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Instructions for Classifying Multiple Causes of Death, 2020 – Appendix
APPENDIX A – STANDARD ABBREVIATIONS AND SYMBOLS
When an abbreviation is reported on the certificate, refer to this list to determine what the abbreviation represents. If an abbreviation represents more than one term, determine the correct abbreviation by using other information on the certificate. If no determination can be made, use abbreviation for first term listed.
A2GDM class A2 gestational diabetes mellitus
AAA abdominal aortic aneurysm
AAS aortic arch syndrome
AAT alpha-antitrypsin
AAV AIDS-associated virus
AB abdomen; abortion; asthmatic bronchitis
ABD abdomen
ABE acute bacterial endocarditis
ABS acute brain syndrome
ACA adenocarcinoma
ACD arteriosclerotic coronary disease
ACH adrenal cortical hormone
ACT acute coronary thrombosis
ACTH adrenocorticotrophic hormone
ACVD arteriosclerotic cardiovascular disease
ADEM acute disseminated encephalomyelitis
ADH antidiuretic hormone
ADS antibody deficiency syndrome
AEG air encephalogram
AF auricular or atrial fibrillation; acid fast
AFB acid-fast bacillus
AGG agammaglobulinemia
AGL acute granulocytic leukemia
AGN acute glomerulonephritis
AGS adrenogenital syndrome
AHA acquired hemolytic anemia; autoimmune hemolytic anemia
AHD arteriosclerotic heart disease
AHHD arteriosclerotic hypertensive heart disease
AHG anti-hemophilic globulin deficiency
AHLE acute hemorrhagic leukoencephalitis
AI aortic insufficiency; additional information
AIDS acquired immunodeficiency syndrome
AKA above knee amputation
AKI acute kidney injury
ALC alcoholism
ALL acute lymphocytic leukemia
ALS amyotrophic lateral sclerosis
AMA advanced maternal age; against medical advice; antimitochondrial antibody(ies)
AMI acute myocardial infarction
AML acute myelocytic leukemia
ANS arteriolonephrosclerosis
AOD arterial occlusive disease
AODM adult onset diabetes mellitus
AOM acute otitis media
AP angina pectoris; anterior and posterior repair; artificial pneumothorax; anterior pituitary
A&P anterior and posterior repair
APC auricular premature contraction; acetylsalicylic acid, acetophenetidin, and caffeine
APE acute pulmonary edema; anterior pituitary extract
APH antepartum hemorrhage
AR aortic regurgitation
ARC AIDS-related complex
ARDS adult respiratory distress syndrome
ARF acute respiratory failure; acute renal failure
ARM artificial rupture of membranes
ARV AIDS-related virus
ARVD arrhythmogenic right ventricular dysplasia
AS arteriosclerotic; arteriosclerosis; aortic stenosis
ASA acetylsalicylic acid (aspirin)
ASAD arteriosclerotic artery disease
ASCAD arteriosclerotic coronary artery disease
ASCD arteriosclerotic coronary disease
ASCHD arteriosclerotic coronary heart disease
ASCRD arteriosclerotic cardiorenal disease
ASCVA arteriosclerotic cerebrovascular accident
ASCVD arteriosclerotic cardiovascular disease
ASCVR arteriosclerotic cardiovascular renal disease
ASCVRD arteriosclerotic cardiovascular renal disease
ASD atrial septal defect
ASDHD arteriosclerotic decompensated heart disease
ASHCVD arteriosclerotic hypertensive cardiovascular disease
ASHD arteriosclerotic heart disease; atrioseptal heart defect
ASHHD arteriosclerotic hypertensive heart disease
ASHVD arteriosclerotic hypertensive vascular disease
ASO arteriosclerosis obliterans
ASPVD arteriosclerotic peripheral vascular disease
ASVD arteriosclerotic vascular disease
ASVH(D) arteriosclerotic vascular heart disease
AT atherosclerosis; atherosclerotic; atrial tachycardia; antithrombin
ATC all-terrain cycle
ATN acute tubular necrosis
ATS arteriosclerosis
ATSHD arteriosclerotic heart disease
ATV all-terrain vehicle
AUL acute undifferentiated leukemia
AV arteriovenous; atrioventricular; aortic valve
AVF arterio-ventricular fibrillation; arteriovenous fistula
AVH acute viral hepatitis
AVNRT atrioventricular nodal re-entrant tachycardia
AVP aortic valve prosthesis
AVR aortic valve replacement
AVRT atrioventricular nodal re-entrant tachycardia
AWMI anterior wall myocardial infarction
AZT azidothymidine
BA basilar artery; basilar arteriogram; bronchial asthma
B&B bronchoscopy and biopsy
BBB bundle branch block
B&C biopsy and cauterization
BCE basal cell epithelioma
BE barium enema
BEH benign essential hypertension
BGL Bartholin gland
BKA below knee amputation
BL bladder; bucolingual; blood loss; Burkitt lymphoma
BMR basal metabolism rate
BNA bladder neck adhesions
BNO bladder neck obstruction
BOMSA bilateral otitis media serous acute
BOMSC bilateral otitis media serous chronic
BOW ‘bag of water’ (membrane)
B/P, BP blood pressure
BPH benign prostate hypertrophy
BSA body surface area
BSO bilateral salpingo-oophorectomy
BSP Bromosulfaphthalein (test)
BTL bilateral tubal ligation
BUN blood, urea, and nitrogen test
BVL bilateral vas ligation
B&W Baldy-Webster suspension (uterine)
BX biopsy
BX CX biopsy cervix
Ca cancer
CA cancer; cardiac arrest; carotid arteriogram
CABG coronary artery bypass graft
CABS coronary artery bypass surgery
CAD coronary artery disease
CAG chronic atrophic gastritis
CAO coronary artery occlusion; chronic airway obstruction
CAR cardiac arrest
CAS cerebral arteriosclerosis
CASCVD chronic arteriosclerotic cardiovascular disease
CASHD chronic arteriosclerotic heart disease
CAT computerized axial tomography
CB chronic bronchitis
CBC complete blood count
CBD common bile duct; chronic brain disease
CBS chronic brain syndrome
CCF chronic congestive failure
CCI chronic cardiac or coronary insufficiency
CF congestive failure; cystic fibrosis; Christmas factor (PTC)
CFT chronic follicular tonsillitis
CGL chronic granulocytic leukemia
CGN chronic glomerulonephritis
CHA congenital hypoplastic anemia
CHB complete heart block
CHD congestive heart disease; coronary heart disease; congenital heart disease; Chediak-Higaski Disease
CHF congestive heart failure
C2H5OH ethyl alcohol
CI cardiac insufficiency; cerebral infarction
CID cytomegalic inclusiondisease
CIS carcinoma in situ
CJD Creutzfeldt-Jakob Disease
CLD chronic lung disease; chronic liver disease
CLL chronic lymphatic leukemia; chronic lymphocytic leukemia
CMID cytomegalic inclusion disease
CML chronic myelocytic leukemia
CMM cutaneous malignant melanoma
CMV cytomegalic virus
CNHD congenital nonspherocytic hemolytic disease
CNS central nervous system
CO carbon monoxide
COAD chronic obstructive airway disease
CO2 carbon dioxide
COBE chronic obstructive bullous emphysema
COBS chronic organic brain syndrome
COFS cerebro-oculo-facio-skeletal
COOMBS test for Rh sensitivity
COLD chronic obstructive lung disease
COPD chronic obstructive pulmonary disease
COPE chronic obstructive pulmonary emphysema
CP cerebral palsy; cor pulmonale
C&P cystoscopy and pyelography
CPB cardiopulmonary bypass
CPC chronic passive congestion
CPD cephalopelvic disproportion; contagious pustular dermatitis
CPE chronic pulmonary emphysema
CRD chronic renal disease
CREST calcinosis cutis, Raynaud phenomenon, sclerodactyly, and telangiectasis
CRF cardiorespiratory failure; chronic renal failure
CRST calcinosis cutis, Raynaud phenomenon, sclerodactyly, and telangiectasis
CS coronary sclerosis; cesarean section; cerebro-spinal
CSF cerebral spinal fluid
CSH chronic subdural hematoma
CSM cerebrospinal meningitis
CT computer tomography; cerebral thrombosis; coronary thrombosis
CTD congenital thymic dysplasia
CU cause unknown
CUC chronic ulcerative colitis
CUP cystoscopy, urogram, pyelogram (retro)
CUR cystocele, urethrocele, rectocele
CV cardiovascular; cerebrovascular
CVA cerebrovascular accident
CV accident cerebral vascular accident
CVD cardiovascular disease
CVHD cardiovascular heart disease
CVI cardiovascular insufficiency; cerebrovascular insufficiency
CVRD cardiovascular renal disease
CWP coalworker pneumoconiosis
CX cervix
DA degenerative arthritis
DBI phenformin hydrochloride
D&C dilation and curettage
DCR dacrocystorhinostomy
D&D drilling and drainage; debridement and dressing
D&E dilation and evacuation
DFU dead fetus in utero
DIC disseminated intravascular coagulation
