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News & Press: Government Affairs News

Outlook: ICD-11 Codes Released by WHO

Friday, June 29, 2018   (0 Comments)
Posted by: Bradley Coffey, MA, AAOE Government Affairs
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Geneva, Switzerland - The World Health Organization (WHO) has released the next iteration of the International Statistical Classification of Diseases and Related Health Problems (ICD). This will be the 11th version of the ICD since 1900.

Why it matters: This is the first step towards worldwide adoption of the ICD-11. WHO member states will vote on adoption in May 2019. After adoption, ICD-11 would go into effect in January 2022.

How is it different from ICD-10?: According to WHO, ICD-11 is a vast improvement over ICD-10 which was launched worldwide 18 years ago (the US did not adopt ICD-10 until 2015). ICD-11 can be "well integrated with electronic health applications and information systems. This new version is fully electronic, significantly easier to implement which will lead to fewer mistakes, allows more detail to be recorded, all of which make the tool much more accessible, particularly for low-resource settings," according to WHO.

Additionally, ICD-11 contains 55,000 codes whereas ICD-10 contains 14,400. This is in part due to the addition of several new chapters, including one on traditional medicine, as well as the addition of new codes including victim of lightening (PJ00), being hit by spacecraft (PD7Z), hairball in the stomach (ND73.20), and problems associated with being in prison (QE41), among others.

New chapters include:

  • Chapter 3 - Diseases of the Blood and Blood-forming Organs
  • Chapter 4 - Disorders of the Immune System
  • Chapter 6 - Conditions related to Sexual Health
  • Chapter 8 - Sleep-Wake Disorders
  • Chapter 26 - Extension Codes
  • Chapter 27 - Traditional Medicine

WHO also indicates that the new coding system is necessary to better capture how our healthcare is changing. The charts below show that between 2000 and 2016, causes of mortality have changed. In 2000, diarrhoeal diseases like cholera were the fifth biggest killer, killing almost 3 million people worldwide; by 2016, Alzheimer's and other dementias have moved into the fifth spot killing approximately 3 million people worldwide. Diarrhoeal diseases had dropped to ninth place by 2016.

When will the United States switch to ICD-11-CM?: The US is likely to take its time in implementing ICD-11 as the codes have to be modified for use in the US into ICD-11-CM. This process took around 22 years to play out in the United States for ICD-10-CM (ICD-10 was introduced in 1993 and adopted by the US in 2015). It is unlikely to take nearly this long for ICD-11-CM to find its way into medical practices, in part because ICD-10-CM already started medical practices on the path towards digitization. 

The Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) will likely require the use of ICD-11-CM or ICD-11-PCS codes for reimbursement by 2032 but as we saw with ICD-10, this transition is always subject to Congress' authority and any transition may be delayed (or accelerated) via congressional legislation.

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