The novel and powerful ICD-11 classification system for neoplasm coding: a comparative study with the ICD-O

Abstract

Background The International Classification of Diseases (ICD) and the International Classification of Diseases for Oncology (ICD-O) are both widely used global classification systems. In 2018, the initial release of the ICD-11 was published by the World Health Organization (WHO), integrating the morphology section of the ICD-O. Methods This paper aims to provide potential ICD-11 users with a profound understanding of the neoplasm classifications of the ICD-11 by analysing the differences and relationships between the ICD-11 and ICD-O in terms of the coding framework, compatibility and intelligence level. Results The ICD-11 and ICD-O have remarkable differences in coding structure. Compared to the ICD-O, the ICD-11 has the following advantages: adding histopathology to the stem codes, obtaining a meaningful minimum amount of information through stem codes for statistics, supporting the usage of ICD-O morphology categories and capturing clinical details via extension codes for multiaxial coding. In addition, the rich Foundation Component, linearization derived from the Foundation Component and updating mechanism all support the compatibility of the ICD-11 with other classification systems. Notably, the WHO provides terminology coding with a smart coding tool, and coding in the ICD-11 can draw on statistical codes and uniform resource identifiers (URIs) simultaneously. Conclusions The ICD-11 represents a novel classification system with distinguishing features that include facilitating statistics, multiaxial coding, coding granularity, compatibility and intelligence. These features enable the ICD-11 to be more powerful for neoplasm coding than the ICD-O and basically meet the needs of stakeholders.

Improvements in Neoplasm Classification in the International Classification of Diseases, Eleventh Revision: Systematic Comparative Study With the Chinese Clinical Modification of the International Classification of Diseases, Tenth Revision

“…The ICD-11 is entirely digital, terminology is coded with the coding tool and application programming interface, and it has a semantic knowledge base; these features are beneficial for standardized data collection. In short, the ICD-11 has benefits in terms of obtaining statistics as well as multiaxial coding, coding granularity [4,17,18] and standardization, achieving the integration of terminology and classification. As shown in Table 1, although the ICD-10-CCM codes are expanded and refined at the leaf code level, the capture of clinical details is still weaker compared to the ICD-11 codes.…”

“…The ICD-11 linearizations, including the ICD-11 MMS and the International Classification of Diseases for Oncology (ICD-O), are subsets derived from the Foundation Component. The ICD-11 integrates the morphology section of the ICD-O, ICD-O linearization, and tumor node metastasis classification, and the histopathology codes of the ICD-11 are also compatible with the ICD-O [4]. Additionally, the ICD-11 integrates numerous clinical terminologies from some expanded versions of the WHO ICD-10.…”

“…The most critical changes in the ICD-11 were the establishment of a semantic knowledge base and the reconstruction of the coding system. It introduced the Foundation Component, the Common Ontology, and linearization, as well as the new concepts of precoordination and postcoordination [3][4][5]. The chapter on neoplasms has also changed.…”