DILD diffuse infiltrative lung disease
DIP distal interphalangeal joint; desquamative interstitial pneumonia
DJD degenerative joint disease
DM diabetes mellitus
DMT dimethyltriptamine
DOA dead on arrival
DOPS diffuse obstructive pulmonary syndrome
DPT diphtheria, pertussis, tetanus vaccine
DR diabetic retinopathy
DS Down syndrome
DT due to; delirium tremens
D/T due to; delirium tremens
DU diagnosis unknown; duodenal ulcer
DUB dysfunctional uterine bleeding
DUI driving under influence
DVT deep vein thrombosis
DWI driving while intoxicated
DX dislocation; diagnosis; disease
EBV Epstein-Barr virus
ECCE extracapsular cataract extraction
ECG electrocardiogram
E coli Escherichia coli
ECT electric convulsive therapy
EDC expected date of confinement
EEE Eastern equine encephalitis
EEG electroencephalogram
EFE endocardial fibroelastosis
EGL eosinophilic granuloma of lung
EH enlarged heart; essential hypertension
EIOA excessive intake of alcohol
EKC epidemic keratoconjunctivitis
EKG electrocardiogram
EKP epikeratoprosthesis
ELF elective low forceps
EMC encephalomyocarditis
EMD electromechanical dissociation
EMF endomyocardial fibrosis
EMG electromyogram
EN erythema nodosum
ENT ear, nose, and throat
EP ectopic pregnancy
ER emergency room
ERS evacuation of retained secundines
ESRD end-stage renal disease
EST electric shock therapy
ETOH ethyl alcohol
EUA exam under anesthesia
EWB estrogen withdrawal bleeding
FB foreign body
FBS fasting blood sugar
Fe symbol for iron
FGD fatal granulomatous disease
FHS fetal heart sounds
FHT fetal heart tone
FLSA follicular lymphosarcoma
FME full-mouth extraction
FS frozen section; fracture site
FT full term
FTA fluorescent treponemal antibody test
FTD fronto-temporal dementia
5FU fluorouracil
FUB functional uterine bleeding
FULG fulguration
FUO fever unknown origin
FX fracture
FYI for your information
GAS generalized arteriosclerosis
GB gallbladder; Guillain-Barre (syndrome)
GC gonococcus; gonorrhea; general circulation (systemic)
GE gastroesophageal
GEN generalized
GERD gastroesophageal reflux disease
GI gastrointestinal
GIB gastrointestinal bleeding
GIST gastrointestinal stromal tumor
GIT gastrointestinal tract
GMSD grand mal seizure disorder
GOK God only knows
GSW gunshot wound
GTT glucose tolerance test
Gtt drop
GU genitourinary; gastric ulcer
GVHR graft-versus-host reaction
GYN gynecology
HA headache
HAA hepatitis-associated antigen
HASCVD hypertensive arteriosclerotic cardiovascular disease
HASCVR hypertensive arteriosclerotic cardiovascular renal disease
HASHD hypertensive arteriosclerotic heart disease
HBP high blood pressure
HC Huntington chorea
HCAP health care associated pneumonia
HCPS Hantivirus (cardio) pulmonary syndrome, Hantavirus cardiopulmonary syndrome
HCT hematocrit
HCVD hypertensive cardiovascular disease
HCVRD hypertensive cardiovascular renal disease
HD Hodgkin disease; heart disease
HDN hemolytic disease of newborn
HDS herniated disc syndrome
HEM hemorrhage
HF heart failure; hay fever
HGB; Hgb hemoglobin
HHD hypertensive heart disease
HIV human immunodeficiency virus
HMD hyaline membrane disease
HN2 nitrogen mustard
HNP herniated nucleus pulposus
H/O history of
HPN hypertension
HPS Hantavirus pulmonary syndrome
HPVD hypertensive pulmonary vascular disease
HRE high-resolution electrocardiology
HS herpes simplex; Hurler syndrome
HSV herpes simplex virus
HTLV human T-cell lymphotropic virus
HTLV human T-cell lymphotropic
III/LAV virus-III/lymphadenopathy- associated virus
HTLV-3 human T-cell lymphotropic virus-III
HTLV-III human T-cell lymphotropic virus-III
HTN hypertension
HVD hypertensive vascular disease
Hx history of
IADH inappropriate antidiuretic hormone
IASD interatrial septal defect
ICCE intracapsular cataract extraction
ICD intrauterine contraceptive device
I&D incision and drainage
ID incision and drainage
IDA iron deficiency anemia
IDD insulin-dependent diabetes
IDDI insulin-dependent diabetes
IDDM insulin-dependent diabetes mellitus
IGA immunoglobin A
IHD ischemic heart disease
IHSS idiopathic hypertrophic subaortic stenosis
IIAC idiopathic infantile arterial calcification
ILD interstitial lung disease; ischemic leg disease
IM intramuscular; intramedullary; infectious mononucleosis
IMPP intermittent positive pressure
INAD infantile neuroaxonal dystrophy
INC incomplete
INE infantile necrotizing encephalomyelopathy
INF infection; infected; infantile; infarction
INH isoniazid; inhalation
INS idiopathic nephrotic syndrome
IRDM insulin resistant diabetes mellitus
IRHD inactive rheumatic heart disease
IRIS immune reconstitution inflammatory syndrome
ISD interatrial septal defect
ITP idiopathic thrombocytopenic purpura
IU intrauterine
IUCD intrauterine contraceptive device
IUD intrauterine device (contraceptive); intrauterine death
IUP intrauterine pregnancy
IV intervenous; intravenous
IVC intravenous cholangiography; inferior vena cava
IVCC intravascular consumption coagulopathy
IVD intervertebral disc
IVH intraventricular hemorrhage
IVP intravenous pyelogram
IVSD intraventricular septal defect
IVU intravenous urethrography
IWMI inferior wall myocardial infarction
JAA juxtaposition of atrial appendage
JBE Japanese B encephalitis
KFS Klippel-Feil syndrome
KS Klinefelter syndrome
KUB kidney, ureter, bladder
K-W Kimmelstiel-Wilson disease or syndrome
LAP laparotomy
LAV lymphadenopathy-associated virus
LAV/HTLV-III lymphadenopathy-associated virus/human T-cell lymphotrophic virus-III
LBBB left bundle branch block
LBNA lysis bladder neck adhesions
LBW low birth weight
LBWI low birth weight infant
LCA left coronary artery
LDH lactic dehydrogenase
LE lupus erythematosus; lower extremity; left eye
LKS liver, kidney, spleen
LL lower lobe
LLL left lower lobe
LLQ lower left quadrant
LMA left mentoanterior (position of fetus)
LML left middle lobe; left mesiolateral
LMCAT left middle cerebral artery thrombosis
LML left mesiolateral; left mediolateral (episiotomy)
LMP last menstrual period; left mento-posterior (position of fetus)
LN lupus nephritis
LOA left occipitoanterior
LOMCS left otitis media chronic serous
LP lumbar puncture
LRI lower respiratory infection
LS lumbosacral; lymphosarcoma
LSD lysergic acid diethylamide
LSK liver, spleen, kidney
LUL left upper lobe
LUQ left upper quadrant
LV left ventricle
LVF left ventricular failure
LVH left ventricular hypertrophy
MAC mycobacterium avium complex
MAI mycobacterium avium intracellulare
MAL malignant
MBAI mycobacterium avium intracellulare
MBD minimal brain damage
MCA metastatic cancer; middle cerebral artery
MD muscular dystrophy; manic depressive; myocardial damage
MDA methylene dioxyamphetamine
MEA multiple endocrine adenomatosis
MF myocardial failure; myocardial fibrosis; mycosis fungoides
MGN membranous glomerulonephritis
MHN massive hepatic necrosis
MI myocardial infarction; mitral insufficiency
MPC meperidine, promethazine, chlorpromazine
MRS methicillin resistant staphylococcal
MRSA methicillin resistant staphylococcal aureus
MRSAU methicillin resistant staphylococcal aureus
MS multiple sclerosis; mitral stenosis
MSOF multi-system organ failure
MT malignant teratoma
MUA myelogram
MVP mitral valve prolapse
MVR mitral valve regurgitation; mitral valve replacement
NACD no anatomical cause of death
NAFLD nonalcoholic fatty liver disease
NCA neurocirculatory asthenia
NDI nephrogenic diabetes insipidus
NEG negative
NFI no further information
NFTD normal full-term delivery
NG nasogastric
NH3 symbol for ammonia
NIDD non-insulin-dependent diabetes
NIDDI non-insulin-dependent diabetes
NIDDM non-insulin-dependent diabetes mellitus
NSTEMI non-ST-elevation myocardial infarction
N&V nausea and vomiting
NVD nausea, vomiting, diarrhea
OA osteoarthritis
OAD obstructive airway disease
OB obstetrical
OBS organic brain syndrome
OBST obstructive; obstetrical
OD overdose; oculus dexter (right eye); occupational disease
OHD organic heart disease
OLT orthotopic liver transplant
OM otitis media
OMI old myocardial infarction
OMS organic mental syndrome
OPCA olivopontocerebellar atrophy
ORIF open reduction, internal fixation
