Lessons from Other Countries with ICD-10 for Medical Coding and Billing Software

The World Health Organization’s International Classification of Disease tenth revision (ICD-10) was rolled out back in 1992. It has been used in the United States to report mortality only, but its mandated use is around the corner and the compliance date has currently been pushed back to October 2013. It could be potentially moved further because it does pose quite a large challenge for medical coding. Fortunately, with an essentially 23 year lag in adoption of this standard, we have had plenty of time to learn lessons from other countries that have made this transition, such as Canada and Australia. The two countries saw a wide disparity in terms of productivity: Canada took years to recover, while Australia was back to pre-implementation levels within months. Let’s take a look at both countries’ experiences and which factors accounted for these differences.


Canada transitioned to ICD-10 with a staggered approach from 2001-2005. After switching from paper ICD-9 coding to the digital ICD-10 coding, on average Canadian coder productivity dropped from 4.62 to 3.75 inpatient charts per hour. In some provinces it took three years to get back to ICD-9 productivity levels. Ultimately, much of this drop could be explained by training as it required coders to learn a completely different way of doing their job.


Australia started its transition process to ICD-10 in 1994, with quite a lot of planning and common understanding between stakeholders long before implementation actually began in 1998. Training programs began in 1995, including implementation kits for facilities. Interestingly, the transition only took one year (from 1998-1999) and yet Australian coders only took three months to get back to pre-transition levels.

Ultimately, both nations had government-sponsored health resources. In the US, hospitals and providers must meet the challenge of both coder training and funding for the technical aspects of the transition. This is why it is imperative for providers to find the right service partner to aid them in this shift. 

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