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ICD-11 Chapter 1 Certain Infectious or Parasitic DiseasesRationale/Differences between ICD-10 Chapter I and ICD-11 Chapter 01The chapter includes more infectious diseases than in the past. The purpose of the structure of Chapter 01 is to minimise the impact on longitudinal statistics of major infections, and allow reporting of main infectious syndromes without mention of a specific agent.Influenza has been moved from the respiratory to the infectious diseases chapter.Tuberculosis and leprosy have been grouped under ‘Mycobacterial diseases’, due to the similarity of the identification, course, and treatment options available are similar.A new block has been added for ‘Certain staphylococcal or streptococcal diseases’ that includes codes for acute rheumatic fever, and toxic shock syndromePrion diseases can be transmissible, genetic or arise spontaneously. They are rare conditions that only affect the nervous system. The presence of a specific gene is a prerequisite to developing a prion disease. In view of these facts, it was decided to keep the prion diseases together in one group and move the whole group to the neurology chapter.Table: Comparison of ICD-10 block structure with ICD-11 equivalent structureICD-11 equivalent structureICD-10 block headingGastroenteritis or colitis of infectious originA00-A09 Intestinal infectious diseasesPart of the grouping:. Mycobacterial diseasesA15-A19 TuberculosisCertain zoonotic bacterial diseasesA20-A28 Certain zoonotic bacterial diseasesOther bacterial diseasesA30-A49 Other bacterial diseasesPredominantly sexually transmitted infectionsA50-A64 Infections with a predominantly sexual mode of transmissionPart of the grouping:. Other bacterial diseasesA65-A69 Other spirochaetal diseasesPart of the grouping:. Other bacterial diseases A70-A74 Other diseases caused by chlamydiaePart of the grouping:. Other bacterial diseases A75-A79 RickettsiosesViral infections of the central nervous systemA80-A89 Viral infections of the central nervous systemSplit into two subsections:. Certain arthropod-borne viral fevers;. Certain zoonotic viral diseasesA92-A99 Arthropod-borne viral fevers and viral haemorrhagic feversViral infections characterised by skin or mucous membrane lesionsB00-B09 Viral infections characterised by skin and mucous membrane lesionsViral hepatitisB15-B19 Viral hepatitisHuman immunodeficiency virus diseaseB20-B24 Human immunodeficiency virus [HIV] diseaseCertain other viral diseasesB25-B34 Other viral diseaseMycosesB35-B49 MycosesPart of the grouping:. Parasitic diseases B50-B64 Protozoal diseasesPart of the grouping:. Parasitic diseases B65-B83 HelminthiasesPart of the grouping:. Parasitic diseases B85-B89 Pediculosis, acariasis and other infestationsSequelae of infectious diseaseB90-B94 Sequelae of infectious and parasitic diseasesNow part of extension codes for organismsB95-B98 Bacterial, viral and other infectious agentsCertain other disorders of infectious originB99-B99 Other infectious diseasesICD-11 Chapter 2 NeoplasmsRationale/Differences between ICD-10 Chapter II and ICD-11 Chapter 02The most significant change to the hierarchy of Chapter 02 is the inclusion of certain morphology types within the chapter (previously found in ICD-10, Appendix A). There are now precoordinated codes consisting of both morphology and site.Other types of morphology and greater site specificity not included in Chapter 02 are found in the Extension Codes chapter and can be used for postcoordination.Other changes include:grouping together neoplasms of brain and central nervous systemgrouping together neoplasms of haematopoietic and lymphoid tissuesthe addition of the new group for malignant mesenchymal neoplasms.The previous ICD-10 group for neoplasms of uncertain or unknown behaviour has been split into two groups:Neoplasms of uncertain behaviourNeoplasms of unknown behaviour.Progress in oncology has demonstrated that a site-only based categorisation of malignant and benign tumours provides limited information for prevention, treatment, and prognosis for persons that are affected by a tumour. ICD-10 had already included some categories based on histopathology (e.g. some lymphoid neoplasms, malignant melanoma etc.).In ICD-11, main tumour sites are subdivided by histopathology first.The groups chosen were based on an analysis of international mortality and morbidity reporting, cancer registries, and clinical reporting.Keeping the main anatomical axes intact allows backward compatibility.However, the structure was adjusted in a few places to comply with new knowledge.For tumours of the central nervous system, the histological and behavioural distinction between benign and malignant is a grey area. As such, it was decided to move all central nervous system tumours outside the basic framework of behaviour and group them together.The field of genetic markers is rapidly changing. For some tumours, such markers have been used for many years, for others, this is not the case. As such, apart from haematological tumours, genetic markers were not included, and have not been used for classification. They are, however, included in the Extension code chapter and can be added as a second code to the relevant code from the neoplasms chapter to fully describe the relevant tumour entity.Table: Comparison of ICD-10 block structure with ICD-11 equivalent structureICD-11 equivalent structureICD-10 block headingSplit into three subsections:. Neoplasms of brain or central nervous system;. Neoplasms of haematopoietic or lymphoid tissues; . Malignant neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissuesC00-C97 Malignant neoplasmsIn situ neoplasm, except of lymphoid, haematopoietic, central nervous system or related tissuesD00-D09 In situ neoplasmsBenign neoplasms, except of lymphoid, haematopoietic, central nervous system or related tissuesD10-D36 Benign neoplasmsSplit into two subsections:. Neoplasms of uncertain behavior, except of lymphoid, haematopoietic, central nervous system or related tissues;. Neoplasms of unknown behavior, except of lymphoid, haematopoietic, central nervous system or related tissuesD37-D48 Neoplasms of uncertain or unknown behaviourChapter 3 Diseases of the Blood and Blood-forming Organs Rationale/Differences between ICD-10 Chapter III and ICD-11 Chapter 03ICD-10, Chapter III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism has been split into two chapters for ICD-11 (MMS):one for diseases of blood and blood-forming organs (now ICD-11 Chapter 03 Diseases of the blood or blood-forming organs)the other for disorders of the immune system (now ICD-11 Chapter 04 Diseases of the immune system).There has been reorganisation of some categories, but most notably in anaemias, which are now under one group with a separate group for ‘Coagulation defects, purpura or other haemorrhagic related conditions’.Table: Comparison of ICD-10 block structure with ICD-11 equivalent structureICD-11 equivalent structureICD-10 block headingPart of the grouping:. Anaemias and other erythrocyte disorders D50-D53 Nutritional anaemiasPart of the grouping:. Anaemias and other erythrocyte disordersD55-D59 Haemolytic anaemiasPart of the grouping:. Anaemias and other erythrocyte disordersD60-D64 Aplastic and other anaemiasCoagulation defects, purpura or other haemorrhagic related conditionsD65-D69 Coagulation defects, purpura and other haemorrhagic conditionsConcepts redistributed to one of the following groupings:. Anaemias and other erythrocyte disorders;. Coagulation defects, purpura and other haemorrhagic related conditions; . Diseases of the spleenD70-D77 Other diseases of the blood and blood-forming organsMoved to Chapter 04 Diseases of the immune systemD80-D89 Certain disorders involving the immune mechanismChapter 4 Diseases of the Immune SystemICD-10 Chapter III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism has been split into two chapters:one for diseases of blood and blood-forming organs (now ICD-11 Chapter 03)the other for disorders of the immune system (now ICD-11 Chapter 04).For Chapter 04, there are five new sections for immune disorders