ICD-10-Mortality Fetal Manual

Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2024

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U.S. Department of Health and Human Services

Centers for Disease Control and Prevention

National Center for Health Statistics

INSTRUCTIONS FOR THE AUTOMATED CLASSIFICATION OF THE INITIATING AND MULTIPLE CAUSES OF FETAL DEATHS, 2024

SECTION I:听听听 General Concepts For Coding Fetal Deaths

A.听听听听听 INTRODUCTION

This manual provides instructions to NCHS mortality medical coders and nosologists for coding multiple causes of fetal death reported on the 2003 Revision of the Fetal Death Reports filed in the states. These mortality coding instructions are used by the National Center for Health Statistics (NCHS), which is the Federal agency responsible for the compilation of U.S. statistics on causes of fetal death. NCHS is part of the Centers of Disease Control and Prevention.

In coding causes of fetal death, NCHS refers to the World Health Organization鈥檚 most recent revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) for processing the data for fetal mortality tabulation.

Beginning with fetal deaths occurring in 1999, ICD-10 has been used for coding and classifying causes of fetal death. This revision of the Classification is published by the World Health Organization (WHO) and consists of three volumes. Volume 1 contains a list of three-character categories, the tabular list of inclusions, and the four-character sub-categories. The supplementary Z code Classification appears in Volume 1 but is not used for classifying mortality cause of death data, including fetal deaths. Optional fifth characters are provided for certain categories and an optional independent four-character coding system is provided to classify histological varieties of neoplasm, prefixed by the letter M (for morphology) and followed by a fifth character indicating behavior. These optional codes are not used at NCHS. Volume 2 includes the international rules and notes used in classifying and tabulating cause of death data including fetal death data. Volume 3 is an alphabetical index containing a comprehensive list of terms and codes for use in coding. Copies of these volumes may be purchased. See ordering information at https://www.who.int/classifications/icd/en/.

NCHS prepares updated versions of Volume 1 and Volume 3 annually /nchs/nvss/instruction_manuals.htm The major purpose of these updated versions is to provide and maintain a single published source of new and/or corrected code assignments including terms not indexed in Volume 3 and/or not classified in Volume 1 of ICD-10.

Each year, all the major revisions from previous manuals will be documented in the Introduction of this manual under the heading 鈥淢ajor Revisions from Previous Manuals鈥�.

This manual documents concepts and instructions for coding multiple causes of fetal death consistent with the provisions of ICD-10. This manual should be used in conjunction with the latest updated versions of ICD-10, Volumes 1 and 3 and the Perinatal Subset of medical terms. The Perinatal Subset is a list of terms classified to Chapter XVI, Certain conditions originating in the perinatal period (P00-P96). It is updated annually.

ICD-10 provides for the classification of certain medical conditions according to two different axes - the etiology or initiating disease process, referred to as the 鈥渄agger鈥� code, and the manifestation or complication code, referred to as the 鈥渁sterisk鈥� code. NCHS uses and publishes only the dagger codes. This dual system was introduced in the Ninth Revision of the ICD and remained an integral part of the ICD-10.

For example, Coxsackie myocarditis has a code (B33.2鈥�) marked with a 鈥渄agger鈥� in Chapter 1, Certain infectious and parasitic diseases and a different code (I41.1*) marked with an 鈥渁sterisk鈥� in Chapter 9, Diseases of the circulatory system. NCHS only codes the B33.2. Similarly, diabetic nephropathy has a dagger code (E14.2鈥�) in Chapter IV, Endocrine, nutritional and metabolic diseases and an asterisk code (N08.3*) in Chapter XIV, Diseases of the genitourinary system. NCHS only codes the E14.2.

The fetal death multiple cause codes are used as inputs to the ACME System (Automated Classification of Medical Entities) which was developed by NCHS to automatically select the underlying cause of death and the TRANSAX System (Translation of Axes) used to produce multiple cause of death statistics, beginning with deaths occurring in 1968. ACME will be used as the automated system for selecting the initiating cause of fetal deaths. The ACME System requires codes be assigned for each condition reported on the Fetal Death Report, usually in the order the information is recorded on the report. The output data of the system are the initiating causes of fetal deaths assigned by applying the underlying cause Selection Rule 3 and Modification Rules A-E of the Classification. These rules are documented in the ICD-10, Volume 2. The same cause is selected as if one applied the manual cause of fetal death coding instructions specified in Instruction Manual 2J, Instructions for the Manual Classification of the Initiating Cause of Fetal Deaths, 2012.

/nchs/nvss/instruction_manuals.htm

Major revisions from previous manuals

1.听听听听听听 Corrections have been made to clarify instructions, spelling, and format throughout the manual. These changes are not specifically noted.

2. 听听听听听听Added new symbol "99" in Appendix A

3.听听听听听听听Added new ITOP reporting in Appendix I

Other manuals relating to coding causes of death are:

Part 2a, NCHS Instructions for Classifying the Underlying Cause of Death, 2024

Part 2b, Instructions for Classifying Multiple Causes of Death, 2024

Part 2c, ICD-10 ACME Decision Tables for Classifying the Underlying Causes of Death, 2024

Part 2s, SuperMICAR Data Entry Instruction, 2011

B.听听听听听 DEFINITIONS

Fetal Death is defined as 鈥渄eath prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy and which is not an induced termination of pregnancy. The death is indicated by the fact that after such expulsion or extraction, the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps.鈥�

Induced Termination of Pregnancy (Abortion) is defined as 鈥減urposeful interruption of an intrauterine pregnancy with the intention other than to produce a liveborn infant and which does not result in a live birth.鈥� This definition excludes management of prolonged retention of products of conception following fetal death.

Ectopic pregnancy reported with an intentional intervention An ectopic pregnancy reported with an intentional intervention, such as 鈥渞emoval of embryo鈥�, is not included in the fetal death file. Records with this type of event reported will be identified by the coder and proper steps taken for removal.

Live Birth is defined as 鈥渢he expulsion or extraction from its mother of a product of human conception, irrespective of the duration of the pregnancy, which, after such expulsion or extraction, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached. Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps.鈥� "

This manual only includes instructions on coding causes of fetal deaths which includes 鈥渟pontaneous abortions鈥�. Terms interpreted as spontaneous abortions are included in Appendix G.

Induced abortions and live births are not included in the fetal death file. Terms interpreted as induced abortions are included in Appendix H.

C.听听听听听 Item 18. CAUSE/CONDITIONS CONTRIBUTING TO FETAL DEATH

The U.S. Standard Report of Fetal Death provides spaces for a certifier to record pertinent information concerning the diseases, morbid conditions, and injuries which either resulted in or contributed to a fetal death. The CAUSE/CONDITIONS CONTRIBUTING TO FETAL DEATH portion of the Fetal Death Report includes items 18a and 18b. It is designed to obtain the opinion of the certifier as to the initiating cause and prompts the certifier to report specific conditions.

A cause of fetal death is the morbid condition or disease process, abnormality, injury, or poisoning leading directly to fetal death. The initiating cause of fetal death is the disease or injury, which initiated the chain of morbid events leading directly to death or the circumstances of the accident or violence, which produced fatal injury. A fetal death often results from the combined effect of two or more conditions. These conditions may be completely unrelated, arising independently of each other or they may be causally related to each other; that is, one cause may lead to another which in turn, leads to a third cause, etc.

The format in the 2003 Revision of the Fetal Death Report which the certifier is requested to record the causes of fetal death facilitates the selection of the initiating cause when two or more causes are reported. He or she is requested to report an initiating condition in Item 18a and all remaining causes in Item 18b.

D.听听听听听 INCLUSIONS IN THE FILE

In some circumstances, the conditions reported in 18. Cause/Conditions Contributing to Fetal Death may indicate that this is not a fetal death. If the event does not meet the definition of a fetal death, the records will be removed automatically.

Induced terminations of pregnancy should be included in the fetal death file only when the fetus was known dead before the procedure and when the induction was performed for the sole purpose of removing an already-dead fetus. The term 鈥渋nduced termination of pregnancy鈥� implies an induced termination of the pregnancy in progress, not one in which the fetal death has already occurred. Appendix G contains a list of terms not considered as induced abortions and that are coded as fetal deaths.

Image of US standard fetal death certificate

SECTION II:听听 General Instructions

A.听听听听听 INTRODUCTION

EXCERPT FROM U.S. STANDARD REPORT OF FETAL DEATH (Rev. 11/2003)听听听听听听听听听

18. CAUSE/CONDITIONS CONTRIBUTING TO FETAL DEATH

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听18a. INITIATING CAUSE/CONDITION听听听听听听听听听听听18b. OTHER SIGNIFICANT CAUSES OR听听听听听听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听CONDITIONS听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听SELECT THE ONE WHICH MOST LIKELY听听听听听听听听听(SELECT OR SPECIFY ALL OTHER听听听听听听听听听听听听

听BEGAN THE SEQUENCE OF EVENTS听听听听听听听听听听听听听CONDITIONS CONTRIBUTING TO DEATH听听听听听听听听

听RESULTING IN THE DEATH OF THE FETUS)听听听听听IN ITEM 18b)听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Maternal Conditions/Diseases听听听听听听听听听听听听听Maternal Conditions/Diseases听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Complications of Placenta, Cord, or听听听听听听Complications of Placenta, Cord,听or听听听听听

听Membranes听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Membranes听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听鈽愄齊upture of membranes prior to听听听听听听听听听听鈽愄齊upture of membranes prior to听听听听听听听听

听听听听onset of labor听听听听听听听听听听听听听听听听听听听听听听听听听听听onset of labor听听听听听听听听听听听听听听听听听听听听听听听

听鈽愄鼳bruptio placenta听听听听听听听听听听听听听听听听听听听听听听鈽愄鼳bruptio placenta听听听听听听听听听听听听听听听听听听听听

听鈽愄齈lacental insufficiency听听听听听听听听听听听听听听听听鈽愄齈lacental insufficiency听听听听听听听听听听听听听听

听鈽愄齈rolapsed cord听听听听听听听听听听听听听听听听听听听听听听听听听鈽愄齈rolapsed cord听听听听听听听听听听听听听听听听听听听听听听听

听鈽愄鼵horioamnionitis听听听听听听听听听听听听听听听听听听听听听听听鈽愄鼵horioamnionitis听听听听听听听听听听听听听听听听听听听听听

听鈽愄齇ther听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听鈽愄齇ther听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Other Obstetrical or Pregnancy听听听听听听听听听听听Other Obstetrical or Pregnancy听听听听听听听听听听

听Complications听听听听听听听听听听听听听听听听听听听听听听听听听听听听Complications听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Fetal Anomaly听听听听听听听听听听听听听听听听听听听听听听听听听听听听Fetal Anomaly听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Fetal Injury听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Fetal Injury听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Fetal Infection听听听听听听听听听听听听听听听听听听听听听听听听听听Fetal Infection听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Other Fetal Conditions/Disorders听听听听听听听听听Other Fetal Conditions/Disorders听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听鈽愄齍nknown听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听鈽愄齍nknown听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code all information reported in Item 18 of the Fetal Death Report, 鈥�CAUSE/CONDITIONS CONTRIBUTING TO FETAL DEATH鈥�

Refer to the sex of the fetus to assign the most appropriate cause of fetal death code.

