A request for the removal of "Benign" had been submitted in March 2016 on behalf of the Canadian Institute for Health. The request was approved by the WHO-FIC ICD-10 Update and Revision Committee (UCR) in September 2016.

In February 2020, I submitted a proposal for this change to ICD-10 to be carried forward for ICD-11. See previous post #432.


It is understood that NHS Digital has yet to decide whether and when to migrate from ICD-10 Version: 2016 to Version: 2019, or to skip implementation of Version: 2019 and transition directly to ICD-11, at some future point.
 
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New release of ICD-11 for Mortality and Morbidity Statistics (Version: 09/2020) published today:


Note 1: An update of the Blue ICD-11 MMS platform has been released for September 2020. This release replaces the previous release (Version: 04/2019).

ICD-11 for Mortality and Morbidity Statistics (Version : 09/2020):

https://icd.who.int/browse11/l-m/en


The Exclusions for

Postviral fatigue syndrome (8E49)
Chronic fatigue syndrome (8E49)
Benign myalgic encephalomyelitis (8E49)

under 6C20 Bodily distress disorder, which were approved in February 2020 and added to the Orange Maintenance Browser, can now be viewed in the updated release of the Blue ICD-11 MMS browser:

https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f767044268

mms-9.20bdd2.png



Source: ICD-11 for Mortality and Morbidity Statistics (Version : 09/2020). Accessed September 21, 2020



Note 2: Unfortunately, my February 2020 proposal for the removal of the "Benign" prefix from 8E49 Benign myalgic encephalomyelitis to bring ICD-11 into alignment with the WHO-FIC ICD-10 Update and Revision Committee (URC) precedent decision for ICD-10 Version: 2019 [1] has not been processed in time for inclusion in this new release of the Blue ICD-11 MMS.

Having stated on August 22, "We hear you. My colleagues will reach out to you." I asked Dr Tedros Ghebreyesus (Director-General, WHO) if he would demonstrate WHO's commitment by ensuring that Proposal ID #298U for deprecation of the prefix "Benign" from 8E49 Benign myalgic encephalomyelitis (submitted February 2020) was reviewed and processed before the next annual update of the Blue ICD-11 MMS.

Dr Ghebreyesus did not respond to this request and a request via the Proposal Mechanism for fast tracking has not been responded to, either.

A number of proposals submitted from 2017 onwards which had been identified by the WHO, in June 2019, for processing in time for potential inclusion in the next release of the Blue ICD-11 MMS platform and which had been referred to the MSAC and CSAC committees for review and voting also remain unprocessed.


1 New proposal for ICD-11: Deprecate "Benign" submitted by Suzy Chapman, February 14, 2020
https://dxrevisionwatch.files.wordpress.com/2020/02/new-proposal-for-icd-11-remove-benign-1.pdf

2 Update on classification and coding of PVFS, ME and CFS for ICD-11 v4 August 2020, can be downloaded from:
https://dxrevisionwatch.files.wordp...ion-of-pvfs-me-cfs-for-icd-11-august-2020.pdf

or https://bit.ly/ICD118E49
 
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If my proposal and rationale for the removal of "Benign" [1] is processed and approved later this year or next year (and I can see no justification for the WHO rejecting this proposal as the URC had approved its removal for ICD-10 back in 2016 and implemented that decision for the final update of ICD-10) it would be implemented immediately, as a change to the Orange Maintenance Platform. But it would have to wait until the next annual update of the Blue ICD-11 MMS browser before the change appears in the Blue browser version.

(I'll be retired in October, but I will return to this thread to update on the status of this proposal if there is any development, as I shall still be monitoring the Orange Maintenance Platform for my own interest.)


1 New proposal for ICD-11: Deprecate "Benign" submitted by Suzy Chapman, February 14 2020
https://dxrevisionwatch.files.wordpress.com/2020/02/new-proposal-for-icd-11-remove-benign-1.pdf
 
Thank you so much for all your hard work on this, Suzy, this is such important work and something I had no idea about until I started reading your posts. Yet it affects so much, and so many people’s lives and deserves to be more widely appreciated.
 
