1. Icd-11 AND MORE!!

2. 2 YEARS LATER Consulting a lot
Don’t miss the daily trips down the Borman
My home office
Miss the faculty and student exchanges
Exercise and grandchildren are good things

3. The status of icd-11 Will be released by the WHO May 2019
Totally electronic
Multipurpose—morbidity, mortality, the degree of primary care, research, public health
English, French, Spanish, Russian, Chinese, Arabic, etc.

4. Adoption
Scheduled for January 1, 2023 or thereafter US---For death certificates first
Been in development since 2007
Electronic, maybe no books
ICD-10-PCS is NOT AFFECTED and why do we call it ICD-10-PCS
Codes are 4 digits, not 3

5. Concepts Stem codes Extension codes Cluster coding
Primary and secondary parents

6. Stem codes and extension codes
Can be used alone
Found in the Tabular list of ICD-11 for Mortality and Morbidity statistics
Additional detail found in extension codes
Extension codes can’t be used without a stem code
Codes can be grouped together to describe the disease and that is called cluster coding

7. Primary and Secondary parents
Diseases connected like in previous editions
Example: Malignant neoplasm of the skin
Is in the chapter for malignant neoplasms
Dermatologist could see the code also in the chapter on skin.

8. Cluster Coding One of the biggest changes in ICD-11
A link is generated between core diagnostic (stem code concepts) and/or clinical concepts captured in extension codes to primary stem codes
Extension codes are adjunct codes—show laterality, acuity and more.
Clustering is linking

9. Definition of Main Diagnosis
The reason for admission after assessment at the end of the stay
US says: That condition, after study, which was chiefly responsible for occasioning he patient’s admission to the hospital for care.

10. 1B10.0 Respiratory Tuberculosis, confirmed
Was A15 in ICD-10-CM
Will have a description and additional information
61 Index terms

11. 6A10 Type 1 Diabetes Mellitus
DM with diabetic retinopathy
6A10/Mg45

12. 5A10 Type 1 Diabetes Mellitus
Excludes Type II 5A11
DM, other specified type 5A13
DM in pregnancy JA63

13. New Chapters Chapter 3 Diseases of Blood and Blood –forming Organs
Chapter 4 Disorders of the Immune System
Chapter 6 Conditions related to Sexual Health
Chapter 8 Sleep-Wake Disorders
Chapter 26 Traditional Medicine—disorders that originated in ancient Chinese Medicine and still used in China, Japan, Korea, etc.

14. More New Chapters Chapter 27 Supplemental V Codes
Not like the V codes of old
Rather for HCCs, rehab centers and skilled care-----codes describe a patient’s
functional status and disabilities
Chapter 28 Supplemental Extension codes.
X codes to show more detail, severity, tumor staging, history, injury and poisonings, POA

15. What is NCVHS thinking
Not a regulatory process like last time, make it easier
Can’t take 23 years—would be 2042
I’ll be 90 and hope I still know my first name
Do we really need to create a Clinical Modification? Really?
We need a smooth and transparent transition
Isn’t this huge system detailed enough?

16. 3 Recommendations from the NCVHS to the DHHS
Use a subregulatory process unlike last time (Translation: make it simpler)
HHS should invest NOW in a project to evaluate I-11 and develop a smooth transition plan
HHS should clarify that ICD-10-PCS is COMPLETELY separate from ICD-10 and will NOT be updated on the timeline of ICD-10-11

17. A few big picture concepts
117 countries use the system to report mortality data
Translations already underway into 43 languages
System has 55,000 unique codes for injuries, diseases, and causes of death
10 year development process at the WHO
10,00 proposals for revision reviewed. Enough already
The detail we need now in coding continues

18. Two Questions
DID ANYONE IN THIS ROOM BRING THEIR CELL PHONE WITH THEM?
DID ANYONE IN THIS ROOM NOT BRING THEIR CELL WITH THEM?
GET IT OUT PLEASE

19. Icd 11 coding tool Morbid Obesity Sepsis
Gaming Disorder, Predominantly on line vs offline
Gender incongruence of childhood

20. A couple AHIMA/profession thoughts
Where are we and where do we need to go?
Employee relations vs. HR
Medical Record Technology/Administration vs. Health Information Management
AHIMA today-----CE only vs Membership

21. Your comments/Questions