National Vital Statistics System

Instructions for Classifying Multiple Causes of Death, 2019 – Section III


In order to assign the most appropriate code for a given diagnostic entity, it may be necessary to take other recorded information and the order in which the information is reported into account. It is important to interpret this information properly so the meaning intended by the certifier is correctly conveyed. The objective is to code each diagnostic entity in accordance with the intent of the certifier without combining separate codable entities. The following instructions help to determine the intent of the certifier. Apply Intent of Certifier instructions to “See also” terms in the Index and to any synonymous sites or terms as well.

1. Other and unspecified gastroenteritis and colitis of unspecified origin (A099)

  1. Code A090 (Gastroenteritis and colitis of infectious origin)

When reported due to:






            I    (a) Enteritis                                                                        A090

                 (b) Listeriosis                                                                      A329

Code I(a) gastroenteritis and colitis of infectious origin, A090, since enteritis is reported due to a condition classified to A329.

EXCEPTION: When the enteritis is reported due to another infectious condition or an organism classified to A49 or B34, refer to Section III, 7. Organisms and Infections.

  1. Code K529 (Noninfective gastroenteritis and colitis, unspecified)

When reported due to:









            I    (a) Enteritis                                                                        K529

                 (b) Abscess of intestine                                                        K630

Code I(a) noninfective gastroenteritis and colitis, unspecified, K529, since enteritis is reported due to a condition classified to K630.

            I    (a) Colitis                                                                           A099

Code I(c) gastroenteritis and colitis of unspecified origin, A099, as indexed.

2. Cavitation lung (A162)

Code J984 (Nontuberculous cavitation lung)

When reported due to:

A000-A099     G459-G98      O981-P369

A200-B199     H650-H709     P371-R825

B201-B89      H720-H739     R826

B91-F39       H950-J64      R827-R892

F531          J660-L599     R893

F55           L930-L932     R894-R961

F71-F79       M000-N459     R98-R99

F840-F849     N480-N96      S000-Y899

F99-G419      N980-O979

            I    (a) Cavitary lung disease                                                      J984

                 (b) COPD                                                                            J449

Code I(a) nontuberculous cavitation of lung, J984, since cavitary lung disease is reported due to a condition classified to J449.

            I    (a) Respiratory failure                                                          J969

                 (b) COPD                                                                            R570

                 (c) Cavitation lung                                                               A162

Code I(c) cavitation of lung, A162, since it is not reported due to any other conditions.

3. Spinal Abscess (A180)
Vertebral Abscess (A180)

Code M462 (Nontuberculous spinal abscess)

When reported due to:

A400-A419      H650-H669      M910-M939

A500           H950-H959      M960-M969

A509           J00-J399       N10-N12

A527           J950-J959      N136

A539           K650-K659      N151

B200-B24       K910-K919      N159

B89            L00-L089       N288

B99            M000-M1990     N340-N343

C412           M320-M351      N390

C760           M359           N700-N768

C795           M420-M429      N990-N999

C810-C969      M45-M519       R75

D160-D169      M600           S000-T983

D480           M860-M889

D550-D589      M894

            I    (a) Spinal Abscess                                                               M462

                 (b) Staphylococcal septicemia                                               A412

Code I(a) nontuberculous spinal abscess, M462, since spinal abscess is reported due to a condition classified to A412.

4. Charcot Arthropathy (A521)

Code G98 (Arthropathy, neurogenic, neuropathic (Charcot), nonsyphilitic)

When reported due to:

A30       Leprosy                             G608   Hereditary sensory

E10-E14   Diabetes mellitus                           neuropathy

E538      Subacute combined degeneration      G901   Familial dysautonomia

           (of spinal cord)                   G950   Syringomyelia

F101      Alcohol abuse                       Q059   Spina bifida,

F102      Alcoholism                                  meningo-myelocele

G600      Hypertrophic interstitial           Y453   Indomethacin

           neuropathy                         Y453   Phenylbutazone

G600      Peroneal muscular atrophy           Y427   Corticosteroids

            I    (a) Charcot arthropathy                                                       G98

                 (b) Diabetes                                                                        E149

5. General Paresis (A521)

  1. Code G839 (Paralysis)

When reported due to or on the same line with:

A022          A988          B690          D180-D181     I159

A040          B003-B004     B719          D210          I600-I709

A051          B010-B011     B75           D233-D234     I748

A066          B020-B022     B832          D320-D339     J108

A078          B03-B04       B888          D352          J118

A170-A179     B050-B051     B89           D355          M000-M1990

A180          B060          B900          D360-D367     M420-M429

A190-A191     B200-B24      B901-B909     D420-D439     M45-M519

A203          B258          B91           D443          M860-M949

A228          B259          B92-B940      D446          N000-N399

A260-A289     B261-B262     B941          D448          O100-O16

A321-A329     B268          B948-B949     D45-D479      O740-O749

A368          B270-B279     C470          D487          O900-O909

A390-A394     B334-B338     C479          D489          O95

A398-A399     B375          C700-C729     E713          O994

A428          B384          C751          E750-E756     P000-Q079

A440-A539     B428          C754          F449          Q750-Q799

A544          B450-B459     C758          G000-G239     Q860-Q999

A548          B461          C760          G300-G379     R270-R278

A680-A689     B49-B64       C770          G450-G459     R75

A692          B673          C793-C794     G540-G729

A800-A959     B676          C798-C97      G839-G98

A981-A982     B679          D170          I10

            I    (a) CVA with general paresis                                                 I64       G839



  1. Code T144 (Paralysis, traumatic)

Refer to Section V, Part S, Sequela of injuries, poisonings, and other consequences of external causes, if a sequela is indicated.

When reported due to or on the same line with:

S000-T149   W81-X39

T20-T35     X50-X599

T66-T79     X70-X84

T90-T95     X91-Y09

T981-T982   Y20-Y369

V010-W43    Y850-Y872

W45-W77     Y890-Y899

I    (a) General paresis                                                              T144

                 (b) Brain injury                                                                    S069


            II  Auto accident                                                                      &V499

6. Viral Hepatitis (B161, B169, B171-B179)



 For Viral Hepatitis in  Code Chronic Viral Hepatitis



 B161                    B180


 B169                    B181


 B171                    B182


 B172                    B188


 B178                    B188


 B179                    B189


When reported as causing liver conditions in:

K721, K7210



            I    (a) Cirrhosis of liver                                                             K746

                 (b) Viral hepatitis B                                                              B181

Code I(b) B181, chronic viral hepatitis B, since reported as causing a condition classified to K746.

7. Organisms and Infections NOS (B99)



 Bacterial organisms     Viral organisms         Organisms classified to

 classified to A49.-     classified to B34.-     other than A49.- or B34.-


 Escherichia coli        Adenovirus              Aspergillus

 Haemophilus influenzae  Coronavirus             Candida

 Pneumococcal            Coxsackie               Cytomegalovirus

 Staphylococcal          Enterovirus             Fungus

 Streptococcal           Parvovirus              Meningococcal


Infectious conditions

Abscess        Infection     Sepsis, Septicemia

Bacteremia     Pneumonia     Septic Shock

Empyema        Pyemia        Words ending in “itis”

These lists are NOT all inclusive. Use them as a guide.

In order to determine which instruction to use, refer to the Index under the named organism or under Infection, named organism.

