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Comparative Study
. 2020 May 1;27(5):738-746.
doi: 10.1093/jamia/ocaa030.

The new International Classification of Diseases 11th edition: a comparative analysis with ICD-10 and ICD-10-CM

Kin Wah Fung  1 , Julia Xu  1 , Olivier Bodenreider  1
Affiliations
Comparative Study

The new International Classification of Diseases 11th edition: a comparative analysis with ICD-10 and ICD-10-CM

Kin Wah Fung et al. J Am Med Inform Assoc. .

Abstract

Objective: To study the newly adopted International Classification of Diseases 11th revision (ICD-11) and compare it to the International Classification of Diseases 10th revision (ICD-10) and International Classification of Diseases 10th revision-Clinical Modification (ICD-10-CM).

Materials and methods: : Data files and maps were downloaded from the World Health Organization (WHO) website and through the application programming interfaces. A round trip method based on the WHO maps was used to identify equivalent codes between ICD-10 and ICD-11, which were validated by limited manual review. ICD-11 terms were mapped to ICD-10-CM through normalized lexical mapping. ICD-10-CM codes in 6 disease areas were also manually recoded in ICD-11.

Results: Excluding the chapters for traditional medicine, functioning assessment, and extension codes for postcoordination, ICD-11 has 14 622 leaf codes (codes that can be used in coding) compared to ICD-10 and ICD-10-CM, which has 10 607 and 71 932 leaf codes, respectively. We identified 4037 pairs of ICD-10 and ICD-11 codes that were equivalent (estimated accuracy of 96%) by our round trip method. Lexical matching between ICD-11 and ICD-10-CM identified 4059 pairs of possibly equivalent codes. Manual recoding showed that 60% of a sample of 388 ICD-10-CM codes could be fully represented in ICD-11 by precoordinated codes or postcoordination.

Conclusion: In ICD-11, there is a moderate increase in the number of codes over ICD-10. With postcoordination, it is possible to fully represent the meaning of a high proportion of ICD-10-CM codes, especially with the addition of a limited number of extension codes.

Keywords: ICD-10; ICD-10-CM; ICD-11; controlled medical vocabularies; medical terminologies.

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Figures

Figure 1.
Figure 1.
Alignment of codes by chapter based on map from ICD-10 to ICD-11 (I to XXII: ICD-10 chapters, Ch1–Ch25: ICD-11 chapters, CDI: chapter drift index, see text for explanation).
Figure 2.
Figure 2.
Overlap between ICD-10 and ICD-11. (*equivalent codes found by round tripping, not all manually validated)
Figure 3.
Figure 3.
Display of cerebrovascular diseases in 2 tree positions in the MMS browser.
See this image and copyright information in PMC

References

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