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Learn about 2025–2026 plans and updates for CIHI’s classifications and terminologies, Clinical Administrative Databases (CAD), case mix and education products in this bulletin.

Classifications and terminologies updates

New bulletin and updated coding tip: Homelessness

In March 2025, a new bulletin clarified that a definition from the Canadian Observatory on Homelessness can be used for code assignment of Z59.0 Homelessness. This enables consistent and accurate data collection for DAD and NACRS.

Go to Coding direction: Homelessness

CIHI’s tip for coders on Z59.0 Homelessness has also been amended to include the Canadian Observatory on Homelessness definition of this status. It also reminds coders that this status is mandatory to capture whenever homelessness is documented.

Go to Homelessness - Tip for Coders (PDF)

New bulletin: Retiring prefix N 

Prefix N will be retired effective April 1, 2025. Find out more in this bulletin.

Go to Coding direction: Retirement of prefix N

Updated bulletin: Influenza due to influenza A/H5N1 (avian influenza) 

This bulletin clarifies that A/H5N1 [avian influenza] is the only type of influenza virus that is classified to J09 Influenza due to identified zoonotic or pandemic influenza virus and provides updated coding direction for classifying influenza A/H5N1 virus using the Canadian Emergency Department Diagnosis Shortlist (CED-DxS). This change will take effect April 1, 2025.

Go to Coding direction: Influenza due to influenza A/H5N1 (avian influenza)

Coming April 1: New version of the Emergency Department Intervention Value Set (EDVS)

Version 2.4 of the Emergency Department Intervention Value Set (EDVS) will be available April 1 via CIHI’s online store.

This new version aligns with the August and November 2024 release of the SNOMED CT Canadian Edition (SNOMED CT CA).

Note: Not all SNOMED CT CA terms include a French translation because, to date, not all of SNOMED CT CA has been translated.

Coming April 1: New version of the Canadian Emergency Department Diagnosis Shortlist (CED-DxS) 

Version 8.3 of the Canadian Emergency Department Diagnosis Shortlist (CED-DxS) will be available April 1 via CIHI’s online store.

This version is updated to include the ICD-10-CA code J09 Influenza due to identified zoonotic or pandemic influenza virus. It also includes the accompanying common diagnostic term Avian (Bird) Flu to classify influenza due to influenza A/H5N1 virus when using the CED-DxS.

Quick updates: International Classification of Diseases, Eleventh Revision (ICD-11) in Canada

������ϱ�continues to evaluate Canada’s readiness for ICD-11 adoption.

Here are some quick updates on key ICD-11 projects currently underway:

• Pan-Canadian ICD-11 Implementation Task Force: In the new fiscal year, ������ϱ�will be moving forward with convening an ICD-11 Implementation Task Force, bringing together representatives from across the country. The task force will play a key role in providing insights on implementation considerations and guiding the decision-making process.
• French translation: We are collaborating with WHO and with France’s WHO Family of International Classifications (WHO-FIC) Collaborating Centre to validate the French translation of ICD-11 for Mortality and Morbidity Statistics. This process will ensure that the French terms used are accurate and appropriate.
• Impact assessment activities: We are actively conducting impact assessment activities related to ICD-11. Our efforts are focused on determining the need for a country-specific version; developing crosswalks to facilitate transition; and assessing adoption impacts on federal and jurisdictional data systems, as well as on national health indicators. We are also evaluating the clinical utility of ICD-11 across various health care settings, including primary health care and mental health.
• New information sheets: 3 new information sheets are available on CIHI’s ICD-11 progress reports web page:
  • Canadian Stability Analysis: Addressing the Challenges of Achieving Equivalency with ICD-11 MMS Codes (PDF)
  • Assessing the Utility of ICD-11 for Primary ������ϱ� Care Reporting (PDF)
  • Assessing ICD-11 Implementation in Canada: Leveraging Crosswalks to Evaluate Adoption Impacts and Transition Strategies (PDF)

Updates: Canadian Coding Standards (CCS) modernization 

In response to client feedback, ������ϱ�continues to streamline and modernize the CCS. The aim of streamlining these coding standards is to make them easier to read, apply at the time of coding and explain.

All this work supports future coding practices, reduction of coder burden and interoperability for ease of data collection and sharing. Coding standards where direction is found in the classification will be retired in consultation and agreement with our National Coding Advisory Committee.

Currently, work is underway to streamline the remaining 102 coding standards. Also underway is the development of a mandatory ICD-10-CA code list and a new section solely for obstetrical/newborn coding direction.