  1. Bacterial organisms and infections classified to A49 and Viral organisms and infections classified to B34

(1) When an infectious or inflammatory condition is reported and

(a) Is preceded or followed by condition classified to A49 or B34 or

(b) A condition classifiable to A49 or B34 is reported as the only entry or first entry on the next lower line or

(c) Is followed by a condition classified to A49 or B34 separated by a connecting term not indicating a due to relationship

(i)  If a single code is provided for the infectious or inflammatory condition modified by the condition classified to A49 or B34, use this code. Do not assign a separate code for the condition classifiable to A49 or B34. It may be necessary to use “due to” or “in” in the Index to assign the appropriate code.

            I    (a) E. coli diarrhea                                                               A044

Code as indexed under Diarrhea, due to, Escherichia coli.

            I    (a) Pneumonia                                                                     J129

                 (b) Viral infection

Code as indexed under Pneumonia, viral.

            I    (a) Meningitis and sepsis                                                      G000    A413

                 (b) H. influenzae

Code as indexed under Meningitis, Haemophilus (influenzae) and Septicemia, Haemophilus influenzae.

            I    (a) Sepsis with staph                                                           A412

Code as staphylococcal sepsis as indexed under Septicemia, staphylococcal.

            I    (a) Pneumonia c MRSA                                                      J152

Code as methicillin resistant staphylococcal aureus pneumonia as indexed under Pneumonia, MRSA.

(ii) If (i) does not apply, and the Index provides a code for the infectious or inflammatory condition qualified as “bacterial,” “infectious,” “infective,” or “viral,” assign the appropriate code based on the reported type of organism. Do not assign a separate code for the condition classified to A49 or B34.

            I    (a) Coxsackie virus pneumonia                                              J128

Coxsackie virus is a specified virus. Code as indexed under Pneumonia, viral, specified NEC.

            I    (a) Peritonitis                                                                      K650

                 (b) Campylobacter

Campylobacter is a specified bacteria. Code as indexed under Peritonitis, bacterial.

            I    (a) Pneumonia with coxsackie virus                                        J128

Code as coxsackie virus pneumonia. Since coxsackie virus is a specified virus, code as indexed under Pneumonia, viral, specified NEC.

(iii)         If (i) and (ii) do not apply, assign the NOS code for the infectious or inflammatory condition. Do not assign a separate code for the condition classified to A49 or B34.

            I    (a) Klebsiella urinary tract infection                                       N390

The Index does not provide a code for Infection, urinary tract specified as bacterial, infectious, infective, or Klebsiella. Therefore, code Infection, urinary tract.

            I    (a) Pyelonephritis                                                                N12

                 (b) Staphylococcus

The Index does not provide a code for pyelonephritis specified as bacterial, infectious, infective, or staphylococcal. Therefore, code Pyelonephritis as indexed.

            I    (a) Pyelonephritis and pseudomonas                                      N12

The Index does not provide a code for pyelonephritis specified as bacterial, infectious, infective or pseudomonas. Therefore, code pyelonephritis as indexed.

  1. Organisms and infections classified to categories other than A49 and B34

(1) When an infectious or inflammatory condition is reported and

(a) Is preceded by a condition classifiable to Chapter I other than A49 or B34

(i)  Refer to the Index under the infectious or inflammatory condition. If a single code is provided for this condition, modified by the condition from Chapter I, use this code. It may be necessary to use “due to” or “in” in the Index to assign the appropriate code.

                 I    (a) Cytomegaloviral pneumonia                                        B250

Code as indexed under Pneumonia, cytomegaloviral.

(ii) If (i) does not apply, refer to Volume 1, Chapter I to determine if the Classification provides an appropriate fourth character for the organism. Indications of appropriate fourth characters for sites would be “of other sites,” “other specified organs,” or “other organ involvement.”

                 I    (a) Candidiasis peritonitis                                                B378

Since this term is not indexed together, refer to Volume I, Chapter I and select the fourth character, .8, candidiasis of other sites.

(iii) If (i) and (ii) do not apply, code as two separate conditions.

                 I    (a) Mononucleosis pharyngitis                                          B279    J029

Since this term is not indexed together and Volume I, Chapter I does not provide an appropriate fourth character under B27.-, code as two separate conditions.

(b) A condition from Chapter I other than A49 or B34 is reported as the only entry or the first entry on the next lower line

(i)  Code each condition as indexed where reported.

            I    (a) Peritonitis                                                                      K659

                 (b) Candidiasis                                                                    B379

Since candidiasis is classified to a condition other than A49 or B34, code each condition as indexed.

(c) A condition from Chapter I other than A49 or B34 is reported separated by        a connecting term not indicating a due to relationship

(i)  Code each condition as indexed where reported.

            I    (a) Pneumonia with candidiasis                                             J189     B379

Since candidiasis is classified to a condition other than A49 or B34, code each condition as indexed.

  1. Do not use HIV or AIDS to modify an infectious or inflammatory condition. Code as two separate conditions.

            I    (a) HIV pneumonia                                                              B24      J189

  1. When an infectious or inflammatory condition is reported and a specified organism or specifiednonsystemic infection is not the only entry or the first entry on the next lower line.
  • Code the infectious or inflammatory condition and the organism or infection separately.

            I    (a) Pneumonia                                                                     J189

                 (b) Emphysema & viral infection                                            J439     B349

            I    (a) Peritonitis                                                                      K659

                 (b) Gastric ulcer and staphylococcal infection                          K259    A490

  1. When an infectious or inflammatory condition is reported and

(1) Infection NOS is reported as the only entry or the first entry on the next lower line

  • Code the infectious or inflammatory condition where it is entered on the certificate and do not enter a code for infection NOS, but take into account if it modifies the infectious condition.

            I    (a) Cholecystitis & arthritis                                                   K819    M009

                 (b) Infection

            I    (a) Meningitis                                                                      G039

                 (b) Infection & brain tumor                                                   D432

(2) Infection NOS is not the only entry or the first entry on the next lower line

  • Code the infectious or inflammatory condition where it is entered on the certificate and code infection NOS separately.

            I    (a) Septicemia                                                                     A419

                 (b) Diabetes & infection                                                       E149    B99

  1. When a noninfectious or noninflammatory condition is reported and infection NOS is reported on a lower line
  • Code the noninfectious or noninflammatory condition as indexed and code infection NOS (B99) where entered on the certificate.

            I    (a) ASHD                                                                            I251

                 (b) Infection                                                                       B99

  1. When an organism is reported preceding two or more infectious conditions reported consecutively on the same line
  • Code each of the infectious conditions modified by the organism.

            I    (a) Staphylococcal pneumonia and                                         J152     G003

                 (b) meningitis

  1. When one infectious condition is modified by more than one organism, modify the condition by all organisms.

            I    (a) Strep, Klebsiella and MRSA pneumonia                              J154     J150  J152

            I    (a) Strep pneumonia, MRSA                                                  J154     J152

            I    (a) Sepsis enterococcus, MRSA                                              A402    A410

  1. i.   When any condition is reported and a generalized infection such as bacteremia, fungemia, sepsis, septicemia, systemic infection, or viremia is reported on a lower line
  • Code both the condition and the generalized infection where entered on certificate. Do not modify the condition by the infection.

