Instructions for Classifying Multiple Causes of Death, 2022 – 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 11 secondary to

00 11 to secondary to

APPENDIX B - SYNONYMOUS SITES/TERMS

When a condition of a stated anatomical site is indexed in Volume 3, code condition of stated site as indexed. If stated site is not indexed, code condition of synonymous site.

Alimentary canal Gastrointestinal tract

Body Torso, trunk

Brain Anterior fossa, basal ganglion, central nervous

system, cerebral, cerebrum, frontal, occipital,

parietal, pons, posterior fossa, prefrontal, temporal,

III and IV ventricle

NOTE: Do not use brain when ICD provides for CNS

under the reported condition.

Cardiac Heart

Chest Thorax

Geriatric Senile

Greater sac Peritoneum

Hepatic Liver

Hepatocellular Liver

Intestine Bowel, colon

Kidney Renal

Larynx Epiglottis, subglottis, supraglottis, vocal cords

Lesser sac Peritoneum

Nasopharynx, pharynx Throat

Pulmonary Lung

Right\left hemispheric Code brain

Hemispheric NOS Do not assume brain

Right\left ventricle Heart

Third\fourth ventricle Brain

LLL, LUL, RLL, RML, RUL Lobes of the lungs when reported with lobectomy,

pneumonia, etc.

APPENDIX C - GEOGRAPHIC CODES

Alabama AL

Alaska AK

Arizona AZ

Arkansas AR

California CA

Colorado CO

Connecticut CT

Delaware DE

District of Columbia DC

Florida FL

Georgia GA

Hawaii HI

Idaho ID

Illinois IL

Indiana IN

Iowa IA

Kansas KS

Kentucky KY

Louisiana LA

Maine ME

Maryland MD

Massachusetts MA

Michigan MI

Minnesota MN

Mississippi MS

Missouri MO

Montana MT

Nebraska NE

Nevada NV

New Hampshire NH

New Jersey NJ

New Mexico NM

New York NY

North Carolina NC

North Dakota ND

Ohio OH

Oklahoma OK

Oregon OR

Pennsylvania PA

Puerto Rico PR

Rhode Island RI

South Carolina SC

South Dakota SD

Tennessee TN

Texas TX

Utah UT

Vermont VT

Virginia VA

Virgin Islands VI

Washington WA

West Virginia WV

Wisconsin WI

Wyoming WY

Territories and Outlying Areas

American Samoa AS

Federated States of Micronesia FM

Guam GU

Marshall Islands MH

Northern Mariana Islands MP

Palau PW

Puerto Rico PR

Virgin Islands (US) VI

US Minor Outlying Islands UM*

Baker Island

Howland Island

Jarvis Island

Johnston Atoll

Kingman Reef

Midway Islands

Navassa Island

Palmyra Atoll

Wake Island

APPENDIX D - CODE FOR PLACE OF OCCURRENCE

0. 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

2. 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

3. 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

4. Street and highway

Alley

Border crossing

Bridge NOS

Freeway

Interstate

Motorway

Named street/highway/interstate

Pavement

Road (public)

Roadside

Sidewalk NOS

Walkway

5. 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

6. 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

7. 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

8. 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

9. Unspecified place

Bathtub

Bed

Camper (trailer)

Commode

Country

Downstairs

Fireplace

Hot tub

Jobsite

Near any place

On job

Outdoors NOS

Parked car

Rural

Sofa

Table

Tree

Vehicle (any)

APPENDIX E - ACTIVITY CODES

The ICD-10 provides a subclassification for use with external causes and injuries to indicate the activity of the injured person at the time the event occurred. This appendix is designed to document the ICD-10 activity code information but it is not entered in manual coding.

Information may be scattered over different parts of the medical certification, Part I, Part II, 41, 43, etc. However, do not use the information in “Injury at work?” block to code this variable.

If no information concerning the activity of the injured person is reported on the certificate, the item is left blank. “While drinking alcohol” or “while driving” is not considered as a codable activity. When two or more codes appear to be appropriate for the information reported, activity code 8 is assigned.

