Upcoming plans for Clinical Administrative Databases, Case Mix, and Classifications and Terminologies products

CIHI is embarking on a multi-year roadmap to modernize acute and ambulatory care and hospital data. While there are no plans for major changes for the Discharge Abstract Database (DAD), National Ambulatory Care Reporting System (NACRS), Case Mix and Classification and Terminologies products, CIHI will continue to update these products. Please find below the upcoming plans for each product.

New fiscal year 2025–2026 for DAD and NACRS

2025–2026 changes for the DAD and NACRS are limited to those required for a successful rollover to the new fiscal year. Such changes include updated valid date ranges, file-naming convention, and case mix/classification validation tables.

Vendor specifications for 2025–2026 will be released in early December 2024. Existing DAD and NACRS submitting facilities are not required to complete facility testing in 2025–2026.

Only facilities that have changed vendors, have undergone major system changes or are newly reporting to the DAD and/or NACRS in 2025–2026 are required to complete facility testing.

2025–2026 DAD and NACRS abstracting manuals

CIHI is pleased to provide its clients with the DAD Abstracting Manual, 2025–2026 and the NACRS Abstracting Manual, 2025–2026. Both will be available in mid-February 2025. 

Each manual will include a table of changes as the first item in its table of contents. These tables will summarize content changes that apply to all provinces and territories, as well as jurisdiction-specific updates.

If you have any questions regarding the DAD and NACRS abstracting manuals, please email CAD@cihi.ca.

Postponement of the next version of Canadian Classification of Health Interventions (CCI) and related Canadian Coding Standards, and freezing of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada (ICD-10-CA)

CIHI is postponing implementation of new versions of CCI and the Canadian Coding Standards until fiscal year 2027–2028.

CIHI will no longer be updating ICD-10-CA. This aligns with the World Health Organization (WHO), which grants CIHI the licence to maintain a Canadian version of the International Classification of Diseases (ICD) by adding granularity to existing codes.

In anticipation of the International Classification of Diseases, Eleventh Revision (ICD-11) becoming the new international version, WHO stopped updating ICD-10 in 2019, except for the release of codes for emergency use. Although ICD-10-CA will no longer be updated, a contingency will be in place to ensure responsiveness to urgent issues in Canadian health care data needs.

Freezing ICD-10-CA in its 2022 version will enable us to devote resources to assessing the readiness of ICD-11 for Canadian implementation.

If you have questions regarding this update, please contact us at Classifications&Terminologies@cihi.ca.

Available soon: 2025–2026 ICD-10-CA/CCI Classification Tables

The 2025–2026 ICD-10-CA/CCI Classification Tables will be available in October 2024 to allow for system updates for data collection and submission to CIHI databases. 

These classification tables will include newly created Canada-specific provisional use codes (U-codes) and a code title change at B04. 

The Canada-specific U-codes (U50–U99) are to be used by CIHI for provisional assignment on an as-needed basis to respond to urgent or emergent health information needs until the adoption of ICD-11 in Canada.

Postponement of the next update to Case Mix Group+ (CMG+) and Comprehensive Ambulatory Classification System (CACS) grouper methodology

The next update to CMG+ and CACS grouper methodology will be in fiscal year 2027–2028. At that time, new classification codes will be added to both grouper applications.

Additionally, CIHI is currently reviewing a set of enhancements to CMG+ and CACS methodology for 2027–2028. This includes a review of interventions grouping to C999 Intervention Not Generally Ambulatory and outpatient joint replacement in CACS. For CMG+, low-volume CMGs are being reviewed and may be collapsed to provide more stable Resource Intensity Weight indicators.

Also, for interventions such as Hernia and Pacemaker, which take place in both the inpatient and outpatient sectors, Case Mix is exploring opportunities to harmonize and more closely align the CACS and CMG+ methodologies.

April 2027 will include the release of CMG+ and CACS directory products, client tables and a DAD expected length of stay (ELOS) and RIW publication.

For fiscal year 2025-2026, RIW values for CMG+ and CACS will be updated. Additionally, for CACS, the directory (which includes RIW values) and client tables will be released. For CMG+, a revised DAD ELOS RIW publication, CMG+ client tables, and updated RIW education module will be released. Given that the CMG+ directory does not include annual RIW values, this product will not require an update until the next change cycle.