            I    (a) Bronchopneumonia                                                         J180

                 (b) Septicemia                                                                     A419

            I    (a) Pneumonia                                                                     J189

                 (b) Viremia                                                                         B349

8. Eaton-Lambert syndrome (C80)

Code G708 (Eaton-Lambert syndrome unassociated with neoplasm)

When reported on a record without a condition from the following categories also reported:


            Male, 57 years old
I    (a) Aspiration pneumonia                                                     J690
II  (b) Eaton-Lambert syndrome                                                G708

Code I(b) Eaton-Lambert syndrome unassociated with neoplasm (G708) since there is no condition from categories C000 – D489 reported anywhere on the record.

            Female, 69 years old

            I    (a) Eaton-Lambert syndrome                                                C80
I    (b) Small cell lung cancer                                                      C349

Code I(a) Eaton-Lambert syndrome (C80) since there is a condition from categories C000 – D489 reported on the record.

9. Erythremia (C940)

Code D751 (Secondary erythremia):

When reported due to

A000-D489     F55           L710-L719      N700-N768     R730-R739

D510-D619     G000-G419     L930-L932      N980          R75

D751          G450-G459     L950-L959      N990-Q999     R780

D760-E149     G600-G979     M000-M1990     R030          R826

E240-E279     I00-J989      M300-M359      R040-R049     R893

E65-E678      K20-L00       M420-M549      R090-R098     S000-Y899

E890          L100-L139     M800-M949      R160-R162

E896-E899     L230-L309     M960-M969      R31

F100-F199     L500-L599     N000-N399      R58-R5800

            I    (a) Septicemia                                                                     A419

                 (b) Erythremia                                                                     D751

                 (c) Polycythemia                                                                 D45

10. Polycythemia (D45)






Code D751 (Secondary polycythemia)

When reported due to:

A000-D489     F55           L710-L719      N700-N768     R730-R739

D510-D619     G000-G419     L930-L932      N980          R75

D751          G450-G459     L950-L959      N990-Q999     R780

D760-E149     G600-G979     M000-M1990     R030          R826

E240-E279     I00-J989      M300-M359      R040-R049     R893

E65-E678      K20-L00       M420-M549      R090-R098     S000-Y899

E890          L100-L139     M800-M949      R160-R162

E896-E899     L230-L309     M960-M969      R31

F100-F199     L500-L599     N000-N399      R58-R5800

            I    (a) Polycythemia                                                                 D751

                 (b) Pneumonia                                                                     J189

            I    (a) Polycythemia                                                                 &D751

                 (b) Chloromycetin therapy                                                    Y408

            I    (a) Polycythemia vera                                                          D45

                 (b) Emphysema                                                                   J439

11. Hemolytic Anemia (D589)

Code D594 (Secondary hemolytic anemia)

When reported due to:

A000-D489   F180-F199   Q200-Q289

D594        G000-G09    R75

D65-D699    I00-I519    R780

D760        I776        R823

D800-D899   J09-J22     R826

E201        K700-K769   R893

E280-E289   M000-M359   S000-Y899

E40-E46     N000-N399

E700-E899   O000-O998

F100-F169   P550-P579

            I    (a) Hemolytic anemia                                                           D594

                 (b) Hairy cell leukemia                                                          C914


            I    (a) Hemolytic anemia                                                           D589



            II  Hypogammaglobulinemia                                                      D801

            I    (a) Secondary hemolytic                                                       D594

                 (b) anemia

12. Sideroblastic Anemia (D643)

  1. Code D641 (Secondary sideroblastic anemia due to disease)

When reported due to:

A000-C97     E230        F180-F182   J069        M023

D45          E531        F190-F192   J65         M101

D461         E539        F55         K700-K703   M352

D471         E798        G030        K709        N143

D510-D599    E800-E802   G040        K721        N188-N19

D640-D643    E831        G361        K730-K746   N341

D648         E880        G933        K760        O980-O981

D731         E890        I330        K761        R162

D748         F100-F102   I423        K766        R75

D758         F109-F112   I729        K769        R780

D860-D869    F119-F122   I888        K908        R826

D892         F130-F132   J00         L081        R893

E018-E02     F140-F142   J020        L448        R897

E032-E0390   F150-F152   J030        L946

E050-E059    F160-F162   J040-J042   M021

            I    (a) Pneumonia                                                                     J189

                 (b) Sideroblastic anemia                                                       D641

                 (c) Alcoholic cirrhosis                                                           K703

  1. Code D642 (Secondary sideroblastic anemia due to drugs or toxins)

When reported due to:

D642        X60-X69

T510-T659   Y10-Y19

T97         Y400-Y599

X40-X49     Y86-Y880

            I    (a) CHF                                                                              I500

                 (b) Sideroblastic anemia                                                       &D642

                 (c) Chloramphenicol                                                            Y402

13. Hemorrhagic Purpura NOS (D693)

Code D690 (Hemorrhagic purpura not due to thrombocytopenia)

When reported due to:

A000-C97      F119          I771-I779      N19           Q848

D45-D460      F120          I872           N200-N219     Q872-Q873

D462-D469     F121-F122     I878           N250-N311     Q878

D471          F130-F132     I879 -I889     N312-N319     R104

D510          F140          I898-I899      N320-N390     R162

D511-D581     F141-F142     I99-J00        N392          R233

D582          F150          J020           N398-N399     R238

D588-D618     F151-F152     J030           N719          R291

D619          F160-F162     J040-J042      N897          R31

D648          F180-F181     J069           N910-N939     R398

D65-D692      F182          J65            N948          R72

D698-D71      F190-F191     K658           N950-N959     R75

D720          F192          K660           N991          R780

D721          G000-G032     K700-K769      P070-P073     R826

D728          G038-G039     K908           P219          R893

D729-D759     G040          L081           P221-P289     R897

D860-D869     G042-G049     L272           P546          T360-T658

D892          G060          L448           P916          T659

E240          G061-G09      L573           Q458          T780-T784

E241          G312          L80-L819       Q680          T789

E242          G361          L946           Q740-Q741     T806

E243          G373-G374     L958           Q758          T818

E248          G540          L959           Q772          T881

E249          G92           M021-M023      Q775-Q776     T885

E301          G933          M050-M089      Q778          T886-T887

E54           G958          M101           Q779-Q783     T96-T97

E569          G961          M120           Q785          T981

E642          I00-I019      M138           Q788-Q789     X20-X29

E648          I10           M159           Q791          X40-X48

E703          I159          M300           Q794-Q795     X49

E798          I308          M301-M352      Q796          X60-X69

E850-E859     I330-I339     M358           Q798          Y10-Y19

E871          I400-I409     M359           Q808          Y400-Y599

E880          I423          M898           Q810-Q819     Y86

F100          I729          N000-N078      Q820          Y870

F101-F102     I749          N079           Q821-Q825     Y871

F110-F112     I770          N10-N189       Q828          Y872

            I    (a) CVA                                                                              I64

                 (b) Hemorrhagic purpura                                                      D690

                 (c) Leukemia                                                                       C959

14. Thrombocytopenia (D696)

Code D695 (Secondary thrombocytopenia)

When reported due to:

