ICD-10-AM, ACHI and ACS Sixth Edition Forecast

The Sixth Edition has been prepared with input from Australian clinicians, health information managers and clinical coders. It also includes changes derived from the foundation classifications: WHO ICD-10 and the Medicare Benefits Schedule (MBS).

NCCH has continued with its practice of seeking public submissions for changes to the classification. The centre acknowledges input from members of the Clinical Casemix Committee of Australia (CCCA), Clinical Classification and Coding Groups (CCCG) and particularly from the NCCH?s Coding Standards Advisory Committee (CSAC). CSAC has representation from Australian state and territory jurisdictions, New Zealand, the Health Information Management Association of Australia (HIMAA), the Australian Institute of Health and Welfare (AIHW), the Clinical Coders Society of Australia (CCSA), the private sector, CCCA and the Commonwealth Department of Health and Ageing. The depth and scope of the scrutiny of changes emanating from both inside and outside the NCCH, should guarantee the relevance of the classification as the Australian Standard for the next 2 years

Following are the summary statistics regarding the number of new and deleted codes and a summary of the major changes in sixth edition.

Summary statistics - ICD-10-AM, ACHI and ACS Sixth Edition

ICD-10-AM Sixth Edition
Total number of new disease codes 212
Total number of deleted disease codes 41
Australian Classification of Health Interventions (ACHI) Sixth Edition
Total number of new procedure codes 423
Total number of deleted procedure codes 242
Total number of new blocks 3
Total number of deleted blocks 6
Australian Coding Standards (ACS) Sixth Edition
Approximate number of new Australian Coding Standards 3
Approximate number of deleted Australian Coding Standards 4
Approximate number of modified Australian Coding Standards 56
WHO ICD-10 Updates
Proposals considered 192
Proposals included in ICD-10-AM Sixth Edition 129


Summary of Major Changes in ICD-10-AM, ACHI & ACS Sixth Edition

 1. ICD-10-AM Sixth Edition
 The modifications to the disease classification include a number of important improvements to ICD-10-AM

1.1 Major Changes 
 Include, but are not limited to:

  • Abortion, curettage and ectopic pregnancy
  • Additional diagnoses
  • Chronic kidney disease
  • Diabetes Mellitus
  • Condition onset flag
  • Drug and alcohol
  • Effects of radiotherapy
  • Perinatal standards
  • Postpartum anaemia
  • Postprocedural complications
  • Ruptured uterus

1.2 WHO ICD-10 Updates
Recommendations for change to ICD-10 are made by the Update Reference Committee and the WHO Family of International Classifications (WHO-FIC) meeting. ICD-10-AM Sixth Edition contains those recommendations ratified at the Tokyo (October 2005) and Tunis (October 2006) meetings of WHO-FIC.
The main changes include new codes for:

  • other infectious gastroenteritis and colitis
  • gastroenteritis and colitis of unspecified origin
  • acute viral hepatitis, unspecified
  • primary and secondary thrombophilia
  • vascular parkinsonism
  • indeterminate colitis
  • systemic inflammatory response syndrome
  • oesophageal varices, with and without bleeding, at the fourth character level
  • preterm labour without spontaneous delivery
  • immobility


New terminology in the area of:

  • decubitus ulcer and pressure areas
  • keratopathy following cataract surgery
  • ulcerative colitis
  • blindness and low vision
  • pneumocystis jirovecii

Change of classification for:

  • benign neoplasms of prostate (adenoma, fibroadenoma, fibroma and myoma)
  • Stransky Regalia anaemia

1.3 External cause of injury codes
A submission was received by the Research Centre for Injury Studies (RCIS).
Changes made as a result of this submission include the following areas:

  • Bitten (pecked) or struck by birds
  • Fall on and from stairs and steps
  • Diving or jumping into water causing injury other than drowning or submersion
  • Other fall from one level to another
  • Contact with other powered hand tools and household machinery
  • Moving objects
  • Place of occurrence ? home
Other changes made to the external cause of injury section as a result of other public submissions included:
  • Town camps
  • Activity codes

2. Australian Classification of Health Interventions (ACHI) Sixth Edition

The major modifications to the intervention classification include both changes made through public submissions as well as amendments based on the Medicare Benefits Schedule (MBS) changes from November 2004, May 2005 and November 2005 and May 2006
The major changes include:

  • Cardiac electrophysiology study (EPS) with radiofrequency ablation
  • Cerebrovascular embolisation
  • Electroconvulsive therapy
  • Endoscopic procedures
  • Laparoscopic hysterectomy
  • Pacemakers and defibrillators
  • Pharmacotherapy
  • Ventilatory support

NOTE:Despite a significant amount of work performed by the NCCH the Mental Health Intervention codes will not be included in the Sixth Edition.

3. Australian Coding Standards

3.1 Major amendments
There have been fifty six ACS amended for Sixth Edition.
Six of these amended standards have been significant including:

  • ACS 0002 Additional diagnoses
  • ACS 0020 Multiple/bilateral procedures
  • ACS 0503 Drug, alcohol and tobacco use disorders
  • ACS 0936 Pacemakers and defibrillators
  • ACS 1006 Ventilatory support
3.2 Major deletions
With the changes incorporated into ICD-10-AM and ACHI with regard to the classification of pharmacoptherapy, there has been a complete deletion of ACS 0045 Drug delivery devices

3.3 Major additions
With final approval as a National Minimum Data Set (NMDS) item for collection effective July 2008, the Condition onset flag is a major addition to the ACS for Sixth Edition. Other major additions to the ACS include a standard on the coding of Chronic kidney disease (CKD) and Electroconvulive therapy (ECT).

Publication Information 
ICD-10-AM/ACHI/ACS Sixth Edition will be published in March 2008, for implementation from July 2008. ICD-10-AM/ACHI/ACS will be available as:

  • Five volumes in hard copy, with optional slipcases
  • eBook, the electronic version, which can be networked for designated numbers of users, or as stand alone options. The eBook?s features include split screen (can view up to four components of the eBook at any one time), global notes, which allows an administrator to create or edit notes that can be seen by all users, and a personal notes field. Links make looking up Australian Coding Standards and the latest published information from 10-AM Commandments easy and fast
  • electronic code list ? an ASCII comma delimited file