MCCD Training Module

MCCD_Training
Module
Office of the Dy. Director of Health

Services (SBHI & VS), Pune
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MEDICAL CERTIFICATION OF CAUSE OF DEATH (MCCD)
1) INTRODUCTION :
Medical Certification of Cause of Death Scheme is an important tool of
obtaining authentic and scientific information regarding causes of mortality. The
scheme formulated by office of the Registrar General, India is a big step towards
establishment of a system in the country for obtaining data on cause of death.
The scheme had undergone phase-wise implementation in the State starting
from Medical College Hospitals and in second phase District Hospitals,
Specialised Hospitals were covered. The office of the Registrar General had
given necessary administrative guidelines regarding the coverage of MCCD
Scheme in both Urban and Rural areas. Attempts are being made to cover all
Private Hospitals and Rural Hospitals since 1998.
Medical Certification of Cause of Death Scheme was introduced for the

first time in Maharashtra State in Pune city in 1951. Later it was also extended to
Nagpur (1957), Mumbai (1962) and Solapur (1969) cities. The remaining urban
areas were added in 1970 and onwards, with the encouragement of the Director
General of Health Services, G.O.I. and with the co-operation of the Director of
Municipal Administration. A directive was issued to all the Municipalities towards
the end of 1969 to bring into effect MCCD, in their respective areas, for certifying
the cause of death under the Maharashtra Municipality Act 1965.
This manual is prepared for medical officers to improve their skills for
writing accurate cause of death in form No. 4/4A according to the guidelines
given by WHO. This manual has two parts. Part-I is concerned with
implementation of MCCD scheme, formats and the duties of implementing
officers. Part II is mainly focused on International Classification of Diseases 10th
Revision and illustrations regarding various case histories of the deceased and
its coding.
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2) IMPORTANCE OF MCCD SCHEME:
Mortality statistics is essential for better health planning and management
of programmes and for undertaking control measures in an effective and planned
manner for welfare of people. It also provides a scientific and basic information
for medical research as well as gives mortality profile for medical professionals. It
is also useful to know the impact of health services and to evaluate health
indicators like infant mortality, maternal mortality etc. It helps to understand the
trend and changing mortality pattern of various diseases as well as to find out the
magnitude of newly emerged diseases like HIV/AIDS.
3) LEGAL PROVISION:
Registration of Births and Deaths Act, 1969 has a provision for MCCD under
section 10(2) and 10(3)
Section 10 (2):- In any area, the State Govt. having regard to the facilities
available therein in this behalf, may require that a certificate as to the cause of
death shall be obtained by the Registrar from such person and in such form as
may be prescribed.
Section 10 (3):- Where the State Govt. has required under subsection (2) that a
certificate as to the cause of death shall be obtained, in the event of the death of
any person who, during his last illness, was attended by a medical practitioner,
the medical practitioner shall, after the death of that person, forthwith, issue
without charging any fee, to the person required under this Act to give
information concerning the death, a certificate in the prescribed form stating to
the best of his knowledge & belief the cause of Death; & the certificate shall be
received and delivered by such person to the Registrar at the time of giving
information concerning the death as required by this Act (Revised form No. 4/4A
(Old form No. 8 by Rule No. 8 of Maharashtra RBD Rules, 1976).
Section 17(1)(b):- Subject to any rules made in this behalf by State Govt.
including rules relating to the payment of fees and postal charges, any person
may obtain an extract from such register relating to any birth or death; Provided
that no extract relating to any death, issued to any person, shall disclose
the particulars regarding the cause of death as entered in the register.
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4) REVISED RULES OF REGISTRATION OF BIRTHS AND DEATHS OF
MAHARASHTRA 2000.
Govt. of Maharashtra has now framed the Rules based on the provisions
of RBD Act, 1969, with the approval of Central Govt. They have come into force
with effect from 1st May 2000 by a notification in the official Gazette. These Rules
replace the Maharashtra Registration of Births and Death Rules, 1976 and all its
subsequent amendments notified from time to time. Submission of MCCD to the
local registrar is obligatory under the Rule No. 7 of Maharashtra Registration of
Births and Deaths Rules, 2000.
5) WHO PRESCRIBED FORM OF MEDICAL CERTIFICATE
(Please see ANNEXURE V,VI)
The standard format of the certificate prescribed by WHO is incorporated
in the Rules 2000 viz. form No. 4 & form No. 4A.
A medical person attending the deceased in his/her last illness, after death
of a person shall fill in form No. 4 for institutional deaths/ 4A for non-institutional
deaths.
The cause of Death:- The cause of death is a disease, abnormality, injury or
poisoning that contributed directly or indirectly to death.
Besides medical part, Form No. 4/4A contains some minimum
demographic and identification particulars such as age, sex, date of death of the
deceased.
"Cause of death" part of MCCD form has two parts.
Part I of the cause of death statement:
Only one cause is to be entered on each line of part I. The underlying
cause of death should be entered on the lowest line used in this part. The
underlying cause of death is the condition that started the sequence of events
between normal health and the immediate cause of death.
Line (a): Immediate cause.
The direct or immediate cause of death is reported on line (a). This is the
disease, injury or complication that directly preceded death. It can be the sole
entry in the statement if only one condition was present at death. There must
always be an entry on line (a).
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The mode of dying (e.g. Heart failure, respiratory failure) should not be stated
at all since it is no more than a symptom of the fact that death occurred and
provides no useful information.
In the case of a violent death, enter the result of the external cause (e.g.
fracture of vault of skull, crushed chest etc.).
Line (b): Due to (or as a consequence of)
If the condition on line (a) was the consequence of another condition, record
that on the line (b). This condition must be antecedent to the immediate cause
of death, both with respect to time and aetiological or pathological
relationship. In case of injury, the form of external violence or circumstances
of accident is antecedent to an injury entered on line (a) and should be
entered on line (b), although the two events are almost simultaneous (e.g.
automobile accident, fall from tree etc.).
An antecedent condition might have just prepared the way for
immediate cause of death, by damage to tissues or impairment of
function, even after a long interval.
Line (c): The condition, if any which gave rise to the antecedent condition on
line (b) is to be reported here. If the condition on line (b) is the underlying
cause, nothing more be entered on this line. However, if the sequence of
event comprise more than three stages, extra line (and entries) may be made
in part I as (d).
However many conditions are involved, write the full sequence one
condition per line, with the most recent condition (immediate cause) at the top
and the earliest (the condition that started the sequence of events between
normal health and death) last.
Normally the condition on the lowest line of part - I will be taken as a
underlying cause and used for statistical classification of causes of deaths by
International Classification of Diseases (ICD) 10.
Part II : Other significant conditions :
Enter all other diseases or conditions believed to have influenced the
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course of the morbid process and thus contributed to death but which were not
related to the disease or conditions directly causing the death.
A form has a detachable portion separated by perforation mark, containing
information on the fact of death, which after filling 4/4A will be handed over to
relatives of the deceased for further procedures.
Normally the medical part of the MCCD certificate is the responsibility of
the attending physician and based on his individual assessment. In case of
medico-legal cases, cause of death should be written by medical officer who
performs post-mortem & on the basis of evidence noticed by him.
All such certificates of cause of deaths are sent to the local Registrar
along with the death report on 5th of every month. All hospital in-charge are to
be instructed not to submit form no. 4 for still births.
Completeness and accuracy with which the certificate of cause of deaths
is filled by the attending physician are of prime importance in building the base of
cause of death statistics. It is also important to choose underlying cause of death
when two or more morbid conditions might have precipitated to death. This
underlying cause of death is to be taken into account for coding of cause of
death.
6) LACUNAE SEEN IN THE CERTIFICATION OF CAUSE OF DEATH IN FORM

NO.4, REGARDING MEDICO-LEGAL CASES.
1. In case of deaths due to violence, the column Interval between onset and
death cannot be mentioned.
Comment:- When the death occurs after admission to the hospital, then only
interval between onset and death can be mentioned.
2. In many cases bodies are brought dead from the outside. In such cases it is
not possible to write the chain of event leading to death in form no. 4 as the
past history of the patient/circumstances of injury is not known.
Comment:- In these cases only Immediate cause of death can be given
after postmortem examination while antecedent cause as well as other
significant conditions can not be commented since the past history of the
patient is not always known. When the cause of death is injury, specify the
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nature of injury (e.g. fracture, dislocation, crush injury etc.) along with part of
body involved as an immediate cause. It will minimize the percentage of ill
defined cause of death category which is 14% (1998)
3. While commenting on manner of death it is not always possible to conclude
about the exact manner of death. The reason for this is when a dead body is
sent for autopsy along with inquest and dead body challan, information
furnished by investigating officer is as per his inquiry. During the preliminary
inquiry, he may not be able to get correct information. But from later
investigations, the situation may appear to be different. In such cases, if the
comment is made on manner of death on available information then it may
create problems in the court of law. Whenever possible it can be commented
but in other cases, instead of helping the judiciary, it may mislead them.
Comment:- It can be commented only if authentic information is available.
4. Some times cause of death is written as Body sent for PM/ Advised MLC
PM /Opinion reserved and viscera preserved
Comment:- If the medical officer performing post-mortem examination had
come to a conclusion about the cause of death it should be written in form no.
4. If the viscera is preserved and opinion about the cause of death is reserved
then MCCD should not be sent. Such MCCD certificate should be submitted to
the local Registrar mentioning the cause of death after the receipt of chemical
analysis report.
In medico-legal post-mortem cases MLPM No., date of admission, date of
death, date of notification and post-mortem should be written at top of MCCD
form which will facilitate identification of the case.
5. Supplementary information about the cause of death is not written in MCCD
form.
Comment:- When the death is not a natural death {that means the cause of
death is related to injury, poisoning and other consequences of external
causes [S00 To T98] as in ICD-10} it is important to write the actual injury
along with the part of body involved. To facilitate the classification of
supplementary causes, it is necessary to specify descriptions of the
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circumstances in which the violence had taken place (e. g. fire, explosion, fall,
assault, collision and submersion etc.). For transport accidents it is necessary
to state the vehicle involved and the type of accident e.g. collision, non-
collision, traffic, non-traffic etc. along with the victims mode of transport.
These details about the accident should be written in the column How did
injury occur?
Illustration
CAUSE OF DEATH Interval
I between
Immediate cause (a) Head injury leading to fracture on set &
State the disease, injury or complication of skull with laceration of brain death
which caused death, not the mode of Due to (or as a consequences of) approx.
dying such as heart failure, asthenia, etc. .................
Antecedent cause (b) Accidental collision of .........
rickshaw and truck. The victim
was a rickshaw driver
Morbid conditions, if any, giving rise to Due to (or as a consequences of)
the above Cause, stating underlying
conditions last (c) ...............................................
II
Other significant conditions contributing Nil
to the death but not related to the disease .................................................
or conditions causing it
Manner of Death How did the injury occur ?
1. Natural 2. Accident 3. Suicide 4. Homicide Accidental collision of rickshaw and

truck. The victim was a rickshaw driver
5. Pending investigation
In case of assault, specific cause should be written e.g. in case of assault

by sharp/blunt instrument, drugs, medicament, biological or corrosive substance,
gases/vapours chemicals, name of the substance should be written.
In case of deaths due to burns it is very important to specify the extent of
injury by rule of nine i. e. % of body surface involved or at least the part of body
involved along with the intention of injury i.e. accidental/suicide/homicide if
possible.
In case of violent deaths and other medico-legal cases, the cause of death
may be written by a medical person who performs postmortem examination, to
the best of his knowledge and on the basis of evidence noticed by him. WHO has
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stressed that in the Statistical use of the data based on MCCD, necessary
safeguards to preserve the confidential nature of the cause of death written in
MCCD form, should be provided. This aspect is well taken care in the RBD Act
1969 section 17 (1)(b). (See page no. 3)
7) REPORTING UNITS OF MCCD:

MCCD Certificates from all hospitals and private medical practitioners are
collected at the office of local Registrars and are sent to office of Dy. Chief
Registrar of Births & Deaths (Maharashtra State) Pune regularly along with the
monthly Birth & Death reports. Rural/Cottage hospitals situated at Municipal
Council are submitting MCCD certificates to local Registrar i.e. to the Chief
Officer, Municipal Council while Rural/Cottage hospitals situated at
Grampanchayat are sending MCCD certificates to the local Registrar i.e.
Gramsevak of Grampanchayat. MCCD certificates are collected centrally at state
headquarters from following reporting units:
Urban :- 1) Municipal Corporations 23

2) Municipal Councils 226
3) Cantonment Boards 7
4) Ordnance Factories 4
Rural :- 1) Rural/Cottage Hospitals 345

(situated at Grampanchayat
are sending MCCD through
the respective Grampanchayat)
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FLOW OF MCCD FROM URBAN AND RURAL AREAS
Urban Rural
Head of Medical Private Medical Medical Medical

Institutions (All Practitioners in Superintendent of Superintendent of
types) in Form Form No..4A R. H./C.H. situated R. H./C.H. situated
No. 4 at Municipal at Grampanchayat
Council
5th of every month 5th of every month

Local Registrar of Births & Local Registrar of
Deaths Municipal Corporations / Births & Deaths
Municipal Councils/Cantonment i.e. Gramsevak of
Boards/Ordnance Factories Grampanchayat
Additional District
Registrar & Block
10th of every month Development
Dy.Chief Registrar of Births and Officer, Panchayat
Deaths and Dy. Director of Samiti
S.B.H.I.& V.S., Pune
On behalf of
Chief Registrar of Births and
Deaths & DGHS Maharashtra
State, Mumbai.
Registrar General,
Govt. of India,
New Delhi.
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8) COMPILATION OF DATA :
After the receipt of certificates the coding of cause of death is done
centrally according to alphanumeric coding system of ICD 10th revision. It is
cross tabulated (following National list of tabulation) by age, sex and cause of
death category in a prescribed format. The data are processed with the help of
computers at Data Processing Unit, SBHI &VS, Pune. The annual report is
generated and submitted to the Registrar General, GOI, and also published in
the Annual Vital Statistics Report (table No. 24) of Maharashtra State, every
year.
9) RESPONSIBILITIES OF A PHYSICIAN ABOUT MCCD SCHEME :

1) It is the prime responsibility of a physician/surgeon (who has attended the
deceased in his/her last illness) to write cause of death in details to the best
of his knowledge in form No. 4 on the basis of the hospital records available.
It is obligatory to the attending physician/surgeon to write cause of death
under section 10(3) of Registration of Birth and Death Act 1969 and
Maharashtra Birth and Death Registration Rules 2000- Rule 7.
2) All morbid conditions are to be written in sequence, starting from immediate
cause to underlying cause. It allows the selection of the underlying cause of
death, which facilitates the statistical classification of it.
3) The name of the disease is to be written in full form. Abbreviations and short
forms of disease/ disease conditions should not be used. It puts the statistical
office in difficulty at the time of classification of the diseases.
4) Physician should follow the guidelines given by office of the Registrar
General, Government of India to write accurate cause of death in form No.
4/4A.
5) Form 4/4A contains a detachable portion at the bottom of the form, which
contains only the facts of death certified by physician. This part should be
issued to the relative of a deceased so that it will not disclose the cause of
death and gives adequate information for death registration, e. g. in case of
AIDS deaths, sometimes cause of death is kept confidential. So by using the
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detachable slip we can retain the confidentiality of the cause of death.
6) MCCD forms of deaths occurred in the first week of neonatal period should be
submitted to the local Registrar.
10) EXPECTATIONS FROM HEAD OF MEDICAL INSTITUTION

(Dean, Medical Colleges/Civil Surgeon, District Hospitals/Medical
Superintendent, R.H./C.H. & In-charge of Hospitals)
1. All hospital deaths including medico-legal case deaths are to be covered
under MCCD.
2. Cent percent collection of MCCD forms from all wards should be ensured to
transmit them to the respective Registrar of B & D, up to 5th of every month.
3. RMO (Clinical/Outreach) in Civil Hospital and Head of the PSM Department in
Medical College Hospital may be asked to shoulder the responsibility for
monitoring and submission of MCCD.
4. Civil Surgeon should ensure regular submission of MCCD from Rural
Hospitals to their respective Registrar.
5. Medical Superintendent of Rural/Cottage Hospitals should submit MCCD
forms to the respective Registrar along with the summary report (as shown
below) and copy of the summary report should be submitted to the respective
Civil Surgeon of the District Hospital .
Medical Certification of Cause of Death
Monthly Summary Report
Name of Institution: - Month:-
No. of Out of which how No. of MCCD No. of pending No. of pending
Institutional many MLC PM/ Certificates MCCD MCCD
Deaths Clinical PM had sent Certificates Certificates
been done sent
Monthly Prog. Monthly Prog. Monthly Prog. Monthly Prog.
6. Regular review of MCCD in monthly meeting.

7. Training of medical officers in the hospitals may be taken for writing accurate
cause of death as per the guidelines given by WHO, in prescribed format.
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ANNEXURE- I
Percentage of Medically Certified Deaths to Total Registered &
Registered Urban Deaths Maharashtra
Year Maharashtra
Registered Deaths MCCD Percentage of MCCD
Received received to Reg. Deaths
Total Urban Total Urban
1993 445569 209531 129512 29.1 61.8
1994 425999 207571 135132 31.7 65.1
1995 436146 208890 145704 33.4 69.8
1996 453940 222237 148313 32.7 66.7
1997 412066 218461 151541 36.8 69.4
1998 512649 255158 172494 33.6 67.6
1999 510291 247561 170406 33.4 68.8
2000 512330 265149 172714 33.7 65.1
2001 512241 254227 173026 33.7 68.6
2002 564485 276901 172995 30.7 62.5
2003 602711 290326 182910 30.4 63.0
2004 518533 251810 181294 35.0 72.0
2005 554633 279627 191586 34.5 68.5
2006 565892 269432 209515 37.0 77.8
2007 608598 304524 215045 35.3 70.6
2008 629760 320634 217642 34.6 67.9
2009 *633206 *324768 212335 33.53 65.38
* Data for the year 2009 are provisional.
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ANNEXURE- V
FORM NO. 4
(See Rule 7)
MEDICAL CERTIFICATION OF CAUSE OF DEATH
(Hospital in-patients. Not to be used for still births)
To be sent to Registrar along with Form No.2 (Death Report)
Name of the Hospital .............................................................................................. I hereby certify that the

person whose particulars are given below died in the hospital in Ward No ........................ on ..................... at
........... A.M./P.M.
NAME OF DECEASED For use of

Statistical
Office
Sex Age at Death
If 1 year or more, If less than 1 If less than one month, age If less
age in Years year, age in in Days than one
Months day, age
in Hours
1. Male
2. Female
I between
Immediate cause (a) ............................................... on set &
State the disease, injury or complication Due to (or as a consequences of) death
which caused death, not the mode of approx.
dying such as heart failure, asthenia, etc. .................
Antecedent cause (b) ............................................... .........
II
Other significant conditions contributing .................................................
1. Natural 2. Accident 3. Suicide 4. Homicide

If deceased was a female, was the death associated with pregnancy ? 1. Yes 2. No
If yes, was there a delivery ? 1. Yes 2. No
Name and signature of the Medical Attendant certifying the cause of death
Date of certification ........................................................................................
SEE REVERSE FOR INSTRUCTIONS

(To be detached and handed over to the relative of the deceased)
Certified that Shri/Smt./Kum. ............................................................................. S/W/D of Shri

............................. ...................................... R/O ....................................................... Was admitted to this
hospital on ..................................... and expired on ....................................
Doctor ...................................................
(Medical Supdt. & Name of Hospital)
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MEDICAL CERTIFICATE OF CAUSE OF DEATH
Directions for completing the form
Name of deceased : To be given in full. Do not use Initials. If deceased is an infant, not yet named at
time of death, write. Son of (S/O) or Daughter of (D/O), followed by names of mother and father.
Age : If the deceased was over 1 year of age, give age in completed years. If the deceased was below
1 year of age, give age in months and if below 1 month give age in completed number of days, and if
below one day, in hours.
Cause of Death : This part of the form should always be completed by the attending physician
personally.
The certificate of cause of death is divided into two parts, I and II, Part I is again
divided into three parts, lines (a) (b) (c) . If a single morbid condition completely explains the deaths,
then this will be written on line (a) of Part I, and nothing more is needed to be written in the rest of Part
I or Part II, for example gastroentritis, lobar pneumonia, rabies are sufficient cause of death and
usually nothing more is needed.
Often, however, a number of morbid conditions will have been present at death, and
the doctor must then complete the certificate in the proper manner so that the correct underlying cause
will be tabulated. First, enter in Part I (a) the immediate cause of death. This does not mean the mode
of dying. e.g. heart failure, respiratory failure, etc. These terms should not appear on the certificate at
all since they are modes of dying and not causes of death. Next consider whether the immediate
cause is a complication or delayed result of some other cause. If so, enter the antecedent cause in
part I, line (b). Sometimes there will be three stages in the course of events leading to death. If so, line
(c) will be completed. The underlying cause to be tabulated is always written last in Part I.
Morbid conditions or injuries may be present which were not directly related to the
chain of events causing death but which contributed in some way to the fatal outcome. Sometimes the
doctor finds it difficult to decide, especially for infant deaths, which of several independent conditions
was the primary cause of death; but only one cause can be tabulated, so the doctor must decide. If the
other diseases are not effects of the underlying cause, they are entered in Part II.
Do not write two or more conditions on a single line. Please write the names of the
diseases (in full ) in the certificates as legible as possible to avoid the risk of their being misread.
Onset : Complete the column for interval between onset and death whenever possible, even if very
approximately, e.g. from birth several years.
Accidental or violent deaths : Both the external cause and the nature of the injury are needed and
should be stated. The doctor or hospital should always be able to describe the injury, stating the part
of the body injured, and should give the external cause in full when this is shown. Example: (a)
Hypostatic pneumonia ; (b) Fracture of neck of lemur, (c) fall from ladder at home.
Maternal deaths : Be sure to answer the questions on pregnancy and delivery. This information is
needed for all women of child-bearing age, even though the pregnancy may have had nothing to do
with the death.
Old age or senility: Old age (or senility) should be not given as a cause of death if a more specific
cause is known. If old age was a contributory factor, it should be entered in Part II. Example: (a)
Chronic bronchitis, II old age.
Completeness of information : A complete case history is not wanted, but if the information is
available enough details should be given to enable the underlying cause to be property classified.
Example : Anaemia - Give type of anaemia, if known, Neoplasms- indicate whether benign or
malignant, and site with site of primary neoplasm, whenever possible, Heart disease-Describe the
condition specifically, if congestive heart failure, chronic on pulmonale, etc are mentioned , give the
antecedent conditions. Tetanus -Describe the antecedent injury, if known. Operation-State the
condition for which the operation was performed. Dysentry-Specify whether becillary, amoebic, etc, if
know. Complications of pregnancy or delivery-Describe the complication specifically Tuberculosis-Give
organs affected.
Symptomatic statement: Convulsions, diarrhoea, fever, ascites, jaundice, debility etc. are symptoms
which may be due to any one of a number of different conditions. Sometimes nothing more is know,
but whenever possible, give the disease which caused the symptom.
Manner of Death : Deaths not due to external cause should be identified as Natural. If the cause of
death is known, but it is not known whether it was the result of an accident suicide or homicide and is
subject to further investigation, the cause of death should invariably be filled in and the manner of
death should be shown as Pending investigation.
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ANNEXURE- VI
FORM NO. 4A
(See Rule 7)
MEDICAL CERTIFICATION OF CAUSE OF DEATH
(For non-institutional deaths. Not to be used for still births)
To be sent to Registrar along with Form No.2 (Death Report)
I hereby certify that the deceased Shri/Smt./Km. ............................................... son of /wife of/ daughter of
.................................................. resident of .................................................................. was under my
treatment from ....................... to ..................... and he/she died on .......................... at ...................
A.M./P.M.
NAME OF DECEASED For use of

