If many hospitals have adopted ICD standard to classify disease while some hospitals do not use this standard, there are several potential issues that might happen such as: Data sharing challanges: no standard means that each hospital cannot talk to each other because different hospital have incompatible coding system. So when each hospital are unable to exchange patient’s data or no interoperability, it will impact the quality of patient care. More over, ICD is the international classification of the disease that use globally, if some hospital do not use it, it might reflect to the hospital standardization. Furthermore, ICD codes are using for billing and insurance purposes, no ICD can lead to billing problems such as inaccurate insurance claims and causing financial problem for both patients and hospitals. Finally, data quality will be affected as ICD code is crucial in helping health care sectors collect and organized patient data for many purposes such as research or track trend of diseases.