ICD-11 in 2025: Evolution, Global Progress, and What to Watch

In the ever-evolving world of health information, few transitions generate as much anticipation and uncertainty as the adoption of a new international classification system. The 11th Revision of the International Classification of Diseases (ICD-11), developed by the World Health Organization (WHO), has reached a pivotal moment in 2025. It is no longer on the horizon; it is taking root across the globe.

ICD-11 is not merely a coding update – it represents a transformational shift in how health data is captured, classified, and leveraged. With the global health ecosystem moving toward greater digitalization, interoperability, and data granularity, ICD-11 is designed to meet these evolving demands.

A Brief History: From ICD-10 to ICD-11

ICD-10 has served as the international health classification standard since the 1990s. It provided the necessary foundation to support mortality and morbidity statistics, reimbursement, and quality initiatives. However, as healthcare delivery models, disease patterns, and technologies have rapidly advanced, ICD-10 has shown significant limitations. Its static, hierarchical design and its absence of modern clinical terminology have hindered its effectiveness in today’s healthcare environment.

After over a decade of development, ICD-11 was officially released by WHO in January 2022, ushering in a new era of classification that aligns with modern medicine, electronic health records (EHRs), and public health demands.

What Makes ICD-11 Different?

ICD-11 marks a complete overhaul of the traditional disease classification model. Key innovations include:

• Digital-native structure: ICD-11 is built to integrate seamlessly with EHRs and clinical decision support systems;
• Post-coordination: Coding professionals can combine multiple entities to describe complex clinical concepts, increasing precision;
• Clinical language alignment: Terms and definitions reflect current medical practice, minimizing ambiguity;
• Semantic network design: Unlike ICD-10’s linear structure, ICD-11 uses a multidimensional network that supports sophisticated data analytics and epidemiological reporting; and
• Extensibility: ICD-11 allows for the addition of local codes without disrupting global standards, making it adaptable to national needs.

These features not only improve data accuracy, but they also support a learning health system by enabling richer data capture and analysis.

Global Adoption and Use in 2025

ICD-11 is no longer a theoretical concept. As of 2025, more than 45 countries have adopted or begun the transition to ICD-11 for mortality, morbidity, and health system management. Countries like Canada, the Netherlands, Norway, Finland, and Thailand are at the forefront, using ICD-11 in both public health reporting and clinical reimbursement contexts.

These countries have reported improvements in coding efficiency, data specificity, and interoperability with international health surveillance systems. Their experiences are providing critical insights into implementation pathways, training needs, and policy adjustments.

The World Health Organization is actively working with member states to refine the transition process, with emphasis on providing translation tools, mapping resources, and training infrastructure. The ICD-11 Maintenance Platform continues to receive input from clinical and informatics experts to keep the classification updated and responsive.

The U.S. Landscape: Progress and Challenges

The United States remains in the exploratory phase of ICD-11 adoption. While it is not currently mandated for billing, key agencies like the National Center for Health Statistics (NCHS) and the Centers for Medicare & Medicaid Services (CMS) are conducting research, pilot studies, and public listening sessions.

Some of the challenges unique to the U.S. include:

• The dual use of ICD-10-CM and ICD-10-PCS, which would need to evolve alongside any transition;
• The complexity of payor systems and regulatory frameworks;
• Large-scale retraining of coding professionals and clinical staff; and
• Updating health IT systems, including EHRs, claims platforms, and analytic tools.

Nonetheless, there is clear momentum. Healthcare organizations such as the American Health Information Management Association (AHIMA), American Hospital Association (AHA), and  National Center for Health Statistics (NCHS) have begun offering educational resources to prepare professionals for eventual implementation. Leading academic centers are also involved in research to determine the feasibility of mapping, workflow integration, and clinical documentation changes.

What to Watch in 2025 and Beyond

As we look forward, several key developments should be on every health information (HI) leader’s radar:

1. Pilot Testing and Proof-of-Concept Programs – U.S. health systems are starting to test ICD-11 in parallel environments to evaluate coding accuracy, system performance, and training impact;
2. Mapping and Crosswalks – WHO and national partners are refining tools to translate ICD-10 codes into ICD-11 equivalents. These tools will be essential for historical data continuity and population health monitoring;
3. Training and Certification – Coding professionals will need to understand ICD-11’s structure, post-coordination logic, and clinical terminology. Certification programs and continuing education are expected to roll out in waves;
4. EHR and Vendor Readiness – EHR vendors must adapt interfaces to support ICD-11 concepts, modifiers, and coding conventions. Many systems will require significant updates to accommodate semantic tagging and post-coordination; and
5. Policy and Reimbursement Alignment – Future U.S. transition timelines will depend on how well ICD-11 can be integrated with DRGs, payment models, and compliance frameworks.

Conclusion

ICD-11 represents a bold step forward in health data modernization. It promises enhanced specificity, clinical relevance, and digital alignment. While the U.S. transition will take time, now is the moment to start preparing. From strategic planning and workforce education to vendor engagement and clinical documentation alignment, early action will ensure a smoother path when the eventual shift occurs. ICD-11 may not be required for billing yet, but its relevance is growing by the day.

As stewards of health data, HI professionals must lead the way, bridging the gap between policy, practice, and patient care in this new digital health era.

Programming note: Listen live today when Angela Comfort cohosts Talk Ten Tuesday with Chuck Buck, 10 am Eastern.