For more information, refer to the spreadsheet Canadian Coding Standards Proposed Changes.

Go to Canadian Coding Standards Proposed Changes (XLSX)

Update: Canadian Classification of ������ϱ� Interventions (CCI) modernization and streamlining 

Work is ongoing to review specific rubrics and codes in CCI, as well as mandatory attributes. The aim is to determine their relevancy and to alleviate coder burden for collecting data that is not necessary.

Additional work is also underway to review pop-up notes and Code Also notes, determining whether they are required, redundant or outdated.

All of this work supports future coding practices, reduction of coder burden and enablement of interoperability for ease of data collection and sharing.

For more information, refer to the spreadsheet CCI Classification Enhancement Requests for Version 2027.

Go to CCI Classification Enhancement Requests for Version 2027 (XLSX)

External posting for changes to CCI

CCI Classification Enhancement Requests for Version 2027 has been updated and includes information on requests received for changes to CCI as of October 31, 2024.

This document provides information on each CCI change request, including the decision and rationale following classifications and terminologies review. This spreadsheet will be updated on a quarterly basis.

Go to CCI Classification Enhancement Requests for Version 2027 (XLSX)

Update: ������ϱ�SNOMED CT CA to ICD-10-CA map release

The ������ϱ�SNOMED CT CA to ICD-10-CA reference set and the Pan-Canadian ������ϱ� Concern Value Set are being updated quarterly to align with the release of SNOMED CT CA.

The current versions align with the August 30 release of SNOMED CT CA and were published on November 6. These maps can be found on CIHI’s vendor licensing web page and in CIHI’s online store.

The next release is targeted for mid-March 2025 with updates that will align with the February 28 release of SNOMED CT CA.

To learn more about the maps and opportunities for pilot testing, please visit CIHI’s web page about SNOMED CT CA to classifications maps.

Go to CIHI’s SNOMED CT CA to classifications maps web page 

Now available: ICD-10-CA/CCI public submission forms

Public submission forms for changes to ICD-10-CA and CCI are now available.

CCI requests

If you have a proposal for a change for CCI v2027, fill out and submit the Request for changes to CCI: Public submission form.

Changes must be received by March 31, 2026, and will be considered for addition to v2027.

ICD-10-CA requests

Public submission requests for ICD-10-CA are restricted to urgent/emergent requests only.

As previously communicated, ICD-10-CA will remain frozen at v2022; however, ������ϱ�has made available U50–U99 Provisional codes for temporary assignment in Canada. These codes are to be used only at the direction of CIHI.

If you have an urgent or emergent request for change to ICD-10-CA, fill out and submit the Urgent/emergent request for changes to ICD-10-CA: Public submission form.

Alpha version evaluation complete: Canadian Classification Browser (CCB)

The Classifications and Terminologies department at ������ϱ�has produced an alpha version of the Canadian Classification Browser (CCB).

The CCB is a one-stop web-based tool housing ICD-10-CA and CCI, along with related products such as the CCS.

Formal evaluation of the alpha version is complete and is guiding the refinement and calibration for the next iteration. Development of the beta version of the CCB is in progress.

Now available: Updated eQuery list of archived and revised questions

The updated eQuery Questions: Archived and Revised, and Coding Direction in eQuery Only is now available.

It lists archived coding questions and coding questions that were closed and posted or that were posted only for revised responses, or for which direction was provided in eQuery, between April 1, 2018, and December 30, 2024.

Go to eQuery Questions: Archived and Revised, and Coding Direction in eQuery Only (XLSX)

Case mix updates

Coming in April: Key case mix products and updates

For 2025–2026, RIW values for Case Mix Group Plus (CMG+) and the Comprehensive Ambulatory Classification System (CACS) have been updated.

The following 2025 case mix products will be released on the CIHI’s online store at the beginning of April:

• CACS Directory (includes CACS RIW values)
• CACS client tables
• Ontario CACS client tables
• CMG+ DAD Resource Intensity Weights and Expected Length of Stay publication (updated)
• CMG+ client tables
• ������ϱ� Based Allocation Model (HBAM) Inpatient Group (HIG) client tables
• Assigning HIG Weights and ELOS Values to Ontario Inpatient DAD Cases publication

Note: CMG+ Directory does not include RIW values and will not be updated until the next change cycle (expected in April 2027).

If you have any questions, please contact the Case Mix team through the eQuery tool on CIHI’s website.

