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ICD-11 pilot in West China: feasibility evaluation and implications for future implementation.

Xingyu Ming¹, Han Wei¹, Die Zhou¹

¹Department of Medical Records and Statistics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32 West Second Section, First Ring Road, Oingyang District, Chengdu, China.

Scientific Reports

|June 3, 2026

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Implementing the International Classification of Diseases, 11th Revision (ICD-11) in West China is feasible but requires improved medical record quality and coder training. The transition presents challenges but offers more accurate clinical diagnosis expression.

Area of Science:

Medical Informatics
Health Information Management
Public Health Surveillance

Background:

The International Classification of Diseases, 10th Revision (ICD-10) has been the standard for morbidity and mortality coding.
Transitioning to the International Classification of Diseases, 11th Revision (ICD-11) offers potential improvements in coding accuracy and clinical representation.
Evaluating the feasibility of ICD-11 implementation is crucial for healthcare systems worldwide.

Purpose of the Study:

To assess the feasibility of replacing ICD-10 with ICD-11 in West China for morbidity and mortality coding.
To summarize practical experiences and provide insights for global ICD-11 transitions.
To identify challenges and facilitators in the ICD-11 coding process.

Main Methods:

Keywords:

Evaluation Facilitators ICD-10 ICD-11 Implementation Obstacle

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Collected and compared ICD-10 and ICD-11 coding data from a pilot hospital over two months.

Conducted a questionnaire survey and focused interviews with 20 medical coders.

Analyzed changes in primary disease codes, postcoordination usage, and coder perceptions.

Main Results:

92.30% of primary disease codes maintained chapter allocation; 41.10% involved postcoordination.
Topology Scale Value, Anatomy and topography, and Histopathology were common extension dimensions.
Coders found ICD-11 more accurate but noted challenges with manual postcoordination and medical record quality.

Conclusions:

ICD-11 implementation in West China is feasible with groundwork in medical record quality, training, and official resources.
The transition is smoother than previous upgrades, but coding remains complex and time-consuming.
Addressing coding obstacles and improving documentation are key for successful ICD-11 adoption.