All medical billing and coding professionals must be highly familiar with the International Classification of Diseases (ICD) diagnostic tool in order to properly bill their patients. Currently, the ICD-10, officially implemented in the United States in 2015, is used as the global standard for medical codes. The ICD-11 is the eleventh revision of the ICD. It will officially come into effect on January 1, 2022, at which time member nations of the World Health Organization (WHO) may begin reporting morbidity and mortality statistics using the ICD-11’s system of classification, although most countries will not adopt the ICD-11 by the time of its launch; the United States Secretary of Health and Human Services has given an expected implementation year of 2025. 

The ICD-11 represents an exciting new change in the world of disease classification. Although it is not currently in effect, it is never too early for medical billers, coders, or simply those interested in disease classification to learn about the changes that it will introduce. The ICD-11 will include five new chapters, as well as a more flexible coding structure. Perhaps the biggest change to the diagnostic tool, however, is the addition of several mental disorders.

In this blog post, we discuss various innovations and changes in the ICD-11 classification of mental, behavioral, and neurodevelopmental disorders. At Comprehensive Healthcare Revenue Management it is our mission to provide healthcare facilities with professional medical revenue cycle management services that are consistent with the latest updates in medical coding and billing. Our medical billers and coders are committed to familiarizing themselves with the ICD-11 by the time of its launch. Read on to learn more about the latest revisions to the ICD, then get in touch with our outsourced medical billing and coding service today. 

Overall Changes

The ICD-11 is generally considered to be a vast improvement on previous revisions, reflecting critical advances in science and medicine and containing much more meaningful clinical content than the ICD-10. In addition, the ICD-11 will be the first edition of the ICD that is fully electronic, with an index-based search algorithm interpreting more than 1.6 million terms. Even though the ICD-11 will undoubtedly streamline the medical coding process, it will still require major training, research, and practice for coders to be able to comprehensively understand it. Thankfully, CHRM is here to provide your healthcare facility with a team of dedicated revenue cycle management professionals who are committed to learning the ins and outs of the ICD-11.

In addition to featuring a more flexible coding structure, the ICD-11 will include five new chapters of disease classifications, including a chapter on “diseases of the blood or blood-forming organs,” a chapter on “diseases of the immune system,” a chapter on “sleep-wake disorders,” a chapter on “conditions related to sexual health,” and a supplementary chapter on traditional medicine. 

Newly Added Mental Disorders

While the ICD-10-CM (ICD-10 Clinical Modification) adaptation of the ICD-10 already includes various mental disorders that were omitted from the original document (including binge eating disorder, bipolar type II disorder, body dysmorphic disorder, hoarding disorder, and more), several other mental, behavioral, and neurodevelopmental disorders have been newly added to the ICD-11:

  • Avoidant/restrictive food intake disorder: This disorder is characterized by the avoidance or restriction of certain foods, with the result being an insufficient quantity or variety of food to meet adequate nutritional requirements. This results in clinically significant weight loss and nutritional deficiencies. This disorder causes significant impairments in personal, familial, social, educational, and/or occupational functioning, due to avoidance of social experiences related to eating. Avoidant/restrictive food intake disorder is not motivated by a preoccupation with body weight. 
  • Body integrity dysphoria: Body integrity disorder is marked by an intense, persistent desire to become physically disabled in some way, for example by being blinded or having a major limb amputated. Onset of the disorder begins in early adolescence and results in harmful consequences, such as being preoccupied with the desire to the detriment of social functioning or by attempting to become disabled, putting the individual’s health life in significant jeopardy.
  • Catatonia: Catatonia is a psychomotor disturbance characterised by the simultaneous occurrence of several symptoms such as stupor, catalepsy, posturing, mutism, agitation, echolalia, etc. Catatonia often occurs in the context of specific mental disorders, particularly mood disorders, schizophrenia, or psychotic disorders.
  • Complex post-traumatic stress disorder: This disorder may develop following ongoing traumatic experiences from which escape is difficult or impossible, such as torture, slavery, genocide campaigns, domestic violence, and repeated childhood abuse. A patient with C-PTSD must meet all requirements of PTSD as well as severe and persistent problems in emotional regulation, low self-esteem, and difficulties sustaining interpersonal relationships. 
  • Gaming disorder: Gaming disorders are characterized by a pattern of persistent or recurrent video gaming behavior, which may be online or offline, manifested by impaired control over gaming, increasing priority of gaming at the expense of other life interests and daily activities, and continuation or escalation of gaming despite these negative consequences. The pattern of this behavior may be chronic or episodic and recurrent and is normally evident over a period of at least 12 months in order for a diagnosis to be assigned.
  • Olfactory reference disorder: Olfactory reference disorder refers to a persistent preoccupation with the false belief that one has a perceived foul or offensive body odor, making the individual excessively self-conscious. In response to this preoccupation, individuals engage in repetitive and excessive behaviors such as repeatedly checking for body odor, repeatedly seeking reassurance, excessively attempting to camouflage the perceived odor, and avoiding social situations at the expense of their personal, familial, social, educational, and/or occupational functioning. 
  • Prolonged grief disorder: Prolonged grief disorder refers to a disturbance following the death of someone close to the bereaved that results in a persistent and pervasive grief response characterised by intense longing for the deceased accompanied with severe emotional pain. In order to classify as prolonged grief disorder, these symptoms must have persisted for at least six months following the loss and clearly exceed expected social, cultural, or religious norms of grief. 

Personality Disorders

The personality disorders section of the ICD-10 has been completely revamped for the ICD-11, with all personality disorders being merged into one, which can either be coded as Mild, Moderate, or Severe. A category called “Personality Difficulty” has also been added, which can be used to classify personality traits that are problematic but have not risen to the level of a personality disorder. Once a personality disorder or difficulty has been established, it may be specified by one or more prominent personality traits or patterns: 1) negative affect 2) detachment 3) dissociation 4) disinhibition and/or 5) perfectionism. 

The decision to restructure the personality disorders section was due to disproportionate use of the borderline personality disorder and antisocial personality disorder classifications. In addition, many categories overlapped, and individuals with severe difficulties often met the criteria for multiple personality disorders. There has been considerable debate in the psychiatric community about this restructuring and whether or not borderline personality disorder is an independently valid category.

Transitioning to the ICD-11 Is Easy With CHRM

Unsurprisingly, a new medical coding tool means that there will likely be an increase in medical billing errors and denied claims once the ICD-11 finally takes effect. Fortunately, CHRM is here to help. Our staff of medical billing and coding professionals receive ongoing training in the latest changes in medical coding, including the ICD-11. If you’re looking to get the money that you’re owed faster, without overburdening or expanding your in-house medical billing team, then contact our outsourced medical billing company today. We promise to uphold the values of transparency, honesty, integrity, and excellence so that you can stop worrying about medical billing and coding and get back to what you do best — taking care of patients.