Cause of death
For national mortality statistics, every death is attributed to one underlying condition, based on information reported on the death certificate and using international rules for selecting the underlying cause of death from the conditions stated on the certificate. The underlying cause is defined by the World Health Organization as “the disease or injury that initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury.” Generally, more medical information is reported on death certificates than is directly reflected in the underlying cause of death. Conditions that are not selected as the underlying cause of death constitute the nonunderlying causes of death, also known as multiple cause of death.
Cause of death is coded according to the appropriate revision of the International Classification of Diseases (ICD) (see Sources and Definitions, International Classification of Diseases [ICD]). Effective with deaths occurring in 1999, the United States began using the 10th revision of ICD (ICD–10); during 1979–1998, causes of death were coded and classified according to the 9th revision (ICD–9). COD-Table lists ICD codes for the 6th through 10th revisions for causes of death shown in Health, United States. In Health, United States, common terms are sometimes used in the text in place of medical terminology. Examples include cancer for “malignant neoplasm” and kidney disease for “nephritis, nephrotic syndrome and nephrosis.”
Each ICD revision has produced discontinuities in cause-of-death trends. These discontinuities are measured by using comparability ratios that are essential to the interpretation of mortality trends. (Also see Sources and Definitions, Comparability ratio.) For further discussion, see: https://www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm. (Also see Sources and Definitions, Comparability ratio; International Classification of Diseases [ICD]; and National Vital Statistics System [NVSS]: Multiple Cause-of-Death File.)
COD-Table. Cause-of-death codes, by applicable revision of International Classification of Diseases (ICD)
| Cause of death (10th revision titles) | 6th and 7th revisions | 8th revision | 9th revision | 10th revision |
|---|---|---|---|---|
| Communicable diseases | … | … | 001–139, 460–466, 480–487, 771.3 |
A00–B99, J00–J22 |
| Chronic and noncommunicable diseases | … | … | 140–459, 470–478, 490–799 |
C00–I99, J30–R99 |
| Septicemia | … | … | 038 | A40–A41 |
| Human immunodeficiency virus (HIV) disease1 | … | … | *042–*044 | B20–B24 |
| Malignant neoplasms | 140–205 | 140–209 | 140–208 | C00–C97 |
| Colon, rectum, and anus | 153–154 | 153–154 | 153, 154 | C18–C21 |
| Trachea, bronchus and lung | 162–163 | 162 | 162 | C33–C34 |
| Diabetes mellitus | 260 | 250 | 250 | E10–E14 |
| Anemias | … | … | 280–285 | D50–D64 |
| Meningitis | … | … | 320–322 | G00, G03 |
| Parkinson’s disease | 350 | 342 | 332 | G20–G21 |
| Alzheimer’s disease | … | … | 331.0 | G30 |
| Diseases of the circulatory system | … | … | 390–459 | I00–I99 |
| Diseases of heart | 400–402, 410–443 | 390–398, 402, 404, 410–429 | 390–398, 402, 404, 410–429 |
I00–I09, I11, I13, I20–I51 |
| Ischemic heart disease | … | … | 410–414, 429.2 | I20–I25 |
| Essential hypertension and hypertensive renal disease | … | … | … | I10, I12, I15 |
| Cerebrovascular diseases | 330–334 | 430–438 | 430–434, 436–438 | I60–I69 |
| Atherosclerosis | … | … | 440 | I70 |
| Influenza and pneumonia2 | 480–483, 490–493 | 470–474, 480–486 | 480–487 | J09–J18 |
| Chronic lower respiratory diseases | 241, 501, 502, 527.1 | 490–493, 519.3 | 490–494, 496 | J40–J47 |
| Chronic liver disease and cirrhosis | 581 | 571 | 571 | K70, K73–K74 |
| Nephritis, nephrotic syndrome and nephrosis | … | … | 580–589 | N00–N07, N17–N19, N25–N27 |
| Pregnancy, childbirth and the puerperium | 640–689 | 630–678 | 630–676 | O00–O99 |
| Congenital malformations, deformations and chromosomal abnormalities | … | … | 740–759 | Q00–Q99 |
| Certain conditions originating in the perinatal period | … | … | 760–779 | P00–P96 |
| Newborn affected by maternal complications of pregnancy | … | … | 761 | P01 |
| Newborn affected by complications of placenta, cord and membranes | … | … | 762 | P02 |