A000-D447     F110         J030          P350 -P399    T752

D448          F111-F112    J040-J042     P550 -P560    T780-T783

D449-D509     F119         J069          P570          T784

D510          F120         J09-J118      P610          T788-T789

D511-D691     F121-F122    J65           P614          T803-T804

D692          F130         K658          P916          T808-T809

D693-D699     F131-F132    K660-K661     Q204 -Q205    T818

D730-D752     F140         K700-K769     Q206          T881

D758          F141-F142    K908          Q208          T882 -T883

D759-D763     F150         K920-K921     Q209          T885

D814          F151-F152    K922          Q210          T886 -T888

D820          F160         L081          Q220 -Q246    T889

D821          F161-F162    L448          Q248          T950 -T97

D840          F180-F181    L590          Q249          T981

D841-D848     F182         L818          Q289          T983

D860-D892     F190-F191    L946          Q758          V010-V99

E000-E009     F192         M021          Q775-Q776     W00-W53

E018-E02      F55          M023          Q778          W54-W56

E031-E033     G000-G032    M050-M089     Q779-Q783     W57

E034          G038-G039    M101          Q788-Q789     W58-W87

E035-E0390    G040         M120          Q798          W88-W93

E055          G042-G048    M138          Q828          W94-X19

E059          G049-G060    M159          Q850          X20-X32

E071          G061-G09     M199-M1990    R001          X34-X39

E230          G312         M219          R008          X40-X48

E349          G361         M300          R012          X49-X599

E46           G373-G374    M301-M329     R161-R162     X65

E538          G450-G452    M352          R233          X69-Y369

E539-E54      G454-G459    M898          R291          Y400-Y601

E560-E639     G540         N000-N078     R31           Y603

E642          G903         N079          R398          Y605

E648          G92          N10-N219      R58-R5800     Y610-Y611

E649          G933         N250-N311     R75           Y613

E713          G936         N312-N319     R771          Y615

E740          G938         N320-N390     R780          Y617

E750          G951         N392          R788          Y620-Y621

E752          G958         N398-N399     R798          Y623

E753          G961         N980-N989     R825          Y625

 E755-E756    I00-I019     N991          R826          Y630-Y633

 E768-E779    I10-I629     O360-O369     R827-R828     Y640-Y655

 E782         I630-I6300   O430-O431     R829          Y658

 E798         I631-I6310   O438          R893          Y66-Y831

 E803         I633-I677    O439-O469     R897          Y840

 E835         I678-I679    O60           T200           Y842

 E871         I690-I891    O670-O689     T201-T289     Y848-Y849

 E880         I898         O700-O719     T300          Y850-Y872

 E888         I899-I972    O908          T301-T329     Y880-Y881

 E890         I978         O980-O981     T360-T658     Y890-Y891

 E898         I99          P070-P073     T659          Y899

 F100         J00          P219          T66-T670

 F101-F102    J020         P221-P289     T68

            I    (a) Multiple hemorrhages                                                      R5800

                 (b) Thrombocytopenia                                                          D695

                 (c) Cancer lung                                                                   C349

15. Hyperparathyroidism (E213)

Code E211 (Secondary hyperparathyroidism)

When reported due to:

A180          D136-D137

A187          D300-D309

A188          D351-D353

B650-B839     D410-D419

B902-B908     D442-D444

C250-C259     E130-E139

C64-C689      E15-E215

C750-C752     E240-E259

C788          E270-E279

C790-C791     E892

C798          M880-M889

C900-C902     N000-N399

D017          Q600-Q649

D090-D091     Q770-Q789

D093          Q798

            I    (a) Hypercalcemia                                                                E835

                 (b) Hyperparathyroidism                                                      E211

                 (c) Cancer parathyroid gland                                                C750

16. Hyperaldosteronism (E269)

Code E261 (Secondary hyperaldosteronism)

When reported due to:

A220-A229     E270-E46      I500-I509      T96-T97

B500-B54      E511-E519     I701           T983

B560-B575     E660-E669     I778           X40-X49

C740-C749     E713          K700-K709      X60-X69

C797          E86           K721-K7210     X85-X90

D093          E871          K730-K746      Y10-Y19

D350          E880          K850-K851      Y400-Y599

D441          E890          K853-K859      Y86-Y880

D448-D449     E892          N000-N399

D840-D849     E895-E899     T360-T659

E000-E249     I10-I150      T783

E250-E269     I159          T880-T889

            I    (a) MI                                                                                I219

                 (b) Hyperaldosteronism                                                        E261

                 (c) Renal artery stenosis                                                      I701

17. Lactase Deficiency (E730)

Code E731 (Secondary lactase deficiency)

When reported due to:

E730-E749     K590-K599

K500          K630

K508-K510     K633

K519-K529     K639

K570          K900-K902

K574          K912

K580-K589     N200-N209

            I    (a) Severe diarrhea                                                              K529

                 (b) Lactase deficiency                                                           E731

                 (c) Celiac disease                                                                 K900

Code I(b) secondary lactase deficiency, E731, since reported due to celiac disease.

18. Korsakov Disease, Psychosis, or Syndrome (F106)

Code F04 (Nonalcoholic Korsakovs disease, psychosis, or syndrome)

When reported due to :

A000-D591     L920          S710-S729     T904

D592          L928-L932     S740-S799     T905

D593-D610     L951          S810-S829     T908

D611          L980-L981     S840-S899     T909

D612-E243     M000-N459     S910-S929     T910

E248-E519     N490-N809     S940-S999     T911-T915

E52           N990-N992     T012-T029     T918

E530-F09      N994-Q999     T041-T08      T919-T922

F200-G311     R54           T091          T924-T926

G318-G619     R75           T093-T10      T928

G620          S010-S029     T111          T929-T932

G622          S040-S050     T113-T12      T934-T936

G628-G720     S052-S099     T131          T938

G722-G98      S110-S129     T133-T139     T939

I00-I4250     S140-S199     T141-T142     T940-T953

I427-J989     S210-S229     T144-T329     T954

K20-K291      S240-S299     T340-T349     T958-T959

K293-K669     S310-S328     T351-T399     T96-X40

K710-K851     S340-S399     T410-T422     X43-X44

K853-K859     S410-S429     T425-T426     X46-Y449

K861-L109     S440-S499     T427          Y451-Y468

L129-L449     S510-S529     T428          Y480-Y485

L510-L599     S540-S599     T440-T509     Y500-Y899

L710-L719     S610-S628     T520-T889

L88           S640-S69      T901-T903

I (a)      Korsakoff psychosis                                                                  F04

  (b)     Wernicke encephalopathy                                                          E512


19. Drug Use NOS – Named Drug Use (F11-F16, F18-F19)

Code drug use NOS, F199, when reported anywhere on the certificate. Code use of named drug, F11-F16, F18-F19 with fourth character “9,” when reported anywhere on the certificate and the named drug is listed in Volume 3, under Addiction/Dependence. If the named drug is not listed in Volume 3 under Addiction/Dependence, do not enter a code.


(1) Complication(s) reported due to (named) drug use. Code the (named) drug use to the appropriate external cause code for adverse effects of drugs in therapeutic use unless the drug is one not used for medical care purposes. Refer to Section V, Part R, 1, Drugs, medicaments, biological substances causing adverse effects in therapeutic use (Y40-Y59) for coding instructions.

(2) There is mention of drug poisoning anywhere on the certificate, code the (named) drug use to F11-F16, F18-F19, with fourth character “9,” if listed in Volume 3 under Addiction/Dependence. If (named) drug is not indexed in Volume 3 under Addiction/Dependence, code F19, specified drug NEC with fourth character “9.” Refer to Section V, Part Q, 2, Poisoning by drugs.

