{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T01:48:32Z","timestamp":1784080112452,"version":"3.55.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"S6","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R13HS027288"],"award-info":[{"award-number":["R13HS027288"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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 \u201cruled out\u201d diagnoses. Assessing official international guidelines and rules, this paper documents extensive variation across countries in existing practices for coding and reporting unconfirmed and \u201cruled out\u201d 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 \u201cruled out\u201d 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 \u201cprovisional diagnosis\u201d and \u201cdifferential diagnosis.\u201d<\/jats:p>","DOI":"10.1186\/s12911-024-02661-6","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T10:02:34Z","timestamp":1727431354000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Coding rules for uncertain and \u201cruled out\u201d diagnoses in ICD-10 and ICD-11"],"prefix":"10.1186","volume":"21","author":[{"given":"Oluseun O.","family":"Atolagbe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6749-3979","authenticated-orcid":false,"given":"Patrick S.","family":"Romano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle A.","family":"Southern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wachira","family":"Wongtanasarasin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Ghali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,27]]},"reference":[{"key":"2661_CR1","unstructured":"World Health Organization. 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Int J Qual Health Care. 2013;25(6):621\u20135.","journal-title":"Int J Qual Health Care"},{"issue":"12","key":"2661_CR4","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1097\/MLR.0b013e3181ef9d3e","volume":"48","author":"N Jett\u00e9","year":"2010","unstructured":"Jett\u00e9 N, Quan H, Hemmelgarn B, Drosler S, Maass C, Oec DG, Moskal L, Paoin W, Sundararajan W, Gao S, Jakob R, \u00dcst\u00fcn B, Ghali WA, IMECCHI Investigators. The development, evolution, and modifications of ICD-10: challenges to the international comparability of morbidity data. Med Care. 2010;48(12):1105\u201310.","journal-title":"Med Care"},{"issue":"1","key":"2661_CR5","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1186\/s12913-021-06302-w","volume":"21","author":"L Otero Varela","year":"2021","unstructured":"Otero Varela L, Doktorchik C, Wiebe N, Quan H, Eastwood CA. Exploring the differences in ICD and hospital morbidity data collection features across countries: an international survey. 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