OS oculus sinister (left eye); occipitosacral (fetal position)
OT occupational therapy; old TB
OU oculus uterque (each eye); both eyes
PA pernicious anemia; paralysis agitans; pulmonary artery; peripheral arteriosclerosis
PAC premature auricular contraction; phenacetin, aspirin, caffeine
PAF paroxysmal auricular fibrillation
PAOD peripheral arterial occlusive disease; peripheral arteriosclerosis occlusive disease
PAP primary atypical pneumonia
PAS pulmonary artery stenosis
PAT pregnancy at term; paroxysmal auricular tachycardia
Pb chemical symbol for lead
PCD polycystic disease
PCF passive congestive failure
PCP pentachlorophenol; pneumocystis carinii pneumonia
PCT porphyria cutanea tarda
PCV polycythemia vera
PDA patent ductus arteriosus
PE pulmonary embolism; pleural effusion; pulmonary edema
PEG percutaneous endoscopic gastrostomy; pneumoencephalography
PEGT percutaneous endoscopic gastrostomy tube
PET pre-eclamptic toxemia
PG pregnant; prostaglandin
PGH pituitary growth hormone
PH past history; prostatic hypertrophy; pulmonary hypertension
PI pulmonary infarction
PID pelvic inflammatory disease; prolapsed intervertebral disc
PIE pulmonary interstitial emphysema
PIP proximal interphalangeal joint
PKU phenylketonuria
PMD progressive muscular dystrophy
PMI posterior myocardial infarction; point of maximum impulse
PML progressive multifocal leukoencephalopathy
PN pneumonia; periarteritis nodosa; pyelonephritis
PO postoperative; by mouth
POC product of conception
POE point (or portal) of entry
POSS possible; possibly
PP postpartum
PPD purified protein derivative test for tuberculosis
PPH postpartum hemorrhage
PPLO pleuropneumonia-like organism
PPS postpump syndrome
PPT precipitated; prolonged prothrombin time
PREM prematurity
PROB probably
PPROM preterm premature rupture of membranes
PROM premature rupture of membranes
PSVT paroxysmal supraventricular tachycardia
PT paroxysmal tachycardia; pneumothorax; prothrombin time
PTA persistent truncus arteriosus
PTC plasma thromboplastin component
PTCA percutaneous transluminal coronary angioplasty
PTLA percutaneous transluminal laser angioplasty
PU peptic ulcer
PUD peptic ulcer disease; pulmonary disease
PUO pyrexia of unknown origin
P&V pyloroplasty and vagotomy
PVC premature ventricular contraction
PVD peripheral vascular disease; pulmonary vascular disease
PVI peripheral vascular insufficiency
PVL periventricular leukomalacia
PVT paroxysmal ventricular tachycardia
PVS premature ventricular systole (contraction)
PWI posterior wall infarction
PWMI posterior wall myocardial infarction
PX pneumothorax
R right
RA rheumatoid arthritis; right atrium; right auricle
RAAA ruptured abdominal aortic aneurysm
RAD rheumatoid arthritis disease; radiation absorbed dose
RAI radioactive iodine
RBBB right bundle branch block
RBC red blood cells
RCA right coronary artery
RCS reticulum cell sarcoma
RD Raynaud disease; respiratory disease
RDS respiratory distress syndrome
RE regional enteritis
REG radioencephalogram
RESP respiratory
RHD rheumatic heart disease
RLF retrolental fibroplasia
RLL right lower lobe
RLQ right lower quadrant
RMCA right middle cerebral artery
RMCAT right middle cerebral artery thrombosis
RML right middle lobe
RMLE right mediolateral episiotomy
RNA ribonucleic acid
RND radical neck dissection
R/O rule out
RSA reticulum cell sarcoma
RSR regular sinus rhythm
Rt right
RT recreational therapy; right
RTA renal tubular acidosis
RUL right upper lobe
RUQ right upper quadrant
RV right ventricle
RVH right ventricular hypertrophy
RVT renal vein thrombosis
RX drugs or other therapy or treatment
SA sarcoma; secondary anemia
SACD subacute combined degeneration
SARS severe acute respiratory syndrome
SBE subacute bacterial endocarditis
SBO small bowel obstruction
SBP spontaneous bacterial peritonitis
SC sickle cell
SCC squamous cell carcinoma
SCI subcoma insulin; spinal cord injury
SD spontaneous delivery; septal defect; sudden death
SDAT senile dementia Alzheimer type
SDII sudden death in infancy
SDS sudden death syndrome
SEPT septicemia
SF scarlet fever
SGA small for gestational age
SH serum hepatitis
SI saline injection
SIADH syndrome of inappropriate antidiuretic hormone
SICD sudden infant crib death
SID sudden infant death
SIDS sudden infant death syndrome
SIRS systemic inflammatory response syndrome
SLC short leg cast
SLE systemic lupus erythematosus; Saint Louis encephalitis
SMR submucous resection
SNB scalene node biopsy
SO or S&O salpingo-oophorectomy
SOB shortness of breath
SOM secretory otitis media
SOR suppurative otitis, recurrent
S/P status post
SPD sociopathic personality disturbance
SPP suprapubic prostatectomy
SQ subcutaneous
S/R schizophrenic reaction; sinus rhythm
S/p P/T schizophrenic reaction, paranoid type
SSE soapsuds enema
SSKI saturated solution potassium iodide
SSPE subacute sclerosing panencephalitis
STAPH staphylococcal; staphylococcus
STB stillborn
STREP streptococcal; streptococcus
STS serological test for syphilis
STSG split thickness skin graft
SUBQ subcutaneous
SUD sudden unexpected death
SUDI sudden unexplained death of an infant
SUID sudden unexpected infant death
SVC superior vena cava
SVD spontaneous vaginal delivery
SVT superventricular tachycardia
Sx symptoms
SY syndrome
T&A tonsillectomy and adenoidectomy
TAH total abdominal hysterectomy
TAL tendon achilles lengthening
TAO triacetyloleandomycin (antibiotic); thromboangiitis obliterans
TAPVR total anomalous pulmonary venous return
TAR thrombocytopenia absent radius (syndrome)
TAT tetanus anti-toxin
TB tuberculosis; tracheobronchitis
TBC, Tbc tuberculosis
TCI transient cerebral ischemia
TEF tracheoesophageal fistula
TF tetralogy of Fallot
TGV transposition great vessels
THA total hip arthroplasty
TI tricuspid insufficiency
TIA transient ischemic attack
TIE transient ischemic episode
TL tubal ligation
TM tympanic membrane
TOA tubo-ovarian abscess
TP thrombocytopenic purpura
TR tricuspid regurgitation, transfusion reaction
TSD Tay-Sachs disease
TTP thrombotic thrombocytopenic purpura
TUI transurethral incision
TUR transurethral resection (NOS) (prostate)
TURP transurethral resection of prostate
TVP total anomalous venous return
UC ulcerative colitis
UGI upper gastrointestinal
UL upper lobe
UNK unknown
UP ureteropelvic
UPJ ureteropelvic junction
URI upper respiratory infection
UTI urinary tract infection
VAMP vincristine, amethopterine, 6-mercaptopurine, and prednisone
VB vinblastine
VC vincristine
VD venereal disease
VDRL venereal disease research lab
VEE Venezuelan equine encephalomyelitis
VF ventricular fibrillation
VH vaginal hysterectomy; viral hepatitis
VL vas ligation
VM viomycin
V&P vagotomy and pyloroplasty
VPC, VPCS ventricular premature contractions
VR valve replacement
VSD ventricular septal defect
VT ventricular tachycardia
WBC white blood cell
WC whooping cough
WE Western encephalomyelitis
W/O without
WPW Wolfe-Parkinson-White syndrome
YF yellow fever
ZE Zollinger-Ellison (syndrome)
‘ minute
” second(s)
< less than
> greater than
⬇ decreased
⬆ increased; elevated
c with
s without
00 11 secondary to
00 11 to secondary to
APPENDIX B – SYNONYMOUS SITES/TERMS
When a condition of a stated anatomical site is indexed in Volume 3, code condition of stated site as indexed. If stated site is not indexed, code condition of synonymous site.
Alimentary canal Gastrointestinal tract
Body Torso, trunk
Brain Anterior fossa, basal ganglion, central nervous
system, cerebral, cerebrum, frontal, occipital,
parietal, pons, posterior fossa, prefrontal, temporal,
III and IV ventricle
NOTE: Do not use brain when ICD provides for CNS
under the reported condition.
Cardiac Heart
Chest Thorax
Geriatric Senile
Greater sac Peritoneum
Hepatic Liver
Hepatocellular Liver
Intestine Bowel, colon
Kidney Renal
Larynx Epiglottis, subglottis, supraglottis, vocal cords
Lesser sac Peritoneum
Nasopharynx, pharynx Throat
Pulmonary Lung
Right\left hemispheric Code brain
Hemispheric NOS Do not assume brain
Right\left ventricle Heart
Third\fourth ventricle Brain
LLL, LUL, RLL, RML, RUL Lobes of the lungs when reported with lobectomy,
pneumonia, etc.