Blueskytoo said:
Thank you so much for all your hard work on this, Suzy, this is such important work and something I had no idea about until I started reading your posts. Yet it affects so much, and so many people’s lives and deserves to be more widely appreciated.
Click to expand...


Thank you, @Blueskytoo for your very kind words. I was disappointed, this morning, that I won't be signing off in a few weeks time with the removal of "Benign" in the bag.

But I am fairly confident the proposal will be approved later this year or early next year; ICD-11 cannot be used until January 01, 2022, anyway, so there is a good 15 months before then, during which time, hopefully, the proposal will be processed.
 
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According to Dr Samira Asma (WHO Assistant Director-General):




Edited to add: The earliest date from which member states can begin using the new edition (if their health systems are ready to roll out ICD-11) is from January 01, 2022.

There is no mandatory implementation date. Member states will migrate to ICD-11 at their own pace and according to their countries' needs and resources but there is an expectation that countries will begin planning for transition [1].

1 World Health Assembly adopts ICD-11: When will member states start using the new edition? Dx Revision Watch, June 17, 2019.

 
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Update on development of ICPC-3:

Invitation to field test ICPC-3

As reported in previous posts, since January 2018, the ICPC-2 (International Classification of Primary Care, Second edition) has been under revision for ICPC-3.

The ICPC-2 is a WHO approved classification system for recording clinical information in primary care. It is used for recording reasons for encounter, practitioner’s assessment of diagnosis, care plans etc.

ICPC-2 is available in 34 countries and is used in primary care in around 27 countries. It is not mandated for use in NHS England but it is mandatory for use in primary care in around 6 EU countries, including the Netherlands. Some countries, for example Denmark, have developed national extensions and translations.

The full ICPC-2 classification system is available under licence.

An abridged version of the diagnostic codes is available here: http://docpatient.net/3CGP/QC/ICPC_desk.pdf


"The International Classification of Primary Care (ICPC) is the most widely used international classification for systematically capturing and ordering clinical information in primary care. It is developed and updated by the World Organization of Family Doctors’ (WONCA) International Classification Committee (WICC).

The most recent version is ICPC-2 which was revised in 2015. ICPC is formally recognised by the World Health Organization’s (WHO) Family of International Classifications (WHO-FIC) as a classification system for primary care. It is mapped to the International Classification of Diseases (ICD). This allows communication between the two classification systems and complementary usage. Ongoing cooperation between WONCA and the WHO-FIC network exists for the revision of ICD-10 to ICD-11 and harmonization with ICPC." [1]​


1 WONCA International Classification of Primary Care Introduction:
https://www.globalfamilydoctor.com/site/DefaultSite/filesystem/documents/Groups/WICC/International Classification of Primary Care Dec16.pdf


ICPC-3 will also be linked to other classifications, including ICD-10, ICD-11, ICF, ICHI and Snomed CT.

In September, the ICPC-3 Consortium put out a call for field testing the ICPC-3.

The ICPC-3 development timeline has slipped its targets and the testing period has been extended to October 31, 2020:


https://www.globalfamilydoctor.com/News/ICPC-3fieldtestinvitation.aspx

ICPC-3 field test invitation

October 2020 Working Party News

September, 2020

Dear colleague,

The ICPC is the most widely used international classification for the systematic recording and organizing of clinical information in primary care.

The newest version ICPC-3 designed by the ICPC-3 Consortium in collaboration with the WONCA classification committee is in the testing phase.

The ICPC-3 Consortium is established in cooperation with WONCA, WONCA Europe, and a number of participating Countries/Institutes to develop the ICPC-3 within a set time frame.

We would like to invite you to test it. You can do this by sending an email, with your name, profession and country to: info@icpc-3.info

For more information about the ICPC-3 and the field test see on our website: www.icpc-3.info/field-test

etc

----------------------------


As I am stepping down from the advocacy work I do around classification and terminology systems by the end of October, I won't be monitoring and reporting on the development of the ICPC-3 in the future.

ICPC-3 Consortium website

Projected development timeline (slipped for field testing dates)
 
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