Statistical
Office
Sex Age at Death
If 1 year or If less than If less than one month, age in Days If less
more, age in 1 year, age than one
Years in Months day, age
in Hours
1. Male
2. Female
I between
Immediate cause (a) ............................................... on set &
State the disease, injury or complication Due to (or as a consequences of) death
which caused death, not the mode of approx.
dying such as heart failure, asthenia, etc. ...............
Antecedent cause (b) ............................................... ...........
II
Other significant conditions contributing .................................................
Name and signature of the Medical Practitioner certifying the cause of death
Date of certification ........................................................................................
SEE REVERSE FOR INSTRUCTIONS

(To be detached and handed over to the relative of the deceased)
Certified that Shri/Smt./Kum. ............................................................................. S/W/D of Shri

............................. ...................................... R/O ....................................................... Was under my treatment
from ......................................... to .......................... and he/she expired on ........................... at
................................. A.M./P.M.
Doctor ...................................................
(Name of Doctor)
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MEDICAL CERTIFICATE OF CAUSE OF DEATH
Directions for completing the form
Name of deceased : To be given in full. Do not use Initials. If deceased is an infant, not yet named at
time of death, write. Son of (S/O) or Daughter of (D/O), followed by names of mother and father.
Age : If the deceased was over 1 year of age, give age in completed years. If the deceased was below
1 year of age, give age in months and if below 1 month give age in completed number of days, and if
below one day, in hours.
Cause of Death : This part of the form should always be completed by the attending physician
personally.
The certificate of cause of death is divided into two parts, I and II, Part I is again
divided into three parts, lines (a) (b) (c). If a single morbid condition completely explains the deaths,
then this will be written on line (a) of Part I, and nothing more is needed to be written in the rest of Part
I or Part II, for example gastroentritis, lobar pneumonia, rabies are sufficient cause of death and
usually nothing more is needed.
Often, however, a number of morbid conditions will have been present at death, and
the doctor must then complete the certificate in the proper manner so that the correct underlying cause
will be tabulated. First, enter in Part I (a) the immediate cause of death. This does not mean the mode
of dying. e.g. heart failure, respiratory failure, etc. These terms should not appear on the certificate at
all since they are modes of dying and not causes of death. Next consider whether the immediate
cause is a complication or delayed result of some other cause. If so, enter the antecedent cause in
part I, line (b). Sometimes there will be three stages in the course of events leading to death. If so, line
(c) will be completed. The underlying cause to be tabulated is always written last in Part I.
Morbid conditions or injuries may be present which were not directly related to the
chain of events causing death but which contributed in some way to the fatal outcome. Sometimes the
doctor finds it difficult to decide, especially for infant deaths, which of several independent conditions
was the primary cause of death; but only one cause can be tabulated, so the doctor must decide. If the
other diseases are not effects of the underlying cause, they are entered in Part II.
Do not write two or more conditions on a single line. Please write the names of the
diseases (in full ) in the certificates as legible as possible to avoid the risk of their being misread.
Onset : Complete the column for interval between onset and death whenever possible, even if very
approximately, e.g. from birth several years.
Accidental or violent deaths : Both the external cause and the nature of the injury are needed and
should be stated. The doctor or hospital should always be able to describe the injury, stating the part
of the body injured, and should give the external cause in full when this is shown. Example: (a)
Hypostatic pneumonia; (b) Fracture of neck of lemur, (c) fall from ladder at home.
Maternal deaths : Be sure to answer the questions on pregnancy and delivery. This information is
needed for all women of child-bearing age, even though the pregnancy may have had nothing to do
with the death.
Old age or senility: Old age (or senility) should be not given as a cause of death if a more specific
cause is known. If old age was a contributory factor, it should be entered in Part II. Example: (a)
Chronic bronchitis, II old age.
Completeness of information : A complete case history is not wanted, but if the information is
available enough details should be given to enable the underlying cause to be property classified.
Example : Anaemia - Give type of anaemia, if known, Neoplasms- indicate whether benign or
malignant, and site with site of primary neoplasm, whenever possible, Heart disease-Describe the
condition specifically, if congestive heart failure, chronic on pulmonale, etc are mentioned , give the
antecedent conditions. Tetanus -Describe the antecedent injury, if known. Operation-State the
condition for which the operation was performed. Dysentry-Specify whether becillary, amoebic, etc, if
know. Complications of pregnancy or delivery-Describe the complication specifically Tuberculosis-Give
organs affected.
Symptomatic statement: Convulsions, diarrhoea, fever, ascites, jaundice, debility etc. are
symptoms which may be due to any one of a number of different conditions. Sometimes
nothing more is know, but whenever possible, give the disease which caused the symptom.
19
22
MCCD_Training_
Module
}}}
23
1) SALIENT FEATURES OF INTERNATIONAL CLASSIFICATION OF
DISEASES 10th REVISION - (ICD-10)
A Classification of diseases may be defined as a system of categories to

which morbid entities are assigned according to established criteria.
1.1 Purpose and applicability :-
The purpose of the ICD is to permit systematic recording, analysis,
interpretation and comparison of morbidity and mortality data collected in
different countries or areas and at different times. The ICD is used to translate
diagnosis of diseases and other health related problems from words into an
alphanumeric code, which permits easy storage, retrieval and analysis of data.
Its original use was to classify causes of mortality as recorded at the time of
registration of death. Now the revised ICD-10 provides not only diagnosis but
also wide variety of signs, symptoms, abnormal findings, complaints and social
circumstances that may stand in place of a diagnosis on health records. From
these records statistics and other information on health situations are derived. So
ICD has become the international standard for diagnostic classification for all
general epidemiological studies and health management purposes.
1.2 Concept of the family of diseases and health related classification:-
It was felt that main ICD alone (the three and four character classification)
could not incorporate all the additional information and remain accessible and
relevant to its traditional users. So the idea arose of a family of disease and
health related classification including volumes published separately from the
main ICD, to be used as required. e. g. ICD-O (Oncology) was published in 1990
which contains coded nomenclature for the morphology of Neoplasms in
conjunction with chapter II of ICD 10. These types of classifications can be used
at speciality hospitals to maintain the disease specific morbidity and mortality
data.
The core classification of ICD-10 is the three-character code, which is the
mandatory level of coding for international reporting to the WHO mortality
database and for general international comparisons.
24
There are two main types of classifications. First group covers data related
to diagnosis and health status and are derived directly from the ICD by either
condensation or expansion of the tabular list. The condensed lists can be used
for many kinds of data presentation, for summary statistical tables, and
potentially for information that supports the development of primary health care.
The expanded lists are used to obtain increased clinical details as in the
specialty-based adaptations. This group also includes classification
complementary to the tabular list, and allows the allocation of diagnosis using
different axis of classification, such as morphology of tumors. The second group
of classification not related to formal diagnosis, includes classification of
disablements of medical and surgical procedures and of reasons for contact with
health care provider e.g. carrier of infectious disease, adjustment and
management of implanted/ prosthetic device / transplants etc.
1.3 The basic structure and principles of classification of ICD-10:-
A statistical classification of disease must be confined to a limited number
of exclusive categories, able to encompass the whole range of morbid conditions.
A specific disease entity that is of particular public Health importance or occurs
frequently, should have its own category e.g. pulmonary tuberculosis, malaria
etc. ICD-10 has developed as a practical, rather than purely theoretical
classification, in which there are a number of compromises between classification
based on aetiology, anatomical site, circumstances of onset etc.
The classification pattern shows the structure suggested by Mr. William
Farr in the early days of international discussions, which is proved the most
useful structure for general epidemiological purposes. It starts with epidemic
diseases, then constitutional or general disease, local disease arranged by site,
developmental disease followed by injuries and poisoning.
1.4 The Role of WHO :-
ICD-10 is the product of very closed collaboration between non
governmental organization, other agencies and divisions and units of WHO. The
role of WHO in the development of new classifications, adaptations, is to provide
cooperative leadership and to act as a clearinghouse giving technical advice,
25
guidance and support when needed.
1.5 Volumes of ICD-10:-
1.5.1 Volume- I:-
ICD-10 has three volumes, out of these first contains main classification of
diseases and related health problems. It is composed of the list of three
character categories and four character sub categories.
It also contains morphology of neoplasms special (morbidity & mortality)
tabulation lists, standard definitions (adopted by World Health Assembly to
facilitate the international comparability of health statistics and regulations
regarding nomenclature).
Chapters of ICD-10:- Volume- I
The core classification of ICD-10 is divided into 21 chapters. The first
character of ICD code is a letter & is associated with a particular chapter
e.g. C-is related to Neoplasm, O- is related to diseases related to pregnancy,
child birth and puerperium----
I) Certain infectious and parasitic diseases (A00-B99)
II) Neoplasms (C-00 to D-48)
III) Diseases of the blood and blood-forming organs and certain disorders
involving the immune mechanism (D-50 to D-89)
IV) Endocrine, nutritional and metabolic diseases (E-00 to E-90)
V) Mental and behavioural disorders (F-00 to F-99)
VI) Diseases of the nervous system (G00 to G-99)
VII) Diseases of the eye and adnexa (H-00 to H-59)
VIII) Diseases of the ear and mastoid process (H-60 to H-95)
IX) Diseases of the circulatory system (I-00 to I-99)
X) Diseases of the respiratory system (J-00 to J-99)
XI) Diseases of the digestive system (K-00 to K-99)
XII) Diseases of the skin and subcutaneous tissue (L-00 to L-99)
XIII) Diseases of the musculoskeletal system and connective tissue (M-00
to M-99)
26
XIV) Diseases of the genitourinary system (N-00 to N-99)
XV) Pregnancy, childbirth and the puerperium (O-00 to O-99)
XVI) Certain conditions originating in the perinatal period (P-00 to P-96)
XVII) Congenital malformations, deformities and chromosomal
abnormalities (Q-00 to Q-99)
XVIII) Symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified (R-00 to R-99)
XIX) Injury, poisoning and certain other consequences of external causes
(S-00 to S-99 and T-00 to T-98)
XX) External causes of morbidity and mortality (V-01 to V-99 and W-00 to
W-99 and X-00 to X-99 and Y-00 to Y-98)
XXI) Factors influencing health status and contact with health services.
(Z-00 to Z-99)
Out of XXI Chapters I to XVII are related to diseases & other morbid
conditions. Chapter XVIII is related to symptoms, signs and abnormal clinical &
laboratory findings. Chapter XIX is related to injury, poisoning and certain other
consequences of external causes. The former (ICD-9) supplementary
classifications of external causes of injuries and poisoning and factors influencing
health status and contact with health services now form part of main
classification and have been placed separately at chapter XX & XXI respectively.
These Chapters are subdivided into homogenous blocks of three
character categories. Within the chapter the axes of classification depend upon
mode of transmission or broad groups of infecting organisms. In case of
neoplasm (chapter II) the axis of classification is the behavior of neoplasm or its
morphological type. Within each block, some of the three character categories
are for single condition, selected because of their frequency, severity or
susceptibility to public health intervention, while others are for groups of diseases
with some common characteristic. There is usually provision for other &
unspecified conditions to be classified. Three character categories are
subdivided by means of fourth numeric character after a decimal point allowed up
27
to ten subcategories. e. g. (B 20.0 to B 20.9). Statistical coding starting with
alphabet U-00 to U- 49 is kept reserved and will be used for provisional
assignment or newly emerged diseases of uncertain etiology and code U-50 U-
99 may be used in research works.
1.5.2 Volume- II:-

This volume contains guidelines for recording and coding of causes of
deaths on the basis of underlying cause of death and instructions for its use.
1.5.3 Volume- III:-

Third volume of ICD-10 includes alphabetical index with an introduction
and expanded instructions on its use.
1.6 Inclusion of newly emerged diseases like HIV/AIDS in ICD-10 :-

AIDS - Aquired Immuno-Deficiency Syndrome is a fatal illness caused by
retrovirus known as Human Immuno-Deficiency Virus (HIV) by which the total
immune system is collapsed leaving the victim vulnerable to a host of life-
threatening opportunistic infections, neurological disorders & unusual
malignancies. The peculiar feature of AIDS is that once a person is infected, then
morbid condition remains forever. The real measure of the epidemic is number of
people infected with HIV infection. Number of AIDS cases today gives foretaste
rather than a true reflection of the health crisis. It is the last stage of the infection
of HIV virus, which will give rise to the signs and symptoms according to aquired
opportunistic infections.
So the data collected about AIDS deaths through the Medical Certification
of Cause of Death will definitely help to gauge the magnitude of the problem in
the community. It will also give the information about the associated diseases
causing the death.
28
1.6.1 Immunology :-
Due to HIV infection, immune mechanism is broken down because of

gradual depletion in a specialised group of white blood cells (lymphocytes) called
as T-helper cells or T-4 cells. As the disease progresses following clinical
features are seen in HIV infected patients.
1) Initial infection with HIV virus and development of antibodies.

2) Asymptomatic carrier stage
3) AIDS related complex
4) AIDS case.
An alarming factor in the AIDS epidemic is increasing link between HIV

infection and tuberculosis. One of the aspects of monitoring the epidemiology of
disease is regular reporting. It is very important to write down detailed cause of
death that means chain of events leading to death along with the seropositive
status of the deceased while reporting cause of death as AIDS in form No. 4
(Institutional Deaths) and 4A (Non- institutional deaths but certified by medical
practitioners). In case of AIDS death a single or multiple opportunistic infections
may results in fatal outcome. So all details about the infectious and parasitic
diseases/malignancies/cerebral manifestations or other specific condition should
be written in the form 4/4A. It should be noted that death of a woman due to HIV
while pregnant or within 42 days of termination of pregnancy, details about HIV
status as well as pregnancy/puerperium should be written in MCCD form. This
will focus on maternal mortality due to AIDS.
Documentation of detailed cause of death will facilitate deriving the
authentic information on AIDS deaths and the trends and differentials in overall
mortality related to HIV infection. For this purpose a medical person should know
the correct diagnosis of AIDS case as per the guidelines given by National AIDS
Control Organisation (NACO), New Delhi. (see Annexure -I)
29
2) IMPORTANCE OF WRITING ACCURATE SEQUENCE OF IMMEDIATE CAUSE, ANTECEDENT CAUSE AND
UNDERLYING CAUSE OF DEATH IN FORM NO. 4/4A.
Following are some case studies where the correct method of writing cause of death in form no. 4/4A is illustrated.
1. 59 Years old male was admitted to the hospital with shock & with signs of septicemia along with gangrene of (Lt) foot. Patient
had swelling of lt. foot and fever since 3 days. He had H/O COPD due to chronic bronchitis and had Diabetes since 5 years.
Patient had diagnosed as C/O carcinoma of pancreas and operated for the same 5 years back. Patient died 2 days after
admission due to septicaemic shock.
Incorrect Cause of Death Correct Cause of Death
CAUSE OF DEATH Interval CAUSE OF DEATH Interval
between between
onset & onset &
death death
approx. approx.
I I
Immediate cause (a) Diabetes Mellitus Immediate cause (a) Septicaemic shock..
State the disease, injury or complication Due to (or as a consequences of) State the disease, injury or complication Due to (or as a consequences of)
which caused death, not the mode of which caused death, not the mode of
dying such as heart failure, asthenia, etc. dying such as heart failure, asthenia, etc.
Antecedent cause (b) Gangrene of (Lt) foot Antecedent cause (b) Gangrene of (Lt) foot 5days
Morbid conditions, if any, giving rise to Due to (or as a consequences of) Morbid conditions, if any, giving rise to Due to (or as a consequences of)
The above Cause, stating underlying the above Cause, stating underlying
Condition last (c) Carcinoma of pancreas & condition last (c) Diabetes Mellitus 5 Years
Chronic bronchitis
II 5 Years
Other significant conditions contributing II (d) Ca Pancreas
To the death but not related to the disease Nil Other significant conditions contributing
Or conditions causing it to the death but not related to the disease COPD due to chronic
or conditions causing it bronchitis
Manner of Death Manner of Death
1Natural 2 Accident 3 Suicide 4 Homicide 5 Pending Investigation 1 Natural 2 Accident 3 Suicide 4 Homicide 5 Pending Investigation
30
2. 34 years old female met an accident while crossing the road and dashed by a car and had a crushed injury to thorax 2 hours
back. Patient was admitted to the hospital in shock showing profused haemorrhage. Patient died hour after admission due
to haemorrhagic shock. Being a Medico-legal case body sent for PM. Post mortem findings were suggestive of multiple rib
fractures and haemorrhagic shock due to rupture of lungs and internal organs of thorax.

between between
onset & onset &
death death
approx. approx.
I I
Immediate cause (a) PM done Immediate cause (a) Haemorrhageic shock hours
State the disease, injury or complication Due to (or as a consequences of) State the disease, injury or complication Due to (or as a consequences of) back
which caused death, not the mode of which caused death, not the mode of
Antecedent cause (b) ___________________ Antecedent cause (b) Crushed injury thorax 2
Morbid conditions, if any, giving rise to Due to (or as a consequences of) Morbid conditions, if any, giving rise to (multiple rib fractures, rupture
hours
The above Cause, stating underlying the above Cause, stating underlying of lungs & injury to internal
Condition last (c) ____________________ condition last organs of thorax) 2
II Due to (or as a consequences of) hours
Other significant conditions contributing (c) Victim was pedestrian and
To the death but not related to the disease Road traffic Accident dashed by a car
Or conditions causing it II
Other significant conditions contributing
to the death but not related to the disease NIL

1Natural 2 Accident 3 Suicide 4 Homicide 5 Pending Investigation 1Natural 2 Accident 3 Suicide 4 Homicide 5 Pending Investigation
How did injury occur ? Road traffic Accident How did injury occur ? Patient was pedestrian and dashed by a car
31
3. 22 years old female admitted to the hospital in unconscious stage and had history of vomiting. Patient was in shock and had
systolic blood pressure 80 mm of Hg. She had H/o consumption of organophosphorus compound 6 hours back with intention
of selfharm showing pin point pupils, fasciculations. After 2 hours patient developed respiratory paralysis and pulmonary
oedema. Patient was resuscitated but died 4 hours after admission. Body sent for PM.

between between
onset & onset &
death death
approx. approx.
I I
Immediate cause (a) PM done Immediate cause (a) Respiratory paralysis with 2 hours
State the disease, injury or complication Due to (or as a consequences of) State the disease, injury or complication pulmonary oedema
which caused death, not the mode of which caused death, not the mode of Due to (or as a consequences of)
Antecedent cause (b) ____________________ Antecedent cause (b) Poisoning by consumption 8 hours
Morbid conditions, if any, giving rise to Due to (or as a consequences of) of organophosphorus
the above Cause, stating underlying compound
condition last (c) ____________________ Morbid conditions, if any, giving rise to Due to (or as a consequences of)
II the above Cause, stating underlying
Other significant conditions contributing condition last (c) Intentional self-poisoning
to the death but not related to the disease Nil by pesticide
or conditions causing it (organophosphorous comp.)
II
to the death but not related to the disease Nil

32
4. 70 years old female was admitted to the hospital for fracture neck femur 6 hours back due to fall in a bathroom. She was
known diabetic since 10 years and hypertensive since 15 years. Open reduction of the fracture was advised but operative
was delayed for fitness, as BSL was not within normal limits. On 6 th day patient deteriorated becoming severe breathless and
had sudden collapse showing signs of pulmonary embolism. Patient died after 5 hours.

between between
onset & onset &
death death
approx. approx.
I I
Immediate cause (a) Fracture neck femur by fall Immediate cause (a) Pulmonary embolism 1 day
State the disease, injury or complication Due to (or as a consequences of) State the disease, injury or complication
dying such as heart failure, asthenia, etc. dying such as heart failure, asthenia, etc. 2 days
Antecedent cause (b) Pulmonary embolism Antecedent cause (b) Fracture neck femur
Morbid conditions, if any, giving rise to Due to (or as a consequences of) Morbid conditions, if any, giving rise to Due to (or as a consequences of)
The above Cause, stating underlying the above Cause, stating underlying
Condition last (c) Diabetes mellitus and condition last (c) Fall in bathroom 9 days
Hypertension II back
(d) H/o fall in bathroom Other significant conditions contributing Diabetes mellitus 10 yrs
II to the death but not related to the disease and hypertension 15 yrs
To the death but not related to the disease Nil
Or conditions causing it