that differ from the section previously located in Chapter III of ICD-10.Disorders of the immune system is classified mainly by clinical syndrome. A section for allergic and hypersensitive conditions, including anaphylaxis, has been included in this chapter. Overall, more detail has been added to the chapter.Codes for non-organ specific systemic autoimmune disorders have been moved from the musculoskeletal system in ICD-10 to this chapter for ICD-11.Table: Comparison of ICD-10 block structure with ICD-11 equivalent structureICD-11 equivalent structureICD-10 block headingSplit into eight subsections:. Primary immunodeficiencies;. Acquired immunodeficiencies;. Nonorgan specific systemic autoimmune disorders;. Newly created: Autoinflammatory disorders;. Allergic or hypersensitivity conditions;. Immune system disorders involving white cell lineages;. Certain disorders involving the immune system; . Diseases of thymusD80-D89 Certain disorders involving the immune mechanismChapter 5 Endocrine, nutritional or metabolic diseasesRationale/Differences between ICD-10 Chapter IV and ICD-11 Chapter 05ICD-10 Chapter IV Endocrine, nutritional and metabolic diseases has been split into four sections:Endocrine diseasesNutritional disordersMetabolic disordersPostprocedural endocrine or metabolic disordersInternational standardisation of endocrine disease terminology is being used to describe the complex nature of endocrine conditions.Diabetes mellitus and acute complications of diabetes mellitus have been expanded to reflect current terminology used internationally. The chronic complications often associated with diabetes (‘diabetic’ complications) are primarily parented to their respective body system but postcoordination options have been added at the diabetes codes. Categories for Intermediate hyperglycaemia (including Impaired glucose regulation) and Insulin-resistance syndromes have been included.Nutritional disorders are split into:Undernutrition Overweight, obesity or specific nutrient excesses.Two subsections have been added for Undernutrition:Undernutrition based on anthropometric or clinical criteria such as wasting, stunting, etc.Undernutrition due to specific nutrient deficiencies such as vitamin, protein, mineral deficiencies.Two subsections have been created for Overweight, obesity or specific nutrient excesses: Overweight or obesitySpecific nutrient excesses such as vitamin, mineral excessesMetabolic disorders are now aetiologically based and have been classified following clinical advice received from the relevant international societies for metabolic diseases.Cystic fibrosis is located in Chapter 12 Diseases of the respiratory system.ICD-11 equivalent structureICD-10 block heading5A00-5A0Z Disorders of the thyroid gland or thyroid hormones system E00-E07 Disorders of thyroid gland5A10-KB60.2 Diabetes mellitusE10-E14 Diabetes mellitus5A40-5A4Z Other disorders of glucose regulation and pancreatic internal secretionE15-E16 Other disorders of glucose regulation and pancreatic internal secretion5A50-5A5Z Disorders of the parathyroids or parathyroid hormone system5A60-5A6Z Disorders of the pituitary hormone system 5A70-5A7Z Disorders of the adrenal glands or adrenal hormone system 5A80-5A8Z Disorders of the gonadal hormone system5A90-5A9Z Certain disorders of puberty 5B00-5B0Z Polyglandular dysfunction 5B10-5B1Y Endocrine disorders, not elsewhere classified E20-E35 Disorders of other endocrine glands5B50-5B7Z Undernutrition E40-E46 Malnutrition5B50-5B7Z Undernutrition E50-E64 Other nutritional deficiencies5B80-5C1Z Overweight, obesity or specific nutrient excessesE65-E68 Obesity and other hyperalimentation5C50-5C5Z Inborn errors of metabolism5D40-5D46 Postprocedural endocrine or metabolic disorders5C60-5C6Z Disorders of metabolite absorption or transport 5C70-5C7Z Disorders of fluid, electrolyte or acid-base balance 5C80-5C8Z Disorders of lipoprotein metabolism or certain specified lipidaemias 5C90.0-5C90.Z Metabolic or transporter liver disease 5D00-5D0Y Other metabolic disorders CA25 Cystic fibrosis 5D40-5D46 Postprocedural endocrine or metabolic disorders E70-E90 Metabolic disorders2E6B-2D1Z Neoplasms of the endocrine system moved from Chapter 2 Neoplasms5B3Y-5B3Z Endocrine tumours moved from Chapter 2 NeoplasmsNewly created: 5C3Y-5C3Z Nutritional or toxic disorders of the nervous system MA50-MA6Y Symptoms, signs or clinical findings of endocrine, nutritional or metabolic diseases moved from Chapter 18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classifiedMG24.B-MA6Y Symptoms, signs or clinical findings of endocrine, nutritional or metabolic diseases Chapter 6 Mental, behavioural or neurodevelopmental disordersRationale/Differences between ICD-10 Chapter V and ICD-11 Chapter 06Changes to this chapter include restructuring of the hierarchy, the inclusion of current terminology, and specific groupings for intoxication, harmful use, and dependence by substance type.In ICD-10, due to the decimal coding system used in the classification (corresponding to digits 0 to 9), it was only possible to have a maximum of ten major groupings of disorders within the mental and behavioural disorder chapter. Some groups of disorders were created not based on clinical utility or scientific evidence. In ICD-10, for example, “Behavioural syndromes associated with physiological disturbances and physical factors” ? unites disorders that are unrelated in terms of clinical symptoms and symptomatology. The restructuring of the hierarchy and the inclusion of current terminology will improve the clinical utility of this chapter.The high degree of similarity between the overall structure of DSM-5 (American Psychiatric Association, 2013) and the linear structure of the ICD- 11 Mental and Behavioural Disorders chapter represents a major success of the ICD – DSM harmonisation effort.ICD-11 equivalent structureICD-10 block heading6D70-6E0Z Neurocognitive disordersF00-F09 Organic, including symptomatic, mental disorders6C40-6C5Z Disorders due to substance use or addictive behaviours6D70-6E0Z Neurocognitive disordersF10-F19 Mental and behavioural disorders due to psychoactive substance abuse6A20-6A2Z Schizophrenia or other primary psychotic disorders 6A40-6A4Z Catatonia F20-F29 Schizophrenia, schizotypal and delusional disorders6A60-6A6Z Mood disordersF30-F39 Mood affective disorders6B40-6B4Z Disorders specifically associated with stress 6B00-6B0Z Anxiety or fear-related disorders6B20-6B2Z Obsessive-compulsive or related disorders 6B60-6B6Z Dissociative disorders F40-F48 Neurotic stress-related and somatoform disorders6B80-6B8Z Feeding or eating disorders6E20-6E2Z Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium F50-F59 Behavioural syndromes associated with physiological disturbances and physical factors6C70-6C7Z Impulse control disorders6D10-6E68 Personality disorders and related traits6D50-6D5Z Factitious disordersF60-F69 Disorders of adult personality and behaviour 6A00-6A0Z Neurodevelopmental disordersF70-F79 Mental retardation6A00-6A0Z Neurodevelopmental disordersF80-F89 Disorders of psychological development6A00-6A0Z Neurodevelopmental disorders6B00-6B0Z Anxiety or fear-related disorders6C00-6C0Z Elimination disorders 6C90-6C9Z Disruptive behaviour or dissocial disordersF90-F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence6E8Z Mental, behavioural or neurodevelopmental disorders, unspecified F99 Unspecified mental disorderNewly created: 6C20-6C2Z Disorders of bodily distress or bodily experienceNewly created: 6D30-6D3Z Paraphilic disorders Newly created: 6E40 Psychological or behavioural factors affecting disorders or diseases classified elsewhere Newly created: 6E60-6E6Z Secondary mental or behavioural syndromes associated with disorders or diseases classified elsewhere Chapter 7 Sleep-wake disordersDifferences between ICD-10 and ICD-11 Chapter 07Chapter 07 is a new chapter in ICD-11.Sleep-wake disorders were previously located within the respiratory, neurology, or mental health chapters of ICD-10. By combining these disorders into one chapter, more detail can be included for many of the disorders.ICD-11 equivalent