Impact of the ICD-11 on the accuracy of clinical coding in Korea

Abstract

Background: ICD-11 was officially released at the World Health Assembly on 25 May 2019. Objective: To find effective ways to increase the accuracy of coding for diagnostic terms in Korea for a stable transition from Korean modification of ICD-10 (7th Revision of Korean Classification of Disease, KCD-7) to ICD-11. Method: A total of 27 skilled Korean health information managers performed KCD-7 and ICD-11 coding simultaneously (line coding [56]; case coding [17]). Accuracy rates and percentage agreements were calculated, and granularity and difficulty of the ICD-11 were rated by participants. Results: The average accuracy rate of line coding was 71.6 % in ICD-11 and 80.2% in KCD-7, which was similar to results in other studies. The mean percentage agreements for ICD-11 and KCD-7 for line coding were 64.2% and 72.1%, respectively; while for case coding it was 15.3% and 26.6%. Selection criteria for the case scenarios may have influenced the low agreements in case coding. Cluster coding, changes of terms in ICD-11 and removal of codes used in ICD-10 contributed to low agreement in ICD-11 (46.6% of participants reported that granularity of ICD-11 was similar to ICD-10, while 36.9% reported that ICD-11 had finer granularity). In terms of difficulty, 15.3% of participants found line coding difficult and 10.9% found case coding difficult. Conclusion: Provision of more detailed reference guidelines and efficient training for coding professionals by the World Health Organization would enable ICD-11 to be an excellent tool for gathering relevant information about diseases in Korea.

Improvements in Neoplasm Classification in the International Classification of Diseases, Eleventh Revision: Systematic Comparative Study With the Chinese Clinical Modification of the International Classification of Diseases, Tenth Revision

“…Second, coders are accustomed to using the old classification system and need time to familiarize themselves with the new coding system and tool. Studies have shown that some coders have difficulties coding on the web due to a lack of familiarity with software [24,25]. In this study, 2 skilled coders who received ICD-11 training still had 213 inconsistent codes.…”

“…Web-based coding requires high professional ability. Studies have also shown that the reliability and accuracy of ICD-11 coding are lower than those of ICD-10 coding [23][24][25]. In the early stages of ICD-11 promotion, countries involved in the transition need to conduct ICD-11 training and transform coders' coding concepts.…”

Automated Generation of ICD-11 Cluster Codes for Precision Medical Record Classification

“…Furthermore, the significant differences between the 11th Revision of the International Classification of Diseases (ICD-11) and other ICD versions make upgrading existing coding systems a difficult and time-consuming task. ICD-11 was officially released during the World Health Assembly in 2019, marking the latest chapter in the evolution of this globally adopted classification system for diseases [20]. With each new iteration of the ICD, it is customary for the code syntax to undergo modifications, ostensibly to avert confusion with previous versions [21].…”