ICD-11 Medical Coding: How to Prepare your Healthcare Organization for ICD-11

Healthcare organizations in the United States and around the world use the ICD-10 medical coding standard. Starting in 2022, however, organizations will switch to the ICD-11 standard.

ICD-11 has four times as many codes as ICD-10. That means new challenges for healthcare providers – and new problems with missed revenue, coding errors, and denied claims.

Keep reading to discover some of the significant changes in ICD-11 medical coding, including how your organization can prepare for the release of ICD-11.

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What is ICD-11?

The World Health Organization has created the ICD-10 medical coding standard, which is currently in use in the United States and around the world. It’s the tenth version of the International Classification of Disease (ICD) codes.

In May 2019, WHO member states voted to implement the 11th version of that system: ICD-11. As healthcare changes and new diagnoses and treatments emerge, WHO regularly needs to update its coding system.

ICD-11 is scheduled to be implemented in all WHO member states, including the United States, in January 2022.

ICD-11 marks a significant increase in medical coding challenges. While ICD-10 had just 10,000 codes, ICD-11 has over 40,000.

Complicating matters further is that healthcare organizations in the United States use a modified version of ICD-10 that has 140,000+ codes, including 70,000 codes for diagnoses and 70,000+ codes for treatments.

In other words, ICD-11 is expected to introduce significant coding challenges for healthcare organizations in the United States.

Top 4 Ways to Prepare Your Healthcare Organization for ICD-11 Medical Coding

Healthcare organizations in the United States already struggle with ICD-10 coding challenges. Organizations lose revenue, sacrifice patient care, and face insurance denials, among other issues. Across the country, organizations lose billions to coding challenges every year.

With the launch of ICD-11, organizations will face new coding challenges. Smart healthcare organizations are already preparing. Here are some steps to help your organization get started.

1. Become familiar with new ICD-11 codes and chapters

ICD-11 has thousands of new codes and chapters. Many of these codes and chapters have not been seen in previous versions, and they’re totally unfamiliar even to experienced medical coders.

There’s a new code for work burnout, for example. Burnout appears in the ICD-11 section on problems related to employment or unemployment. The goal of adding this code is to make physician burnout a thing of the past.

ICD-11 defines physician burnout as:

• Feelings of energy depletion or exhaustion
• Increased mental distance or feelings of negativism or cynicism related to one’s job
• Reduced professional efficacy

Issues like time constraints, technology, and regulations increase the rate of physician burnout.

This code may seem straightforward to implement, but it’s more complicated than organizations realize. As AMA explains, organizations need to differentiate professional burnout from adjustment disorder, anxiety disorders, and mood disorders. Organizations also need to use this classification exclusively for professional burnout – not burnout in other areas of one’s life.

This is just one example of how ICD-11 will change the way organizations handle various challenges. Smart organizations are familiarizing themselves with these new codes and chapters today to avoid surprises in the future.

2. Update EHR and revenue cycle management software

To prepare for ICD-11, organizations need to ensure they have the latest versions of EHR and revenue cycle management software.

Inevitably, during the switch to ICD-11, some organizations will get stuck using older versions of software. This will introduce significant coding challenges and missed revenue opportunities, among many other issues.

Ensure your EHR and revenue cycle management software is updated and optimized to the new changes to ensure a smooth transition process.

3. Hire someone to oversee ICD-11 implementation

Some organizations are hiring leaders to oversee the implementation of ICD-11. These leaders self-assess the organization for coding discipline. They oversee training efforts in the leadup to January 2022. They lead educational initiatives for the new codes and challenges of ICD-11.

Ultimately, organizations that start preparing for ICD-11 today will be better equipped to handle these challenges than their competitors – and that means better organizational efficiency moving forward.

4. Hire a medical coding specialist

ICD-11 can be overwhelming – especially for organizations that lack medical coding leaders.

Many organizations have begun to hire medical coding specialists to prepare for the implementation of ICD-11.

A good medical coding specialist can optimize revenue cycle management, reduce coding errors, and enhance patient care, among other benefits. Even months before ICD-11 is implemented, medical coding specialists can recommend actionable changes that improve the efficiency of your organization.

Medical coding specialists are experts at ICD-10 and ICD-11. It’s their job to understand the unique challenges of ICD-11. They know the medical coding challenges faced by organizations, and they know the changes organizations need to make to optimize efficiency during the shift.

How HMI Helps with ICD-11 Medical Coding

Contact HMI, LLC to hire a contract medical coding specialist today.

HMI, LLC has a proven reputation for solving complex organizational challenges. We’ve helped organizations deal with ICD-10 coding challenges – and challenges related to the upcoming launch of ICD-11, among many other coding challenges.

Optimize your revenue cycle today by solving your organization’s coding challenges. Hire HMI, LLC and discover how your organization can improve and prepare for ICD-11 medical coding.

Dr. West has more than thirty years of executive management experience in health care. As CEO and Medical Director of American Pathology Resources, Inc. Dr. West joined HMI Corporation as Chief Executive Officer and Chief Medical Officer.