structureICD-10 block heading7A00-7A0Z Insomnia disordersG40-G47 Episodic and paroxysmal disorders7A20-7A2Z Hypersomnolence disordersG40-G47 Episodic and paroxysmal disorders7A40-7A47 Sleep-related breathing disordersG40-G47 Episodic and paroxysmal disorders7A60-7A6Z Circadian rhythm sleep-wake disordersG40-G47 Episodic and paroxysmal disorders7A80-7B2Z Sleep-related movement disordersF40-F48 Neurotic, stress-related and somatoform disorders7B2Y-7B2Z Parasomnia disordersF40-F48 Neurotic, stress-related and somatoform disordersChapter 08 – Diseases of the nervous systemRationale/Differences between ICD-10 and ICD-11 MMS Chapter 08ICD-11 sees a major overhaul in the organisation of the blocks which make up the neurology chapter. There has been a major restructuring and re-location of previous ICD-10 concepts into and out of this chapter, including dementia, cerebrovascular diseases and Transient Ischaemic attack (TIA).The restrictive decimal coding system of the ICD-10, with its capacity to contain only 11 blocks of disorders per chapter, resulted in blocks containing miscellaneous neurological entities which did not logically fit together.Not only has the structure of the neurological chapter changed, but the approach to classification also integrates current clinical practice and advancements in the understanding of neurological diseases.ICD-11 equivalent structureICD-10 block heading8E40-8E4Z Other disorders of the nervous system G00-G09 Inflammatory diseases of the central nervous system8B60-8B6Z Motor neuron diseases or related disordersG10-G14 Systemic atrophies primarily affecting the central nervous system8A00-8A0Z Movement disordersG20-G26 Extrapyramidal and movement disorders8A20-8A2Z Disorders with neurocognitive impairment as a major feature8D40-8D4Z Nutritional or toxic disorders of the nervous systemG30-G32 Other degenerative diseases of the nervous system8A40-8A4Z Multiple sclerosis or other white matter disorders8B40-8B4Z Spinal cord disorders excluding traumaG35-G37 Demyelinating diseases of the central nervous system8A60-8A6Z Epilepsy or seizures8A80-8A8Z Headache disordersG40-G47 Episodic and paroxysmal disorders8B80-8B8Z Disorders of nerve root, plexus or peripheral nervesG50-G59 Nerve, nerve root and plexus disordersMoved to 8D40-8D4Z Nutritional or toxic disorders of the nervous systemG60-G64 Polyneuropathies and other disorders of the peripheral nervous systemMoved to 9C8Y-9C8Z Diseases of neuromuscular junction or muscleG70-G73 Diseases of myoneural junction and muscle8D20-8D2Z Cerebral palsy G80-G83 Cerebral palsy and other paralytic syndromes8D60-8D6Z Disorders of cerebrospinal fluid pressure or flow 8D80-8D8Z Disorders of autonomic nervous system 8E00-8E0Z Human prion diseases 8E20-8E2Z Disorders of consciousness G90-G99 Other disorders of the nervous system9C8Y-9C8Z Diseases of neuromuscular junction or muscle moved from Chapter 7 Diseases of the eye and adnexa8B00-8B2Z Cerebrovascular diseases moved from Chapter 9 Diseases of the circulatory systemNewly created: 8E60-8E66 Postprocedural disorders of the nervous system Moved from Chapter 19 Injury, poisoning and certain other consequences of external causes NA00-ND15 Injuries of the nervous system Moved from Chapter 2 2C40-2E09 Neoplasms of the nervous system Chapter 9 Diseases of the visual systemRationale/Differences between ICD-10 Chapter VII and ICD-11 Chapter 09The structure and hierarchy of this chapter in ICD-11 have changed, providing more specificity. Most disorders have been grouped relating to their anatomical sites while disorders such as Glaucoma and Strabismus are retained at the 1st level to include the multiple subcategories of these conditions.The Exclusion and Coded Elsewhere instructions at the beginning of Chapter 09 in ICD-11 provides more detailed guidelines on the correct assignment of codes in this chapter.ICD-11 equivalent structureICD-10 block heading9A02.0-9A02.Y Inflammatory disorders of eyelid9A06.0-9A06.Y Certain specified disorders of eyelid9A10-9A1Z Disorders of lacrimal apparatus9A20-9A2Z Disorders of orbitH00-H06 Disorders of eyelid, lacrimal system and orbit9A60-9A6Z Disorders of conjunctivaH10-H13 Disorders of conjunctiva9B50-9B5Z Disorders of sclera9A70-9A7Z Disorders of the cornea9A90-9A9Z Disorders of the anterior uvea H15-H22 Disorders of sclera, cornea, iris and ciliary body9B10-9B10.Z Disorders of lensH25-H28 Disorders of lens9B60-9B6Z Disorders of the choroid9B70-9B7Z Disorders of the retinaH30-H36 Disorders of choroid and retina9C60-9C6Z Glaucoma or glaucoma suspectH40-H42 Glaucoma9B80-9C0Z Disorders of the vitreous bodyH43-H45 Disorders of vitreous body and globe9C40-9C40.Z Disorders of the visual pathways or centresH46-H48 Disorders of optic nerve and visual pathways9C81.0-9C81.Z Strabismus or ocular motilityH49-H52 Disorders of ocular muscles, binocular movement, accommodation and refractionMC10-MC1Y Symptoms or signs involving the visual systemH53-H54 Visual disturbances and blindness9C84.0-9C84.Z NystagmusH55-H59 Other disorders of eye and adnexaChapter 10 Diseases of the ear and mastoid processRationale/Differences between ICD-10 Chapter VIII and ICD-11 Chapter 10There has been some restructuring and regrouping throughout this chapter, with new concepts based on current medical advancements and medical terminology has been updated. The sections on hypertension and heart valve diseases have been expanded. Heart valve diseases has also had a change in hierarchy from aetiology (rheumatic/nonrheumatic) as the main axis, with heart valve type now being the main axis, followed by aetiology. Cerebrovascular diseases have been moved to the Neurology chapter as their primary parent with the Circulatory chapter being a secondary parent. The section on congenital anomaly of heart and great vessels and related acquired abnormalities has been revised, based on the International Paediatric and Congenital Cardiac Code (IPCCC) and the Anatomic and clinical classification of congenital heart defects (ACC-CHD) with the corresponding IPCCC and ICD-10 codes.Changes to pulmonary heart disease and diseases of pulmonary circulation have also occurred.ICD-11 equivalent structureICD-10 block headingE640-EG4Z Inflammatory disorders of the external earAA00-AA0Z Infectious diseases of external earAA40-AA41 Noninflammatory disorders of the external earH60-H62 Diseases of external earAA80-AA8Z Nonsuppurative otitis mediaAA90-AA9Z Suppurative otitis mediaAB10.0-AB10.Z Disorders of Eustachian tubeAB11.0-AB11.Z Mastoiditis or related conditionsAB12 Cholesteatoma of middle earAB13.0-AB13.Z Perforation of tympanic membraneAB1A-AB1Z Polyp of middle earH65-H75 Diseases of middle ear and mastoidAB30-AB50.2 Diseases of inner earH80-H83 Diseases of inner earAB50-AB5Z Disorders with hearing impairmentAB70-AB7Y Disorders of ear, not elsewhere classifiedAB90-AB93 Postprocedural disorders of ear or mastoid processH90-H95 Other disorders of earChapter 11 – Diseases of the circulatory system Rationale/Differences between ICD-10 Chapter IX and ICD-11 in Chapter 11There has been some restructuring and regrouping throughout this chapter, with new concepts based on current medical advancements and medical terminology has been updated. The sections on hypertension and heart valve diseases have been expanded. Heart valve diseases has also had a change in hierarchy from aetiology (rheumatic/nonrheumatic) as the main axis, with heart valve type now being the main axis, followed by aetiology. Cerebrovascular diseases have been moved to the Neurology chapter as their primary parent with the Circulatory chapter being a secondary parent. The section on congenital anomaly of heart and great vessels and related acquired abnormalities has been revised, based on the International Paediatric and Congenital Cardiac Code (IPCCC) and the Anatomic and clinical classification of congenital heart defects (ACC-CHD) with the corresponding IPCCC and ICD-10 codes.Changes to pulmonary heart disease and diseases of pulmonary circulation have also occurred. ICD-11 equivalent structureICD-10 block heading1B40.0-1B40.Z Acute rheumatic feverIB41.0-1B41.Z Acute rheumatic fever