By DeVry University
The International Classification of Diseases database (ICD) was created by the World Health Organization (WHO) as a globally-recognized diagnostic tool for epidemiology, health management and clinical purposes.
Currently, healthcare organizations are using ICD-10, and many will start switching to ICD-11 in January 2022. The WHO doesn't impose a deadline on the implementation of ICD-11, and each member country can determine its own timeline. However, we expect U.S. healthcare organizations to expedite the adoption of the new version to support the use of new technologies and improve operational cost-efficiency.
In this article, we'll explore what's new in ICD-11, how to improve medical coding accuracy and how to prepare your organization for these medical billing updates.
How ICD-11 Differs From ICD-10
ICD-11 addresses the latest healthcare challenges and incorporates new diagnoses and treatments. ICD-11 has 80,000 entries that correspond to 17,000 codes, compared with the 14,000 codes in ICD-10. The WHO has redesigned the classification system in ICD-11 to make it more IT-compatible than the previous versions.
The WHO also added five new chapters to ICD-11, which caused the ordering of the chapters to shift:
- Diseases of the blood or blood-forming organs (Chapter 03)
- Disorders of the immune system (Chapter 04)
- Sleep-Wake disorders (Chapter 07)
- Conditions related to sexual health (Chapter 17)
- Traditional medicine (Chapter 27)
The practice of traditional medicine has never been defined in the ICD until now. The supplementary chapter includes standardized descriptions to support data capture and country-level monitoring. These treatments can now be documented alongside mainstream practices for international comparison.
Meanwhile, the ICD-11 pulled out various conditions previously classified under other categories to create the sexual health chapter (for example, gender incongruence was previously listed under mental health conditions.)
The ICD-11 also includes a new supplementary section for Functioning Assessment. It enables practitioners to monitor functional status before and after an intervention. They can then calculate a summary functioning score based on the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) or the WHO Model Disability Survey (MDS).
The WHO also incorporated all rare diseases in ICD-11. While only a few of them have an individual code, all will have a unique Uniform Resource Identifier (URI). This will allow rare disease registries and researchers to access detailed epidemiological data, so medical professionals can better understand these conditions and develop treatments.
Why Healthcare Organizations Should Adopt ICD-11
If you’re wondering how to improve medical coding accuracy in your organization, implementing ICD-11 can be a great place to start. The ICD-11 coding system is more comprehensive than previous versions and is modernized for easy integration with electronic health records (EHRs). The fully digital and multilingual version also includes a reference guide and an online coding tool.
All the content, including structural information, references and descriptions, comes in a machine-readable format, making the database readily useable either electronically or in print. The uniform resource identifiers and the ontological underpinning facilitate the use of digital health platforms. Healthcare organizations can connect the ICD-11 database with any software using a standard API to embed the coding tool into local digital records or IT systems.
The new digital infrastructure also supports more intuitive and straightforward coding. Clinicians can search for diagnoses using natural or preferred terminology. The system will then automatically match it with the correct technical code. ICD-11 can help healthcare providers streamline workflows, improve user compliance, increase coding accuracy and lower costs by combining recording with coding.
Moreover, ICD-11 is better aligned with codes related to antimicrobial resistance in the Global Antimicrobial Resistance Surveillance System. The identification of healthcare safety data is improved to record and track harmful health events. Meanwhile, new coding functions such as extensions and clustering provide more accurate diagnostic descriptions.
ICD-11 incorporates the most up-to-date scientific knowledge to reflect the latest medical insights, technologies, scientific findings, practices and diagnostic concepts. Meanwhile, the more accurate and flexible new system enables the use of health information in a wide range of applications. Besides improving treatment outcomes and patient safety, it can also support population health reporting, integrated care and strategic planning.
Lastly, ICD-11 is built on an ontological core. It can be quickly expanded to incorporate new terms, synonyms, concepts and user guidelines in all language versions. Departments or facilities with focused practices (i.e., mental health, dermatology) can create specialty customized versions to optimize the use of the database and streamline processes.
Prepare Your Organization to Use ICD-11
Implementing a new ICD version may pose some challenges, but with the appropriate preparation you can set your organization up to make the transition as smooth as possible.
Familiarize Your Staff with the New ICD-11
ICD-11 contains many new codes and chapters, which may require an adjustment period for even the most experienced medical coders and billers. Give your staff the time and support to learn the new coding system before implementation so you can maintain accuracy and efficiency throughout the transition.
Update Your EHR and Revenue Management Software
To take advantage of the API integration offered by ICD-11, you must upgrade to the latest versions of your EHR, practice management and medical billing software to ensure a smooth transition, and to avoid missing revenue opportunities or delaying collection.
Appoint Dedicated Resources to Lead the Transition
ICD-11 implementation is complex, and you need dedicated and experienced healthcare administrators to guide the transition by assessing your organization's coding discipline and overseeing the training efforts that lead up to the switch.
Meanwhile, experienced coding specialists can help evaluate your current coding and billing practice. They can recommend changes to optimize revenue cycle management, reduce coding errors and improve patient outcomes based on the new ICD-11.
ICD-11 Implementation in the United States
In the past, countries have built upon ICD to create their own medical billing code sets. With ICD-11, member states can define a specific linearization for their needs. Since they don't have to create a unique code set, they can save on time and implementation costs.
In the U.S., the Department of Health and Human Services (HHS) secretary tasked the National Committee on Vital and Health Statistics (NCVHS) to evaluate pathways to adoption and make recommendations on the implementation of ICD-11.
The improved system will help make the job of medical billers and coders more efficient. Meanwhile, the expanded scope of ICD-11 means that experienced and knowledgeable medical billing coding professionals will be critical in helping organizations navigate this new database.
Interested in medical billing and coding?
If you’re looking to explore a career in medical billing and coding, advancing your education is a great place to start. At DeVry, our Undergraduate Certificate in Medical Billing and Coding program is 100% online, making it easier for you to take classes anywhere, at your own pace. Classes start every 8 weeks.