Skip to main content

DIFFERNCE BETWEEN ICD 10 AND ICD 11

WHO recently already released ICD 11th edition and will come into effect on Jan 01, 2022. Let’s all not come into panic mode and note that so far the USA is not sure about when they’ll be ready to implement ICD 11 so far, but still, we cannot say anything.

Let’s see the Difference between the ICD 10 and the ICD 11 Coding systems. The ICD-11 MMS is the primary derivative of the Foundation Component, and that is commonly referred to and recognized as "ICD-11 MMS. The abbreviation is variously written with or without a hyphen between 11 and MMS. 

  • MMS stands for Mortality and Morbidity Statistics.
  • These codes are a minimum of 4 character codes in ICD 11 and 2 levels of subcategories.
  • The chapter numbering of ICD 11 is Arabic numbers, not Roman numbers

ICD 10 represents 14400 diagnosis but ICD 11 has 55,000 unique codes to represent the comprehensive list of diagnosis. Changing the number of items in the ICD is considered extremely useful because it allows researchers and health care organizers to have a more complete picture. 

For example, in ICD-11 all types of diabetes and other conditions are described in detail

There is major codes structural difference between ICD 10 and ICD 11. ICD-11 changes the 3- character category codes (the characters to the left of the decimal) to four with an alpha-character in the second position and a number always in the third position. 

So the coding scheme always has a letter in the second position to differentiate from the codes of ICD-10 For example, 1A00

In the ICD-10, every code starts with a letter, indicating the chapter. The first character of code always relates to the chapter. Numbers 1-9 are used for the first nine chapters and letters are used for chapters 10 to 26. A letter is always in the 2nd position to differentiate from ICD-10 codes.

  • No more “I” and “O” in ICD MMS to avoid confusion between “1” and “0” in ICD 11.
  • Residual categories use Y for other, Z for Other Specified, and unspecified Category. 

For Example

  • 1C4Y – Other Specified Bacterial Disease and 1C4Z - Unspecified Bacterial Disease.

Below is the list of ICD 11 MMS Chapters

  1. A00–1H0Z Certain infectious or parasitic diseases
  2. A00–2F9Z Neoplasms
  3. A00–3C0Z Diseases of the blood or blood-forming organs
  4. A00–4B4Z Diseases of the immune system
  5. A00–5D46 Endocrine, nutritional or metabolic diseases
  6. A00–6E8Z Mental, behavioral or neurodevelopmental disorders
  7. A00–7B2Z Sleep-wake disorders
  8. A00–8E7Z Diseases of the nervous system
  9. A00–9E1Z Diseases of the visual system
  10. AA00–AC0Z Diseases of the ear or mastoid process
  11. BA00–BE2Z Diseases of the circulatory system
  12. CA00–CB7Z Diseases of the respiratory system
  13. DA00–DE2Z Diseases of the digestive system
  14. EA00–EM0Z Diseases of the skin 
  15. FA00–FC0Z Diseases of the musculoskeletal system or connective tissue
  16. GA00–GC8Z Diseases of the genitourinary system
  17. HA00–HA8Z Conditions related to sexual health
  18. JA00–JB6Z Pregnancy, childbirth or the puerperium
  19. KA00–KD5Z Certain conditions originating in the perinatal period
  20. LA00–LD9Z Developmental anomalies
  21. MA00–MH2Y Symptoms, signs or clinical findings, not elsewhere classified
  22. NA00–NF2Z Injury, poisoning or certain other consequences of external causes
  23. PA00–PL2Z External causes of morbidity or mortality
  24. QA00–QF4Z Factors influencing health status or contact with health services
  25. RA00–RA26 Codes for special purposes
  26. SA00–SJ3Z Supplementary Chapter Traditional Medicine Conditions - Module I
  27. VA00–VC50 Supplementary section for functioning assessment
  28. X...–X... Extension Codes

With the addition of New Chapters related to Disorders of the Immune system, Diseases of the blood and blood-forming organs, Conditions related to sexual health, and Sleep-Wake Disorder, Extension codes, Traditional medicine in ICD 11 represents the more complex diagnosis. 

For example delayed sleep-wake phase disorder (7A60), advanced sleep-wake phase disorder (7A61), Irregular sleep-wake rhythm disorder (7A62)

  • Skin Ca type – Basalioma was missing in ICD 10, so added in ICD 11. 

