Data capture and classification has been occurring for centuries. With clinical documentation, it first started as a way to identify causes of death, or mortality. Soon, it expanded to include disease states, or morbidities, that impact individuals’ overall health status, culminating in the creation of a system called the International Classification of Diseases (ICD).
In 1948, The World Health Organization (WHO) became the industry steward of the system with the ICD-10 sixth edition revision. Standardizing the collection of mortality and morbidity data remained the main purpose of the system, but this edition also expanded to support additional uses of healthcare data – like clinical research and allocation of resources.
And just as medicine continues to evolve, so do the code sets designed for clinical documentation. WHO released ICD-10 in 1992, but due to technology advancements – and the industry’s need for detailed data – the release of ICD-11 extended past the standard 10-year time frame for updates.
The first work groups began in 2007 with the following revision goals:
- Ensure ICD remains an international standard through routine updates
- Align code classification with scientific and electronic advancements
- Link to other healthcare classification and terminologies
WHO established January 2022 as the implementation date for member countries to begin reporting ICD-11 codes for mortality code and is supporting a five year transition for member countries. However, country morbidity coding transitions to ICD-11 will vary from country to country, meaning that implementation times will vary between member countries. For example, the United States’ adoption of ICD-10 required the creation of a revised manual, the ICD-10-CM, or clinical manifestation.
Uniqueness of ICD-11
Many may wonder what is so unique about this version of ICD as compared to prior editions? One of the most significant changes is that ICD-11 is designed for a digital world, with no need for paper books. Additionally, ICD-11 incorporates both technological and scientific advancements while maintaining fundamental principles of ICD classification. For example, the updated system contains new categories and modified classification schemes incorporating disorders, signs and symptoms, injuries, and external causes that were not part of the previous unmodified ICD-10 version. It also incorporates traditional medicine into the system via chapter 26.
One of the most significant changes is ICD-11 contains postcoordination features, or the ability to cluster two or more codes together to represent a larger clinical concept. Traditionally ICD has contained precoordination features, where all pertinent information is contained with one ICD code and its corresponding code description.
For example, the ICD-10-CM code J18.9 Pneumonia, unspecified organism is an example of a precoordinated description. Using the same clinical condition of pneumonia, ICD-11 offers codes for conditions such as lung laterality, causality, and time in life. The ability to post-coordinate codes systematically expands the capture of clinical condition details without having to create unique individual codes and code descriptions.