News: WHO releases first edition of ICD-11

The World Health Organization (WHO) released a version of the 11th Revision of the International Classification of Diseases (ICD-11) last week, JustCoding reported. ICD-11 reflects critical advances in science and medicine and is the first code set revision to be well integrated with EHRs and information systems, the WHO says.

ICD-11 contains 55,000 codes, compared to the 14,400 found in ICD-10, according to WHO. WHO says 31 countries were involved with ICD-11 field testing and 1,673 participants are currently taking part in 112,383 code assignments, JustCoding reported.

ICD-11 code structure

According to WHO, the new ICD-11 coding scheme always has a letter in the second position to differentiate from the codes of ICD-10, and in ICD-11 the first character of the code always relates to the chapter number, which may be a number or a letter. The code range of a single chapter always has the same character in the first position, WHO says. For example, 1A00 is a code in Chapter 1, and BA00 is a code in Chapter 11, says WHO.

The codes in ICD-11 are alphanumeric and range from 1A00.00 to ZZ9Z.ZZ, according to JustCoding. Codes starting with X indicate an extension code, which are codes comprised of groups of codes. The inclusion of a forced number at the third character position prevents the spelling of undesirable words, WHO says. Additionally, the letters O and I are omitted in ICD-11 to prevent confusion with the numbers 0 and 1. Chapters are indicated by the first character.

According to WHO, ICD-11 codes are comprised of stem codes and extension codes.

Stem codes, WHO says, are codes in a particular tabular list that can be used alone. Stem codes may be entities or groupings of high relevance or clinical entities that should always be described as one entity. WHO says the design of stem codes makes sure that in cases that require only one code per case, a meaningful minimum of information is collected.

Extension codes were designed to standardize the way additional information is added to stem codes, WHO says.

Implementation

The version of ICD-11 given to the World Health Assembly in 2019 will go into effect January 1, 2022, according to WHO. “However, given the vast technical and technological adaptation and training required to move to a new system—thousands of coders from small primary healthcare clinics to large hospitals will need retraining—the switch from using ICD-10 to ICD-11 is unlikely to happen overnight,” says WHO.

Despite the ICD-11 release, it is unlikely to supplant ICD-10-CM in the U.S. in the near future, according to JustCoding. The WHO originally accepted ICD-10 for use in 1990, but it took decades for the U.S. to create and implement its modified version in 2015. Editor’s note: This article originally appeared in JustCoding. For more information surrounding the release of ICD-11, click here. For further information regarding expectations, concerns, and issues surrounding the release of ICD-11, visit the WHO website here.