COVID-19 Coding and Reporting Guidance
In public health emergencies, mortality surveillance provides crucial information about population-level disease progression, as well as guides the development of public health interventions and assessment of their impact. Monitoring and analysis of mortality data allow dissemination of critical information to the public and key stakeholders. One of the most important methods of mortality surveillance is through monitoring causes of death as reported on death certificates. Death certificates are registered for every death occurring in the United States, offering a complete picture of mortality nationwide. The death certificate provides essential information about the deceased and the cause(s) and circumstances of death. Through a combination of automated coding systems and manual review, the National Center for Health Statistics (NCHS) assigns codes to each death record as defined in the International Classification of Diseases, 10th Revision, based on cause-of-death reporting.
On January 30, 2020, the World Health Organization (WHO) declared the 2019 Novel Coronavirus (2019-nCoV) disease outbreak a public health emergency of international concern.
As a result of the declaration, WHO Family of International Classifications (WHOFIC) Network Classification and Statistics Advisory Committee (CSAC) convened an emergency meeting on January 31, 2020 to discuss the creation of a specific code for this new coronavirus. A new International Classification of Diseases, 10th Revision (ICD–10) emergency code (U07.1, 2019-nCoV acute respiratory disease) has been established by WHO.
U07.1 – COVID-19
Excludes: Coronavirus infection, unspecified site (B34.2) Severe acute respiratory syndrome (SARS), unspecified (U04.9)
The WHO has provided a second code, U07.2, for clinical or epidemiological diagnosis of COVID-19 where a laboratory confirmation is inconclusive or not available. Because laboratory test results are not typically reported on death certificates in the United States, NCHS is not planning to implement U07.2 for mortality statistics.
Guidance for Certifying Deaths Due to Coronavirus Disease 2019 (COVID–19)
- If COVID-19 played a role in the death, it should be mentioned on the death certificate.
- Normally abbreviations and acronyms are discouraged, but COVID-19 is unambiguous and is acceptable.
- Include pre-existing conditions that complicated death in Part 2 of the death certificate.
- It is acceptable to report COVID-19 on a death certificate as “probable” or “presumed”—certifiers should use their best clinical judgement in determining if a COVID-19 infection was likely.
During this COCA Call, presenters will provide an overview of the importance of mortality data, discuss the NCHS publication and the guidance it provides to clinicians who may need to certify a death involving COVID-19, and present a summary of COVID-19 surveillance through the National Vital Statistics System (NVSS).
- COVID-19 and Funerals
- COVID-19 testing guidance:
- Guidance for filling out death certificates (general):