11 Things to Know About ICD-11

The countdown begins! The World Health Organization (WHO) recently announced the expected release of the International Classification of Diseases, Eleventh Edition (ICD-11), and some of the major changes that will follow. The World Health Assembly meets to accept the proposed version in May 2019, and the WHO effective date for ICD-11 is January 1, 2022. You may be thinking, "Jenna, why are you telling us about this when we don't have to worry about it for another 4 years?" There's a reason the WHO made this announcement so far in advance. You have more time to prepare for implementation, and for some providers, this version will be a huge undertaking. Here are 11 things you should know about ICD-11. 

Medical billing is hard, that's where we come in.
  1. There are 30 chapters in ICD-11, compared to 21 in ICD-10. Areas of interest include the addition of Gaming Disorder to the Addictive Disorders section and Gender Incongruence moved to a new Sexual Health chapter.
  2. Some of the new chapters include the following:

Diseases of the Immune System
Sleep-Wake Disorders
Conditions Related to Sexual Health
Developmental Abnormalities (separated from Conditions Arising in the Perinatal Period)
Codes for Special Purposes
Traditional Medicine Conditions
Supplementary Section for Functioning Assessment
Extension Codes

  1. Gaming Disorder will be newly added to the Addictive Disorders section. Gaming Disorder is described as a "pattern of persistent or recurrent gaming behavior ('digital gaming' or 'video-gaming') which may be online (i.e., over the internet) or offline, manifested by impaired control over gaming, increased priority given to gaming to the extent that gaming takes precedence over other life interested and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences. This will be done in efforts to raise awareness among medical professionals and to help provide prevention and treatment. 
  2. ICD-11 will better capture data regarding healthcare safety. "With ICD-11, patient safety events can be recorded better than ever before and prevented," said WHO's Classifications, Terminologies, and Standards Team Lead Robert Jakob, MD. "This is a topic of extreme relevance that has not been possible to document properly with the old ICD. With the new ICD-11, we have a complete system to document events or near misses."
  3. Codes will have four (instead of three) characters before the decimal point and up to three characters after. This will be done to provide further specificity in the associated condition or injury. 
  4. Codes will range from 1A00.00 to ZZ9Z.ZZ and all three of the code set volumes - Index, Reference and Tabular - are required to correctly assign the code.
  5. Terminal letters. Terminal letter "Y" represents the "other specified" category, and the terminal letter "Z" is reserved for the "unspecified" category. 
  6. "Code also" instructions will provide additional information that should be coded in conjunction with certain categories because the information is relevant for primary tabulation. "Due to" will refer to the linkage of two conditions with causal relationship. "Associated with" will refer to the linkage of two concurrent conditions without causal sequence.
  7. Categories will have a short description and long definition labeled 'additional information'. The short description will consist of a 100-word maximum, while the long 'additional information' will contain the full definition, without length restriction. 
  8. The goal is for ICD-11 to function in an electronic environment and support electronic health records (EHRs). This version will link with the Systematized Nomenclature of Medicine (SNOMED-CT), which is already a component of many EHRs. 
  9. Sections on Cardiology, Allergies and Immune System Disorders, Infectious Diseases, Cancer, Dementia, and Diabetes will be extensively updated. This is being done in efforts to promote proper documentation, support research, and produce new methods of treatment. 

Want more information on ICD-11? The WHO's website contains descriptions of the ICD-11 code development process, a code browser, and a timeline for the ICD-11 introduction.

Sources:

http://www.who.int/classifications/icd/revision/en/
https://www.icd10monitor.com/icd-11-hurry-up-and-wait
https://www.beckersasc.com/asc-coding-billing-and-collections/icd-11-contains-nearly-4x-as-many-codes-as-icd-10-here-s-what-who-has-to-say.html
https://www.beckersasc.com/asc-coding-billing-and-collections/icd-11-will-include-9-new-chapters-and-several-changes-8-key-updates-to-note.html

Author

JENNA TROPEA

As a long-time writer and content marketer, Jenna Tropea covers a wide range of topics from patient engagement to healthcare policy and regulations. Jenna received her MBA from Clemson University and currently serves as Online Marketing Strategist to ImagineSoftware.