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Updates on status of ICD-11 and changes to other classification and terminology systems

Discussion in 'Disease coding' started by Dx Revision Watch, May 4, 2018.

  1. Inara

    Inara Senior Member (Voting Rights)

    Ah, there was a question....In the public release now available there are the codes missing. I am sure you explained that somewhere. When will the codes be added or am I using the wrong version?
    Melanie likes this.
  2. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)



    A version of ICD-11 was released on 18 June 2018 to allow Member States to prepare for implementation, including translating ICD into their national languages. ICD-11 will be submitted to the 144th Executive Board Meeting in January 2019 and the Seventy-second World Health Assembly in May 2019 and, following endorsement, Member States will start reporting using ICD-11 on 1 January 2022.​

    It will be 3.5 years until WHO begins accepting data using the new edition.

    MSAC chair, Dr Christopher Chute, projected in February 2017, that it would likely be 5 to 6 years before the first country implements the new edition.

    My understanding is that whilst Member States will be encouraged to start preparing for transition from ICD-10 to the new edition, there will be no WHO mandatory adoption date; Member States will transition at their own pace and according to their countries' specific timelines and requirements.

    Global adoption of ICD-11 (once endorsement has come into effect) will likely be a patchy and prolonged process and for a period of time, WHO will be accepting data recorded using both ICD-10 and ICD-11.

    NHS Digital has published no projected timeline for the evaluation and eventual adoption of ICD-11.

    In the meantime, the mandatory systems for use in the NHS are SNOMED CT UK Edition (mandatory terminology system for use in primary care since April 2018) and ICD-10. (All NHS secondary care will be expected to be using SNOMED CT UK Edition by 2020.)
    Last edited: Jun 18, 2018
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  3. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)


    What specific codes or category terms are you looking for?

    ICD-10 has a Tabular List (Volume 1) and an Alphabetical Index (Volume 3) which contains all the entities listed in ICD-10.

    For ICD-11, the Mortality and Morbidity Statistics Linearization (ICD-11 MMS) is the equivalent of the ICD-10 Tabular List.

    This is the blue MMS platform that was released, today: https://icd.who.int/browse11/l-m/en

    The MMS is the Linearization that contains the alphanumeric codes.

    The version that has been released, today, shows Parent classes (which may not be assigned a code), coded-for categories and any code-for Child categories that sit underneath them, Inclusion terms and Exclusion terms, but not Synonym terms or Index terms.

    The version released today is for the MMS Linearization only and it is not yet endorsed for use. It has been released now, in order for Member States to evaluate, give feedback on the user guidance, begin translations, and to start preparing their health agencies for eventual transition.

    The version released today does not toggle to display the Foundation Component listings. The Foundation Component is a collection of ALL ICD entities, from which a smaller number of entities are included in the MMS.

    So the MMS does not contain all the category terms. For that you need to view the Foundation Component (in the orange Maintenance Platform browser) here: https://icd.who.int/dev11/f/en

    The orange Maintenance Platform is a work in progress in between released versions. So you may see changes to the orange browser which won't be reflected in the blue browser until the next update is released (MMS 2019 or MMS 2020).

    (The orange Maintenance Platform browser toggles for the MMS or the Foundation Component by selecting the appropriate tab along the top of the right hand panel.)

    There is also a Coding Tool here for the blue MMS platform: https://icd.who.int/ct11_2018/icd11_mms/en/release#/

    And a Coding Tool here for the orange Maintenance Platform: https://icd.who.int/devct11/icd11_mms/en/current#/

    Both the blue and the orange platform also have Search functions.

    If you still can't find what you are looking for, let me know what the terms are and I will look for them for you.
    Last edited: Jun 18, 2018
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  4. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    (My emphasis)



    WHO releases new International Classification of Diseases (ICD 11)

    17 June 2018
    News Release


    18 June 2018 ¦ Geneva: The World Health Organization (WHO) is today releasing its new International Classification of Diseases (ICD-11).

    The ICD is the foundation for identifying health trends and statistics worldwide, and contains around 55 000 unique codes for injuries, diseases and causes of death. It provides a common language that allows health professionals to share health information across the globe.

    “The ICD is a product that WHO is truly proud of," says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “It enables us to understand so much about what makes people get sick and die, and to take action to prevent suffering and save lives."