33
5. 25 years old female, 4th para, had a full term normal delivery at home. On 5th day of puerperium she started high grade fever.
Fever was neglected for 3 days. On 8th day of puerperium patient was shifted to the hospital. O/E patient was febrile, had foul
smelling vaginal discharge. Uterus was not involuted and had tenderness over both fornices. On investigations patient found
severely anaemic (Hb - 4.5gm%). Patient was treated vigorously. On the same day patient had oliguria, hypotension and had
acute renal failure due to puerperal sepsis. Patient died on 9th day of puerperium.

between between
onset & onset &
death death
approx. approx.
I I
Immediate cause (a) Puerperal sepsis Immediate cause (a) Acute renal failure 1 day
State the disease, injury or complication Due to (or as a consequences of) State the disease, injury or complication back
Antecedent cause (b) Anaemia Antecedent cause (b) Puerperal sepsis 4 days
Morbid conditions, if any, giving rise to Due to (or as a consequences of) Morbid conditions, if any, giving rise to Due to (or as a consequences of) back
The above Cause, stating underlying
Condition last (c) Acute renal failure
condition last (c) ---------------------
II
II
To the death but not related to the disease Nil
to the death but not related to the disease Severe anaemia
Or conditions causing it
Manner of Death How did the injury occur ? N. A. Manner of Death How did the injury occur ? N. A.
1Natural 2. Accident 3. Suicide 4. Homicide 5. Pending investigation 1Natural 2. Accident 3. Suicide 4. Homicide 5. Pending investigation
If deceased was a female, was the death associated with If deceased was a female, was the death associated with pregnancy ?
pregnancy ? 1. Yes 2. No pregnancy ? 1. Yes 2. No
If yes, was there a delivery ? 1. Yes 2. No If yes, was there a delivery ? 1. Yes 2. No
34
3) CASE BANK
3.1 Part- A
Here are some case studies with accurate cause of death written
according to the guidelines given in ICD-10. You have to select and write
appropriate code no. by referring to ICD-10.
1. 62 yrs. old female was diagnosed as a case of adenocarcinoma of rectum 2
years back and operated for the same. She was admitted to a hospital for
recurrent carcinoma of rectum with invasion of urinary bladder and metastases
throughout the abdomen. Patient was known diabetic since 10 years. On 5th
day of admission patient became febrile and breathless and developed
pneumonia. Patient remained critical and died on 6th day of admission.
CAUSE OF DEATH Interval between ICD
I onset & death approx. Code
Immediate cause (a) Pneumonia 2 Days
State the disease, injury or complication
which caused death, not the mode of Due to (or as a consequences of)
dying such as heart failure, asthenia, etc.
Antecedent cause (b) Metastatic cancer of bladder
and abdomen
condition last (c) Adenocarcinoma of rectum 2 Years
II
to the death but not related to the disease Diabetes Mellitus 10 Years
Manner of Death
1 Natural 2 Accident 3 Suicide 4 Homicide 5 Pending Investigation
Primary lesion of neoplasm (carcinoma) is taken as an underlying cause
of death even though the signs and symptoms of immediate cause are related to
the metastatic lesion of primary carcinoma.
2. A lady aged 23 years was admitted to a hospital. She had H/O suicidal burn-
because of pouring of kerosene and burnt herself. O/E patient had 78% burn
(superficial & deep). She developed septicemia and died after 3 days of
admission.
Immediate cause (a) Septicemic shock 3 days
State the disease, injury or complication Due to (or as a consequences of)
which caused death, not the mode of
Antecedent cause (b) Burn 78% (deep & superficial)
3 days
condition last (c) Intentional self-harm by by 3 days back
fire and flames
II
Manner of Death
How did injury occur? Patient had done intentional self-harm (suicide) due to burns which resulted in
superficial & deep burn extending - 78 %
36
Nature of injury, the part of the body injured and whether the death is
accidental/ suicidal/ homicidal should be written along with the circumstances of
accident.
3. A 64 years old female, a known diabetic, was on insulin since 12 years. She
had an ischaemic heart disease since 5 years for which she was under
treatement. Since 15 days patient was C/O scanty urine (oliguria) and
puffiness of face. Patient was admitted and investigated which showed signs
of acute renal failure with hyperglycemia. Even after vigorous treatment with
fluids, electolytes, insulin patient's hyperglycemic stage was resolved.
However she remained anuric. Attempts of renal dialysis were unsuccessful
and patient died on seventh hospital day due to acute renal failure.
a) Immediate cause (a) Acute renal failure 7 day
b) Antecedent cause (b) Nephropathy
condition last (c) Diabetes mellitus 12 years
II
to the death but not related to the disease Ischaemic heart disease 5 years
Manner of Death
4. 26 years old, 2nd para delivered a male child (having completed 32 weeks of
gestation) on 15.12.2000 at 7.30 pm. A baby was premature having birth
weight 1350 grams. After birth baby had respiratory distress. O/E baby was
hypothermic and had blood stained froth at nostrils and mouth. Inspite of
treatment baby deteriorated and died on 16.12.2000 at 5.30 a.m. The
diagnosis was suggestive of pulmonary haemorrhage.
Immediate cause (a) Pulmonary haemorrhage 10 hours back
Antecedent cause (b) Respiratory distress and
Morbid conditions, if any, giving rise to hypothermia 10 hours back
Due to (or as a consequences of)
condition last (c) Prematurity
II
Manner of Death
37
5. 24 years old male, a motorbike rider was admitted to a hospital with H/o road
traffic accident (dashed by truck). O/E patient was unconscious and had
bleeding through ears and nostrils and had convulsion. X-ray showed fracture
of skull. Patient died 4 hours after admission.

Immediate cause (a Fracture of skull 4 hours back
Antecedent cause (b) Collision between motorcycle 4 hours back
Morbid conditions, if any, giving rise to and truck.
the above Cause, stating underlying Due to (or as a consequences of)
condition last (c) __________
II
Manner of Death
How did injury occur ? The victim was a motor cycle rider died in traffic accident.
6. 26 years old third para, had full termed normal delivery on 15th Dec. 2000 at
home. On 5th day she had a high degree fever and severe pain in abdomen.
On next day she was shifted to the hospital. O/E doctors noticed that she was
in shock and having foul smelling discharge per vagina. Immediately the
treatment was started but after 8 hours patient died on 22-12-2000. Relatives
gave history that she was treated for severe anaemia in second trimaster.

a) Immediate cause (a) Septicemic shock 2 days
Antecedent cause (b) Puerperal sepsis 2 days
condition last (c)
II
1
to the death but not related to the disease Anaemia 5 /2 months
or conditions causing

1. Natural 2. Accident 3. Suicide 4. Homicide
38
7. 31 years old male had tuberculosis since 11 months. He was taking treatment and
remained defaulter. One month back he relapsed and again had cough, fever and
loss of weight along with intermittent diarrhoea. Even after treatment he had not
responded to the treatment. Since 2 days he had severe, cough with respiratory
distress along with massive haemoptysis. On the day of admission investigations
were done including HIV status. Patient was HIV positive, which was confirmed by
elisa test with two different media. Patient worsened and died on 4th day of
admission.
Immediate cause (a) Haemoptysis 6 days
11 Months
Antecedent cause (b) Pulmonary tuberculosis
the above Cause, stating underlying (c) Acquired Immunodeficiency (HIV positive status
condition last Syndrome was confirmed by
(d) Human Immunodeficiency elisa with two different
Virus infection media)
II
to the death but not related to the disease Diarrhoea (intermittent) 1 month
Manner of Death
In case of AIDS deaths it is necessary to write immediate cause of death in

details along with the HIV positive status of the patient which confirms him/her as a
case of AIDS in the above case. Actually the cause of death was pulmonary
tuberculosis but underlying cause was HIV infection, which had laid the patient
towards pulmonary tuberculosis infection and worsened the condition because of
diminished immunity.
8. A male patient, aged 54 years was admitted to hospital on 11/1/2001 complaining

of pain in abdomen since 3 days and on 11/1/2001 he had a fecal vomitus and
developed high degree fever. O/E and further investigation it was diagnosed as a
case of strangulated inguinal hernia. Patient was under gone laparotomy along
with resection anastomosis of small intestine on 12-1-2001. On third day of
operation (14-1-2001) patient started showing signs of peritonitis, deteriorated
and died on 15-1-2001. Patient had H/O myocardial infarction 1 year back.
Immediate cause (a) Peritonitis 1 day
a) Antecedent cause (b) Strangulated inguinal hernia 5 days
condition last (c) ________________
II
to the death but not related to the disease Myocardial infarction 1 year back
Manner of Death
39
9. 47 years old male who was chronic alcoholic admitted to the hospital with
massive haematemesis since an hour. After investigations it was noticed
that he was a case of portal hypertension due to liver cirrhosis. On second
day patient died due to haemorrhagic shock due to haematemesis. Patient
was habitual alcohol drinker since 15 years.
Immediate cause (a) HaemorrhagicShock 1 day
Antecedent cause (b) Haematemesis 1day
-------
condition last (c) Portal Hypertension
(d) Cirrhosis of Liver due to H/O alcoholism since
chronic alcoholism 15 years
II
Manner of Death
10. 64 years old male was admitted to a hospital with H/O unconsciousness
since 2 hours. He had H/O bronchial asthma since 20 years and had
previous admissions to the hospital for chronic pyelonephritis. On
investigations he was found hypertensive and had history of same since 3
years. Diagnosis was cerebral haemorrhage. Patient died 5 days after
admission.
Immediate cause (a) Raised intracranial tension 5 days
State the disease, injury or complication due to cerebral haemorrhage
Antecedent cause (b) Hypertension 3 years
condition last (c) Chronic Pyelonephritis
II
to the death but not related to the disease Bronchial Asthma 20 years
Manner of Death
40
Part- B
Write down the accurate cause of death of following case studies
and appropriate code no. by referring ICD-10.
11. 49 years old male was admitted to the hospital with complaints of
midepigastric and left-sided chest pain for last 3 hours. The pain rediated to
his left arm and was accompanied by nausea and vomiting. He had H/O
occasional chest discomfort & syncopal episodes 6 months back. Patient
was known hypertensive since 5 years. O/E he was found to be in shock.
Patient was shifted to ICU. ECG showed changes suggestive of acute
myocardial infarction. He died 2 hours after admission.
Immediate cause (a) ----------------------------------------
Antecedent cause (b) ------------------------------------------
condition last (c) ____________________________
II
to the death but not related to the disease _________________________
Manner of Death
12. 40 years old male was admitted to the hospital with H/O pain in abdomen &
vomiting since 1 day. He was chronic alcoholic. He was found to be
dehydrated & in shock. Patient was investigated & diagnosed as a case of
perforation peritonitis. He was resuscitated & operated on the second day of
admission. Laparotomy revealed perforated gastric ulcer with peritonitis. He
developed pneumonia on third operative day and remained critical. Patient
died on 4th postoperative day.
Interval between ICD
CAUSE OF DEATH onset & death approx. Code
I
condition last (c) ____________________________
II
Manner of Death
41
13. 10 years old female brought to the hospital with fever and convulsions since 2
days. O/E she had high degree fever, neck rigidity and exaggerated deep
reflexes and she was unconscious. She had H/O chronic suppurative otitis
media since 1 year. Inspite of vigorous treatment she died due to pyogenic
meningitis 4 days after admission.

condition last (c) ____________________________
II
1. Natural 2. Accident 3. Suicide 4. Homicide 5. Pending investigation
14. 32 years male, resident of a remote village admitted to the district hospital on
13.10.2001 at 4 am with history of snake bite to his right foot at 11 pm on
12.10.2001. Patient had cellulitis with bleeding from the site of bite. Patient
was semiconscious and had facial oedema, pulse & BP were not recordable
showing signs of hypovolumic shock. Immediately he was transferred to ICU
from the casualty. Patient was put on anti-snake venom and corticosteroids
along with I/V fluids. Blood was sent for grouping and cross matching. B.T.,
C.T. and P.T. were done. B.T., C.T. were prolonged. The patient could not
revived even after vigorous management of 1 hour and declared dead at
5 am.

condition last (c) ____________________________
II

42
15. 20 years old male admitted in the hospital with C/O nausea, vomiting, low
grade fever and loss of appetite since 15 days. Patient had yellow
discoloration of eyes, high colored urine since 10 days and altered behaviour
since 1 day. He was diagnosed as a case of viral hepatitis. On investigation
patient had raised serum bilirubin (21mg %) with raised SGPT, SGOT levels.
Patient died 3 days after admission.

condition last (c) ____________________________
II
Manner of Death
16. 2 years old female child was brought to the hospital with fever cough, coryza
since last 8 days history of rash on body since 5 days. O/E child had severe
breathlessness, high degree fever, bilateral crepitations. Child was cachexic
and irritable. She was diagnosed as a case of bronchopneumonia with grade
III malnutrition. Child was not vaccinated against measles. Inspite of
treatment child died after 3 days.

condition last (c) ____________________________
II
Manner of Death
43
17. 27 years old male was admitted in a hospital in an unconscious state with H/o
convulsions since 5 hours. Patient was detected as HIV positive 4 years
back. He was taking treatment for pulmonary tuberculosis since 8 months.
After admission his CSF revealed tubercular meningitis. Patient had not
responded to anti-tubercular line of treatment and died after 3 days.

condition last (c) ____________________________
II
Manner of Death
18. 3 years old mentally retarded male child was admitted for burns in hospital for
80% burns. He had history of fall in a domestic fireplace (Chool). Child was in
hypovolumic shock and resuscitated but died after 6 hours due to shock due
to burns.

The above Cause, stating underlying
Condition last (c) ____________________________
II
Manner of Death How did the injury occur?
44
19. 65 years old male patient was known diabetic since 8 years, met with
vehicular accident (dashed by a motor cycle) and had fracture neck femur.
Patient was immediately admitted to the hospital. Investigation revealed BSL
level 550 mg/dl and opinion of a physician about the fitness was asked.
Suddenly patient deteriorated with signs of dyspnoea, tachycardia, &
tachypnea and died after 2 hours. A clinical autopsy revealed pulmonary
embolism.

condition last (c) ____________________________
II
Manner of Death How did the injury occur?

20. 38 years old male was admitted to the hospital for high degree fever since 4
days and convulsions since 4 hours before admission. Patient had altered
sensorium. On investigations his peripheral blood smear showed
Plasmodium Falciparum and haemogram was suggestive of severe anaemia
(Hb-6 gm%). Patient was chronic alcoholic. Patient died 1 day after
admission.

condition last (c) ____________________________
II

45
21. 4 days old pre-term male child had cleft lip and cleft palate along with
hypoplasia of genitalia and with multiple congenital anomalies. Baby became
sudden breathless and cyanosed after feeding suggestive of aspiration
pneumonia. Child died after 4 hours.

condition last (c) ____________________________
II
Manner of Death
22. 62 years old male was brought to hospital with breathlessness, cough &
weakness on Lt. Side of body for about 2-3 hours. He was taking treatment
for hypertension for last 8 years. On admission he was dyspnoec. Had
hemiparesis on Lt side. But the neurological picture started deteriorating
rapidly within 2 hours he became unconscious. His pupils became pinpoint
and he developed neck stiffness. Fundoscopy revealed papilloedema. Pt
died 12 hours after admission.

condition last (c) ____________________________
II
Manner of Death
46
23. 14 years male was admitted to a hospital on 12.09.2001 with breathlessness,
cough, fever, joint pain and pedal oedema. Pulse was 120/min, BP 130/60
mm of Hg. O/E swelling of elbow, wrist and small joints seen along with pan
systolic murmur. Investigations also revealed mitral regurgitation + aortic
regurgitation+ aortic stenosis and left ventricular hypertrophy along with
pulmonary hypertension. Patient was alright 6 years back then started joint
pain off and on which was migratory in nature since 3 years. Patient started
complaining dyspnoea on exertion, which was increased since 10 days.
Patient was diagnosed as rheumatic valvular heart disease with pulmonary
hypertension with CCF. Patient died on 21.09.2001.

condition last (c) ____________________________
II
Manner of Death
24. 7 years old male child referred from remote village to the district hospital with
H/O vomiting & loose motions since 2 days. O/E patient had severe
dehydration and was in hypovolumic shock. Immediately he was treated
vigorously with IV fluids and antibacterial agents & stool sample was sent for
pathology. But he was not revived because of irreversible shock and died
due to gastroenteritis on 3rd day of admission.
condition last (c) ____________________________
II
Manner of Death
47
25. 70 years old male was admitted to the hospital with swelling of Lt. foot. He
was known diabetic since 15 years. He had H/O injury to his Lt. foot 10 days
back. O/E patient was febrile and showing severe cellulitis of Lt. foot along
with gangrene. Investigations showed hyperglycemia. Immediately he was
treated with insulin and antibiotics. Patient worsened on 7 day of admission
and died due to septicaemic shock.
condition last (c) ____________________________
II
Manner of Death
48
ANNEXURE- I
CASE DEFINITION OF AIDS

(ABOVE 12 YEARS OF AGE)
1. Two positive tests for HIV infection (by ERS test)

AND
2. Any one of the following criteria -
a) Significant weight loss (> 10% of body weight) within last one month/Cachexia
(not known to be due to be a condition other than HIV infection)
b) Chronic diarrhoea (intermittent or continuous)
c) Prolonged fever (intermittent or continuous)
d) Tuberculosis - Extensive pulmonary tuberculosis, disseminated, miliary, extra-
pulmonary
e) Neurological impairment preventing independent daily activities, not known to
be due to the conditions unrelated to HIV infection (e. g. trauma)
f) Candidiasis of the oesophagus (diagnosable by oral candidiasis with
odynophagia)
g) Clinically diagnosed life-threatening or recurrent episodes of pneumonia, with
or without aetiological confirmation
h) Kaposis Sarcoma
i) Other conditions
Cryptococcal meningitis
Neuro Toxoplasmosis
Penicillium marneffei
CMV retinitis
Recurrent Herpes Zoster and Multi-dermatomal
Disseminated molluscum
49
CASE DEFINITION OF AIDS FOR CHILDREN
(UPTO 12 YEARS OF AGE)
1. Two positive tests for HIV infection (by ERS) in children older than 18
months or confirmed maternal HIV infection for children < 18 months.
AND
2. Presence of at least two major and two minor signs of the following in the
absence of known causes of immuno-suppression.
MAJOR SIGNS:
a) Loss of weight or failure to thrive, which is not known to be due to medical

