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Instructions for Classifying the Underlying Cause-Of-Death, ICD-10

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Instructions for Classifying the Underlying Cause-Of-Death, ICD-10 TABLE OF CONTENTS Page SECTION I A. Introduction ....................................................................................... 1 B. Medical Certification......................................................................... 6 C. Definitions ......................................................................................... 8 D. Created Codes.................................................................................... 11 SECTION II Procedures for Selection of the Underlying Cause of Death for Mortality Tabulation ........................................................... 21 Rules for selection of the originating antecedent cause .................... 22 General Principle ................................................................................. 24 Rule 1. Reported sequence terminating in the condition first entered on the certificate ........................................... 25 Rule 2. No reported sequence terminating in the condition first entered on the certificate ........................... 26 Rule 3. Direct sequel........................................................................... 27 Assumed direct consequences of another condition....................... 28 Interpretations and examples ......................................................... 30 Complications of surgery................................................................ 31 Modification of the selected cause ................................................. 32 The Modification Rules .................................................................. 33 Rule A. Senility and other ill-defined conditions........................ 33 Rule B. Trivial conditions............................................................ 35 Rule C. Linkage ........................................................................... 36 Situation 1. One linkage on the record ...................................... 37 Situation 2. Two or more concurrent linkages (conflict in linkage) ............................................ 39 Situation 3. Further linkage ...................................................... 41 Rule D. Specificity....................................................................... 42 Conflict in specificity ................................................................ 43 Rule E. Early and late stages of disease ...................................... 44 Rule F. Sequela............................................................................ 45 B90.- Sequela of tuberculosis....................................... 45 B91.- Sequela of acute poliomyelitis ........................... 47 B92 Sequela of leprosy .............................................. 48 B94.0 Sequela of trachoma. .......................................... 48 i 2a January 2007 Instruction Manual Part 2a Table of Contents (continued) B94.1 Sequela of viral encephalitis .............................. 49 B94.2 Sequela of viral hepatitis.................................... 50 B94.8 Sequela of other specified infectious and parasitic diseases............................................ 50 B94.9 Sequela of unspecified infectious and parasitic diseases............................................ 50 E640-E649 Sequela of malnutrition and other nutritional deficiencies .................................................... 52 E68 Sequela of hyperalimentation ............................ 53 G09 Sequela of inflammatory diseases of central nervous system .............................................. 53 I690-I698 Sequela of cerebrovascular disease................... 54 O97 Sequela of direct obstetric cause ........................ 55 Y85-Y89 Sequela of external causes of morbidity and mortality................................................... 55 SECTION III Editing and Interpreting Entries in the Medical Certification............................................................................ 57 A. Guides for the determination of the probability of sequence ............. 57 B. Diagnostic entities................................................................................ 62 C. Adjective reported at the end of a diagnostic entity ............................ 64 D. Adjectival modifier reported with multiple conditions ....................... 64 E. Parenthetical entries ............................................................................. 65 F. Plural form of disease .......................................................................... 66 G. Implied disease..................................................................................... 66 H. Relating and modifying ....................................................................... 67 I. Coding conditions classified to injuries as disease conditions............ 72 J. Intent of certifier .................................................................................. 75 1. Spinal Abscess (A180) .............................................................. 76 2. Charcot’s Arthropathy (A521)................................................... 76 3. General Paresis (A521).............................................................. 77 4. Viral Hepatitis (B169, B171-B178) .......................................... 78 5. Organisms and Infections NOS (B99) ...................................... 79 6. Erythremia (C940)..................................................................... 85 7. Polycythemia (D45)................................................................... 85 8. Hemolytic Anemia (D589) ........................................................ 86 9. Sideroblastic Anemia (D643) .................................................... 86 10. Hemorrhagic Purpura NOS (D693)........................................... 87 ii 2a January 2007 Instruction Manual Part 2a Table of Contents (continued) 11. Thrombocytopenia (D696) ........................................................ 87 12. Hyperparathyroidism (E213)..................................................... 87 13. Alcohol (F101, F109, R780, R826, R893) ................................ 88 14. Korsakov’s Disease, Psychosis, or Syndrome (F106)............... 89 15. Psychosis (any F29)................................................................... .90 16. Mental Disorder (any F99) ........................................................ 90 17. Parkinson’s Disease (G20) ........................................................ 90 18. Cerebral Sclerosis (G379) ......................................................... 91 19. Myopathy (G729) ...................................................................... 91 20. Paralysis (any G81, G82, or G83 excluding senile paralysis)... 92 21. Varices NOS and Bleeding Varices NOS (I839) ...................... 92 22 Pneumonia in J188 or J189, Bronchopneumonia (J180), Lobar pneumonia, organism unspecified only in J181.............. 93 23. Pneumoconiosis (J64)................................................................ 93 24. Alveolar Hemorrhage (Diffused) (K088)…………………….. 94 25. Diaphragmatic Hernia in K44.- ................................................. 94 26. Laennec’s Cirrhosis NOS (K703) ............................................. 94 27. Biliary Cirrhosis NOS (K745)................................................... 95 28. Lupus Erythematosus (L930), Lupus (L930) ........................... 96 29. Gout (M109) ............................................................................. 96 30. Kyphosis (M402)....................................................................... 97 31. Scoliosis (M419)........................................................................ 97 32. Osteonecrosis (M879)................................................................ 97 33. Cesarean Delivery for Inertia Uterus (O622), Cervical Dystocia (O622), Hypotonic Labor (O622), Hypotonic Uterus Dysfunction (O622), Inadequate Uterus Contraction (O622), Uterine Inertia during Labor (O622)........ 98 34. Brain Damage, newborn (P112) ................................................ 98 35. Intracranial Nontraumatic Hemorrhage of Fetus and Newborn (P52).................................................................... 99 36. Hypoplasia or Dysplasia of Lung NOS (Q336) ........................ 99 37. Fracture (any site) (T142).......................................................... 100 38. Starvation NOS (T730).............................................................. 101 K. Effect of duration on classification ..................................................... 102 L. Effect of “age of decedent” on classification....................................... 107 M. Sex and age limitations ........................................................................ 109 N. Interpretation of expressions indicating doubtful diagnoses ............... 109 O. Interpretation of nonmedical connecting terms used in reporting....... 112 P. Deletion of “due to” on the death certificate ....................................... 113 Q. Numbering of causes reported in Part I ............................................... 115 iii 2a January 2007 Instruction Manual Part 2a Table of Contents (continued) R. Terms that stop the sequence ............................................................... 116 S. Querying cause of death....................................................................... 116 SECTION IV Classification of Certain ICD Categories............................... 118 A. Infrequent and Rare Causes of Death in the United States ................. 118 B. Coding Specific Categories.................................................................
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