ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.[1] Work on ICD-10 began in 1983,[2] became endorsed by the Forty-third World Health Assembly in 1990, and was first used by member states in 1994.[1]

While WHO manages and publishes the base version of the ICD, several members states have modified it to better suit their needs. In the base classification, the code set allows for more than 14,000 different codes[3] and permits the tracking of many new diagnoses compared to the preceding ICD-9. Through the use of optional sub-classifications ICD-10 allows for specificity regarding the cause, manifestation, location, severity and type of injury or disease.[4] The adapted versions may differ in a number of ways, and some national editions have expanded the code set even further; with some going so far as to add procedure codes. ICD-10-CM, for example, has over 70,000 codes.[5]

The WHO provides detailed information regarding the ICD via its website including an ICD-10 online browser[6] and ICD training materials.[7] The online training includes a support forum,[8] a self learning tool[7] and user guide.[9]


The following table lists the chapter number (using Roman numerals), the code range of each chapter, and the chapter's title from the international version of the ICD-10.[10]

ICD-10 chapters
Chapter Block Title
I A00–B99 Certain infectious and parasitic diseases
II C00–D48 Neoplasms
III D50–D89 Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
IV E00–E90 Endocrine, nutritional and metabolic diseases
V F00–F99 Mental and behavioural disorders
VI G00–G99 Diseases of the nervous system
VII H00–H59 Diseases of the eye and adnexa
VIII H60–H95 Diseases of the ear and mastoid process
IX I00–I99 Diseases of the circulatory system
X J00–J99 Diseases of the respiratory system
XI K00–K93 Diseases of the digestive system
XII L00–L99 Diseases of the skin and subcutaneous tissue
XIII M00–M99 Diseases of the musculoskeletal system and connective tissue
XIV N00–N99 Diseases of the genitourinary system
XV O00–O99 Pregnancy, childbirth and the puerperium
XVI P00–P96 Certain conditions originating in the perinatal period
XVII Q00–Q99 Congenital malformations, deformations and chromosomal abnormalities
XVIII R00–R99 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
XIX S00–T98 Injury, poisoning and certain other consequences of external causes
XX V01–Y98 External causes of morbidity and mortality
XXI Z00–Z99 Factors influencing health status and contact with health services
XXII U00–U99 Codes for special purposes

National adoptions

Approximately 27[11][12] countries use ICD-10 for reimbursement and resource allocation in their health system, and some have made modifications to ICD to better accommodate its utility. The unchanged international version of ICD-10 is used in 117 countries for performing cause of death reporting and statistics.[1]

The national versions may differ from the base classification in the level of detail, incomplete adoption of a category,[13] or the addition of procedure codes.


Introduced in 1998, ICD-10 Australian Modification (ICD-10-AM) was developed by the National Centre for Classification in Health at the University of Sydney.[14] It is currently maintained by the Australian Consortium for Classification Development.[15]

ICD-10-AM has also been adopted by New Zealand,[16] the Republic of Ireland,[17] Saudi Arabia[18] and several other countries.[19]


Brazil introduced ICD-10 in 1996.[20]


Canada began using ICD-10 for mortality reporting in 2000.[21] A six-year, phased implementation of ICD-10-CA for morbidity reporting began in 2001.[22] It was staggered across Canada's ten provinces, with Quebec the last to make the switch.[22]

ICD-10-CA is available in both English and French language versions.[21]


China adopted ICD-10 in 2002.[23]

Czech Republic

The Czech Republic adopted ICD-10 in 1994, one year after its official release by WHO.[24] Revisions to the international edition are adopted continuously.;[25][26] The official Czech translation of ICD-10 2016 10th Revision was published in 2018.[24]


France introduced a clinical addendum to ICD-10 in 1997.[27] See also website of the ATIH.