    ICD-11, which has been over a decade in the making, provides significant improvements on previous versions. For the first time, it is completely electronic and has a much more user-friendly format. And there has been unprecedented involvement of health care workers who have joined collaborative meetings and submitted proposals. The ICD team in WHO headquarters has received over 10 000 proposals for revisions.

    ICD-11 will be presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on 1 January 2022. This release is an advance preview that will allow countries to plan how to use the new version, prepare translations, and train health professionals all over the country.

    The ICD is also used by health insurers whose reimbursements depend on ICD coding; national health programme managers; data collection specialists; and others who track progress in global health and determine the allocation of health resources.

    The new ICD-11 also reflects progress in medicine and advances in scientific understanding. For example, the codes relating to antimicrobial resistance are more closely in line with the Global

    Antimicrobial Resistance Surveillance System (GLASS). ICD-11 is also able to better capture data regarding safety in healthcare, which means that unnecessary events that may harm health – such as unsafe workflows in hospitals - can be identified and reduced.

    The new ICD also includes new chapters, one on traditional medicine: although millions of people use traditional medicine worldwide, it has never been classified in this system. Another new chapter on sexual health brings together conditions that were previously categorized in other ways (e.g. gender incongruence was listed under mental health conditions) or described differently. Gaming disorder has been added to the section on addictive disorders.

    “A key principle in this revision was to simplify the coding structure and electronic tooling – this will allow health care professionals to more easily and completely record conditions,” says Dr Robert Jakob, Team Leader, Classifications Terminologies and Standards, WHO.

    Dr Lubna Alansari, WHO’s Assistant Director-General for Health Metrics and Measurement, says: “ICD is a cornerstone of health information and ICD-11 will deliver an up-to-date view of the patterns of disease.”

    Editors’ note:
    ICD-11 is linked to the WHO non-proprietary names of pharmaceutical products, and it can be used for cancer registration. ICD-11 has been designed to be used in multiple languages: a central translation platform ensures that its features and outputs are available in all translated languages. Transition tables from and to ICD-10 support migration to ICD-11. WHO will support countries as they move towards implementation of the new ICD-11.
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  5. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)



    Classifying disease to map the way we live and die


    Ready for the 21st century

    On 18 June 2018, 18 years after the launch of ICD-10, WHO released a version of ICD-11 to allow Member States time to plan implementation. This is anticipating the presentation of ICD-11 to the World Health Assembly in 2019 for adoption by countries...

    The version given to the World Health Assembly in 2019 will go into effect on 1 January 2022. However, given the vast technical and technological adaptation and training required to move to a new system – thousands of coders from small primary health care clinics to large hospitals will need retraining – the switch from using ICD-10 to ICD-11 is unlikely to happen overnight.

    While there will be a few early adopters, not many countries are likely to adapt that quickly – some countries are still using ICD-9, and a few are even using ICD-8. ICD-10 which was released in 1990 was first implemented by Thailand in 1994; the USA only switched to it in 2015...

    What shelf life will ICD-11 have?

    The reason for revising the code every decade or so is this: countries can apply to develop their own adaptations. They are not allowed to change the basic code, but they can add detail – essentially producing more granular versions tailored to their health systems and circumstances.

    Countries that create bespoke versions can then sell those to other countries, training them in its use. Practitioners of specialities such as dermatology or mental health may want to produce their own adaptations too.

    As WHO tweaks the ICD through the years to take into account new understandings of medicine, countries are expected to follow suit. Many do not, however.

    Every year, WHO takes slightly incompatible data from countries and makes them comparable.

    Over the years though, version control slips too far and several slightly varying versions appear all over the world. Thus, a new version becomes necessary to reset the system.

    ICD-11, however, has been produced electronically and therefore should act more as a living document to which everyone access the latest version. Its agility should ensure considerable longevity.​


    Canada uses a clinical modification (CM) of ICD-10 (ICD-10-CA) and has published no projected timeline for development, testing and implementation of a CM of ICD-11.

    Germany uses a clinical modification of ICD-10 (ICD-10-GM) which is developed and managed by DIMDI. DIMDI recently posted that it has not yet determined any date by which it projects a CM of ICD-11 will have been adapted for use in Germany.

    The U.S. specific ICD-10-CM is developed and maintained by NCHS/CDC. CDC's Donna Pickett has stated it could be 2027 before the U.S. is ready to begin rule making for implementation of a clinical modification of ICD-11. An ICD-11-PCS for procedural codes would also need be developed.

