ICD-11

By Dr. M. Santosh Kumar Guptha · Founder & CEO, MEDESUN Medical Coding Academy – ICD-11 Implementation Ask most coding professionals what a classification system is for, and the honest answer in the United States today is “reimbursement.” But the International Classification of Diseases was built to do far more — to describe disease accurately enough that clinicians, researchers, and health systems could learn from it. Nowhere is the gap between those two purposes clearer than in how we code a condition that touches roughly 25 million Americans: asthma. Asthma is also the single best illustration of what ICD-11 changes — and why U.S. healthcare should begin preparing now, even though full adoption remains years away. The big flip: from severity to phenotype In ICD-10-CM, asthma (the J45 family) is organized first and foremost by severity and control — mild intermittent, mild persistent, moderate persistent, severe persistent — with a […]

The Cardiac Arrhythmia Edition – ICD-11 Implementation Series ICD-10-CM can tell you that a patient went into cardiac arrest. It cannot tell you the rhythm that stopped their heart. For anyone who has stood in a resuscitation, that sentence should land hard — because the rhythm is the entire story. The moment a heart stops When a hospitalized patient arrests, the first question the team answers is not why — it is what rhythm. A shockable rhythm — ventricular tachycardia or ventricular fibrillation — can often be reversed with defibrillation. A non-shockable rhythm — asystole or pulseless electrical activity — carries a far lower chance of survival and demands an entirely different response. Every code-blue debrief, every survival statistic, every quality review turns on that single distinction. Now look at how ICD-10-CM lets us record it: I46.2 — Cardiac arrest due to underlying cardiac condition I46.8 — Cardiac arrest due […]

Published by MEDESUN Global — Medical Coding Education & Credentialing Every few decades, the language we use to describe disease has to grow up. ICD-10-CM has served US healthcare well, but it was built for a paper-and-database world. ICD-11 was built for a digital, interoperable, AI-assisted one. The clearest way to understand the difference is not to argue it in the abstract — it is to take a single, extremely common diagnosis and code it in both systems. So let’s code heart failure. The core difference: one fixed code vs. a flexible cluster ICD-10-CM is a precoordinated system. Almost everything you want to say about a condition has to be baked into a single fixed code (and where it cannot fit, you add a second, separate code and rely on sequencing rules). The code description carries the detail. ICD-11 introduces postcoordination. Instead of forcing all clinical meaning into one rigid […]