Keeping our classification up to date.
Abstract: In Australia, the National Centre for Classification in Health (NCCH) is ultimately responsible for updating ICD-10-AM disease codes and Australian Classification of Health Interventions (ACHI) procedure codes, and the accompanying Australian Coding Standards (ACS). New editions of these publications are released every two years. This article outlines the updating procedure and lists the sources of information upon which the NCCH draws when compiling data for new coding manuals.

Keywords (MeSH): ICD-10-AM; ICD Codes; Australia; Clinical Coding.
Article Type: Report
Subject: Diseases (Australia)
Diseases (Identification and classification)
Practice guidelines (Medicine) (Management)
Authors: Doyle, Kerri
Dimitropoulos, Vera
Pub Date: 02/01/2009
Publication: Name: Health Information Management Journal Publisher: Health Information Management Association of Australia Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 Health Information Management Association of Australia Ltd. ISSN: 1833-3583
Issue: Date: Feb, 2009 Source Volume: 38 Source Issue: 1
Topic: NamedWork: International Classification of Deaths (Standard) Event Code: 200 Management dynamics Computer Subject: Company business management
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 216488650
Full Text: Introduction

The National Centre for Classification in Health (NCCH) is ultimately responsible for updating ICD-10-AM disease codes and Australian Classification of Health Interventions (ACHI) procedure codes, and the accompanying Australian Coding Standards (ACS). New editions of these publications are released every two years. The impetus for the majority of changes that occur in each edition of the ICD-10-AM manual is driven predominantly by the users of the classification. NCCH responds directly to classification queries received from the states and territories and to public submissions for changes to the content of the classification.

Proposed changes

Proposed changes to the classification may originate from:

* Coding queries

** Coding queries may highlight an area of the classification that needs updating in a future edition.

** Queries received from each state/territory coding committee are discussed at a roundtable meeting of NCCH's Classification Support and Development (CSD) staff. Responses to all queries are drafted and submitted to CSAC for approval before publication in the Coding Matters newsletter.

** NCCH is currently working on a new online tool for coding queries which will help streamline the process in the future.

** Coders can be assured that, where a query response provides an ongoing coding directive, this will be published in either Coding Matters or incorporated into a future edition of ICD-10AM/ACHI/ACS.

* Public submissions

** All classification users, for example: clinical coders, health information managers, clinicians, epidemiologists and researchers who identify a need for improvement to the classification content (codes in the tabular, changes to the index, or perhaps clarification of a coding standard) are invited to submit their suggestion through the NCCH Public Submission process.

** This process has recently been automated and submissions can be made through the NCCH website at any time. NCCH staff constantly monitor the submissions and assess each proposal as it is received.

* WHO updates to ICD-10 (diseases)

** Every year the World Health Organization's (WHO) Update and Revision Committee (URC) meets to discuss suggested changes to the parent classification ICD-10. NCCH actively participates in these meetings and incorporates all approved changes into ICD-10-AM.

* MBS item number updates (interventions)

** ACHI was originally based on the Australian Medicare Benefits Schedule (MBS), so all new, revised or deleted MBS item numbers are considered for inclusion in the procedure classification.

Update process

The NCCH update process is as follows:

* Task database

** As changes to the classification are identified, the details are entered into a task database to allow each task to be tracked and prioritised.

** Each proposal is allocated to a particular Classification Support and Development (CSD) staff member and given a task number.

* Proposal

** Each task is carefully considered, and a formal proposal written regarding the impact on the classification.

** The proposals provide background information, including research undertaken and clinical advice received.

** Every draft proposal is circulated to CSD staff for their comments regarding the changes, and for further quality review.

** A task may require multiple version changes before a final draft is ready for presentation to the national Coding Standards Advisory Committee (CSAC).

** CSAC members also provide input to the proposal, which may require a number of version changes before final approval for inclusion in ICD-10-AM/ACHI/ACS.

* Coding Standards Advisory Committee (CSAC)

** CSAC's overall function relates to providing advice on classification development and standards for coding of diseases and interventions for morbidity and mortality reporting.

** All state and territory coding committees are represented, as are other organisations such as the Health Information Management Association of Australia (HIMAA), the private healthcare sector, the Clinical Coder Society of Australia (CCSA), the Australian Institute of Health and Welfare (AIHW) and the Commonwealth Department of Health and Aged Care (DoHA).

** CSAC members are invited (via email) to comment on each proposal prior to the face-toface meetings. These comments are carefully considered by the CSD staff and amendments made to the proposals as required. This cycle is repeated until the proposal is ready for ratification at the next CSAC meeting.

** CSAC meetings are convened by the NCCH and are held quarterly (minimum). They involve a full day of often vigorous discussion and debate. Members are committed to ensuring the best outcome for the classification and clinical coders.

* Publication

* Changes to the next edition need to be finalised at least 12 months prior to the effective release date, to allow adequate publication timeframes.

* When a proposal is approved by CSAC, each and every change to the ICD-10-AM and ACHI Tabular List and Alphabetic Index is entered into a database, designed specifically for publication.

* Extracts are created that resemble how the changes will look in the next edition, and these are carefully checked by CSD staff and external proof readers.

* Mapping Tables and an Electronic Code List (ECL) in ASCII format are published and made available to software developers, state and territory health departments and used by DoHA for Diagnosis Related Group (DRG) development.

* Each volume of the classification is edited and proof-read to ensure appropriate layout and formatting of the final product.

* The final step to the process is the production of the books in both print and electronic format.

While one edition is in the stages of publication, NCCH is also developing education material that will be provided to assist with the transition to the new edition. At the same time, CSD staff members are already working on the next edition, incorporating changes that did not make it into the edition currently in production. And so the cycle goes on ...

Corresponding author

Kerri Doyle BBus(HlthAdmin)

Health Information Manager

NCCH--Project Officer

National Centre for Classification in Health

The University of Sydney

PO Box 170

Lidcombe NSW 1825

AUSTRALIA

Tel: +61 2 9351 9461

Fax: +61 2 9351 9603

email: k.doyle@usyd.edu.au

Vera Dimitropoulos BAppSc(MRA)

Classification Support Manager

National Centre for Classification in Health

The University of Sydney

PO Box 170

Lidcombe NSW 1825

AUSTRALIA

Tel: +61 2 9351 9394

Fax: +61 2 9351 9603

Email: v.dimitropoulos@usyd.edu.au
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