In Volumes 1 and 3 of ICD-10 and the Perinatal Subset, the fourth-character subcategories of three-character categories are preceded by a decimal point. For coding purposes, omit the decimal point.

The data will be entered in the same format for coding and entering multiple causes of fetal deaths as used for coding multiple causes of death for regular mortality data and will be processed through Underlying cause selection Rule 3 and the Modification Tables of the ACME System Decision Tables. A screen will be generated in the same format used for entering regular mortality multiple cause data. The State File Number will also be generated.

Enter codes in 18a as if reported on the uppermost line of Part I of the regular death certificate in the same order as the entries they represent, proceeding from the entry reported uppermost, downward and from the left to right. Terms requiring special formatting may affect the placement of codes. If the lower line is an obvious continuation of a line above, enter the codes accordingly. When an identical code applies to more than one condition reported, enter the code for the first-mentioned of these conditions only. If the entries are numbered, code in numeric order.

Enter codes in 18b as if reported in Part II of the regular death certificate in the same order as the entries they represent, proceeding from the entry reported uppermost, downward and from the left to right. If the lower line is an obvious continuation of a line above, enter the codes accordingly. When an identical code applies to more than one condition reported, enter the code for the first-mentioned of these conditions only.

NOTE: Repetitive (identical) codes are acceptable, if reported once in 18a (Part 1) and once in 18b (Part II). They are not acceptable if reported together in 18a (Part 1) or together in 18b (Part II).

EXAMPLE:

听听18a. INITIATING CAUSE/CONDITION听听听听听听听听听听听18b. OTHER SIGNIFICANT CAUSES OR听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听SELECT THE ONE WHICH MOST LIKELY听听听听听听听听听(SELECT OR SPECIFY ALL OTHER听听听听听听听听听听听听

听BEGAN THE SEQUENCE OF EVENTS听听听听听听听听听听听听听CONDITIONS CONTRIBUTING TO DEATH听听听听听听听听

听RESULTING IN THE DEATH OF THE FETUS)听听听听听IN ITEM 18b)听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Maternal Conditions/Diseases听听听听听听听听听听听听听Maternal Conditions/Diseases听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Complications of Placenta, Cord, or听听听听听听Complications of Placenta, Cord,听or听听听听听

听

听鈽愄齊upture of membranes prior to听听听听听听听听听听鈽愄齊upture of membranes prior to听听听听听听听听

听听听听onset of labor听听听听听听听听听听听听听听听听听听听听听听听听听听听onset of labor听听听听听听听听听听听听听听听听听听听听听听听

听鈽愄鼳bruptio placenta听听听听听听听听听听听听听听听听听听听听听听鈽愄鼳bruptio placenta听听听听听听听听听听听听听听听听听听听听

听鈽愄齈lacental insufficiency听听听听听听听听听听听听听听听听鈽愄齈lacental insufficiency听听听听听听听听听听听听听听

听X听Prolapsed cord听听听听听听听听听听听听听听听听听听听听听听听听听鈽愄齈rolapsed cord听听听听听听听听听听听听听听听听听听听听听听听

听鈽愄鼵horioamnionitis听听听听听听听听听听听听听听听听听听听听听听听鈽愄鼵horioamnionitis听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Other Obstetrical or Pregnancy听听听听听听听听听听听Other Obstetrical or Pregnancy听听听听听听听听听听

听Complications听听听听听听听听听听听听听听听听听听听听听听听听听听听听Complications听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)听听Breech delivery听听听听听听听听听听听听听听

听

听Fetal Anomaly听听听听听听听听听听听听听听听听听听听听听听听听听听听听Fetal Anomaly听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Fetal Injury听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Fetal Injury听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Fetal Infection听听听听听听听听听听听听听听听听听听听听听听听听听听Fetal Infection听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)_____________________________听听听(Specify)_____________________________听听

听

听Other Fetal Conditions/Disorders听听听听听听听听听Other Fetal Conditions/Disorders听听听听听听听听

听(Specify)听听fetal distress听听听听听听听听听听听听听听听听(Specify)听fetal heart failure during听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听delivery听听听听听听听听听听听听听听听听听听听听听听

听

听鈽愄齍nknown听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听鈽愄齍nknown听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code in this order, Part 1 (18a) prolapsed cord, fetal distress, Part II (18b) breech delivery affecting fetus and fetal heart failure.

B.听听听听听 EXCESSIVE CODES

When a line in 18a (Part I) or 18b (Part II) requires more than eight codes, delete the excessive codes (any over eight) for the line using the following criteria in the order listed:

NOTE: During the deletion process, when the numbers of existing codes become eight, discontinue the deletion process. The ACME System can tolerate a record with eight codes per line.

1.听听 Delete ill-defined conditions, P042, P070, P071, P072, P073, P201, P209, P219, P95, and R000-R99 (except when one of these codes is the first code on the line), proceeding right to left.

2.听听 Delete any nature of injury codes classified to S000-T983 (except when one of these codes is the first code on the line), proceeding right to left.

3.听听 Delete any repetitive codes (except the first one on a line) proceeding right to left.

4.听听 If, after applying the preceding criteria, 18a or 18b still has more than eight codes, delete beginning with the last code on the line until only eight remain.

When a single record requires more than fourteen codes, delete the excessive codes using the following criteria in the order listed:

NOTE: During the deletion process, when the number of existing codes become fourteen, discontinue the deletion process. The ACME System can tolerate a record with fourteen codes.

Begin deleting in 18b (Part II).

1.听听 Delete all ill-defined conditions classified to P042, P070, P071, P072, P073, P201, P209, P219, P95 and R000-R99 in 18b (Part II). Do not delete an ill-defined condition when it is the first code in 18b (Part II). Proceed deleting right to left in 18b (Part II). If there are more than fourteen codes remaining after deleting the ill-defined codes in 18b (Part II), delete any of the above ill-defined codes in 18a (Part I) applying the same criteria and order of deletion.

2.听听 Delete any nature of injury codes classified to S000-T983. Do not delete a nature of injury code when it is the first code in 18b (Part II). Proceed deleting right to left in 18b (Part II). If there are more than fourteen codes remaining after deleting the nature of injury codes in 18b (Part II), delete any of the above nature of injury codes in 18a (Part I) applying the same criteria and order of deletion.

3.听听 Delete any repetitive codes. Do not delete a repetitive code when it is the first code in 18b (Part II). If there are more than fourteen codes remaining after deleting the repetitive codes in 18b (Part II), delete repetitive codes in 18a (Part I), applying the same criteria and order of deletion. Proceed right to left until there are only fourteen codes remaining on the record.

C.听听听听听 GENERAL CODING CONCEPT

The coding of cause of fetal death information consists of the assignment of the most appropriate ICD-10 code(s) for each diagnostic entity reported on the Fetal Death Report. In order to arrive at the appropriate code for a diagnostic entity, code each entity separately. Do not apply provisions in ICD-10 for linking two or more diagnostic terms to form a composite diagnosis classifiable to a single ICD-10 code.

听

Plural form of disease

Do not use the plural form of a disease or the plural form of a site to indicate 鈥渕ultiple鈥�.

EXAMPLE: Congenital defects听听听 Q899

Code Q899, Defect, congenital. Do not code Q897, multiple congenital defects.

听

Implied 鈥渄isease鈥�

When an adjective or noun form of a site is entered as a separate diagnosis, i.e., it is not part of the entry immediately preceding or following it, assume the word 鈥渄isease鈥� after the site and code accordingly.

听

Drug dependent, drug dependency

When drug dependent or drug dependency modifies a condition, consider as a non-codable modifier unless indexed.

听

Conditions qualified by 鈥渞ule out,鈥� 鈥渞uled out,鈥� 鈥渞/o鈥�

When a condition is qualified by 鈥渞ule out,鈥� 鈥渞uled out,鈥� or 鈥渞/o,鈥� etc., do not enter a code for the condition.

听

Non-indexed and illegible entries

Terms not indexed

When a term is reported that is not in the index, enter 鈥淧95鈥� on the record where a code for the non-indexed term would go. If there are other classifiable entries reported, disregard the non-indexed term and code the remaining entries as indexed.

Illegible entries

When an illegible entry is the only entry on the report, code P95. When an illegible entry is reported with other classifiable entries, disregard the illegible entry and code the remaining entries as indexed.

听

Qualifying Conditions as Acute or Chronic

Acute and chronic

Sometimes the terms acute and chronic are reported preceding two or more conditions. In these cases, use the term (鈥渁cute鈥� or 鈥渃hronic鈥�) with the condition it immediately precedes.

听

Punctuation Marks

1.听听 Disregard punctuation marks such as a period, comma, semicolon, colon, dash, slash, question mark or exclamation mark when placed at the end of a line in 18a. Do not apply this instruction to a hyphen (-) which indicates a word is incomplete.

2.听听 When conditions are separated by a slash (/), code each condition as indexed.

3.听听 When a dash (-) or slash (/) is used to separate sites reported with one condition and the combination of the sites is indexed to a single ICD-10 code, disregard the punctuation and code as indexed. This does not apply to commas.

4.听听 When conditions are indexed together, yet separated by a comma, code the conditions separately. If the term following the comma is an adjective, refer to instructions on coding adjectival modifiers.

D.听听听听听 Definitions and Types of Diagnostic Entities

A diagnostic entity is a single term or a composite term, comprised of one word or of two or more adjoining words, that is used to describe a disease, nature of injury, or other morbid condition. In this manual, diagnostic entity and diagnostic term are used interchangeably. A diagnostic entity may indicate the existence of a condition classifiable to a single ICD-10 category or it may contain elements of information that are classifiable to different ICD-10 categories. For coding purposes, it is necessary to distinguish between two different kinds of diagnostic entities - a 鈥渙ne-term entity,鈥� and a 鈥渕ultiple one-term entity.鈥�

One-term entity

1.听听 A one-term entity is a diagnostic entity classifiable to a single ICD-10 code.

2.听听 A diagnostic term that contains one of the following adjectival modifiers indicates the condition modified has undergone certain changes and is considered to be a one-term entity:

adenomatous听听听听听hypoxemic

anoxic听听听听听听听听听听hypoxic

congestive听听听听听听inflammatory

cystic听听听听听听听听听听ischemic

embolic听听听听听听听听听necrotic

erosive听听听听听听听听听obstructed, obstructive

gangrenous听听听听听听ruptured

hemorrhagic

听听听听听听听听听 (These instructions apply to the above adjectival modifiers only.)

