Despite endorsement of a direct move to ICD-11 from the American Medical Association and others, don't be surprised to see CMS ignore that advice. "It took the U.S. eight years to adapt the WHO version of ICD-10 and create ICD-10-CM for use in this country," the American Health Infor-mation Management Association counters in a recent article. "Regardless of the benefits of ICD-11, the U.S. would need a national version to allow for the annual updating required by Congress and U.S. stakeholders. Assuming that the development timeline for a national version or clinical modification of ICD-11 could be cut in half down to four years, it would then take an additional two years to get through the HIPAA rulemaking process. As with ICD-10-CM/PCS, the industry would want at least a three-year period for converting systems to ICD-11," the AHIMA article says. End result: "Assuming that ICD-11 be-comes available on schedule from WHO in 2016, then the earliest the U.S. could move to ICD-11 would be 2025, or 13 years from now," the AHIMA article points out.