            I    (a) Chronic alcoholism                                                         F102



            II  Drug use                                                                            F199

Code drug use to F199. There is no complication reported due to the drug use.

            I    (a) Cancer of pancreas                                                         C259



            II  Methadone use                                                                    F119

Code methadone use to F119 as listed under Dependence in Volume 3. There is no complication reported due to the methadone use.

            I    (a) Systemic lupus erythematosus                                          M329



            II  Steroid use

Do not scode steroid use. Steroid is not listed in Volume 3 under Addiction/Dependence and no complication is reported due to the steroid use.

            I    (a) Diabetes                                                                        E139

                 (b) Steroid use                                                                    Y427


            II  Rheumatoid arthritis                                                            &M069

Code the diabetes as a complication of the steroids given in therapeutic use for rheumatoid arthritis. Refer to Section V, Part R, 1, Drugs, medicaments, biological substances causing adverse effects in therapeutic use (Y40-Y59) for coding complications of drugs during therapeutic use.

            I    (a) Bacterial endocarditis                                                      &I330

                 (b) Use of morphine                                                             Y450


Code the bacterial endocarditis as a complication of the morphine given in therapeutic use. Precede the complication with an ampersand since the condition requiring the drug is not reported. Refer to Section V, Part R, 1, Drugs, medicaments, biological substances causing adverse effects in therapeutic use (Y40-Y59) for coding complications of drugs during therapeutic use.

Place     I    (a) Acute cocaine poisoning                                                  T405 &X42

  9             (b)


MOD     II  Cocaine use                                                                        F149 T405


Accident       Ingested cocaine

Code cocaine use to F149 as listed under Dependence in Volume 3 since reported on the certificate with drug poisoning. Refer to Section V, Part Q, 2, Poisoning by drugs for instructions in coding drug poisoning.

Place     I    (a) Respiratory failure                                                          J969

  9             (b) Acute drug use                                                               F199


MOD     II                                                                                           &X42    T402


Accident       Overdose of morphine

Code acute drug use to F199 since reported on the certificate with drug poisoning.

Place     I    (a) Poisoning by drugs                                                         T509    &X44

  9             (b)


            II Use of sedatives                                                                   F139

Code use of sedative to F139 as listed under Dependence in Volume 3 since reported on the certificate with drug poisoning.

20. Tobacco Use (F179)

Code F179 (Tobacco use)

  1. When age of the decedent is greater than or equal to (>=) 1 year


  1. When the certifier selects “Yes” or “Probably” in the tobacco box on the US Standard Certificate of Death.

Did tobacco use contribute to death?

Yes     ☐           Probably       ☐

No      ☐           Unknown      ☐

The F179 should follow the last code in Part II.

            I    (a) Pneumonia                                                                     J189

                 (b) Lung cancer                                                                   C349

            II  COPD                                                                                 J449     F179

Did tobacco use contribute to death?

Yes     ☒           Probably       ☐

No      ☐           Unknown      ☐

          Female, 2 months

            I    (a) Pneumonia                                                                     J189



Did tobacco use contribute to death?

Yes     ☒           Probably       ☐

No      ☐           Unknown      ☐

No F179 is necessary for the tobacco box entry since age of decedent is less than 1 year old.

21. Psychotic Episode NOS (F239)

Code F068 (Psychotic episode, organic NEC)

When reported due to or on the same line with conditions classifiable to the following categories:

A000-E899      L88            R042-R048

F068           L920           R060-R065

G000-G98       L92-L932       R068

H600-H709      L951           R090-R091

H720-H739      L980-L981      R291

I00-J989       M000-N459      R54

K20-L109       N490-N809      R600-R609

L120-L449      N990-N992      R75

L510-L599      N994-Q999

L710-L719      R02

            I    (a) TIA’s with psychotic episodes                                          G459    F068

                 (b) Cerebral arteriosclerosis                                                  I672

                 (c) Arteriosclerosis                                                              I709

Code psychotic episode on I(a) F068, since reported on the same line with TIA (G459). It could also be coded to F068 since reported due to cerebral arteriosclerosis (I672).

22. Psychosis (any F29)

Code F09 (Psychosis, organic NEC)

When reported due to or on the same line with conditions classifiable to the following categories:

A000-E899     R75           S840-S899     T909

F09           S010-S029     S910-S929     T910

G000-G98      S040-S050     S940-S999     T911-T915

I00-J989      S052-S099     T012-T029     T918

K20-L109      S110-S129     T041-T08      T919-T922

L120-L449     S140-S199     T091          T924-T926

L510-L599     S210-S229     T093-T10      T928

L710-L719     S240-S299     T111          T929-T932

L88           S310-S328     T113-T12      T934-T936

L920          S340-S399     T131          T938

L928-L932     S410-S429     T133-T139     T939

L951          S440-S499     T141-T142     T940-T953

L980-L981     S510-S529     T144-T329     T954

M000-N459     S540-S599     T340-T349     T958-T959

N490-N809     S610-S628     T351-T889     T96-Y899

N950-N959     S640-S699     T901-T903

N990-N992     S710-S729     T904

N994-Q999     S740-S799     T905

R54           S810-S829     T908

            I    (a) Pneumonia                                                                     J189

                 (b) Psychosis – cerebrovascular arteriosclerosis                       F09      I672

                 (c) Arteriosclerosis                                                              I709

23. Dissociative Disorder (F449)

Code F065 (Organic dissociative disorder)

When reported due to conditions classifiable to the following categories:

A000-E899     L88           R042-R048

F065          L920          R060-R065

G000-G98      L928-L932     R068

H600-H709     L951          R090-R091

H720-H739     L980-L981     R291

I00-J989      M000-N459     R54

K20-L109      N490-N809     R600-R609

L120-L449     N990-N992     R75

L510-L599     N994-Q999     S000-Y899

L710-L719     R02

            I    (a) Dissociative disorder                                                       F065

                 (b) Remote subdural hematoma                                             T905

                 (c) Car accident                                                                   &Y850

Code I(a) organic dissociative disorder, F065, since reported due to an injury.

            I    (a) Dissociative disorder                                                       F065

                 (b) Senility                                                                          R54

Code I(a) organic dissociative disorder, F065, since reported due to senility.

24.     Personality Disorder (F609), Personality Change (Enduring) (F629)

Code F070 (Organic personality disorder)

When reported due to conditions classifiable to the following categories:

A000-E899     N490-N809     S440-S499     T093-T10

F070          N990-Q999     S510-S529     T111

G000-G98      R54           S540-S599     T113-T12

I00-J989      R75           S610-S628     T131

K20-L109      S010-S029     S640-S699     T133-T139

L120-L449     S040-S050     S710-S729     T141-T142

L510-L599     S052-S099     S740-S799     T144-T329

L710-L719     S110-S129     S810-S829     T340-T349

L88           S140-S199     S840-S899     T351-T889

L920          S210-S229     S910-S929     T901-T922

L928-L932     S240-S299     S940-S999     T924-T932

L951          S310-S328     T012-T029     T934-Y899

L980-L981     S340-S399     T041-T08

M000-N459     S410-S429     T091

Place     I    (a) Personality disorder                                                        F070

  9             (b) Head injury                                                                    S099

                 (c) Assault                                                                          &Y09

Code I(a) organic personality disorder, F070, since reported due to a head injury.