causes other than HIV infection
b) Chronic diarrhoea (intermittent or continuous) > 1 month duration
c) Prolonged fever (intermittent or continuous) > 1 month duration
MINOR SIGNS:
a) Repeated common infections (e.g. Pneumonitis, otitis media, pharyngitis etc.)
b) Generalised lymphadenopathy
c) Oropharyngeal candidiasis
d) Persistent cough for more than 1 month
e) Disseminated maculo-papular dermatosis
50
INTERNATIONAL
STATISTICAL
CLASSIFICATION
ICD-10
OF DISEASES
AND
RELATED
HEALTH
PROBLEMS
51
Chapter I A31 Infection due to other mycobacteria
Certain infectious and parasitic diseases (A00-B99) A32 Listeriosis
A33 Tetanus neonatorum
Intestinal infectious diseases (A00-A09) A34 Obstetrical tetanus
A00 Cholera A35 Other tetanus
A01 Typhoid and paratyphoid fevers A36 Diphtheria
A02 Other salmonella infections A37 Whooping cough
A03 Shigellosis A38 Scarlet fever
A04 Other bacterial intestinal infections A39 Meningococcal infection
A05 Other bacterial foodborne intoxications A40 Streptococcal septicaemia
A06 Amoebiasis A41 Other septicaemia
A07 Other protozoal intestinal diseases A42 Actinomycosis
A08 Viral and other specified intestinal infections A43 Nocardiosis
A09 Diarrhoea and gastroenteritis of presumed infectious origin A44 Bartonellosis
A46 Erysipelas
Tuberculosis (A15-A19) A48 Other bacterial diseases, not elsewhere classified
A15 Respiratory tuberculosis, bacteriologically and histologically A49 Bacterial infection of unspecified site
confirmed
A16 Respiratory tuberculosis, not confirmed bacteriologically or Infections with a predominantly sexual mode of transmission (A50-A64)
histologically A50 Congenital syphilis
A17 Tuberculosis of nervous system A51 Early syphilis
A18 Tuberculosis of other organs A52 Late syphilis
A19 Miliary tuberculosis A53 Other and unspecified syphilis
A54 Gonococcal infection
Certain zoonotic bacterial diseases (A20-A28) A55 Chlamydial lymphogranuloma (venereum)
A20 Plague A56 Other sexually transmitted chlamydial diseases
A21 Tularaemia A57 Chancroid
A22 Anthrax A58 Granuloma inguinale
A23 Brucellosis A59 Trichomoniasis
A24 Glanders and melioidosis A60 Anogenital herpesviral (herpes simplex) infections
A25 Rat-bite fevers A63 Other predominantly sexually transmitted diseases, not elsewhere
A26 Erysipeloid classified.
A27 Leptospirosis A64 Unspecified sexually transmitted disease
A28 Other zoonotic bacterial diseases, not elsewhere classified
Other spirochaetal diseases (A65-A69)
Other bacterial diseases (A30-A49)
A30 Leprosy (Hansens disease) A65 Nonvenereal syphilis
1
A66 Yaws A96 Arenaviral haemorrhagic fever
A67 Pinta (carate) A98 Other viral haemorrhagic fevers, not elsewhere classified
A68 Relapsing fevers A99 Unspecified viral haemorrhagic fever
A69 Other spirochaetal infections
Viral infections characterized by skin and mucous membrane
Other diseases caused by chlamydiae (A70-A74) lesions (B00-B09)
A70 Chlamydia psittaci infection B00 Herpesviral (herpes simplex) infection
A71 Trachoma B01 Varicella (chickenpox)
A74 Other diseases caused by chlamydiae B02 Zoster (herpes Zoster)
B03 Smallpox
Rickettsioses (A75-A79) B04 Monkeypox
A75 Typhus fever B05 Measles
A77 Spotted fever (tick-borne rickettsioses) B06 Rubella (German measles)
A78 Q fever B07 Viral warts
A79 Other rickettsioses B08 Other viral infections characterized by skin and mucous membrane
lesions, not elsewhere classified
Viral infections of the central nervous system (A80-A89) B09 Unspecified viral infection characterized by skin and mucous
A80 Acute poliomyelitis membrane lesions
A81 Slow virus infections of central nervous system
A82 Rabies Viral hepatitis (B15-B19)
A83 Mosquito-borne viral encephalitis B15 Acute hepatitis A
A84 Tick-borne viral encephalitis B16 Acute hepatitis B
A85 Other viral encephalitis,not elsewhere classified B17 Other acute viral hepatitis
A86 Unspecified viral encephalitis B18 Chronic viral hepatitis
A87 Viral meningitis B19 Unspecified viral hepatitis
A88 Other viral infections of central nervous system, not elsewhere
classified. Human immunodeficiency virus (HIV) disease (B20-B24)
A89 Unspecified viral infection of central nervous system B20 Human immunodeficiency virus (HIV) disease resulting in infectious
and parasitic diseases
Arthropod-borne viral fevers and viral heaemorrhagic fevers B21 Human immunodeficiency virus (HIV) disease resulting in malignant
(A90-A99) neoplasms
A90 Dengue fever (classical dengue) B22 Human immunodeficiency virus (HIV) disease resulting in other
A91 Dengue haemorrhagic fever specified diseases
A92 Other mosquito-borne viral fevers B23 Human immunodeficiency virus (HIV) disease resulting in other
A93 Other arthropod-borne viral fevers, not elsewhere classified conditions
A94 Unspecified arthropod-borne viral fever B24 Unspecified human immunodeficiency virus (HIV) disease
A95 Yellow fever
2
B60 Other protozoal diseases, not elsewhere classified
Other viral diseases (B25-B34) B64 Unspecified protozoal disease
B25 Cytomegaloviral disease
B26 Mumps Helminthiases (B65-B83)
B27 Infectious mononucleosis B65 Schistosomiasis (bilharziasis)
B30 Viral conjunctivitis B66 Other fluke infections
B33 Other viral diseases, not elsewhere classified B67 Echinococcosis
B34 Viral infection of unspecified site B68 Taeniasis
B69 Cysticercosis
Mycoses (B35-B49) B70 Diphyllobothriasis and sparganosis
B35 Dermatophytosis B71 Other cestode infections
B36 Other superficial mycoses B72 Dracunculiasis
B37 Candidiasis B73 Onchocerciasis
B38 Coccidioidomycosis B74 Filariasis
B39 Histoplasmosis B75 Trichinellosis
B40 Blastomycosis B76 Hookworm diseases
B41 Paracoccidioidomycosis B77 Ascariasis
B42 Sporotrichosis B78 Strongyloidiasis
B43 Chromomycosis and phaeomycotic abscess B79 Trichuriasis
B44 Aspergillosis B80 Enterobiasis
B45 Cryptococcosis B81 Other intestinal helminthiases, not elsewhere classified
B46 Zygomycosis B82 Unspecified intestinal parasitism
B47 Mycetoma B83 Other helminthiases
B48 Other mycoses, not elsewhere classified
B49 Unspecified mycosis Pediculosis, acariasis and other infestations (B85-B89)
B85 Pediculosis and phthiriasis
Protozoal diseases (B50-B64) B86 Scabies
B50 Plasmodium falciparum malaria B87 Myiasis
B51 Plasmodium vivax malaria B88 Other infestations
B52 Plasmodium malariae malaria B89 Unspecified parasitic disease
B53 Other parasitologically confirmed malaria
B54 Unspecified malaria Sequelae of infectious and parasitic diseases (B90-B94)
B55 Leishmaniasis B90 Sequelae of tuberculosis
B56 African trypanosomiasis B91 Sequelae of Poliomyelitis
B57 Chagas disease B92 Sequelae of leprosy
B58 Toxoplasmosis B94 Sequelae of other and unspecified infectious and parasitic diseases
B59 Pneumocystosis
3
C16 Malignant neoplasm of stomach
Bacterial, viral and other infectious agents (B95-B97) C17 Malignant neoplasm of small intestine
B95 Streptococcus and staphylococcus as the cause of diseases C18 Malignant neoplasm of colon
classified to other chapters C19 Malignant neoplasm of rectosigmoid junction
B96 Other bacterial agents as the cause of diseases classified to C20 Malignant neoplasm of rectum
other chapters C21 Malignant neoplasm of anus and anal canal
B97 Viral agents as the cause of diseases classified to other chapters C22 Malignant neoplasm of liver and intrahepatic bile ducts
C23 Malignant neoplasm of gallbladder
Other infectious diseases (B99) C24 Malignant neoplasm of other and unspecified parts of biliary tract
B99 Other and unspecified infectious diseases C25 Malignant neoplasm of pancreas
C26 Malignant neoplasm of other and ill-defined digestive organs
Chapter II
Neoplasms (C00-D48) Malignant neoplasms of respiratory and intrathoracic organs (C30-C39)
C30 Malignant neoplasm of nasal cavity and middle ear
Malignant neoplasms (C00-C97) C31 Malignant neoplasm of accessory sinuses
C32 Malignant neoplasm of larynx
Malignant neoplasms of lip,oral cavity and pharynx (C00-C14) C33 Malignant neoplasm of trachea
C00 Malignant neoplasm of lip C34 Malignant neoplasm of bronchus and lung
C01 Malignant neoplasm of base of tongue C37 Malignant neoplasm of thymus
C02 Malignant neoplasm of other and unspecified parts of tongue C38 Malignant neoplasm of heart, mediastinum and pleura
C03 Malignant neoplasm of gum C39 Malignant neoplasm of other and ill-defined sites in the respiratory
C04 Malignant neoplasm of floor of mouth system and intrathoracic organs
C05 Malignant neoplasm of palate
C06 Malignant neoplasm of other and unspecified parts of mouth Malignant neoplasm of bone and articular cartilage (C40-C41)
C07 Malignant neoplasm of parotid gland C40 Malignant neoplasm of bone and articular cartilage of limbs
C08 Malignant neoplasm of other and unspecifed major salivary C41 Malignant neoplasm of bone and articular cartilage of other and
glands unspecified sites
C09 Malignant neoplasm of tonsil
C10 Malignant neoplasm of oropharynx Melanoma and other malignant neoplasm of skin (C43-C44)
C11 Malignant neoplasm of nasopharynx C43 Malignant melanoma of skin
C12 Malignant neoplasm of pyriform sinus C44 Other malignant neoplasms of skin
C13 Malignant neoplasm of hypopharynx
C14 Malignant neoplasm of other and ill-defined sites in the lip,oral Malignant neoplasms of mesothelial and soft tissue (C45-C49)
cavity and pharynx C45 Mesothelioma
C46 Kaposis sarcoma
Malignant neoplasms of digestive organs (C15-C26) C47 Malignant neoplasm of peripheral nerves and autonomic nervous
C15 Malignant neoplasm of oesophagus system.
4
C48 Malignant neoplasm of retroperitoneum and peritoneum parts of central nervous system.
C49 Malignant neoplasm of other connective and soft tissue Malignant neoplasms of thyroid and other endocrine glands (C73-C75)
C73 Malignant neoplasm of thyroid gland
Malignant neoplasm of breast (C50) C74 Malignant neoplasm of adrenal gland
C50 Malignant neoplasm of breast C75 Malignant neoplasm of other endocrine glands and related structures
Malignant neoplasms of female genital organs (C51-C58) Malignant neoplasms of ill-defined, secondary and unsepcified sites
C51 Malignant neoplasm of vulva (C76-C80)
C52 Malignant neoplasm of vagina C76 Malignant neoplasm of other and ill-defined sites
C53 Malignant neoplasm of cervix uteri C77 Secondary and unspecified malignant neoplasm of lymph nodes
C54 Malignant neoplasm of corpus uteri C78 Secondary malignant neoplasm of respiratory and digestive, organs
C55 Malignant neoplasm of uterus, part unspecified C79 Secondary malignant neoplasm of other sites
C56 Malignant neoplasm of ovary C80 Malignant neoplasm without specification of site
C57 Malignant neoplasm of other and unspecified female genital
organs Malignant neoplasms of lymphoid, haematopoietic and related tissue
C58 Malignant neoplasm of placenta (C81-C96)
C81 Hodgkins disease
Malignant neoplasms of male genital organs (C60-C63) C82 Follicular (nodular) non-Hodgkins lymphoma
C60 Malignant neoplasm of penis C83 Diffuse non-Hodgkins lymphoma
C61 Malignant neoplasm of prostate C84 Peripheral and cutaneous T-cell lymphomas
C62 Malignant neoplasm of testis C85 Other and unspecified types of non-Hodgkins lymphoma
C63 Malignant neoplasm of other and unspecified male genital C88 Malignant immunoproliferative disease
organs C90 Multiple myeloma and malignant plasma cell neoplasms
C91 Lymphoid leukaemia
Malignant neoplasms of uninary tract (C64-C68) C92 Myeloid leukaemia
C64 Malignant neoplasm of kidney, except renal pelvis C93 Monocytic leukaemia
C65 Malignant neoplasm of renal pelvis C94 Other leukaemias of specified cell type
C66 Malignant neoplasm of ureter C95 Leukaemia of unspecified cell type
C67 Malignant neoplasm of bladder C96 Other and unsepcified malignant neoplasms of lymphoid,
C68 Malignant neoplasm of other and unspecified urinary organs haematopoietic and related tissue
Malignant neoplasms of eye, brain and other parts of central Malignant neoplasms of independent (primary) multiple sites (C97)
nervous system (C69-C72) C97 Malignant neoplasms of independent (primary) multiple sites
C69 Malignant neoplasm of eye and adnexa
C70 Malignant neoplasm of meninges In situ neoplasms (D00-D09)
C71 Malignant neoplasm of brain D00 Carcinoma in situ of oral cavity, oesophagus and stomach
C72 Malignant neoplasm of spinal cord, cranial nerves and other D01 Carcinoma in situ of other and unspecified digestive organs
5
D02 Carcinoma in situ of middle ear and respiratory system D35 Benign neoplasm of other and unspecified endocrine glands
D03 Melanoma in situ D36 Benign neoplasm of other and unspecified sites
D04 Carcinoma in situ of skin
D05 Carcinoma in situ of breast Neoplasms of uncertain or unknown behaviour (D37-D48)
D06 Carcinoma in situ of cervix uteri D37 Neoplasm of uncertain or unknown behaviour of oral cavity and
D07 Carcinoma in situ of other and unspecified genital organs digestive organs
D09 Carcinoma in situ of other and unspecified sites D38 Neoplasm of uncertain or unknown behaviour of middle ear and
respiratory and intrathoracic organs
Benign neoplasms (D10-D36) D39 Neoplasm of uncertain or unknown behaviour of female genital organs
D10 Benign neoplasm of mouth and pharynx D40 Neoplasm of uncertain or unknown behaviour of male genital organs
D11 Benign neoplasm of major salivary glands D41 Neoplasm of uncertain or unknown behaviour of urinary organs
D12 Benign neoplasm of colon, rectum, anus and anal canal D42 Neoplasm of uncertain or unknown behaviour of meningers
D13 Benign neoplasm of other and ill-defined parts of digestive D43 Neoplasm of uncertain or unknown behaviour of brain and central
system nervous system
D14 Benign neoplasm of middle ear and respiratory system D44 Neoplasm of uncertain or unknown behaviour of endocrine glands
D15 Benign neoplasm of other and unspecified intrathoracic organs D45 Polycythaemia vera
D16 Benign neoplasm of bone and articular cartilage D46 Myelodysplastic syndromes
D17 Benign lipomatous neoplasm D47 Other neoplasms of uncertain or unknown behaviour of lymphoid,
D18 Haemangioma and lymphangioma, any site haematopoietic and related tissue
D19 Benign neoplasms of mesothelial tissue D48 Neoplasm of uncertain or unknown behaviour of other and
D20 Benign neoplasms of soft tisue of retroperitoneum and unspecified sites
peritoneum
D21 Other benign neoplasms of connective and other soft tissue Chapter III
D22 Melanocytic naevi Diseases of the blood and blood-forming organs and certain disorders
D23 Other benign neoplasms of skin involving the immune mechanism (D50-D89)
D24 Benign neoplasm of breast
D25 Leiomyoma of uterus Nutritional anaemia (D50-D53)
D26 Other benign neoplasms of uterus D50 Iron deficiency anaemia
D27 Benign neoplasm of ovary D51 Vitamin B12 deficiency anaemia
D28 Benign neoplasm of other and unspecified female genital organs D52 Folate deficiency anaemias
D29 Benign neoplasm of male genital organs D53 Other nutritional anaemia
D30 Benign neoplasm urinary organs
D31 Benign neoplasm of eye and adnexa Haemolytic anaemias (D55-D59)
D32 Benign neoplasm of meninges D55 Anaemia due to enzyme disorders
D33 Benign neoplasm of brain and other parts of central nervous D56 Thalassaemia
system D57 Sickle-cell disorders
D34 Benign neoplasm of thyroid gland D58 Other hereditary haemolytic anaemias
6
D59 Acquired haemolytic anaemia
Aplastic and other anaemias (D60-D64) Chapter IV
D60 Acquired pure red cell aplasia (erythroblastopenia) Endocrine, nutritional and metabolic diseases (E00-E90)
D61 Other aplastic anaemias
D62 Acute posthaemorrhagic anaemia Disorders of thyroid gland (E00-E07)
D63 Anaemia in chronic diseases classified elsewhere E00 Congenital iodine-deficiency syndrome
D64 Other anaemias E01 Iodine-deficiency-related thyroid disorders and allied conditions
E02 Subclinical iodine-deficiency hypothyroidism
Coagulation defects, purpura and other haemorrhagic conditions E03 Other hypothyroidism
(D65-D69) E04 Other nontoxic goitre
D65 Disseminated intravascular coagulation (defibrination syndrome) E05 Thyrotoxicosis (hyperthyroidism)
D66 Hereditary factor VIII deficiency E06 Thyroiditis
D67 Hereditary factor IX deficiency E07 Other disorders of thyroid
D68 Other coagulation defects
D69 Purpura and other haemorrhagic conditions Diabetes mellitus (E10-E14)
E10 Insulin-dependent diabetes mellitus
Other diseases of blood and blood-forming organs (D70-D77) E11 Non-insulin-dependent diabetes mellitus
D70 Agranulocytosis E12 Malnutrition-related diabetes mellitus
D71 Functional disorders of polymorphonuclear neutrophils E13 Other specified diabetes mellitus
D72 Other disorders of white blood cells E14 Unspecified diabetes mellitus
D73 Diseases of spleen
D74 Methaemoglobinaemia Other disorders of glucose regulation and pancreatic internal secretion
D75 Other diseases of blood and blood-forming organs (E15-E16)
D76 Certain diseases involving lymphoreticular tissue and E15 Nondiabetic hypoglycaemic coma
reticulohistiocytic system E16 Other disorders of pancreatic internal secretion
D77 Other disorders of blood and blood-forming organs in diseases
classified elsewhere. Disorders of other endocrine glands (E20-E35)
Certain disorders involving the immune mechanism (D80-D89) E20 Hypoparathyroidism
D80 Immunodeficiency with predominantly antibody defects E21 Hyperparathyroidism and other disorders of parathyroid gland
D81 Combined immunodeficiencies E22 Hyperfunction of pituitary gland
D82 Immunodeficiency associated with other major defects E23 Hypofunction and other disorders of pituitary gland
D83 Common variable immunodeficiency E24 Cushings syndrome
D84 Other immunodeficiencies E25 Adrenogenital disorders
D86 Sarcoidosis E26 Hyperaldosteronism
D89 Other disorders involving the immune mechanism, not elsewhere E27 Other disorders of adrenal gland
classified E28 Ovarian dysfunction
E29 Testicular dysfunction
7
E30 Disorders of puberty, not elsewhere classified E70 Disorder of aromatic amino-acid metabolism
E31 Polyglandular dysfunction E71 Disorders of branched-chain amino-acid metabolism and fatty- acid
E32 Diseases of thymus metabolism
E34 Other endocrine disorders E72 Other disorders of amino-acid metabolism
E35 Disorders of endocrine glands in diseases classified elsewhere. E73 Lactose intolerance
E74 Other disorders of carbohydrate metabolism
Malnutrition (E40-E46) E75 Disorder of sphingolipid metabolism and other lipid storage disorders
E40 Kwashiorkor E76 Disorder of glycosaminoglycan metabolism
E41 Nutritional marasmus E77 Disorders of glycoprotein metabolism
E42 Marasmic kwashiorkor E78 Disorders of lipoprotein metabolism and other lipidaemias
E43 Unspecified severe protein-energy malnutrition E79 Disorders of purine and pyrimidine metabolism
E44 Protein-energy malnutrition of moderate and mild degree E80 Disorders of porphyrin and bilirubin metabolism
E45 Retarded development following protein-energy malnutrition E83 Disorders of mineral metabolism
E46 Unspecified protein-energy malnutrition. E84 Cystic fibrosis
E85 Amyloidosis
Other nutritional deficiencies (E50-E64) E86 Volume depletion
E50 Vitamin A deficiency E87 Other disorders of fluid, electorlyte and acid-base balance
E51 Thiamine deficiency E88 Other metabolic disorders
E52 Niacin deficiency (pellagra) E89 Postprocedural endocrine and metabolic disorders, not elsewhere
E53 Deficiency of other B group vitamins classified
E54 Ascorbic acid deficiency E90 Nutritional and metabolic disorders in diseases classified elsewhere
E55 Vitamin D deficiency
E56 Other vitamin deficiencies Chapter V
E58 Dietary calcium deficiency Mental and behavioural disorders
E59 Dietary selenium deficiency (F00-F99)
E60 Dietary zinc deficiency
E61 Deficiency of other nutrient elements Organic, including symptomatic, mental disorders(F00-F09)
E63 Other nutritional deficiencies F00 Dementia in Alzheimers disease
E64 Sequelae of malnutrition and other nutritional deficencies F01 Vascular dementia
F02 Dementia in other diseases classified elsewhere
Obesity and other hyperalimentation (E65-E68) F03 Unspecified dementia
E65 Localilzed adiposity F04 Organic amnesic syndrome, not induced by alcohol and other
E66 Obesity psychoactive substances
E67 Other hyperalimentation F05 Delirium, not induced by alcohol and other psychoactive substances
E68 Sequelae of hyperalimentation F06 Other mental disorders due to brain damage and dysfunction and to
physical disease
Metabolic disorders (E70-E90) F07 Personality and behavioural disorders due to brain disease, damage
8
and dysfunction
F09 Unspecified organic or symptomatic mental disorders Neurotic, stress-related and somatoform disorders (F40-F48)
F40 Phobic anxiety disorders
Mental and behavioural disorders due to psychoactive substance F41 Other anxiety disorders
use (F10-F19) F42 Obsessive-compulsive disorders
F10 Mental and behavioural disorders due to use of alcohol F43 Reaction to serve stress, and adjustment disorders
F11 Mental and behavioural disorders due to use of opioids F44 Dissociative (conversion) disorders
F12 Mental and behavioural disorders due to use of cannabinoids F45 Somatoform disorders
F13 Mental and behavioural disorders due to use of sedatives or F48 Other neurotic disorders
hypnotics
F14 Mental and behavioural disorders due to use of cocaine Behavioural syndromes associated with physiological disturbances and
F15 Mental and behavioural disorders due to use of other stimulants, physical factors (F50-F59)
including caffeine F50 Eating disorders
F16 Mental and behavioural disorders due to use of hallucinogens F51 Nonorganic sleep disorders
F17 Mental and behavioural disorders due to use of tobacco F52 Sexual dysfunction, not caused by organic disorder or disease
F18 Mental and behavioural disorders due to use of volatile solvents F53 Mental and behavioural disorders associated with the puerperium, not
F19 Mental and behavioural disorders due to multiple drug use and elsewhere classified
use of other psychoactive substances F54 Psychological and behavioural factors associated with disorders or
diseases classified elsewhere
Schizophrenia, schizotypal, delusional disorders (F20-F29) F55 Abuse of non dependence-producing substances
F20 Schizophrenia F59 Unspecified behavioural syndromes associated with physiological
F21 Schizotypal disorder disturbances and physical factors
F22 Persistant delusional disorders
F23 Acute and transient psychotic disorders Disorders of adult personality and behaviour (F60-F69)
F24 Induced delusional disorder F60 Specific personality disorders
F25 Schizoaffective disorders F61 Mixed and other personality disorders
F28 Other nonorganic psychotic disorders F62 Enduring personality changes, not attributable to brain damage and
F29 Unspecified nonorganic psychosis disease
F63 Habit and impulse disorders
Mood (affective) disorders (F30-F39) F64 Gender identity disorders
F30 Manic episode F65 Disorders of sexual preference
F31 Bipolar affective disorder F66 Psychological and behavioural disorders associated with sexual
F32 Depressive episode development and orientation
F33 Recurrent depressive disorder F68 Other disorders of adult personality and behaviour
F34 Persistent mood (affective) disorders F69 Unspecified disorder of adult personality and behaviour
F38 Other mood (affective) disorders
F39 Unspecified mood (affective) disorders Mental retardation (F70-F79)
9
F70 Mild mental retardation G00 Bacterial meningitis, not elsewhere classified
F71 Moderate mental retardation G01 Meningitis in bacterial diseases classified elsewhere
F72 Severe mental retardation G02 Meningitis in other infectious and parasitic diseases classified
F73 Profound mental retardation elsewhere
F78 Other mental retardation G03 Meningitis due to other and unspecified causes
F79 Unspecified mental retardation G04 Encephalitis, myelitis and encephalomyelitis
G05 Encephalitis, myelitis and encephalomyelitis in diseases classified
Disorders of psychological development (F80-F89) elsewhere
F80 Specific developmental disorders of speech and language G06 Intracranial and intraspinal abscess and granuloma
F81 Specific developmental disorders of scholastic skills G07 Intracranial and intraspinal abscess and granuloma in diseases
F82 Specific developmental disorders of motor function classified elsewhere
F83 Mixed specific developmental disorders G08 Intracranial and intraspinal phlebitis and thrombophlebitis
F84 Pervarsive developmental disorders G09 Sequelae of inflammatory diseases of central nervous system
F88 Other disorders of psychological development
F89 Unspecified disorders of psychological development Systemic atrophies primarily affecting the central nervous system (G10-
G13)
Behavioural and emotional disorders with onset usual occurring in G10 Huntingtons disease
childhood and adolescence (F90-F98) G11 Hereditary ataxia
F90 Hyperkinetic disorders G12 Spinal muscular atrophy and related syndromes
F91 Conduct disorders G13 Systemic atrophies primarily affecting central nervous system in
F92 Mixed disorders of conduct and emotions diseases classified elsewhere
F93 Emotional disorders with onset specific to childhood
F94 Disorders of social functioning with onset specific to childhood Extrapyramidal and movement disorders (G20-G26)
and adolescence G20 Parkinsons diseases
F95 Tic disorders G21 Secondary parkinsonism
F98 Other behavioural and emotional disorders with onset usually G22 Parkinsonism in diseases classified elsewhere
occuring in childhood and adolescence G23 Other degenerative diseases of basal ganglia
G24 Dystonia
Unspecified mental disorders (F99) G25 Other extrapyramidal and movement disorders
F99 Mental disorder, not otherwise specified G26 Extrapyramidal and movement disorders in diseases classified
elsewhere
Other degenerative diseases of the nervous system (G30-F32)
G30 Alzheimers disease
Chapter VI G31 Other degenerative disease of nervous system, not elsewhere
classified
Diseases of the nervous system (G00-G99) G32 Other degenerative disorders of nervous system in diseases classified
elsewhere
Inflammatory diseases of the central nervous system (G00-G09)
10
G70 Myasthenia gravis and other myoneural disorders
Demyelinating diseases of the central nervous system (G35-G37) G71 Primary disorders of muscles
G35 Multiple sclerosis G72 Other myopathies
G36 Other acute disseminated demyelination G73 Disorders of myoneural junction and muscle in diseases classified
G37 Other demyelinating diseases of central nervous system elsewhere
Episodic and paroxysmal disorders (G40-G47) Cerebral palsy and other paralytic syndromes (G80-G83)
G40 Epilepsy G80 Infantile cerebral palsy
G41 Status epilepticus G81 Hemiplegia
G43 Migraine G82 Paraplegia and tetraplegia
G44 Other headache syndromes G83 Other paralytic syndromes
G45 Transient cerebral ischaemic attacks and related syndromes
G46 Vascular syndromes of brain in cerebrovascular diseases Other disorders of the nervous system (G90-G99)
G47 Sleep disorders G90 Disorders of autonomic nervous system
G91 Hydrocephalus
Nerve, nerve root and plexus disorders (G50-G59) G92 Toxic encephalopathy
G50 Disorders of trigeminal nerve G93 Other disorders of brain
G51 Facial nerve disorder G94 Other diseases of brain in diseases classified elsewhere
G52 Disorders of other cranial nerves G95 Other diseases of spinal cord
G53 Cranial nerve disorders in diseases classified elsewhere G96 Other disorders of central nervous system
G54 Nerve root and plexus disorders G97 Postprocedural disorders of nervous system, not elsewhere classified
G55 Nerve root and plexus compressions in diseases classified G98 Other disorders of nervous system in diseases not elsewhere
elsewhere classified
G56 Mononeuropathies of upper limb G99 Other disorders of nervous system in diseases classified elsewhere
G57 Mononeuropathies of lower limb
G58 Other mononeuropathies
G59 Mononeuropathy in diseases classified elsewhere Chapter VII
Diseases of the eye and adnexa (H00-H59)
Polyneuropathies and other disorders of the peripheral nervous
system (G60-G64) Disorders of eyelid, lacrimal system and orbit (H00-H06)
G60 Hereditary and idioopathic neuropathy H00 Hordeolum and chalazion
G61 Inflammatory polyneuropathy H01 Other inflammation of eyelid
G62 Other polyneuropathies H02 Other disorders of eyelid
G63 Polyneuropathy in diseases classified elsewhere H03 Disorders of eyelid in diseases classified elsewhere
G64 Other disorders of peripheral nervous system H04 Disorders of lacrimal system
H05 Disorders of orbit
Diseases of myoneural junction and muscle (G70-G73) H06 Disorders of lacrimal system and orbit in diseases classified
11
elsewhere
Disorders of conjunctiva (H10-H13) Disorders of vitreous body and globe (H43-H45)
H10 Conjunctivitis H43 Disorders of vitreous body
H11 Other disorders of conjunctiva H44 Disorders of globe
H13 Disorders of conjunctiva in diseases classified elsewhere H45 Disorders of vitreous body and globe in diseases classified elsewhere
Disorders of sclera, cornea, iris and ciliary body (H15-H22) Disorders of optic nerve and visual pathways (H46-H48)
H15 Disorders of sclera H46 Optic neuritis
nd
H16 Keratitis H47 Other disorders of optic (2 ) nerve and visual pathways
nd
H17 Corneal scars and opacities H48 Disorders of optic (2 ) nerve and visual pathways in diseases
H18 Other disorders of cornea classified elsewhere
H19 Disorders of sclera and cornea in diseases classified elsewhere
H20 Iridocyclitis Disorders of ocular muscles, binocular movement, accommodation and
H21 Other disorders of iris and ciliary body refraction (H49-H52)
H22 Disorders of iris and ciliaary body in diseases classified H49 Paralytic strabismus
elsewhere H50 Other strabismus
H51 Other disorders of binocular movement
Disorders of lens (H25-H28) H52 Disorders of refraction and accommodation
H25 Senile cataract
H26 Other cataract Visual disturbances and blindness (H53-H54)
H27 Other disorders of lens H53 Visual disturbances
H28 Cataract and other disorders of lens in diseases classified H54 Blindness and low vision
elsewhere
Other disorders of eye and adnexa (H55-H59)

