ICD-11 Coding

ICD-11 Coding Guidelines 2025: Essential Knowledge for U.S. Clinicians

The International Classification of Diseases, 11th Revision (ICD-11), represents a transformative step forward in global health data management. It goes beyond being a mere update to ICD-10, offering enhanced precision, interoperability, and functionality. Designed with the future in mind, ICD-11 provides healthcare systems worldwide with a modern framework that facilitates improved outcomes, fosters innovation, and supports resource optimisation.

What is ICD-11?

ICD-11 is the latest iteration of the International Classification of Diseases, developed by the World Health Organization (WHO). It builds upon more than a century of progress in the classification and standardisation of health data, offering a digital-first, comprehensive system that integrates seamlessly into modern healthcare environments. Officially adopted in 2019 and effective from January 2022, ICD-11 is positioned as a cornerstone of healthcare transformation.

Key Highlights of ICD-11

Global Health Standard: Legally mandated under the WHO Constitution.
Digital-Ready Framework: Fully integrated with APIs and online/offline tools for easy adoption.
Semantic Interoperability: Facilitates the exchange and reusability of data across platforms and regions.
Expanded Knowledge Base: Incorporates up-to-date scientific advancements, including traditional medicine classification.
Multi-Language Accessibility: Available in 10 languages with ongoing translations in 25 additional languages.

Why ICD-11 Matters

1. Enhanced Precision and Diagnostic Capabilities

ICD-11 introduces over 200 new codes for allergens, improved categorisation for rare diseases, and greater granularity in clinical reporting. This level of detail not only enhances diagnostic accuracy but also enables better understanding and management of complex conditions.

2. Interoperability for Global Health Systems

Designed for seamless integration with digital systems, ICD-11 supports cross-border collaboration by ensuring consistent and comparable health data. This is critical for addressing global health challenges and advancing research.

3. Support for Modern Healthcare Innovations

ICD-11 is a foundational framework for advancements in artificial intelligence (AI) and data analytics, allowing healthcare providers and policymakers to harness these technologies for predictive modelling, personalised medicine, and resource allocation.

Transition from ICD-10 to ICD-11: A Modern Approach

The transition from ICD-10 to ICD-11 is a significant undertaking that WHO has facilitated through:

Digital Mapping Tables: Detailed cross-references between ICD-10 and ICD-11 ensure continuity and accuracy in data migration.
Enhanced Training and Resources: Tools such as updated APIs and candidate versions of the DORIS tool aid in implementing ICD-11 for cause-of-death selection and reporting.
Pilot Programmes: Member States have engaged in pilot studies to refine and adapt ICD-11 for their healthcare systems.

Benefits for Policymakers, Clinicians, and Researchers

1. Policy Alignment

ICD-11 supports policymakers by providing a unified framework for aligning national and global healthcare strategies. Accurate and comprehensive data enable evidence-based decision-making for resource allocation, public health interventions, and cost management.

2. Clinical Efficiency

Healthcare providers benefit from improved coding accuracy and interoperability. The enhanced classification system simplifies documentation, streamlines workflows, and facilitates better patient outcomes.

3. Research and Innovation

ICD-11 enables large-scale health research through standardised and comparable datasets. Its integration with terminology systems such as MedDRA, Orphanet, and LOINC strengthens research capabilities, particularly in rare diseases, pharmacovigilance, and laboratory diagnostics.

ICD-11 and Digital Healthcare Transformation

ICD-11 is designed to integrate with modern digital health systems, leveraging advanced technologies to maximise its impact:

API Integration: Supports seamless implementation within electronic health record (EHR) systems and health information exchanges.
Artificial Intelligence: Facilitates AI-driven decision support, predictive analytics, and precision medicine.
Global Interoperability: Aligns with terminology standards such as MONDO Disease Ontology and SNOMED CT, ensuring compatibility across platforms.

Implementation Progress as of 2024

Two years after its official roll-out, ICD-11 is being actively implemented by 132 countries:

72 Countries: Translation and integration efforts underway.
50 Countries: Piloting and expanding implementation processes.
14 Countries: Actively collecting and reporting data using ICD-11.