with heart involvementIB42 Rheumatic choreaI00-I002 Acute rheumatic feverBB60.0-BB6Z Mitral valve diseaseBB70-BB7Z Aortic valve diseaseBB80-BB8Z Tricuspid valve diseaseBC00-BC0Z Pulmonary valve diseaseBC20.0-BC20.Z Chronic rheumatic heart diseases, not elsewhere classifiedI05-I09 Chronic rheumatic heart diseaseBA00-BA04 Hypertensive diseasesI10-I15 Hypertensive diseasesBA40-Ischaemic heart diseases I20-I25 Ischaemic heart diseasesBB00-BB0Z Pulmonary heart disease or diseases of pulmonary circulation I26-I28 Pulmonary heart disease and diseases of pulmonary circulationBB20-1B41.0 PericarditisBB40-BB4Z Acute or subacute pericarditisBC43-BC4Z CardiomyopathyBC63.0-BC63.Z Conduction disordersMC82.0-MC82.Z Cardiac arrestMC81.0-MC81.Z Abnormalities of heart beatBC80-BC8Z Supraventricular rhythm disturbanceBD10-BD1Z Heart failureI30-I52 Other forms of heart disease8B00-8B2Z Cerebrovascular diseasesI60-I69 Cerebrovascular diseasesBD40-BD4Z Chronic arterial occlusive diseaseBD50-BD5Z Aortic aneurysm or dissectionI70-I79 Diseases of arteries, arterioles and capillariesBD70-BD7Z Diseases of veinsBD90-BD9Z Disorders of lymphatic vessels or lymph nodesI80-I89 Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classifiedBE2Z Diseases of the circulatory system, unspecifiedI95-I99 Other and unspecified disorders of the circulatory systemChapter 12 – Diseases of the Respiratory SystemRationale/Differences between ICD-10 Chapter X and ICD-11 Chapter 12There has been some restructuring and regrouping of this chapter, with new concepts and updated current terminology included. A new section, for inhalational, occupational and environmental lung disease has been added to improve the classification of respiratory disorders according to their aetiology. Sleep disorders of breathing and respiratory control has been added to Chapter 07 Sleep-wake disorders and secondarily parented to the Respiratory chapter. Based on input from international societies and stakeholders, the changes to Chapter 12 have been made principally to provide current clinical terminology and classification of conditions primarily affecting the respiratory system. Infectious lung diseases have been moved to Chapter 01 Infectious diseases to better reflect the infectious nature of these conditions.ICD-11 equivalent structureICD-10 block headingCA00-CA0Z Upper respiratory tract disordersJ00-J06 Acute upper respiratory infectionsCA40-CA4Z Lung infectionsCA60-CA8Z Lung diseases due to external agentsJ09-J18 Influenza and pneumoniaCA40-CA4Z Lung infectionsJ20-J22 Other acute lower respiratory infectionsCA00-CA0Z Upper respiratory tract disordersJ30-J39 Other diseases of upper respiratory tractCA20-CA2Z Certain lower respiratory tract diseasesJ40-J47 Chronic lower respiratory diseasesCA60-CA8Z Lung diseases due to external agentsJ60-J70 Lung diseases due to external agentsCB00-CB0Z Respiratory diseases principally affecting the lung interstitium J80-J84 Other respiratory diseases principally affecting the interstitiumCB00-CB0Z Respiratory diseases principally affecting the lung interstitium J85-J86 Suppurative and necrotic conditions of lower respiratory tractCB20-CB2Z Pleural, diaphragm or mediastinal disordersJ90-J94 Other diseases of pleuraCB40 Certain diseases of the respiratory system CB41 Respiratory failure CB60-CB64 Postprocedural disorders of the respiratory system J95-J99 Other diseases of the respiratory system2C22-2B6D Neoplasms of the respiratory system moved from Chapter 2 NeoplasmsLA77-LB00 Developmental respiratory diseases moved from Chapter 17 Congenital malformations, deformations and chromosomal abnormalitiesMD10-MD6Y Symptoms, signs or clinical findings of the respiratory system moved from Chapter 18Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classifiedPulmonary heart disease or diseases of pulmonary circulation moved from Chapter 9 Diseases of the circulatory system7A40-CB7Z Sleep-related breathing disorders moved from Chapter 6 Diseases of the nervous systemChapter 13 – Diseases of the digestive systemRationale/Differences between ICD-10 Chapter XI and ICD-11 Chapter 13Major changes have been made to this chapter with very detailed anatomical groups being added to the hierarchy, with the exception of categories for hernia and functional gastrointestinal disorders. Functional gastrointestinal disorders are independently described because their pathophysiology is considered from the standpoint of “Brain-Gut axis” (ie the biochemical signalling that occurs between the gastrointestinal tract and the nervous system). Important or common digestive diseases have been allocated their own category, for example gastro-oesophageal reflux disease, ulcerative colitis, non-alcoholic fatty liver disease and diverticular disease. Polyps are now classified as benign neoplasms, not in the “other diseases” of the anatomical site.There are new independent sections for Diseases of the gallbladder and biliary ducts, Diseases of the peritoneum and Diseases of the pancreas. Within these new sections, there are new categories including congenital anomalies, metabolic and transporter liver disease, infectious liver diseases (containing both acute and chronic viral hepatitis), non-alcoholic fatty liver disease, autoimmune liver disease and hepatic vascular disorders, infectious cholangitis, cystic diseases of the pancreas and chronic pancreatitis.Additional dimensions are available from Chapter X Extension Codes chapter for use in post-coordination. For example, with and without haemorrhage, with and without obstruction, laterality and greater site specificity, etc.ICD-11 equivalent structureICD-10 block headingDA00-DA0Z Diseases or disorders of orofacial complexK00-K14 Diseases of oral cavity, salivary glands and jawsDA20-DA2Z Diseases of the oesophagusDA40-DA7Z Diseases of the stomach or duodenumK20-K31 Diseases of oesophagus, stomach and duodenumDB10-DB1Z Diseases of appendixK35-K38 Diseases of appendixDD50-DD5Z Hernias K40-K46 HerniaDD70-DD7Z Inflammatory bowel diseases K50-K52 Noninfective enteritis and colitisDC70-DD1Z Diverticular disease of intestineDD30-DD3Z Ischaemic vascular disorders of intestineDB50-DB7Z Diseases of anal canalDD90-DD9Z Functional gastrointestinal disorders DB30-DB3Z Diseases of large intestineK55-K63 Other diseases of intestinesDC50-DC5Z Diseases of peritoneumK65-K67 Diseases of peritoneum,DB90-DB9Z Diseases of liverK70-K77 Diseases of liverDC10-DC1Z Diseases of gallbladder or biliary tract DC30-DC3Z Diseases of pancreasK80-K87 Disorders of gallbladder, biliary tract and pancreasDA90-DA9Z Diseases of small intestineDE10-DE2Z Postprocedural disorders of digestive systemK90-K93 Other diseases of the digestive systemChapter 14 Diseases of the skinRationale/Differences between ICD-10 Chapter 12 and ICD-11 Chapter 14Chapter 14 has undergone major restructuring, with the addition of more detailed entities. For example, skin disorders attributable to infection or infestation has subsections of codes for skin disorders caused viral, bacterial, fungal, parasitic and ectoparasitic infections.The terminology has been updated for currency.ICD-11 equivalent structureICD-10 block headingEA00-EA6Y Certain skin disorders attributable to infection or infestationL00-L08 Infections of the skin and subcutaneous tissueEB40-EB4Y Immunobullous diseases of the skinL10-L14 Bullous disordersEA80-EA8Z Dermatitis and eczemaL20-L30 Dermatitis and eczemaEA90-EA95 Papulosquamous dermatosesL40-L45 Papulosquamous disordersEB00-EB0Y Urticaria, angioedema and other urticarial disorders L50-L54 Urticaria and erythemaEJ20-EJ9Y Dermatoses provoked by light or UV radiationEK00-EK0Z Dermatitis due to exogenous factorsL55-L59 Radiation-related disorders of the skin and subcutaneous tissueED50-EE21 Disorders of the epidermis and epidermal appendagesL60-L75 Disorders of skin appendagesL80 Vitiligo moved to ED63 Acquired hypomelanotic disordersL81 Other disorders of pigmentation moved to ED61 Acquired melanotic macules or lentiginesL82 Seborrhoeic keratosis moved to 2F21 Benign keratinocytic acanthomasL83 Acanthosis nigricans moved to ED51 Diffuse epidermal hyperkeratosis and