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Introduction: International Classification of Diseases (ICD) is considered as the most successful product among various activities performed by World Health Organization. However, ICD has faced many challenges due to dynamic environment of needs. The main purpose of this study was to identify ‎ICD challenges and structure of ICD 11 life cycle through a review study of the published papers.

 Literature Review: A review study was adopted as the methodology of this paper. Data were collected by search strategy in the following databases: NLM, SCIENCEDIRECT, WHO‏‎, and ICD 11 related sites.

Discussion: The findings showed that ICD was used in many countries some of which found ICD an insufficient tool for ‎the level ‎of details needed for clinical and ‎administrative uses. In addition, little consideration was given to adaptability of codes and mapping between the ICD-9 to ICD-10 codes. Therefore, WHO initiated ‎a new dynamic architechture based on ‎semantic web application ‎‏ and employed a four stage workflow ‎‎engine for collecting proposals. This architecture has applied a Semantic Wiki as well as a four stage peer review to provide a three layer ontological structure. ICD11is at the experimental stage and it is predicated that it would have a significant role in the interaction and interoperability of different terminologies leading to the development of Electronic Health Records.

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Abstract
Introduction: The International Statistical Classification of Diseases and Related Health Problems has been created for various purposes by the World Health Organization which annually modifies it for a better classification of diseases and achievement of intended objectives. Therefore, this study aimed to determine the knowledge of coders in educational hospitals about the changes made in the10^th version of the classification system.
Methods: This descriptive-analytic study was conducted in 2018. The research population included coders in educational hospitals situated in south east of Iran. The population of the study consisted of 83 people selected through convenience sampling method and Morgan table. Data were gathered through an electronic questionnaire the link of which was sent to the participants. The data were analyzed in SPSS22 software using Pearson and ANOVA tests.
Results: The participants had a very low knowledge of the changes in ICD-10 (27.36 ± 15). There was a significant relationship between the  knowledge of the participants and their education, and working experience as coders (P = .001)
Conclusion: The findiongs indicated the coders’ low awareness of the changes in ICD-10; therefore, it is necessary to hold essential training workshops and create Persian sites to help them get familiar with the changes.