APPENDIX C – GEOGRAPHIC CODES
Alabama AL
Alaska AK
Arizona AZ
Arkansas AR
California CA
Colorado CO
Connecticut CT
Delaware DE
District of Columbia DC
Florida FL
Georgia GA
Hawaii HI
Idaho ID
Illinois IL
Indiana IN
Iowa IA
Kansas KS
Kentucky KY
Louisiana LA
Maine ME
Maryland MD
Massachusetts MA
Michigan MI
Minnesota MN
Mississippi MS
Missouri MO
Montana MT
Nebraska NE
Nevada NV
New Hampshire NH
New Jersey NJ
New Mexico NM
New York NY
North Carolina NC
North Dakota ND
Ohio OH
Oklahoma OK
Oregon OR
Pennsylvania PA
Puerto Rico PR
Rhode Island RI
South Carolina SC
South Dakota SD
Tennessee TN
Texas TX
Utah UT
Vermont VT
Virginia VA
Virgin Islands VI
Washington WA
West Virginia WV
Wisconsin WI
Wyoming WY
Territories and Outlying Areas
American Samoa AS
Federated States of Micronesia FM
Guam GU
Marshall Islands MH
Northern Mariana Islands MP
Palau PW
Puerto Rico PR
Virgin Islands (US) VI
US Minor Outlying Islands UM*
Baker Island
Howland Island
Jarvis Island
Johnston Atoll
Kingman Reef
Midway Islands
Navassa Island
Palmyra Atoll
Wake Island
APPENDIX D – CODE FOR PLACE OF OCCURRENCE
- Home
Excludes: Abandoned or derelict house (8)
Home under construction, but not yet occupied (6)
Institutional place of residence (1)
Office in home (5)
About home
Apartment
Bed and breakfast
Boarding house
Cabin (any type)
Caravan (trailer) park – residential
Condominium
Farm house
Dwelling
Hogan
Home premises
Home sidewalk
Home swimming pool
House (residential) (trailer)
Noninstitutional place of residence
Penthouse
Private driveway to home
Private garage
Private garden to home
Private walk to home
Private wall to home
Residence
Rooming house
Storage building at apartment
Swimming pool in private home, private garden, apartment or residence
Townhome
Trailer camp or court
Yard (any part) (area) (front) (residential)
Yard to home
- Residential institution
Almshouse
Army camp
Assisted Living
Board and care facility
Children’s home
Convalescent home
Correctional center
Detox center
Dormitory
Fraternity house
Geriatric center
Halfway house
Home for the sick
Hospice
Institution (any type)
Jail
Mental Hospital
Military (camp) (reservation)
Nurse’s home
Nursing home
Old people’s home
Orphanage
Penitentiary
Pensioner’s home
Prison
Prison camp
Reform school
Retirement home
Sorority house
State hospital
- School, other institution and public administrative area
Excludes: Building under construction (6)
Residential institution (1)
Sports and athletic areas (3)
Armory Police station or cell
Assembly hall Post office
Campus Private club
Child center Public building
Church Public hall
Cinema Salvation army
Clubhouse School (grounds) (yard)
College School (private) (public) (state)
Country club (grounds) Theatre
Court house Turkish bath
Dance hall University
Day nursery (day care) YMCA
Drive in theater Youth center
Fire house YWCA
Gallery
Health club
Health resort
Health spa
Hospital (parking lot)
Institute of higher learning
Kindergarten
Library
Mission
Movie house
Museum
Music hall
Night club
Opera house
Playground, school
Police precinct
- Sports and athletics area
Excludes: Swimming pool or tennis court in private home or garden (0)
Baseball field
Basketball court
Cricket ground
Dude ranch
Fives court
Football field
Golf course
Gymnasium
Hockey field
Ice palace
Racecourse
Riding school
Rifle range – NOS
Skating rink
Sports ground
Sports palace
Squash court
Stadium
Swimming pool (private) (public)
Tennis court
- Street and highway
Alley
Border crossing
Bridge NOS
Freeway
Interstate
Motorway
Named street/highway/interstate
Pavement
Road (public)
Roadside
Sidewalk NOS
Walkway
- Trade and service area
Excludes: Garage in private home (0)
Airport
Animal hospital
Bank
Bar
Body shop
Cafe
Car dealership
Casino
Electric company
Filling station
Funeral home
Garage – place of work
Garage away from highway except home
Garage building (for car storage)
Garage NOS
Gas station
Hotel (pool)
Laundry Mat
Loading platform – store
Mall
Market (grocery or other commodity)
Motel
Office (building) (in home)
Parking garage
Radio/television broadcasting station
Restaurant
Salvage lot, named
Service station
Shop, commercial
Shopping center (shopping mall)
Spa
Station (bus) (railway)
Storage Unit
Store
Subway (stairs)
Tourist court
Tourist home
Warehouse
- Industrial and construction areas
Building under construction
Coal pit
Coal yard
Construction (area, job or site)
Dairy processing plant
Dockyard
Dry dock
Electric tower
Factory (building) (premises)
Foundry
Gas works
Grain elevator
Gravel pit
Highway under construction
Industrial yard
Loading platform – factory
Logging operation area
Lumber yard
Mill pond
Oil field
Oil rig and other offshore installations
Oil well
Plant, industrial
Power-station (coal) (nuclear) (oil)
Produce building
Railroad track or trestle
Railway yard
Sand pit
Sawmill
Sewage disposal plant
Shipyard
Shop
Substation (power)
Subway track
Tannery
Tunnel under construction
Water filtration plant
Wharf Workshop
- Farm
Excludes: Farm house and home premises of farm (0)
Barn NOS
Barnyard
Corncrib
Cornfield
Dairy (farm) NOS
Farm buildings
Farm pond or creek
Farmland under cultivation
Field, numbered or specialized
Gravel pit on farm
Orange grove
Orchard
Pasture
Ranch NOS
Range NOS
Silo
State Farm
- Other specified places
Abandoned gravel pit Military training ground
Abandoned public building or home Mountain
Air force firing range Mountain resort
Balcony Named city
Bar pit or ditch Named lake
Beach NOS (named) (private) Named room
Beach resort Named town
Boy’s camp Nursery NOS
Building NOS Open field
Bus stop Park (amusement) (any) (public)
Camp Parking lot
Camping grounds Parking place
Campsite Pier
Canal Pipeline (oil)
Caravan site NOS Place of business NOS
Cemetery Playground NOS
City dump Pond or pool (natural)
Community jacuzzi Porch
Creek (bank) (embankment) Power line pole
Damsite Prairie
Derelict house Private property
Desert Public place NOS
Ditch Public property
Dock NOS Railway line
Driveway Reservoir (water)
Excavation site Resort NOS
Fairgrounds River
Field NOS Room (any)
Forest Sea
Fort Seashore NOS
Hallway Seashore resort
Harbor Sewer
Hill Specified address
Holiday camp Stream
Irrigation canal or ditch Swamp
Junkyard Trail (bike)
Kitchen Vacation resort
Lake NOS Woods
Lake resort Zoo
Manhole
Marsh
- Unspecified place
Bathtub
Bed
Camper (trailer)
Commode
Country
Downstairs
Fireplace
Hot tub
Jobsite
Near any place
On job
Outdoors NOS
Parked car
Rural
Sofa
Table
Tree
Vehicle (any)
APPENDIX E – ACTIVITY CODES
The ICD-10 provides a subclassification for use with external causes and injuries to indicate the activity of the injured person at the time the event occurred. This appendix is designed to document the ICD-10 activity code information but it is not entered in manual coding.
Information may be scattered over different parts of the medical certification, Part I, Part II, 41, 43, etc. However, do not use the information in “Injury at work?” block to code this variable.
If no information concerning the activity of the injured person is reported on the certificate, the item is left blank. “While drinking alcohol” or “while driving” is not considered as a codable activity. When two or more codes appear to be appropriate for the information reported, activity code 8 is assigned.
0 While engaged in sports activity
Physical exercise with a described functional element such as:
. golf
. jogging
. riding
. school athletics
. skiing
. swimming
. trekking
. waterskiing
1 While engaged in leisure activity
Hobby activities
Leisure time activities with an entertainment element such as going to the cinema,
to a dance or to a party
Participation in sessions and activities of voluntary organizations
Excludes: sport activities (0)
2 While working for income
Paid work (manual) (professional)
Transportation (time) to and from such activities
Work for salary, bonus and other types of income
3 While engaged in other types of work
Domestic duties such as:
. caring for children and relatives
. cleaning
. cooking
. gardening
. household maintenance
Duties for which one would not normally gain an income
Learning activities, e.g. attending school session or lesson
Undergoing education
4 While resting, sleeping, eating and other vital activities
Personal hygiene
8 While engaged in other specified activities
APPENDIX F – INVALID AND SUBSTITUTE CODES
The following categories are invalid for underlying cause coding in the United States registration areas. Substitute code(s) for use in underlying cause coding appears to the right.
Use the substitute codes when conditions classifiable to the following codes are reported:
Invalid Codes Substitute Codes
A150-A153 A162
A154 A163
A155 A164
A156 A165
A157 A167
A158 A168
A159 A169
A160-A161 A162
B95-B97 Code the disease(s) classified
to other chapters modified by
the organism. Do not enter a
code for the organism.
F70.- F70 (3-characters only)
F71.- F71 (3-characters only)
F72.- F72 (3-characters only)
F73.- F73 (3-characters only)
F78.- F78 (3-characters only)
F79.- F79 (3-characters only)
I151-I158 R99
I23.- I21 or I22
I240 I21 or I22
I252 I258
I65-I66 I63
O08.- O00 – O07
O80.- O95
O81-O84 O759
P95 P969
R69 R95-R99
APPENDIX G – CODES FOR SPECIAL PURPOSES (U00-U99)
Provisional assignment of new codes (U00-U99)
1. Terrorism Classification (*U01-*U03)
NCHS has developed a set of new codes within the framework of the ICD that will allow the identification of deaths from terrorism reported on death certificates through the National Vital Statistics System. Terrorism-related ICD-10 codes for mortality have been assigned to the “U” category which has been designated by WHO for use by individual countries. The asterisk preceding the alphanumeric code indicates the code was introduced by the United States and is not officially part of the ICD.
