The Canadian Institute for Health Information (CIHI) has established a public submission process for requests to update the classifications in order to improve data collection that will meet the needs for quality, relevant, accurate and comparable clinical data in Canada.
You can request an update to the International Statistical Classification of Diseases and Related Health Problems, 10th Edition, Canada (ICD-10-CA) or the Canadian Classification of Health Interventions (CCI).
View the public request form for enhancement of ICD-10-CA or CCI to begin your request.
These guidelines provide supplementary information that will assist users in completing the public submission request form.
ICD-10-CA
The World Health Organization (WHO) is the official publisher of ICD-10 (in English and French) and holds the international copyright. WHO has granted CIHI the licence to enhance the classifications to meet Canadian needs for collection of morbidity data through ICD-10-CA.
CCI
CCI was developed and is maintained solely by CIHI. CCI is designed to be provider- and location-neutral so that it may be used across the continuum of health care settings in Canada.
Sources of updates to the classifications
Identification of potential updates to ICD-10-CA or CCI are based on the following sources:
- WHO
- CIHI’s eQuery service
- Clinical experts
- Other health organizations or ministries of health
- Public submitters
Rules governing maintenance and enhancement of ICD-10-CA and CCI
Code additions or deletions or a change in hierarchy must follow the code structure of ICD-10-CA or CCI. The updating process includes consultation with, and feedback from, internal and external advisors, including various experts and clinicians across Canada.
CIHI adheres to the following principles when updating ICD-10-CA and CCI:
- No additions of new code categories and new clinical concepts for ICD-10-CA
As of 2017, WHO no longer updates the international ICD-10 with new or modified content. Therefore, to maintain international comparability, no new codes or clinical concepts will be added to future versions of ICD-10-CA at the third or fourth character codes. Updates to ICD-10-CA are permitted at the fifth and sixth characters to add specificity only. Note that, at this time, there is no decision to adopt ICD-11 in Canada. Consistent with purpose of classification
The purpose of ICD-10-CA is to permit the systematic recording, analysis, interpretation and comparison of morbidity statistics. The national standard for reporting morbidity statistics in Canada is ICD-10-CA. Its use enables the capture of diagnostic information from health encounters, thereby contributing to national reporting, research, and policy- and decision-making in Canada.CCI provides comprehensive coverage of diagnostic, therapeutic and other associated health care interventions across a broad spectrum of health care services. The range of interventions reflects the broad spectrum of providers and variety of applications for use in Canada. CCI’s purpose is to meet national reporting, epidemiological and health research requirements for Canadians.
- Clinical relevancy
Enhancements to ICD-10-CA and CCI need to demonstrate important details about a particular disease, related health problem or health intervention that are clinically significant in Canada (e.g., the intervention is an accepted practice in Canada and is performed in a Canadian health care setting).
The public submission process
What are the criteria for submitting a proposed update?
Any submission to CIHI for enhancements to ICD-10-CA or CCI must clearly demonstrate compliance with one of the following criteria:
- The enhancement addresses a gap in the classification related to a specific disease or health problem, or to a specific intervention or technique performed in Canada that is evidence-based.
- An existing code or note is outdated and lacks clinical relevancy due to advances in health care technology.
- The requested change provides clarity in the classification where there is ambiguity.
- The requested change will assist in care planning, outcome measurement, national reporting, research and data collection for funding. The request can be related to a topic of public interest and/or a national health priority.
Requests regarding typographical errors or errors in functionality of the electronic code books are excluded from this process. The public submission process is to be used only to request new codes/notes or deletions. Typographical errors can be sent to classifications@cihi.ca; functionality issues can be sent to help@cihi.ca.
How to proceed with your submission
View the public request form for enhancement of ICD-10-CA or CCI to begin your enhancement request.
All public submissions must be supported by clinical evidence, which must be included in each request. Clinical evidence must be identified via references such as a high-quality internet link to valid research and/or literature. If you have a request for each of ICD-10-CA and CCI, a submission form must be completed for each classification.
All submissions must include detailed contact information.
Note: Supporting clinical evidence/documentation must not contain patient record information (including personal health information). If you wish to submit clinical documentation related to a specific case, please email classifications@cihi.ca for guidance.
What will happen with your submission?
All submissions are first analyzed by CIHI’s classifications specialists for comprehensiveness and compliance with the submission criteria. Appropriate submissions are then compiled for review and may require review by our expert sources. Enhancements that are approved will be included in the next version of ICD-10-CA or CCI.
CIHI may contact the public submitter for further information if required. Public submitters will be notified via email at the end of a review cycle if their request has been rejected, with rationale.
Deadline for public submissions
The deadline for public submission for the next version of the classifications can be found at the top of the public submission request form for enhancement of ICD-10-CA or CCI.
Updates on ICD-10-CA and CCI enhancement requests
This document (posted on our web page, Codes, Classifications, and Terminologies) provides the status of each enhancement received for the current version of the classifications under development, with the decision and rationale for each request. It is updated quarterly during the development phase of the classifications.
Questions about this process or the public submission request form can be directed to classifications@cihi.ca.