听听听听听听听听听 For code assignment, apply the following criteria in the order stated:

a.听听 If the modifier and lead term are indexed together, code as indexed.

b.听听 If the modifier is not indexed under the lead term, but 鈥渟pecified鈥� is, use the code for specified (usually .8).

c.听听听 If neither the modifier nor 鈥渟pecified鈥� is indexed under the lead term, refer to Volume 1 under the NOS code for the lead term and look for an applicable specified 4th character subcategory.

d.听听 If neither a, b, or c apply, code the lead term without the modifier.

Multiple one-term entity

A multiple one-term entity is a diagnostic entity consisting of two or more contiguous words on a line for which the Classification does not provide a single code for the entire entity but does provide a single code for each of the components of the diagnostic entity. Consider as a multiple one-term entity if each of the components can be considered as separate one-term entities, i.e., they can stand alone as separate diagnosis. Code each component of the multiple one-term entity as indexed and on the same line where reported.

Adjectival modifiers

NOTE: Code an adjective reported at the end of a diagnostic entity as if it preceded the entity. If indexed to a single code, use that code. If not indexed together, follow the instructions for coding multiple one-term entities.

1.听听 If an adjectival modifier is reported with more than one condition, modify only the first condition.

2.听听 If an adjectival modifier is reported with one condition and more than one site is reported, modify all sites.

3.听听 If an adjectival modifier precedes two different diseases that are reported with a connecting term, modify only the first disease.

4.听听 If the adjectival form of a word(s) or a qualifier(s) is reported in parenthesis, use the adjective to modify the term preceding it.

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE SELECT THE ONE WHICH MOST LIKELY听听听

听BEGAN THE SEQUENCE OF EVENTS RESULTING IN THE DEATH OF THE FETUS)听听听

听

听Maternal Conditions/Diseases听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify) Diabetic nephrosis and vascular disease听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part 1) to P701 P003.

Code 18a (Part I) P701, Maternal condition, affecting fetus or newborn, diabetes mellitus (conditions in E10-E14) and P003, Maternal condition, affecting fetus or newborn, circulatory disease, (conditions in I00-I99, Q20-Q28). Do not modify the vascular disease as diabetic since there are two separate diseases reported with a connecting term.

Parenthetical Entries

When one medical entity is reported, followed by another complete medical entity enclosed in parenthesis, disregard the parenthesis and code as separate terms.

a)听听 When the adjective form of words or qualifiers are reported in parenthesis, use the adjectives to modify the entity preceding it.

b)听听 If the term in parenthesis is not a complete term and is not a modifier, consider as part of the preceding term.

EXAMPLES:

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听听(AMONG THE CHOICES BELOW, PLEASE SELECT THE ONE WHICH MOST LIKELY听听听听

听听BEGAN THE SEQUENCE OF EVENTS RESULTING IN THE DEATH OF THE FETUS)听听听听

听

听听Maternal Conditions/Diseases听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify) Diabetic renal disease (Nephrosis)听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part 1) P701 P001.

Code 18a (Part I) P701, Maternal condition, affecting fetus or newborn, diabetes mellitus (conditions in E10-E14) and P001, Maternal condition, affecting fetus or newborn, nephritis, nephrotic syndrome and nephrosis (conditions in N00-N08). Nephrosis enclosed in parenthesis is a complete medical entity that can stand alone; therefore, code as a separate entity.

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE SELECT THE ONE WHICH MOST LIKELY听听听

听BEGAN THE SEQUENCE OF EVENTS RESULTING IN THE DEATH OF THE FETUS)听听听

听

听Maternal Conditions/Diseases听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify) Renal disease (Diabetic)听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part 1) P701.

Code 18a (Part I) P701, Maternal condition, affecting fetus or newborn, diabetes mellitus (conditions in E10-E14). Code as Diabetic renal disease. Consider 鈥淒iabetic鈥� as an adjective modifying renal disease.

E.听听听听听听 CODING FETAL CONDITIONS

Conditions of the fetus can be coded to almost any category in the list of valid codes (Appendix D) other than P000-P049 but will most often be coded to categories P050-P95, Perinatal conditions and Q000-Q999, Congenital anomalies.

In assigning codes for conditions of the fetus, code as indexed in this priority order:

fetus

fetal

affecting fetus or newborn

fetus or newborn

congenital

However, pay special attention to the availability of a relevant code in the Perinatal Subset. There is a subset of Volume 3, the alphabetical index, dedicated to perinatal conditions and referred to as the Perinatal Subset. NCHS provides this as a separate document to assist coders in identifying conditions indexed as 鈥渇etus and newborn鈥� or classified to Chapter XVI. It is updated annually.

EXAMPLES:

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE SELECT THE ONE WHICH MOST LIKELY听听听

听BEGAN THE SEQUENCE OF EVENTS RESULTING IN THE DEATH OF THE FETUS)听听听

听

听Fetal anomaly听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify) Congenital diaphragmatic hernia听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part 1) Q790.

Code 18a (Part I) Q790, Hernia, diaphragm, diaphragmatic, congenital since not indexed as fetus, fetal, affecting fetus or newborn, fetus or newborn or newborn. or less than 28 days.

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE SELECT THE ONE WHICH MOST LIKELY听听听

听BEGAN THE SEQUENCE OF EVENTS RESULTING IN THE DEATH OF THE FETUS)听听听

听

听Other Fetal Conditions/Disorders听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify) Central respiratory failure听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part 1) G938

Code 18a (Part 1) G938, Failure, respiratory, central since central respiratory failure is not indexed as fetus, fetal, fetus or newborn or congenital. G938 is a valid fetal death code. Refer to Appendix D for a list of Valid Fetal Death Codes.

F.听听听听听听 CODING MATERNAL CONDITIONS

Maternal conditions affecting the fetus should be coded to categories P000-P049. When conditions of the mother directly impact the fetus and are reported on the Fetal Death Report and the condition is not indexed, refer to Volume I, Chapter XVI to categories P000-P049, Fetus and newborn affected by maternal factors and by complications of pregnancy, labor and delivery. Also, refer to the Index under:

Maternal condition, affecting fetus or newborn

Pregnancy, complicated by

Delivery, complicated by

Labor

The complication itself, such as Placenta, abnormality, affecting fetus or newborn.

EXAMPLES:

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE SELECT THE ONE WHICH MOST LIKELY听听听

听BEGAN THE SEQUENCE OF EVENTS RESULTING IN THE DEATH OF THE FETUS)听听听

听

听Maternal Conditions/Diseases听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify) Maternal malnutrition听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part I) P004

Code 18a (Part I) P004, Maternal malnutrition affecting fetus or newborn as indexed.

Assign category P008 to maternal conditions not indexed or classifiable to any other specified category. A list of all conditions not indexed and assigned code P008 will be maintained and will be added to the annual update of Volume 3 and also included in the Perinatal Subset. Please refer all conditions assigned to code P008 to Supervisor and/or a designated contact to ensure they will be incorporated into the next annual edition of Volume 3 and the Perinatal Subset.

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE SELECT THE ONE WHICH MOST LIKELY听听听

听BEGAN THE SEQUENCE OF EVENTS RESULTING IN THE DEATH OF THE FETUS)听听听

听

听Maternal Conditions/Diseases听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify) Crohn disease听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part 1) P008

Code 18a (Part 1) P008, Maternal condition, affecting fetus or newborn, Crohn's disease.

Complications of Placenta, Cord, or Membranes

When the checkbox items in 18a and 18b are marked, each should be assigned codes as follows:

听Rupture of membranes prior to onset of labor

听Abruptio placenta

听Placental insufficiency

听Prolapsed cord

听Chorioamnionitis

听Other (specify)

If the checkbox for rupture of membranes prior to onset of labor is marked, assign code P011.

If the checkbox for abruptio placenta is marked, assign code P021.

If the checkbox for placental insufficiency is marked, assign code P022.

If the checkbox for prolapsed cord is marked, assign code P024.

If the checkbox for chorioamnionitis is marked, assign code P027.

If the checkbox for Other is marked ‘Y鈥� and no codeable condition or a condition classified to P95 is reported in the ‘Other (specify)鈥�, assign codes P022, P026, and P029; regardless of whether any of the previous boxes have been checked.

If specified conditions are written in the ‘Other (specify)鈥�, code the condition to the mother unless obviously of the fetus. (example, anencephaly - the absence of a large part of the brain and the skull; this is clearly a condition of the fetus.)听听听听听听听听听听听

鈽愄鼺etal injury听听听 If reported as a result of an external cause, the instructions for coding external causes on regular mortality data will apply.

鈽愄齍nknown听听听听听听 code P95 (only if no other information is on record)

EXAMPLES:

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Complications of Placenta, Cord, or Membranes听听听听听听听听听听听听听听听听听听听听听听听

听

听Other:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Other:听听Y听听听听听听听听听听听听听听听听听听听听听

听

听Other (specify) Unknown听听听听听听听听OR听听听听听Other (specify):听听NONE听听听听听听听听

听

Code 18a (Part I) P022 P026 P029

Code 18a (Part I) P022 P026 P029, complication of placenta, cord, or membranes. It seems that the certifier is saying yes, there is a complication of the placenta, cord, or membranes: they鈥檙e just not sure what the specific complication is.

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Complications of Placenta, Cord, or Membranes听听听听听听听听听听听听听听听听听听听听听听听

听

听Rupture of membranes:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Other:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Other (specify):听听Previous Birth听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part I) P011 P022 P026 P029

Code 18a (Part I) P011, Rupture of membranes and P022, P026, P029 complication of placenta, cord, or membranes since the checkbox is marked ‘Y鈥� and previous birth is not a codeable condition.

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Complications of Placenta, Cord, or Membranes听听听听听听听听听听听听听听听听听听听听听听听

听

听Other:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Other (specify):听听Twin-Twin Transfusion Syndrome听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part I) P023

Code 18a (Part I) P023, Twin-Twin Transfusion Syndrome. Since a codeable condition is reported in the ‘Other (specify)鈥�, do not assign the 3 codes for complication of placenta, cord, or membranes.

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Complications of Placenta, Cord, or Membranes听听听听听听听听听听听听听听听听听听听听听听听

听

听Other:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Other (specify):听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听18b. OTHER SIGNIFICANT CAUSES OR CONDITIONS听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Other Fetal Conditions/Disorders: Fetal Demise听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part I) P022 P026 P029

Code 18a (Part I) P022 P026 P029, complication of placenta, cord, or membranes and leave 18b (Part II) blank since P95 is not assigned when other information is on the record.

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Complications of Placenta, Cord, or Membranes听听听听听听听听听听听听听听听听听听听听听听听

听

听Other:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Other (specify):听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听18b. OTHER SIGNIFICANT CAUSES OR CONDITIONS听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Complications of Placenta, Cord, or Membranes听听听听听听听听听听听听听听听听听听听听听听听

听

听Other:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Other (specify):听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part I) P022 P026 P029/Code 18b (Part II) P022 P026 P029

Code 18a (Part I) P022 P026 P029, complication of placenta, cord, or membranes and code 18b (Part II) P022 P026 P029, complication of placenta, cord, or membranes since the checkbox is marked ‘Y鈥� in both places.