Disorders of choroid and retina (H30-H36) H55 Nystagmus and other irregular eye movements
H30 Chorioretinal inflammation H57 Other disorders of eye and adnexa
H31 Other disorders of choroid H58 Other disorders of eye and adnexa in diseases classified elsewhere
H32 Chorioretinal disorders in diseases classified elsewhere H59 Postprocedural disorders of eye and adnexa, not elsewhere classified
H33 Retinal detachments and breaks
H34 Retinal vascular occlusions Chapter VIII
H35 Other retinal disorders Diseases of the ear and mastoid process (H60-H95)
H36 Retinal disorders in diseases classified elsewhere
Diseases of external ear (H60-H62)
Glaucoma (H40-H42) H60 Otitis externa
H40 Glaucoma H61 Other disorders of external ear
H42 Glaucoma in diseases classified elsewhere H62 Disorders of external ear in diseases classified elsewhere
12
I02 Rheumatic chorea
Diseases of middle ear and mastoid (H65-H75)
H65 Nonsuppurative otitis media Chronic rheumatic heart diseases (I05-I09)
H66 Suppurative and unspecified otitis media I05 Rheumatic mitral valve diseases
H67 Otitis media in diseases classified elsewhere I06 Rheumatic aortic valve diseases
H68 Eustachian salpingitis and obstruction I07 Rheumatic tricuspid valve diseases
H69 Other disorders of Eustachian tube I08 Multiple valve diseases
H70 Mastoiditis and related conditions I09 Other rheumatic heart diseases
H71 Cholesteatoma of middle ear
H72 Perforation of tympanic memebrane Hypertensive diseases (I10-I15)
H73 Other disorders of tympanic membrane I10 Essential (primary) hypertension
H74 Other disorders of middle ear and mastoid I11 Hypertensive heart disease
H75 Other disorders of middle ear and mastoid in diseases classified I12 Hypertensive renal disease
elsewhere I13 Hypertensive heart and renal disease
I15 Secondary hypertension
Diseases of inner ear (H80-H83)
H80 Otosclerosis Ischaemic heart diseases (I20-I25)
H81 Disorders of vestibular function I20 Angina pectoris
H82 Vertiginous syndromes in diseases classified elsewhere I21 Acute myocardial infarction
H83 Other diseases of inner ear I22 Subsequent myocardial infarction
I23 Certain current complications following acute myocardial infarction
I24 Other acute ischaemic heart diseases
Other disorders of ear (H90-H95) I25 Chronic ischaemic heart disease
H90 Conductive and sensorineural hearing loss
H91 Other hearing loss Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)
H92 Otalgia and effusion of ear I26 Pulmonary embolism
H93 Other disorders of ear, not elsewhere classified I27 Other pulmonary heart diseases
H94 Other disorders of ear in diseases classified elsewhere I28 Other diseases of pulmonary vessels
H95 Postprocedural disorders of ear and mastoid process, not
elsewhere classified Other forms of heart disease (I30-I52)
I30 Acute pericarditis
Chapter IX I31 Other diseases of pericardium
Diseases of the circulatory system (I00-I99) I32 Pericarditis in diseases classified elsewhere
I33 Acute and subacute endocarditis
Acute rheumatic fever (I00-I02) I34 Nonrheumatic mitral valve disorders
I00 Rheumatic fever without mention of heart involvement I35 Nonrheumatic aortic valve disorders
I01 Rheumatic fever with heart involvement I36 Nonrheumatic tricuspid valve disorders
13
I37 Pulmonary valve disorders I74 Arterial embolism and thrombosis
I38 Endocarditis, valve unspecified I77 Other disorders of arteries and arterioles
I39 Endocarditis and heart valve disorders in diseases classified I78 Diseases of capillaries
elsewhere I79 Disorders of arteries, arterioles and capillaries in diseases classified
I40 Acute myocarditis elsewhere
I41 Myocarditis in diseases classified elsewhere
I42 Cardiomyopathy Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere
I43 Cardiomyopathy in diseases classified elsewhere classified (I80-I89)
I44 Atrioventricular and left bundle-branch block I80 Phlebitis and thrombophlebitis
I45 Other conduction disorders I81 Portal vein thrombosis
I46 Cardiac arrest I82 Other venous embolism and thrombosis
I47 Paroxysmal tachycardia I83 Varicose veins of lower extremities
I48 Atrial fibrillation and flutter I84 Haemorrhoids
I49 Other cardiac arrhythmias I85 Oesophageal varices
I50 Heart failure I86 Varicose veins of other sites
I51 Complications and ill-defined descriptions of heart disease I87 Other disorders of veins
I52 Other heart disorders in diseases classified elsewhere I88 Nonspecific lymphadenitis
I89 Other noninfective disorders of lymphatic vessels and lymph nodes
Cerebrovascular diseases (I60-I69)
I60 Subarachnoid haemorrhage Other and unspecified disorders of the circulatory system (I95-I99)
I61 Intracerebral haemorrhage I95 Hypotension
I62 Other nontraumatic intracranial haemorrhage I97 Postprocedural disorders of circulatory system, not elsewhere
I63 Cerebral infarction classified
I64 Stroke, not specified as haemorrhage or infarction I98 Other disorders of circulatory system in diseases classified elsewhere
I65 Occlusion and stenosis of precerebral arteries, not resulting in I99 Other and unspecified disorders of circulatory system
cerebral infarction
I66 Occlusion and stenosis of cerebral arteries, not resulting in Chapter X
cerebral infarction Diseases of the respiratory system (J00-J99)
I67 Other cerebrovascular diseases
I68 Cerebrovascular disorders in diseases classified elsewhere Acute upper respiratory infections (J00-J06)
I69 Sequelae of cerebrovascular disease J00 Acute nasopharyngitis (common cold)
J01 Acute sinusitis
Diseases of arteries, arterioles and capillaries (I70-I79) J02 Acute pharyngitis
I70 Atherosclerosis J03 Acute tonsillitis
I71 Aortic aneurysm and dissection J04 Acute laryngitis and tracheitis
I72 Other aneurysm J05 Acute obstructive laryngitis (croup) and epiglottitis
I73 Other peripheral vascular diseases J06 Acute upper respiratory infections of multiple and unspecified sites
14
J45 Asthma
Influenza and pneumonia (J10-J18) J46 Status asthmaticus
J10 Influenza due to identified influenza virus J47 Bronchiectasis
J11 Influenza, virus not identified
J12 Viral pneumonia, not elsewhere classified Lung diseases due to external agents (J60-J70)
J13 Pneumonia due to streptococcus pneumoniae J60 Coalworkers pneumoconiosis
J14 Pneumonia due to Haemophilus influenzae J61 Pneumoconiosis due to asbestos and other mineral fibres
J15 Bacterial pneumonia, not elsewhere classified J62 Pneumoconiosis due to dust containing silica
J16 Pneumonia due to other infectious organisms, not elsewhere J63 Pneumoconiosis due to other inorganic dusts
classified J64 Unspecified pneumoconiosis
J17 Pneumonia in diseases classified elsewhere J65 Pneumoconiosis associated with tuberculosis
J18 Pneumonia organism unspecified J66 Airway disease due to specific organic dust
J67 Hypersensitivity pneumonitis due to organic dust
Other acute lower respiratory infections (J20-J22) J68 Respiratory conditions due to inhalation of chemicals, gases, fumes
J20 Acute bronchitis and vapours
J21 Acute bronchiolitis J69 Pneumonitis due to solids and liquids
J22 Unspecified acute lower respiratory infection J70 Respiratory conditions due to other external agents
Other respiratory diseases principally affecting the interstitium (J80-J84)

Other diseases of upper respiratory tract (J30-J39) J80 Adult respiratory distress syndrome
J30 Vasomotor and allergic rhinitis J81 Pulmonary oedema
J31 Chronic rhinitis, nasopharyngitis and pharyngitis J82 Pulmonary eosinophilia, not elsewhere classified
J32 Chronic sinusitis J84 Other interstitial pulmonary diseases
J33 Nasal polyp
J34 Other disorders of nose and nasal sinuses Suppurative and necrotic conditions of lower respiratory trac
J35 Chronic diseases of tonsils and adenoids (J85-J86)
J36 Peritonsillar abscess J85 Abscess of lung and mediastinum
J37 Chronic laryngitis and laryngotracheitis J86 Pyothorax
J38 Diseases of vocal cords and larynx, not elsewhere classified
J39 Other diseases of upper respiratory tract Other diseases of pleura (J90-J94)
J90 Pleural effusion, not elsewhere classified
Chronic lower respiratory diseases (J40-J47) J91 Pleural effusion, in conditions classified elsewhere
J40 Bronchitis, not specified as acute or chronic J92 Pleural plaque
J41 Simple and mucopurulent chronic bronchitis J93 Pneumothorax
J42 Unspecified chronic bronchitis J94 Other pleural condition
J43 Emphysema
J44 Other chronic obstructive pulmonary disease Other diseases of the respiratory system (J95-J99)
15
J95 Postprocedural respiratory disorders, not elsewhere classified
J96 Respiratory failure, not elsewhere classified Diseases of appendix (K35-K38)
J98 Other respiratory disorders K35 Acute appendicitis
J99 Respiratory disorders in diseases classified elsewhere K36 Other appendicitis
K37 Unspecified appendicitis
Chapter XI K38 Other diseases of appendix
Diseases of the digestive system (K00-K93)
Hernia (K40-K46)
Diseases of oral cavity, salivary glands and jaws (K00-K14) K40 Inguinal hernia
K00 Disorders of tooth development and eruption K41 Femoral hernia
K01 Embedded and impacted teeth K42 Umbilical hernia
K02 Dental caries K43 Ventral hernia
K03 Other diseases of hard tissues of teeth K44 Diaphragmatic hernia
K04 Diseases of pulp and periapical tissues K45 Other abdominal hernia
K05 Gingivitis and periodontal diseases K46 Unspecified abdominal hernia
K06 Other disorders of gingiva and edentulous alveolar ridge
K07 Dentofacial anomalies (including malocclusion)
K08 Other disorders of teeth and supporting structures Noninfective enteritis and colitis (K50-K52)
K09 Cysts of oral region, not elsewhere classified K50 Crohns disease (regional enteritis)
K10 Other diseases of jaws K51 Ulcerative colitis
K11 Diseases of salivary glands K52 Other noninfective gastroenteritis and colitis
K12 Stomatitis and related lesions
K13 Other diseases of lip and oral mucosa Other diseases of intestines (K55-K63)
K14 Diseases of tongue K55 Vascular disorders of intestine
K56 Paralytic ileus and intestinal obstruction without hernia
Diseases of oesophagus, stomach and duodenum (K20-K31) K57 Diverticular disease of intestine
K20 Oesophagitis K58 Irritable bowel syndrome
K21 Gastro-oesophageal reflux disease K59 Other functional intestinal disorders
K22 Other diseases of oesophagus K60 Fissure and fistula of anal and rectal regions
K23 Disorders of oesophagus in diseases classified elsewhere K61 Abscess of anal and rectal regions
K25 Gastric ulcer K62 Other diseases of anus and rectum
K26 Duodenal ulcer K63 Other diseases of intestine
K27 Peptic ulcer, site unspecified
K28 Gastrojejunal ulcer Diseases of peritoneum (K65-K67)
K29 Gastritis and duodenitis K65 Peritonitis
K30 Dyspepsia K66 Other disorders of peritoneum
K31 Other diseases of stomach and duodenum K67 Disorders of peritoneum in infectious diseases classified elsewhere
16
L03 Celluliltis
Diseases of liver (K70-K77) L04 Acute lymphadenitis
K70 Alcoholic liver disease L05 Pilonidal cyst
K71 Toxic liver disease L08 Other local infections of skin and subcutaneous tissue
K72 Hepatic failure, not elsewhere classified
K73 Chronic hepatitis, not elsewhere classified Bullous disorders (L10-L14)
K74 Fibrosis and cirrhosis of liver L10 Pemphigus
K75 Other inflammatory liver diseases L11 Other acantholytic disorders
K76 Other diseases of liver L12 Pemphigoid
K77 Liver disorders in diseases classified elsewhere L13 Other bullous disorders
L14 Bullous disorders in diseases classified elsewhere
Disorders of gallbladder, biliary tract and pancreas (K80-K87)
K80 Cholelithiasis Dermatitis and eczema (L20-L30)
K81 Cholecystitis L20 Atopic dermatitis
K82 Other disease of gallbladder L21 Seborrhoeic dermatitis
K83 Other diseases of biliary tract L22 Diaper (napkin) dermatitis
K85 Acute pancreatitis L23 Allergic contact dermatitis
K86 Other diseases of pancreas L24 Irritant contact dermatitis
K87 Disorders of gallbladder, biliary tract and pancreas in diseases L25 Unspecified contact dermatitis
classified elsewhere L26 Exfoliative dermatitis
L27 Dermatitis due to substances taken internally
Other diseases of the digestive system )K90-K93) L28 Lichen simplex chronicus and prurigo
K90 Intestinal malabsorption L29 Pruritus
K91 Postprocedural disorders of digestive system, not elsewhere L30 Other dermatitis
classified
K92 Other diseases of digestive system Papulosquamous disorders (L40-L45)
K93 Disorders of other digestive organs in diseases classified L40 Psoriasis
elsewhere. L41 Parapsoriasis
L42 Pityriasis rosea
Chapter XII L43 Lichen planus
Diseases of the skin and subcutaneous tissue L44 Other papulosquamous disorders
(L00-L99) L45 Papulosquamous disorders in diseases classified elsewhere
Infections of the skin and subcutaneous tissue (L00-L08) Urticaria and erythema (L50-L54)
L00 Staphylococcal scalded skin syndrome L50 Urticaria
L01 Impetigo L51 Erythema multiforme
L02 Cutaneous abscess, furuncle and carbuncle L52 Erythema nodosum
17
L53 Other erythematous conditions L88 Pyoderma gangrenosum
L54 Erythema in diseases classified elsewhere L89 Decubitus ulcer
L90 Atrophic disorders of skin
Radiation-related disorders of the skin and subcutaneous tissue L91 Hypertrophic disorders of skin
(L55-L59) L92 Granulomatous disorders of skin and subcutaneous tissue
L55 Sunburn L93 Lupus erythematosus
L56 Other acute skin changes due to ultraviolet radiation L94 Other localized connective tissue disorders
L57 Skin changes due to chronic exposure to nonionizing radiation L95 Vasculitis limited to skin, not elsewhere classified
L58 Radiodermatitis L97 Ulcer of lower limb, not elsewhere classified
L59 Other disorders of skin and subcutaneous tissue related to L98 Other disorders of skin and subcutaneous tissue, not elsewhere
radiation classified
L99 Other disorders of skin and subcutaneous tissue in diseases classified
Disorders of skin appendages (L60-L75) elsewhere
L60 Nail disorders
L62 Nail disorders in diseases classified elsewhere
L63 Alopecia areata Chapter XIII
L64 Androgenic alopecia Diseases of the musculoskeletal system and connective tissue (M00-
L65 Other nonscarring hair loss M99)
L66 Cicatricial alopecia (scarring hair loss)
L67 Hair colour and hair shaft abnormalities Arthropathies (M00-M25)
L68 Hypertrichosis
L70 Acne Infections arthropathies (M00-M03)
L71 Rosacea M00 Pyogenic arthritis
L72 Follicular cysts of skin ans subcutaneous tissue M01 Direct infections of joint in infectious and parasitic diseases classified
L73 Other follicular disorders elsewhere
L74 Eccrine sweat disorders M02 Reactive arthropathies
L75 Apocrine sweat disorders M03 Postinfective and reactive arthropathies in diseases classified
elsewhere
Other disorders of the skin and subcutaneous tissue (L80-L99)
L80 Vitiligo Inflammatory polyarthropathies (M05-M14)
L81 Other disorders of pigmentation M05 Seropositve rheumatoid arthritis
L82 Seborrhoeic keratosis M06 Other rheumatoid arthritis
L83 Acanthosis nigricans M07 Psoriatic and enteropathic arthropathies
L84 Corns and callosities M08 Juvenile arthritis
L85 Other epidermal thickening M09 Juvenile arthritis in diseases classified elsewhere
L86 Keratoderma in diseases classified elsewhere M10 Gout
L87 Transepidermal elimination disorders M11 Other crystal arthropathies
18
M12 Other specific arthropathies
M13 Other arthritis Spondylopathies (M45-M49)
M14 Arthropathies in other diseases classified elsewhere M45 Ankylosing spondylitis
M46 Other inflammatory spondylopathies
Arthrosis (M15-M19) M47 Spondylosis
M15 Polyarthrosis M48 Other spondylopathies
M16 Coxarthrosis (arthrosis of hip) M49 Spondylopathies in diseases classified elsewhere
M17 Gonarthrosis (arthrosis of knee)
M18 Arthrosis of first carpometacarpal joint Other dorsopathies (M50-M54)
M19 Other arthrosis M50 Cervical disc disorders
M51 Other intervertebral disc disorders
Other joint disorders (M20-M25) M53 Other dorsopathies, not elsewhere classified
M20 Acquired deformities of fingers and toes M54 Dorsalgia
M21 Other acquired deformities of limbs
M22 Disorders of patella Soft tissue disorders (M60-M79)
M23 Internal derangement of knee Disorders of muscles (M60-M63)
M24 Other specific joint derangements M60 Myositis
M25 Other joint disorders, not elsewhere classified M61 Calcification and ossification of muscle
M62 Other disorders of muscle
Systemic connective tissue disorders (M30-M36) M63 Disorders of muscle in diseases classified elsewhere
M30 Polyarteritis nodosa and related conditions
M31 Other necrotizing vasculopathies Disorders of synovium and tendon (M65-M68)
M32 Systemic lupus erythematosus M65 Synovitis and tenosynovitis
M33 Dermatopolymyositis M66 Spontaneous rupture of synovium and tendon
M34 Systemic sclerosis M67 Other disorders of synovium and tendon
M35 Other systemic involvement of connective tissue M68 Disorders of synovium and tendon in diseases classified elsewhere
M36 Systemic disorders of connective tissue in diseases classified
elsewhere Other soft tissue disorders (M70-M79)
M70 Soft tissue disorders related to use, overuse and pressure
Dorsopathies (M40-M54) M71 Other bursopathies
Deforming dorsopathies (M40-M43) M72 Fibroblastic disorders
M40 Kyphosis and lordosis M73 Soft tissue disorders in diseases classified elsewhere
M41 Scoliosis M75 Shoulder lesions
M42 Spinal osteochondrosis M76 Enthesopathies of lower limb, excluding foot
M43 Other deforming dorsopathies M77 Other enthesopathies
M79 Other soft tissue disorders, not elsewhere classified
19
N00 Acute nephritic syndrome
Osteopathies and chondropathies (M80-M94) N01 Rapidly progressive nephritic syndrome
Disorders of bone density and structure (M80-M85) N02 Recurrent and persistent haematuria
N03 Chronic nephritic syndrome
M80 Osteoporosis with pathological fracture N04 Nephrotic syndrome
M81 Osteoporosis without pathological fracture N05 Unspecified nephritic syndrome
M82 Osteoporosis in diseases classified elsewhere N06 Isolated proteinuria with specified morphological lesion
M83 Adult osteomalacia N07 Hereditary nephropathy, not elsewhere classified
M84 Disorders of continuity of bone N08* Glomerular disorders in diseases classified elsewhere
M85 Other disorders of bone density and structure
Renal tubulo-interstitial diseases (N10-N16)
Other osteopathies (M86-M90) N10 Acute tubulo-interstitial nephritis
M86 Osteomyelitis N11 Chronic tubulo-interstitial nephiritis
M87 Osteonecrosis N12 Tubulo-interstitial nephiritis, not specified as acute or chronic
M88 Pagets disease of bone (osteitis deformans) N13 Obstructive and reflux uropathy
M89 Other disorders of bone N14 Drug and heavy-metal-induced tubulo-interstitial and tubular
M90 Osteopathies in diseases classified elsewhere conditions
Chondropathies (M91-M94) N15 Other renal tubulo-interstitial diseases
M91 Juvenile osteochondrosis of hip and pelvis N16* Renal tubulo-interstitial disorders
M92 Other juvenile osteochondrosis
M93 Other osteochondropathies Renal failure (N17-N19)
M94 Other disorders of cartilage N17 Acute renal failure
N18 Chronic renal failure
Other disorders of the musculoskeletal system and connective N19 Unspecified renal failure
tissue (M95-M99)
Urolithiasis(N20-N23)
M95 Other acquired deformities of musculoskeletal system and N20 Calculus of kidney and ureter
connective tissue N21 Calculus of lower urinary tract
M96 Postprocedural musculoskeletal disorders, not elsewhere N22* Calculus of urinary tract in diseases classified elsewhere
classified N23 Unspecified renal colic
M99 Biomechanical lesions, not elsewhere classified.
Other disorders of kidney and ureter(N25-N29)
CHAPTER XIV N25 Disorders resulting from impaired renal tubular function
N26 Unspecified contracted kidney
Diseases of the genitourinary system (N00-N99) N27 Small kidney of unknown cause
N28 Other disorders of kidney and ureter, not elsewhere classified
Glomerular diseases (N00-N08) N29 Other disorders of kidney and ureter in diseases classified elsewhere
20
N71 Inflammatory disease of uterus, except cervix
Other diseases of the urinary system (N30-N39) N72 Inflammatory disease of cervix uteri
N30 Cystitis N73 Other female pelvic inflammatory diseases
N31 Neuromuscular dysfunction of bladder, not elsewhere classified N74 Female pelvic inflammatory disorders in diseases classified elsewhere
N32 Other disorders of bladder N75 Diseases of Bartholins gland
N33 Bladder disorders in diseases classified elsewhere N76 Other inflammation of vagina and vulva
N34 Urethritis and urethral syndrome N77 Valvovaginal ulceration and inflammation in diseases classified
N35 Urethral stricture elsewhere
N36 Other disorders of urethra
N37 Urethral disorders in diseases classified elsewhere Noninflammatory disorders of female genital tract (N80-N98)
N39 Other disorders of urinary system N80 Endometrosis
N81 Female genital prolapse
Diseases of male genital organs (N40-N51) N82 Fistulae involving female genital tract
N40 Hyperplasia of prostate N83 Noninflammatory disorders of ovary, fallopian tube and broad ligament
N41 Inflammaatory diseases of prostate N84 Polyp of female genital tract
N42 Other disorders of prostate N85 Other noninflammatory disorders of uterus, except cervix
N43 Hydrocele and spermatocele N86 Erosion and ectropion of cervix uteri
N44 Torsion of testis N87 Dysplasia of cervix uteri
N45 Orchitis and epididymitis N88 Other noninflammatory disorders of cervix uteri
N46 Male infertility N89 Other noninflammatory disorders of vagina
N47 Redundant prepuce, phimosis and paraphimosis N90 Other noninflammatory disorders of vulva and perineum
N48 Other disorders of penis N91 Absent, scanty and rare menstruation
N49 Inflammatory disorders of male genital organs, not elsewhere N92 Excessive, frequent and irregular menstruation
classified N93 Other abnormal uterine and vaginal bleeding
N50 Other disorders of male genital organs N94 Pain and other conditions associated with female genital organs and
N51 Disorders of male genital organs in diseases classified menstrual cycle.
elsewhere N95 Menopausal and other perimenopausal disorders
N96 Habitual aborter
Disorders of breast (N60-N64) N97 Female infertility
N60 Benign mammary dysplasia N98 Complications associated with artificial fertilization
N61 Inflammatory disorders of breast
N62 Hypertrophy of breast Other disorers of the genitourinary system (N99)
N63 Unspecified lump in breast N99 Postprocedural disorders of genitourinary system not elsewhere
N64 Other disorders of breast classified.
Inflammatory diseases of female pelvic organs (N70-N77)

