ICD-9/CCP and ICD-9-CM

Prior to implementation of ICD-10-CA and CCI, a variety of medical classification standards were used in Canada for morbidity purposes. Two standards were in use at the national level for diagnosis classification: the International Statistical Classification of Diseases, Injuries, and Causes of Death, Ninth Revision(ICD-9) and the ICD-9-Clinical Modification(ICD-9-CM). There were also two standards for procedure classification: the Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures(CCP) and the procedure section of the ICD-9-CM.

This mixture of classification standards existed in Canada from 1979 and on the CIHI Discharge Abstract Database from 1987. Beginning April 1, 2001 this mix of classifications is being replaced with the new, single, national standards for diagnosis and procedure classification. For more information, see ICD-10-CA/CCI Implementation Status.


The Ninth Revision of the International Classification of Diseases was approved by the 29th World Health Assembly in May 1976 to come into effect January 1, 1979. ICD-9 was adopted in Canada in 1979. ICD-9 is divided into two volumes: the Tabular List and the Alphabetic Index.


The Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures (CCP) was originally developed by Statistics Canada in 1978 to meet Canadian needs for a procedural classification to be used in conjunction with ICD-9. CCP is divided into two parts: the Tabular LIst and the Alphabetic Index.


ICD-9-CM is a Clinical Modification of ICD-9 published by the United States government for morbidity coding in the US. Clinical modification was needed to better describe the clinical picture of the patient. The codes are more precise than those needed only for statistical groupings and trend analysis. The diagnosis component of ICD-9-CM is completely comparable to ICD-9:

  • 3-digit rubrics and their contents are the same as ICD-9;
  • sequence of 3-digit rubrics is the same a ICD-9;
  • 5th digits are added where necessary to provide more specificity.

ICD-9-CM has 3 parts:

  • Diseases Tabular List (Vol 1);
  • Diseases Alphabetic Index (Vol 2); and
  • Procedures: Tabular List and Alphabetic Index (Vol 3).