ICD-10 transition: Challenges in trend analysis

Introduction: The federal mandate to transition all health care entities to International Classification of Diseases version 10 (ICD-10) on October 1st, 2014 will have a significant impact on public health surveillance activities. Public health officials currently rely on ICD-9-CM coded data to conduct disease surveillance activities for a wide range of health conditions. Identifying and addressing the impacts to the “systems, people, and processes” presents a unique set of challenges, especially given today's resource-constrained environment.

Methods: Centers for Disease Control and Prevention (CDC) created the ICD-10 Transition Workgroup (“Workgroup”) to help the agency transition to ICD-10-CM/PCS. CDC is primarily a secondary user of ICD-9-CM data and the data are primarily used for surveillance. The presentation will highlight key areas in which the transition to ICD-10-CM/PCS can impact surveillance activities. The Workgroup's strategies to assist programs in preparing for the transition will also be described.

Results: CDC will describe the Workgroup's activities to address the transition, including developing ICD-10-CM/PCS training that targets public health users of ICD-coded data. Possible needed system changes include structural revisions to processing operations, increased capacity for transmitting or storing data, and rewriting programs to include the new code sets. People changes include training to learn about the new code sets and any needed business operations changes. Process changes include revising case finding lists, mapping between code sets, and conducting trend analyses that include both ICD-9-CM and ICD-10 code sets.

Discussion: Public health agencies and others will be able to leverage the work done within CDC as they transition their own public health activities to ICD-10 code sets.