            I    (a) Personality disorder                                                        F070

                 (b) Meningioma brain                                                           D320

Code I(a) organic personality disorder, F070, since reported due to a meningioma brain.

            I    (a) Personality change                                                         F070

                 (b) Jakob-Creutzfeldt Syndrome                                            A810

Code I(a) organic personality disorder, F070, since reported due to Jakob-Creutzfeldt Syndrome.

25. Mental Disorder (any F99)

Code F069 (Organic mental disorder)

When reported due to or on the same line with conditions classifiable to the following categories:

A000-G98      M000-N459     S000-S199     T510-T519

H600-H709     N490-N809     T019          T66-T68

H720-H739     N990-N992     T028          T698-T758

I00-J989      N994-Q999     T029          T790-T799

K20-L109      R02           T049          T900-T911

L120-L449     R042-R048     T062          T913

L510-L599     R060-R065     T064          T918-T919

L710-L719     R068          T07-T08       T940-T950

L88           R090-R091     T093-T094     T958-T959

L920          R291          T140-T149     T97

L928-L932     R54           T200-T207     T981-T982

L951          R600-R609     T340-T341     V010-Y872

L980-L981     R75           T350-T352

            I    (a) Cardiorespiratory arrest                                                  I469

                 (b) Heart failure                                                                   I509

                 (c) Multiple sclerosis and mental disorder                               G35      F069

26. Parkinson Disease (G20)
Advanced Parkinson Disease (G2000)
Grave Parkinson Disease (G2000)
Severe Parkinson Disease (G2000)

  1. Code G214 (Vascular parkinsonism)

     When reported due to:






            I    (a) Parkinsonism                                                                 G214

                 (b) Arteriosclerosis                                                              I709


  1. Code G219 (Secondary parkinsonism)

          When reported due to:

A170-A179     B900          R75

A504-A539     B902          S000-T357

A810-A819     B91           T66-T876

A870-A89      B941          T900-T982

B003          B949          T983

B010          F200-F209     X50-X599

B021-B022     G000-G039     X70-X84

B051          G041-G09      X91-Y09

B060          G20-G2000     Y20-Y369

B200-B24      G218-G219     Y600-Y849

B261          G300-G309     Y850-Y872

B375          I950-I959     Y881-Y899

            I    (a) Parkinson disease                                                           G219

                 (b) Tuberculous meningitis                                                    A170


            I    (a) Secondary Parkinson disease                                           G219



27. Cerebral Sclerosis (G379)

Code I672 (Cerebrovascular atherosclerosis)

  1. When reported due to or on the same line with:

A500-A539     M100-M109

E000-E349     M300-M359

E660-E669     N000-N289

E700-E839     N390

E890-E899     Q600-Q619

I10-I150      Q630-Q639

I159          Q890-Q892

I672          R54

I700-I709     T383

I770          Y423


  1. When reportedas causing:



            I    (a) Cerebral edema                                                              G936

                 (b) Cerebral sclerosis                                                           G379

            I    (a) Cerebral thrombosis                                                       I633

                 (b) Cerebral sclerosis                                                           I672

            I    (a) ASHD                                                                            I251



            II  Cerebral sclerosis, hypertension                                            1672    I10

28. Myopathy (G729)

Code I429 (Cardiomyopathy)

When reported due to:

A150-A1690     E648-E649      R54

A178           E660-E669      R75

A181           E740           T360-T66

A188           E760-E769      T97

B332           E831           X45

B560-B575      E880-E889      X65

B948           I00-I259       Y15

D500-D649      I300-I4290     Y400-Y599

D758           I514-I5150     Y842

E100-E149      I700-I709      Y86-Y872

E40-E519       P200-P220      Y883

E639           P916

E641           R31

            I    (a) Myopathy                                                                      I429

                 (b) ASHD                                                                            I251


Code I(a) cardiomyopathy, I429, since reported due to a specific heart condition.

29. Brain Damage, child (G809)

Code G939 (Brain damage)

When reported due to:

A000-F199     M000-N399     R400-R402

F200-F99      N700-N889     R54

G000-G98      O000-Q999     R560-R5800

H600-H749     R02           R600-R609

H950-J80      R040-R049     R630

J82-J989      R060-R068     R75

K700-K769     R090-R092     S000-Y899

L00-L989      R291

            Male, 11 years

            I    (a) Cardiac arrest                                                                I469

                 (b) Brain damage                                                                 G809

Since the age of the decedent is less than 18 years of age and there is no indication of the cause of the brain damage, code G809, brain damage, child.

            Male, 11 years

            I    (a) Brain damage                                                                 G939

                 (b) Down syndrome                                                             Q909

Since there is an indication of the cause of the brain damage, code brain damage, G939.

30. Paralysis (any G81, G82, or G83 excluding senile paralysis)

Code the paralysis for decedent age 28 days and over to G80 (Infantile cerebral palsy) with appropriate fourth character

When reported due to:


            Female, 3 months

            I    (a) Pneumonia                                                      1wk         J189

                 (b) Paraplegia                                                       3 mos      G808

                 (c) Injury spinal cord since birth                                           P115

Code the paraplegia on I(b) to infantile paraplegia, G808, since reported due to an injury of the spinal cord since birth.

31. Cataract (H269)

Code H264 (Secondary cataract)

When reported due to:

A1690         H269

B200-B24      H579

E100-E149     R54

E160-E162     R75

E711          T66

E742          Y493

E830          Y540

E835          Y576


            I    (a) CVA                                                                              I64

                 (b) Cataract                                                                        H264

                 (c) Diabetes                                                                        E149

Code I(b), secondary cataract, H264, since reported due to diabetes (E149).

32. Varices NOS and Bleeding Varices NOS (I839)

Code    (a)        I859 (Esophageal varices) or
(b)        I850 (Bleeding esophageal varices)

When reported due to or on same line with:

Alcoholic diseases classified to: F100-F109

Liver diseases classified to: B150-B199, B251, B942, K700-K769

Toxic effect of alcohol classified to: T510-T519, T97

            I    (a) Varices                                                                          I859

                 (b) Cirrhosis of liver                                                             K746

            I    (a) Bleeding varices                                                             I850

                 (b) Cirrhosis of liver                                                             K746

33. Pneumoconiosis (J64)

Code J60 (Coalworker pneumoconiosis)

When Occupation is reported as:

Coal miner

Coal worker


Occupation: Coal Miner

            I    (a) Bronchitis                                                                      J40

                 (b) Pneumoconiosis                                                              J60

34. Diaphragmatic Hernia in K44

Code Q790 (Congenital diaphragmatic hernia)

When reported as causing hypoplasia or dysplasia of lung NOS (Q336).

