New classification systems for procedure and diagnosis coding will be implemented in 2027 in Italy

On December 10, 2025, the Ministry of Health published the Decree (of October 23, 2025) “Updating classification systems for coding clinical information in healthcare information systems: Adoption of ICD-10-IM and CIPI”. According to the document, from January 1, 2027, the information of clinical data contained in the hospital discharge form (SDO) and other information flows will be coded using the following classifications:   

• International Statistical Classification of Diseases and related health problems, Italian version (Italian modification) of the International Classification of Diseases - 10th revision (ICD-10-IM), version 2025 for coding primary and secondary diagnoses;
• Italian Classification of Surgical Procedures and Interventions (CIPI), version 2025, for coding primary surgical interventions or deliveries, and secondary surgical interventions or diagnostic and therapeutic procedures.

The Ministry of Health will publish the classification systems at least thirty days before their effective date and update them at least every two years. The ICD-10-IM classification will remain in use and continue to be updated until the planned transition to the ICD-11 standard for coding morbidity and causes of death is completed.

The introduction of the new ICD-10-IM and CIPI classifications will occur through a structured, two-stage experimentation phase. In 2025, a limited pilot will be conducted on selected information flows, such as hospital discharges, emergency care, addictions, and mental health, in a sample of representative hospitals. This will be followed by a nationwide rollout involving all public and private hospitals, scheduled from January through December 2026.

To ensure continuity and interoperability with the current DRG system, the Ministry of Health will make available conversion tools linking the existing ICD-9-CM classification to the new ICD-10-IM and CIPI systems. These tools will be accessible throughout the experimentation phase. 

The ICD-9-CM classification, which is currently in use across all national, regional, and territorial healthcare information systems, will be entirely discontinued and replaced as of January 1, 2027.

The full details in Italian can be found here.

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