ICD-11: International Classification of Disease, 11th edition

icd-11Being hit by spacecraft (PD7Z), Hairball in the stomach (ND73.20), Victim of lightning (P100), Hoarding disorder (6B24), and Contacting health services for ear piercing (QB90) are just some of the new ICD-11 codes announced by the WHO on June 18, 2018.

ICD-10 codes were first launched by the World Health Organization (WHO) 18 years ago. Although not adopted by the United States until 3 years ago, the WHO announced that it will present ICD-11 in May 2019 for January 2022 adoption. Intended to capture quality of care guidelines, safety events, advances in science and medicine, and the use of traditional medicine, the WHO’s intent is to simplify coding, meet electronic documentation of diseases, and reporting and analyzing health information. eHealth readiness, clinical detail data coding, multilingual support, terminology and classification links, updated scientific content, and more user friendly coding are the intended accommodations for ICD-11.

Nine chapters have been added bringing the total to 30, including chapters such as one for Sleep-Wake Disorders, Codes for Special Purposes, and Conditions Related to Sexual Health. With the categories added will come with a short description with a 100-word max and additional information with no maximum length. One big change, regarding morbidity, is the definition for ‘main diagnosis’ will change to the ‘reason for admission’ at the end of a stay to be used for worldwide statistical data. Because it was recognized that due to the scarcity of mental health providers and clinicians, as compared to those needing mental health care, PTSD diagnostic terms have been reduced for easier diagnosis and mental health condition coding by primary providers.

In addition to the mental health chapter, three codes were added for gaming disorders, one each for gaming disorder with these descriptions: gaming disorder unspecified, gaming disorder predominantly online and gaming disorder predominantly offline. Code formats will also change from one single alpha character in the first position to a letter in the second position distinguishing ICD-11 from ICD-10. The codes will now contain 4 characters before the decimal as opposed to ICD-10’s 3, i.e., 5A02.Z (11) and E05.90 (10). The first character will indicate the chapter, codes will range from 1A00.00 to ZZ97Z.ZZ, and will allow for multiple parenting when one disease is classified in two separate places such as lung disease as a malignant neoplasm and also as a respiratory system condition. So, if there wasn’t one before, there truly will be, “a code for that.”

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