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ICD-10 Transition Will Be Convoluted, Study Finds

May 8, 2013
by Gabriel Perna
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According to a recent study headed by researchers at the University of Illinois, the oft-controversial transition to the 10th revision of the International Classification of Diseases (ICD-10) code set will be a challenge for many providers thanks to convoluted conversion mappings.  The convoluted, or complex, entangled, and non-reciprocal, mappings will possibly impact a provider’s staffing, supply management, and clinical revenue, the researchers found.

For the study, the researchers used datasets from the Center for Medicaid and Medicare Services (CMS) ICD-9 to ICD-10 mapping files, general equivalence mappings, and statewide Medicaid emergency department billing. The mappings were divided by the researchers into five categories: identity, class-to-subclass, subclass-to-class, convoluted, and no mapping.

Overall, 60 percent of the ICD-9 codes are “non-entangled motifs,” which would map without discontinuity and should be immediately interpretable. However, it’s those remaining convoluted codes, which accounted for 36 percent of the codes the researchers looked at, which could cause problems.  In one study, where the researchers looked at 24,008 clinical encounters in 217 emergency departments, 27 percent of the costs were associated with convoluted diagnoses.

The researchers say the convoluted mappings range from 5 percent in hematology to 60 percent in obstetrics and injuries. Forty-two percent of infectious disease code mappings remain convoluted, which will impact most specialties, the researchers say.

In the conclusion, the researchers say, “training of personnel and management resources of clinical specialties should focus on the frequently used and complex mapping motifs to ensure a successful transition to ICD-10-CM.”

The study appears in a recent issue of the Journal of the American Medical Informatics Association.

The ICD-10 transition is set to take place officially on Oct. 1, 2014. Some studies have shown that small-to-midsized hospitals are having trouble transitioning to the new code-set, while others have indicated this is the case for all of healthcare.



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