To classify a death as terrorist-related, it is necessary for the incident to be designated as such by the Federal Bureau of Investigation (FBI). Neither a medical examiner nor a coroner who would be completing/certifying the death certificate, nor the nosologist coding the death certificate would determine that an incident is an act of terrorism. If an incident or event is confirmed by the FBI as terrorism, it may be so described on the certificate. If the incident is confirmed as terrorism after the death certificate is completed, the certificate can be recoded at a later date.
Not to be used unless notified by NCHS
Tabular List
Assault (homicide)
*U01-*U02
*U01 Terrorism
Includes: assault-related injuries resulting from the unlawful use of force or violence against persons or property to intimidate or coerce a Government, the civilian population, or any segment thereof, in furtherance of political or social objectives
*U01.0 Terrorism involving explosion of marine weapons
Depth-charge
Marine mine
Mine NOS, at sea or in harbor
Sea-based artillery shell
Torpedo
Underwater blast
*U01.1 Terrorism involving destruction of aircraft
Includes: aircraft used as a weapon
Aircraft:
- burned
- exploded
- shot down
Crushed by falling aircraft
*U01.2 Terrorism involving other explosives and fragments
Antipersonnel bomb (fragments)
Blast NOS
Explosion (of):
- NOS
- artillery shell
- breech-block
- cannon block
- mortar bomb
- munitions being used in terrorism
- own weapons
Fragments from:
- artillery shell
- bomb
- grenade
- guided missile
- land-mine
- rocket
- shell
- shrapnel
Mine NOS
*U01.3 Terrorism involving fires, conflagration and hot substances
Asphyxia originating from fire caused directly
Burns by fire-producing device or indirectly
Other injury by any conventional weapon
Petrol bomb
Collapse of
Fall from
Falling from burning building or structure
Hit by object
Jump from
Conflagration
Fire
Melting of fittings or furniture
Smoldering
*U01.4 Terrorism involving firearms
Bullet
- carbine
- machine gun
- pistol
- rifle
- rubber (rifle)
Pellets (shotgun)
*U01.5 Terrorism involving nuclear weapons
Blast effects
Exposure to ionizing radiation from nuclear weapon
Fireball effects
Heat
Other direct and secondary effects of nuclear weapons
*U01.6 Terrorism involving biological weapons
Anthrax
Cholera
Smallpox
*U01.7 Terrorism involving chemical weapons
Gases, fumes and chemicals:
- Hydrogen cyanide
- Phosgene
- Sarin
*U01.8 Terrorism, other specified
Lasers
Battle wounds
Drowned in terrorist operations NOS
Piercing or stabbing object injuries
*U01.9 Terrorism, unspecified
*U02 Sequelae of terrorism
Intentional self-harm (suicide)
*U03
*U03 Terrorism
*U03.0 Terrorism involving explosions and fragments
Includes: destruction of aircraft used as a weapon
Aircraft:
- burned
- exploded
- shot down
Antipersonnel bomb (fragments)
Blast NOS
Explosion (of):
- NOS
- artillery shell
- breech-block
- cannon block
- mortar bomb
- munitions being used in terrorism
- own weapons
Fragments from:
- artillery shell
- bomb
- grenade
- guided missile
- land-mine
- rocket
- shell
- shrapnel
Mine NOS
*U03.9 Terrorism by other and unspecified means
SECTION II – External causes of injury
Air
– blast in terrorism U01.2
Asphyxia, asphyxiation
– by
– – chemical in terrorism U01.7
– – fumes in terrorism (chemical weapons) U01.7
– – gas (see also Table of drugs and chemicals)
– – – in terrorism (chemical weapons) U01.7
– from
– – fire (see also Exposure, fire)
– – – in terrorism U01.3
Attack
– terrorist NEC U01.9
Bayonet wound
– in
– – terrorism U01.8
Blast (air) in terrorism U01.2
– from nuclear explosion U01.5
– underwater U01.0
Burn, burned, burning (by) (from) (on)
– chemical (external) (internal)
– – in terrorism (chemical weapons) U01.7
– in terrorism (from fire-producing device) NEC U01.3
– – nuclear explosion U01.5
– – petrol bomb U01.3
Casualty (not due to war) NEC
– terrorism U01.9
Collapse
– building
– – burning (uncontrolled fire)
– – – in terrorism U01.3
– structure
– – burning (uncontrolled fire)
– – – in terrorism U01.3
Crash
– aircraft (powered)
– – in terrorism U01.1
Crushed
– by, in
– – falling
– – – aircraft
– – – – in terrorism U01.1
Cut, cutting (any part of body) (by) (see also Contact, with, by object or machine)
– terrorism U01.8
Drowning
– in
– – terrorism U01.8
Effect(s) (adverse) of
– nuclear explosion or weapon in terrorism (blast) (direct) (fireball) (heat) (radiation)
(secondary) U01.5
Explosion (in) (of) (on) (with secondary fire)
– terrorism U01.2
Exposure to
– fire (with exposure to smoke or fumes or causing burns, or secondary explosion)
– – in, of, on, starting in
– – – terrorism (by fire-producing device) U01.3
– – – – fittings or furniture (burning building) (uncontrolled fire) U01.3
– – – – from nuclear explosion U01.5
Fall, falling
– from, off
– – building
– – – burning (uncontrolled fire)
– – – – in terrorism U01.3
– – structure NEC
– – – burning (uncontrolled fire)
– – – – in terrorism U01.3
Fireball effects from nuclear explosion in terrorism U01.5
Heat (effects of) (excessive)
– from
– – nuclear explosion in terrorism U01.5
Infection, infected (opportunistic)
– coronavirus NEC
– – severe acute respiratory syndrome (SARS) U04.9
Injury, injured NEC
– by, caused by, from
– – terrorism – see Terrorism
– due to
– – terrorism – see Terrorism
Jumped, jumping
– from
– – building (see also Jumped, from, high place)
– – – burning (uncontrolled fire)
– – – – in terrorism U01.3
– – structure (see also Jumped, from, high place)
– – – burning (uncontrolled fire)
– – – – in terrorism U01.3
Poisoning (by) (see also Table of drugs and chemicals)
– in terrorism (chemical weapons) U01.7
Radiation (exposure to)
– in
– – terrorism (from or following nuclear explosion) (direct) (secondary) U01.5
– – – laser(s) U01.8
– laser(s)
– – in terrorism U01.8
Sequelae (of)
– in terrorism U02
Shooting, shot (see also Discharge, by type of firearm)
– in terrorism U01.4
Struck by
– bullet (see also Discharge, by type of firearm)
– – in terrorism U01.4
– missile
– – in terrorism – see Terrorism, missile
– object
– – falling
– – – from, in, on
– – – – building
– – – – – burning (uncontrolled fire)
– – – – – – in terrorism U01.3
Suicide, suicidal (attempted) (by)
– explosive(s) (material)
– – in terrorism U03.0
– in terrorism U03.9
Terrorism (by) (in) (injury) (involving) U01.9
– air blast U01.2
– aircraft burned, destroyed, exploded, shot down U01.1
– – used as a weapon U01.1
– anthrax U01.6
– asphyxia from
– – chemical (weapons) U01.7
– – fire, conflagration (caused by fire-producing device) U01.3
– – – from nuclear explosion U01.5
– – gas or fumes U01.7
– bayonet U01.8
– biological agents (weapons) U01.6
– blast (air) (effects) U01.2
– – from nuclear explosion U01.5
– – underwater U01.0
– bomb (antipersonnel) (mortar) (explosion) (fragments) U01.2
– – petrol U01.3
– bullet(s) (from carbine, machine gun, pistol, rifle, rubber (rifle), shotgun) U01.4
– burn from
– – chemical U01.7
– – fire, conflagration (caused by fire-producing device) U01.3
– – – from nuclear explosion U01.5
– – gas U01.7
– burning aircraft U01.1
– chemical (weapons) U01.7
– cholera U01.6
– conflagration U01.3
– crushed by falling aircraft U01.1
– depth-charge U01.0
– destruction of aircraft U01.1
– disability as sequelae one year or more after injury U02
– drowning U01.8
– effect (direct) (secondary) of nuclear weapon U01.5
– – sequelae U02
– explosion (artillery shell) (breech-block) (cannon block) U01.2
– – aircraft U01.1
– – bomb (antipersonnel) (mortar) U01.2
– – – nuclear (atom) (hydrogen) U01.5
– – depth-charge U01.0
– – grenade U01.2
– – injury by fragments (from) U01.2
– – land-mine U01.2
– – marine weapon(s) U01.0
– – mine (land) U01.2
– – – at sea or in harbor U01.0
– – – marine U01.0
– – missile (explosive) (guided) NEC U01.2
– – munitions (dump) (factory) U01.2
– – nuclear (weapon) U01.5
– – other direct and secondary effects of U01.5
– – own weapons U01.2
– – sea-based artillery shell U01.0
– – torpedo U01.0
– exposure to ionizing radiation from nuclear explosion U01.5
– falling aircraft U01.1
– fire or fire-producing device U01.3
– firearms U01.4
– fireball effects from nuclear explosion U01.5
– fragments from artillery shell, bomb NEC, grenade, guided missile, land-mine, rocket,
shell, shrapnel U01.2
– gas or fumes U01.7
– grenade (explosion) (fragments) U01.2
– guided missile (explosion) (fragments) U01.2
– – nuclear U01.5
– heat from nuclear explosion U01.5
– hot substances U01.3
– hydrogen cyanide U01.7
– land-mine (explosion) (fragments) U01.2
– laser(s) U01.8
– late effect (of) U02
– lewisite U01.7
– lung irritant (chemical) (fumes) (gas) U01.7
– marine mine U01.0
– mine U01.2
– – at sea U01.0
– – in harbor U01.0
– – land (explosion) (fragments) U01.2
– – marine U01.0
– missile (explosion) (fragments) (guided) U01.2
– – marine U01.0
– – nuclear U01.5
– mortar bomb (explosion) (fragments) U01.2
– mustard gas U01.7
– nerve gas U01.7
– nuclear weapons U01.5
– pellets (shotgun) U01.4
– petrol bomb U01.3
– piercing object U01.8
– phosgene U01.7
– poisoning (chemical) (fumes) (gas) U01.7
– radiation, ionizing from nuclear explosion U01.5
– rocket (explosion) (fragments) U01.2
– saber, sabre U01.8
– sarin U01.7
– screening smoke U01.7
– sequelae effect (of) U02
– shell (aircraft) (artillery) (cannon) (land-based) (explosion) (fragments) U01.2
– – sea-based U01.0
– shooting U01.4
– – bullet(s) U01.4
– – pellet(s) (rifle) (shotgun) U01.4
– shrapnel U01.2
– smallpox U01.6
– stabbing object(s) U01.8
– submersion U01.8
– torpedo U01.0
– underwater blast U01.0
– vesicant (chemical) (fumes) (gas) U01.7
– weapon burst U01.2
Date of death 9/11/2001
PLACE I (a) Burns T300
5 (b) Terrorist attack on the Pentagon &U011
MOD II
H
Homicide The Pentagon Date of injury 9/11/2001
Code as terrorism involving destruction of aircraft. The FBI declared the Pentagon incident an act of terrorism.
