Implementation of New Coding Methods

With the release of final 2018 mortality data, the National Center for Health Statistics (NCHS) is resuming publication of an official maternal mortality rate (MMR). For 2019 and subsequent years, the MMR and detailed data files will be available with the annual release of the final mortality data.
NCHS is modifying the way two pieces of information on the death certificate—the checkbox and the certified recording of the cause of death—are used together.
Previously, for women aged 55 and over, NCHS had coded a death as maternal only if a positive checkbox entry was accompanied by mention of a maternal-related condition as a cause of death.
Beginning with 2018 data, NCHS will apply this coding convention to all deaths to women aged 45 and over. This change is being made because of findings about error rates in this age group.
NCHS’ evaluation of maternal mortality reinforced the need for modernizing the underlying vital statistics system and the electronic systems that support vital registration. These systems need to be updated to be more flexible and responsive to changing content, as well as to provide for greater real-time quality checks as deaths are being recorded and causes of death defined.
Short of a fundamental modernization of the system, NCHS will explore options for adding quality to the system, including approaches such as adding pop-up prompts that alert certifying physicians to validate information that may seem to be in error.