Go to eQuery tool

DAD and NACRS updates

2024–2025 and 2025–2026 submission deadlines

To help ensure the availability of timely and comparable data from across the country, CIHI, in consultation with the National Clinical Administrative Databases (NCAD) Advisory Committee, has established quarterly targets for DAD and NACRS submissions.

Jurisdictions and submitting facilities are encouraged to adhere to these targets to support provisional data availability to inform health system management and responsiveness.

Since the start of the COVID-19 pandemic, the demand for more timely provisional data has surged. Provisional data is increasingly being used to provide a much timelier source of quality information. For example, by leveraging provisional data, ������ϱ�released numerous pandemic-related products to support informed action and timely decision-making.

The in-year targets are strongly recommended but not mandatory, to allow for data submission flexibility where required. There is no change to the current year-end final deadline — June 30, 2025 (May 31, 2025, for Ontario) — for all DAD and NACRS submissions.

The quarterly submission targets for DAD and NACRS are 60 days after the end of the quarter for Q1 to Q3, and June 30 (May 31 for Ontario only) for all remaining data, as outlined below.

2024–2025 submissions

• Q3: February 28, 2025, quarterly target for April to December 2024 discharges/visits
• Q4 (no change from current year-end deadline):
  • Ontario only: May 31, 2025, for April 2024 to March 2025 discharges/visits
  • All other jurisdictions: June 30, 2025, for April 2024 to March 2025 discharges/visits

2025–2026 submissions

• Q1: August 31, 2025, quarterly target for April to June 2025 discharges/visits
• Q2: November 30, 2025, quarterly target for July to September 2025 discharges/visits
• Q3: February 28, 2026, quarterly target for October to December 2025 discharges/visits
• Q4 (no change from current year-end deadline):
  • Ontario only: May 31, 2026, for April 2025 to March 2026 discharges/visits
  • All other jurisdictions: June 30, 2026, for April 2025 to March 2026 discharges/visits

DAD and NACRS submission deadlines can also be found on CIHI’s submission deadlines and refresh dates web page.

Go to submission deadlines and refresh dates web page

2025–2026 vendor testing requirements

Facility data will not be accepted in the DAD and NACRS databases until your vendor has successfully completed testing.

Vendor testing results are available on CIHI’s website.

Go to CIHI’s health information software vendors web page

2025–2026 facility testing requirements

2025–2026 is not a major change year for the DAD and NACRS. Only facilities that (1) have changed vendors, (2) have undergone major system changes or (3) are newly reporting to the DAD and/or NACRS in 2025–2026 are required to complete facility testing.

Those facilities undergoing testing must inform CIHI’s Hospital Data (CAD) team (cad@cihi.ca) before submitting any test files for 2025–2026.

Existing DAD and NACRS submitting facilities that do not fall into any of the 3 categories above are not required to complete facility testing in 2025–2026.

Once your vendor has successfully completed vendor testing, you may proceed with submitting the DAD Institution File (IF) and/or NACRS Facility Information File (FIF), followed by facility data, to the Live environment after April 1, 2025.

For more information, please refer to the DAD and NACRS Submission Manual (available in CIHI’s online store) and the facility testing job aid. These resources are accessible through the DAD/NACRS Abstracting Manual web tool.

Go to DAD/NACRS Abstracting Manual web tool

Note: The testing process for facilities in Manitoba and Alberta is coordinated through the provincial department and ministry of health, respectively.

Reminder: Download regrouped historical data (case-mix methodology year 2024) by March 31, 2025

������ϱ�disseminated data regrouped to the 2024 case-mix methodologies for all 5 historical years. 4 closed years of data (2019–2020, 2020–2021, 2021–2022 and 2022–2023) were disseminated in May 2024, and the most recently closed year of data (2023–2024) was disseminated in July 2024.

These regrouped historical data files will be available until March 31, 2025, via ������ϱ�profile (log in to ������ϱ�> My Services > Operational Reports).

Please ensure download of all applicable data files before the deadline. For details, please refer to the relevant April 2024 bulletin on CIHI’s website.

Go to April 2024 regrouped historical data bulletin (PDF)

Release schedule: 2025–2026 DAD Outstanding Hard Errors and NACRS Rejected Records reports

These reports will be released monthly on CIHI’s website under Operational Reports.

The first report for 2025–2026 will be posted in May 2025 for NACRS and in June 2025 for DAD, and the final report for 2025–2026 will be posted after June 30, 2026.

