Introduction 

The World Health Organization (WHO) created the International Classification of Diseases (ICD) as a universally accepted diagnostic tool for epidemiology, health management, and therapeutic purposes. The number 11 in ICD-11 denotes that healthcare organizations in the United States and other WHO member countries are now using the ICD’s eleventh iteration, which went into effect on January 1, 2022. 

This long-overdue upgrade (ICD-10 has been in use for almost 25 years) encompasses the substantial advances achieved in science and medicine over the last 30 years, reflects current cultural standards, and modifies the way diseases are categorized and recorded in the clinical context.

Goals of ICD-11

Despite the upgrading procedure, the WHO found that ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) was clinically and technologically outmoded, with lacking material for various de facto ICD applications, such as primary care or clinical judgments. To move the system into the twenty-first century, structural adjustments were required, as well as the ability to operate in today’s electronic medical record environment and gather more information for morbidity use cases.

The goals of the eleventh ICD revision, according to the Centers for Disease Control and Prevention, included ensuring that ICD-11 will be a digital product capable of functioning in an electronic health records environment and linking with terminologies such as SNOMED (Standardized Nomenclature of Medicine).

ICD-11: The Latest Changes and Updates in Medical Coding

Simply said, the categorization system has been completely revamped. It is now structured as a database with more than a dozen dimensions, with enhancements ranging from making it more IT-friendly and better suited to facilitate morbidity data gathering to cutting costs. There was also a name change. ICD-11 for Mortality and Morbidity Statistics, or ICD-11-MMS, is its full name. Several revisions have been made to the list of mental health illnesses, including some that professionals may consider long overdue.

A partial list of additions and changes is as follows:

• A new HIV categorization has been developed to account for the expanding number of people living with the disease for an extended period of time, allowing the virus to be linked to disorders such as malaria, TB, and dementia, among others.
  
• Antimicrobial resistance coding, which previously lacking in ICD-10, is now incorporated to allow for data collection and analysis in accordance with the WHO Global Antimicrobial Resistance Surveillance System (GLASS).
  
• Gender incongruence (gender dysphoria in the DSM) is now classified as a sexual health problem rather than a mental disease. This modification is designed to eliminate the stigma associated with a psychological ailment rather than a physical disease.
  
• The personality disorders section has been fully rewritten. Due to clinical practice overlap, there is now a single diagnosis of “personality disorder” designated as mild, moderate, or severe, and assessed in terms of 6 trait domain regions to maintain some of the prior specificity of diagnosis.
  
• There are new chapters on sleep-wake disorders and sexual health.

Extensions and clustering are two notable elements that have the potential to improve ICD-11 code data. Extensions are non-diagnostic codes that provide categorization flexibility. They are intended to be used in conjunction with a stem code, replacing ICD-10 adjunct codes. Extension codes are used to describe laterality, acuity, severity, and other dimensions and external sources of damage.

ICD-11 designates post-coordinated codes to represent one illness via cluster coding, or combining two or more codes to describe a recognized clinical notion. When a diagnostic statement is divided into component components for ease of use, clustering allows them to be connected in the coded record.

How to Prepare for ICD-11 Medical Coding Changes

Since a high number of illnesses were introduced to this edition, as well as the new coding methodology, medical coding, and health information management (HIM) experts must take the time to become comfortable with the new ICD-11 principles and prepare for the shift.

While the enhanced capabilities of ICD-11 will eventually provide medical coders and billers with more advanced tools to conduct their jobs, they will require training to learn how to use them correctly.

Before the transition, healthcare organizations should proactively help their medical coders and billers by implementing training plans and assisting their personnel in learning the new coding system. You may need to rethink your training approaches to guarantee that your coding crew is equipped to respond to ICD-11 changes.

Meanwhile, the Medical coding companies like Oriental Solutions in Chennai should collaborate with IT to upgrade all of their systems and applications (e.g., EHR, practice management, revenue cycle management software) to versions that allow ICD-11 database integration.

You may also wish to consult with experienced coding professionals from Oriental Solutions, Medical coding company, in the UK to determine how you may modify your present coding and billing practices to improve revenue cycle management, eliminate coding mistakes, and improve patient outcomes in light of the new ICD-11.

A dedicated resource like the Oriental Solutions Medical coding company, in the US should be assigned to monitor changes and convey ICD-11 status to stakeholders. This resource ought to be informed of ICD-11 updates and notices disseminated by the US Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), the American Health Information Management Association (AHIMA), the American Medical Association (AMA), and other appropriate industry entities.

The better system and technology integration of ICD-11 will assist medical coders and billers in being more accurate and efficient in their work. Because of the new version’s larger breadth, it will need much more expertise and understanding to explore the database properly and code correctly.

Get ready for ICD-11 transition with Oriental Solutions Medical coding company – your reliable partner for expert guidance and system integration.