acanthosis L84 Corns and callosities moved to EH92.0 Corns or callositiesL85 Other epidermal thickening moved to ED50 IchthyosesL87 Transepidermal elimination disorders moved to EC20 Genetic disorders of keratinisationL88 Pyoderma gangrenosum moved to EB21 Pyoderma gangrenosumL89 Decubitus ulcer and pressure area moved to EH90 Pressure ulcerationL90 Atrophic disorders of skin moved to EE7Y Other specified disorders of cutaneous connective tissueL91 Hypertrophic disorders of skin moved to EE60 Keloid or hypertrophic scarsL92 Granulomatous disorders of skin and subcutaneous tissue moved to EE80 Necrobiotic granulomatous skin disordersL93 Lupus erythematosus moved to EB51 Chronic cutaneous lupus erythematosusL94 Other localized connective tissue disorders moved to EB61 MorphoeaL95 Vasculitis limited to skin, not elsewhere classified moved to EF50 Livedoid vasculopathyL97 Ulcer of lower limb, not elsewhere classified moved to ME60 Skin lesion of uncertain or unspecified natureL98 Other disorders of skin and subcutaneous tissue, not elsewhere classifiedL80-L99 Other disorders of the skin and subcutaneous tissueChapter 15 – Diseases of the musculoskeletal system and connective tissueRationale/Differences between ICD-10 Chapter XIII and ICD-11 Chapter 15The blocks in this chapter have been reordered, and a new block for Autoinflammatory disorderssyndromes has been added to Chapter 04 Disorders of the immune system and secondarily parented Chapter 15. Spinal conditions have been restructured and renamed Conditions associated with the spine.Revisions have been made to the code hierarchy and content model attributes for:rheumatoid arthritisvasculitis spondyloarthritisThe category for ‘systemic connective tissue disorders’ has been amended to ‘non-organ specific systemic autoimmune disorders’. The category for ‘Dermatopolymyositis’ has been amended to ‘Idiopathic inflammatory myopathies’ with a change of axes and further granularity. ICD-11 equivalent structureICD-10 block headingFA00-FA1Z ArthopathiesM00-M03 Infectious arthropathiesFA20-FA5Z Inflammatory arthropathiesM05-M14 Inflammatory polyarthropathiesFA00-FA1Z ArthopathiesM15-M19 ArthosisFA30.0-FA30.Z Certain specified joint disorders or deformities of limbsFB80-FB8Z Osteopathies or chondropathiesM20-M25 Other joint disordersFC00 Certain specified acquired deformities of musculoskeletal system or connective tissue, not elsewhere classifiedM30-M36 Systemic connective tissue disordersFA70-FA7Z Conditions associated with the spineM40-M43 Deforming dorsopathiesFB00-FB1Z SpondylopathiesM45-M49 SpondylopathiesFA80-FA8Z Degenerative condition of spineFB00-FB1Z SpondylopathiesME84 Spinal painM50-M54 Other dorsopathiesFB30-FB3Z Disorders of musclesM60-M63 Disorders of musclesFB40-FB4Z Disorders of synovium or tendonM65-M68 Disorders of synovium and tendonFB50-FB6Z Miscellaneous specified soft tissue disordersM70-M79 Other soft tissue disordersFB80-FB8Z Osteopathies or chondropathiesM80-M85 Disorders of bone density and structureFB80-FB8Z Osteopathies or chondropathiesM86-M90 Other osteopathiesFB80-FB8Z Osteopathies or chondropathiesM91-M94 ChondropathiesME90-MF1Y Clinical findings in the musculoskeletal systemM95-M99 Other disorders of the musculoskeletal system and connective tissueChapter 16 Diseases of the genitourinary systemRationale/Differences between ICD-10 Chapter XXIV and ICD-11 MMS Chapter 16Chapter 16 has been reordered to distinguish diseases of the female genital system, the male genital system, breast disorders and the urinary system. The changes to Chapter 16 are aimed at increasing the clinical utility of the classification by providing a more user-friendly hierarchical structure, increased international comparability and standardisation of genitourinary conditions.There is more specificity within the section on the female genital system reflecting current scientific understanding. Additional detail has been included for the following areas:AmenorrhoeaOvarian dysfunctionFemale pelvic painEndometriosisAdenomyosisFemale infertilityMale infertilityRecurrent pregnancy lossThe female genital system hierarchy is now divided into non-inflammatory disorders and inflammatory disorders, which are further divided by anatomical groupings. These groupings are in order followed by gynaecological and obstetric examinations (ie. from external to internal genitalia). These groupings have further subdivisions for congenital and acquired abnormalities, as appropriate.All diseases relating to the kidney are now classified under the main category for ‘Diseases of the urinary system’.A block has been added for cystic and dysplastic kidney disease, with relevant entities grouped together.The classification of glomerular diseases has been restructured and is now divided into clinical features or syndromes.The kidney failure section of the classification has been revised to incorporate the current evidence-based definitions and staging classification of acute kidney failure and chronic kidney disease as proposed by Kidney Disease Improving Global Outcomes (KDIGO). These concepts have been precoordinated:Postcoordination of concepts allows more detail to be added about associated or causing conditions, specific anatomy, laterality or infectious agent. Extension codes can be used to postcoordinate the concept Vulvitis to create a code string which includes specific anatomy and infectious agent.3863975235122400ICD-11 equivalent structureICD-10 block headingGB40-GC2Z Diseases of the urinary systemN00-N08 Glomerular diseaseGB40-GC2Z Diseases of the urinary systemN10-N16 Renal tubule-interstitial diseasesGB40-GC2Z Diseases of the urinary systemN17-N19 Renal failureGB40-GC2Z Diseases of the urinary systemN20-N23 UrolithiasisGB40-GC2Z Diseases of the urinary systemN25-N29 Other disorders of kidney and ureterGB40-GC2Z Diseases of the urinary systemN30-N39 Other diseases of urinary systemGA80-GB0Z Diseases of male genital systemN40-N51 Diseases of male genital organsGB20-GB2Z Disorders of breastN60-N64 Disorders of breastGA00-GA0Z Inflammatory disorders of the female genital tractN70-N77 Inflammatory diseases of female pelvic organsGA10-GA6Z Noninflammatory diseases of the female genital tractN80-N98 Noninflammatory disorders of female genital tractGC40-GC8Z Other conditions of the genitourinary systemN99 Other disorders of the genitourinary systemChapter 17 Conditions related to sexual healthRationale/Differences between ICD-10 and ICD-11 in Chapter 17Chapter 17 is a new addition to ICD-11 and was not found in past editions.The chapter has been formulated to group sexually related conditions. This also allows categorisation of gender identity related conditions without stigmatisation, while maintaining recognition of these entities as real conditions so that related heath interventions can be accommodated within the health system.ICD-11 equivalent structureICD-10 block headingSexualDysfunctionsHA00 Hypoactive sexual desire dysfunctionHA01 Sexual arousal dysfunctions HA02 Orgasmic dysfunctions HA03 Ejaculatory dysfunctionsGC42 Sexual dysfunction associated with pelvic organ prolapse HA0Y Other specified sexual dysfunctions HA0Z Sexual dysfunctions, unspecified Codes from Mental Health category F52 Sexual dysfunction, not caused by organic disorder or diseaseSexual painDisordersHA20 Sexual pain-penetration disorder GA12 Dyspareunia HA2Y Other specified sexual pain disorders HA2Z Sexual pain disorders, unspecified Codes from Mental Health category F52 Sexual dysfunction, not caused by organic disorder or disease and Genitourinary category N94 Pain and other conditions associated with female genital organs and menstrual cycleGender incongruence6E8Y Other specified mental, behavioural or neurodevelopmental disorders 6E8Z Mental, behavioural or neurodevelopmental disorders, unspecified Codes from Mental Health category F64 Gender identity disordersPostcoordination using extension codes allows more detail to be added about associated aetiology or causing conditions.Chapter 18 Pregnancy, childbirth and the puerperiumRationale/Differences between ICD-10 Chapter 15 and ICD-11 MMS Chapter 18The changes to this