G.听听听听听 Format

Conditions reported in 18a

Enter the codes for entries in 18a in the order the entries are reported, proceeding from the entry reported uppermost in 18a from left to right, if there is more than one entry on the same line. If the entries are numbered, code in numeric order.

Connecting Terms

鈥淒ue to鈥� written in or implied in Items 18a and 18b

When the certifier has stated that one condition was due to another or has used another connecting term that implies a due to relationship between conditions in items18 and 18b, take into consideration the position of the term in 18a/18b and code the entry following the 鈥渨ritten-in due to鈥� directly preceding the term.

a)听听 The following connecting terms must be 鈥渨ritten in鈥� and are interpreted as meaning 鈥渄ue to鈥� when the entity immediately preceding and following these terms is a disease condition, nature of injury or an external cause:

after听听听听听听听听听听听听听听听听听听听听incident to听听听听听听听received in

arising in or during听听听听听incurred after听听听听resulting from

as (a) complication of听听听incurred during听听听resulting when

as a result of听听听听听听听听听听听incurred in听听听听听听听secondary to (2°)

because of听听听听听听听听听听听听听听听incurred when听听听听听subsequent to

caused by听听听听听听听听听听听听听听听听induced by听听听听听听听听sustained as

complication(s) of听听听听听听听occurred after听听听听sustained by

during听听听听听听听听听听听听听听听听听听听occurred during听听听sustained during

etiology听听听听听听听听听听听听听听听听听occurred in听听听听听听听sustained in

following听听听听听听听听听听听听听听听听occurred when听听听听听sustained when

for听听听听听听听听听听听听听听听听听听听听听听occurred while听听听听sustained while

from听听听听听听听听听听听听听听听听听听听听听origin

in听听听听听听听听听听听听听听听听听听听听听听听received from

听

EXAMPLES:

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW, PLEASE SELECT THE ONE WHICH MOST LIKELY听听听听

听BEGAN THE SEQUENCE OF EVENTS RESULTING IN THE DEATH OF THE FETUS)听听听听

听

听Other Fetal Conditions/Disorders听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify) Anoxia and hemorrhage caused by hemolytic disease of fetus听

听

Code 18a (Part 1) to P209 P559 P509

Code 18a (Part 1) P209, Anoxia, fetal, fetus, P559, Disease, hemolytic (fetus) (newborn) and P509, Hemorrhage, fetal, fetus. Code the Hemolytic disease of fetus immediately preceding the hemorrhage.

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Maternal Conditions/Diseases听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(Specify) Fetal cardiac failure due to maternal polyhydramnios听听听听听听

听

Code 18a (Part 1) P013 P298

Code 18a (Part 1) P013, Polyhydramnios, affecting fetus or newborn and P298, Failure, heart, fetal. Code maternal polyhydramnios as the first entry in 18a (Part I), directly preceding the fetal cardiac failure.

When one of the above terms is the first entry in 18b, indicating the entry following the term on the above list is a continuation of 18a, code in 18a. Take into consideration the position of the term in 18a and code the entry following the 鈥渨ritten-in due to鈥� in 18b directly preceding the term in 18a.

EXAMPLES:

听听18a. INITIATING CAUSE/CONDITION听听听听听18b. OTHER SIGNIFICANT CAUSES OR听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听CONDITIONS听听听听听听听听听听听听听听听听听听听

听

听(AMONG THE CHOICES BELOW,听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听PLEASE SELECT THE ONE WHICH听听听听听听听听(SELECT OR SPECIFY ALL OTHER听听听听听听

听MOST LIKELY BEGAN THE SEQUENCE听听听听听CONDITIONS CONTRIBUTING TO听听听听听听听听

听OF EVENTS RESULTING IN THE听听听听听听听听听DEATH IN ITEM 18b)听听听听听听听听听听听听听听听听

听DEATH OF THE FETUS)听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Fetal Injury听听听听听听听听听听听听听听听听听听听听听听听Maternal Conditions/Diseases听听听听听听

听(Specify)Fetal anoxia听听听听听听听听听听听听听听(Specify)resulting from maternal听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听hypertension听听听听听听听听听听听听听

听

Code 18a (Part 1) P000 P209

Code 18a (Part 1) P000, Maternal condition, affecting fetus or newborn, hypertension (conditions in 010-011, 013-016) and P209, Anoxia, fetal, fetus. Code maternal hypertension in 18b directly preceding fetal anoxia in 18a.

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听18a. INITIATING CAUSE/CONDITION听听听听听听18b. OTHER SIGNIFICANT CAUSES OR听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听CONDITIONS听听听听听听听听听听听听听听听听听听听

听(AMONG THE CHOICES BELOW,听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听PLEASE SELECT THE ONE WHICH听听听听听听听听听(SELECT OR SPECIFY ALL OTHER听听听听听听

听MOST LIKELY BEGAN THE SEQUENCE听听听听听听CONDITIONS CONTRIBUTING TO听听听听听听听听

听OF EVENTS RESULTING IN THE听听听听听听听听听听DEATH IN ITEM 18b)听听听听听听听听听听听听听听听听

听DEATH OF THE FETUS)听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Maternal Conditions/Diseases听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)Fetopelvic disproportion听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Other Fetal Conditions/Disorders听听

听Other Fetal Conditions/Disorders听听听听(Specify)Breech deliver听听听听听听听听听听听

听(Specify)听Anoxia due to 18b听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part 1) P031 P030 P209

Code 18a (Part 1) P031, Disproportion (fetopelvic), affecting fetus or newborn, P030, Delivery, breech, affecting fetus or newborn, and P209, Anoxia, fetal, fetus. Code Breech delivery, affecting fetus or newborn in18b, directly preceding the anoxia in 18a.

b)听听 Not indicating a 鈥渄ue to鈥� relationship

When conditions are separated by 鈥渁nd鈥� or by another connecting term that does not imply a 鈥渄ue to鈥� relationship, enter the codes for these conditions on the same line in the order the conditions are reported.

听

The following terms imply that conditions are meant to remain on the same line. They are separated by 鈥渁nd鈥� or by another connecting term that does not imply a 鈥渄ue to鈥� relationship鈥�:

and听听听听听听听听听听听听听听听听听听consistent with

accompanied by听听听听听听听with (c)

also听听听听听听听听听听听听听听听听听precipitated by

associated with听听听听听听predisposing (to)

complicated by听听听听听听听superimposed on

complicating

听

EXAMPLE:

听听18b.听听OTHER SIGNIFICANT CAUSES OR CONDITIONS听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听(SELECT OR SPECIFY ALL OTHER CONDITIONS CONTRIBUTING TO DEATH IN听听听听听

听ITEM 18b)听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Fetal Anomaly听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听(Specify)听Cleft palate with cleft lip听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18b (Part II) Q359 Q369

Code 18b (Part II) Q359, Cleft, palate and Q369, Cleft lip. Code each entity separately even though ICD-10 provides a combination code for cleft palate and cleft lip.

c)听听 Conditions reported in 18b

NOTE: Enter the codes for entries in 18b in the order the entries are reported, proceeding from the entry reported uppermost in 18b from left to right, if there is more than one entry on the same line. If entries are numbered, code in numeric order.

听

d)听听 Deletion of 鈥�18b鈥� on Fetal Death Report

When the certifier has marked through the printed 18b, disregard the marking and code the entities as reported in 18b (Part II).

e)听听 Doubtful Diagnosis

1.听听 Doubtful qualifying expression: When expressions such as 鈥渁pparently,鈥� 鈥減resumably,鈥� 鈥�?,鈥� 鈥減erhaps,鈥� and 鈥減ossibly,鈥� qualify any condition, disregard these expressions and code the condition as indexed.

a)听听 Interpretation of 鈥渆ither…or…鈥�

Consider the following as a statement of 鈥渆ither or:鈥�

· Two conditions reported on one line and both conditions qualified by expressions such as 鈥渁pparently,鈥� 鈥減resumably,鈥� 鈥�?,鈥� 鈥減erhaps,鈥� and 鈥減ossibly鈥�.

· Two or more conditions connected by 鈥渙r鈥� or 鈥渧ersus鈥�.

2.听听 Code as follows:

When more than one condition of the placenta classifiable to P020, P021,P022 is qualified by one of the expressions interpreted as 鈥渆ither/or,鈥� code P022, 鈥淯nspecified morphological and functional abnormalities of the placenta鈥�.

EXAMPLE:

Placenta previa versus abruption placenta

Code P022, Placenta, abnormal, affecting fetus or newborn.

3.听听 When more than one condition of the umbilical cord classifiable to P024, P025, P026 is qualified by one of the expressions interpreted as 鈥渆ither/or,鈥� code P026, Unspecified condition of the umbilical cord.鈥�

EXAMPLE:

Knot in umbilical cord or short cord

Code P026, Abnormal, abnormality, umbilical cord, affecting fetus or newborn.

4.听听 When more than one condition of the maternal membranes (P027, P028) is qualified by one of the expressions interpreted as 鈥渆ither/or,鈥� code P029, 鈥淯nspecified abnormality of membranes鈥�.

5.听听 When more than one fetal anomaly is reported and qualified by one of the terms interpreted as 鈥渆ither/or,鈥� code as follows:

a) If an anomaly is reported of different parts of the same site, code Anomaly of the specified site only.

EXAMPLE:

Congenital anomaly of the tricuspid or aortic valve

Code Q248, Anomaly of heart valve NEC.

b)听听 When conditions are qualified by a statement of 鈥渆ither or鈥� and only one site/system is involved, code to the residual category for the site/system.

EXAMPLES:

Encephalocele or hypoplasia of brain
Code Q049, Anomaly, of brain.

Anomaly of the bladder or kidney
Code Q649, Anomaly, unspecified of the urinary system.

c)听听 If different specified anomalies of the same system, code anomaly of the specified system only.

EXAMPLE:
Congenital stenosis of pylorus or atresia of duodenum.
Code Q459, Anomaly, gastrointestinal tract NEC.

听

NOTE: IF MORE THAN ONE CONDITION OF THE FETUS (INCLUDING MATERNAL CONDITIONS) IS REPORTED WITH A TERM INTERPRETED AS 鈥淓ITHER/OR,鈥� AND THE ABOVE INSTRUCTIONS DO NOT APPLY, REFER TO IMMEDIATE SUPERVISOR FOR A CODE ASSIGNMENT.

H.听听听听听 Screening/Tests Results

When a statement is reported on the Fetal Death Report indicating a screening or diagnostic test was performed and the results of the test are not reported, do not enter a code for the screening/test. Tests are used for diagnostic purposes and not considered a diagnosis unless the results are reported. If results are reported, code as indexed.

EXAMPLES

Diagnostic imaging of the kidney performed
Liver function studies
Screened for tuberculosis

Do not enter a code for a condition when the results are reported as 鈥渘egative鈥�.