Date of death 9/11/2001
PLACE I (a) Chest trauma S299
5 (b)
MOD II World Trade Center Disaster &U011
H
Homicide World Trade Center Date of injury 9/11/2001
Code as terrorism involving destruction of aircraft. The FBI declared the World Trade Center incident an act of terrorism.
Date of death 11/1/2017
PLACE I (a) Metastatic lung cancer caused by 9/11 C349
5 (b) First responder at World Trade Center T941 &U02
MOD II
N
Natural
Code as sequela of terrorism. The FBI declared the 9/11 World Trade Center incident an act of terrorism.
2. Severe Acute Respiratory Syndrome [SARS] (U04)
Tabular List
U04 Severe acute respiratory syndrome [SARS]
U04.9 Severe acute respiratory syndrome [SARS], unspecified
SECTION I – Alphabetical index to diseases and nature of injury
Syndrome
– respiratory
– – severe acute U04.9
– severe acute respiratory syndrome (SARS) U04.9
- Coronavirus Disease (COVID-19) 2019 (U07.1)
Tabular List
U07 Codes for emergency use
U07.1 COVID-19
Excludes: Coronavirus infection, unspecified site (B34.2)
Severe acute respiratory syndrome [SARS], unspecified (U04.9)
SECTION I – Alphabetical index to diseases and nature of injury
Coronavirus Disease 2019 U07.1
COVID-19 U07.1
Disease
– Coronavirus 2019 U07.1
Infection
– Coronavirus
– – 2019 novel U07.1
– – unspecified site B34.2
– – when referring to COVID-19 U07.1
SARS-CoV-2 U07.1
Severe acute respiratory syndrome coronavirus 2019 U07.1
2019-nCoV U07.1
2019 novel coronavirus U07.1
Ia) Acute respiratory distress syndrome J80
- b) PneumoniaJ189
- c) COVID-19U071
Code the COVID -19 to U071.
Ia) Acute hypoxic respiratory failure J960
- b) Pneumonia with coronavirus disease 2019J189 U071
II Chronic obstructive pulmonary disease J449
Code coronavirus disease 2019 to U071.
APPENDIX H – ADDITIONAL DRUG EXAMPLES
- Place I (a) Ingested overdose of opiates and ingested alcohol T406 &X42 F109
9
Code I(a) nature of injury and external cause code for opiate overdose. Code ingested alcohol as indexed. No evidence of alcohol and drug synergism is reported.
- Place I (a) Ingested overdose of (opiates) and ingested alcohol T406 &X42 F109
9
Code I(a) nature of injury and external cause code for opiate overdose. Code ingested alcohol as indexed. No evidence of alcohol and drug synergism is reported.
- Place I (a) Intoxication by the use of cocaine and opiates T405 &X42 T406
9
Code I(a) nature of injury and external cause code for cocaine and opiate intoxication. Since the drugs are assigned to the same external cause code, code X42. Do not enter a Chapter V code (F codes).
- Place I (a) Intoxication by the use of (cocaine and opiates) T405 &X42 T406
9
Code I(a) nature of injury and external cause code for cocaine and opiates intoxication. Since the drugs are assigned to the same external cause code, code X42. Do not enter a Chapter V code (F codes).
- Place I (a) Toxic effects of cocaine abuse T405 &X42 F141
9
Interpret I(a) as cocaine poisoning and cocaine abuse. Code nature of injury and external cause code for cocaine poisoning and cocaine abuse as indexed.
- Place I (a) Toxic effects of illicit drug abuse T509 &X44 F191
9
Interpret I(a) as drug poisoning and drug abuse. Code nature of injury and external cause code for drug poisoning and drug abuse as indexed.
- Place I (a) Mixed drug intoxication alcohol and cocaine T519 X45 T405 &X42
9
Interpret I(a) as poisoning and code nature of injury and external cause code for alcohol and cocaine. Precede the external cause code for the cocaine poisoning with an ampersand.
- Place I (a) Mixed drug intoxication (alcohol and cocaine) T519 X45 T405 &X42
9 (b)
II Used combination cocaine and alcohol F149 F109
Interpret I(a) as poisoning and code nature of injury and external cause code for alcohol and cocaine. Precede the external cause code for cocaine poisoning with an ampersand. In Part II, code cocaine use as indexed under Dependence, due to, cocaine, and alcohol as indexed under Use, alcohol.
- Place I (a) Multiple drug intoxication including T509 &X44 T402 T424 T430
9 (b) oxycodone, diazepam, and doxepin
Code the nature of injury code for drug NOS as first entry on I(a). Since the drugs are assigned to different external cause codes, code X44 followed by the nature of injury code for each drug reported.
- Place I (a) Drug (heroin) intoxication T401 &X42
9
Code I(a) nature of injury and external cause code for heroin intoxication.
- Place I (a) Acute multiple drug intoxication (oxycodone T402 &X44 T424
9 (b) and alprazolam)
II Took overdose T509
Code I(a) nature of injury and external cause code for oxycodone and alprazolam intoxication. Since the drugs are assigned to different external cause codes, code X44. Code the nature of injury code for drug NOS in Part II.
- Place I (a) Acute multiple drug intoxication (ethanol, T510 X45 T402 &X44 T424
9 (b) oxycodone and alprazolam)
Interpret I(a) as alcohol poisoning and drug poisoning. Code the nature of injury and external cause for the alcohol and drugs. Since the drugs are assigned to different external cause codes, code X44 and precede with an ampersand.
- Place I (a) Acute combined drug intoxicationT509 &X44
9 (b) (oxycodone, with diazepam and ethyl T402 X45 T424 T510
(c) alcohol)
MOD II T509 F109
A
Accident Took drugs and drank alcoholic beverages
Code the nature of injury for drug NOS as first entry on I(a). Since the drugs are assigned to different external cause codes, code X44. Code the nature of injury for each drug reported on I(b) and the nature of injury and external cause for alcohol. Code the nature of injury for drug NOS and code alcohol as indexed under Drinking, drank (alcohol).
- Place I (a) Acute intoxication due to ethanol T510
9 (b) abuse, opiate abuse F101 F111
MOD II Drug reaction T509 X44 &X45
A
Accident
Code I(a) to the nature of injury code for ethanol since this is the first substance reported in the “due to” position. Code I(b) as indexed. Code Part II to drug poisoning since drug NOS is reported and the certifier stated the death was due to an accident. Code the external code for ethanol poisoning as the last code in Part II and precede with an ampersand.
- Place I (a) Intoxication T402
9 (b) Morphine, Cocaine poisoning T402 &X42 T405
Code I(a) to the nature of injury code for morphine since this is the first substance reported in the “due to” position. Code the nature of injury and external cause code for morphine and cocaine on I(b).
- Place I (a) Acute intoxication due to the T404
9 (b) combined effects of fentanyl T404 &X42 T406
(c) and opiates
Code I(a) to the nature of injury code for fentanyl since this is the first substance reported in the due to position. Code the nature of injury and external cause code for fentanyl and opiates on I (b).
- Place I (a) Cardiac arrhythmia associated with hydroxyzine I499 T435 &X41
9 (b) injection
MOD (c)
A II Hydroxyzine injection T435
Accident
Code first condition on I(a) as indexed. Code hydroxyzine injection as poisoning since it is a psychotropic drug and the certifier reported the death was due to an accident. Code nature of injury for hydroxyzine Part II.
- I (a) Cardiac arrhythmia associated with hydroxyzine I499
(b) injection
(c)
II Hydroxyzine injection
Code first condition on I(a) as indexed. No code required for the hydroxyzine injection since no complication is reported. It is considered drug therapy since the certifier did not report accident or undetermined in the manner of death block.
