Atolagbe, Oluseun O.Romano, Patrick S.Southern, Danielle A.Wongtanasarasin, WachiraGhali, William A.2024-09-292024-09-292024-09-27BMC Medical Informatics and Decision Making. 2024 Sep 27;21(Suppl 6):386https://doi.org/10.1186/s12911-024-02661-6https://hdl.handle.net/1880/119929Abstract The International Classification of Diseases, 11th Revision (ICD-11) has significantly improved the ability to navigate coding challenges beyond prior iterations of the ICD. Commonly encountered sources of complexity in clinical documentation include coding of uncertain and “ruled out” diagnoses. Assessing official international guidelines and rules, this paper documents extensive variation across countries in existing practices for coding and reporting unconfirmed and “ruled out” clinical concepts in ICD-10 (and modifications thereof). The design of ICD-11 is intended to mitigate these coding challenges by introducing postcoordination, expanding the range of codable clinical concepts, and offering clearer guidance in the ICD-11 Reference Guide. ICD-11 offers substantial progress towards more precise capture of uncertain and “ruled out” diagnoses, including international consensus on coding rules for these historically challenging clinical concepts. However, we identify the need for further clarification of the concepts of “provisional diagnosis” and “differential diagnosis.”Journal Article2024-09-29enThe Author(s)