With translations available in 10 languages and more underway, ICD-11 is increasingly accessible to diverse healthcare systems.

New Features in the ICD-11 2024 Version

Expanded Diagnostic Codes:
- Over 200 new codes for allergens.
- Enhanced classification of rare diseases.
Digital Tools:
- Advanced APIs for integration.
- The DORIS tool, supporting improved cause-of-death data management.
Terminology Integration:
- Lossless mapping to MedDRA for drug-related data.
- Embedding of Orphanet terminology for rare diseases.

ICD-11’s Role in Global Health

ICD-11 extends the legacy of the International Classification of Diseases as a critical enabler of global health initiatives. It supports:

Standardised Mortality and Morbidity Reporting: Ensuring consistent data collection across regions and over time.
Resource Allocation: Helping nations optimise their healthcare resources based on precise data.
Public Health Strategies: Informing disease surveillance and epidemic response efforts.

Conclusion: Built for Today, Designed for Tomorrow

ICD-11 is more than just a revision; it is a comprehensive reimagining of global health classification. By integrating cutting-edge technologies and modern healthcare concepts, it empowers stakeholders across the healthcare continuum to achieve better outcomes, reduce costs, and advance innovation. As nations continue to adopt and implement ICD-11, its potential to transform healthcare on a global scale becomes increasingly evident. For healthcare providers, policymakers, and researchers alike, ICD-11 offers the tools needed to meet the challenges of today and anticipate the needs of tomorrow.

Search ICD-11 Codes‎‎

ICD-11 Browser Tool is available at https://icd10cmtool.cdc.gov/

Browser tool features

Official ICD-10-CM Coding Guidelines and Preface
ICD-10-CM Browser Tool User Guide
ICD-10-CM Tabular List of Diseases and Injuries
ICD-10-CM Index to Diseases and Injuries
ICD-10-CM External Cause of Injuries Index
ICD-10-CM Table of Neoplasms
ICD-10-CM Table of Drugs and Chemicals

Resources

ICD-10-PCS: View and download the procedure coding system developed by the Centers for Medicare and Medicaid Services
ICD-9-CM: Find information about the previous ICD clinical modification
ICD-10-CM and ICD-10-PCS transition: Get information and resources about the transition to the latest revisions
Classification of Death and Injury Resulting from Terrorism: Visit the CDC Archive to learn how ICD-10 and ICD-10-CM codes were added after the terrorist attacks of September 11, 2001

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FAQs on USA ICD-11 Coding

What is ICD-11?

The International Classification of Diseases, 11th Revision (ICD-11), is the latest iteration of the globally recognised system for classifying diseases, health conditions, and related information. Developed by the World Health Organization (WHO), it provides a more comprehensive and precise framework for clinical documentation, public health reporting, and research compared to its predecessor, ICD-10.

When Was ICD-11 Published?

ICD-11 was officially adopted by the 72nd World Health Assembly in May 2019. It became effective on 1 January 2022, marking a significant step forward in global health classification systems.

Is ICD-11 in Use?

Yes, as of 2024, many countries are at various stages of implementing ICD-11. Over 70 countries have begun using the system actively, and many others are conducting pilot programmes or translation efforts. ICD-11 is designed for seamless adoption in both digital and traditional healthcare systems.

When is ICD-11 Likely to Be Implemented in the United States?

The United States has yet to establish a definitive timeline for ICD-11 implementation. The transition process is expected to involve extensive planning, system adaptation, and training. It is anticipated that ICD-11 will be implemented in the U.S. within the next several years, though exact dates depend on government agencies and healthcare industry readiness.

What is the Relationship Between DSM-5-TR and ICD-11?

The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Text Revision) and ICD-11 share a complementary relationship:

DSM-5-TR: Primarily used in the United States for diagnosing mental health conditions.
ICD-11: Used globally for classifying all health conditions, including mental health, and aligns with the DSM-5-TR to support standardisation and interoperability.

