Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА Linda Best Wednesday, 7th December 2011 Classification adjustments (ICD-10-AM & ACHI)

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА 2 Development of ICD-10-AM  Modifications to WHO ICD-10  Contract with WHO for use of ICD-10  Changes made at the fifth character level or beyond  ICD-10-AM First Edition 1117 new codes

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА 3 Development of ICD-10-AM cont.  An Australian clinical modification of the ICD-10  Staggered implementation nationally - 1 July 1998, 1 July 1999

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА WHO ICD-10

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА ICD-10-AM modification

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА Code Comparison (diseases) Example: ICD-10ICD-10-AM Acute lymphoblastic leukaemia: In remissionC91.0C91.01 Without mention of remissionC91.0C91.00

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА Data comparability  Implications for coding practices and public health research are to be expected when a version change in classification is implemented. Therefore: –It is vital that both mortality and morbidity researchers understand the impact of classification changes on mortality and morbidity data because:  Mortality coding is population based (all deaths)  Morbidity coding is based on a subset of the population (acute inpatient episodes) Reference: Australian Bureau of Statistics (2000) Causes of Death (3303.0) 7

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА Data comparability cont.  Each revision of the ICD has resulted in some lack of comparability over time for specific conditions  To analyse trends for any given condition, the condition needs to be tracked across ICD revisions and through any categories or chapters in which it appears. 8

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА ICD-10-AM Development process  Ongoing revision cycle  Involves incorporating updates from: - World Health Organisation (WHO) for ICD-10 - Medicare Benefits Schedule (MBS) - Australian Dental Association 9

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА ICD-10-AM Development process cont.  All users of the classification have the ability to submit proposals for changes  Done via public submissions and queries  Involves: - conducting a literature search - reviewing other classifications and monitoring national frequencies - liaising with clinicians and clinical coders as required 10

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА The use of ICD-10-AM in Australia Year of ImplementationEdition 1998/1999First 2000Second 2002Third 2004Fourth 2006Fifth 2008Sixth 2010Seventh Future … 2012Eighth 2014????

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА ICD-10-AM Mapping Tables  Mapping is the process of linking/associating concepts from one system to concepts in another system  Useful for: - Reporting data recorded in a different classification - Comparing 2 classifications - Highlighting differences between classifications

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА ICD-10-AM Mapping Tables cont.  Forward mapping - a code from a classification mapped to a more recent classification e.g. ICD-10 to ICD-10-AM First Edition  Backward mapping - a code from a new classification mapped to an older classification e.g. ICD-10-AM Seventh Edition to ICD-10- AM Sixth Edition

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА ICD-10-AM Mapping Tables cont.  Types of maps - One-to-one map - One-to-many map

Serbia Health Project – Additional Financing Training for Trainers on AR-DRG, Република Србија МИНИСТАРСТВО ЗДРАВЉА Summary of changes to ICD-10-AM Seventh Edition codes  Total number of new disease codes = 552  Total number of deleted disease codes = 61  Total number of new intervention codes = 73  Total number of deleted intervention codes = 72