0 While engaged in sports activity

Physical exercise with a described functional element such as:

. golf

. jogging

. riding

. school athletics

. skiing

. swimming

. trekking

. waterskiing

1 While engaged in leisure activity

Hobby activities

Leisure time activities with an entertainment element such as going to the cinema,

to a dance or to a party

Participation in sessions and activities of voluntary organizations

Excludes: sport activities (0)

2 While working for income

Paid work (manual) (professional)

Transportation (time) to and from such activities

Work for salary, bonus and other types of income

3 While engaged in other types of work

Domestic duties such as:

. caring for children and relatives

. cleaning

. cooking

. gardening

. household maintenance

Duties for which one would not normally gain an income

Learning activities, e.g. attending school session or lesson

Undergoing education

4 While resting, sleeping, eating and other vital activities

Personal hygiene

8 While engaged in other specified activities

APPENDIX F - INVALID AND SUBSTITUTE CODES

The following categories are invalid for underlying cause coding in the United States registration areas. Substitute code(s) for use in underlying cause coding appears to the right.

Use the substitute codes when conditions classifiable to the following codes are reported:

Invalid Codes Substitute Codes

A150-A153 A162

A154 A163

A155 A164

A156 A165

A157 A167

A158 A168

A159 A169

A160-A161 A162

B95-B97 Code the disease(s) classified

to other chapters modified by

the organism. Do not enter a

code for the organism.

F70.- F70 (3-characters only)

F71.- F71 (3-characters only)

F72.- F72 (3-characters only)

F73.- F73 (3-characters only)

F78.- F78 (3-characters only)

F79.- F79 (3-characters only)

I151-I158 R99

I23.- I21 or I22

I240 I21 or I22

I252 I258

I65-I66 I63

O08.- O00 - O07

O80.- O95

O81-O84 O759

P95 P969

R69 R95-R99

APPENDIX G - CODES FOR SPECIAL PURPOSES (U00-U99)

Provisional assignment of new codes (U00-U99)

1. Terrorism Classification (*U01-*U03)

NCHS has developed a set of new codes within the framework of the ICD that will allow the identification of deaths from terrorism reported on death certificates through the National Vital Statistics System. Terrorism-related ICD-10 codes for mortality have been assigned to the “U” category which has been designated by WHO for use by individual countries. The asterisk preceding the alphanumeric code indicates the code was introduced by the United States and is not officially part of the ICD.

To classify a death as terrorist-related, it is necessary for the incident to be designated as such by the Federal Bureau of Investigation (FBI). Neither a medical examiner nor a coroner who would be completing/certifying the death certificate, nor the nosologist coding the death certificate would determine that an incident is an act of terrorism. If an incident or event is confirmed by the FBI as terrorism, it may be so described on the certificate. If the incident is confirmed as terrorism after the death certificate is completed, the certificate can be recoded at a later date.

Not to be used unless notified by NCHS

Tabular List

Assault (homicide)

*U01-*U02

*U01 Terrorism

Includes: assault-related injuries resulting from the unlawful use of force or violence against persons or property to intimidate or coerce a Government, the civilian population, or any segment thereof, in furtherance of political or social objectives

*U01.0 Terrorism involving explosion of marine weapons

Depth-charge

Marine mine

Mine NOS, at sea or in harbor

Sea-based artillery shell

Torpedo

Underwater blast

*U01.1 Terrorism involving destruction of aircraft

Includes: aircraft used as a weapon

Aircraft:

• burned

• exploded

• shot down

Crushed by falling aircraft

*U01.2 Terrorism involving other explosives and fragments

Antipersonnel bomb (fragments)

Blast NOS

Explosion (of):

• NOS

• artillery shell

• breech-block

• cannon block

• mortar bomb

• munitions being used in terrorism

• own weapons

Fragments from:

• artillery shell

• bomb

• grenade

• guided missile

• land-mine

• rocket

• shell

• shrapnel

Mine NOS

*U01.3 Terrorism involving fires, conflagration and hot substances

Asphyxia originating from fire caused directly

Burns by fire-producing device or indirectly

Other injury by any conventional weapon

Petrol bomb

Collapse of

Fall from

Falling from burning building or structure

Hit by object

Jump from

Conflagration

Fire

Melting of fittings or furniture

Smoldering

*U01.4 Terrorism involving firearms

Bullet

• carbine

• machine gun

• pistol

• rifle

• rubber (rifle)

Pellets (shotgun)

*U01.5 Terrorism involving nuclear weapons

Blast effects

Exposure to ionizing radiation from nuclear weapon

Fireball effects

Heat

Other direct and secondary effects of nuclear weapons

*U01.6 Terrorism involving biological weapons

Anthrax

Cholera

Smallpox

*U01.7 Terrorism involving chemical weapons

Gases, fumes and chemicals:

• Hydrogen cyanide

• Phosgene

• Sarin

*U01.8 Terrorism, other specified

Lasers

Battle wounds

Drowned in terrorist operations NOS

Piercing or stabbing object injuries

*U01.9 Terrorism, unspecified

*U02 Sequelae of terrorism

Intentional self-harm (suicide)

*U03

*U03 Terrorism

*U03.0 Terrorism involving explosions and fragments

Includes: destruction of aircraft used as a weapon

Aircraft:

• burned

• exploded

• shot down

Antipersonnel bomb (fragments)

Blast NOS

Explosion (of):

• NOS

• artillery shell

• breech-block

• cannon block

• mortar bomb

• munitions being used in terrorism

• own weapons

Fragments from:

• artillery shell

• bomb

• grenade

• guided missile

• land-mine

• rocket

• shell

• shrapnel

Mine NOS

*U03.9 Terrorism by other and unspecified means

SECTION II – External causes of injury

Air

- blast in terrorism U01.2

Asphyxia, asphyxiation

- by

- - chemical in terrorism U01.7

- - fumes in terrorism (chemical weapons) U01.7

- - gas (see also Table of drugs and chemicals)

- - - in terrorism (chemical weapons) U01.7

- from

- - fire (see also Exposure, fire)

- - - in terrorism U01.3

Attack

- terrorist NEC U01.9

Bayonet wound

- in

- - terrorism U01.8

Blast (air) in terrorism U01.2

- from nuclear explosion U01.5

- underwater U01.0

Burn, burned, burning (by) (from) (on)

- chemical (external) (internal)

- - in terrorism (chemical weapons) U01.7

- in terrorism (from fire-producing device) NEC U01.3

- - nuclear explosion U01.5

- - petrol bomb U01.3

Casualty (not due to war) NEC

- terrorism U01.9

Collapse

- building

- - burning (uncontrolled fire)

- - - in terrorism U01.3

- structure

- - burning (uncontrolled fire)

- - - in terrorism U01.3

Crash

- aircraft (powered)

- - in terrorism U01.1

Crushed

- by, in

- - falling

- - - aircraft

- - - - in terrorism U01.1

Cut, cutting (any part of body) (by) (see also Contact, with, by object or machine)

- terrorism U01.8

Drowning

- in

- - terrorism U01.8

Effect(s) (adverse) of

- nuclear explosion or weapon in terrorism (blast) (direct) (fireball) (heat) (radiation)

(secondary) U01.5

Explosion (in) (of) (on) (with secondary fire)

- terrorism U01.2

Exposure to

- fire (with exposure to smoke or fumes or causing burns, or secondary explosion)

- - in, of, on, starting in

- - - terrorism (by fire-producing device) U01.3

- - - - fittings or furniture (burning building) (uncontrolled fire) U01.3

- - - - from nuclear explosion U01.5

Fall, falling

- from, off

- - building

- - - burning (uncontrolled fire)

- - - - in terrorism U01.3

- - structure NEC

- - - burning (uncontrolled fire)

- - - - in terrorism U01.3

Fireball effects from nuclear explosion in terrorism U01.5

Heat (effects of) (excessive)

- from

- - nuclear explosion in terrorism U01.5

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

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

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

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

b) Pneumonia J189

c) COVID U071

Code the COVID to U071.

