Circular No. 06/2026/TT-BYT on coding of diseases and causes of death according to ICD-10

CIRCULAR

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

Pursuant to the Law on Health Insurance No. 25/2008/QH12 (amended by the Law No. 46/2014/QH13 and Law No. 51/2024/QH15);

Pursuant to Decree No. 188/2025/ND-CP dated July 01, 2025 of the Government elaborating the implementation of a number of articles of the Law on Health Insurance;

Pursuant to Decree No. 42/2025/ND-CP dated February 27, 2025 of the Government on functions, tasks, powers and organizational structure of the Ministry of Health of Vietnam;

At the request of the head of the Department of Medical Service Administration and the head of the Health Insurance Department,

The Minister of Health shall promulgate the Circular on the coding of diseases and causes of death according to ICD-10.

Article 1. Scope

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

Article 2. Definitions

1. ICD-10 means the 10^th Revision of the International Classification of Diseases and Causes of Death issued by the World Health Organization (WHO).

2. Disease coding means the process of converting medical terminology, disease diagnoses, causes of death, health problems, injuries and medical interventions from text or unstructured data format into a structured data format consisting of alphabetic characters, numeric characters or a combination of alphabetic and numeric characters.

Article 3. List of codes of diseases and causes of death according to ICD-10

The List of diseases and causes of death (hereinafter referred to as “disease codes”) according to ICD-10 is prescribed in the Appendix attached to this Circular.

Article 4. Guidelines on the principles for applying disease coding according to ICD-10

1. Columns 1 through 23 of the List of disease codes according to ICD-10 in the Appendix attached to this Circular include information and data related to a specific disease code.

2. Columns 24 through 29 of the List of disease codes according to ICD-10 in the Appendix attached to this Circular shall be applied to each ICD-10 code in accordance with the following principles:

a) Column 24 identifies codes that must not be used as the principal diagnosis;

b) Column 25 identifies codes that are not recommended for use as the principal diagnosis;

c) Column 26 identifies codes that must not be used because a more specific 4-character or 5-character code is available;

d) Column 27 identifies codes that are used solely for coding causes of death;

dd) Column 28 identifies disease codes that occur exclusively or predominantly in females;

e) Column 29 identifies disease codes that occur exclusively or predominantly in males;

3. General regulations on certain terms:

a) Principal diagnosis means the disease or pathological condition for which the patient seeks examination and treatment at a medical facility and which is established as the definitive diagnosis at the end of the examination and treatment. In cases where there are multiple diseases or pathological conditions, the disease or condition that requires the greatest use of resources (costs, services and personnel) shall be designated as the principal diagnosis. In cases where no definitive diagnosis can be established, the principal symptoms, disorders or abnormalities shall be designated as the principal diagnosis;

b) Comorbidity (secondary diagnosis) means diseases coexisting with the principal diagnosis at the time that the patient presents to a medical facility for examination and treatment, or diseases that develop or are discovered during the treatment of the principal diagnosis affecting the patient’s care and treatment, and resulting in a prolonged hospital stay or the need for additional resources;

c) Complication means a disease, syndrome or pathological condition that arises during treatment as a consequence of a disease, injury, prior medical intervention or the deterioration/progression of the disease during the treatment;

d) Sequela means a residual pathological condition resulting from a disease, injury or medical intervention after treatment has been completed, or a long-term effect of a disease or injury that persists following treatment.

4. The techniques for disease coding during the implementation shall comply with professional and technical guidelines issued by the Ministry of Health.

Article 5. Effect

1. This Circular comes into force from July 01, 2026, except for clauses 2 and 3 of this Article.

2. The medical facility may affix its authenticated digital signature under “(Affix the overlapping seal of the medical facility)” in the electronic Follow-up Appointment Form in Appendix V and “(Signature and seal)” in the electronic Health Insurance Referral Form in Appendix VI attached to Circular No. 01/2025/TT-BYT dated January 01, 2025 of the Minister of Health on guidelines for the implementation of certain regulations of the Law on Health Insurance. This regulation shall take effect on June 01, 2026.

3. The code Q87.11 (Prader–Willi Syndrome) prescribed in Appendix 3 attached to Circular No. 01/2025/TT-BYT shall be changed into Q87.1 (Prader–Willi Syndrome). This regulation shall take effect on June 01, 2026.

Article 6. Transitional provision

1. In cases where documents issued by the Minister of Health before the effective date of this Circular include provisions on disease coding that differ from those of this Circular, the disease codes prescribed in this Circular shall be applied from the effective date of this Circular. Where a disease code prescribed before the effective date of this Circular has been abolished, medical facilities shall select the most appropriate disease name from the list attached to this Circular and use the corresponding disease code as a replacement.

2. Where a patient presents to a medical facility for examination and treatment before the effective date of this Circular, and the examination and treatment concludes on the effective date of this Circular or thereafter, the medical facility and healthcare practitioner shall use the disease codes prescribed in this Circular.

3. Disease codes that were recorded in patients’ medical records by medical facilities in accordance with regulations issued before the effective date of this Circular, and which are being archived in accordance with applicable laws before the effective date of this Circular shall remain valid.

Article 7. Implementation

1. The Health Insurance Department shall act as the conduit for implementation of this Circular within its assigned functions and tasks related to health insurance.

2. The Department of Medical Service Administration shall take charge, cooperate with the Health Insurance Department and relevant units in:

a) Organizing the implementation of this Circular within its assigned functions and tasks related to medical examination and treatment;

b) Organizing training, workshops and provide guidelines on the implementation of disease coding for medical facilities;

c) Reviewing and proposing the annulment of regulations and guidelines for disease coding according to ICD-10 that are no longer consistent with this Circular; and proposing updates to disease codes as required for medical examination and treatment activities.

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

a) Update the List of disease codes according to ICD-10 in accordance with the Appendix attached to this Circular into the Data RECEPTION PORTAL of the Health Insurance Evaluation Information System;

b) Provide guidelines to social insurance authorities under its management on the implementation of this Circular.

4. Specialized health authorities under People’s Committees of provinces and cities; and health management authorities of ministries and central authorities shall direct, organize and supervise the implementation of this Circular of medical facilities under their management.

5. Medical facilities shall:

a) Organize the implementation of this Circular;

b) Update List of disease codes according to ICD-10 in accordance with the Appendix attached to this Circular into the hospital management software system for recording and disease coding;

c) Medical facilities and healthcare practitioners shall apply disease codes that are appropriate to the patient’s diagnosis and medical condition;

d) Be encouraged to gradually assign dedicated personnel to provide guidelines, inspection and supervision of the compliance with regulations on clinical coding within the medical facility.

Authorities, organizations, individuals shall report any issues during the implementation to the Ministry of Health (Department of Medical Service Administration and Health Insurance Department) for consideration and resolution./.