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ICD-10 Updates

ICD-10 4th Edition

The updates to ICD-10 classification published by the World Health Organisation (WHO) has been approved for NHS implementation by the Information Standards Board for Health and Social Care.

The updates, referred to by WHO as ICD-10 4th Edition, are mandated for use by the NHS and NHS system suppliers on 1 April 2012 and further information on this requirement is published on the Information Standards Board website.

The updates include the WHO cumulative changes up to and including those with a WHO implementation date of January 2010. The list of WHO ICD-10 updates (PDF 1.12Mb) is published on the WHO website.

The NHS Classifications Service (NCS) team are undertaking the necessary development work to support the implementation of the updates by the NHS.

All implementation files will be available to download from the Technology Reference Data Update Distribution (TRUD) service. The data files available include Codes and Titles and Metadata, Tables of Coding Equivalences, associated specifications and the summary of changes. Download is subject to registration and acceptance of the Licence Agreement terms and conditions.

For more information follow the links below:

National Clinical Coding Standards: ICD-10 4th Edition books

The National Clinical Coding Standards: ICD-10 4th Edition reference book were distributed to the NHS during early February.


The change in content has also brought a change in name to reflect its purpose as a reference manual of clinical coding standards and it is now called the National Clinical Coding Standards: ICD-10 4th Edition. The 500 page reference book provides specific national clinical coding standards to reduce ambiguity and differences in any interpretation. The national clinical coding standards reference manual is a resource primarily aimed at clinical coders.


Training information has been removed, and instead these key learning points will be in the ICD-10 4th Edition training materials released by end of February and in the updated national core curriculum training materials due for release to Approved Clinical Coding Trainers by end of March.

Information on costs and how non-NHS can order the National Clinical coding Standards: ICD-10 4th Edition reference book. (PDF, 184.8kB)

The WHO ICD-10 4th Edition volume set

The NHS Classifications Service has discovered a number of discrepancies in the printed ICD-10 volumes published by the World Health Organisation.

We have taken the step to include errata for ICD-10 4th Edition in our Coding Clinic as:

  • There are delays in the WHO publishing errata and the missing Transport Definitions on their website.
  • The WHO have decided to include changes in the errata which would create a disconnect between the WHO ICD-10 Volumes 1-3 books and the ICD-10 4th Edition data files issued to the NHS and system suppliers in August 2011.
  • The WHO have indicated they will not include all the errata pertinent to the NHS.

To protect the integrity of the data files released in August 2011 and to ensure smooth NHS implementation this issue of the Coding Clinic includes the NHS specific errata for ICD-10 4th Edition. In coding ICD-10 4th Edition from 1 April 2012 coding departments are to use the Coding Clinic for the errata to remain consistent with the data files. Consequently coders are advised not use the errata the WHO will eventually publish on their website.

Full details on how to order the three volume set published by WHO can be found in the attached document ICD-10 4th Edition volume set (PDF, 185Kb).

Definitions related to transport accidents

The definitions of transport accidents and the classification and coding instructions for transport accidents is missing from the ICD-10 4th Edition volume 1 Tabular list. WHO have provided a separate pamphlet (PDF, 89Kb) which can be printed and inserted into the Tabular List.

ICD-10 updates - focus groups

The NHS Classifications Service held several focus group meetings early in financial year 2011-12 mainly for the coding community to review the ICD-10 updates and identify training needs. These proved very successful and have informed development work.