1. You may come across two types of cross references which are used to avoid unnecessary duplication of terms in the Alphabetical index. A cross reference ‘see’ requires the coder to refer to another term, i.e., to an alternate entry to locate the correct code. It is necessary to go to the main term referenced with the “see” note to locate the correct code. A cross reference ‘see also’ directs the coder to refer elsewhere for other additional information that is not indented under the term to which ‘see also’ is attached. It is not necessary to follow the “see also” note if the original main term provides the necessary code

2. ‘Includes’ note which appears immediately under a three-character code title, is used to further define, or give examples of, the content of the category; they are the conditions for which that code is to be used. The terms may be synonyms of the code title or “other specified” codes. They are not necessarily exhaustive; Additional terms are found only in the Alphabetic Index. ‘Excludes’ note, on the other hand, means the conditions is classified elsewhere i.e., tells the coder it is “NOT CODED HERE!” It is used when two conditions cannot be classified together E.g. injuries to the knee and lower leg (S80–S89) and burns (T20–T32) are classified in different places; a congenital heart disease and an acquired heart disease refer to the same organ -heart- but are classified in different areas. Note that for each excluded term, in parentheses, is a category or subcategory code to which the excluded term should be allocated.

3. Underlying cause of death is defined as “(a) the disease or injury which initiated the chain of morbid events leading directly to death, or (b) the circumstances of the accident or violence which produced the fatal injury.” The underlying cause of death should be entered on the lowest used line in part 1. The underlying cause of death is the condition selected for single-cause tabulation. One death, one final (underlying) cause per person. To prevent death, it is necessary to break the chain of events or to effect a cure at some point to prevent the precipitating cause from operating. Underlying cause is used in statistical tabulation and analysis of mortality data

4. Line 1(b) ends with a connecting term ‘and’, so consider hypertensive heart disease, reported online (c) as a part of the enumeration Cerebral thrombosis in line (b) i.e., For clarity the death certificate is re-written as:

   Part 1

   a. Bronchopneumonia

   b. Cerebral thrombosis and hypertensive heart disease

   Part 2

   Thus, there are two conditions on the lowest used line (b) in Part I. There are two reported sequences terminating in the condition first entered on the certificate: bronchopneumonia due to cerebral thrombosis and bronchopneumonia due to hypertensive heart disease. The first mentioned reported sequence is bronchopneumonia due to cerebral thrombosis.

5. Pernicious anemia is not due gangrene of foot and Pernicious anemia is not due to arteriosclerosis. Although there is a reported causal relationship (gangrene of foot due to arteriosclerosis), it does not terminate in the condition first entered on the certificate (pernicious anemia). Therefore, there is no sequence of cause of death in this case.

For a better understanding of ICD mortality coding, please visit the Unit’s Youtube channel which includes videos on the basics of coding with specific cases, such as the coding of forms with COVID-19 reported.

1. Multiple cause codes: U071 J128

2. Step SP2: tentative starting point U071

3. No further linkages or modifications

4. UCOD: U071

For a better understanding of ICD mortality coding, please visit the Unit’s Youtube channel which includes videos on the basics of coding with specific cases, such as the coding of forms with COVID-19 reported.

1. Multiple cause codes: J960/U099*S065 X599 G934 A419

2. Step SP3:tentative starting point U099

3. Step M1:U099 is not to be used as UCOD → tentative underlying cause U071; No further linkages or modifications

4. UCOD: U071

For a better understanding of ICD mortality coding, please visit the Unit’s Youtube channel which includes videos on the basics of coding with specific cases, such as the coding of forms with COVID-19 reported.

1. Multiple cause codes: J969/J189/U071

2. Step SP3:tenative starting point: U071

3. No further linkages or modifications

4. UCOD: U071

For a better understanding of ICD mortality coding, please visit the Unit’s Youtube channel which includes videos on the basics of coding with specific cases, such as the coding of forms with COVID-19 reported.