| Disorders related to short gestation and low birthweight, not elsewhere classified | … | … | 765 | P07 |
| Birth trauma | … | … | 767 | P10–P15 |
| Intrauterine hypoxia and birth asphyxia | … | … | 768 | P20–P21 |
| Respiratory distress of newborn | … | … | 769 | P22 |
| Bacterial sepsis of newborn | … | … | … | P36 |
| Neonatal hemorrhage3 | … | … | 772 | P50–P52, P54 |
| Sudden infant death syndrome | … | … | 798.0 | R95 |
| Injuries4 | … | … | E800–E869, E880–E929, E950–E999 | *U01–*U03, V01–Y36, Y85–Y87, Y89 |
| Unintentional injuries5 | E800–E936, E960–E965 | E800–E929, E940–E946 |
E800–E869, E880–E929 | V01–X59, Y85–Y86 |
| Motor vehicle-related injuries5 | E810–E835 | E810–E823 | E810–E825 | V02–V04, V09.0, V09.2, V12–V14, V19.0–V19.2, V19.4–V19.6, V20–V79, V80.3–V80.5, V81.0–V81.1, V82.0–V82.1, V83–V86, V87.0–V87.8, V88.0–V88.8, V89.0, V89.2 |
| Poisoning | E870–E888, E890–E895 | E850–E877 | E850–E869 | X40–X49 |
| Suicide4 | E963, E970–E979 | E950–E959 | E950–E959 | *U03, X60–X84, Y87.0 |
| Homicide4 | E964, E980–E983 | E960–E969 | E960–E969 | *U01–*U02, X85–Y09, Y87.1 |
| Firearm-related injury | … | E922, E955, E965, E970, E985 | E922, E955.0–E955.4, E965.0–E965.4, E970, E985.0–E985.4 | *U01.4, W32–W34, X72–X74, X93–X95, Y22–Y24, Y35.0 |
| Injury by drug overdose | … | … | … | X40–X44, X60–X64, X85, Y10–Y14 |
| Any opioid | … | … | … | X40–X44, X60–X64, X85, Y10–Y14 (underlying cause) and T40.0–T40.4, T40.6 (multiple cause) |
| Heroin | … | … | … | X40–X44, X60–X64, X85, Y10–Y14 (underlying cause) and T40.1 (multiple cause) |
| Natural and semisynthetic opioids | … | … | … | X40–X44, X60–X64, X85, Y10–Y14 (underlying cause) and T40.2 (multiple cause) |
| Methadone | … | … | … | X40–X44, X60–X64, X85, Y10–Y14 (underlying cause) and T40.3 (multiple cause) |
| Other synthetic opioids (other than methadone) | … | … | … | X40–X44, X60–X64, X85, Y10–Y14 (underlying cause) and T40.4 (multiple cause) |
… Category not applicable; cause-of-death codes are not provided for causes not shown in Health, United States.
1 Categories for coding human immunodeficiency virus (HIV) infection were introduced in 1987. The asterisk (*) indicates codes that were not part of ICD–9.
2 Starting with 2007 data, the National Center for Health Statistics (NCHS) introduced the category J09 for coding avian influenza virus. In 2009, the title for ICD–10 code J09 was changed from “Influenza due to identified avian influenza virus” to “Influenza due to certain identified influenza virus” to accommodate deaths from influenza A (H1N1) virus in the ICD–10 code J09 for data years 2009 and beyond.
3 Under ICD–9, this category is called Fetal and neonatal hemorrhage.
4 Starting with 2001 data, NCHS introduced categories *U01–*U03 for classifying and coding deaths due to acts of terrorism. The asterisk (*) indicates codes that are not part of ICD–10.
5 In the public health community, the term “unintentional injuries” is preferred to accidents, and the term “motor vehicle-related injuries” is preferred to motor vehicle accidents.
SOURCE: National Center for Health Statistics. Advance report: Final mortality statistics, 1974. Monthly Vital Statistics Report; vol 24 no 11 suppl. Hyattsville, MD: National Center for Health Statistics. 1976. Available from: https://www.cdc.gov/nchs/data/mvsr/supp/mv24_11sacc.pdf; Hoyert DL, Kochanek KD, Murphy SL. Deaths: Final data for 1997. National Vital Statistics Reports; vol 47 no 19. Hyattsville, MD: National Center for Health Statistics. 1999. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr47/nvs47_19.pdf; Hoyert DL, Heron MP, Murphy SL, Kung HC. Deaths: Final data for 2003. National Vital Statistics Reports; vol 54 no 13. Hyattsville, MD: National Center for Health Statistics. 2006. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_13.pdf; and Murphy SL, Xu JQ, Kochanek KD. Deaths: Final data for 2010. National Vital Statistics Reports; vol 61 no 4. Hyattsville, MD: National Center for Health Statistics. 2013. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf; Xu JQ, Murphy S, Kochanek KD, Arias E. Deaths: Final data for 2019. National Vital Statistics Reports; vol 70 no 8. Hyattsville, MD: National Center for Health Statistics. 2021. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-08-508.pdf.