Germany's ICD-10 German Modification (ICD-10-GM) is based on ICD-10-AM.[19] ICD-10-GM was developed between 2003 and 2004, by the German Institute for Medical Documentation and Information.[19]


Hungary introduced the use of ICD-10 from January 1 1996 via a ministerial decree.[28]


A Korean modification has existed since 2008.[29]


The Dutch translation of ICD-10 is ICD10-nl, which was created by the WHO-FIC Network in 1994.[30] There is an online dictionary.[31]


The Ministry of Healthcare of the Russian Federation ordered in 1997 to transfer all health organizations to ICD-10.[32]

South Africa

ICD-10 was implemented in July 2005 under the auspice of the National ICD-10 Implementation Task Team which is a joint task team between the National Department of Health and the Council for Medical Schemes.[33]


The current Swedish translation of ICD-10 was created in 1997.[34] A clinical modification has added more detail and omits codes of the international version in the context of clinical use of ICD:

The codes F64.1 (Dual-role transvestism), F64.2 (Gender identity disorder of childhood), F65.0 (Fetishism), F65.1 (Fetishistic transvestism), F65.5 (Sadomasochism), F65.6 (Multiple disorders of sexual preference) are not used in Sweden since 1 January 2009 according to a decision by the present Director General of The National Board of Health and Welfare, Sweden. The code O60.0 (Preterm labor without delivery) is not used in Sweden; instead, since 1 January 2009, the Swedish extension codes to O47 (False labor) are recommended for use.


First published in 1998, the ICD-10-TM (Thai Modification) is a Thai language version of ICD-10. Maintenance and development of ICD-10-TM is the responsibility of the Thai Health Coding Center (THCC), a department of the Thai Ministry of Public Health. The current version of ICD-10-TM is based on the 2016 version of ICD-10. An unusual feature of the index of ICD-10-TM is that it is bilingual, containing both Thai and English trails.[35]

Along with Czechoslovakia and Denmark; Thailand was one of the first adopters of ICD-10 for coding purposes.

United Kingdom

ICD-10 was first mandated for use in the UK in 1995.[36] In 2010 the UK Government made a commitment to update the UK version of ICD-10 every three years.[37] On 1 April 2016, following a year's delay,[37] ICD-10 5th Edition[note 1] replaced the 4th Edition as the mandated diagnostic classification within the UK.[38]

United States

For disease reporting, the US utilizes its own national variant of ICD-10 called the ICD-10 Clinical Modification (ICD-10-CM).[39] A procedural classification called ICD-10 Procedure Coding System (ICD-10-PCS)[note 2] has also been developed for capturing inpatient procedures.[39] The ICD-10-CM and ICD-10-PCS were developed by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS).[39][40] There are over 70,000 ICD-10-PCS procedure codes and over 69,000 ICD-10-CM diagnosis codes, compared to about 3,800 procedure codes and roughly 14,000 diagnosis codes found in the previous ICD-9-CM.[5]

There was much controversy when the transition from the ICD-9-CM to the ICD-10-CM was first announced in the US. Many providers were concerned about the vast number of codes being added, the complexity of the new coding system, and the costs associated with the transition.[41] The Centers for Medicare and Medicaid Services (CMS) weighed these concerns against the benefits of having more accurate data collection, clearer documentation of diagnoses and procedures, and more accurate claims processing.[41] CMS decided the financial and public health cost associated with continuing to use the ICD-9-CM was too high and mandated the switch to ICD-10-CM.[41]

The deadline for the United States to begin using ICD-10-CM for diagnosis coding and Procedure Coding System ICD-10-PCS for inpatient hospital procedure coding was set at October 1, 2015,[42][43] a year later than the previous 2014 deadline.[44] Before the 2014 deadline, the previous deadline had been a year before that on October 1, 2013.[45][46] All HIPAA "covered entities" were required to make the change; a pre-requisite to ICD-10-CM is the adoption of EDI Version 5010 by January 1, 2012.[47] Enforcement of 5010 transition by the Centers for Medicare & Medicaid Services (CMS), however, was postponed by CMS until March 31, 2012, with the federal agency citing numerous factors, including slow software upgrades.[48] The implementation of ICD-10-CM has been subject to previous delays. In January 2009, the date was pushed back to October 1, 2013, rather than an earlier proposal of October 1, 2011.[49]


