• Register to Access the Free Forums and 3 Free CEUs!

    To view the content for the 3 free CEUs, please sign up today.

    CLICK HERE TO REGISTER
  • Missing Access To A Course, Blitz or Exam? Have Technical Issues? Open a Help Desk Ticket
    Please Do Not Post in the Community About Access or Technical Issues
    CCO Business Hours for Help Desk and Coaching: Mon-Fri 9am-4pm Eastern

Resource ICD-11

WHO is ready for ICD-11?
When it might be used for reporting on healthcare claims in the U.S. (replacing ICD-10-CM) is still unknown so do not panic.
New features of ICD-11 include the following:

An entirely new architecture that includes the Foundation Component, an underlying knowledge base from which a subset (or “linearization”) is defined to create a tabular list and alphabetic index;
Over 80,000 entities that point to approximately 17,000 codes in 26 chapters (compared to approximately 14,000 codes in 21 chapters in ICD-10);
Alphanumeric codes ranging from 1A00 to ZZ92.ZZ (minimum of four, maximum of seven characters);
New chapters covering sleep-wake disorders, traditional medicine, and sexual health;
Up-to-date scientific knowledge, for example newly discovered microbes (e.g. COVID-19) and gaming disorders (added to the addictive disorders chapter);
A new coding approach: “cluster” coding, which provides a mechanism to use more than one code, in a cluster, to fully represent a concept; and
Machine computable design, including a unique resource identifier (URI) for each entity and an application program interface.

Read more here:

 

What Is ICD-11?​

ICD-11 is the 11th revision of the International Classification of Diseases (ICD).

When and how the United States will implement ICD-11 remains to be seen, but now is the time to start learning about what this transition could look like.

Why Do We Need ICD-11?​

ICD codes can have enormous financial importance, as they also are used to determine resource allocation, such as funding for health initiatives. In countries where ICD codes are the basis for health insurance billing, such as the United States, ICD is closely tied to healthcare finances and provider reimbursement

ICD-11 Structure and Digital Focus​


The classification system underwent a major redesign. It is now structured as a database that includes up to 13 dimensions, with changes ranging from making it more information technology (IT)-friendly and better able to support data collection on morbidity, to lowering cost. It will also have a new name: ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS)

What’s New in ICD-11: Post-Coordination​


ICD-11 also introduces two noteworthy features — extensions and clustering — which enable two kinds of post-coordination (linking multiple codes to describe a concept) and the addition of specific detail to coded entities. Both features have the potential to improve ICD-11 code data.

Read more here & see an example:

 
The World Health Organization (WHO) has released the official version of ICD-11, and the National Committee on Vital Health Statistics (NCVHS), is calling for research to evaluate its use in the U.S.

Talk Ten podcast:

 
What is the feasibility of replacing ICD-10-CM with ICD-11?

Samples of 388 ICD-10-CM codes from six disease areas, were recoded in ICD-11 to determine whether the meaning could be fully represented with or without post-coordination.

About 60 percent of the ICD-10-CM codes for these conditions could be represented fully by pre- or post-coordinated ICD-11 codes



 
Hi Lori, and thank you for this info. The implementation of ICD-11 will mean that a lot of risk adjustment coding jobs will be lost?
I do not think ICD-11 means the loss of any jobs it is just a better version of ICD-10.

Please watch this video at 12:41 Alicia discusses- Will jobs be lost?



 
ICD-10 is clinically outdated despite the updating process, and some chapters need structural changes. There is also an increasing need to operate in an electronic environment, as well as the need to capture more information for morbidity-use cases.

There is no definite ICD-11 implementation timeline established yet. However, the National Center for Vital and Health Statistics (NCVHS) notes that there are numerous steps needed to move towards ICD-11 implementation including:

• Evaluation of ICD-11 for U.S. purposes (2018 – 2021? 2022? 2023?)
• NCVHS Hearings (2021-2027?)
• Notice of Proposed Rulemaking (NPRM) from HHS published in the Federal Register (? date unknown)
• Final Rule published in the Federal Register (? Date unknown)

WHO ICD-11 revision goals include to:

1. Ensure that ICD-11 will function in an electronic environment by:

  • Presenting a digital product
  • Providing linkage with terminologies (e.g., SNOMED)
  • Defining ICD Categories by “logical operational rules” on their associations and details
  • Supporting electronic health records & information systems
2. Provide a multi-purpose and coherent classification for:

  • Mortality, morbidity, primary care, clinical care, research, public health
  • Consistency & interoperability across different uses
3. Deliver an international, multilingual reference standard for scientific comparability:

  • English, French, Spanish, Russian, Chinese, Arabic

It is also very important to note that ICD-11 is only for diagnoses. ICD-10-PCS is completely separate from ICD-10 and will not update with the transition of ICD-10 to ICD-11.

ICD-11 is a classification that is intended for use with EHRs so CMS would have to figure out how to make ICD-10-PCS compatible with AI or get AMA on board with converting CPT to be compatible.

 
Back
Top