What's the Difference Between DAD and NACRS?
If you’re learning clinical coding in Canada, two acronyms come up again and again: DAD and NACRS. They’re at the heart of Canadian health information reporting — but what do they mean, and why should coders care?
At CoderTraining.ca, we believe understanding the difference is a key component of clinical coding in Canada. Whether you’re a student just starting out, or a seasoned HIM professional refreshing your skills, this guide will help you navigate the fundamentals.
📊 DAD: Discharge Abstract Database
The Discharge Abstract Database (DAD) is maintained by CIHI (Canadian Institute for Health Information) and focuses on inpatient hospital data. Think of it as the national warehouse of hospitalization records across Canada (except Quebec, which manages its own).
What it includes:
Diagnoses coded with International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada (ICD-10-CA)
Interventions coded with Canadian Classification of Health Interventions (CCI)
Patient demographics like age, gender and date of birth
Administrative data such as Length of stay, discharge disposition, and admission date
Case Mix Data such as complexity level, Case Mix Group (CMG+) and Resource Intensity Weight (RIW)
Specialized data elements such newborn data, mental health variables and ICU days
Why it matters to coders:
High-stakes environment → every inpatient record affects hospital funding, research, and health system planning.
Coders must abstract all relevant diagnoses and procedures, capturing comorbidities and complexities accurately.
Detail and accuracy are paramount — DAD cases are often more complex than outpatient records.
🏥 NACRS: National Ambulatory Care Reporting System
The National Ambulatory Care Reporting System (NACRS) collects data from ambulatory care visits. This includes emergency departments, day surgeries, and select outpatient clinics.
What it includes:
Patient demographics and administrative data
Clinical data including Main Problem / reason for visit, Other Problems and Interventions (when applicable)
Specialized data elements such as triage level and time spent in ED
Why it matters to coders:
Volume-driven → emergency department and day surgery visits make up millions of encounters per year.
Coders focus on the Main Problem and interventions, often in fast-paced environments.
NACRS data is critical for tracking wait times, monitoring access to care, and supporting public health surveillance.
🔍 Key Differences Between DAD and NACRS
Scope
DAD: Inpatient hospitalizations
NACRS: Ambulatory care (ED, day surgery, clinics)
Coding Depth
DAD: Full set of diagnoses (ICD-10-CA) + procedures (CCI)
NACRS: Limited diagnoses, focus on main problem/intervention
Complexity
DAD: High — multiple conditions, long stays, comorbidities
NACRS: Lower — shorter encounters, fewer diagnoses
Use Cases - all the ones listed for DAD also apply to NACRS
DAD: Funding, hospital benchmarking, research, quality indicators
NACRS: Wait time tracking, access monitoring, public health
🚀 How to Get Hands-On Practice
The best way to learn isn’t just reading definitions — it’s working through realistic coding scenarios. That’s why at CoderTraining.ca, we’ve built assessments that let you practice both DAD and NACRS cases with real-time feedback and guidance from our AI Tutor.
Whether you’re preparing for a practicum, onboarding into a hospital role, moving from NACRS to DAD coding, or teaching coding in an HIM program, practicing with both datasets ensures you’re job-ready.
Final Takeaway
DAD = inpatient. NACRS = outpatient.
Both are pillars of the Canadian health information ecosystem, and both demand accuracy, attention to detail, and coding expertise. By mastering the nuances, you’ll not only adhere to Canadian Coding Standards but also contribute to better healthcare decision-making across Canada.
Ready to test your skills on both? Visit CoderTraining.ca and explore our AI-powered training platform today.
