What is Chapter 13 of ICD-11?
The Chapter 13 group the diseases of the digestive system. In the ICD-10 it corresponded to Chapter XI (K00–K93). ICD-11 restructures it by adopting a hierarchy detailed anatomical, following the rostro-caudal order of the digestive tube.
The general hierarchy is:
- 1st level: Detailed anatomy (esophagus, stomach, small intestine, colon, liver, etc.)
- 2nd level: Specific disease or type of disorder
- 3rd level: Greater clinical specificity
Within each anatomical group, disorders are organized by etiology into the following categories: acquired anatomical or morphological alterations, motor disorders, inflammation (including ulcer), vascular disorders, and non-neoplastic polyps. Structural developmental anomalies are in Chapter 20 and neoplasms in Chapter 02.
- The esophageal varicose veins (formerly I85) and hemorrhoids (formerly I84) were reclassified here from Chap. 11 circulatory
- The ICD-10 block K20–K31 was disaggregated into two separate groups: Diseases of the esophagus and Diseases of the stomach or duodenum
- Gallbladder and pancreas disorders are also they separated (previously together in K80–K87)
- Separate categories are created for functional gastrointestinal disorders (brain-gut axis) and inflammatory bowel diseases
- The section is significantly expanded Liver diseases with new categories: NAFLD, autoimmune, vascular
- It expands the orofacial complex: previously only in K00–K14, now in more detail
- The term "peptic ulcer, unspecified site" should not be used. The site must be specified: esophageal, gastric, duodenal or anastomotic
- The "gastroenteritis" It is classified as gastritis (stomach diseases). The "gastroduodenal ulcer" It is classified as gastric ulcer
Chapter 13 Blocks
Expanded section in ICD-11. It includes diseases of the teeth, gums, periodontium, salivary glands, jaws and oral soft tissues. Equivalent to K00–K14 of the ICD-10 but with much greater detail for use in oral health.
| Code | Diagnosis |
|---|---|
| DA03 | Diseases of tongue |
| DA04 | Diseases of salivary glands |
| DA05 | Cysts of oral or facial-neck region |
| DA06 | Diseases of jaws |
| DA07 | Disorders of tooth development or eruption |
| DA08 | Diseases of hard tissues of teeth |
| DA09 | Diseases of pulp or periapical tissues |
| DA0B | Gingival diseases |
| DA0C | Periodontal disease |
| DA0E | Dentofacial anomalies |
| DA0F.0 | Burning mouth syndrome |
| DA0Z | Diseases or disorders of orofacial complex, unspecified |
In ICD-11, diseases of the esophagus have their own block, separate from those of the stomach (previously K20–K31 in ICD-10). Includes gastroesophageal reflux disease, esophageal varicose veins — reclassified here from Chap. 11 circulatory — and esophagitis.
| Code | Diagnosis |
|---|---|
| DA22 | Gastro-oesophageal reflux disease |
| DA24 | Oesophagitis |
| DA25 | Oesophageal ulcer |
| DA23 | Columnar metaplastic epithelium of the oesophagus |
| DA21 | Motility disorders of oesophagus |
| DA25 | Oesophageal ulcer |
| DA26 | Vascular disorders of the oesophagus |
| DA26.0 | Oesophageal varices |
ICD-11 states that “gastroenteritis” is classified as “gastritis” and “gastroduodenal ulcer” is classified as “gastric ulcer.” The term “peptic ulcer, site unspecified” should not be used in ICD-11 given advances in medical technology — the site should be specified.
| Code | Diagnosis |
|---|---|
| DA42 | Gastritis |
| DA42 | Gastritis |
| DA42.80 | Alcoholic gastritis |
| DA60 | Gastric ulcer |
| DA44 | Gastric polyp |
| DA44.Z | Gastric polyp, unspecified |
| DA63.Z | Duodenal ulcer, unspecified |
| DA63 | Duodenal ulcer |
| DA63.Z | Duodenal ulcer, unspecified |
| DA7Z | Diseases of the stomach or the duodenum, unspecified |
Includes intestinal malabsorption, protein-losing enteropathy, and other conditions of the small intestine. Celiac disease has its own code. DA93.0 is the code for paralytic ileus, which appears in the mortality instructions.
