HIMagine That: The New Year and ICD-11

Dec. 22, 2016 / By Donna Smith, RHIA, Sue Belley, RHIA

Donna: Happy Holidays, Sue! In the spirit of the season, here’s a gift for you — some information about ICD-11 that I learned at the recent ICD-11 Revision Conference in Tokyo, Japan, which was held in tandem with the IFHIMA meeting.

Sue: Donna, I’m not sure that’s a gift I want to open. We just got started with ICD-10; why are we even talking about ICD-11?

Donna: The World Health Organization (WHO) has been actively working to create the 11^th Revision to the International Classification of Diseases (ICD) for Mortality and Morbidity reporting and this is due out by 2018. The revision process occurred between 2007 and 2016 with over 200 scientists and other experts from more than 35 countries contributing.

Sue: So, when would the United States adopt ICD-11? It took many years to adopt ICD-10 after all the modifications that were made to the classification system.

Donna: I don’t think it will be anytime soon, but I wanted to point out some of the features that have been added to ICD-11. There is a ton of information available on the WHO ICD-11 website, too.

Sue: I just signed in and saw some information about the ICD-11 Browser. It looks like you can see the content in ICD-11, as well as some references to ICD-10 to illustrate how codes transition from ICD-10 to ICD-11.

Donna: There are also training videos on how to use the ICD-11 Browser. In addition to the browser, there is an ICD-11 Coding Tool that is a software tool accessed through the browser. This allows some search functionality that provides  word list matching, matched entities and chapter distribution of the terms.

Sue: Are there new chapters found within ICD-11?

Donna: There are several new chapters within ICD-11, one being Sleep-wake disorders. While these diagnoses have always been present, they are now found within a separate chapter.  There are three new chapters total, including codes for special purposes, extension codes and Traditional Medicine conditions.

Sue: What would be considered extension codes?

Donna: The classification is made up of a stem code, which is sort of a base code that can be used alone or in association with a more detailed extension. Since the U.S. added all the laterality coding in ICD-10, ICD-11 has extension codes to indicate the laterality of the condition. There is also an extension to allow for further specificity of the location. As an example, Breast cancer is reported as 2D3Z for malignant neoplasm of breast, unspecified. If more detail is needed to report the condition, an extension code can be added. The specificity of breast cancer of the areola of the left breast would be reported as: 2D3Z/XB21/XC42, where the first part would indicate the stem code of breast cancer (2D3Z), the second part would be an extension that indicates the left breast (XB21) and the third portion would indicate the specific site of areola (XC42).

Sue: Sounds like 2018 will bring some specifics about the final approval of ICD-11 and how to use this updated classification, but first we have to get started on 2017. Happy New Year!

Sue Belley, RHIA, Donna Smith, RHIA, are with the consulting services business of 3M Health Information Systems.