ICD-11 goals, implementation and codes difference than ICD-10

Goals of ICD-11

According to the World Health Organization (WHO), the goal of ICD-11 is to enable health data comparison at an international level. For example, consider these statistics from the WHO:

Approximately 70 percent of the world’s health care organizations use ICD coding for reimbursement, health initiatives and resource allocation.
In addition, 110 countries that account for 60 percent of the world’s population use ICD cause-of-death data for health planning and monitoring.
ICD-10 diagnosis coding has been cited in more than 20,000 scientific articles, which shows the importance of detailed and precise classifications.

What implementing ICD-11 means

The implementation of ICD-11 will have many benefits for health care providers in the U.S. Our diagnosis coding system today includes inconsistent modifications. These variances limit our ability to compare data internationally, develop guidelines and link to knowledge bases. ICD-11 means improved structure and content reflecting contemporary medicine and better coding quality. The updates also mean better tracking and analysis for global health care.

What’s different in ICD-11?

Besides the structural and content differences, the ICD-11 coding system contains 28 chapters compared to 22 chapters in ICD-10. The additional chapters include developmental anomalies, immune system diseases, sexual health, sleep-wake disorders, traditional medicine and functional assessment. Also, each category contains four characters rather than three and two levels of subcategories.

ICD-11 coding also contains two new terms you will want to know: code extensions and clustering. Code extensions and clustering allow for coding “post-coordination,” defined as linking multiple codes to describe a concept. Extensions should not be used alone and are intended to clarify further the severity, laterality, acuity and other aspects of injuries or external causes. On the other hand, cluster codes combine two or more codes to describe a documented clinical concept. Cluster codes will use a forward slash (/) or ampersand (&) to link ICD-11 codes together, creating a diagnostic sentence. For example:

Right shoulder pain FB56.4 & XK9K & XA2ND5