EXAMPLES:

Negative for tuberculosis
Tested negative for HIV
Tested positive for tuberculosis P370. Indexed under Tuberculosis, congenital

I.听听听听听听 Inclusion of additional information (AI) to Fetal Death Reports

Code supplemental information when it modifies or supplements data on the original Fetal Death Report as follows:

1.听听 When additional information (AI) states the initiating cause of a specified disease or condition in 18a (Part 1), code the additional information (AI) preceding the specified disease.

2.听听 When additional information (AI) modifies a specified disease or condition, use the AI and code the specified disease where reported.

3.听听 When there is a stated or implied complication of surgery and the additional information indicates the condition for which the surgery was performed, code this condition as follows:

a) If the surgical procedure was performed on the mother, code the condition for which the surgical procedure was performed following the P006 (the code used for the fetus and newborn affected by a surgical procedure on the mother).

b) If the surgical procedure was performed on the fetus, refer to your immediate supervisor for a code assignment.

4.听听 When the additional information (AI) states a certain condition is the initiating cause of death, code this as the first condition in 18a (Part 1).

5.听听 When any morphological type of neoplasm is reported in 18a (Part 1) with no mention of the 鈥渟ite鈥� and additional information specifies a site, code the specified site only on the line where the morphological type is reported.

6.听听 When additional information states the primary site of a malignant neoplasm of the fetus, enter the code preceding where information concerning the neoplasm is reported.

7.听听 When the additional information does not modify a condition on the report, or does not state that this condition is the initiating cause, code the AI as the last condition(s) in 18b (Part II).

J.听听听听听听 Amended Reports

When an 鈥淎mended Fetal Death Report鈥� is submitted, code the conditions reported on the amended report only.

K.听听听听听 Sex Limitations

Certain categories in ICD-10 are limited to one sex:

听听听听听听听听听听听听听听听听听听听听For Males Only听听听听听听For Females Only

B260听听听听听听听听听听C51-C579

C60-C63听听听听听听听D06

D074-D076听听听听听D070-D073

D176听听听听听听听听听听D25-D28

D29听听听听听听听听听听听D390-D391

D40听听听听听听听听听听听D397-D399

Q53-Q55听听听听听听听P546

Q98听听听听听听听听听听听Q500-Q529

听听听听听听听听听听听听听听Q960-Q962

听听听听听听听听听听听听听听Q964-Q979

听

L.听听听听听听 Plurality Limitations

Certain categories in ICD-10 are limited to one plurality. If the number in the Plurality box on the Fetal Death Record is greater than 鈥�1鈥�, code P015 as the last entry in 18b (Part II).

For Multiples Only

P01.5

Q89.4

NOTE: Do not add/code P01.5 for 鈥渢win to twin transfusion鈥�. Code to P02.3 as indexed.

M.听听听听听 Relating and modifying conditions

1.听听听听听听 Implied site of disease

Certain conditions are classified in the ICD-10 according to the site affected, e.g.:

atrophy听听听听听听听听听enlargement 听听听听obstruction

calcification听听听failure听听听听听听听听听perforation

calculus听听听听听听听听fibrosis听听听听听听听听rupture

congestion听听听听听听gangrene听听听听听听听听stenosis

degeneration听听听听hypertrophy听听听听听stones

dilatation听听听听听听insufficiency听听听stricture

embolism听听听听听听听听necrosis

听听听听听听听听听听听听听听听听听听 (This list is not all inclusive)

Occasionally, these conditions are reported without specification of site. Relate conditions such as these for which the Classification does not provide a NOS code. Also, relate conditions which are usually reported of a site. Generally, it may be assumed that such a condition was of the same site as another condition if the Classification provides for coding the condition of unspecified site to the site of the other condition. These coding principles apply whether or not there are other conditions reported. Apply the following instructions when relating a condition of unspecified site to the site of the specified condition:

a.听 General instructions for implied site of a disease

When applying the instructions for Implied site of a Disease and Relating and Modifying, consider all specified conditions for the following choices to be on the same line and apply applicable instructions for relating and modifying:

1.听 Maternal Conditions/Diseases

(Specify)_____________________________

2.听 Complications of Placenta, Cord, or Membranes

Rupture of membranes prior to onset of labor

Abruptio placenta

Placental insufficiency

Prolapsed cord

Chorioamnionitis

Other (Specify) _____________________________

3.听 Other Obstetrical or Pregnancy Complications

听听听听 (Specify)_______________________________________

4.听 Fetal Anomaly (Specify)___________________________

5.听 Fetal Injury (Specify) _____________________________

6.听 Fetal Infection (Specify) ___________________________

7.听 Other Fetal Conditions/Disorders

听听听听 (Specify) _______________________________________

8.听 Unknown

(1)听听听听听听听 When conditions are reported on the same line, assume the condition of unspecified site was of the same site as the condition of specified site.

(2)听听听听听听听 When conditions of different sites are reported on the same line, assume the condition of unspecified site was of the same site as the condition immediately preceding it.

b.听 Relating specific categories

(1)听听听听听听听听 When embolism, infarction, occlusion, thrombosis NOS is reported:

·听听听听 from a specified site, code the condition of the site reported.

·听听听听 of a site, from a specified site, code the condition to both sites reported.

(2)听听听听听听听听 Relate a condition of unspecified site to the complete term of a multiple site entity. If it is not indexed together, relate the condition to the site of the complete indexed term.

听

Non-traumatic conditions

Consider conditions that are usually but not always traumatic in origin to be qualified as non-traumatic when reported with a 鈥渨ritten in鈥� due to or on the same line with a disease.

SECTION III: INTENT OF CERTIFIER

A.听听听听听 INTRODUCTION

In order to assign the most appropriate code for a given diagnostic entity, it may be necessary to take other recorded information into account. It is important to interpret this information properly so the meaning intended by the certifier is correctly conveyed. The objective is to code each diagnostic entity in accordance with the intent of the certifier without combining separate codable entities. The following instructions help to determine the intent of the certifier. Apply Intent of Certifier instructions to 鈥淪ee also鈥� terms in the Index as well. These instructions are assumed to be for the fetus unless stated as a maternal condition or reported on the Maternal Condition line.

B.听听听听听 Coding conditions classified to injuries as disease conditions

a.听听 Some conditions (such as injury, hematoma or laceration) of a specified organ are indexed directly to a traumatic category but may not always be traumatic in origin. Consider these types of conditions to be qualified as non-traumatic when reported:

·听听听听 with a written in due to, or on the same line with a disease or reported due to drug poisoning or drug therapy.

·听听听听 When there is provision in the Classification for coding the condition considered to be qualified as non-traumatic as 鈥渘on-traumatic,鈥� code accordingly. Otherwise, code to the category that has been provided for 鈥淥ther鈥� diseases of the organ (usually .8).

b.听听 Some conditions are indexed directly to a traumatic category, but the Classification also provides a non-traumatic code. When these conditions are reported of the fetus and due to or with a disease and an external cause is also reported on the record, the instructions for coding external causes on regular mortality data will apply.

c.听听听 Some conditions are indexed directly to a traumatic category, but the Classification also provides a non-traumatic code. When these conditions are reported, code the condition as non-traumatic unless the condition is reported due to or on the same line with an injury or external cause. This instruction applies only to conditions with the term 鈥渘on-traumatic鈥� in the Index.

C.听听听听听 Organisms and Infections

听听听听听听听听听 Organisms

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听Escherichia coli听听听听听Cytomegalovirus听听听听听Candida听听

听Staphylococcal听听听听听听听Streptococcal听听听听听听听Fungus听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听听听听听听听听听 Infectious conditions

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听Abscess听听听听听听听听Infection听听听听听Sepsis, Septicemia听听听听听听

听Bacteremia听听听听听Pneumonia听听听听听Septic Shock听听听听听听听听听听听

听Empyema听听听听听听听听Pyemia听听听听听听听听Words ending in 鈥渋tis鈥澨�

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

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

Infections and organisms are yet another situation in which care needs to be taken to determine if it is directly affecting the fetus or the fetus is merely impacted by a maternal condition before assigning a code. If the infection or organism is reported in the specified line for maternal conditions or if reported elsewhere but qualified as maternal, then code to a maternal code (e.g., P002 or P008). Otherwise, assume the fetus has the infection or organism and assign a fetal code. (e.g., P35-P39), if indexed.

Take into consideration that some infections and organisms of the fetus are classified to Chapter 1.

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

2.听听 When an infectious or inflammatory condition and a specified organism or specified non-systemic infection is reported, code the infectious or inflammatory condition and the organism or infection separately.

3.听听 When any condition and infection NOS is reported, code both conditions where entered on the report.

4.听听 When a non-infectious or non-inflammatory condition and infection NOS is reported as the initiating cause, code the non-infectious or non-inflammatory condition as indexed and code infection NOS where entered on the report.

5.听听 When an organism is reported preceding two or more infectious conditions reported consecutively on the same line, code each of the infectious conditions modified by the organism.

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

7.听听 When any condition is reported and a generalized infection such as bacteremia, fungemia, sepsis, septicemia, systemic infection, or viremia is reported, code both the condition and the generalized infection where entered on the report. Do not modify the condition by the infection.

D.听听听听听 Drug Use NOS and Noxious Substances

The code assignment depends upon whether the fetus is directly impacted or affected by maternal behavior or exposure. For instance, code maternal drug use P044, when reported in 18a or 18b. Refer to the indexing of maternal conditions in the Perinatal Subset and Volume 1, Category P04 to assign the appropriate code for a fetus affected by maternal behavior or exposure.

SECTION IV:听 CLASSIFICATION OF CERTAIN ICD-10 CATEGORIES

A.听听听听听 CONGENITAL CONDITIONS

The Classification does not provide congenital and acquired codes for all conditions. When no provision is made for a distinction, disregard the statement of congenital or acquired and code the NOS code.

B.听听听听听 CERTAIN FETAL CONDITIONS (P000-P969)

When reported in 18a or 18b, code the following entries as indicated:

Birth weight of听听听听听听听听 2 pounds (999 gms) or under......................................... P070
听听听听听听听听听听听听听听听听听听听听听听听听听听听听听 Over 2 pounds (1000 gms) but not more than
听听听听听听听听听听听听听听听听听听听听听听听听听听听听听 5 ½ pounds (2499 gms)................................................ P071
听听听听听听听听听听听听听听听听听听听听听听听听听听听听听 10 pounds (4500 gms) or more...................................... P080

Gestation of听听听听听听听听听听听听 Less than 28 weeks....................................................... P072
听听听听听听听听听听听听听听听听听听听听听听听听听听听听听 28 weeks but less than 37 weeks................................... P073
听听听听听听听听听听听听听听听听听听听听听听听听听听听听听 42 or more completed weeks......................................... P082

听听听听听听听听听听听听听听听听听听听听听听听听听听听听 NOTE: 37-41 weeks, no code. This is a normal gestation period.

Premature labor or delivery NOS.................................................................. P073

When a condition classifiable to P703-P720, P722-P749 is the only cause(s) reported in 18a or 18b, code P95. If reported with other perinatal conditions, code as indexed.