Both systems often share similar diagnostic criteria, with ICD-11 offering codes that correspond to DSM-5-TR categories for seamless integration.

How Does ICD-11 Differ from ICD-10?

ICD-11 introduces significant advancements over ICD-10:

Digital Integration: Designed as a digital-first tool, with APIs and online accessibility.
Greater Specificity: Features enhanced granularity with additional codes and diagnostic options.
New Chapters: Introduces chapters for traditional medicine, conditions related to sexual health, and other emerging areas.
Improved Usability: Streamlines coding processes with a user-friendly structure.
Semantic Interoperability: Supports data sharing and integration across global health systems.

Which New Chapters Were Added in ICD-11?

ICD-11 includes several new chapters to address modern health challenges:

Traditional Medicine: Recognises traditional and complementary medicine practices.
Conditions Related to Sexual Health: Combines sexual health and sexual dysfunction into a unified category.
Sleep-Wake Disorders: Offers detailed classifications for conditions affecting sleep and circadian rhythms.

When Will ICD-11 Be Implemented in the United States?

While the U.S. has not announced a specific date for ICD-11 implementation, preparation is underway. The transition will require careful planning, testing, and training to ensure a smooth shift from ICD-10. Full adoption is likely to occur over the next several years, depending on regulatory decisions.

How is ICD-11 Used?

ICD-11 is used for:

Clinical Documentation: Recording patient diagnoses and conditions.
Billing and Reimbursement: Linking medical services to diagnoses for accurate claims processing.
Public Health Reporting: Monitoring and analysing health trends at national and global levels.
Research: Supporting studies on disease prevalence, outcomes, and healthcare utilisation.

When Does ICD-11 Take Effect?

Globally, ICD-11 took effect on 1 January 2022. However, each country adopts the system at its own pace, with ongoing pilot programmes and phased implementation schedules.

What Symbol Combines Two Stem Codes in ICD-11-MMS?

In ICD-11’s Morbidity and Mortality Statistics (MMS) system, the ampersand (&) is used to combine two stem codes, enabling detailed representation of complex conditions.

What Condition Did WHO Add to ICD-11 in 2019?

In 2019, the WHO included gaming disorder as a recognised condition in ICD-11, reflecting the growing awareness of behavioural health issues related to digital technology and gaming.

How Do You Cite ICD-11?

To cite ICD-11 in APA style, the following format is recommended:

World Health Organization. (Year). International classification of diseases for mortality and morbidity statistics (11th ed.). Retrieved from [WHO ICD-11 website URL]

Ensure to adjust the “Year” and URL according to the version you are referencing.

What is the ICD-11 Code for Hypertension?

The ICD-11 code for hypertension is BA00.Z. Subcategories within this code provide further specificity, such as distinctions for secondary hypertension.

What is the Difference Between ICD-10 and ICD-11?

The key differences between ICD-10 and ICD-11 include:

Structure: ICD-11 is designed to be fully digital, offering APIs and user-friendly tools.
Content: Expanded chapters and new classifications for emerging health topics.
Precision: Increased granularity and new coding options for accurate documentation.
Global Compatibility: Enhanced semantic interoperability for better data exchange across regions.

How to Reference ICD-11 in Research?

In academic research, referencing ICD-11 involves providing the full name, edition, and publication details. Ensure to include the retrieval date and URL if accessed online.

When is ICD-11 Expected to Be Implemented Outside the United States?

Many countries have already begun adopting ICD-11, with some actively using it for data collection and reporting. Others are piloting the system or translating it for national use. Full global implementation will depend on individual countries’ readiness and infrastructure.

ICD-11 represents a significant leap forward in healthcare classification, offering unparalleled precision, interoperability, and functionality. While its implementation timeline in the United States remains uncertain, it is already shaping global healthcare systems. By embracing this innovative framework, healthcare providers, policymakers, and researchers can drive better outcomes, enhance data quality, and advance medical knowledge in the years to come.