Ia) Acute hypoxic respiratory failure nbsp; J960

b) Pneumonia with coronavirus disease 2019 J189 U071

II Chronic Obstructive pulmonary disease J449

Code coronavirus disease 2019 to U071.

APPENDIX H - ADDITIONAL DRUG EXAMPLES

1. Place I (a) Ingested overdose of opiates and ingested alcohol T406 &X42 F109

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.

2. Place I (a) Ingested overdose of (opiates) and ingested alcohol T406 &X42 F109

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.

3. Place I (a) Intoxication by the use of cocaine and opiates T405 &X42 T406

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).

4. Place I (a) Intoxication by the use of (cocaine and opiates) T405 &X42 T406

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).

5. Place I (a) Toxic effects of cocaine abuse T405 &X42 F141

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.

6. Place I (a) Toxic effects of illicit drug abuse T509 &X44 F191

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.

7. Place I (a) Mixed drug intoxication alcohol and cocaine T519 X45 T405 &X42

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.

8. 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.

9. 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.

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

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

11. 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.

12. 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.

13. Place I (a) Acute combined drug intoxicationT509 &X44

9 (b) (oxycodone, with diazepam and ethyl T402 X45 T424 T510

MOD II T509 F109

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).

14. Place I (a) Acute intoxication due to ethanol T510

9 (b) abuse, opiate abuse F101 F111

MOD II Drug reaction T509 X44 &X45

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.

15. 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).

16. Place I (a) Acute intoxication due to the T404

9 (b) combined effects of fentanyl T404 &X42 T406

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).

17. 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.

18. 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.

19. 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.

20. 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.

21. Place I (a) Acute intravenous narcotism heroin overdose F192 T401 &X42

9 II

MOD

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.

22. 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.

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

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

24. 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.

25. Place I (a) Effects of cocaine and methamphetamine use F149 F159

9 (b)

MOD II Drug intake T509 &X44

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.

26. Place I (a) Adverse effects of drugs T509 &X44

9 II T509

MOD

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.

27. I (a) Gastric ulcer K259

(b) Drug intake Y579

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.

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

9 (b) Heroin and amphetamine T401 T436

MOD II

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.

29. Place I (a) Poisoning T659 &X44

9 (b) Heroin and amphetamine T401 T436

MOD II

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.

30. 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.

31. Place I (a) Subdural hematoma I620

9 (b) Anticoagulation Y442

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.

32. I (a) Cardiac Arrest I469

(b) Bleeding &R5800

MOD (c) Over coumadinization Y442

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.

33. Place I (a) Combined opiate and stimulant poisoning T406 &X44 T509

9 (b) Usage of hydrocodone and cocaine F119 F149

MOD II T406 T509

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.

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

9 antidepressant poisoning

MOD (b) Usage of fentanyl promethazine doxylamine F199

A II F199

Accident

Used combination of prescription drugs

Code I(a) nature of injury and external cause for analgesic, antihistaminic and antidepressant poisoning. Since the drugs are assigned to different external cause codes, code X44. Code I(b) and Part II as indexed applying intent of certifier instructions for use of drugs.

35. 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.

36. Place I (a) Adverse reaction to drugs and ethanol T509 &Y14 T510 Y15
0

MOD II F109 F139 F119

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.

37. Place I (a) Adverse effects of acetaminophen and alcohol T391 &X40 T519 X45
0

MOD II F199 F109

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.

38. Place I (a) Polypharmacy T509
9

MOD II &X44

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.

39. Place I (a) Cardiac arrest I469
9 (b) ASCVD I250

MOD II Polypharmacy

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.

40. Place I (a) Acute polypharmacy intoxication (morphine and venlafaxine) T402 &X44 T432
9

MOD II Polypharmacy present T509

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.

41. I (a) Heart failure I509
(b) Cocaine induced cardiomyopathy Y483 &I427

MOD

Natural

Based on instructions for drug-induced, interpret line (b) as drug therapy. There is no indication
of poisoning on this record.

