The Breathtaking Scope of ICD-10-CM Revisions for 2011

The Centers for Medicare and Medicaid Services just released a 2011 version of ICD-10-CM. A quick look at the "ICD-10-CM 2010 to 2011 Addenda" reveals a breathtaking scope of change.

First, the "Addenda" document (misnamed, since it also includes things removed and edited, not just added) for the tabular index totals 185 pages in a file nearly 1MB in size. Second, the changes span every chapter of ICD-10-CM.

Worse still, is that numerous codes have undergone a change in meaning, something decried by experts in medical informatics over 16 years ago.

Here is an example:

C64.1 Malignant neoplasm of right kidney, except renal pelvis

is now:

C64.1 Malignant neoplasm of left kidney, except renal pelvis

The update also deletes codes, which also militates against best practices in medical terminology management. Deleted codes include C64.0, C65.0, C66.0.

Anyone trying to update software applications that take advantage of particular codes for logic-based processing will surely have to review all 185 pages very carefully to esnure that their logic remains consistent. DRGs will have to be reviewed as well.

These substantial changes just 1.5 years prior to the deadline to switch will increase the cost and complexity of the switch. Another unwelcome development in the long, sad saga of ICD-10-CM.