Most of Europe and others using ICD-10 don’t play silly reimbursement games with ICD-10 (nor did they with ICD-9). So one mess will be the shakeout of how ICD-10 (on which DRGs, APCs, etc, etc are based) affects reimbursement and the hoops providers have to jump through to get the “right billing code.”

That said, ICD-10 as it comes from the World Health Organization is about 12K codes. The UK uses this version.

The Australian modification of ICD-10 (ICD-10-CM) has approx. 16K codes.

The Canadian modification of ICD-10 (ICD-10-CA) has approx. 30K codes.

The United States’ clinical modification, in its 2007 draft form, has 68K codes, or more than twice as many codes as the next biggest modification.

So, another answer is that other countries haven’t made nearly as big a mess out of ICD-10 as we have.

1. Reduce the most “arduous” task – writing an upload and deduplication routine
2. Keep a non-Government entity (3M?) on the payroll to “manage” the process for them

Afterall, they have no experience with this sort of thing. They’ve only provided oversight to the UMLS for the past 10+ years. Oh yeah, most of the expertise through non-Government entities. Oops – a minor lack of foresight.

Dr. Wes is right on the money. ICD-10-CM is a boondoggle. Its official release format from the NCHS is a 2,392 page, 23MB PDF. Codes, delivered as free text! How can a coding system maintained by a word processor support a revolution in our health information infrastructure? Furthermore, shoving modern knowledge of disease into a 1970s classification scheme does not a large improvement make.

I have cataloged the problems with ICD-10-CM at my bog, the Better Diagnosis Coding blog.