- Place I (a) Acute cardiac arrhythmia precipitated by I499 T405 &X42 T406
9 (b) cocaine and opiates
MOD (c)
A II Drug abuse, cocaine and opiates F141 F111
Accident
Code first condition on I(a) as indexed. Code cocaine and opiates as poisoning since the drugs are narcotics and the certifier reported the death was due to an accident. Code the nature of injury and external cause code for cocaine and opiate poisoning. Since the drugs are assigned to the same external cause code, code X42. Code cocaine abuse and opiates abuse as indexed in Part II.
- Place I (a) Acute intravenous narcotism (heroin) F112
9 (b)
II Methadone overdose, heroin injection T403 &X42 T401
Code I(a) F112, acute intravenous heroin narcotism. Consider the methadone overdose and heroin injection as poisoning. Heroin is not used for medical care purposes.
- Place I (a) Acute intravenous narcotism heroin overdose F192 T401 &X42
9 II
MOD
A
Accident
Interpret I(a) as two separate entities. Code acute intravenous narcotism as first entity and code a nature of injury and an external cause code for heroin overdose as second entity.
- Place I (a) Acute intravenous narcotism F112
9 (b) Morphine
II Intravenous use of drugs F199
Consider I(b) as continuation of I(a). Code I(a) acute intravenous morphine narcotism and Part II as indexed.
- I (a) Drug dependence (heroin, cocaine) F112 F142
Code I(a) heroin and cocaine dependence as indexed.
- Place I (a) Renal failure N19
9 (b) Drug induced hepatotoxicity T509 &X44
Code I(a) as indexed. Code I(b) as poisoning since toxicity (of a site) by a drug is one of the terms that is interpreted as poisoning.
- Place I (a) Effects of cocaine and methamphetamine use F149 F159
9 (b)
MOD II Drug intake T509 &X44
A
Accident
Code I(a) as indexed applying intent of certifier instructions for coding use of drugs. Code drug intake as poisoning since drug NOS is reported and the certifier reported the death was due to an accident.
- Place I (a) Adverse effects of drugs T509 &X44
9 II T509
MOD
A
Accident Subject took drugs
Code I(a) to drug poisoning since drug NOS is reported and the certifier stated the death was due to an accident. Code the nature of injury for drug in Part II.
- I (a) Gastric ulcer K259
(b) Drug intake Y579
(c) Arthritis &M139
Code the gastric ulcer as a complication of the drug reported on I(b). Code the E-code for drug therapy on I(b). It is considered drug therapy since the certifier did not indicate the death was due to an accident or it occurred under undetermined circumstances or the drug was taken in conjunction with alcohol. Code I(c) as indexed and precede with an ampersand.
- Place I (a) Combined toxicity T659 &X44
9 (b) Heroin and amphetamine T401 T436
MOD II
A
Accident
Code I(a) to nature of injury for Toxicity NOS, T659 as indexed. Code external cause to X44 since the drugs are classified to different external cause codes.
- Place I (a) Poisoning T659 &X44
9 (b) Heroin and amphetamine T401 T436
MOD II
A
Accident
Code I(a) to nature of injury for Poisoning NOS, T659 as indexed. Code external cause to X44 since the drugs are classified to different external cause codes.
- Place I (a) Mixed drug poisoning (cocaine, T405 &Y12 T406 T510 Y15
9 (b) opiate, ethanol)
MOD (c)
C II Consumed ethanol with illicit drugs F109 T509
Undetermined
Interpret I(a) as poisoning and code nature of injury and external cause for cocaine, opiate and ethanol. Precede the external cause for the drugs with an ampersand. In Part II, code consumed ethanol as indexed under Consumption, ethanol and code the nature of injury for drug.
- Place I (a) Subdural hematoma I620
9 (b) Anticoagulation Y442
(c) Arrhythmia &I499
II Amiodarone lung toxicity T462 &X44
Code I(a) as nontraumatic. Code the E-code for drug therapy on I(b). Code I(c) as indexed and precede with an ampersand to identify the reason for treatment. Code Part II as poisoning since toxicity (of a site) by a drug is one of the terms that is interpreted as poisoning.
- I (a) Cardiac Arrest I469
(b) Bleeding &R5800
MOD (c) Over coumadinization Y442
N
Natural
Code I(a) as indexed. Code the bleeding as a complication of the drug reported on I(c). Drug, medicament or biological substance is assumed to be used for medical care unless there are indications to the contrary.
- Place I (a) Combined opiate and stimulant poisoning T406 &X44 T509
9 (b) Usage of hydrocodone and cocaine F119 F149
MOD II T406 T509
A
Accident Used lethal combination of opiates and stimulant drugs
Code I(a) nature of injury and external cause for opiate and stimulant poisoning. Since the drugs are assigned to different external cause codes, code X44. Code I(b) as indexed applying intent of certifier instructions for use of drugs. Refer to Table of drugs and chemicals to find hydrocodone, T402. In Volume 1, the title of category T402 is “Other opioids”. Code hydrocodone use to Addiction, opioids, with fourth character .9, F119. In Part II, code the nature of injury for opiates and stimulant drugs, since “Lethal (amount) (dose) (quantity) of a drug” is interpreted to mean poisoning.
- Place I (a) Combined analgesic and antihistaminic T398 &X44 T450 T432
9 antidepressant poisoning
MOD (b) Usage of fentanyl promethazine doxylamine F199
A II F199
Accident Used combination of prescription drugs
Code I(a) nature of injury and external cause for analgesic, antihistaminic and antidepressant poisoning. Since the drugs are assigned to different external cause codes, code X44. Code I(b) and Part II as indexed applying intent of certifier instructions for use of drugs.
- Place I (a) Combined ethanol and methadone intoxication T510 X45 T403 &X42
9 II Toxic use of drug and ethanol T509 T510
Interpret I(a) as poisoning and code nature of injury and external cause code for ethanol and methadone. Precede the external cause code for the methadone poisoning with an ampersand. Interpret Part II as poisoning and code nature of injury for drug and ethanol.
- Place I (a) Adverse reaction to drugs and ethanol T509 &Y14 T510 Y15
0
MOD II F109 F139 F119
C
Undetermined Used ethanol, citalopram, hydrocodone and metaxalone
Interpret I(a) as poisoning and code nature of injury and external cause code for drugs and ethanol. Precede the external cause code for drug poisoning with an ampersand. In Part II, code use of ethanol and each named drug as indexed. Citalopram and metaxalone use are both assigned to F139. Code only the first mentioned; do not repeat a code on a line.
- Place I (a) Adverse effects of acetaminophen and alcohol T391 &X40 T519 X45
0
MOD II F199 F109
A
Accident Drug and alcohol use
Interpret I(a) as poisoning and code nature of injury and external cause code for acetaminophen and alcohol. Precede the external cause code for acetaminophen poisoning with an ampersand. In Part II, code drug use and alcohol use as indexed.
- Place I (a) Polypharmacy T509
9
MOD II &X44
A
Accident
Interpret I(a) as poisoning since the certifier reported the death was due to an accident. Assign the nature of injury for drug on line I(a) since polypharmacy is on the N-only list. Assign the E-code for drug NOS in Part II preceded by an ampersand.
- Place I (a) Cardiac arrest I469
9 (b) ASCVD I250
MOD II Polypharmacy
N
Natural
Code condition on I(a) and I(b) as indexed. No code required for the polypharmacy since no complication is reported. It is considered drug therapy since the certifier did not report accident or undetermined in the manner of death block.
- Place I (a) Acute polypharmacy intoxication (morphine and venlafaxine) T402 &X44 T432
9
MOD II Polypharmacy present T509
A
Accident Ingested pharmaceutical substances
Code I(a) nature of injury and external cause code for morphine and venlafaxine intoxication. Since the drugs are assigned to different external cause codes, code X44. Code the nature of injury code for drug NOS in Part II.
- I (a) Heart failure I509
(b) Cocaine induced cardiomyopathy Y483 &I427
MOD
N
Natural
Based on instructions for drug-induced, interpret line (b) as drug therapy. There is no indication
of poisoning on this record.
- Place I (a) Heart failure I509
9 (b) Cocaine induced cardiomyopathy T405 &X42 I427
MOD
A
Accident
Even though drug-induced is usually an indication of drug therapy, since cocaine is a narcotic and
the manner of death is marked as Accident, interpret as poisoning.
- Place I (a) Drug-induced cardiac arrhythmia &X44 I499
9 (b)
MOD II Drug-Induced cardiac arrhythmia T509 I499
A
Accident
Even though drug-induced is usually an indication of drug therapy, since drug nos is reported with
the manner of death marked as Accident, interpret as poisoning.
- Place I (a) Drug-induced cardiac arrhythmia &X42 I499
9 (b)
MOD II T509 T402 T404
A
Accident Consumption of various drugs: codeine, morphine, fentanyl
Even though drug-induced is usually an indication of drug therapy, since narcotics are reported with the manner of death marked as Accident, interpret as poisoning. Assign the E-code for the drug on (a) where the “drug-induced” is reported followed by the condition code. Assign T509 followed by the nature of injuries for the specified drugs reported in the How Injury Occurred block. Do not repeat a code on a line.
- Place I (a) Drug-induced cardiac arrhythmia &X42 I499
9 (b) (Codeine-free, morphine-free) T402
MOD II Drug-Induced arrhythmia T509 I499
A
Accident
Even though drug-induced is usually an indication of drug therapy, since narcotics are reported with the manner of death marked as Accident, interpret as poisoning. Assign the E-code for the drug on (a) where the “drug-induced” is reported followed by the condition code. Disregard the terminology “free” on line (b) and assign T402 for both drugs. Do not repeat a code on a line. Assign T509 for the drug mentioned in Part II followed by the code for arrhythmia.