42. Place I (a) Heart failure I509
9 (b) Cocaine induced cardiomyopathy T405 &X42 I427

MOD

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.

43. Place I (a) Drug-induced cardiac arrhythmia &X44 I499
9 (b)

MOD II Drug-Induced cardiac arrhythmia T509 I499

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.

44. Place I (a) Drug-induced cardiac arrhythmia &X42 I499

9 (b)

MOD II T509 T402 T404

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.

45. Place I (a) Drug-induced cardiac arrhythmia &X42 I499

9 (b) (Codeine-free, morphine-free) T402

MOD II Drug-Induced arrhythmia T509 I499

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.

46. Place I (a) Adverse reaction to heroin T401 &X42

9 (b)

MOD II Used heroin F119

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.

47. Place I (a) Adverse reaction to fentanyl T404 &X42

9 (b)

MOD II Atherosclerotic cardiovascular disease I250 F119

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.

48. Place I (a) Toxicity – multiple drugs T509 &X42 T405 T404 T401 T402

9 including cocaine, fentanyl,

heroin and hydrocodone

MOD II T509

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.

49. Place I (a) Toxicity T659 &X46

9 (b) Intoxication by acetone T524

MOD II

Accident

Multiple drug toxicity

Since there is no indication of drug on the record, code the nature of injury code for toxicity NOS as first entry on I(a) followed by the e-code for the acetone. Code the nature of injury for the acetone reported on line (b).

50. Place I (a) Poisoning by oxycodone, hydroxyzine, T402 &X44 T435

9 (b) dextromethorphan and butalbital T483 T423

MOD

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).

51. 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

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.

52. Place I (a) Alprazolam and carbon monoxide toxicity T424 &Y11 T58 Y17

9 (b)

MOD II

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.

53. 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

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.

54. Place I (a) Mixed drug intoxication, heroin cocaine ethanol T401 &X42 T405 T510 X45

9 (b)

MOD II

Accident

Code I(a) to the nature of injury and external cause codes for the named drugs, preceding the e-code with an ampersand.

55. Place I (a) Mixed drug intoxication: heroin cocaine ethanol T509 &X42 T401 T405 T510 X45

9 (b)

MOD II

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.

56. Place I (a) Mixed drug intoxication; heroin cocaine ethanol T509 &X42 T401 T405 T510 X45

9 (b)

MOD II

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.

57. Place I (a) Mixed drug intoxication - heroin cocaine ethanol T509 &X42 T401 T405 T510 X45

9 (b)

MOD II

Accident

58. Place I (a) Mixed drug intoxication / heroin cocaine ethanol T509 &X42 T401 T405 T510 X45

9 (b)

MOD II

Accident

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

9 (b) opiates, cocaine, and ethanol

MOD II

Accident

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.

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.

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

e-code for restraint where reported

aspiration of substances

or objects

Place I (a) Aspiration of vomitus during prone restraint T179 W78

1 (b) Methamphetamine intoxication &Y356

MOD (c) T436 X41

H II

Homicide

Arrested and taken to jail. Restrained by law enforcement officers in jail.

Code I(a) as indexed. No ampersand is needed for the aspiration since it is due to another external cause. Reformat restraint down to line (b) to accommodate the format term “during”. Code Y356 for restrained by law enforcement officers. Code drug poisoning on line (c). Assign the nature of injury and external cause code for accidental poisoning as directed in the legal intervention guidelines. Precede Y356 with an ampersand since it is the first mentioned e-code.

Place I (a) Sudden cardiac death while being restrained I461

9 (b) during struggle

MOD (c)

H II Mixed drug intoxication; epilepsy; obesity T509 &X85 G409 E669 R55 R451

Homicide

Collapsed after agitated behavior while being controlled by restraint protocol

Code I(a) as indexed. No code required for restrained since there is no resulting injury. Code Part II conditions as indexed. Code R55 for collapse and R451 for agitated behavior as indexed under Agitation.

________________________

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