C.听听听听听 ILL-DEFINED AND UNKNOWN CAUSES

When any of the following terms is the only entry (or entries) on the fetal death report, code P95 everywhere terms are reported in 18a or 18b:

Cause not found听听听听听听听听听听听听听听听听听听听听Immediate cause unknown

Cause unknown听听听听听听听听听听听听听听听听听听听听听听Intrauterine death

Cause undetermined听听听听听听听听听听听听听听听听听No specific etiology

Could not be determined听听听听听听听听听听听听identified

Deadborn fetus NOS听听听听听听听听听听听听听听听听听No specific known causes

Etiology never determined听听听听听听听听听听Non-specific causes

Etiology not defined听听听听听听听听听听听听听听听Not known

Etiology uncertain听听听听听听听听听听听听听听听听听Obscure etiology

Etiology unexplained听听听听听听听听听听听听听听听Stillborn

Etiology unknown听听听听听听听听听听听听听听听听听听听Undetermined

Etiology undetermined听听听听听听听听听听听听听听Uncertain

Etiology unspecified听听听听听听听听听听听听听听听Unclear

Fetal Death听听听听听听听听听听听听听听听听听听听听听听听听Unexplained cause

Fetal Demise听听听听听听听听听听听听听听听听听听听听听听听Unknown

Final event undetermined听听听听听听听听听听听? Cause

Immediate cause not determined听听听听听? Etiology

听

鈥淯nknown鈥� reported in the checkbox, code P95, if no other information is on the record. If the checkbox for Unknown is marked in one section (either 18a or 18b) and there is also a term assigned to P95 reported in the other section, code P95 in both sections.

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Unknown:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听18b. OTHER SIGNIFICANT CAUSES OR CONDITIONS听听听听听听听听听听听听听听听

听

听Maternal Conditions/Diseases:听听Undetermined听听听听听听听听听听听听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part I)P95/Code 18b (Part II) P95

Code 18a (Part I) P95, Ill-defined and Unknown Causes and code 18b (Part II) P95, Ill-defined and Unknown Causes for both reportings.

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听18a.听听INITIATING CAUSE/CONDITION听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听Complications of Placenta, Cord, or Membranes听听听听听听听听听听听听听

听Other:听听Y听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Other (specify):听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

听18b. OTHER SIGNIFICANT CAUSES OR CONDITIONS听听听听听听听听听听听听听听听

听

听Unknown:听听No specific known causes听听听听听听听听听听听听听听听听听听听听听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听

Code 18a (Part I) P022 P026 P029

Code 18a (Part I) P022 P026 P029, complication of placenta, cord, or membranes and leave 18b (Part II) blank since P95 is not assigned when other information is on the record.

D.听听听听听 GENERAL CONCEPT REGARDING EXTERNAL CAUSES REPORTED ON FETAL DEATH REPORTS

If an external event is reported and it is the mother who received the injuries, code the appropriate P000-P049.

If an external event is reported and it is the fetus who received the injury, the instructions for coding external causes on regular mortality data will apply.

Refer to the following instructions on coding external causes on Fetal Death Reports.

E.听听听听听听 Maternal External Causes

When a complication of any type of medical care is reported, including drug therapy, surgery, or a specified type of therapy including obstetrical procedures, code the appropriate P000-P049.

Do not enter the nature of injury code, external cause code or place code. Take into consideration if the condition for which the medical care was administered is reported. If questionable, refer to Supervisor.

If any type of external event (poisonings, accident, suicide, homicide or undetermined) is reported of the mother, code to the appropriate P000-P049. Do not enter a nature of injury code, external cause code or place code.

Take into consideration where the certifier has recorded the external event and code the P000-P049 in that same position. If questionable, refer to your immediate Supervisor.

F.听听听听听听 Fetal Injury

When any type of medical care including drug therapy, surgery, or any other specified type of medical care is reported of the fetus, the instructions for coding external causes on regular mortality data will apply.

If any type of external event or injury is reported of the fetus, the instructions for coding external causes on regular mortality data will apply.

APPENDIX A - Standard Abbreviations and Symbols

When an abbreviation is reported on the certificate, refer to this list to determine what the abbreviation represents. If an abbreviation represents more than one term, determine the correct abbreviation by using other information on the certificate. If no determination can be made, use abbreviation for first term listed.

A2GDM听听听听听听听听听听class A2 gestational diabetes mellitus

AAA听听听听听听听听听听听听abdominal aortic aneurysm

AAS听听听听听听听听听听听听aortic arch syndrome

AAT听听听听听听听听听听听听alpha-antitrypsin

AAV听听听听听听听听听听听听AIDS-associated virus

AB听听听听听听听听听听听听听abdomen; abortion; asthmatic bronchitis

ABD听听听听听听听听听听听听abdomen

ABE听听听听听听听听听听听听acute bacterial endocarditis

ABS听听听听听听听听听听听听acute brain syndrome

ACA听听听听听听听听听听听听adenocarcinoma

ACD听听听听听听听听听听听听arteriosclerotic coronary disease

ACH听听听听听听听听听听听听adrenal cortical hormone

ACT听听听听听听听听听听听听acute coronary thrombosis

ACTH听听听听听听听听听听听adrenocorticotrophic hormone

ACVD听听听听听听听听听听听arteriosclerotic cardiovascular disease

ADEM听听听听听听听听听听听acute disseminated encephalomyelitis

ADH听听听听听听听听听听听听antidiuretic hormone

ADS听听听听听听听听听听听听antibody deficiency syndrome

AEG听听听听听听听听听听听听air encephalogram

AF听听听听听听听听听听听听听auricular or atrial fibrillation; acid fast

AFB听听听听听听听听听听听听acid-fast bacillus

AGG听听听听听听听听听听听听agammaglobulinemia

AGL听听听听听听听听听听听听acute granulocytic leukemia

AGN听听听听听听听听听听听听acute glomerulonephritis

AGS听听听听听听听听听听听听adrenogenital syndrome

AHA听听听听听听听听听听听听acquired hemolytic anemia; autoimmune hemolytic anemia

AHD 听听听听听听arteriosclerotic heart disease

AHHD听听听听听听听听听听听arteriosclerotic hypertensive heart disease

AHG听听听听听听听听听听听听anti-hemophilic globulin deficiency

AHLE听听听听听听听听听听听acute hemorrhagic leukoencephalitis

AI听听听听听听听听听听听听听aortic insufficiency; additional information

AIDS听听听听听听听听听听听acquired immunodeficiency syndrome

AKA听听听听听听听听听听听听above knee amputation

ALC听听听听听听听听听听听听alcoholism

ALL听听听听听听听听听听听听acute lymphocytic leukemia

ALS听听听听听听听听听听听听amyotrophic lateral sclerosis

AMI听听听听听听听听听听听听acute myocardial infarction

AML听听听听听听听听听听听听acute myelocytic leukemia

ANS听听听听听听听听听听听听arteriolonephrosclerosis

AOD听听听听听听听听听听听听arterial occlusive disease

AODM听听听听听听听听听听听adult onset diabetes mellitus

AOM听听听听听听听听听听听听acute otitis media

AP听听听听听听听听听听听听听angina pectoris; anterior and posterior repair; artificial pneumothorax; anterior pituitary

A&P听听听听听听听听听听听听anterior and posterior repair

APC听听听听听听听听听听听听auricular premature contraction; acetylsalicylic acid, acetophenetidin, and caffeine

APE听听听听听听听听听听听听acute pulmonary edema; anterior pituitary extract

APH听听听听听听听听听听听听antepartum hemorrhage

AR听听听听听听听听听听听听听aortic regurgitation

ARC听听听听听听听听听听听听AIDS-related complex

ARDS听听听听听听听听听听听adult respiratory distress syndrome

ARF听听听听听听听听听听听听acute respiratory failure; acute renal failure

ARM听听听听听听听听听听听听artificial rupture of membranes

ARV听听听听听听听听听听听听AIDS-related virus

ARVD听听听听听听听听听听听arrhythmogenic right ventricular dysplasia

AS听听听听听听听听听听听听听arteriosclerotic; arteriosclerosis; aortic stenosis

ASA听听听听听听听听听听听听acetylsalicylic acid (aspirin)

ASAD听听听听听听听听听听听arteriosclerotic artery disease

ASCAD听听听听听听听听听听arteriosclerotic coronary artery disease

ASCD听听听听听听听听听听听arteriosclerotic coronary disease

ASCHD听听听听听听听听听听arteriosclerotic coronary heart disease

ASCRD听听听听听听听听听听arteriosclerotic cardiorenal disease

ASCVA听听听听听听听听听听arteriosclerotic cerebrovascular accident

ASCVD听听听听听听听听听听arteriosclerotic cardiovascular disease

ASCVR听听听听听听听听听听arteriosclerotic cardiovascular renal disease

ASCVRD听听听听听听听听听arteriosclerotic cardiovascular renal disease

ASD听听听听听听听听听听听听atrial septal defect

ASDHD听听听听听听听听听听arteriosclerotic decompensated heart disease

ASHCVD听听听听听听听听听arteriosclerotic hypertensive cardiovascular disease

ASHD听听听听听听听听听听听arteriosclerotic heart disease; atrioseptal heart defect

ASHHD听听听听听听听听听听arteriosclerotic hypertensive heart disease

ASHVD听听听听听听听听听听arteriosclerotic hypertensive vascular disease

ASO听听听听听听听听听听听听arteriosclerosis obliterans

ASPVD听听听听听听听听听听arteriosclerotic peripheral vascular disease

ASVD听听听听听听听听听听听arteriosclerotic vascular disease

ASVH(D)听听听听听听听听arteriosclerotic vascular heart disease

AT听听听听听听听听听听听听听atherosclerosis; atherosclerotic; atrial tachycardia; antithrombin

ATC听听听听听听听听听听听听all-terrain cycle

ATN听听听听听听听听听听听听acute tubular necrosis

ATS听听听听听听听听听听听听arteriosclerosis

ATSHD听听听听听听听听听听arteriosclerotic heart disease

ATV听听听听听听听听听听听听all-terrain vehicle

AUL听听听听听听听听听听听听acute undifferentiated leukemia

AV听听听听听听听听听听听听听arteriovenous; atrioventricular; aortic valve

AVF听听听听听听听听听听听听arterio-ventricular fibrillation; arteriovenous fistula

AVH听听听听听听听听听听听听acute viral hepatitis

AVNRT听听听听听听听听听听atrioventricular nodal re-entrant tachycardia

AVP听听听听听听听听听听听听aortic valve prosthesis

AVR听听听听听听听听听听听听aortic valve replacement

AVRT听听听听听听听听听听听atrioventricular nodal re-entrant tachycardia

AWMI听听听听听听听听听听听anterior wall myocardial infarction

AZT听听听听听听听听听听听听azidothymidine

BA听听听听听听听听听听听听听basilar artery; basilar arteriogram; bronchial asthma

B&B听听听听听听听听听听听听bronchoscopy and biopsy

BBB听听听听听听听听听听听听bundle branch block

B&C听听听听听听听听听听听听biopsy and cauterization

BCE听听听听听听听听听听听听basal cell epithelioma

BE听听听听听听听听听听听听听barium enema

BEH听听听听听听听听听听听听benign essential hypertension

BGL听听听听听听听听听听听听Bartholin gland

BKA听听听听听听听听听听听听below knee amputation

BL听听听听听听听听听听听听听bladder; bucolingual; blood loss; Burkitt lymphoma

BMR听听听听听听听听听听听听basal metabolism rate

BNA听听听听听听听听听听听听bladder neck adhesions

BNO听听听听听听听听听听听听bladder neck obstruction

BOMSA听听听听听听听听听听bilateral otitis media serous acute

BOMSC听听听听听听听听听听bilateral otitis media serous chronic

BOW 听听听听听听听听听听听'bag of water' (membrane)