The expansion of healthcare delivery systems and changes in global health trends prompted a need for codes with improved clinical accuracy and specificity.[40] The alphanumeric coding in ICD-10 is an improvement from ICD-9 which had a limited number of codes and a restrictive structure.[40] Early concerns in the implementation of ICD-10 included the cost and the availability of resources for training healthcare workers and professional coders.[50]

Two common complaints in the United States about the ICD-10-CM are 1) the long list of potentially relevant codes for a given condition (such as rheumatoid arthritis) which can be confusing and reduce efficiency and 2) the assigned codes for seldom seen conditions (e.g. W55.22XA: Struck by cow, initial encounter and V91.07XA: Burn due to water-skis on fire, initial encounter).[51][52]

See also


  1. The numbering system of editions only refers to those used in the UK; not those issued by WHO. For example, whilst the 5th edition is based on ICD-10 version:2016, the 4th edition was based on the version from 2010 (skipping the versions of ICD-10 from 2014 and 2015).
  2. Although named ICD-10-PCS, this volume is not based on any of the WHO-FIC publications.


  1. "International Classification of Diseases (ICD) Information Sheet". Retrieved 29 October 2018.
  2. "ICD-10 Fifth Edition" (PDF). apps.who.int. p. 5. Retrieved 29 October 2018.
  3. "FAQ on ICD". Retrieved 29 October 2018.
  4. "ICD-10 Second Edition Volume 2 – World Health Organization, p15" (PDF). Who.int. Retrieved 23 May 2017.
  5. "The switch from ICD-9 to ICD-10: When and why". icd.codes. Retrieved 19 January 2018.
  6. "ICD-10 Version:2016". apps.who.int. Retrieved 29 October 2018.
  7. "ICD-10 Training Tool". apps.who.int. Retrieved 23 May 2017.
  8. "ICD-10-online-training". sites.google.com. Retrieved 23 May 2017.
  9. "ICD-10 User Guide" (PDF). Retrieved 20 November 2018.
  10. "International Classification of Diseases 10th Revision". World Health Organization. 2010. Retrieved February 26, 2010.
  11. "3M Health Information Services: ICD-10 Overview" (PDF). Eastern Ohio Health Information Management Association. 2009. Retrieved Dec 2, 2015.
  12. France, Francis H. Roger (2001). Case Mix: Global Views, Local Actions : Evolution in Twenty Countries. Amsterdam: IOS Press. ISBN 1 58603 217 8.
  13. National Clinical Coding Standards ICD-10 5th Edition (2017). NHS Digital Clinical Classification Services. April 2017. p. 200.
  14. "ICD-10-AM/ACHI/ACS: Australian Consortium for Classification Development". Australian Consortium for Classification Development. Retrieved 3 December 2018.
  15. "Overview : Australian Consortium for Classification Development". Australian Consortium for Classification Development. Retrieved 3 December 2018.
  16. "ICD-10-AM/ACHI/ACS". Ministry of Health NZ. Retrieved 3 December 2018.
  17. "Irish Coding Standards Version 9" (PDF). Healthcare Pricing Office. Retrieved 3 December 2018.
  18. الصحة, فريق بوابة وزارة. "ICD-10-AM - Introduction". www.moh.gov.sa. Retrieved 3 December 2018.
  19. Killewo, Japhet; Heggenhougen, Kristian; Quah, Stella R. (2010). Epidemiology and Demography in Public Health. Academic Press. ISBN 9780123822017. Retrieved 3 December 2018.
