ICD-11, short for International Classification of Disease – Eleventh Revision, is a code set that is used in medical coding created and maintained by the World Health Organization (WHO). The code set serves the purpose of documenting symptoms, diseases, diagnosis, and other social circumstances.

The ICD-11 builds upon the ICD-10 and further adds the data and medical findings that have been discovered since the publication of the ICD-10 code set back in the early 90s. Currently, the ICD-11 beta version is available with the actual release to the public set to be in the next year.
Apart from the additions of various new findings in the code set, ICD-11 also incorporates an interactive web portal that is easily accessible, gets daily updates and comes with a search engine to make it easier than before for physicians and medical coders to call upon codes. Moreover, unlike its predecessor, the ICD-11 code set will be released in multiple languages. The World Health Organization also stated that the new code set will be electronic health record ready.
History of the ICD
The ICD has been revised and published in a series of editions to reflect advances in health and medical science over time. The first classification edition was adopted by the International Statistical Institute in 1893, known as the International List of Causes of Death back then.
It was not until 1948 when the ICD was taken under the ownership of the World Health Organization, which marked the sixth version and incorporated morbidity for the first time. Later, with the emergence of the WHO Nomenclature Regulations in 1967, it was required for all Member States to employ the most current ICD version for morbidity and mortality stats.
ICD-10 was officially endorsed in the forty-third World Health Assembly in 1990. Since then, it has been applied by more than 100 countries around the world and cited in over 20,000 scientific papers and articles. On October 1, 2015, ICD-10 was formally incorporated in the US healthcare industry, effectively replacing its predecessor, ICD-9.
The transition from a previous code set to the next one is never easy. It took nearly two decades for the US to completely shift to the ICD-10 codes and even the WHO acknowledges that not many countries are likely to adopt the new code set quickly. It is up to each member nation when they choose to adopt and transition to ICD-11. It is expected that the US will implement the ICD-11 by the end of 2025, but if a clinical modification comes into the equation, like the ICD-10-CM, the timeline may extend two years further.
The transition from a previous code set to the next one is never easy. It took nearly two decades for the US to completely shift to the ICD-10 codes and even the WHO acknowledges that not many countries are likely to adopt the new code set quickly. It is up to each member nation when they choose to adopt and transition to ICD-11. It is expected that the US will implement the ICD-11 by the end of 2025, but if a clinical modification comes into the equation, like the ICD-10-CM, the timeline may extend two years further.
Publish and Release of ICD-11
The ICD-11 release date for the preliminary version was June,18 2018. The next year, it was presented officially at the World Health Assembly and is set to be officially recognized and adopted by all member states in 2022.
The preliminary release is intended to provide a preview to member countries to give them time so that they can work out a plan to implement and use the new ICD-11, train their medical experts and personnel, and get translations where required. The World Health Organization also entertains evidence-based proposals for any revisions in a transparent and open way.
The ICD-11 is a result of ten years of work involving hundreds of specialists spanning across 50+ countries who gave their expertise, and input. Physicians and healthcare workers also gave their precious insights to incorporate additional medical concepts, specifically in the mental health area.
Why ICD-11?
Back in 2000, it was decided at the World Health Assembly to revise the ICD, keeping in view the dynamic progress in medical practices and health sciences as well as the need for electronic health information systems.

The ICD-11 further adds new conditions and diagnoses that were previously undiscovered and provides enhanced their medical coding possibilities to improve the overall coding process. Below are the revision goals that the World Health Organization aims to meet with the publication of the ICD-11:
· Revise the ICD in a way to accurately reflect the new advancements in medicine and science.
· The new code set is set to be used in morbidity and mortality stats, that are to be used in primary care, specialty care and research.
· The ICD-11 will be available in multiple languages to ensure that the code set serves as an international standard for better comparable data.
· The code set is fully electronic, to meet the electronic health applications and information systems, making it easier to use and be more accessible for everyone.
Improvements
The ICD-11 incorporates various improvements based on the gaps identified in the ICD-10, as well as to add the medical updates since the release of the last code set. Major changes put into effect relate to the coding structure, international usage, digital readiness, and dimensional approach.
Coding Structure
To start with, the ICD-11 has a much more enhanced structure than its predecessor. There are over 55,000 codes that are used to classify disorders, diseases, injuries and causes of deaths, for which ICD-11 provides a comprehensive methodology to code the conditions.
International Usage
The ICD-10 was available in English language only which posed some challenges for many countries where the code set had to be translated and then applied. With the ICD-11, the code set is available in 43 different languages, to make it easier for researchers and healthcare professionals worldwide in international usage and comparisons in data.
Digital Readiness
Since the ICD-11 is set to be used by the global audience, it has been designed to be user-friendly and electronic to serve as a central platform that is easily accessible to everyone. The ICD-11 can connect to any software, available in a machine-readable format in this digital age.

Dimensional Approach
Another enhancement of the ICD-11 is that it’s based on a dimensional approach that makes it better at capturing change over time, is consistent with research evidence, and will improve recovery from illness. This dimensional approach also helps to reduce artificial comorbidity, which refers to a person being diagnosed with more than one illness when in fact their symptoms are all part of the same illness.
Additions in the ICD-11
Some of the major diagnoses that are now incorporated in the ICD-11 are:
Complex PTSD
Complex PTSD is defined in the ICD-11 comprehensively with a description for the symptoms involved in the condition. The diagnoses also highlight the issues in emotion regulation, interpersonal conflict in a broader way and the effects that the condition has on a person’s entire life.
Gaming Disorder
The ICD-11 gaming disorder is newly defined in the code set as a “a pattern of persistent or recurrent gaming behavior (‘digital gaming’ or ‘video-gaming’).”
Compulsive Sexual Behavior Disorder
Compulsive sexual behavior disorder is defined in the ICD-11 as “characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior.”
Conclusion
The ICD-11 is set to serve as a comprehensive system for diagnosing mental health disorders, not unlike the DSM-4 structure. The difference is that where DSM-5 is primarily used in the United States, the ICD-11 is to be applied internationally for insurance and billing purposes. The latest version of the ICD is believed to alter and influence the existing standards of disease and diagnosis classification due to its dimensional approach.
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