B/P, BP听听听听听听听听blood pressure

BPH 听听听听听听听听听听听benign prostate hypertrophy

BSA听听听听听听听听听听听听body surface area

BSO听听听听听听听听听听听听bilateral salpingo-oophorectomy

BSP听听听听听听听听听听听听Bromosulfaphthalein (test)

BTL听听听听听听听听听听听听bilateral tubal ligation

BUN听听听听听听听听听听听听blood, urea, and nitrogen test

BVL听听听听听听听听听听听听bilateral vas ligation

B&W听听听听听听听听听听听听Baldy-Webster suspension (uterine)

BX听听听听听听听听听听听听听biopsy

BX CX听听听听听听听听听听biopsy cervix

Ca听听听听听听听听听听听听听cancer

CA听听听听听听听听听听听听听cancer; cardiac arrest; carotid arteriogram

CABG听听听听听听听听听听听coronary artery bypass graft

CABS听听听听听听听听听听听coronary artery bypass surgery

CAD听听听听听听听听听听听听coronary artery disease

CAG听听听听听听听听听听听听chronic atrophic gastritis

CAO听听听听听听听听听听听听coronary artery occlusion; chronic airway obstruction

CAR听听听听听听听听听听听听cardiac arrest

CAS听听听听听听听听听听听听cerebral arteriosclerosis

CASCVD听听听听听听听听听chronic arteriosclerotic cardiovascular disease

CASHD听听听听听听听听听听chronic arteriosclerotic heart disease

CAT听听听听听听听听听听听听computerized axial tomography

CB听听听听听听听听听听听听听chronic bronchitis

CBC听听听听听听听听听听听听complete blood count

CBD听听听听听听听听听听听听common bile duct; chronic brain disease

CBS听听听听听听听听听听听听chronic brain syndrome

CCF听听听听听听听听听听听听chronic congestive failure

CCI听听听听听听听听听听听听chronic cardiac or coronary insufficiency

CF听听听听听听听听听听听听听congestive failure; cystic fibrosis; Christmas factor (PTC)

CFT听听听听听听听听听听听听chronic follicular tonsillitis

CGL听听听听听听听听听听听听chronic granulocytic leukemia

CGN听听听听听听听听听听听听chronic glomerulonephritis

CHA听听听听听听听听听听听听congenital hypoplastic anemia

CHB听听听听听听听听听听听听complete heart block

CHD听听听听听听听听听听听听congestive heart disease; coronary heart disease; congenital heart disease; Chediak-Higaski Disease

CHF听听听听听听听听听听听听congestive heart failure

C2H5OH听听听听听听听听听ethyl alcohol

CI听听听听听听听听听听听听听cardiac insufficiency; cerebral infarction

CID听听听听听听听听听听听听cytomegalic inclusiondisease

CIS听听听听听听听听听听听听carcinoma in situ

CJD听听听听听听听听听听听听Creutzfeldt-Jakob Disease

CLD听听听听听听听听听听听听chronic lung disease; chronic liver disease

CLL听听听听听听听听听听听听chronic lymphatic leukemia; chronic lymphocytic leukemia

CMID听听听听听听听听听听听cytomegalic inclusion disease

CML听听听听听听听听听听听听chronic myelocytic leukemia

CMM听听听听听听听听听听听听cutaneous malignant melanoma

CMV听听听听听听听听听听听听cytomegalic virus

CNHD听听听听听听听听听听听congenital nonspherocytic hemolytic disease

CNS听听听听听听听听听听听听central nervous system

CO听听听听听听听听听听听听听carbon monoxide

COAD听听听听听听听听听听听chronic obstructive airway disease

CO2听听听听听听听听听听听听carbon dioxide

COBE听听听听听听听听听听听chronic obstructive bullous emphysema

COBS听听听听听听听听听听听chronic organic brain syndrome

COFS听听听听听听听听听听听cerebro-oculo-facio-skeletal

COOMBS听听听听听听听听听test for Rh sensitivity

COLD听听听听听听听听听听听chronic obstructive lung disease

COPD听听听听听听听听听听听chronic obstructive pulmonary disease

COPE听听听听听听听听听听听chronic obstructive pulmonary emphysema

CP听听听听听听听听听听听听听cerebral palsy; cor pulmonale

C&P听听听听听听听听听听听听cystoscopy and pyelography

CPB听听听听听听听听听听听听cardiopulmonary bypass

CPC听听听听听听听听听听听听chronic passive congestion

CPD听听听听听听听听听听听听cephalopelvic disproportion; contagious pustular dermatitis

CPE听听听听听听听听听听听听chronic pulmonary emphysema

CRD听听听听听听听听听听听听chronic renal disease

CREST 听听听听听听听听听calcinosis cutis, Raynaud phenomenon, sclerodactyly, and telangiectasis

CRF听听听听听听听听听听听听cardiorespiratory failure; chronic renal failure

CRST听听听听听听听听听听听calcinosis cutis, Raynaud phenomenon, sclerodactyly, and telangiectasis

CS听听听听听听听听听听听听听coronary sclerosis; cesarean section; cerebro-spinal

CSF听听听听听听听听听听听听cerebral spinal fluid

CSH听听听听听听听听听听听听chronic subdural hematoma

CSM听听听听听听听听听听听听cerebrospinal meningitis

CT听听听听听听听听听听听听听computer tomography; cerebral thrombosis; coronary thrombosis

CTD听听听听听听听听听听听听congenital thymic dysplasia

CU听听听听听听听听听听听听听cause unknown

CUC听听听听听听听听听听听听chronic ulcerative colitis

CUP听听听听听听听听听听听听cystoscopy, urogram, pyelogram (retro)

CUR听听听听听听听听听听听听cystocele, urethrocele, rectocele

CV听听听听听听听听听听听听听cardiovascular; cerebrovascular

CVA听听听听听听听听听听听听cerebrovascular accident

CV accident听听听听cerebral vascular accident

CVD听听听听听听听听听听听听cardiovascular disease

CVHD听听听听听听听听听听听cardiovascular heart disease

CVI听听听听听听听听听听听听cardiovascular insufficiency; cerebrovascular insufficiency

CVID听听听听听听听听听听听common variable immunodeficiency

CVRD听听听听听听听听听听听cardiovascular renal disease

CWP听听听听听听听听听听听听coalworker pneumoconiosis

CX听听听听听听听听听听听听听cervix

DA听听听听听听听听听听听听听degenerative arthritis

DBI听听听听听听听听听听听听phenformin hydrochloride

D&C听听听听听听听听听听听听dilation and curettage

DCR听听听听听听听听听听听听dacrocystorhinostomy

D&D听听听听听听听听听听听听drilling and drainage; debridement and dressing

D&E听听听听听听听听听听听听dilation and evacuation

DFU听听听听听听听听听听听听dead fetus in utero

DIC听听听听听听听听听听听听disseminated intravascular coagulation

DILD听听听听听听听听听听听diffuse infiltrative lung disease

DIP听听听听听听听听听听听听distal interphalangeal joint; desquamative interstitial pneumonia

DJD听听听听听听听听听听听听degenerative joint disease

DM听听听听听听听听听听听听听diabetes mellitus

DMT听听听听听听听听听听听听dimethyltriptamine

DOA听听听听听听听听听听听听dead on arrival

DOPS听听听听听听听听听听听diffuse obstructive pulmonary syndrome

DPT听听听听听听听听听听听听diphtheria, pertussis, tetanus vaccine

DR听听听听听听听听听听听听听diabetic retinopathy

DS听听听听听听听听听听听听听Down syndrome

DT听听听听听听听听听听听听听due to; delirium tremens

D/T听听听听听听听听听听听听due to; delirium tremens

DU听听听听听听听听听听听听听diagnosis unknown; duodenal ulcer

DUB听听听听听听听听听听听听dysfunctional uterine bleeding

DUI听听听听听听听听听听听听driving under influence

DVT听听听听听听听听听听听听deep vein thrombosis

DWI听听听听听听听听听听听听driving while intoxicated

DX听听听听听听听听听听听听听dislocation; diagnosis; disease

EBV听听听听听听听听听听听听Epstein-Barr virus

ECCE听听听听听听听听听听听extracapsular cataract extraction

ECG听听听听听听听听听听听听electrocardiogram

E coli听听听听听听听听听Escherichia coli

ECT听听听听听听听听听听听听electric convulsive therapy

EDC听听听听听听听听听听听听expected date of confinement

EEE听听听听听听听听听听听听Eastern equine encephalitis

EEG听听听听听听听听听听听听electroencephalogram

EFE听听听听听听听听听听听听endocardial fibroelastosis

EGL听听听听听听听听听听听听eosinophilic granuloma of lung

EH听听听听听听听听听听听听听enlarged heart; essential hypertension

EIOA听听听听听听听听听听听excessive intake of alcohol

EKC听听听听听听听听听听听听epidemic keratoconjunctivitis

EKG听听听听听听听听听听听听electrocardiogram

EKP听听听听听听听听听听听听epikeratoprosthesis

ELF听听听听听听听听听听听听elective low forceps

EMC听听听听听听听听听听听听encephalomyocarditis

EMD听听听听听听听听听听听听electromechanical dissociation

EMF听听听听听听听听听听听听endomyocardial fibrosis

EMG听听听听听听听听听听听听electromyogram

EN听听听听听听听听听听听听听erythema nodosum

ENT听听听听听听听听听听听听ear, nose, and throat

EP听听听听听听听听听听听听听ectopic pregnancy

ER听听听听听听听听听听听听听emergency room

ERS听听听听听听听听听听听听evacuation of retained secundines

ESRD听听听听听听听听听听听end-stage renal disease

EST听听听听听听听听听听听听electric shock therapy

ETOH听听听听听听听听听听听ethyl alcohol

EUA听听听听听听听听听听听听exam under anesthesia

EWB听听听听听听听听听听听听estrogen withdrawal bleeding

FB听听听听听听听听听听听听听foreign body

FBS听听听听听听听听听听听听fasting blood sugar

Fe听听听听听听听听听听听听听symbol for iron

FGD听听听听听听听听听听听听fatal granulomatous disease

FHS听听听听听听听听听听听听fetal heart sounds

FHT听听听听听听听听听听听听fetal heart tone

FLSA听听听听听听听听听听听follicular lymphosarcoma

FME听听听听听听听听听听听听full-mouth extraction

FS听听听听听听听听听听听听听frozen section; fracture site

FT听听听听听听听听听听听听听full term

FTA听听听听听听听听听听听听fluorescent treponemal antibody test

FTD听听听听听听听听听听听听fronto-temporal dementia

5FU听听听听听听听听听听听听fluorouracil

FUB听听听听听听听听听听听听functional uterine bleeding

FULG听听听听听听听听听听听fulguration

FUO听听听听听听听听听听听听fever unknown origin

FX听听听听听听听听听听听听听fracture

FYI听听听听听听听听听听听听for your information

GAS听听听听听听听听听听听听generalized arteriosclerosis

GB听听听听听听听听听听听听听gallbladder; Guillain-Barre (syndrome)