  20. Fazito, Erika; Cuchi, Paloma; Fat, Doris Ma; Ghys, Peter Denis; Pereira, Mauricio G.; Vasconcelos, Ana Maria Nogales; Pascom, Ana Roberta Pati (1 December 2012). "Identifying and quantifying misclassified and under-reported AIDS deaths in Brazil: a retrospective analysis from 1985 to 2009". Sex Transm Infect. 88 (Suppl 2): i86–i94. doi:10.1136/sextrans-2012-050632. ISSN 1368-4973. PMC 3512438. PMID 23172349. Retrieved 3 December 2018.
  21. Moskal, Lori (15 October 2004). "Implementation of ICD-10-CA and CCI in Canada". Implementation of ICD-10-CA and CCI in Canada / AHIMA, American Health Information Management Association. Retrieved 3 December 2018.
  22. Walker, Robin L; Hennessy, Deirdre A; Johansen, Helen; Sambell, Christie; Lix, Lisa; Quan, Hude (10 June 2012). "Implementation of ICD-10 in Canada: how has it impacted coded hospital discharge data?". BMC Health Services Research. 12: 149. doi:10.1186/1472-6963-12-149. PMC 3411494. PMID 22682405.
  23. "Deloitte Center for Health Solutions" (PDF). Deloitte.com. Retrieved 23 May 2017.
  24. "MKN Mezinárodní statistická klasifikace nemocí a přidružených zdravotních problémů" [International Statistical Classification of Diseases and Related Health Problems]. uzis.cz (in Czech). Retrieved 26 April 2019.
  25. "Spolupráce s WHO" [Cooperation with WHO]. uzis.cz (in Czech). Retrieved 26 April 2019.
  26. Zvolský, Miroslav. "Implementation of international classifications in the Czech Republic", cz:ÚZIS, December 2016. Retrieved on 26 April 2019.
  27. "History of ICD-10". 2015-02-17.
  28. "42/1995. (XI. 14.) NM rendelet a Betegségek Nemzetközi Osztályozása X. Revíziója bevezetéséről".
  29. Kim, Sukil (July 18, 2013). "Use of Classifications in Korea" (PDF). Retrieved Oct 10, 2017.
  30. "WHO-Fic". Rivm.nl. Retrieved 23 May 2017.
  31. "Browser". class.who-fic.nl.
  32. "Приказ Минздрава РФ от 27.05.97 № 170 (ред. от 12.01.98) "О переходе органов и учреждений здравоохранения Российской Федерации на Международную статистическую классификацию болезней и проблем, связанных со здоровьем X пересмотра"". zakonbase.ru (in Russian). Retrieved 2 November 2018.
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  35. "ICD10TM2016VOL1_FINAL". thcc.or.th.
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  39. "ICD-10 FAQs". www.ahima.org. Retrieved 2018-11-20.
  40. "ICD - ICD-10-CM - International Classification of Diseases,(ICD-10-CM/PCS Transition". www.cdc.gov. Retrieved 2018-11-20.
  41. "Misperceptions, Misinformation, and Misrepresentations: the ICD-10-CM/PCS Saga".
  42. "Senate Approves ICD-10 Delay, 'Doc Fix'". Healthdatamanagement.com. Retrieved 23 May 2017.
  43. "H.R. 4302 (Protecting Access to Medicare Act of 2014)". United States Senate. March 31, 2014
  44. "Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD–10–CM and ICD–10–PCS) Medical Data Code Sets". Centers for Medicare and Medicaid Services{{inconsistent citations}} Cite journal requires |journal= (help). 77 FR 54664 of 5 September 2012. 77 FR 60629 of 4 October 2012.
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  50. Association, American Hospital (2003-09-23). American Hospital Association; AHIMA. "ICD-10-CM Field Testing Project: Report on Findings: Perceptions, Ideas and Recommendations from Coding Professionals Across the Nation". ICD-10-CM Field Testing Project: Report on Findings: Perceptions, Ideas and Recommendations from Coding Professionals Across the Nation / AHIMA, American Health Information Management Association.
  51. "ICD-10: An Ode to Code - The Rheumatologist". The-rheumatologist.org. Retrieved 23 May 2017.
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