New ICD-11 features for coding late sequelae and chronic post-procedural conditions.

There are many clinical circumstances in life where people live with chronic conditions (or states) that arose from either (1) a prior clinical diagnosis (e.g. a stroke) or (2) a prior healthcare-related event or medical procedure. Unfortunately, capturing such concepts is not straightforward in coded health data. This paper describes the coding rubric for sequelae (also often referred to as 'late effects') in the new ICD-11 coding system and some clinical coding examples. Earlier versions of ICD were constrained, in all but a few exceptions, by the need to combine all aspects of a clinical scenario into a single code. ICD-11 permits the clustering (postcoordination) of multiple codes to describe multifaceted clinical scenarios. This article features both precoordinated (single code) and postcoordinated (multi-code) descriptions of late effect situations where a prior health problem is the remote cause of current symptoms or conditions - i.e. sequelae. The late effect of a prior health problem rubric is yet another example of enhanced ICD-11 features that will improve future health information systems.