N70 Salpingitis and oophoritis
21
O25 Malnutrition in pregnancy
Chapter XV O26 Maternal care for other conditions predominantly related to pregnancy
Pregnancy, childbirth and the puerperium ( O00-O99) O28 Abnormal findings on antenatal screening of mother
O29 Complications of anaesthesia during pregnancy
Pregnancy with abortive outcome (O00-O08)
O00 Ectopic pregnancy Maternal care related to the fetus and amniotic cavity and possible
O01 Hydatidiform mole delivery problems (O30-O48)
O02 Other abnormal products of conception O30 Multiple gestation
O03 Spontaneous abortion O31 Complications specific to multiple gestation
O04 Medical abortion O32 Maternal care for known or suspected malpresentation of fetus
O05 Other abortion O33 Maternal care for known or suspected disproportion
O06 Unspecified abortion O34 Maternal care for known or suspected abnormality of pelvic organs
O07 Failed attempted abortion O35 Maternal care for known or suspected fetal abnormality and damage
O08 Complications following abortion and ectopic and molar O36 Maternal care for other known or suspected fetal problems
pregnancy O40 Polyhydramnios
O41 Other disorders of amniotic fluid and membranes
Oedema, proteinuria and hypertensive disorders in pregnancy, O42 Premature rupture of membranes
childbirth and the puerperium (O10-O16) O43 Placental disorders
O10 Pre-existing hypertension complicating pregnancy, childbirth and O44 Placenta praevia
the puerperium O45 Premature separation of placenta (abruptio placentae)
O11 Pre-existing hypertensive disorder with superimposed proteinuria O46 Antepartum haemorrhage, not elsewhere classified
O12 Gestational (pregnancy-induced) oedema and proteinuria without O47 False labour
hypertension O48 Prolonged pregnancy
O13 Gestational (pregnancy-induced) hypertension without significant
proteinuria Complications of labour and delivery (O60-O75)
O14 Gestational (pregnancy-induced) hypertension with significant O60 Preterm delivery
proteinuria O61 Failed induction of labour
O15 Eclampsia O62 Abnormalities of forces of labour
O16 Unspecified maternal hypertension O63 Long labour
O64 Obstructed labour due to malposition and malpresentation of fetus
Other maternal disorders predominantly related to pregnancy O65 Obstructed labour due to maternal pelvic abnormality
(O20-O29) O66 Other obstructed labour
O20 Haemorrhage in early pregnancy O67 Labour and delivery complicated by intrapartum haemorrhage, not
O21 Excessive vomiting in pregnancy elsewhere classified
O22 Venous complications in pregnancy O68 Labour and delivery complicated by fetal stress (distress)
O23 Infections of genitourinary tract in pregnancy O69 Labour and delivery complicated by umbilical cord complications
O24 Diabetes mellitus in pregnancy O70 Perineal laceration during delivery
22
O71 Other obstetric trauma
O72 Postpartum haemorrhage Fetus and newborn affected by maternal factors and by complications of
O73 Retained placenta and membranes, without haemorrhage pregnancy, labour and delivery (P00-P04)
O74 Complications of anaesthesia during labour and delivery P00 Fetus and newborn affected by maternal conditions that may be
O75 Other complications of labour and delivery, not elsewhere unrelated to present pregnancy
classified P01 Fetus and newborn affected by maternal complications of pregnancy
P02 Fetus and newborn affected by complications of placenta, cord and
Delivery (O80-O84) membranes
O80 Single spontaneous delivery P03 Fetus and newborn affected by other complications of labour and
O81 Single delivery by forceps and vacuum extractor delivery
O82 Single delivery by caesarean section P04 Fetus and newborn affected by noxious influences transmitted via
O83 Other assisted single delivery placenta or breast milk.
O84 Multiple delivery
Disorders related to length of gestation and fetal growth (P05-P08)
Complications predominantly related to the puerperium (O85-O92) P05 Slow fetal growth and fetal malnutrition
O85 Puerperal sepsis P07 Disorders related to short gestation and low birth weight, not
O86 Other puerperal infections elsewhere classified
O87 Venous complications in the puerperium P08 Disorders related to long gestation and high birth weight
O88 Obstetric embolism
O89 Complications of anaesthesia during the puerperium Birth trauma (P10-P15)
O90 Complications of the puerperium , not elsewhere classified P10 Intracranial laceration and haemorrhage due to birth injury
O91 Infection of breast associated with childbirth P12 Birth injury to scalp
O92 Other disorders of breast and lactation associated with childbirth P13 Birth injury to skeleton
P14 Birth injury to peripheral nervous system
Other obstetric conditions, not elsewhere classified (O95-O99) P15 Other birth injuries
O95 Obstetric death of unspecified cause
O96 Death from any obstetric cause occurring more than 42 days but Respiratory and cardiovascular disorders specific to the perinatal period
less than one year after delivery (P20-P29)
O97 Death from sequelae of direct obstetric causes P20 Intrauterine hypoxia
O98 Maternal infectious and parasitic diseases classifiable elsewhere P21 Birth asphyxia
but complicating pregnancy, childbirth and the puerperium P22 Respiratory distress of newborn
O99 Other maternal diseases classifiable elsewhere but complicating P23 Congenital pneumonia
pregnancy, childbirth and the puerperium P24 Neonatal aspiration syndromes
P25 Interstitial emphysema and related conditions originating in the
Chapter XVI perinatal period
P26 Pulmonary haemorrhage originating in the perinatal period
Certain conditions originating in the perinatal period (P00-P96) P27 Chronic respiratory disease originating in the perinatal period
23
P28 Other respiratory conditions originating in the perinatal period P77 Necrotizing enterocolitis of fetus and newborn
P29 Cardiovascular disorders originating in the perinatal period P78 Other perinatal digestive system disorders
Infections specific to the perinatal period (P35-P39) Conditions involving the integument and temperature regulation of fetus
P35 Congenital viral diseases and newborn (P80-P83)
P36 Bacterial sepsis of newborn P80 Hypothermia of newborn
P37 Other congenital infectious and parasitic diseases P81 Other disturbances of temperature regulation of newborn
P38 Omphalitis of newborn with or without mild haemorrhage P83 Other conditions of integument specific to fetus and newborn
P39 Other infections specific to the perinatal period
Other disorders originating in the perinatal period (P90-P96)
Haemorrhagic and haemoatological disorders of fetus and newborn P90 Convulsions of newborn
(P50-P61) P91 Other disturbances of cerebral status of newborn
P50 Fetal blood loss P92 Feeding problems of newborn
P51 Umbilical haemorrhage of newborn P93 Reactions and intoxications due to drugs administered to fetus and
P52 Intracranial nontraumatic haemorrhage of fetus and newborn newborn
P53 Haemorrhagic disease of fetus and newborn P94 Disorders of muscle tone of newborn
P54 Other neonatal haemorrhages P95 Fetal death of unspecified cause
P55 Haemolytic disease of fetus and newborn P96 Other conditions originating in the perinatal period
P56 Hydrops fetalis due to haemolytic disease
P57 Kernicterus
P58 Neonatal jaundice due to other excessive haemolysis Chapter XVII
P59 Neonatal jaundice from other and unspecified causes Congenital malformations, deformations and chromosomal
P60 Disseminated intravascular coagulation of fetus and newborn abnormalities (Q00-Q99)
P61 Other perinatal haematological disorders
Congenital malformations of the nervous system (Q00-Q07)
Transitory endocrine and metabolic disorders specific to fetus and Q00 Anencephaly and similar malformation
newborn (P70-P74) Q01 Encephalocele
P70 Transitory disorders of carbohydrate metabolism specific to fetus Q02 Microcephaly
and newborn Q03 Congenital hydrocephalus
P71 Transitory neonatal disorders of calcium and magnesium Q04 Other congenital malformations of brain
metabolism Q05 Spina bifida
P72 Other transitory neonatal endocrine disorders Q06 Other congenital malformations of spinal cord
P74 Other transitory neonatal electrolyte and metabolic disturbances Q07 Other congenital malformations of nervous system
Digestive system disorders of fetus and newborn (P75-P78) Congenital malformations of eye, ear, face and neck (Q10-Q18)
P75 Meconium ileus Q10 Congenital malformations of eyelid,lacrimal apparatus and orbit
P76 Other intestinal obstruction of newborn Q11 Anophthalmos, microphthalmos and macrophthalmos
24
Q12 Congenital lens malformations Q43 Other congenital malformations of intestine
Q13 Congenital malformations of anterior segment of eye Q44 Congenital malformations of gallbladder, bile ducts and liver
Q14 Congenital malformations of posterior segment of eye Q45 Other congenital malformations of digestive system
Q15 Other congenital malformations of eye
Q16 Congenital malformations of ear causing impairment of hearing Congenital malformations of genital organs (Q50-Q56)
Q17 Other congenital malformations of ear Q50 Congenital malformations of ovaries, fallopian tubes and broad
Q18 Other congenital malformations of face and neck ligaments
Q51 Congenital malformations of uterus and cervix
Congenital malformations of the circulatory system (Q20-Q28) Q52 Other congenital malformations of female genitalia
Q20 Congenital malformations of cardiac chambers and connections Q53 Undescended testicle
Q21 Congenital malformations of cardic septa Q54 Hypospadias
Q22 Congenital malformations of pulmonary and tricuspid valves Q55 Other congenital malformations of male genital organs
Q23 Congenital malformations of aortic and mitral valve Q56 Indeterminate sex and pseudohermaphroditism
Q24 Other congenital malformations of heart
Q25 Congenital malformations of great arteries Congenital malformations of the urinary system (Q60-Q64)
Q26 Congenital malformations of great veins Q60 Renal agenesis and other reduction defects of kidney
Q27 Other congenital malformations of peripheral vascular system Q61 Cystic kidney disease
Q28 Other congenital malformations of circulatory system Q62 Congenital obstructive defects of renal pelvis and congenital
malformations of ureter
Congenital malformations of the respiratory system (Q30-Q34) Q63 Other congenital malformations of kidney
Q30 Congenital malformations of nose Q64 Other congenital malformations of urinary system
Q31 Congenital malformations of larynx
Q32 Congenital malformations of trachea and bronchus Congenital malformations and deformations of the musculoskeletal
Q33 Congenital malformations of lung system (Q65-Q79)
Q34 Other congenital malformations of respiratory system Q65 Congenital deformities of hip
Q66 congenital deformities of feet
Cleft lip and cleft palate (Q35-Q37) Q67 Congenital musculoskeletal deformities of head, face, spine and chest
Q35 Cleft palate Q68 Other congenital musculoskeletal deformities
Q36 Cleft lip Q69 Polydactyly
Q37 Cleft palate with cleft lip Q70 Syndactyly
Q71 Reduction defects of upper limb
Other congenital malformations of the digestive system (Q38-Q45) Q72 Reduction of defects of lower limb
Q38 Other congenital malformations of tongue, mouth and pharynx Q73 Reduction defects of unspecified limb
Q39 Congenital malformations of oesophagus Q74 Other congenital malformations of limb(s)
Q40 Other congenital malformations of upper alimentary tract Q75 Other congenital malformations of skull and face bones
Q41 Congenital absence, atresia and stenosis of small intestine Q76 Congenital malformations of spine and bony thorax
Q42 Congenital absence, atresia and stenosis of large intestine Q77 Osteochondrodysplasia with defects of growth of tubular bones and
25
spine
Q78 Other osteochondrodysplasias Chapter XVIII
Q79 Congenital malformations of musculoskeletal system, not
elsewhere classified Symptoms, signs and abnormal clinical and laboratory findings, not
elsewhere classified (R00-R99)
Other congenital malformations (Q80-Q89)
Q80 Congenital ichthyosis Symptoms and signs involving the circulatory and respiratory systems
Q81 Epidermolysis bullosa (R00-R09)
Q82 Other congenital malformations of skin R00 Abnormalities of heart beat
Q83 Congenital malformations of breast R01 Cardiac murmurs and other cardiac sounds
Q84 Other congenital malformations of integument R02 Gangrene, not elsewhere classified
Q85 Phakomatoses, not elsewhere classified R03 Abnormal blood-pressure reading, without diagnosis
Q86 Congenital malformation syndromes due to known exogenous R04 Haemorrhage from respiratory passages
causes, not elsewhere classified R05 Cough
Q87 Other specified congenital malformation syndromes affecting R06 Abnormalities of breathing
multiple system R07 Pain in throat and chest
Q89 Other congenital malformations, not elsewhere classified R09 Other symptoms and signs involving the circulatory and respiratory
system
Chromosomal abnormalities, not elsewhere classified (Q90-Q99)
Q90 Downs syndrome Symptoms and signs involving the digestive system and abdomen
Q91 Edwards syndrome and Pataus syndrome (R10-R19)
Q92 Other trisomies and partial trisomies of the autosomes, not R10 Abdominal and pelvic pain
elsewhere classified R11 Nausea and vomiting
Q93 Monosomies and deletions form the autosomes, not elsewhere R12 Heartburn
classified R13 Dysphagia
Q95 Balanced rearrangements and structural markers, not elsewhere R14 Flatulence and related conditions
classified R15 Faecal incontinence
Q96 Turners syndrome R16 Hepatomegaly and splenomegaly, not elsewhere classified
Q97 Other sex chromosome abnormalities, female phenotype, not R17 Unspecified jaundice
elsewhere classified R18 Ascites
Q98 Other sex chromosome abnormalities, male phenotype, not R19 Other symptoms and signs involving the digestive system and
elsewhere classified abdomen
Q99 Other chromosome abnormalities, not elsewhere classified
Symptoms and signs involving the skin and subcutaneous tissue
(R20-R23)
R20 Disturbances of skin sensation
R21 Rash and other nonspecific skin eruption
26
R22 Localized swelling, mass and lump of skin and subcutaneous R47 Speech disturbances, not elsewhere classified
tissue
R23 Other skin changes R48 Dyslexia and other symbolic dysfunctions, not elsewhere classified
R49 Voice disturbances
Symptoms and signs involving the nervous and musculoskeletal
systems (R25-R29) General symptoms and signs (R50-R69)
R25 Abnormal involuntary movements R50 Fever of unknown origin
R26 Abnormalities of gait and mobility R51 Headache
R27 Other lack of coordination R52 Pain, not elsewhere classified
R28 Other symptoms and signs involving the nervous and R53 Malaise and fatigue
musculoskeletal system R54 Senility
R29 Other symptoms and signs involving the nervous and R55 Syncope and collapse
musculoskeletal systems R56 Convulsions,. Not elsewhere classified
R57 Shock, not elsewhere classified
Symptoms and signs involving the urinary system (R30-R39) R58 Haemorrhage, not elsewhere classified
R30 Pain associated with micturition R59 Enlarged lymph nodes
R31 Unspecified haematuria R60 Oedema, not elsewhere classified
R32 Unspecified urinary incontinenece R61 Hyperhidrosis
R33 Retention of urine R62 Lack of expected normal physiological development
R34 Anuria and oliguria R63 Symptoms and signs concerning food and fluid intake
R35 Polyuria R64 Cachexia
R36 Urethral discharge R68 Other general symptoms and signs
R37 Other symptoms and signs involving the urinary system R69 Unknown and unspecified causes of morbidity
Symptoms and signs involving cognition, perception, emotional Abnormal findings of examination of blood, without diagnosis
state and behaviour (R40-R46) (R70-R79)
R40 Somnolence, stupor and coma R70 Elevated erythrocyte sedimentation rate and abnormality of plasma
R41 Other symptoms and signs involving cognitive functions and viscosity
awareness R71 Abnormality of red blood cells
R42 Dizziness and giddiness R72 Abnormality of white blood cells, not elsewhere classified
R43 Disturbances of smell and taste R73 Elevated blood glucose level
R44 Other symptoms and signs involving general sensations and R74 Abnormal serum enzyme levels
perceptions R75 Laboratory evidence of human immunodeficiency virus (HIV)
R45 Symptoms and signs involving emotional state R76 Other abnormal immunological findings in serum
R46 Symptoms and signs involving appearance and behaviour R77 Other abnormalities of plasma proteins
R78 Findings of drugs and other substances, not normally found in blood
Symtpoms and signs involving speech and voice (R47-R49) R79 Other abnormal findings of blood chemistry
27
causes (S00-T98)
Abnormal findings of examination of urine, without diagnosis Injuries to the head (S00-S09)
(R80-R82) S00 Superficial injury of head
R80 Isolated proteinuria S01 Open wound of head
R81 Glycosuria S02 Fracture of skull and facial bones
R82 Other abnormal findings in urine S03 Dislocation, sprain and strain of joints and ligaments of head
S04 Injury of cranial nerves
Abnormal findings of examination of other body fluids, substances S05 Injury of eye and orbit
and tissues, without diagnosis (R83-R89) S06 Intracranial injury
R83 Abnormal findings in cerebrospinal fluid S07 Crushing injury of head
R84 Abnormal findings in specimens from respiratory organs and S08 Traumatic amputation of part of head
thorax S09 Other and unspecified injuries of head
R85 Abnormal findings in specimens from digestive organs and
abdominal cavity Injuries to the neck (S10-S19)
R86 Abnormal findings in specimens from male genital organs S10 Superficial injury of neck
R87 Abnormal findings in specimens form female genital organs S11 Open wound of neck
R89 Abnormal findings in specimens from other organs, systems and S12 Fracture of neck
tissues S13 Dislocation, sprain and strain of joints and ligaments at neck level
S14 Injury of nerves and spinal cord at neck level
Abnormal findings on diagnostic imaging and in function studies, S15 Injury of blood vessels at neck level
without diagnosis (R90-R94) S16 Injury of muscle and tendon at neck level
R90 Abnormal findings on diagnostic imaging of central nervous S17 Crushing injury of neck
system S18 Traumatic amputation at neck level
R91 Abnormal findings on diagnostic imaging of lung S19 Other and unspecified injuries of neck
R92 Abnormal findings on diagnostic imaging of breast
R93 Abnormal findings on diagnostic imaging of other body structures Injuries to the thorax (S20-S29)
R94 Abnormal results of function studies S20 Superficial injury of thorax
S21 Open wound of thorax
Ill- defined and unknown causes of mortality (R95-R99) S22 Fracture of rib(s), sternum and thoracic spine
R95 Sudden infant death syndrome S23 Dislocation, sprain and strain of joints and ligaments of thorax
R96 Other sudden death, cause unknown S24 Injury of nerves and spinal cord at thorax level
R98 Unattended death S25 Injury of blood vessels of thorax
R99 Other ill-defined and unspecified causes of mortality S26 Injury of heart
S27 Injury of other and unspecified intrathoracic organs
Chapter XIX S28 Crushing injury of thorax and traumatic amputation of part of thorax
Injury, poisoning and certain other consequences of external S29 Other and unspecified injuries of thorax
28
S54 Injury of nerves at forearm level
S55 Injury of blood vessels at forearm level
Injuries to the abdomen, lower back, lumbar spine and pelvis S56 Injury of muscle and tendon at forearm level
(S30-S39) S57 Crushing injury of forearm
S30 Superficial injury of abdomen, lower back and pelvis S58 Traumatic amputation of forearm
S31 Open wound of abdomen, lower back and pelvis S59 Other and unspecified injuries of forearm
S32 Fracture of lumbar spine and pelvis
S33 Dislocation, sprain and strain of joints and ligaments of lumbar Injuries to the wrist and hand (S60-S69)
spine and pelvis S60 Superficial injury of wrist and hand
S34 Injury of nerves and lumbar spinal cord at abdomen, lower back S61 Open wound of wrist and hand
and pelvis level S62 Fracture at wrist and hand level
S35 Injury of blood vessels at abdomen, lower back and pelvis level S63 Dislocation, sprain and strain of joints and ligaments at wrist and hand
S36 Injury of intra-abdominal organs level
S37 Injury of pelvic organs S64 Injury of nerves at wrist and hand level
S38 Crushing injury and traumatic amputation of part of abdomen, S65 Injury of blood vessels at wrist and hand level
lower back and pelvis S66 Injury of muscle and tendon at wrist and hand level
S39 Other and unspecified injuries of abdomen, lower back and S67 Crushing injury of wrist and hand
pelvis S68 Traumatic amputation of wrist and hand
S69 Other and unspecified injuries of wrist and hand
Injuries to the shoulder and upper arm (S40-S49)
S40 Superficial injury of shoulder and upper arm
S41 Open wound of shoulder and upper arm
S42 Fracture of shoulder and upper arm Injuries to the hip and thigh (S70-S79)
S43 Dislocation, sprain and strain of joints and ligaments of shoulder S70 Superficial injury of hip and thigh
girdle S71 Open wound of hip and thigh
S44 Injury of nerves at shoulder and upper arm level S72 Fracture of femur
S45 Injury of blood vessels at shoulder and upper arm level S73 Dislocation, sprain and strain of joint and ligaments of hip
S46 Injury of muscle and tendon at shoulder and upper arm level S74 Injury of nerves at hip and thigh level
S47 Crushing injury of shoulder and upper arm S75 Injury of blood vessels at hip and thigh level
S48 Traumatic amputation of shoulder and upper arm S76 Injury of muscle and tendon at hip and thigh level
S49 Other unspecified injuries of shoulder and upper arm S77 Crushing injury of hip and thigh
S78 Traumatic amputation of hip and thigh
Injuries to the elbow and forearm (S50-S59) S79 Other and unspecified injuries of hip and thigh
S50 Superficial injury of forearm
S51 Open wound of forearm Injuries to the knee and lower leg (S80-S89)
S52 Fracture of forearm S80 Superficial injury of lower leg
S53 Dislocation, sprain and strain of joints and ligaments of elbow S81 Open wound of lower leg
29
S82 Fracture of lower leg, including ankle T11 Other injuries of upper limb, level unspecified
S83 Dislocation, sprain and strain of joints and ligaments of knee T12 Fracture of lower limb, level unspecified
S84 Injury of nerves at lower leg level T13 Other injuries of lower limb, level unspecified
S85 Injury of blood vessels at lower leg level T14 Injury of unspecified body region
S86 Injury of muscle and tendon at lower leg level
S87 Crushing injury of lower leg Effects of foreign body entering through natural orifice (T15-T19)
S88 Traumatic amputation of lower leg T15 Foreign body on external eye
S89 Other and unspecified injuries of lower leg T16 Foreign body in ear
T17 Foreign body in respiratory tract
Injuries to the ankle and foot (S90-S99) T18 Foreign body in alimentary tract
S90 Superficial injury of ankle and foot T19 Foreign body in genitourinary tract
S91 Open wound of ankle and foot
S92 Fracture of foot, except ankle Burns and corrosions (T20-T32)
S93 Dislocation, sprain and strain of joints and ligaments at ankle
and foot level Burns and corrosions of external body surface, specified by site
S94 Injury of nerves at ankle and foot level (T20-T25)
S95 Injury of blood vessels at ankle and foot level T20 Burn and corrosion of head and neck
S96 Injury of muscle and tendon at ankle and foot level T21 Burn and corrosion of trunk
S97 Crushing injury of ankle and foot T22 Burn and corrosion of shoulder and upper limb, except wrist and hand
S98 Traumatic amputation of ankle and foot T23 Burn and corrosion of wrist and hand
S99 Other and unspecified injuries of ankle and foot T24 Burn and corrosion of hip and lower limb, except ankle and foot
T25 Burn and corrosion of ankle and foot
Injuries involving multiple body regions (T00-T07)
T00 Superficial injuries involving multiple body region Burns and corrosions confined to eye and internal organs (T26-T28)
T01 Open wounds involving multiple body regions T26 Burn and corrosion confined to eye and adnexa
T02 Fractures involving multiple body regions T27 Burn and corrosion of respiratory tract
T03 Dislocations, sprains and strains involving multiple body regions T28 Burn and corrosion of other internal organs
T04 Crushing injuries involving multiple body regions
T05 Traumatic amputations involving multiple body region Burns and corrosions of multiple and unspecified body regions
T06 Other injuries involving multiple body regions, not elsewhere (T29-T32)
classified T29 Burns and corrosions of multiple body regions
T07 Unspecified multiple injuries T30 Burn and corrosion, body region unspecified
T31 Burns classified according to extent of body surface involved
Injuries to unspecified part of trunk, limb or body region (T08-T14) T32 Corrosions classified according to extent of body surface involved
T08 Fracture of spine, level unspecified
T09 Other injuries of spine and trunk, level unspecified Frostbite (T33-T35)
T10 Fracture of upper limb, level unspecified T33 Superficial frostbite
30
T34 Frostbite with tissue necrosis hydrocarbons
T35 Frostbite involving multiple body regions and unspecified T54 Toxic effect of corrosive substances
frostbite T55 Toxic effect of soaps and detergents
Poisoning by drugs, medicaments and biological substances T56 Toxic effect of metals
(T36-T50) T57 Toxic effect of other inorganic substances
T36 Poisoning by systemic antibiotics T58 Toxic effect of carbon monoxide
T37 Poisoning by other systemic anti-infectives and antiparasitics T59 Toxic effect of other gases, fumes and vapours
T38 Poisoning by hormones and their synthetic substitutes and T60 Toxic effect of pesticides
antagonists, not elsewhere classified T61 Toxic effect of noxious substances eaten as seafood
T39 Poisoning by nonopioid analgesics, antipyretics and T62 Toxic effect of other noxious substances eaten as food
antirheumatics T63 Toxic effect of contact with venomous animals
T40 Poisoning by narcotics and psychodysleptics (hallucinogens) T64 Toxic effect of aflatoxin and other mycotoxin food contaminants
T41 Poisoning by anaesthetics and therapeutic gases T65 Toxic effect of other and unspecified substances
T42 Poisoning by antiepileptic, sedative-hypnotic and
antiparkinsonism drugs Other and unspecified effects of external causes (T66-T78)
T43 Poisoning by psychotropic drugs, not elsewhere classified T66 Unspecified effect of radiation
T44 Poisoning by drugs primarily affecting the autonomic nervous T67 Effects of heat and light
system T68 Hypothermia
T45 Poisoning by primarily systemic and haematological agents, not T69 Other effects of reduced temperature
elsewhere classified T70 Effects of air pressure and water pressure
T46 Poisoning by agents primarily affecting the cardiovascular T71 Asphyxiation
system T73 Effects of other deprivation
T47 Poisoning by agents primarily affecting the gastrointestinal T74 Maltreatment syndromes
system T75 Effects of other external causes
T48 Poisoning by agents primarily acting on smooth and skeletal T78 Adverse effects, not elsewhere classified
muscles and the respiratory system
T49 Poisoning by topical agents primarily affecting skin and mucous Certain early complications of trauma (T79)
membrane and by ophthalmological, otorhinolaryngological and T79 Certain early complications of trauma, not elsewhere classified
dental drugs
T50 Poisoning by diuretics and other and unspecified drugs, Complications of surgical and medical care, not elsewhere classified
medicaments and biological substances (T80-T88)
T80 Complications following infusion, transfusion and therapeutic injection
Toxic effects of substances chiefly nonmedicinal as to source T81 Complications of procedures, not elsewhere classified
(T51-T65) T82 Complications of cardiac and vascular prosthetic devices, implants
T51 Toxic effect of alcohol and grafts
T52 Toxic effect of organic solvents T83 Complications of genitourinary prosthetic devices, implants and grafts
T53 Toxic effect of halogen derivatives of aliphatic and aromatic T84 Complications of internal orthopaedic prosthetic devices, implants and
31
grafts
T85 Complications of other internal prosthetic devices, implants and Pedal cyclist injured in transport accident (V10-V19)
grafts V10 Pedal cyclist injured in collision with pedestrian or animal
T86 Failure and rejection of transplanted organs & tissues V11 Pedal cyclist injured in collision with other pedal cycle
T87 Complications peculiar to reattachment and amputation V12 Pedal cyclist injured in collision with two or three wheeled motor
T88 Other complications of surgical and medical care, not elsewhere vehicle
classified V13 Pedal cyclist injured in collision with car pick-up truck or van
V14 Pedal cyclist injured in collision with heavy transport vehicle or bus
Sequelae of injuries, of poisoning and of other consequences of V15 Pedal cyclist injured in collision with railway train or railway vehicle