So many new conditions Compulsive sexual behavior disorder, Body integrity dysphoria, Gaming disorder categorized in mental, behavioral, and neurodevelopmental disorders. MBND contains 21 disorder groupings compared with 11 disorder groupings in ICD-10.

In below list of each disorder added into the ICD 11 list under Mental Health Disorders

  • Anxiety or fear-related disorders
  • Catatonia
  • Disorders of bodily distress or bodily experience
  • Disorders due to substance use or addictive behaviors
  • Disorders specifically associated with stress
  • Disruptive behavior or dissocial disorders
  • Dissociative disorders
  • Elimination disorders
  • Factitious disorders
  • Feeding or eating disorders
  • Impulse control disorders
  • Mental or behavioral disorders associated with pregnancy, childbirth, and the puerperium
  • Mood disorders
  • Neurocognitive disorders
  • Neurodevelopmental disorders
  • Obsessive-compulsive or related disorders
  • Paraphilic disorders
  • Personality disorders and related traits
  • Schizophrenia or other primary psychotic disorders

Please note that ICD-11 is only for diagnosis coding and ICD-10-PCS is completely separate from ICD-10 and will not be updated with the transition of ICD-10 to ICD-11. ICD-10-PCS is not a WHO-developed or maintained vocabulary. ICD-10-PCS is a procedure classification system designed by CMS for coding hospital-based procedures.

Labels:

Popular posts from this blog

Usage of CPT Index - Instructions

The alphabetic index is not a substitute for the main text of the CPT codebook. Even if only one code is present, the coder must refer to the main term to ensure that the code is selected accurately and correctly to identify the services rendered. Main Terms The index is organized by main terms. Each main term can stand alone or can be followed by up to three modifying terms. There are four primary classes of main entries, Procedures or Services - E.g, Scopic, Anastomosis, Splint, Opening Organ or Other Anatomical Site - E.g, Knee, Arm, Ear, Tibia, Colon Conditions - E.g, Abscess, Entropion, Tetralogy of Fallot. Synonyms, Eponyms, and Abbreviations. - ECG, EEG, PET, Brock Operations, Clagett Procdures Modifying Terms The main term may be followed by up to three indented terms that modify the terms they follow. EG. The main term "Endoscopy" is subdivided by the anatomical sites in which the procedure is used. And within these anatomical sites, the specific purpose of the pr
Read more

Additional Information About Modifiers

Sequencing of modifiers  How can that be if the modifiers used were accurate?  There is an order to reporting modifiers and there are three categories that modifier usage fall under:  1. Pricing  Pricing modifiers are always sequenced “before” payment modifiers and/or location modifiers.   The only exception to this rule is when a global surgery package is involved.  For example, you would code modifier 58 first and modifier 82 second in a global surgery.  A few examples of pricing modifiers are: 22, 26, 50, 52, 53, 62, 80, and P1-P6.   2. Payment   Payment modifiers alert the insurance carrier that there is a special situation within the claim  Some examples of payment modifiers would be: 24, 25, 51, 57, 58, 59, 76, and 78.  3. Location  Examples of location modifiers are: E1-E4, FA, F1-F9, LC, LD, LT, RT, RC, TA, and T1-T9.  The general order of sequencing modifiers is ( 1) pricing (2) payment (3) location. Location modifiers, in all coding situations, are coded “last”.  If you code
Read more

Evaluation and Management (E/M) Services - Domiciliary or Rest Home Environment

Domiciliary, Rest Home, or Custodial Care Services CPT codes 99324 - 99337 Domiciliary, Rest Home (e.g. Boarding Home), or Custodial Care Services, are used to report E/M services to individuals residing in a facility which provides room, board, and other personal assistance services, generally on a long-term basis.  These codes are also used to report E/M services in an assisted living facility. The facility’s services do not include a medical component. A home or domiciliary visit includes a patient History, Physical Examination and Medical Decision Making in various levels depending upon a patient’s needs and diagnosis.  The visits may also be performed as counseling and/or coordination of car, when medically necessary outside the office environment and are an integral part of a continuous of the patient's care.  The patients seen may have chronic conditions, may be disabled, either physically or mentally, making access to a traditional office visit very difficult, or may have l
Read more