    Australia uses ICD-10-AM (which is also used in Ireland). I envisage that Australia may potentially be among the early implementers. Australian classification and terminology agencies have 6 reps on the 22 member Joint Task Force and have been closely involved in the ICD-11 development process since its launch in 2007/2008.

    There are a number of other countries that use country specific adaptations of ICD-10, who won't be using ICD-11 straight out of the box.

    NHS Digital:


    "...A final version of ICD-11 will be published in 2018 for testing and implementation according to countries' specific timelines and requirements. Following field testing, planned to take place 01-Jun-2018 - 31 Mar-2019*, NHS Digital will consider the readiness of the health and care system for an ICD-11 migration and consider potential dates for this migration.

    As a WHO Collaborating Centre, NHS Digital is supporting the testing of this classification..."

    *Please note that these dates are indicative of current thinking only and will change as we develop our five-year strategic roadmap.​
    Last edited: Jun 18, 2018
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  6. JemPD

    JemPD Senior Member (Voting Rights)

    Wow @Dx Revision Watch this whole situation is deeply disturbing & scary & it just stinks that a few patients/advocates - mainly yourself & Mary Dimmock as i understand it, are having to do all this massively complex, confusing & seemingly never ending work. I cant keep up with it at all, you are beyond amazing.

    From the bottom of my heart, i thank you.
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  7. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)


    You are welcome, JemPD.

    I've been researching, monitoring and reporting around ICD-11 since 2008 (initially, with the "Elephant in the Room" series of reports on my old ME agenda site, the research for which started in 2006/7).

    Apart from maintaining an interest in the progress of the joint proposal submitted with Mary Dimmock, in March 2017, and in the progress of my other unprocessed proposals; and apart from responding to any potential future proposals from WHO, I shall be retiring from all advocacy work in August, (after the July 31 release of the SNOMED CT International Edition has gone live) for personal and political reasons.

    Edited to add: I shall update my site during July and intend to keep all my WordPress sites online for the foreseeable future, for their archived content and as a resource.

    Last edited: Jun 18, 2018
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  8. Inara

    Inara Senior Member (Voting Rights)

    When I went to ICD 11 via google, there was a version without codes. But then I followed your links and there were the codes. Funny.

    Edit: I understood it I think.
    Melanie likes this.
  9. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    Without knowing what link you found on Google, I can't offer any explanation.
    Melanie likes this.
  10. Inara

    Inara Senior Member (Voting Rights)

    Melanie likes this.
  11. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)


    No problem, Inara.

    That URL would point you to the ICD-11 Foundation Component - which does not display the alphanumeric codes. But opening the

    Linearizations Tab, then selecting

    Mortality and Morbidity Statistics

    would take you to the right listing.
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  12. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)


    DIMDI manages the German CM of ICD-10 (ICD-10-GM):


    WHO bringt ICD-11 auf den Weg


    Ein zukünftiger Einsatz der ICD-11 in Deutschland ist Gegenstand von Beratungen, an denen sich u.a. die Organisationen der Selbstverwaltung im Gesundheitswesen, das Bundesgesundheitsministerium und das DIMDI beteiligen. Die ICD ist hierzulande sehr weitreichend in den verschiedenen Anwendungsbereichen integriert. Daher sind die Auswirkungen eines Umstiegs und mögliche Anforderungen an eine deutsche Fassung der ICD-11 sehr sorgfältig zu evaluieren, was mehrere Jahre in Anspruch nehmen wird.

    Via Google Translate:

    Future use of the ICD-11 in Germany is the subject of deliberations in which, amongst others, self-governing health sector organizations, the Federal Ministry of Health and DIMDI participate. In this country, the ICD is very widely integrated in the various application areas. Therefore, the effects of a change and possible requirements for a German version of the ICD-11 should be evaluated very carefully, which will take several years.


    Edited to add: DIMDI's Dr Stefanie Weber Head, Medical Vocabularies German Institute for Medical Documentation and Information (DIMDI) has co-chaired the ICD-11 Joint Task Force, with Australia's, Prof James Harrison, Director, Research Centre for Injury Studies.
    Last edited: Jun 18, 2018
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  13. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    (Graphic may be reposted)


    Note that January 01, 2022 is not a mandatory WHO implementation date.