external causes (T90-T98) V16 Pedal cyclist injured in collision with other nonmotor vehicle
T90 Sequelae of injuries of head V17 Pedal cyclist injured in collision with fixed or stationary object
T91 Sequelae of injuries of neck and trunk V18 Pedal cyclist injured in noncollision transport accidents
T92 Sequelae of injuries of upper limb injury V19 Pedal cyclist injured in other and unspecified transport accidents
T93 Sequelae of injuries of lower limb
T94 Sequelae of injuries involving multiple and unspecified body Motorcycle rider injured in transport accident (V20-V29)
regions V20 Motorcycle rider injured in collision with pedestrian or animal
T95 Sequelae of burns, corrosions and frostbite V21 Motorcycle rider injured in collision with pedal cycle
T96 Sequelae of poisoning by drugs, medicaments and biological V22 Motorcycle rider injured in collision with two or three wheeled motor
substances vehicle
T97 Sequelae of toxic effects of substances chiefly nonmedicinal as V23 Motorcycle rider injured in collision with car pick-up truck or van
to source V24 Motorcycle rider injured in collision with heavy transport vehicle or bus
T98 Sequelae of other and unspecified effects of external causes. V25 Motorcycle rider injured in collision with railway train or railway vehicle
V26 Motorcycle rider injured in collision with other non motor vehicle
Chapter XX V27 Motorcycle rider injured in collision with fixed or stationary object
External causes of morbidity and mortality (V01-Y99) V28 Motorcycle rider injured in noncollision transport accident
V29 Motorcycle rider injured in other and unspecified transport accident
Transport accidents (V01-V99)
Occupant of three wheeled motor vehicle injured in transport accident
Pedestrian injured in transport accident (V01-V09) (V30-V39)
V01 Pedestrian injured in collision with pedal cycle V30 Occupant of three wheeled motor vehicle injured in collision with
V02 Pedestrian injured in collision with two or three wheeled motor pedestrian or animal
vehicle V31 Occupant of three wheeled motor vehicle injured in collision with pedal
V03 Pedestrian injured in collision with car, pick-up truck or van cycle
V04 Pedestrian injured in collision with heavy transport vehicle or bus V32 Occupant of three wheeled motor vehicle injured in collision with two
V05 Pedestrian injured in collision with railway train or railway vehicle or three wheeled motor vehicle
V06 Pedestrian injured in collision with other nonmotor vehicle V33 Occupant of three wheeled motor vehicle injured in collision with car
V09 Pedestrian injured in other and unspecified transport accidents pick-up truck or van
32
V34 Occupant of three wheeled motor vehicle injured in collision with V53 Occupant of pick-up truck or van injured in collision with car, pick-up
heavy transport vehicle or bus truck or van
V35 Occupant of three wheeled motor vehicle injured in collision with V54 Occupant of pick-up truck or van injured in collision with heavy
railway train or railway vehicle transport vehicle or bus
V36 Occupant of three wheeled motor vehicle injured in collision with V55 Occupant of pick-up truck or van injured in collision with railway train
nonmotor vehicle or railway vehicle
V37 Occupant of three wheeled motor vehicle injured in collision with V56 Occupant of pick-up truck or van injured in collision with other
fixed or stationary object nonmotor vehicle
V38 Occupant of three wheeled motor vehicle injured in noncollision V57 Occupant of pick-up truck or van injured in collision with fixed or
transport accident stationary object
V39 Occupant of three wheeled motor vehicle injured in other and V58 Occupant of pick-up truck or van injured in noncollision transport
unspecified transport accident accident
V59 Occupant of pick-up truck or van injured in other and unspecified
Car occupant injured in transport accident (V40-49) transport accidents
V40 Car occupant injured in collision with pedestrian or animal
V41 Car occupant injured in collision with pedal cycle Occupant of heavy transport vehicle injured in transport accident
V42 Car occupant injured in collision with two or three-wheeled motor (V60-V69)
cycle V60 Occupant of heavy transport vehicle injured in collision with pedestrian
V43 Car occupant injured in collision with car, pick-up truck or van or animal
V44 Car occupant injured in collision with heavy transport vehicle or V61 Occupant of heavy transport vehicle injured in collision with pedal
bus cycle
V45 Car occupant injured in collision with railway train or railway V62 Occupant of heavy transport vehicle injured in collision with two or
vehicle three wheeled motor vehicle
V46 Car occupant injured in collision with other nonmotor vehicle V63 Occupant of heavy transport vehicle injured in collision with car, pick-
V47 Car occupant injured in collision with fixed or stationary object up truck or van
V48 Car occupant injured in noncollision transport accident V64 Occupant of heavy transport vehicle injured in collision with heavy
V49 Car occupant injured in other and unspecified transport transport vehicle or bus
accidents V65 Occupant of heavy transport vehicle injured in collision with railway
train or railway vehicle
Occupant of pick-up truck or van injured in transport accident V66 Occupant of heavy transport vehicle injured in collision with other
(V50-V59) nonmotor vehicle
V50 Occupant of pick-up truck or van injured in collision with V67 Occupant of heavy transport vehicle injured in collision with fixed or
pedestrian or animal stationary object
V51 Occupant of pick-up truck or van injured in collision with pedal V68 Occupant of heavy transport vehicle injured in noncollision transport
cycle accident
V52 Occupant of pick-up truck or van injured in collision with two or V69 Occupant of heavy transport vehicle injured in collision with
three-wheeled motor vehicle unspecified transport accidents.
33
Water transport accidents (V90-V94)
Bus occupant injured in transport accident (V70-V79)
V70 Bus occupant injured in collision with pedestrian or animal V90 Accident to watercraft causing drowning and submersion
V71 Bus occupant injured in collision with pedal cycle V91 Accident to watercraft causing other injury
V72 Bus occupant injured in collision with two or three wheeled motor V92 Water transport related drowning and submersion without accident to
vehicle watercraft
V73 Bus occupant injured in collision with car, pick up truck or van V93 Accident on board watercraft without accident to watercraft, not
V74 Bus occupant injured in collision with heavy transport vehicle or causing drowning and submersion
bus V94 Other and unspecified water transport accident
V75 Bus occupant injured in collision with railway train or railway
vehicle Air and space transport accidents (V95-V97)
V76 Bus occupant injured in collision with other nonmotor vehicle V95 Accident to powered aircraft causing injury to occupant
V77 Bus occupant injured in collision with fixed or stationary object V96 Accident to nonpowered aircraft causing injury to occupant
V78 Bus occupant injured in noncollision transport accident V97 Other specified air transport accidents
V79 Bus occupant injured in other and unspecified transport
accidents Other and unspecified transport accidents (V98-V99)
V98 Other specified transport accidents
Other land transport accidents (V80-V89) V99 Unspecified transport accident
V80 Animal rider or occupant of animal-drawn vehicle injured in
transport accident Other external causes of accidental injury (W00-X59)
V81 Occupant of railway train or railway vehicle injured in transport
accident Falls (W00-W19)
V82 Occupant of streetcar injured in transport accident W00 Fall on same level involving ice and snow
V83 Occupant of special vehicle mainly used on industrial premises W01 Fall on same level from slipping, tripping and stumbling
injured in transport accident W02 Fall involving ice-skates, skis, roller-skates or skateboards
V84 Occupant of special vehicle mainly used in agriculture injured in W03 Other fall on same level due to collision with, or pushing by, another
transport accident person
V85 Occupant of special construction vehicle injured in transport W04 Fall while being carried or supported by other persons
accident W05 Fall involving wheelchair
V86 Occupant of special all terrain or other motor vehicle designed W06 Fall involving bed
primarily for off-road use, injured in transport accident W07 Fall involving chair
V87 Traffic accident of specified type but victims mode of transport W08 Fall involving other furniture
unknown W09 Fall involving playground equipment
V88 Nontraffic accident of specified type but victims mode of W10 Fall on and from stairs and steps
transport unknown W11 Fall on and from ladder
V89 Motor or nonmotor vehicle accident, type of vehicle unspecified W12 Fall on and from scaffolding
W13 Fall from, out of or through building or structure
34
W14 Fall from tree
W15 Fall from cliff Exposure to animate mechanical forces (W50-W64)
W16 Diving or jumping into water causing injury other than drowning W50 Hit, struck, kicked, twisted, bitten or scratched by another person
or submersion W51 Striking against or bumped into by another person
W17 Other fall from one level to another W52 Crushed, pushed and stepped on by crowd or human stampede
W18 Other fall on same level W53 Bitten by rat
W19 Unspecified fall W54 Bitten or struck by dog
W55 Bitten or struck by other mammals
Exposure to inanimate mechanical forces (W20-W49) W56 Contact with marine animal
W20 Struck by thrown, projected or falling object W57 Bitten or stung by nonvenomous insect and other nonvenomous
W21 Striking against or struck by sports equipment arthropods
W22 Striking against or struck by other objects W58 Bitten or struck by crocodile or alligator
W23 Caught, crushed, jammed or pinched in or between object W59 Bitten or crushed by other reptiles
W24 Contact with lifting and transmission devices, not elsewhere W60 Contact with plant thorns and spines and sharp leaves
classified W61 Exposure to other and unspecified animate mechanical forces
W25 Contact with sharp glass Accidental drowning and submersion (W65-W74)
W26 Contact with knife, sword or dagger W65 Drowning and submersion while in bath-tub
W27 Contact with nonpowered hand tool W66 Drowning and submersion following fall into bath-tub
W28 Contact with powered lawonmower W67 Drowning and submersion while in swimming-pool
W29 Contact with other powered hand tools and household machinery W68 Drowning and submersion following fall into swimming-pool
W30 Contact with agricultural machinery W69 Drowning and submersion while in natural water
W31 Contact with other and unspecified machinery W70 Drowning and submersion following fall into natural water
W32 Handgun discharge W71 Other specified drowning and submersion
W33 Rifle, shotgun and larger firearm discharge W74 Unspecified drowning and submersion
W34 Discharge form other and unspecified firearms
W35 Explosion and rupture of boiler Other accidental threats to breathing (W75-W84)
W36 Explosion and rupture of gas cylinder W75 Accidental suffocation and strangulation in bed
W37 Explosion and rupture of pressurized tyre, pipe or hose W76 Other accidental hanging and strangulation
W38 Explosion and rupture of other specified pressurized devices W77 Threat to breathing due to cave in, falling earth and other substances
W39 Discharge of firework W78 Inhalation of gastric contents
W40 Explosion of other materials W79 Inhalation and ingestion of food causing obstruction of respiratory
W41 Exposure to high-pressure jet tract
W42 Exposure to noise W80 Inhalation and ingestion of other objects causing obstruction of
W43 Exposure to vibration respiratory tract
W44 Foreign body entering into or through eye or natural orifice W81 Confined to or trapped in a low-oxygen environment
W45 Foreign body or object entering through skin W83 Other specified threats to breathing
W49 Exposure to other and unspecified inanimate mechanical forces W84 Unspecified threat to breathing
35
X15 Contact with hot household appliances
X16 Contact with hot heating appliances, radiators and pipes
X17 Contact with hot engines, machinery and tools
X18 Contact with other hot metals
Exposure to electric current, radiation and extreme ambient air X19 Contact with other and unspecified heat and hot substances
temperature and pressure (W85-W99)
W85 Exposure to electric transmission lines Contact with venomous animals and plants (X20-X29)
W86 Exposure to other specified electric current X20 Contact with venomous snakes and lizards
W87 Exposure to unspecified electric current X21 Contact with venomous spiders
W88 Exposure to ionizing radiation X22 Contact with scorpions
W89 Exposure to man-made visible and ultraviolet light X23 Contact with hornets, wasps and bees
W90 Exposure to other nonionizing radiation X24 Contact with centipedes and venomous millipedes (tropical)
W91 Exposure to unspecified type of radiation X25 Contact with other specified venomous arthropods
W92 Exposure to excessive heat of man-made origin X26 Contact with venomous marine animals and plants
W93 Exposure to excessive cold of man-made origin X27 Contact with other specified venomous animals
W94 Exposure to high and low air pressure and changes in air X28 Contact with other specified venomous plants
pressure X29 Contact with unspecified venomous animal or plant
W95 Exposure to other and unspecified man-made environmental
factors Exposure to forces of nature (X30-X39)
X30 Exposure to excessive natural heat
Exposure to smoke, fire and flames (X00-X09) X31 Exposure to excessive natural cold
X00 Exposure to uncontrolled fire in building or structure X32 Exposure to sunlight
X01 Exposure to uncontrolled fire, not in building or structure X33 Victim of lightning
X02 Exposure to controlled fire in building or structure X34 Victim of earthquake
X03 Exposure to controlled fire, not in building or structure X35 Victim of volcanic eruption
X04 Exposure to ignition of highly flammable material X36 Victim of avalanche, landslide and other earth movements
X05 Exposure to ignition or melting of nightwear X37 Victim of cataclysmic storm
X06 Exposure to ignition or melting of other clothing and apparel X38 Victim of flood
X08 Exposure to other specified smoke, fire and flames X39 Exposure to other and unspecified forces of nature
X09 Exposure to unspecified smoke, fire and flames
Accidental poisoning by and exposure to noxious substances
Contact with heat and hot substances (X10-X19) (X40-X49)
X10 Contact with hot drinks, food, fats and cooking oils X40 Accidental poisoning by and exposure to nonopioid analgesics,
X11 Contact with hot tap-water antipyretics and antirheumatics
X12 Contact with other hot fluids X41 Accidental poisoning by and exposure to antiepileptic,
X13 Contact with steam and hot vapours sedativehypnotic, antiparkinsonism and psychotropic drugs, not
X14 Contact with hot air and gases elsewhere classified
36
X42 Accidental poisoning by and exposure to narcotics and X64 Intentional self-poisoning by and exposure to other and unspecified
psychodysleptics (hallucinogens), not elsewhere classified drugs, medicaments and biological substances
X43 Accidental poisoning by and exposure to other drugs acting on X65 Intentional self-poisoning by and exposure to alcohol
the autonomic nervous system X66 Intentional self-poisoning by and exposure to organic solvents and
X44 Accidental poisoning by and exposure to other and unspecified halogenated hydrocarbons and their vapours
drugs, medicaments and biological substances X67 Intentional self-poisoning by and exposure to other gases and vapours
X45 Accidental poisoning by and exposure to alcohol X68 Intentional self-poisoning by and exposure to pesticides
X46 Accidental poisoning by and exposure to organic solvents and X69 Intentional self-poisoning by and exposure to other and unspecified
halogenated hydrocarbons and their vapours chemicals and noxious substances
X47 Accidental poisoning by and exposure to other gases and X70 Intentional self-harm by hanging, strangulation and suffocation
vapours X71 Intentional self-harm by drowning and submersion
X48 Accidental poisoning by and exposure to pesticides X72 Intentional self-harm by handgun discharge
X49 Accidental poisoning by and exposure to other and unspecified X73 Intentional self-harm by rifle, shotgun and larger firearm discharge
chemicals and noxious substances X74 Intentional self-harm by other and unspecified firearm discharge
X75 Intentional self-harm by explosive material
Overexertion, travel and privation (X50-X57) X76 Intentional self-harm by smoke, fire and flames
X50 Overexertion and strenuous or repetitive movements X77 Intentional self-harm by steam, hot vapours and hot objects
X51 Travel and motion X78 Intentional self-harm by sharp object
X52 Prolonged stay in weightless environment X79 Intentional self-harm by blunt object
X53 Lack of food X80 Intentional self-harm by jumping from a high place
X54 Lack of water X81 Intentional self-harm by jumping or lying before moving object
X57 Unspecified privation X82 Intentional self-harm by crashing of motor vehicle
X83 Intentional self-harm by other specified means
Accidental exposure to other and unspecified factors (X58-X59) X84 Intentional self-harm by unspecified means
X58 Exposure to other specified factors
X59 Exposure to unspecified factors Assault (X85-Y09)
X85 Assault by drugs, medicaments and biological substances
Intentional self-harm (X60-X84) X86 Assault by corrosive substance
X60 Intentional self-poisoning by and exposure to nonopioid X87 Assault by pesticides
analgesics, antipyretics and antirheumatics X88 Assault by gases and vapours
X61 Intentional self-poisoning by and exposure to antiepileptic, X89 Assault by other specified chemicals and noxious substances
sedative-hypnotic, antiparkinsonism and psychotropic drugs, not X90 Assault by unspecified chemical or noxious substance
elsewhere classified X91 Assault by hanging, strangulation and suffocation
X62 Intentional self-poisoning by and exposure to narcotics and X92 Assault by drowning and submersion
psychodysleptics (hallucinogens), not elsewhere classified X93 Assault by handgun discharge
X63 Intentional self-poisoning by and exposure to other drugs acting X94 Assault by rifle, shotgun and larger firearm discharge
on the autonomic nervous system X95 Assault by other and unspecified firearm discharge
37
X96 Assault by explosive material Y23 Rifle, shotgun and larger firearm discharge, undermined intent
X97 Assault by smoke, fire and flames Y24 Other and unspecified firearm discharge, undermined intent
X98 Assault by steam, hot vapours and hot object Y25 Contact with explosive material, undetermined intent
X99 Assault by sharp object Y26 Exposure to smoke, fire and flames, undetermined intent
Y00 Assault by blunt object Y27 Contact with steam, hot vapours and hot objects, undetermined intent
Y01 Assault by pushing from high place Y28 Contact with sharp object, undetermined intent
Y02 Assault by pushing or placing victim before moving object Y29 Contact with blunt object, undetermined intent
Y03 Assault by crashing of motor vehicle Y30 Falling, jumping or pushed from a high place, undetermined intent
Y04 Assault by bodily force Y31 Falling, lying or running before or into moving object, undetermined
Y05 Sexual assault by bodily force intent
Y06 Neglect and abandonment Y32 Crashing or motor vehicle, undetermined intent
Y07 Other maltreatment syndromes Y33 Other specified events, undetermined intent
Y08 Assault by other specified means Y34 Unspecified event, undetermined intent
Y09 Assault by unspecified means
Legal intervention and operations of war (Y35-Y36)
Event of undermined intent (Y10-Y34) Y35 Legal intervention
Y10 Poisoning by and exposure to nonopioid analgesics, antipyretics Y36 Operations of war
and antirheumatics, undetermined intent
Y11 Poisoning by and exposure to antiepileptic, sedative-hypnotic, Complications of medical and surgical care (Y40-Y84)
antiparkinsonism and psychotropic drugs, not elsewhere
Y12 Poisoning by and exposure to narcotics and psychodysleptics Drugs, medicaments and biological substances causing adverse effects
(hallucinogens) not elsewhere classified, undetermined intent in therapeutic use (Y40-Y59)
Y13 Poisoning by and exposure to other drugs acting on the Y40 Systemic antibiotics
autonomic nervous system, undetermined intent Y41 Other systemic anti-infectives and antiparastitics
Y14 Poisoning by and exposure to other and unspecified drugs, Y42 Hormones and their synthetic substitutes and antagonists, not
medicaments and biological substances, undetermined intent elsewhere classified
Y15 Poisoning by and exposure to alcohol, undetermined intent Y43 Primarily systemic agents
Y16 Poisoning by and exposure to organic solvents and halogenated Y44 Agents primarily affecting blood constituents
hydrocarbons and their vapours, undetermined intent Y45 Analgesics, antipyretics and anti-inflammatory drugs
Y17 Poisoning by and exposure to other gases and vapours, Y46 Antiepileptics and antiparkinsonism drugs
undetermined intent Y47 Sedatives, hyhpnotics and antianxiety drugs
Y18 Poisoning by and exposure to pesticides, undetermined intent Y48 Anaesthetics and therapeutic gases
Y19 Poisoning by and exposure to other and unspecified chemicals Y49 Psychotropic drugs, not elsewhere classified
and noxious substances, undetermined intent Y50 Central nervous system stimulants, not elsewhere classified
Y20 Hanging, strangulation and suffocation, undetermined intent Y51 Drugs primarily affecting the autonomic nervous system
Y21 Drowning and submersion, undetermined intent Y52 Agents primarily affecting the cardiovascular system
Y22 Handgun discharge, undetermined intent Y53 Agents primarily affecting the gastrointestinal system
38
Y54 Agents primarily affecting water-balance and mineral and uric Y78 Radiological devices associated with adverse incidents
acid metabolism Y79 Orthopaedic devices associated with adverse incidents
Y55 Agents primarily acting on smooth and skeletal muscles and the Y80 Physical medicine devices associated with adverse incidents
respiratory system Y81 General and plastic-surgery devices associated with adverse incidents
Y56 Topical agents primarily affecting skin and mucous membrane Y82 Other and unspecified medical devices associated with adverse
and ophthalmological, otorhinolaryngological and dental drug incidents
Y57 Other and unspecified drugs and medicaments
Y58 Bacterial vaccines Surgical and other medical procedures as the cause of abnormal
Y59 Other and unspecified vaccines and biological substances reaction of the patient, or of later complication, without mention of
misadventure at the time of the procedure (Y83-Y84)
Misadventures to patients during surgical and medical care Y83 Surgical operation and other surgical procedure as the cause of
(Y60-Y69) abnormal reaction of the patient, or of later complication, without
mention of misadventure at the time of the procedure
Y60 Unintentional cut, puncture, perforation or haemorrhage during Y84 Other medical procedures as the cause of abnormal reaction of the
surgical and medical care patient, or of later complication, without mention of misadventure at
Y61 Foreign object accidentally left in body during surgical and the time of the procedure
medical care
Y62 Failure of sterile precautions during surgical and medical care Sequelae of external causes of morbidity and mortality (Y85-Y89)
Y63 Failure in dosage during surgical and medical care Y85 Sequelae of transport accidents
Y64 Contaminated medical or biological substances Y86 Sequelae of other accidents
Y65 Other misadventures during surgical and medical care Y87 Sequelae of intentional self-harm, assault and events of undetermined
Y66 Nonadministration of surgical and medical care intent
Y69 Unspecified misadventure during surgical and medical care Y88 Sequelae of surgical and medical care as external cause
Y89 Sequelae of other external causes
Medical devices associated with adverse incidents in diagnostic
and therapeutic use (Y70-Y82) Supplementary factors related to causes of morbidity and mortality
Y70 Anaesthesiology devices associated with adverse incidents classified elsewhere (Y90-Y98)
Y71 Cardiovascular devices associated with adverse incidents Y90 Evidence of alcohol involvement determined by blood alcohol level
Y72 Otorhinolaryngological devices associated with adverse incidents Y91 Evidence of alcohol involvement determined by level of intoxication
Y73 Gastroenterology and urology devices associated with adverse Y95 Nosocomial condition
incidents Y96 Work-related condition
Y74 General hospital and personal-use devices associated with Y97 Environmental-pollution-related condition
adverse incidents Y98 Lifestyle-related condition
Y75 Neurological devices associated with adverse incidents
Y76 Obstetric and gynaecological devices associated with adverse Chapter XXI
incidents
Y77 Ophthalmic devices associated with adverse incidents Factors influencing health status and contact with health services (Z00-
39
Z99)
Persons encountering health services in circumstances related to
reproduction (Z30-Z39)
Persons encountering health services for examination and Z30 Contraceptive management
investigation (Z00-Z13) Z31 Procreative management
Z00 General examination and investigation of persons without Z32 Pregnancy examination and test
complaint or reported diagnosis Z33 Pregnant state, incidental
Z01 Other special examinations and investigations of persons without Z34 Supervision of normal pregnancy
complaint or reported diagnosis Z35 Supervision of high-risk pregnancy
Z02 Examination and encounter for administrative purposes Z36 Antenatal screening
Z03 Medical observation and evaluation for suspected diseases and Z37 Outcome of delivery
conditions Z38 Liveborn infants according to place of birth
Z04 Examination and observation for other reasons Z39 Postpartum care and examination
Z08 Follow-up examination after treatment for malignant neoplasm
Z09 Follow-up examination after treatment for conditions other than Persons encountering health services for specific procedures and health
malignant neoplasm care (Z40-Z54)
Z10 Routine general health check-up of defined subpopulation Z40 Prophylactic surgery
Z11 Special screening examination for infectious and parasitic Z41 Procedures for purposes other than remedying health state
diseases Z42 Follow-up care involving plastic surgery
Z12 Special screening examination for neoplasm Z43 Attention to artificial openings
Z13 Special screening examination for other diseases and disorders Z44 Fitting and adjustment of external prosthetic device
Z45 Adjustment and management of implanted device
Persons with potential health hazards related to communicable Z46 Fitting and adjustment of other devices
diseases (Z20-Z29) Z47 Other orthopaedic follow-up care
Z48 Other surgical follow-up care
Z20 Contact with and exposure to communicable diseases Z49 Care involving dialysis
Z21 Asymptomatic human immunodeficiency virus (HIV) infection Z50 Care involving use of rehabilitation procedures
status Z51 Other medical care
Z22 Carrier of infectious disease Z52 Donors of organs and tissues
Z23 Need for immunization against single bacterial diseases Z53 Persons encountering health services for specific procedures, not
Z24 Need for immunization against certain single viral diseases carried out
Z25 Need for immunization against other single viral diseases Z54 Convalescence
Z26 Need for immunization against other single infectious diseases
Z27 Need for immunization against combinations of infectious Persons with potential health hazards related to socioeconomic and
diseases psychosocial circumstances (Z55-Z65)
Z28 Immunization not carried out Z55 Problems related to education and literacy
Z29 Need for other prophylactic measures Z56 Problems related to employment and unemployment
40
Z57 Occupational exposure to risk-factor Z91 Personal history of risk-factors, not elsewhere classified
Z58 Problems related to physical environment Z92 Personal history of medical treatment
Z59 Problems related to housing and economic circumstances Z93 Artificial opening status
Z60 Problems related to social environment Z94 Transplanted organ and tissue status
Z61 Problems related to negative life events in childhood Z95 Presence of cardiac and vascular implants and grafts
Z62 Other problems related to upbringing Z96 Presence of other functional implants
Z63 Other problems related to primary support group, including family Z97 Presence of other devices
circumstances Z98 Other postsurgical states
Z64 Problems related to certain psychosocial circumstances Z99 Dependence on enabling machines and devices, not elsewhere
Z65 Problems related to other psychosocial circumstances classified.
Persons encountering health services in other circumstances

