The Canadian Institute for Health Information (CIHI) is pleased to announce that version 2018 of the following products is now available to download in English and French from CIHI’s eStore:

  • Folio application for the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada and the Canadian Classification of Health Interventions (ICD-10-CA/CCI); and
  • The Canadian Coding Standards and related products. 

Version 2018 of both ICD-10-CA/CCI and the Canadian Coding Standards comes into effect April 1, 2018, for use with 2018–2019, 2019–2020 and 2020–2021 data.

Note: You will need a CIHI profile to download the products from CIHI’s eStore. If you do not have a profile, email

Version 2018 ICD-10-CA/CCI classifications

We recommend that you download v2018 ICD-10-CA/CCI Folio application early to allow sufficient time to address any questions prior to April 1. 

Please note that the licensing has changed for this version. The number of licences available to Core Plan subscribers has increased: with this release, Core Plan clients may download the 100-user licence. See CIHI’s eStore for more information.

Enhancements to v2018 ICD-10-CA/CCI classifications

Enhancements to v2018 ICD-10-CA/CCI classifications were performed to reflect current clinical practice and technology to ensure the continued relevancy of the classifications.

What has changed?

Changes ICD-10-CA CCI
Complete list of all changes (enhanced and disabled codes)
Number of new codes 87 344
Examples of enhancements
  • Medical assistance in dying (MAID)
  • Specific opioids used in poisoning
  • Further specification of a third-degree perineal laceration during delivery
  • Transgender reassignment surgery
  • Endobronchial ultrasound (EBUS)
  • Radiofrequency ablation (RFA)
Number of disabled codes 714 969
Examples of disabled codes All morphology codes (689) have been removed to align with WHO changes to the international ICD-10
  • The majority of codes pertaining to rubrics for aorta anatomic sites
  • Other enhancements pertaining to
    • Eye procedures (e.g., cataract, vitrectomy, cornea transplant)
    • Heart valve procedures
    • Forefoot reconstruction

Enhancements to v2018 ICD-10-CA/CCI Folio application

  • Code Basket: A feature in the Folio Views software that provides functionality for gathering and organizing classification codes so that they can be exported for use in patient record abstracting systems. Code Basket makes it easier to transfer codes between Folio and an abstracting system. When using Code Basket, it is not necessary to copy and paste codes one by one. Instructions for using Code Basket.
  • NEW: Enhanced search functionality: This enables searching terms in the tabular listing within Includes, Excludes, Code Also and Notes, as well as in content in Attributes (CCI only). Instructions for searching terms.
  • NEW: Searching the ICD-10-CA/CCI Infobase: On the first page of each of the Folio infobases (ICD-10-CA/CCI), there’s a new link to instructions on how to search Folio: Search Techniques for ICD-10-CA and Search Techniques for CCI Using Folio Views.
  • Shadow File: As always, users may transfer notes from their 2015 shadow file to the 2018 shadow file. Instructions for transferring Shadow File notes.

Discontinued: ICD-10-CA/CCI Folio in CD and PDF formats

For version 2018 ICD-10-CA/CCI, both the CD and PDF formats have been discontinued. A new resource has been developed: ICD-10-CA and CCI Trending (Evolution). For more information, see the section ICD-10-CA and CCI Trending (Evolution) below.

Canadian Coding Standards for v2018 ICD-10-CA and CCI

What has changed?

In addition to 5 new, 37 amended and 5 deleted standards, here are some highlights of other changes:

  • The coding standards have a new look, which ensures that the document is accessible to all users. Text alternatives have been written for all images and flow diagrams, and are found in the new Appendix G.
  • Tips for Coders are now found in the new Appendix E, which consolidates all of the relevant Tips for Coders released between 2009 and spring of 2017. Tips included in this appendix are no longer available on the website; only new tips will be posted to CIHI’s website, via a link on the Codes and Classifications page.
  • Appendix A — Resources has been enhanced by incorporating content from several of the education products that are being retired beginning 2018–2019.

NEW: Canadian Coding Standards Evolution Chronicle

Canadian Coding Standards Evolution Chronicle, a new product that comprehensively documents the changes to the coding standards from 2009 to 2018, will be released in April 2018. It will be available via the Codes and Classifications web page.

NEW: ICD-10-CA and CCI Trending (Evolution) for v2018 ICD-10-CA/CCI

ICD-10-CA and CCI Trending (Evolution) outlines the changes in a code from version 2015 to version 2018, and includes a comprehensive listing of all the ICD-10-CA and CCI codes in v2018. It is available via the Codes and Classifications web page.


As the result of a review of our existing education products, we have streamlined Classifications and Terminologies products and services for 2018–2019. This responds to client feedback to reduce the number of resources that our clients need to reference, and is also reflective of the low rate of enrolment of some courses.

As such, some courses will be updated to version 2018, while others will be retired or moved to a resource format. To ensure that no pertinent content was lost due to the retirement of products, any applicable content has been incorporated into the Canadian Coding Standards for Version 2018 ICD-10-CA and CCI.

Over the years, the classifications have been enhanced such that the alphabetical index and the instructional notes more clearly direct classification users to the correct code. The coding standards have also been further developed and/or amended to provide clear direction and examples that demonstrate the application of the directive statements.

Please visit CIHI’s website for further details on updates to education products.

If you have questions, please contact CIHI by email at