    It is the date from which WHO will begin accepting data reported using the new version.

    Member States will be adopting and rolling out ICD-11 (or preparing a national adaptation of ICD-11) according to their own schedules.

    There will be a lengthy period during which data will be accepted using both ICD-10 (and earlier versions) and ICD-11.

    The last update for ICD-10 (apart from corrections) is planned for 2019. After 2019, WHO will continue to accept data using ICD-10.

    When NHS Digital has announced a tentative roadmap for evaluation and migration to ICD-11, I will update the thread.

    U.S. and ICD-10-CM:

    CDC's Donna Pickett presented on ICD-11 in June 2017 and January 2018 to the U.S. Department of Health and Human Services National Committee on Vital and Health Statistics. CDC projects it could be 2027 before the U.S. begins rule making for implementation of a clinical modification of ICD-11. The U.S. would also need to develop an ICD-11 PCS for procedural codes. NCHS/CDC said several years ago that it cannot begin the work of developing a modification until the ICD-11 codes have been ratified.

    NCVHS June 21, 2017 Full Committee Meeting
    Agenda Item: ICD-10 CM and ICD-11
    Mrs Donna Pickett (CDC) Transcript Donna Pickett:

    NCVHS January 9-10, 2018 Full Committee Meeting:
    ICD-11 Update and Discussion:
    Mrs Donna Pickett (CDC) Transcript Donna Pickett:

    Donna Pickett's meeting slides: https://ncvhs.hhs.gov/wp-content/uploads/2018/05/Update-on-ICD-11-Pickett-NCVHS.pdf
    Last edited: Jul 5, 2018
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  14. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    Status of the "ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders"

    Chapter V Mental and behavioural disorders

    becomes Chapter 06 Mental, behavioural or neurodevelopmental disorders for ICD-11.


    A stand alone publication, "The ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders" will be the companion publication to ICD-11 Chapter 06 (the equivalent of ICD-10's Blue Book).

    It has been developed by the WHO Department of Mental Health and Substance Abuse with review input from clinicians who have registered with the Global Clinical Practice Network, a platform initiated by ICD Revision's Dr Geoffrey Reed. The GCP.Network includes over 12000 clinicians from 151 countries:


    "These draft guidelines include the Essential (Required) Features, Boundaries with Other Disorders and Normality, and Additional Features sections. Additional sections (e.g., Culture-Related Features) will be posted when completed."

    There has been no platform where the public can review the draft for this publication; and although the GCP.Network site states that the publication was "due to be finalized in 2017, prior to the approval of the ICD-11 by the World Health Assembly in May, 2018" the timeline has been revised since then: WHO is not presenting ICD-11 to the WHA until May 2019 and WHA's endorsement will not come into effect until January 2022.

    When WHO launched what it is now pitching as an "advance preview" of ICD-11 on June 18, no information on the current status of "The ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders" was released.

    WHO has been asked: "In what year is the "ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders" (the ICD-11 equivalent of ICD-10's "Blue Book") projected for finalization and release, thank you."

    with little expectation of any meaningful response.

    The disorder descriptions on the blue and orange ICD-11 MMS and Maintenance platforms need to be read in the context of the full clinical descriptions and diagnostic guidelines, but the drafts for these texts are not available for public scrutiny.

    Likewise, when the "advance preview" of ICD-11 was released on June 18, there was no indication of the status of the ICD-11 PC (aka ICD-11-PHC). It may be the case that this publication cannot be finalized until the core version codes have been WHA endorsed - but this is unclear.

    On April 18, I submitted a WHO Information Request via the designated channel:

    WHO has published its intention to release an initial version of ICD-11 in June 2018. It has also published its intention to defer WHA endorsement of ICD-11 until May 2019 [1].

    There is no publicly available information for the Department of Mental Health and Substance Abuse's projected timeline for the finalisation and publication of the proposed "ICD-11 classification of mental disorders for primary care" for which recommendations have been made by the Primary Care Consultation Group (PCCG).

    I request the following information:

    a) By what date is the "ICD-11 classification of mental disorders for primary care" publication currently projected to be finalised?

    b) By what date is the "ICD-11 classification of mental disorders for primary care" publication currently projected to be published?

    1 ICD Project Plan 2015-2018 http://www.who.int/entity/classifications/icd/revision/icdprojectplan2015to2018.pdf

    There is a 60 day response period.

