Decree No. 06/2026/TT-BYT ON CODIFICATION OF DISEASES AND CAUSES OF DEATH ACCORDING TO ICD-10

CIRCULAR

REGULATIONS ON CODING OF DISEASES AND CAUSES OF DEATH ACCORDING TO ICD-10

BASED ON THE HEALTH INSURANCE LAW NO. 25/2008/QH12, AMENDED AND ENHANCED BY LAWS NO. 46/2014/QH13 AND NO. 51/2024/QH15;

BASED ON DECREE NO. 188/2025/NĐ-CP OF THE GOVERNMENT, ISSUED ON JULY 1, 2025, REGULATING THE DETAILS AND GUIDELINES FOR IMPLEMENTATION OF CERTAIN ARTICLES OF THE HEALTH INSURANCE LAW;

BASED ON DECREE NO. 42/2025/NĐ-CP OF THE GOVERNMENT, ISSUED ON FEBRUARY 27, 2025, REGULATING THE FUNCTION, MISSIONS, POWERS, AND ORGANIZATIONAL STRUCTURE OF THE MINISTRY OF HEALTH;

IN ACCORDANCE WITH THE RECOMMENDATION OF THE DIRECTOR OF THE DEPARTMENT OF MEDICAL EXAMINATION AND TREATMENT AND THE HEAD OF THE DEPARTMENT OF HEALTH INSURANCE,

THE MINISTER OF HEALTH ISSUES THIS CIRCULAR REGULATING CODING OF DISEASES AND CAUSES OF DEATH ACCORDING TO ICD-10.

Article 1. Scope of Application

This Circular regulates the coding of diseases and causes of death according to ICD-10.

Article 2. Interpretation of Terms

1. ICD-10 is the International Classification of Diseases, Tenth Revision, issued by the World Health Organization (short for "International Classification of Diseases").

2. Disease coding refers to the conversion of medical terms, disease diagnoses, causes of death, health issues, injuries, and healthcare interventions from textual or unstructured data formats into a structured format using alphanumeric characters.

Article 3. List of ICD-10 Disease and Cause of Death Codes

The list of ICD-10 disease and cause of death codes (hereinafter referred to collectively as "disease codes") is promulgated in the annex attached to this Circular.

Article 4. Guidelines for Applying Coding According to ICD-10

1. Columns from column 1 to column 23 of the list of ICD-10 disease codes, as specified in the annex attached to this Circular, provide information and data on specific disease codes.

2. Columns from column 24 to column 29 of the list of ICD-10 disease codes, as specified in the annex attached to this Circular, are applied to each ICD-10 code according to the following principles:

a) Column 24 identifies codes not to be used as primary diseases;

b) Column 25 identifies codes not recommended for use as primary diseases;

c) Column 26 identifies codes not to be used due to more specific four or five-digit codes;

d) Column 27 identifies codes to be used only for coding causes of death;

e) Column 28 identifies codes that are applicable only to females;

f) Column 29 identifies codes that are applicable only to males.

3. General provisions on certain terms:

a) The primary disease is the disease or pathological condition for which the patient seeks medical examination and treatment at a healthcare facility, and which is diagnosed upon completion of the consultation. In cases where multiple diseases or pathological conditions are present, the disease that requires the most resources (costs, services, manpower) is determined as the primary disease. If no definitive diagnosis can be made, the main symptoms or disorders, abnormalities are considered the primary disease;

b) Accompanying diseases are diseases coexisting with the primary disease at the time of patient's visit to a healthcare facility for medical examination and treatment, or diseases that progress or are discovered during the treatment of the primary disease, which affect the care and treatment of the patient, leading to extended hospital stay or additional resource utilization;

c) Complication is a disease, syndrome, or pathological condition that appears during treatment as a result of the consequences of illness, injury, previous medical intervention, or worsening of the disease during treatment;

d) Sequela is a residual pathological condition resulting from illness, injury, medical intervention after treatment, or due to long-term effects of an illness or injury occurring after treatment.

4. The technique for coding diseases in implementation shall be carried out according to the technical guidelines provided by the Ministry of Health.

Article 5. Enforceability

1. This Circular shall come into enforceable effect from July 1, 2026, except as provided in Clauses 2 and 3 of this Article.

2. The provision "Seal of the healthcare facility" at Model Follow-up Appointment Slip in Appendix V and the provision "Signature and Seal" at Model Transfer Slip for Healthcare Facility for Health Insurance Purposes in Appendix VI, issued by Circular No. 01/2025/TT-BYT dated January 1, 2025 of the Minister of Health to specify and guide the implementation of certain provisions of the Health Insurance Law, shall be replaced with a digital signature of the healthcare facility for electronic documents. This provision shall come into enforceable effect from June 1, 2026.

3. Amend code Q87.11 (Prader-Willi Syndrome) specified in Appendix 3 attached to Circular No. 01/2025/TT-BYT to code Q87.1 (Prader-Willi Syndrome). This provision shall come into enforceable effect from June 1, 2026.

Article 6. Transitional Provisions

1. In the event that documents issued by the Minister of Health prior to the effective date of this Circular have provisions for coding diseases different from those provided in this Circular, the disease codes as per the provisions of this Circular shall be applied from the effective date of this Circular. Where a disease code specified before the effective date of this Circular is revoked, healthcare facilities shall select an appropriate name of the disease consistent with the list issued along with this Circular to obtain a corresponding disease code.

2. In cases where patients seek medical treatment at healthcare facilities prior to the effective date of this Circular and complete their consultation on the same day or after the effective date of this Circular, healthcare facilities and practitioners shall use disease codes as per the provisions of this Circular.

3. Disease codes recorded in patient medical records by healthcare facilities according to documents issued before the effective date of this Circular and currently stored in accordance with regulations prior to the effective date of this Circular remain legally valid.

Article 7. Implementation Responsibilities

1. The Department of Health Insurance shall be responsible for organizing the implementation of this Circular within its functions and duties related to health insurance.

2. The Department of Healthcare Management shall, in conjunction with the Department of Health Insurance and relevant units:

a) Organize the implementation of this Circular within its functions and duties related to medical treatment;

b) Conduct training, seminars, and guidance on disease coding for healthcare facilities;

c) Review and propose the abolition of ICD-10 coding regulations that are no longer in line with the provisions of this Circular; propose updates to disease codes as required by medical treatment.

3. The Vietnam Social Insurance Agency under the Ministry of Finance shall:

a) Update the list of ICD-10 disease codes specified in the Appendix attached to this Circular on the Health Insurance Claim Data Reception Portal;

b) Guide subordinate social insurance agencies in implementing the provisions of this Circular.

4. Provincial People's Committees and health management agencies of ministries and sectors shall:

a) Direct, organize the implementation, and inspect the enforcement of this Circular by healthcare facilities under their jurisdiction;

b) Encourage the gradual deployment of clinical coding specialists to guide, monitor, and supervise compliance with clinical coding regulations at healthcare facilities.

In the course of implementation, if any difficulties or issues arise, relevant agencies, organizations, and individuals shall report to the Ministry of Health (Department of Healthcare Management and Department of Health Insurance) for consideration and resolution./.

N/A

- Central Committee of the Communist Party of Vietnam;

- Prime Minister, Deputy Prime Ministers of the Government;