(Z70-Z76)
Z70 Counselling related to sexual attitude, behaviour and orientation
Z71 Persons encountering health services for other counselling and
medical advice, not elsewhere classified
Z72 Problems related to lifestyle
Z73 Problems related to life management difficulty
Z74 Problems related to care-provider dependency
Z75 Problems related to medical facilities and other health care
Z76 Persons encountering health services in other circumstances
Persons with potential health hazards related to family and personal

history and certain conditions influencing health status (Z80-Z99)
Z80 Family history of malignant neoplasm
Z81 Family history of mental and behavioural disorders
Z82 Family history of certain disabilities and chronic diseases leading
to disablement
Z83 Family history of other specific disorders
Z84 Family history of other conditions
Z85 Personal history of malignant neoplasm
Z86 Personal history of certain other diseases
Z87 Personal history of other diseases and conditions
Z88 Personal history of allergy to drugs, medicaments and biological
substances
Z89 Acquired absence of limb
Z90 Acquired absence of organs, not elsewhere classified
41
Summary
MCCD Scheme is implemented under RBD Act, 1969, Section 10(2) (3) and
Maharashtra Registration of Births and Deaths Rules, 2000-Rule 7.
It is obligatory to the attending physician/surgeon to certify death in
form No. 4/4A.
It is the legal responsibility of the head of institutions to submit MCCD to the
local Registrar.
Fill in form No.4 for institutional deaths and 4A for domiciliary events but
certified by private medical practitioners.
Do not fill in MCCD form 4/4A for still births.
Each and every column of certificate should be filled in.
Cause of Death :-
(I) Write the immediate cause, first.
(ii) Antecedent cause on next line.
(iii) Underlying cause, last.
In case of injury and poisoning- Write the type of injury and the part of the
body involved and supplementary cause of injury/poisoning.
In case of deaths due to HIV/AIDS write the seropositive status along with
opportunistic infection or disease conditions responsible for fatal outcome.
International Classification of Diseases 10th Revision (ICD-10) is used for
classification of causes of deaths.

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MCCD_Training

Office of the Dy. Director of Health

Medical Certification of Cause of Death Scheme was introduced for the

Part II : Other significant conditions :

Enter all other diseases or conditions believed to have influenced the

6) LACUNAE SEEN IN THE CERTIFICATION OF CAUSE OF DEATH IN FORM

Manner of Death How did the injury occur ?

1. Natural 2. Accident 3. Suicide 4. Homicide Accidental collision of rickshaw and

In case of assault, specific cause should be written e.g. in case of assault

7) REPORTING UNITS OF MCCD:

Urban :- 1) Municipal Corporations 23

Rural :- 1) Rural/Cottage Hospitals 345

Head of Medical Private Medical Medical Medical

5th of every month 5th of every month

9) RESPONSIBILITIES OF A PHYSICIAN ABOUT MCCD SCHEME :

10) EXPECTATIONS FROM HEAD OF MEDICAL INSTITUTION

6. Regular review of MCCD in monthly meeting.

* Data for the year 2009 are provisional.

Name of the Hospital .............................................................................................. I hereby certify that the

NAME OF DECEASED For use of

Manner of Death How did the injury occur ?

1. Natural 2. Accident 3. Suicide 4. Homicide

SEE REVERSE FOR INSTRUCTIONS

Certified that Shri/Smt./Kum. ............................................................................. S/W/D of Shri

NAME OF DECEASED For use of

SEE REVERSE FOR INSTRUCTIONS

Certified that Shri/Smt./Kum. ............................................................................. S/W/D of Shri

A Classification of diseases may be defined as a system of categories to

1.5.2 Volume- II:-

1.5.3 Volume- III:-

1.6 Inclusion of newly emerged diseases like HIV/AIDS in ICD-10 :-

Due to HIV infection, immune mechanism is broken down because of

1) Initial infection with HIV virus and development of antibodies.

An alarming factor in the AIDS epidemic is increasing link between HIV

Incorrect Cause of Death Correct Cause of Death

Manner of Death Manner of Death

Incorrect Cause of Death Correct Cause of Death

Manner of Death Manner of Death

Incorrect Cause of Death Correct Cause of Death

Manner of Death Manner of Death

Incorrect Cause of Death Correct Cause of Death

CAUSE OF DEATH Interval between ICD

CAUSE OF DEATH Interval between ICD

Manner of Death How did the injury occur ?

In case of AIDS deaths it is necessary to write immediate cause of death in

8. A male patient, aged 54 years was admitted to hospital on 11/1/2001 complaining

CAUSE OF DEATH Interval between ICD

CAUSE OF DEATH Interval between ICD

Manner of Death How did the injury occur ?

CAUSE OF DEATH Interval between ICD

CAUSE OF DEATH Interval between ICD

CAUSE OF DEATH Interval between ICD

CAUSE OF DEATH Interval between ICD

Manner of Death How did the injury occur?

1 Natural 2 Accident 3 Suicide 4 Homicide 5 Pending Investigation

CAUSE OF DEATH Interval between ICD

Manner of Death How did the injury occur?

CAUSE OF DEATH Interval between ICD

Manner of Death How did the injury occur ?