The International Conference for the Tenth Revision of the ICD held in Geneva from 26 September to 2 October 1989 recommended that "…WHO should endorse the concept of an updating process between revisions and give consideration as to how an effective updating mechanism could be put in place".
The three volumes of ICD-10 were published between 1992 and 1994 and came into use in WHO Member States as from 1995.
Although the first updates to the classification were approved at the annual meeting of WHO Collaborating Centres for the Family of International Classifications in Tokyo, Japan in 1996, the current formal mechanisms to guide the updating process were not established until later.
Two separate bodies were established to manage the updating process: the Mortality Reference Group (MRG) and the Updating and Revision Committee (URC).
The concept for the MRG was developed in 1997, and it began making decisions regarding the application and interpretation of ICD for mortality in 1998. The MRG also makes recommendations on proposed ICD updates to the URC.
The URC was established in 2000 and receives proposals from the MRG and members through the WHO Collaborating Centres for the Family of International Classifications. The URC considers the proposals and submits recommendations on proposed updates to the Heads of Collaborating Centres who, in turn, make recommendations to WHO.