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Tokyo, Japan 16-22 October 2005

Reviewing the ICD-10 classification of haematological neoplasms on its way to ICD-11

WHO-FIC 2005/B.6-3

instead of the C88.1. This would allow the monitoring of this disease without any change for the relevant countries. The Alpha heavy chain disease (C88.1) in the non mediterranean countries is a rare disease and the disappearing of the code would be insignificant and the disease can still be identified with the C88.3.

The changes between the old and the new C83 seem huge (see appendix). Indeed many of them are just clarifications and allow the identification of new lymphoma entities, hidden in the old structure within other terms. The old and the new C83 will code nearly the same group of patients.

For use at international level the stability of the 3 character categories in the sophisticated and rapidly changing field of lymphomas and leukaemias may be sufficient. For reimbursement more detail is required and has to be up to date to reflect the treatment (costs) as well as the prognosis. For scientific purposes ICD-10 can hardly provide the full detail that ICD-O already does.

Seeking for international agreement first results have already been shared with the International Agency for Research on Cancer (IARC) by WHO. An official statement from IARC is pending. Still, we do think results can already support the updating process of ICD-10 in short- and mid-term.

The preliminary results are provided in two separate documents. One shows the restructured and updated tabular list, the other one presents a synopsis of the current ICD-10 and the new proposal (see attached documents).

Preliminary crosswalks are under construction and will be available in October 2005. As a second step clinicians and DRG experts will prepare DRG- mappings of this new classification in cooperation with the German DRG institute (InEK). First results can be expected in late 2005.

Entries in both the Alphabetic Index and the Morphology of Neoplasms will need an appropriate review as well. Due to the amount of modifications this challenge should be taken into account, too. However, this work should start after the endorsement of the changes to ICD-10.

From today’s perspective there is a broad range of institutions, medical societies and legal authorities in German supporting an update of the German Modification of ICD-10.

When international feedback to this proposal is available a consensus proposal will be submitted to the URC and the WHO-FIC Network for implementation in ICD-10 as a first step. Afterwards a proposal for structure and content of ICD- 11 can be developed.

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b_6-3 reviewing the icd-10 classification of haematological neoplasms on its way to icd-11.doc 2005-10-06

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