chapter are intended to increase clinical utility of the classification by providing:a more user-friendly hierarchical structureincreased international comparability and standardisation of conditions related to pregnancy, childbirth and the puerperiumThere have been some changes and additions made to the sections for maternal care related to the foetus and amniotic cavity and possible delivery problems, and complications of labour and deliveryA new section for obstetric haemorrhage has been added to enable all types of haemorrhage to be grouped together.It is now possible (using a code from Chapter X Extension codes) to code conditions in the foetus and newborn that affect the mother (outside of those already within this chapter). A code for a neonatal condition can be reported in the context of the mother using XX2QG9 Condition of the foetus and newborn reported in the context of the mother.The changes reflect the current understanding for certain conditions related to pregnancy, childbirth and the puerperium.Additional specifications have been included for early pregnancy loss and pregnancy outcomes.Extension codes to specify duration of pregnancy can be used, if desired, for cases of:Abortive outcome of pregnancyThreatened abortionFetal death in uteroPremature rupture of membranes (before 37 completed weeks of gestation)False labour before 37 completed weeks of gestation (threatened premature labour)Preterm labour (early conset labour).ICD-11 equivalent structureICD-10 block headingJA00-JA0Z Abortive outcome of pregnancyO00-O08 Pregnancy with abortive outcomeJA20-JA2Z Oedema, proteinuria, or hypertensive disorders in pregnancy, childbirth, or the puerperium O10-O16 Oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperiumJA60-JA6Z Certain specified maternal disorders predominantly related to pregnancy O20-O29 Other maternal disorders predominantly related to pregnancyJA80-JA8Z Maternal care related to the foetus, amniotic cavity or possible delivery problemsO30-O48 Maternal care related the fetus and amniotic cavity and possible delivery problemsJA40-JA4Z Obstetric haemorrhage JB00-JB0Z Complications of labour or delivery O60-O75 Complications of labour and deliveryJB20-JB2Z DeliveryO80-O84 DeliveryJB40-JB4Z Complications predominantly related to the puerperium O85-O92 Complications predominantly related to the puerperiumJB60-JB6Z Certain obstetric conditions, not elsewhere classified O94-O99 Other obstetric conditions, not elsewhere classifiedNewly created: 2C75.0-JA02 Gestational trophoblastic diseasesQA20-QA4Z Contact with health services for reasons associated with reproduction moved from Chapter 21 Factors influencing health status and contact with health servicesChapter 19 Certain conditions originating in the perinatal periodRationale/Differences between ICD-10 and ICD-11 MMS in Chapter 19There has been some movement in code positions within this chapter for ICD-11 MMS, but it remains similar to that of ICD–10.There is a new category for Neurological disorders specific to the perinatal or neonatalperiod and an expansion of codes for the birthweight and gestational age of a newborn.Respiratory and cardiovascular disorders specific to the perinatal period have been split into two groups: Respiratory disorders specific to the perinatal or neonatal period and Cardiovascular disorders present in the perinatal or neonatal period.Conditions involving the integument and temperature regulation of foetus and newborn have also been split into two groups: Disorders involving the integument of foetus or newborn and Disturbances of temperature regulation of newborn.ICD-11 equivalent structureICD-10 block headingKA00-KA0Z Foetus or newborn affected by maternal factors or by complications of pregnancy, labour or delivery P00-P04 Fetus and newborn affected by material factors and by complications of pregnancy, labour and deliveryKA20-KA2Z Disorders of newborn related to length of gestation or foetal growth P05-P08 Disorders related to length of gestation and fetal growthKA40-KA4Z Birth injury P10-P15 Birth traumaKB20-KB2Z Respiratory disorders specific to the perinatal or neonatal period KB40-KB4Z Cardiovascular disorders present in the perinatal or neonatal period P20-P29 Respiratory and cardiovascular disorders specific to the perinatal periodKA60-KA6Z Infections of the foetus or newborn P35-P39 Infections specific to the perinatal periodKA80-KA8Z Haemorrhagic or haematological disorders of foetus or newborn P50-P61 Haemorrhagic and haematological disorders of fetus and newbornKB60-KB6Z Transitory endocrine or metabolic disorders specific to foetus or newborn P70-P74 Transitory endocrine and metabolic disorders specific to fetus and newbormKB80-KB8Z Digestive system disorders of foetus or newborn P75-P78 Digestive system disorders of fetus and newbornKC00-KC0Z Genitourinary system disorders specific to the perinatal or neonatal period KD10-KD1Z Disturbances of temperature regulation of newborn P80-P83 Conditions involving the integument and temperature regulation of fetus and newbornKB00-KB0Z Neurological disorders specific to the perinatal or neonatal period P90-P96 Other disorders originating in the perinatal periodKC20-KC9Z Disorders involving the integument of foetus or newborn moved from Chapter 15 Pregnancy, childbirth and the puerperiumNewly created: KD5Z Certain disorders originating in the perinatal period Chapter 20 Developmental anomaliesRationale/Differences between ICD-10 and ICD-11 in Chapter 20This chapter has undergone major restructuring including a title change from Congenital malformations, deformations and chromosomal abnormalities to Developmental anomalies, including malformations, genetic syndromes (with or without malformations) and chromosomal anomalies. All genetic syndromes without structural developmental anomalies have been re-located to appropriate chapters in the ICD, according to the affected body system(s).The ‘Structural developmental anomalies/malformations’ section includes isolated conditions affecting only one body system.The ‘Multiple developmental anomalies and syndromes’ section includes conditions affecting several locations within one body system, or several body systems simultaneously.The ‘Chromosomal anomalies and genetic defects’ section classifies developmental anomalies defined genetically or cytogenetically, since there is no clear-cut distinction between genetics and cytogenetics.The section on congenital anomaly of heart and great vessels and related acquired abnormalities has been revised.ICD-11 equivalent structureICD-10 block headingLA00-LA0Z Structural development anomalies of the nervous systemQ00-Q07 Congenital malformations of the nervous systemLA10-LA1Z Structural development anomalies of the eye, eyelid or lacrimal apparatusLA20-LA2Z Structural development anomalies of the earLA30-LA31 Structural development anomalies of the face, mouth or teethLA60-LA6Z Structural development anomalies of the neckQ10-Q18 Congenital malformations of eye, ear, face and neckLA80-LA8Z Structural development anomaly of heart or great vesselsLA9Y-LA9Z Structural development anomalies of the peripheral vascular systemQ20-Q28 Congenital malformations of the circulatory systemLA70-LA7Z Structural development anomalies of the respiratory systemQ30-Q34 Congenital malformations of the respiratory systemLA50-LA5Z Clefts of lip, alveolus or palateQ35-Q37 Cleft lip and cleft palateLB10-LB1Z Structural developmental anomalies of the digestive tract Q38-Q45 Other congenital malformations of the digestive systemLB40-LB4Z Structural developmental anomalies of the female genital systemLB50-LB5Z Structural developmental anomalies of the male genital systemQ50-Q56 Congenital malformations of the genital organsLB30-LB3Z Structural developmental anomalies of the urinary systemQ60-Q64 Congenital malformations of the urinary systemLB70-LB7Z Structural developmental anomalies of the skeletonQ65-Q79 Congenital malformations and deformations of the musculoskeletal systemLD20-LD2Z Multiple developmental anomalies or syndromesQ80-Q89 Other congenital malformationsLD40-LD7Z Chromosomal anomalies, excluding