ICD-11 – International Classification of Diseases
For a long time, doctors in different countries and even within the same country called the same diseases by different terms. The solution to the problem was the creation of the ICD – International Classification of Diseases. In essence, the ICD is a list of diagnoses and their code designations.

The ICD is accepted and updated by WHO – World Health Organization. The first version of the ICD appeared in the 1940s. Then several versions of the classifier came out, and the penultimate one – ICD-10 – was approved in 1990. This classifier is currently used in WHO member countries.

Physicians in medical institutions and private practitioners are guided by the ICD when they make a diagnosis and enter patient data into medical records.

What is ICD-11

The ICD-11 is the most modern classifier of diseases and health-related problems to date. The WHO adopted the ICD-11 in 2019 during the 72nd Assembly.

The information structure of ICD-11 consists of three parts:

  • database or Foundation;
  • classifications obtained on the basis of the Fund;
  • general biomedical ontology associated with the Foundation.

The Foundation has collected about 80 articles, which are supplemented by 000 synonyms. Each synonym characterizes a disease, syndrome, or health-related event in a way that can be taken into account by digital systems. In other words, the Foundation is a semantic network.

When will ICD-11 be adopted in Russia?

It was assumed that Russia would start using the ICD-11 from January 1, 2022. However, practice shows that it takes much more time to switch to a new classifier. For example, ICD-10 in our country began to be applied in 1999, only 9 years after its development. For comparison: in the USA, the ICD-10 began to be used only in 2015, and before that they were guided by the ICD-9 codes and their own classification, which was valid within the country.

In 2021, the Russian government issued a plan for the transition to ICD-11. The process has already started and is estimated to take 3 years.

During the transition you will need:

  • translate the classifier into Russian;
  • agree on terminology;
  • make changes to the documentation;
  • train physicians and statisticians to work with ICD-11.

Given all this, we can hope that full-fledged work with the ICD-11 will begin in 2025. During the transition period, two classifiers will be used simultaneously – ICD-10 and ICD-11.

Comparison of ICD-10 and ICD-11

The main difference between ICD-11 and ICD-10 is the emergence of new diagnoses and groups of diseases. Some changes are listed in the table

ICD-10ICD-11
Did not haveNew diagnoses have emerged, including hording (hoarding), prolonged grief (loss), attention deficit hyperactivity disorder, gaming disorder (addiction to computer games) and body dysmorphic disorder (obsessive experience of one’s physical imperfection)
“Diseases of the blood, hematopoietic organs and certain disorders involving the immune mechanism”From this section, the group “Diseases of the immune system” was singled out.
“Mental and behavioral disorders”, “Diseases of the nervous system”All types of insomnia and drowsiness from these sections were identified in a separate group “Disorders of sleep and wakefulness”
Did not have“Conditions related to sexual health”

Also, for the first time, ICD-11 introduced codes for the causes of diseases, for example, the XT9T code, which means “associated with age”. Thus, WHO emphasizes that biological aging is a process that requires prevention and treatment. Therefore, doctors should not only treat “age-related” diseases – hypertension, dementia, sarcopenia – but also timely diagnose accelerated pathological aging and engage in its prevention.

Mental disorders in the ICD-11

In ICD-11, several changes were made to the section on mental disorders. “Mental and behavioral disorders” in the ICD-10 is chapter 5, which includes 11 sections1. In the ICD-11, this chapter became 6 in a row and was called “Mental, behavioral or developmental disorders of the nervous system”1. Some sections of the ICD-10 have been renamed, others have been merged, others have been deleted, including “Emotional and behavioral disorders with onset specific to childhood and adolescence.” Instead, several new sections were added to the ICD-11, now their total number is 211.

The sequence of sections has also changed, and the descriptions of all disorders have included features of their manifestation at different ages. Added new diagnoses, which are mentioned in the table. It became possible to put a person with several diagnoses.

Some terms were also corrected, for example, “mental retardation” was replaced with “intellectual developmental disorder”3. This is a more neutral and yet informative term. And the diagnosis of “Autism Spectrum Disorder” or ASD after the adoption of the ICD-11 in Russia for the first time will become official3.

Detection of microorganisms resistant to antimicrobial agents

This section includes about 100 categories of infectious agents resistant to antimicrobials. The need for this arose due to the emergence of a large number of pathogenic microorganisms that are resistant to antibiotics. In addition, people who have contracted a super-resistant infection need to be treated differently.

Conditions related to sexual health

This is the title of a new chapter that was not in ICD-102. Transsexualism and hermaphroditism were transferred into it, which are now considered conditions, and not disorders or disorders, as it was before.2. In addition, in ICD-11, transsexualism began to be defined as “gender mismatch”, while in ICD-10 there was a different wording – “the desire to live and be perceived by others as a person of the opposite sex”2.

Popular questions and answers

The most popular questions about the international classifier of diseases are answered Candidate of Medical Sciences, psychotherapist Ivan Martynikhin и doctor of medical sciences Tatyana Brodovskaya.

What is the MKB for?

– The ICD is very important for statistics and the organization of medical care at the state level. Thanks to the classifier, the government understands how many people have a particular disease. This allows you to calculate how much money you need to spend on training doctors, buying medicines and medical equipment.

How many diseases are in the ICD?

– The number of diseases in the ICD-11 is very difficult to count, since the count depends on the level of detail (the number of nested levels), as well as various combinations of individual codes. For convenience, ICD-11 was released in electronic form, but even after that it is impossible to calculate the exact number of diseases. We can only say with certainty that with each revision of the classifier there are more and more of them – this reflects the level of development of medicine.

How often is the ICD updated?

– In the 70-80s, this happened quite often, however, the creation of the ICD-11 took a record amount of time – 29 years, if we count from 1990, when the ICD-10 was adopted. This happened for several reasons. Firstly, doctors from different countries could not agree on common diagnostic criteria for a long time, which they decided to include in the new classifier.

Secondly, in many states the healthcare structure is very complex, and any changes become painful for it. This is a big problem that the WHO is trying to solve. The electronic version is designed to simplify work with the ICD-11. You can quickly make the necessary additions and amendments to it, for example, to include a diagnosis of COVID-19.

Sources of:

  1. Innovations of the ICD-11: stages of revision and implications for clinical practice. M. A. Kulygina, candidate of psychological sciences. 2018 year. https://disk.yandex.ru/i/3hoOoIvuJdomvw
  2. In Russia, the transition to the new International System of Classification of Diseases has begun. https://journal.tinkoff.ru/news/icd-11/
  3. 11 questions about ICD-11. Ivan Martynikhin answers https://antontut.ru/news/11-voprosov-pro-mkb-11/

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