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  • Angel Callaway, CPC, CPB

Are You Ready For ICD-11?

You may be saying ICD-11 already? It seems like ICD-10 was just implemented but ICD-10 was released in 1992. It was not adopted by the United States until October 1, 2015.

The Internation Classification of Diseases (ICD) system was intended for review every ten years. Work on ICD-11 began in 2007. The World Health Organization (WHO) established work groups to begin the revision with goals to:

  • Ensure ICD continues to servie as an internation standard

  • Align with scientifice and electronic advancements

  • Link to other classification and terminologies.

ICD-11 builds upon the previous editions of ICD and reflects digital and scientific advancements. Two major featurs of ICD-11 is:

  • Foundation Component-ICD-11 introduces a foundtion component to its structure allowing for creation of defined tabular lists. ICD-11 for Mortality and Morbidity STatistics (ICD-11 MMS) is the tablular list created for reporting morbidity and mortality codes. The tablular list follows the same category and subcategory structur of prior ICD versions leading to an ICD-11 code.

  • Stem and Extension Codes-Stem and Extension codes are new features for ICD-11

    • Stem codes contain enough information in the code descriptor to be used independently (e.g. BA00.Z Essential Hypertension, unspecified; 5C76 Hyperkalemia).

    • Extension codes are designed to add meaning to a stem code in a standard manner (e.g. XT9T Ageing-relate; XH70J2 Adenoid basal carcinoma).

Stem codes may be reported alone or they may be reported in conjunction with an extension code or other stem codes. The linking of codes is known as post-coordination and allows for the codes to fully describe documented conditions.

ICD-11 continues to be alphanumeric like ICD10. However to distinguish ICD-11 from ICD-10 the second character in an ICD-11 code is an alphabetical character. The first character represents the chapter value which could be either an alpha or numeric character. The letters “O” and “I” are omitted to avoid confusion with numeric values “0” and “1”.

Here are examples of an ICD-11 codes with stem and extension codes:

  • 2C25.Z Malignant neoplasms of bronchus or lung, unspecified

    • Stem code

    • The first character “2” presents the second chapter (Neoplasms)

  • XA2UD3 Left lung

    • Extension code

    • The first character “X” represents the extension code chapter

Some countries have already moved toward the transition to ICD-11 In 2017 Pan American Health Organization carried out a series of systematic self -assessments for 15 countries to identify classification requirements an current status for the transition. Since 2019, early adopters are starting the implementation of ICD-11 in all regions.

Transitioning to a new system requires careful planning. The maintenance of current classification for a definded period-allowing for an overlap of at least 18 months with the use of the new system is encouraged, until the complete implementation of ICD-11. Self-Assessment is a fundamental part of any transition planning. Self Assessment allows project leaders to identify a clar picture of what and how much is necessary to progress, identify obstacles and it is critical in guiding budegetary and personnel needs and for correctly estimating timeframes.

ICD-11 has been adopted by WHO Assembly in 2019 to come into effect on January 1st, 2022.


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