| Code | Diagnosis |
|---|---|
| DA96.0Z | Intestinal malabsorption, unspecified |
| DA95 | Coeliac disease |
| DA91.31 | Enterolith of small intestine |
| DA93 | Motility disorders of small intestine |
| DA93.0 | Paralytic ileus |
| DB1Z | Diseases of appendix, unspecified |
| DB10.0 | Acute appendicitis |
ICD-11 adds very detailed anatomical groups such as "Diseases of the anal canal." Hemorrhoids are reclassified here from Chap. 11 circulatory (formerly I84). Obstruction of the large intestine has its own group (DB30).
| Code | Diagnosis |
|---|---|
| DB60.Z | Haemorrhoids, unspecified |
| DC5Z | Diseases of peritoneum, unspecified |
| DC50.Z | Peritonitis, unspecified |
| DB1Z | Diseases of appendix, unspecified |
The ICD-11 creates separate categories for both groups. Functional gastrointestinal disorders are described from the point of view of the "gut-brain axis." Inflammatory bowel diseases are separated because Crohn's disease affects several organs.
| Code | Diagnosis |
|---|---|
| DD9Z | Functional gastrointestinal disorders, unspecified |
| DD71 | Ulcerative colitis |
| DD70 | Crohn disease |
| DD7Z | Inflammatory bowel diseases, unspecified |
The hernia has its own section in Chapter 13. Post-coordination allows specifying laterality, obstruction and other characteristics. Equivalent to K40–K46 of the ICD-10.
| Code | Diagnosis |
|---|---|
| DD51 | Inguinal hernia |
| DD52 | Femoral hernia |
| DD53 | Umbilical hernia |
| DD5Z | Hernias, unspecified |
Vascular disorders of the digestive system have their own category in ICD-11. Includes mesenteric ischemia and other intestinal vascular conditions.
| Code | Diagnosis |
|---|---|
| DD3Z | Ischaemic vascular disorders of intestine, unspecified |
| DD30.0 | Acute mesenteric arterial infarction |
| DD30.1 | Acute mesenteric arterial ischaemia |
| DD3Z | Ischaemic vascular disorders of intestine, unspecified |
Expanded section with new independent categories: NAFLD (non-alcoholic fatty liver disease), autoimmune liver diseases, metabolic liver diseases and vascular disorders of the liver. Chronic liver cirrhosis is classified into "Liver fibrosis and cirrhosis" (DB93).
| Code | Diagnosis |
|---|---|
| DB91 | Acute or subacute hepatic failure |
| DB91.Z | Acute or subacute hepatic failure, unspecified |
| DB92 | Non-alcoholic fatty liver disease |
| DB92.1 | Non-alcoholic steatohepatitis |
| DB92.Z | Non-alcoholic fatty liver disease, unspecified |
| DB93 | Hepatic fibrosis or cirrhosis |
| DB93.0 | Hepatic fibrosis |
| DB93.1 | Hepatic cirrhosis |
| DB94 | Alcoholic liver disease |
| DB94.0 | Alcoholic fatty liver |
| DB94.1 | Alcoholic hepatitis |
| DB94.2 | Alcoholic liver fibrosis |
| DB94.3 | Alcoholic cirrhosis of liver without hepatitis |
| DB94.Z | Alcoholic liver disease, unspecified |
| DB95 | Drug-induced or toxic liver disease |
| DB96.1 | Primary biliary cholangitis |
| DB97.2 | Chronic hepatitis, not elsewhere classified |
| DB98.7Z | Portal hypertension, unspecified |
| DB99.7 | Hepatic failure without mention whether acute or chronic |
| DB99.8 | Chronic hepatic failure |
| DB9Z | Diseases of liver, unspecified |
- DB91.Z (acute liver failure) + alcohol (6C40) → DB94 Alcoholic liver disease
- DB92 (NAFLD, except DB92.1) + alcohol → DB94.0 Alcoholic fatty liver disease
- DB92.1 (non-alcoholic steatohepatitis) + alcohol → DB94 Alcoholic liver disease
- DB93 (fibrosis or cirrhosis, except DB93.0) + alcohol → DB94.3 Alcoholic cirrhosis of the liver
- DB93.0 (liver fibrosis) + alcohol → DB94.2 Alcoholic liver fibrosis
- DB97.2 (chronic hepatitis NEC) + alcohol → DB94.1 Alcoholic hepatitis
Separate block in ICD-11. Formerly next to the pancreas in K80–K87 of the ICD-10. Includes cholelithiasis, cholecystitis, cholangitis and choledocholithiasis. Acute chronic cholecystitis has its own combined code (DC12.00).