    That has now been reached. I have received no response and a request on April 18 for an acknowledgement of receipt of my Information Request was not responded to, either. It appears that the WHO Information Request service is yet another WHO Black Hole.

    On my advice, these same questions (and some additional questions) were also raised on behalf of Forward-ME directly with ICD Revision's, Dr Geoffrey Reed, on April 27.
    Last edited: Jun 21, 2018
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  15. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    For ease of access, key links for the June 18, 2018 ICD-11 "preview" release and related platforms and release materials are collated below:

    Blue platform:
    ICD-11 MMS 2018 preview release:

    Coding Tool: https://icd.who.int/ct11_2018-2/icd11_mms/en/2018-05-18#/

    Orange platform:
    ICD-11 Maintenance Platform, Comments, Proposals

    (Working Draft with daily updates. Registration required to view/interact with some parts of this platform)

    Foundation Component: https://icd.who.int/dev11/f/en#/
    Mortality and Morbidity Statistics (MMS) Linearization: https://icd.who.int/dev11/l-m/en
    Coding Tool: https://icd.who.int/devct11/icd11_mms/en/current#/

    ICD-11 Home Page:
    (Not all materials/tools listed on the Implementation Support tab, for example, "Specialty versions" are currently available.)

    WHO introduces ICD-11: http://www.who.int/health-topics/international-classification-of-diseases

    News Release (18.06.18): http://www.who.int/news-room/detail...rnational-classification-of-diseases-(icd-11)

    Reference Guide: https://icd.who.int/browse11/content/refguide.ICD11_en/html/

    (This is an html version of the Reference Guide. When the PDF version is available, I will add the URL.)
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  16. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    Dr. Robert Jakob on ICD10 Monitor's "Talk Ten Tuesdays"

    On Tuesday, June 26, Dr. Robert Jakob, Team Leader of Classifications and Terminologies for the World Health Organization, will be the special guest on ICD10 Monitor's "Talk Ten Tuesdays" live broadcast reporting on key changes in ICD-11.


    From 10:00 a.m. Eastern Time.

    10-10:30 a.m. EST; 7-7:30 a.m. PST

    Program 330

    I asked ICD10 Monitor's Chuck Buck, via Twitter: If time permits, it would be good to have Dr Jakob confirm in what year the companion publication that expands on the Mental disorder chapter - The Clinical Descriptions and Diagnostic Guidelines for ICD-11 Mental and Behavioural Disorders, is slated for finalization and release.

    Chuck says: We have contacted Dr. Robert Jakob and will have the answer by the broadcast on 6/24.

    Register for live broadcast or listen later via podcast.
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  17. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    Mary Dimmock and I have updated our

    Comparison of Classification and Terminology Systems

    document to reflect this week's release of an "advance preview" version of ICD-11.

    If you downloaded the document in Post #1 please replace v1 with

    Comparison of Classification and Terminology Systems
    Version 2
    | June 2018


    or http://bit.ly/2yC6sIe

    Edited to add:

    Version 2 | June 2018 has been amended. Please replace with Version 3 | July 2018




    Attached Files:

    Last edited: Jul 20, 2018
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  18. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    Current ICD-11 Foundation and MMS Linearization disorder Descriptions for

    Bodily distress disorder (BDD) and its three severity specifiers:

    (Blue browser) ICD-11 for Mortality and Morbidity Statistics (2018 Release):


    (Orange browser) ICD-11 Maintenance Platform:
    (The content on the Orange browser is not a released version of the ICD-11, as frozen for release on June 18, 2018. It is a work in progress in between released versions)


    Current ICD-11 Foundation and MMS Linearization disorder Descriptions for Bodily distress disorder (BDD)


    Last edited: Jul 25, 2018
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  19. Seven

    Seven Senior Member (Voting Rights)

    So what happened with ME and cfs in the new classification?
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  20. Dx Revision Watch

    Dx Revision Watch Senior Member (Voting Rights)

    See Post #11:

    Update on current status of proposals for ICD-11 for the ICD-10 G93.3 terms:

    Postviral fatigue syndrome
    Benign myalgic encephalomyelitis
    Chronic fatigue syndrome


    and Post #32:

    As published by WHO on June 18, 2018:

    ICD-11 for Mortality and Morbidity Statistics (2018)

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