The World Health Organization (WHO) released a new International Classification of Diseases (ICD-11) that took effect on Jan. 1, 2022, and will be important to billing and coding professionals. The United States does not have a set transition date for officially adopting ICD-11 and its Clinical Modification (ICD-11).
What are the major differences?
The Centers for Disease Control and Prevention (CDC) published a summary outlining differences between ICD-10 and ICD-11:
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- ICD-10 contains 14,400 codes whereas ICD-11 contains 55,000 codes
- The cardiology, allergies and immune systems disorders, infectious diseases, cancer, dementia, and diabetes sections have been extensively updated
- Codes look different (e.g., Alzheimer disease in ICD-10 is G30 and in ICD-11 is 8A20)
- The code structure has been simplified
- Some diseases have changed location (e.g., cerebrovascular diseases have moved to the nervous system from the circulatory system)
- Better capture of data regarding safety in healthcare
- There are six new chapters for a total of 27 chapters
- Traditional medicine
- Conditions related to sexual health
- Diseases of the blood and blood-forming organs
- Disorders of the immune system
- Sleep-wake disorders
- Extension codes (e.g., temporality, severity, dimensions of injury and external causes)
- Added to the section on addictive disorders is “gaming disorder.”
How can you prepare?
HMI, LLC suggests ways to prepare for ICD-11:
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- Become familiar with the new ICD-11 codes and chapters
- When the United States signals adoption of ICD-11 and its Clinical Modification (ICD-11-CM):
- Hire leaders to oversee ICD-11 implementation
- Update EHR software (EHR and Revenue Cycle Management)
- Hire a medical coding specialist
Additional hires you may also consider:
Keep current with up-to-date information from NHA, a leading accredited certification agency for Allied Health professions, including Billing & Coding and Electronic Health Record Specialists.
REFERENCES:
- Centers for Disease Control and Prevention (CDC)
- Centers for Medicare and Medicaid (CMS)
- HMI, LLC (n.d.). ICD-11 medical coding: how to prepare your healthcare organization for ICD-11. Retrieved from ICD-11 Medical Coding: How to Prepare your Healthcare Organization for ICD-11 (hmi-corp.com)
- Pickett, Donna (Sept. 12, 2018). Update on ICD-11: The WHO launch and implications for U.S. implementation. Retrieved from ICD11 PowerPoint Presentation (cdc.gov)
- Pickett, Donna (Feb. 17, 2016). Status of ICD-11. Retrieved from Status of ICD-11 (hhs.gov)
- Stanfill, Mary (Oct. 14, 2018). ICD-11 is on the horizon. Here’s how US healthcare organizations should prepare. Retrieved from ICD-11 Is on the Horizon. Here's How US Healthcare Organizations Should Prepare - UASI Solutions
- Stewart, Angie (Jun. 19, 2018). ICD-11 contains nearly 4x as many codes as ICD-10: Here’s what WHO has to say. Retrieved from ICD-11 contains nearly 4x as many codes as ICD-10: Here's what WHO has to say (beckersasc.com)
- World Health Organization (WHO)
- Youmans, Karen (n.d.). Background & overview of ICD-11 before implementation in 2022. Retrieved from Background & Overview of ICD-11 Before Implementation in 2022 (yes-himconsulting.com)