| Code | Diagnosis |
|---|---|
| DC11 | Cholelithiasis |
| DC12.0 | Acute cholecystitis |
| DC12.1 | Chronic cholecystitis |
| DC12.00 | Acute on chronic cholecystitis |
| DC13 | Cholangitis |
| DC13 | Cholangitis |
Separate block in ICD-11 (formerly next to gallbladder in K80–K87). New independent categories: cystic diseases of the pancreas, chronic pancreatitis and autoimmune pancreatitis. Acute and chronic pancreatitis have specific codes for the alcoholic form.
| Code | Diagnosis |
|---|---|
| DC31 | Acute pancreatitis |
| DC31.1 | Acute alcohol-induced pancreatitis |
| DC31.Z | Acute pancreatitis, unspecified |
| DC32 | Chronic pancreatitis |
| DC32.3 | Chronic alcohol-induced pancreatitis |
| DC32.Z | Chronic pancreatitis, unspecified |
| DC3Z | Diseases of pancreas, unspecified |
- DC31.Z (acute pancreatitis s/e) + alcohol (6C40) → DC31.1 Acute alcoholic pancreatitis
- DC32.Z (chronic pancreatitis s/e) + alcohol (6C40) → DC32.3 Chronic alcoholic pancreatitis
Post-procedure digestive disorders section. In ICD-10 they were in K91. ICD-11 indicates that when an appendectomy is mentioned, the appendix is the organ operated on and is coded under DB1Z (diseases of the appendix), not post-procedure disorders.
| Code | Diagnosis |
|---|---|
| DE10 | Vomiting following gastrointestinal surgery |
| DE12 | Malfunction or complication of external stoma of digestive organs |
Comparison ICD-10 vs ICD-11 — Chapter 13
| ICD-10 block | ICD-11 Equivalent |
|---|---|
| K00–K14 Diseases of the oral cavity, salivary glands and jaws | DA00–DA0Z Diseases of the orofacial complex (expanded structure) |
| K20–K31 Diseases of the esophagus, stomach and duodenum | DA20–DA2Z Diseases of the esophagus (own block) + DA40–DA7Z Diseases of the stomach or duodenum |
| K35–K38 Diseases of the appendix | DA95 Diseases of the appendix (within diseases of the small intestine) |
| K40–K46 Hernia | DD40–DD6Z Hernia (own block) |
| K50–K52 Noninfectious enteritis and colitis | DB25 Ulcerative colitis + DB26 Crohn's disease (independent categories) |
| K55–K64 Other diseases of the intestines | Redistributed into several anatomical groups: DB00 colon, DB05 rectum/anal canal, DB06 hemorrhoids, DD30 vascular |
| I84 Hemorrhoids | DB06 Hemorrhoids — reclassified to Chap. 13 from Chap. 11 circulatory |
| I85 Esophageal varices | DA26.0 Esophageal varices — reclassified to Chap. 13 from Chap. 11 circulatory |
| K65–K67 Diseases of the peritoneum | DB10 Diseases of the peritoneum |
| K70–K77 Liver diseases | DB90–DB9Z Liver diseases (new categories: NAFLD, autoimmune, vascular) |
| K80–K87 Disorders of the gallbladder, bile ducts and pancreas | DC00–DC2Z Gallbladder or bile ducts (own block) + DC30–DC3Z Pancreas (own block) |
| K90–K93 Other diseases of the digestive system | Redistributed: DB20 functional, DE10–DE12 post-procedure, DA90 malabsorption |