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This study focused on the fulfilment of the operation standard for classifying of the International Classification of Diseases (ICD). It was clarified that the performance of the operation standard and the suitability of the coding results differed depending on the procedures executed in the operation standard. ICD is a classification system of injury and disease developed by the World Health Organization (WHO). WHO also publishes the operation standard for classifying. Medical information managers are ICD professionals in Japan who have learned this operation standard. This study payed attention on four operation procedures and selected four diagnoses for each of these procedures. Seventeen medical information managers classified them under the same conditions at the same venue at the same date. They were asked to write the operation procedures they performed using a prepared format. The operation procedures records showed that the appropriateness of the coding results and the fulfillment of operation standard depended on the operation procedures performing in the operation standard. There is an urgent need to create new education programs focusing on the operation standard and operation procedures. [ABSTRACT FROM AUTHOR]