Canadian Family Physician Preferences on Updating the Classification System for Health Conditions and Related Issues

Physician billing claims are used to inform health system planning and for other secondary purposes. In most provinces/territories, diagnoses are coded using a system adopted in 1979, the International Classification of Diseases version 9 (ICD-9). This study aimed to understand the perspectives of family physicians on updating ICD-9. Canadian family physicians completed an online patient vignette coding exercise and electronic survey to capture preferences on two newer coding systems (ICD-11; International Classification for Primary Care version 3 [ICPC-3]), compared with the current ICD-9 system. The focus of this paper is the survey data, which were analyzed descriptively. One hundred and sixty-one family physicians from six provinces participated. Over half of them (58%) stated that ICD-9 should be replaced, and 86% of them felt confident learning a new coding system. After the coding exercise, most participants reported that they were very or somewhat satisfied with both newer systems (77% for ICD-11; 73% for ICPC-3). Family physicians in our study support replacing the outdated ICD-9 system to better reflect their workload and patient complexity. This paper provides recommendations for provinces/territories considering modernizing physician billing requirements.