ICD-11: Hurry Up and Wait

U.S. adoption of the new codes is not expected until after 2022.

A lot of excitement was generated last week when the World Health Organization (WHO) announced that the International Classification of Diseases, Eleventh Edition (ICD-11) was being released.  But there is a long way to go before the finalization of ICD-11.   

The next milestone is for the World Health Assembly to accept the proposed version, and that organization does not meet until May 2019. The WHO effective date for ICD-11 is Jan. 1, 2022, so the U.S will not be able to implement any earlier than that.

ICD-11 was released at this time to permit members to plan and prepare for implementation. For some, translation of the classification will be a huge undertaking. In the United States, the typical process is for the Centers for Disease Control and Prevention (CDC) to evaluate the classification and clinically modify it. This process takes approximately four to six years to complete. It is important to note that the classification will have electronic and print versions.  

According to the WHO, ICD-11 is a system of medical coding created for documenting diagnoses, diseases, signs and symptoms, and social circumstances. The major changes for ICD-11 include:

  1. There are 30 chapters rather than 21.
  2. Each category will feature four characters rather than three; for example, 1A00.00.
  3. There are two levels of subcategories.
  4. The alphanumeric codes have a letter in the second position and a number in the third position. A number will always be in the third position.
  5. The range of codes is 1A00.00 to ZZ9Z.ZZ.
  6. Extension codes begin with letter “X” and have their own chapter. The extension chapter groups anatomy, agent, histopathology, and other criteria that may be used to add detail to the code.
  7. The terminal letter “Y” is reserved for the residual category of “other specified,” and the terminal character “Z” is reserved for residual category of “unspecified.”
  8. The linkage of two conditions with causal relationship is “due to.” The linkage of two concurrent conditions is “associated with,” without causal sequence.
  9. “Code also” instructions provide additional information that should be coded in conjunction with certain categories because the information is relevant for primary tabulation.
  10. Categories will include short (100 words) description and long (unlimited words) description.
  11. The code set has three volumes – Index, Reference, and Tabular. All three are required to assign the code correctly.

Some interesting changes include the addition of Internet gaming disorder as a mental health disorder. In the U.S., the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists this condition as meriting further study. Transgender identification is listed as gender incongruence in the chapter titled “Conditions Related to Sexual Health.”  

There are a few new chapters in ICD-11, which include:

  1. Chapter 4 – Diseases of the Immune System
  2. Chapter 7 – Sleep-Wake Disorders
  3. Chapter 17 – Conditions Related to Sexual Health
  4. Chapter 20 – Developmental Anomalies (separated from Conditions Arising in the Perinatal Period)
  5. Chapter 25 – Codes for Special Purposes
  6. Chapter 26 – Traditional Medicine Conditions – Module 1
  7. Chapter V – Supplementary Section for Functioning Assessment
  8. Chapter X – Extension Codes

The WHO website contains a description of the ICD-11 code development process as well as a code browser and other electronic tools. The site also contains a timeline for ICD-11 introduction. The website is accessible at https://icd.who.int. To learn more in-depth information about ICD-11, please review this site.

It is exciting to see ICD-11 in “print,” but it is also important to understand that the actual implementation and readiness is still several years away. Lessons learned from the ICD-10 implementation include that it is important to provide much education and communication regarding a new code set. At the moment, we are in a hurry-up-and-wait mode.

 
Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.

April 9, 2024
2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
Mastering Healthcare Refunds: Navigating Compliance with Confidence

Mastering Healthcare Refunds: Navigating Compliance with Confidence

Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.

February 29, 2024
2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 15, 2024

Trending News

SPRING INTO SAVINGS! Get 21% OFF during our exclusive two-day sale starting 3/21/2024. Use SPRING24 at checkout to claim this offer. Click here to learn more →