National Vital Statistics System

Instructions for Classifying Multiple Causes of Death, 2024 – 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

CVID           common variable immunodeficiency

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             secondary to

11

00             secondary to

                    11 to

                    99                         means unknown when reported in duration block, such as “99 years” = unknown number of years

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

  1. 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

  1. 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

  1. 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

  1. 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

  1. Street and highway

Alley

Border crossing

Bridge NOS

Freeway

Interstate

Motorway

Named street/highway/interstate

Pavement

Road (public)

Roadside

Sidewalk NOS

Walkway

  1. 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

  1. 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

  1. 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

  1. 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

  1. 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 multiple cause coding in the United States registration areas. Substitute code(s) for use in multiple 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

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

3. Vaping-related disorder (U07.0)

Tabular List

U07 Codes for emergency use

U07.0 Vaping-related disorder

SECTION I – Alphabetical index to diseases and nature of injury

Damage

– lung

– – dabbing related U07.0

– – electronic cigarette related U07.0

Disorder

– dabbing related U07.0

– electronic cigarette related U07.0

EVALI (e-cigarette or vaping, product use associated lung injury) U07.0

Injury

– lung

– – dabbing related U07.0

– – electronic cigarette related U07.0

4. 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 U07.1

COVID-19 U07.1

Disease

– Coronavirus 2019 U07.1

Infection

– Coronavirus NEC

– – 2019 novel U07.1

– – severe acute respiratory syndrome (SARS) U04.9

– – unspecified site B34.2

– – when referring to COVID-19 U07.1

SARS-CoV-2 U07.1

Severe acute respiratory syndrome coronavirus 2019 U07.1

Severe acute respiratory syndrome coronavirus type 2 U07.1

Sudden acute respiratory syndrome coronavirus type 2 U07.1

2019-nCoV U07.1

2019 novel coronavirus U07.1

Ia) Acute respiratory distress syndrome                               J80

  1. b) Pneumonia                                                                  J189
  2. c) COVID                                                                       U071

Code the COVID to U071.

Ia) Acute hypoxic respiratory failure                                  J960

  1. b) Pneumonia with coronavirus disease 2019                      J189 U071

II Chronic Obstructive pulmonary disease                           J449

Code coronavirus disease 2019 to U071.

5. Post COVID-19 Condition (U09.9)

Tabular List

U09 Post Covid-19 condition

U09.9 Post COVID-19 condition, unspecified

NOTE:   This optional code serves to allow establishment of a link with COVID-19.

             This code is not to be used in cases that are still presenting COVID-19.

             This code is valid for multiple cause coding only.

SECTION I – Alphabetical index to diseases and nature of injury

COVID-19 U07.1

– after effect U09.9

– cleared U09.9

– cured U09.9

– long U09.9

– long haul U09.9

– long hauler U09.9

– long-term U09.9

– long-term effects U09.9

– PASC U09.9

– past U09.9

– post U09.9

– post-acute U09.9

– post-acute-SARS-CoV-2 U09.9

– post-acute sequela (PASC) U09.9

– post acute syndrome U09.9

– post COVID condition U09.9

– post COVID syndrome U09.9

– previous U09.9

– prior U09.9

– recovered U09.9

– resolved U09.9

Ia) Acute renal failure                                                           N179

  1. b) Post COVID                                                                     U099

Code post COVID to U099.

Ia) Acute hypoxemic respiratory failure                               J960

  1. b) Hypovolemic shock                                                         R571

c) Urinary tract infection                                                      N390

  1. d) GI Bleed                                                                           K922

II Patient recovered from COVID-19                                  U099

Code recovered from COVID-19 to U099.

APPENDIX H – ADDITIONAL DRUG EXAMPLES

  1. 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.

  1. 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.

  1. 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).

  1. 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).

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. Place I    (a) Drug (heroin) intoxication                                               T401  &X42

       9

Code I(a) nature of injury and external cause code for heroin intoxication.

  1. 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.

  1. 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.

  1. Place I    (a) Acute combined drug intoxication                                  T509          &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).

  1. 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.

  1. 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).

  1. 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).

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. I    (a) Drug dependence (heroin, cocaine)                                   F112   F142

Code I(a) heroin and cocaine dependence as indexed.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. Place I    (a) Combined toxicity                                                          T509  &X44

       9             (b) Heroin and amphetamine                                                T401  T436

     MOD     II

       A

Accident

Code I(a) to nature of injury for Toxicity, with drugs reported elsewhere on the certificate T509 as indexed. Code external cause to X44 since the drugs are classified to different external cause codes.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. Place I    (a) Combined analgesic and antihistaminic                             T398  &X44  T450  T432

       9                 antidepressant poisoning

     MOD           (b) Usage of fentanyl promethazine doxylamine                      F119  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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1.          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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. Place    I  (a) Toxicity                                                                         T659 &X46

       9            (b) Intoxication by acetone                                                   T524

     MOD     II

       A

Accident

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).

  1. 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).

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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

  1. 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.

  1. Place    I (a) Acute combined drug intoxication with                   T509 &X42 T406 T405 T510 X45

       9           (b) opiates, cocaine, and ethanol

     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.

  1. Place    I (a) Multidrug Toxicity                                                   T509 &X44

       9           (b)

     MOD     II                                                                                  F119 F149

       A

Accident

Used fentanyl and cocaine

Code I(a) T509 followed by the external cause code for drug NOS preceded by an ampersand. In Part II, code used fentanyl and cocaine as indexed.

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.

 

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i Similar terms include modifiers such as many, numerous, recurrent, repeated, serial, series, or several.