- Place I (a) Adverse reaction to heroin T401 &X42
9 (b)
MOD II Used heroin F119
A
Accident
Code Part I as poisoning since heroin is not a drug used in therapy. Additionally, the Manner of Death is marked Accident with a narcotic, both indications of poisoning. Code Part II as indexed.
- Place I (a) Adverse reaction to fentanyl T404 &X42
9 (b)
MOD II Atherosclerotic cardiovascular disease I250 F119
A
Accident Used fentanyl
Code Part I as poisoning since a narcotic is reported with the manner of death marked as Accident. Code Part II and How Injury Occurred as indexed.
- Place I (a) Toxicity – multiple drugs T509 &X42 T405 T404 T401 T402
9 including cocaine, fentanyl,
heroin and hydrocodone
MOD II T509
A
Accident Multiple drug toxicity
Code the nature of injury code for toxicity NOS (with drugs reported elsewhere on the certificate) as first entry on I(a) followed by the e-code for the drugs. Since the drugs are assigned to the same external cause code, code X42. Code the nature of injury for each drug reported, including drug NOS in Part II.
- Place I (a) Toxicity T659 &X46
9 (b) Intoxication by acetone T524
MOD II
A
Accident Multiple drug toxicity
Since there is no indication of drug on the record, code the nature of injury code for toxicity NOS as first entry on I(a) followed by the e-code for the acetone. Code the nature of injury for the acetone reported on line (b).
- Place I (a) Poisoning by oxycodone, hydroxyzine, T402 &X44 T435
9 (b) dextromethorphan and butalbital T483 T423
MOD
A
Accident
Code nature of injury codes for the oxycodone and hydroxyzine reported on line I(a). Since the drugs are assigned to different external cause codes, assign X44. Code the nature of injury codes for the dextromethorphan and butalbital reported on I(b).
- Place I (a) Combined morphine, citalopram, diphendydramine T402 &X44 T432 T450
9 (b) Alprazolam, bupropion and topiramate intoxication T424 T432 T426
MOD II COPD, HTN, Asthma J449 I10 J459 T509
A
Accident Drug related
Code nature of injury codes for the drugs reported on line I(a). Since the drugs are assigned to different external cause codes, assign X44 in the second position on I(a). Code the nature of injury codes for the drugs reported on I(b). Code Part II conditions as indexed. Assign T509 for drug reported in the How Injury Occurred block.
- Place I (a) Alprazolam and carbon monoxide toxicity T424 &Y11 T58 Y17
9 (b)
MOD II
C
Could not be determined
Code nature of injury and external cause code for the alprazolam followed by the nature of injury and external cause code for the carbon monoxide. There is no appropriate combination category for drugs and chemicals, so code separately.
- Place I (a) Positional asphyxia in the setting of mixed drug T71 &W84
9 (b) toxicity (heroin, trazadone, diltiazem) T401 X44 T432 T461
MOD II F191 T71
A
Accident Drug abuse/positional asphyxia
Code I(a) as indexed, preceding the W84 with an ampersand since it is the first mentioned E-code. Assign the N and E-codes for the named drug poisoning on line I(b). In Part II, code drug abuse as indexed and repeat the nature of injury code for asphyxia.
- Place I (a) Mixed drug intoxication, heroin cocaine ethanol T401 &X42 T405 T510 X45
9 (b)
MOD II
A
Accident
Code I(a) to the nature of injury and external cause codes for the named drugs, preceding the e-code with an ampersand.
- Place I (a) Mixed drug intoxication: heroin cocaine ethanol T509 &X42 T401 T405 T510 X45
9 (b)
MOD II
A
Accident
Code I(a) T509 followed by the external cause code for the drug preceded by an ampersand. Assign the nature of injuries for the remaining specified drugs and the nature of injury and external cause code for the ethanol poisoning.
- Place I (a) Mixed drug intoxication; heroin cocaine ethanol T509 &X42 T401 T405 T510 X45
9 (b)
MOD II
A
Accident
Code I(a) T509 followed by the external cause code for the drug preceded by an ampersand. Assign the nature of injuries for the specified drugs and the nature of injury and external cause code for the ethanol poisoning.
- Place I (a) Mixed drug intoxication – heroin cocaine ethanol T509 &X42 T401 T405 T510 X45
9 (b)
MOD II
A
Accident
Code I(a) T509 followed by the external cause code for the drug preceded by an ampersand. Assign the nature of injuries for the specified drugs and the nature of injury and external cause code for the ethanol poisoning
- Place I (a) Mixed drug intoxication / heroin cocaine ethanol T509 &X42 T401 T405 T510 X45
9 (b)
MOD II
A
Accident
Code I(a) T509 followed by the external cause code for the drug preceded by an ampersand. Assign the nature of injuries for the specified drugs and the nature of injury and external cause code for the ethanol poisoning.
APPENDIX I – GUIDANCE IN CERTAIN EXTERNAL CATEGORIES
1. General Guidelines in coding Legal Intervention (Y35)
There are very few guidelines offered in the Classification for addressing Legal Interventions and it can be very difficult to determine when these categories are appropriate. To aid in classifying these types of records, apply the general interpretations below:
General Guidelines
– When alcohol or drug poisoning is reported in addition to a legal intervention event, do not apply the legal intervention concept to the poisoning; code according to the usual guidelines
NOTE: If the Manner of Death is marked Homicide, disregard and code poisoning as Accidental.
– When a police chase results in death to the person(s) being chased, code as a legal intervention death; when a police chase results in death to an innocent bystander, do not apply the legal intervention concept to the bystander
– When a decedent kills themselves and police are mentioned on the record, do not apply the legal intervention concept; code according to the usual guidelines.
– When a ‘suicide by cop’ is reported, code as a legal intervention death according to the circumstances described
I (a) Gunshot wounds to chest S219 &Y350
(b) Massive trauma to internal organs T148
MOD (c)
H II Lethal dose of methamphetamine T436 X41
Homicide Justifiable homicide by law enforcement
Code as legal intervention involving firearm. Assign the nature of injury and external cause code for accidental poisoning as directed in the legal intervention guidelines.
I (a) Asphyxia due to drowning T751 &Y356
(b) T751
MOD (c)
A II T751
Accident Drowning in river while fleeing police
Code as legal intervention by other specified means since it seems a police chase resulted in the death of the person being chased.
Place I (a) Contact gunshot wound to chest S219 &X72
9 (b)
MOD (c)
S II T141
Suicide Shot self with handgun during police standoff
Code as suicidal gunshot wound since the police did not inflict the fatal injury.
2. Restraint
Restraint can be seen reported in conjunction with drug intoxication or a mental health crisis. When reported as a means of limiting another’s physical movement, code restraint only when reported with a resulting injury such as asphyxia, suffocation, etc.
A.
When Is reported on the Code
record with
A threat to breathing
term such as: restraint the asphyxia, strangulation, suffocation
asphyxia T71 followed by the appropriate external
strangulation cause code for the restraint
suffocation
Place I (a) Restraint asphyxia with methamphetamine intoxication T71 &X58 T436 X41
9 (b)
MOD (c)
A II T71 T436
Accident Asphyxiated after being restrained while intoxicated on methamphetamine
Code T71 for the asphyxia followed by the external cause code for specified accident to represent the restraint. Assign the nature of injury and external cause code for the poisoning. In Part II, assign the nature of injury codes for asphyxia and methamphetamine reported in the how injury occurred block.
I (a) Cardiac arrhythmia during police restraint I499
(b) Heart enlargement from hypertension
MOD (c) Alcohol dependence, cocaine abuse, I517
H (d) and schizophrenia I10
(e) F102 F141 F209
II T149 &Y356
Homicide Altercation with police
Code I(a) as indexed. Reformat police restraint down to line (b) to accommodate the format term “during”. No code required since there is no resulting injury. Code remaining Part I conditions as indexed. Code Y356 for altercation with police in Part II. Precede with a T149 since no injury is reported.
B.
When Is reported on the Code
record with
T17 plus appropriate fourth character.
aspiration NOS restraint Also, code the appropriate W78, W79,
W80 if not previously coded
or
e-code for restraint where reported
aspiration of substances
or objects
Place I (a) Aspiration of vomitus during prone restraint T179 W78
1 (b) Methamphetamine intoxication &Y356
MOD (c) T436 X41
H II
Homicide Arrested and taken to jail. Restrained by law enforcement officers in jail.
Code I(a) as indexed. No ampersand is needed for the aspiration since it is due to another external cause. Reformat restraint down to line (b) to accommodate the format term “during”. Code Y356 for restrained by law enforcement officers. Code drug poisoning on line (c). Assign the nature of injury and external cause code for accidental poisoning as directed in the legal intervention guidelines. Precede Y356 with an ampersand since it is the first mentioned e-code.
Place I (a) Sudden cardiac death while being restrained I461
9 (b) during struggle
MOD (c)
H II Mixed drug intoxication; epilepsy; obesity T509 &X85 G409 E669 R55 R451
Homicide Collapsed after agitated behavior while being controlled by restraint protocol
Code I(a) as indexed. No code required for restrained since there is no resulting injury. Code Part II conditions as indexed. Code R55 for collapse and R451 for agitated behavior as indexed under Agitation.
________________________
i Similar terms include modifiers such as many, numerous, recurrent, repeated, serial, series, or several.