Will ICD-11 Have a Code for ‘Struck by Turtle’?

Subcategory W59.22- (Struck by turtle) is an ICD-10-CM code that’s been in the blog a few times. So when I started playing with the WHO ICD-11 Coding Tool, I had to try “turtle” as a search term. No luck, but I did find PA71 (Unintentionally struck, kicked, or bumped by animal) after I changed my search to “reptile.”

Not finding the turtle-specific code may be because of my novice ICD-11 skills or because, as WHO repeatedly warns, the current beta draft is not final and is updated daily. The final version of ICD-11 is supposed to be out in June 2018. We won’t be using it for reporting then (or probably any time soon), but it’s worth checking into the structure and changes so you’re familiar with ICD-11 and can form your own opinion of it. Here are three areas you may want to review.

1. Get to Know the ICD Universe

One of the goals of the ICD revision is to improve consistency and comparability in spite of use in different countries and settings. So ICD-11 has a “Foundation,” a digital library of ICD entities (like diseases and disorders). As the Help box on the Foundation tab at this ICD-11 site says, the Foundation “represents the whole ICD universe.”

From the Foundation, ICD-11 has four subsets called Linearizations that are like the Tabular List we’re familiar with:

  • Linearization 1 for use in Mortality and Morbidity Statistics (e.g. Cause of Death and Casemix)
  • Linearization 2 for use in Primary Care
  • Linearization 3 for use in Cancer Registration
  • Linearization N for specified Use Cases.

2. Visual Person? Don’t Miss This Option

Take some time to explore the ICD-11 Mortality and Morbidity Statistics site, and you’ll see how those involved are taking advantage of making this a digital code set. (Don’t be afraid to click the ? icons. You’ll need them!) Just under the Search bar, you’ll find the ICD-11 chapters. On the top line, there are buttons for options like visualizations and showing a chapter’s availability in the main linearizations.

If you like to see how codes relate, see what you can do with the visualizations option. It lets you see how parent and child codes connect.

3. Dig Deep (238 Pages Deep!)

If you’re really into ICD-11, the Info tab for that ICD-11 browser has resources to make you an ICD-11 ace, like a User Guide, training videos, and a 238-page Reference Guide.

Tip: In the Reference Guide PDF, search the term “differences” to help you find differences between ICD-10 and ICD-11. (Keep in mind that ICD-10-CM is a clinical modification of ICD-10, not an exact duplicate.) Start on page 22 to find some overarching differences, like categories will have four characters before the decimal instead of the three that ICD-10 categories have. There is also a new term, “cluster coding,” which involves a way of marking codes used together to describe a single condition. The chapter-specific differences start on page 195.

What About You?

What do you think of the possibility of switching to ICD-11 in the future? Do you like the idea of a code set designed keeping electronic health records (EHRs) in mind? And if you find a turtle-specific code, let me know!




Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.


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