            I    (a) Lung dysplasia                                                               Q336

                 (b) Diaphragmatic hernia                                                      Q790


35. Laennec’s Cirrhosis NOS (K703)

Code K746 (Nonalcoholic Laennec’s cirrhosis)

When reported due to:

A000-B99       K710-K718              Y574-Y599

C000-D539      K730-K760              Y640

D730-D739      K761                   Y86

E02-E0390      K763                   Y870-Y872

E100-E149      K768-K851              Y880

E500-E519      K853-K859              Y881

E52            K861-K909

E530-E849      Q410-Q459Q900-Q999

F110-F169      R75

F180-F199      T360-T509

I050-I099      T520-T659

I110-I119      T97

I130-I4250     X40-X44

I427-I519      X46-X49

I81            Y400-Y572

K500-K519      Y573


            I    (a) Cardiac arrest                                                                I469

                 (b) Laennec’s cirrhosis                                                          K746

                 (c) Diabetes                                                                        E149

Code I(b) nonalcoholic Laennec’s cirrhosis since reported “due to” diabetes

36. Biliary Cirrhosis NOS (K745)

Code K744 (Secondary biliary cirrhosis)

When reported due to:

A000-B99      K763

C000-D539     K768-K909

D730-D739     Q410-Q459

E02-E0390     Q900-Q999

E100-E149     R75

E500-E849     R780

F100-F169     R826

F180-F199     R893

I050-I099     T360-T659

I110-I119     T97

I130-I519     X40-X49

I81           X65

K500-K519     Y15

K630-K639     Y400-Y599

K700-K718     Y640

K730-K760     Y86-Y880

K761          Y881

            I    (a) Biliary cirrhosis                                                               K745



            I    (a) Primary biliary cirrhosis                                                   K743



            I    (a) Secondary biliary cirrhosis                                               K744



            I    (a) Biliary cirrhosis                                                               K744

                 (b) Carcinoma pancreas                                                        C259


37. Lupus Erythematosus (L930), Lupus (L930)

Code M321 (Systemic lupus erythematosus with organ or system involvement)

When reported as causing a disease of the following systems:


Circulatory (including cardiovascular,

          lymph nodes, spleen)






            I    (a) Nephritis                                                                       N059

                 (b) Lupus erythematosus                                                      M321


38. Gout (M109)

Code M104 (Secondary gout)

When reported due to:

B200-B24      L578-L589

C880-C959     L930-L932

D45           L945

D550-D599     L951

D751          L981

D758          M100-M109

E168          R75

E740          T510-T519

F100-F102     T97

F109          X45

K700-K769     X65

L100-L109     Y15

L120-L449     Y86-Y872


I    (a) Perforated gastric ulcer                                                   K255

                 (b) Gout                                                                             M104

                 (c) Waldenstrom macroglobulinemia                                      C880

39. Polyarthrosis (M159)

Code M153 (Secondary multiple arthrosis)

When reported due to:











            I    (a) Hypostatic pneumonia                                                     J182

                 (b) Polyarthrosis                                                                  M153

                 (c) Obesity                                                                         E669

Code I(b) secondary multiple arthrosis, M153, since reported due to obesity.

40. Coxarthrosis (M169)

Code    (a)        M166 (Coxarthrosis, secondary, bilateral):
(b)        M167 (Coxarthrosis, secondary, NEC, (unilateral))

When reported due to:











            I    (a) Pneumonia                                                                     J189

                 (b) Debility                                                                         R53

                 (c) Coxarthrosis                                                                  M167

                 (d) Polyarthrosis                                                                  M159

Code I(c) secondary coxarthrosis, M167, since reported due to polyarthrosis (M159).

41. Gonarthrosis (M179)

Code    (a)        M174 (Secondary gonarthrosis, bilateral):
(b)        M175 (Secondary gonarthrosis, (unilateral))

When reported due to:











            I    (a) Pneumonia, gonarthrosis                                                 J189     M175

                 (b) Hemiplegia                                                                    G819

                 (c) Old CVA                                                                        I694

Code I(a) secondary gonarthrosis, M175, since reported due to hemiplegia.

42. Arthrosis (M199)

Code M192 (Secondary arthrosis)

When reported due to:











            I    (a) Pathological fractures                                                      M844

                 (b) Arthrosis                                                                       M192

                 (c) Senility                                                                          R54

Code I(b) secondary arthrosis, M192, since reported due to senility.

43. Kyphosis (M402)

Code M401 (Secondary kyphosis)

When reported due to:

A1690         E890-E899      M359-M489

A180          G110-G119      M800-M949

B902          G20-G2000      M960-M969

B91           G35-G379       Q050-Q059

C400-C419     G540-G549      Q760-Q799

C490-C499     G600-G839      Q850

C795          G950-G959      Q870-Q878

D166          G970-G979      Q893-Q999

D480          M000-M120      S000-Y899

E200-E215     M150-M1990

E550-E559     M320-M351

            I    (a) COPD                                                                            J449

                 (b) Kyphosis                                                                        M401

                 (c) Spinal osteoarthritis                                                       M479

Code I(b) secondary kyphosis, M401, since reported due to spinal osteoarthritis.

44. Scoliosis (M419)

  1. Code M414 (Neuromuscular scoliosis)

When reported due to:

A800-A809     G700-G709

B91           G800-G809

G111          M414

            I    (a) Respiratory failure                                                                      J969

                 (b) Severe scoliosis   years                                                             M414

                 (c) Polio      years                                                                        B91

Code I(b) neuromuscular scoliosis, M414, since reported due to polio (B91).

  1. Code M415   (secondary scoliosis)

When reported due to:

A1690         G09            M415-M489

A180          G20-G2000      M800-M949

B902          G360-G379      M960-M969

C400-C419     G540-G549      Q050-Q059

C490-C499     G600-G64       Q760-Q799

C795          G950-G959      Q850

D166          G970-G979      Q870-Q878

D480          M000-M120      Q893-Q999

E200-E215     M150-M1990     S000-Y899

E550-E559     M320-M351

E890-E899     M359-M413

            I    (a) Pneumonia                                                                     J189

                 (b) Scoliosis                                                                        M415

                 (c) Progressive systemic sclerosis                                          M340

Code I(b) secondary scoliosis, M415, since reported due to progressive systemic sclerosis.

45. Osteonecrosis (M879) )

Code M873 (Secondary osteonecrosis)

When reported due to:

A000-A399     D550-D589      M860-M870

A400-A419     H650-H669      M873

A420-B889     J00-J399       M878-M889

B89           L00-L089       M894

B900-B949     M000-M1990     M910-M939

B99           M320-M351      N340-N343

C400-C419     M359           N390

C763          M420-M429      N700-N768

C795          M45-M461       R75

C810-C969     M462

D160-D169     M463-M479

D480          M600

            I    (a) Septicemia                                                                     A419

                 (b) Osteonecrosis hip                                                           M873

                 (c) Infective myositis                                                           M600

Code I(b) secondary osteonecrosis, M873, since reported due to infective myositis (M600).

46. Dysmenorrhea (N946)

Code N945 (Secondary dysmenorrhea)

When reported due to:

C530-C55      N800-N809

C798          N840-N841

D060-D069     N850-N889

D073          N945

D250-D269     Q510-Q519

D390          Q528


I    (a) Anemia and gastric ulcer                                                 D649    K259

                 (b) Menorrhagia with dysmenorrhea                                      N920    N945

                 (c) Cancer of endocervix                                                      C530

Code I(b) secondary dysmenorrhea, N945, since reported due to cancer of endocervix (C530).