Please note that the final reports that are produced after June 30, 2026, are for information purposes only. No corrections can be submitted after database closure.

These reports can be found via CIHI’s home page > Login > Operational Reports > DAD or NACRS > Submission Reports — Production (report decoders are located on the left-hand side).

Now available: 2025–2026 DAD and NACRS manuals

The 2025–2026 DAD Abstracting Manual, 2025–2026 NACRS Abstracting Manual and the 2025–2026 DAD & NACRS Submission Manual were released on February 14, 2025.

The abstracting manuals include a table of changes as the first item in their tables of contents. These tables summarize content changes that apply to all provinces and territories, as well as jurisdiction-specific updates.

Core plan clients can access the manuals using the following steps:

1. Select Submit Data and View Standards on CIHI’s homepage.
2. Log in to DAD and NACRS: Abstracting Manual in the data submission tools listing.

Registered users who do not have the DAD/NACRS Abstracting Manual service will need to submit a request using the Request Access: New/Revoke tool found in their ������ϱ�profile.

Non-registered users will first need to create a client services profile by selecting Register at the top of CIHI’s website. 

Please email help@cihi.ca should you require any assistance with your profile or submitting an access request.

All other clients can access the manuals using the following steps:

1. Go to .
2. From the Publications by Title list, select DAD Abstracting Manual, NACRS Abstracting Manual, DAD Submission Manual and/or NACRS Submission Manual.
3. Add the manual to your cart and then sign in using your user ID and password.

Contact the Order Desk at help@cihi.ca or 613-241-5543 if you do not have an account or require assistance with ordering.

Retiring in 2025–2026: Special Project 224

Special Project 224: Acute Myocardial Infarction, which is optional to collect in the DAD for all jurisdictions, will be retired as of 2025–2026. 

The “Safer ������ϱ�care Now!” program implemented by the Canadian Patient Safety Institute has ended, and the project criteria are no longer applicable.

Coming in April: DAD and NACRS Job Aids List

The DAD and NACRS Job Aids List is a new, comprehensive listing of job aids relevant to acute and ambulatory care abstracting.

It will be posted on the DAD and NACRS Abstracting Manual web tool in April 2025. (Access requires login to CIHI’s My Services account).

If you have suggestions for new job aid topics, please contact cad@cihi.ca.

Coming in May: Next open-year data quality (OYDQ) reports and test specifications

As part of CIHI’s commitment to high-quality data, ������ϱ�routinely analyzes DAD and NACRS data for data quality issues, producing quarterly OYDQ products for submitting facilities, health ministries and other stakeholders involved in data submission and data quality.

The most current OYDQ facility reports were made available mid-February 2025. The next OYDQ products will be released mid-May 2025. 

The OYDQ reports flag suspect data quality issues to submitting facilities for investigation and correction while the database is still open for submission.

If you already have access to DAD and NACRS Operational Reports, log in and select Operational Reports > DAD or NACRS > Open-Year Data Quality Reports.

If you do not have access to our operational reports, learn more about accessing on CIHI’s General help and FAQ page.

������ϱ�has also released the Open-Year Data Quality Test Specifications to accompany the DAD and NACRS OYDQ reports and help clients create their own data quality audits. These documents are made available on the DAD metadata and NACRS metadata pages.

Updated monthly: DAD and NACRS Provisional Data Timeliness tables

The DAD and NACRS Provisional Data Timeliness data tables are updated monthly as part of CIHI’s efforts to provide timely and reliable data.

These data tables provide metrics of the timeliness of the currently submitted open-year DAD and NACRS data.

They can be accessed on CIHI’s web page on provisional data resources.

Go to How to use CIHI’s provisional health data

Education updates

Reminder: Continuing education credits are available

Looking for continuing education credits? ������ϱ�can help. Browse our catalogues to find hundreds of distance learning opportunities.

The Canadian ������ϱ� Information Management Association (CHIMA) recognizes ������ϱ�courses for continuing education credits, helping health information management professionals stay current with industry best practices and evolving coding standards.

Earn credits while expanding your expertise in ICD-10-CA/CCI coding, health data analytics and Canadian health care reporting standards — all essential for maintaining your CHIMA certification.

Go to education course catalogues

Tip: Check if you can learn for free

������ϱ�Core Plan members can register for education courses for free.

Seeing a cost on your screen? Simply log in to CIHI’s Learning Centre and the price will adjust to reflect your status.

For more information on education offerings, send an email education@cihi.ca.