The International Classification of Disease, or ICD, is the most critical classification and terminology tool for cataloging injuries, diseases, and causes of mortality around the globe. As such, it is paramount that this standard evolves with the rapid changes in the healthcare landscape.
Since the 10th revision of the International Classification of Disease (ICD-10) was released, the global healthcare ecosystem has matured, relying more on electronic health information systems. This paradigm shift to using technology to increase the quality of care and patient outcomes has predicted the need for the World Health Organization (WHO) to contemporize the ICD coding conventions.
The upcoming revision, ICD-11, facilitates health data interoperability in the digital age and will be instrumental for bolstering decision support and revenue cycle management solutions. Its rollout in January 2022 is bittersweet as those that remember ICD-10, implementation proved challenging. The healthcare IT industry is well poised to get in front of the imposed mandate.
Key Differences Between ICD-10 and 11
It makes sense that ICD-11 would have changed dramatically since the last revision. The past two decades have seen numerous changes in Healthcare Information Technology and have taught us lessons about standardizing coding universally and overcoming the challenges of ICD implementation.
ICD-11 has 55,000 codes and features clusters and extensions that facilitate comprehensive data recording more precisely. In essence, categories are broken down into sub-categories, selected in countless arrangements to code complex information accurately. The new revision addresses those changes and resolves some of the implementation challenges by:
- Offering a more detailed coding structure that classifies diseases, injuries, disorders, procedures, and causes of death more specifically;
- Providing a digital focus and integrating seamlessly with electronic health records;
- Staying relevant to the current research;
- Allowing for the increased flexibility of application;
- Offering the ability to define a linearization instead of creating unique code sets, allowing for better worldwide monitoring, reporting, and comparison of medical conditions;
- Integrating with other ICD classification systems;
- Expanding the resources users need to operate the system and reduce errors.
These fundamental differences make the 11th revision so critical and why ICD compliance is mandated worldwide.
What Does It Mean to Be ICD Compliant?
ICD compliance is critical because it provides a common language for reporting on and monitoring diseases. Having a globally recognized, standardized set of codes allows providers to exchange data despite where it originated.
HIPAA‐covered entities must have ICD codes implemented for healthcare services rendered before the mandated compliance dates. Organizations should strive to maintain standardization within their software to support the universal coding system.
According to WHO, ICD codes “capture mortality and morbidity data. It organizes and codes health information used for statistics and epidemiology, health care management, allocation of resources, monitoring and evaluation, research, primary care, prevention, and treatment.” These codes are the foundation for healthcare billing and provider reimbursement.
Previous diagnostic and procedure codes will no longer be functional for services administered after the specified date. There will be a bit of room for error as medical entities adjust. However, after the two- to three-year transition period, the Centers for Medicare & Medicaid Services will be issuing penalties for non-compliance.
ICD-11 Integration Solutions
The January 2022 rollout will require plenty of ICD-11 preparation and planning. Implementation of ICD-10 was not without its difficulties. Even though ICD-11 aims to mitigate these challenges, adopting new codes takes time and care to implement. The ICD-11 classification system has been revised and expanded to reflect technological and scientific advancements.
ICD-11 Browser and Coding Tools:
Two of ICD-11’s electronic resources include browsing and coding tools. It’s essential to learn how and when to use each one. The ICD-11 browser and coding tool can be used as a search engine to find codes that match symptoms and diagnoses. They function slightly differently in their search and display features. Namely, the browser tool provides results in hierarchies and offers context-sensitive help. The coding tool displays your search results as links to relevant browser results, word lists, and chapters associated with the search term.
ICD-API and Embedded Classification Tool (ECT):
ICD-11 allows users to deploy an API locally. The embedded classification tool will enable users to seamlessly integrate ICD-11, including the browser and coding tools, into their electronic data management systems.
ICD-11 Preparation and Implementation
These updates are essential for adequately managing healthcare revenue systems, allocating medical resources, and continually improving worldwide public health. The changes will affect the entire continuum of care, and software companies need to take proactive measures to ensure their users are compliant. Hiring a HIT development company can eliminate headaches and save time while ensuring the migration to ICD 11 is seamless.
John Bailey | Global Director of Healthcare, Chetu Inc.
John Bailey is a health informatics expert and works for Chetu Inc., a software development company with established thought leadership within the IT community. He offers commentary on changing tides at the intersection between healthcare and technology; including interoperability, value-based care, EHRs, RCM, telehealth and more.
end-to-end rcm solution
Demand more from your revenue cycle.
Our integrated solution brings together robust data, intelligent claim handling, and performance consulting to guarantee a 10% increase in cash flow.