47. Cesarean Delivery for Inertia Uterus (O622)

Hypotonic Labor (O622)

Hypotonic Uterus Dysfunction (O622)

Inadequate Uterus Contraction (O622)

Uterine Inertia During Labor (O622)

Code O621 (Secondary uterine inertia)

When reported due to:

O100-O209     O440-O469

O230-O249     O621

O260-O264     O670-O679

O266-O269     O95

O310          O980-O998


            I    (a) Cardiac arrest                                                                O754

                 (b) Uterine inertia                                                                O621

                 (c) Diabetes mellitus of pregnancy                                         O249

Code I(b) secondary uterine inertia, O621, since reported due to diabetes mellitus of pregnancy (O249).

48. Brain Damage, newborn (P112)

Code P219 (Anoxic brain damage, newborn)

When reported due to:










            Male, 9 hours

            I    (a) Brain damage                                                                 P219

                 (b) Congenital heart disease                                                 Q249

Code I(a) anoxic brain damage, P219, since reported due to congenital heart disease.

49. Intracranial Nontraumatic Hemorrhage of Fetus and Newborn (P52)

Code P10 (Intracranial laceration and hemorrhage due to birth injury) with the appropriate fourth character

When reported due to:






            Male, 9 hours

            I    (a) Cerebral hemorrhage                                                      P101

                 (b) Fractured skull during birth                                              P130


Code I(a) cerebral hemorrhage due to birth injury, P101, since reported due to a fracture skull occurring during birth.

            Female, 2 weeks

            I    (a) Cerebral hemorrhage                                                      P101

                 (b) Birth injury                                                                    P159


Code I(a) cerebral hemorrhage due to birth injury, P101.

50. Septal Defect, (atrial), (auricular), (heart), (ventricular), (Q210, Q211, Q212, Q219)

Code I510 (Acquired septal defect) providing there is no indication the defect is congenital

  1. When reported due to:

A000-A099     I400-I519      N990-N999     R502-R509

A181          I700-J80       P000-P049     R53-R54

A200-B89      J82-J989       P100-Q079     R560-R609

B908-E899     K20-K929       Q240-Q249     R634-R635

F100-F199     L890-L899      Q260-Q349     R64

G000-G419     L97            Q380-Q459     R688-R799

G450-G459     L984           Q600-Q799     R826

G500-G729     M000-M1990     Q850-R098     R893

G900-G98      M300-M549      R11           S000-Y899

H650-H839     M800-M959      R160-R18

I00-I029      N000-N399      R222

I10-I339      N600-N96       R300-R398

  1. When reported on the same line with:





            I    (a) Cardiac arrest                                                                I469

                 (b) Ventricular septal defect                                                  I510

                 (c) Myocardial infarction                                                       I219

51. Hypoplasia or Dysplasia of Lung NOS (Q336)

Code P280 (Primary atelectasis of newborn)

When reported anywhere on the record with the following codes and not reported due to diaphragmatic hernia in K44.













            I    (a) Hypoplasia lung                                                                         P280



            II  Prematurity                                                                                    P073

            Female, 5 hrs.

            I    (a) Dysplasia of lung                                                            5 hrs    Q336



            II  Hyaline membrane disease                                                               P220

Code Q336, since the duration and age are the same indicating the condition was congenital.

52. Injury (S000-T149)

Code P10-P15 (Birth trauma)

  1. When the age of decedent is less than 28 days


  1. There is no mention of external cause


  1. Reported due to a condition in P000-P969

            Male, 5 days

            I    (a) Femur fracture                                                                P132

                 (b) Breech delivery                                                               P030

Code femur fracture as indexed under Birth, injury, fracture, femur.

53. Fracture (any site) (T142)

Code M844 (Pathological fracture)

  1. When reported due to:

A180          D160-D169      M320-M351     M854-M879      Q799

A500-A509     D480           M359          M893-M895      T810-T819

A521          D489           M420-M429     M898-M939      T840-T849

A527-A539     E210-E215      M45-M519      M941-M949      T870-T889

A666          E550-E559      M600          M960

C000-C399     E896-E899      M843-M851     M966-M969

C430-C794     G120-G129                    Q770-Q789

C796-C97      M000-M1990

  1. When reported due to or on the same line with:

C40-C41       M80-M81        M88

C795          M83

NOTE 1: If accident box is checked, do not enter an external cause code.

NOTE 2: If a fracture qualifies as pathological, all fractures reported of the same site will be coded pathological as well.

            I    (a) Fracture hip                                                                   M844

                 (b) Osteoarthritis                                                                 M199

            I    (a) Myocardial infarction                                                       I219

                 (b) ASHD                                                                            I251


            II  Fracture of spine due to                                                       M844    M139  W19

                 arthritis causing fall

            I    (a) Pneumonia                                                                     J189

                 (b) Osteoporosis fracture spine                                             M819    M844

            I    (a) Pneumonitis                                                                   J189

                 (b) Arteriosclerosis                                                              I709

                 (c) Fracture femur                                                                M844
MOD     II


Accident       Spontaneous in bed

Code fracture of femur as pathological, M844, since the certifier indicated it was spontaneous. Do not enter code for “accident” in checkbox.

            I    (a) Aspiration pneumonia                                                     J690

                 (b) Left hip fracture                                                             M844


            II  Hip fracture, anemia, osteoporosis                                        M844    D649  M819

Code the hip fracture on (b) and in Part II as pathological, applying instruction b and note 2.

54. Starvation NOS (T730)

Code E46 (Malnutrition NOS)

When reported due to:

A000-E649     L100-L129      R13           T058

E670-F509     L400-L409      R54           T065-T08

F530-F539     L510-L539      R600-R609     T091-T099

F608-F609     L890-L899      R630          T141

F680-F73      L97            R633-R634     T148-T149

F920          L984           R75           T170-T217

F982-F983     M000-M1990     S010-S099     T270-T329

F989-G98      M300-N459      S110-S199     T360-T659

I00-J80       N700-N768      S210-S299     T800-T889

J82-J989      O000-Q079      S310-S399     T97

K020-K029     Q200-Q824      T019-T021     T983

K040-K069     Q850-Q999      T029          V010-X52

K080-K929     R11            T041          X54-Y05


            I    (a) Anemia                                                                          D649

                 (b) Starvation                                                                     E46

                 (c) Cancer of esophagus                                                       C159

Code I(b) E46, malnutrition, since reported due to a neoplasm.

            I    (a) Starvation                                                                     E46

                 (b) Crushed abdomen                                                           S381

            II  Auto accident                                                                      &V499

Code I(a) E46, malnutrition, since reported due to an internal injury.

55. Compartment Syndrome (T796)

Code M622 (Nontraumaic compartment syndrome)

When reported due to:

A530-A539     F109          N040-N049

B200-B24      F449          N170-N19

B91           G10-G419      Q000-Q079

C000-D489     G450-G98      Q250-Q269

D610-D699     I250-I259     Q650-Q799

E000-E039     I48           Q900-Q999

E230-E237     I600-I99      R190

E40-E46       K310-K389     R198

E511-E52      K560-K567     R263

E630-E649     K590-K599     R402

E750-E752     K650-K659     R58-R5800

E754          K850-K869     R75

E872          K910-K919

E890-E899     L890-L899

F100-F102     L97-M999

            I    (a) Compartment syndrome                                                  M622

                 (b) Hemorrhagic pancreatitis                                                 K859

Code I(a) M622 since reported due to pancreatitis.

Page last reviewed: May 14, 2021