gene mutations LD90 Conditions with disorders of intellectual development as a relevant clinical featureQ90-Q99 Chromosomal abnormalities, not elsewhere classifiedNewly created: LB00-LB0Z Structural developmental anomalies of the diaphragm, abdominal wall or umbilical cordNewly created: LB20-LB2Z Structural developmental anomalies of the liver, biliary tract, pancreas or spleenNewly created: LB60-LB6Z Structural developmental anomalies of the breastNewly created: LC00-LC7Z Structural developmental anomalies of the skinNewly created: LD0Y-LD0Z Structural developmental anomalies of the adrenal glandsChapter 21 Symptoms, signs or clinical findings, not elsewhere classifiedRationale/Differences between ICD-10 Chapter 18 and ICD-11 Chapter 21Both follow the main organisation by anatomy, and the anatomical groupings have a secondary parent to the relevant organ chapter.The clinical finding of microorganisms that are resistant to antimicrobial drugs is located in Chapter 21 rather than in the chapter for Codes for special purposes as per ICD-10. Note: Antimicrobial resistance is ‘allowed’ with codes for infection. This information is not mandatory as it is not available everywhere.Table: Comparison of ICD-10 block structure with ICD-11 equivalent structureICD-11 equivalent structureICD-10 block headingSplit into two groupings:. Symptoms, signs or clinical findings of the circulatory system;. Symptoms, signs or clinical findings of the respiratory systemR00-R09 Symptoms and signs involving the circulatory andrespiratory systemsSymptoms, signs or clinical findings of the digestive system or abdomenR10-R19 Symptoms and signs involving the digestive systemand abdomenSplit into two groupings: . Symptoms, signs or clinical findings of the nervous system;. Symptoms, signs or clinical findings of the musculoskeletal systemR20-R23 Symptoms and signs involving the skin andsubcutaneous tissueSymptoms, signs or clinical findings of the genitourinary system - part of the grouping Symptoms, signs or clinical findings of the genitourinary systemR30-R39 Symptoms and signs involving the urinary systemReorganised into various subsections under Mental or behavioural symptoms, signs or clinical findingsR40-R46 Symptoms and signs involving cognition,perception, emotional state and behaviourSymptoms, signs or clinical findings of speech or voiceR47-R49 Symptoms and signs involving speech and voiceGeneral symptoms, signs or clinical findingsR50-R69 General symptoms and signsIncluded in the grouping Symptoms, signs or clinical findings of blood, blood-forming organs or the immune systemR70-R79 Abnormal findings on examination of blood,without diagnosisClinical findings on examination of urine, without diagnosis under the grouping Symptoms, signs or clinical findings involving the urinary system and tissues, without diagnosis R80-R82 Abnormal findings on examination of urine,without diagnosisClinical findings in specimens from other specified organs, systems and tissues under the grouping General symptoms, signs or clinical findingsR83-R89 Abnormal findings on examination of other bodyfluids, substancesSplit into two subsections:. Abnormal diagnostic imaging results not elsewhere classified;. Abnormal results of function studies of other organs and systems in the grouping Abnormal results not elsewhere classifiedR90-R94 Abnormal findings on diagnostic imaging and infunction studies, without diagnosisIll-defined and unknown causes of mortalityR95-R99 Ill-defined and unknown causes of mortalityChapter 22 Injury, poisoning or certain other consequences or external causesRationale/Differences between ICD-10 Chapter 19 and ICD-11 Chapter 22The principles of the revision were:? Maintain good back-compatibility with ICD–10, particularly by minimising change at the former three-character level. Change at the former four-character level is more extensive but has also been done with this principle in mind.? Take account of the extensions to this chapter in clinical modifications of ICD–10 because:– They are evidence of extensions required to serve clinical purposes in identified situations.– It is preferable to minimise incompatibilities with these classifications.? Take account of classifications other than ICD that are in wide clinical use for conditions in scope for this chapter.? Take account of advice, solicited and proffered.– Increased attention to distinctions pertinent to treatment choices and to outcomes, including disability.These include allowing identification of clinically and prognostically important aspects of fractures (notably whether they extend into a joint) and organ/vessel injuries (degree).Some conditions are much more important when bilateral, and in such instances side has been proposed as precoordinated entities (e.g. injury of the eyes). Increased attention has been given to injury conditions specific to childhood (e.g. greenstick and epiphyseal fractures) and to injury conditions that are indicative of possible intentional injury (e.g. posterior rib fractures, ‘bucket-handle’ and ‘corner’ fractures).The high-level categories have only a few changes. Changes are mainly at the lower character level and include additions of more specific categories of injury types and body location of the injury. There are no longer separate codes for burns and for corrosions. They are all together under Burns. Additional dimensions are available from Chapter X Extension codes, for postcoordination to add further detail such as laterality, or depth of burn. Major changes have been made to the section for complications of medical and surgical care. The Quality and Safety TAG has revised the coding of health care related injuries and events. The concept of a mechanical complication of a device is now classified as an external cause of harm.Table: Comparison of ICD-10 block structure with ICD-11 equivalent structureICD-11 equivalent structureICD-10 block headingInjuries to the headS00-A09 Injuries to the headInjuries to the neckS10-S19 Injuries to the neckInjuries to the thoraxS20-S29 Injuries to the thoraxInjuries to the abdomen, lower back, lumbar spine or pelvisS30-S39 Injuries to the abdomen, lower back, lumbar spine and pelvisInjuries to the shoulder or upper armS40-S49 Injuries to the shoulder and upper armInjuries to the elbow or forearmS50-S59 Injuries to the elbow and forearmInjuries to the wrist or handS60-S69 Injuries to the wrist and handInjuries to the hip or thighS70-S79 Injuries to the hip and thighInjuries to the knee or lower legS80-S89 injuries to the knee and lower legInjuries to the ankle or footS90-S99 Injuries to the ankle and footInjuries involving multiple body regionsT00-T07 Injuries involving multiple body regionsInjuries to unspecified part of trunk, limb or body regionT08-T14 Injuries to unspecified part of trunk, limb or body regionEffects of foreign body entering through natural orificeT15-T19 Effects of foreign body entering through natural orificeBurnsT20-T32 Burns and corrosionsFrostbiteT33-T35 FrostbitePart of the grouping:. Harmful effects of substances T36-T50 Poisoning by drugs medicaments and biological substancesPart of the grouping:. Harmful effects of substances T51-T65 Toxic effects of substances chiefly nonmedicinal as to sourceOther or unspecified effects of external causesT66-T78 Other and unspecified effects of external causesOther or unspecified effects of external causesT79 Certain early complications of traumaInjury or harm arising from surgical or medical care, not elsewhere classifiedT80-T88 Complications of surgical and medical care, not elsewhere classifiedRedistributed to the specific body grouping as index terms. Sequelae will now be indicated by a cluster identifying the condition that is the sequelae, a code from Chapter 24 QC50 and the original injury.T90-T98 Sequelae of injuries, poisoning and of other consequences of external causesChapter 23 External causes of morbidity or mortalityRationale/Differences between ICD-10 Chapter 20 and ICD-11 Chapter 23The main aim of the changes was to provide a more uniform coding structure while still maintaining high compatibility with ICD–10. The changes