TRANSITION FROM ICD-10 TO ICD-11 IN DIABETES MELLITUS: IMPLICATIONS FOR CLINICAL DOCUMENTATION, COMPLICATION CODING, AND ENDOCRINE CARE

Abstract

Background. Diabetes mellitus is a chronic, multisystem disease, which needs appropriate clinical records and coding to facilitate safe patient management, quality of measurement, payment, and population health observation. The international change in classification of diseases, Tenth Revision (ICD-10) to the Eleventh Revision (ICD-11) is a significant structural and conceptual move in the classification of diseases, specifically diabetes because of its complicated complication archetypes and longitudinal care pathways. The ICD-10 influenced documentation practices not be sufficient to promote the greater granularity and digit-first architecture of ICD-11.

Objective. This paper will seek to put together the available secondary literature on changes in ICD-10 to ICD-11 in diabetes mellitus with respect to its clinical documentation, coding of complications, endocrine workflows, and health informatics systems implications.

Materials and methods. It used narrative secondary research design, which entailed thematic synthesis. The types of literature used include peer-reviewed, international guidance documents and publications of health informatics studies without older than 2018 and 2025, selected by using PubMed, Scopus and IEEE Xplore. Sources that are related to ICD-11 implementation, coding of diabetes, clinical documentation, electronic health records, and data governance were incorporated. The thematic synthetization of findings was aimed at determining repeated implications on practice and informatics.

Results. Five connected themes were found, which include changing documentation needs in diabetes care, endangering the accuracy of complication coding and case-mix integrity, requiring reformed electronic health record templates and clinical decision support, facing difficulties in data governance, reporting, and quality measurement, and workforce preparedness to adopt ICD-11. In all themes, poor documentation specificity was identified as the key risk to effective implementation of ICD-11.

Conclusions. ICD-11 transition has considerable implications in diabetes care beyond the level of the replacement of technical codes. Failure to change documentary practice in a systematic fashion, informatics infrastructure, and training of workforce will likely undermine data quality and clinical insight by ICD-11 adoption. Active synchronization of endocrine record, EHRS, and governance structure is needed in order to achieve the clinical and analytical advantages of ICD-11.