to the traffic accident categories are aimed at simplifying code selection, while the section on Operations of war and armed conflicts has been revised to capture the more current situations of armed conflicts.Changes from ICD-10 to ICD-11 include, but not limited to:? More uniform code structure? Revised ‘intent’ dimension? Retain transport codes, but expand vehicle types? Expansion of place of occurrence codes? Expansion and revision of activity dimension? Revision of complications of medical and surgical care? Expansion of legal/war codes? Improved provision for maltreatment syndromes? Introduction of additional dimensions (optional)? Revision of external cause index, rules and guidelines? Provision for mortality, morbidity, lower resource settings, researchTransportFour dimensions are implicit in the ICD–10 range V01-V89: injured person’s mode of transport (e.g. motorcycle), whether the injurious event occurred in road traffic (if so, the resulting injury is a road injury), the injured person’s role (e.g. passenger), and what other type of vehicle was involved, if any (counterpart). All four dimensions are required for a revised structure that is conceptually equivalent to the ICD–10 ‘transport accidents’ module at four- character level. All four dimensions have been precoordinated in the unintentional transport injury module. This produces a structure with high back-compatibility with ICD–10 V– at four character level. Note that the coordination order has been altered from the equivalent in ICD–10, from: mode, counterpart, then user role and traffic status combined to: mode, traffic status, user role, andcounterpart.The main reason for this change was to simplify the selection of ‘traffic accident’ categories, which are frequently required when reporting road injury.War and armed conflictThe classification largely follows the expansion of Y36 in the United States’ clinical modification of ICD–10 (ICD–10-CM). This follows the 4-character categories in ICD–10 and provides subdivisions, which follow inclusion notes given in ICD–10. In addition, subcategories are provided to distinguish whether the injured person was military or civilian.Toxic effects of substancesAnother enhancement has been to produce a single, hierarchical list of noxious substances to serve the injury and external causes chapters. This list has been drawn from appropriate external systems (e.g. SNOMED-CT) for reference information.The benefits of this are: external source(s) can define-by-example the inclusions of the ICD–11 list; and if the external source(s) are actively updated, then this provides a way for the ICD–11 coverage of substances to remain current.The term ‘harmful effects’ is used for all types of harm resulting from harmful chemical effects of substances of all types. It is recognised that other terms, such as ‘toxic effect’, ‘poisoning’, ‘chemical corrosion’ and ‘envenomation’ are sometimes used in the context of particular substances. These terms will be included as synonyms and subordinate terms where in common use. Complications of care (Quality and Safety)The model has three parts, each of which must be coded. The postcoordinated codes for all the parts must be designated as belonging to a cluster. The three concepts are:1. The resultant injury or harm – code selected from anywhere in ICD-11;2. The cause of harm – code selected from the relevant block in Chapter 23 External causes of morbidity or mortality; and3. The ‘mode/mechanism’ of harm – sanctioning rules lead coders to the subset of ‘mode’ codes that are relevant, given the selected ‘cause’ (e.g. if ‘Cause’ is a drug, then the relevant ‘Modes’ are categories such as overdose and underdose).The primary axis for all external causes except exposure to extreme forces of nature, maltreatment, legal intervention, armed conflict and health care related harm or injury is now based on ‘intent’. The codes are a combination of intent, followed by mechanism and object or substance involved in occurrence of injury. There has been an expansion in the areas of vehicle types, places of occurrence, types of activities, legal/war codes, and substances. The areas of complications of medical and surgical care and maltreatment syndromes have been revised and improved. Additional dimensions are available from Chapter X Extension codes, for use in postcoordination.Table: Comparison of ICD-10 block structure with ICD-11 equivalent structureICD-11 equivalent structureICD-10 block headingRedistributed to the main groupings of:. Unintentional cause . Intentional self-harm . Assault. Unknown intent V01-X59 AccidentsIntentional self-harmX60-X84 Intentional self-harmAssaultX85-Y09 AssaultUndetermined intentY10-Y34 Event of undetermined intentSplit into two subsections:. Legal interventions. Armed conflictY35-Y36 Legal intervention and operations of warCauses of health care related harm or injuryY40-Y84 Complications of medical and surgical careRedistributed to the specific external cause grouping as index terms. Sequelae will now be indicated by a cluster identifying the condition that is the sequelae, a code from Chapter 24 QC50 and the original external cause codeY85-Y89 Sequelae of external causes of morbidity and mortalityEntities from this block are now found in either Chapter 21 Symptoms, signs and clinical findings (eg blood alcohol level findings) or have been added to Section X Extension codes (eg nosocomial condition)Y90-Y98 Supplementary factors related to causes of morbidity and mortality classified elsewhereChapter 24 Factors influencing health status or contact with health servicesRationale/Differences between ICD-10 Chapter 21 and ICD-11 Chapter 24ICD-10 Chapter 21 was reviewed, and a revised hierarchical structure was created for the remaining essential content. The content of ICD-11 Chapter 24 is both clinically relevant and use-friendly, as well as allowing necessary space for expansion using the extension codes (i.e. from Chapter X). Chapter 24 includes major ‘types’ of codes (i.e. ‘diagnostic’, ‘interventional’, ‘contextual factors’ and ‘other’).The chapter review also removed unnecessary granularity in the new structureThere has been an expansion of the section relating to reproduction, with the addition of a new section Contact with health services for procreative management.There is also a new section for health care related adverse events that occur but do not result in any harm to the patient.Table: Comparison of ICD-10 block structure with ICD-11 equivalent structureICD-11 equivalent structureICD-10 block headingContact with health systems for purposes of examination or investigation – a section under the grouping Reasons for contact with the health systemZ00-Z13 Persons encountering health services for examination and investigationContact with or exposure to communicablediseases – a section under the grouping Reasons for contact with the health systemZ20-Z29 Persons with potential health hazards related to communicable diseasesContact with health services for reasons associated with reproduction diseases – a section under the grouping Reasons for contact with the health systemZ30-Z39 Persons encountering health services in circumstancesrelated to reproductionSplit into two new sections, under Reasons for contact with the health system: . Contact with health services for specific surgical interventions;. Contact with health services for nonsurgical interventions not involving devicesZ40-Z54 Persons encountering health services for specificprocedures and health careReorganised and now appears under main groupingof Factors influencing health statusZ55-Z65 Persons with potential health hazards related to socioeconomic and psychosocial circumstancesReorganised and now appears under main groupingof Factors influencing health statusZ70-Z76 Persons encountering health services in othercircumstancesReorganised and now appears under main groupingof Factors influencing health statusZ80-Z99 Persons with potential health hazards related to familyand personal history and certain conditions influencing health status ................
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