GC听听听听听听听听听听听听听gonococcus; gonorrhea; general circulation (systemic)

GE听听听听听听听听听听听听听gastroesophageal

GEN听听听听听听听听听听听听generalized

GERD听听听听听听听听听听听gastroesophageal reflux disease

GI听听听听听听听听听听听听听gastrointestinal

GIB听听听听听听听听听听听听gastrointestinal bleeding

GIST听听听听听听听听听听听gastrointestinal stromal tumor

GIT听听听听听听听听听听听听gastrointestinal tract

GMSD听听听听听听听听听听听grand mal seizure disorder

GOK听听听听听听听听听听听听God only knows

GSW听听听听听听听听听听听听gunshot wound

GTT听听听听听听听听听听听听glucose tolerance test

Gtt听听听听听听听听听听听听drop

GU听听听听听听听听听听听听听genitourinary; gastric ulcer

GVHR听听听听听听听听听听听graft-versus-host reaction

GYN听听听听听听听听听听听听gynecology

HA听听听听听听听听听听听听听headache

HAA听听听听听听听听听听听听hepatitis-associated antigen

HASCVD听听听听听听听听听hypertensive arteriosclerotic cardiovascular disease

HASCVR听听听听听听听听听hypertensive arteriosclerotic cardiovascular renal disease

HASHD听听听听听听听听听听hypertensive arteriosclerotic heart disease

HBP听听听听听听听听听听听听high blood pressure

HC听听听听听听听听听听听听听Huntington chorea

HCAP听听听听听听听听听听听health care associated pneumonia

HCPS听听听听听听听听听听听Hantivirus (cardio) pulmonary syndrome, Hantavirus cardiopulmonary syndrome

HCT听听听听听听听听听听听听hematocrit

HCVD听听听听听听听听听听听hypertensive cardiovascular disease

HCVRD听听听听听听听听听听hypertensive cardiovascular renal disease

HD听听听听听听听听听听听听听Hodgkin disease; heart disease

HDN听听听听听听听听听听听听hemolytic disease of newborn

HDS听听听听听听听听听听听听herniated disc syndrome

HEM听听听听听听听听听听听听hemorrhage

HF听听听听听听听听听听听听听heart failure; hay fever

HGB; Hgb听听听听听听听hemoglobin

HHD听听听听听听听听听听听听hypertensive heart disease

HIV听听听听听听听听听听听听human immunodeficiency virus

HMD听听听听听听听听听听听听hyaline membrane disease

HN2听听听听听听听听听听听听nitrogen mustard

HNP听听听听听听听听听听听听herniated nucleus pulposus

H/O听听听听听听听听听听听听history of

HPN听听听听听听听听听听听听hypertension

HPS听听听听听听听听听听听听Hantavirus pulmonary syndrome

HPVD听听听听听听听听听听听hypertensive pulmonary vascular disease

HRE听听听听听听听听听听听听high-resolution electrocardiology

HS听听听听听听听听听听听听听herpes simplex; Hurler syndrome

HSV听听听听听听听听听听听听herpes simplex virus

HTLV听听听听听听听听听听听human T-cell lymphotropic virus

HTLV听听听听听听听听听听听human T-cell lymphotropic

III/LAV听听听听听听听听virus-III/lymphadenopathy- associated virus

HTLV-3听听听听听听听听听human T-cell lymphotropic virus-III

HTLV-III听听听听听听听human T-cell lymphotropic virus-III

HTN听听听听听听听听听听听听hypertension

HVD听听听听听听听听听听听听hypertensive vascular disease

Hx听听听听听听听听听听听听听history of

IADH听听听听听听听听听听听inappropriate antidiuretic hormone

IASD听听听听听听听听听听听interatrial septal defect

ICCE听听听听听听听听听听听intracapsular cataract extraction

ICD听听听听听听听听听听听听intrauterine contraceptive device

I&D听听听听听听听听听听听听incision and drainage

ID听听听听听听听听听听听听听incision and drainage

IDA听听听听听听听听听听听听iron deficiency anemia

IDD听听听听听听听听听听听听insulin-dependent diabetes

IDDI听听听听听听听听听听听insulin-dependent diabetes

IDDM听听听听听听听听听听听insulin-dependent diabetes mellitus

IGA听听听听听听听听听听听听immunoglobin A

IHD听听听听听听听听听听听听ischemic heart disease

IHSS听听听听听听听听听听听idiopathic hypertrophic subaortic stenosis

IIAC听听听听听听听听听听听idiopathic infantile arterial calcification

ILD听听听听听听听听听听听听interstitial lung disease; ischemic leg disease

IM听听听听听听听听听听听听听intramuscular; intramedullary; infectious mononucleosis

IMPP听听听听听听听听听听听intermittent positive pressure

INAD听听听听听听听听听听听infantile neuroaxonal dystrophy

INC听听听听听听听听听听听听incomplete

INE听听听听听听听听听听听听infantile necrotizing encephalomyelopathy

INF听听听听听听听听听听听听infection; infected; infantile; infarction

INH听听听听听听听听听听听听isoniazid; inhalation

INS听听听听听听听听听听听听idiopathic nephrotic syndrome

IRDM听听听听听听听听听听听insulin resistant diabetes mellitus

IRHD听听听听听听听听听听听inactive rheumatic heart disease

IRIS听听听听听听听听听听听immune reconstitution inflammatory syndrome

ISD听听听听听听听听听听听听interatrial septal defect

ITP听听听听听听听听听听听听idiopathic thrombocytopenic purpura

IU听听听听听听听听听听听听听intrauterine

IUCD听听听听听听听听听听听intrauterine contraceptive device

IUD听听听听听听听听听听听听intrauterine device (contraceptive); intrauterine death

IUFD听听听听听听听听听听听intrauterine fetal death

IUP听听听听听听听听听听听听intrauterine pregnancy

IV听听听听听听听听听听听听听intervenous; intravenous

IVC听听听听听听听听听听听听intravenous cholangiography; inferior vena cava

IVCC听听听听听听听听听听听intravascular consumption coagulopathy

IVD听听听听听听听听听听听听intervertebral disc

IVH听听听听听听听听听听听听intraventricular hemorrhage

IVP听听听听听听听听听听听听intravenous pyelogram

IVSD听听听听听听听听听听听intraventricular septal defect

IVU听听听听听听听听听听听听intravenous urethrography

IWMI听听听听听听听听听听听inferior wall myocardial infarction

JAA听听听听听听听听听听听听juxtaposition of atrial appendage

JBE听听听听听听听听听听听听Japanese B encephalitis

KFS听听听听听听听听听听听听Klippel-Feil syndrome

KS听听听听听听听听听听听听听Klinefelter syndrome

KUB听听听听听听听听听听听听kidney, ureter, bladder

K-W听听听听听听听听听听听听Kimmelstiel-Wilson disease or syndrome

LAP听听听听听听听听听听听听laparotomy

LAV听听听听听听听听听听听听lymphadenopathy-associated virus

LAV/HTLV-III听听听lymphadenopathy-associated virus/human T-cell lymphotrophic virus-III

LBBB听听听听听听听听听听听left bundle branch block

LBNA听听听听听听听听听听听lysis bladder neck adhesions

LBW听听听听听听听听听听听听low birth weight

LBWI听听听听听听听听听听听low birth weight infant

LCA听听听听听听听听听听听听left coronary artery

LDH听听听听听听听听听听听听lactic dehydrogenase

LE听听听听听听听听听听听听听lupus erythematosus; lower extremity; left eye

LKS听听听听听听听听听听听听liver, kidney, spleen

LL听听听听听听听听听听听听听lower lobe

LLL听听听听听听听听听听听听left lower lobe

LLQ听听听听听听听听听听听听lower left quadrant

LMA听听听听听听听听听听听听left mentoanterior (position of fetus)

LML听听听听听听听听听听听听left middle lobe; left mesiolateral

LMCAT听听听听听听听听听听left middle cerebral artery thrombosis

LML听听听听听听听听听听听听left mesiolateral; left mediolateral (episiotomy)

LMP听听听听听听听听听听听听last menstrual period; left mento-posterior (position of fetus)

LN听听听听听听听听听听听听听lupus nephritis

LOA听听听听听听听听听听听听left occipitoanterior

LOMCS听听听听听听听听听听left otitis media chronic serous

LP听听听听听听听听听听听听听lumbar puncture

LRI听听听听听听听听听听听听lower respiratory infection

LS听听听听听听听听听听听听听lumbosacral; lymphosarcoma

LSD听听听听听听听听听听听听lysergic acid diethylamide

LSK听听听听听听听听听听听听liver, spleen, kidney

LUL听听听听听听听听听听听听left upper lobe

LUQ听听听听听听听听听听听听left upper quadrant

LV听听听听听听听听听听听听听left ventricle

LVF听听听听听听听听听听听听left ventricular failure

LVH听听听听听听听听听听听听left ventricular hypertrophy

MAC听听听听听听听听听听听听mycobacterium avium complex

MAI听听听听听听听听听听听听mycobacterium avium intracellulare

MAL听听听听听听听听听听听听malignant

MBAI听听听听听听听听听听听mycobacterium avium intracellulare

MBD听听听听听听听听听听听听minimal brain damage

MD听听听听听听听听听听听听听muscular dystrophy; manic depressive; myocardial damage

MDA听听听听听听听听听听听听methylene dioxyamphetamine

MEA听听听听听听听听听听听听multiple endocrine adenomatosis

MF听听听听听听听听听听听听听myocardial failure; myocardial fibrosis; mycosis fungoides

MGN听听听听听听听听听听听听membranous glomerulonephritis

MHN听听听听听听听听听听听听massive hepatic necrosis

MI听听听听听听听听听听听听听myocardial infarction; mitral insufficiency

MPC听听听听听听听听听听听听meperidine, promethazine, chlorpromazine

MRS听听听听听听听听听听听听methicillin resistant staphylococcal

MRSA听听听听听听听听听听听methicillin resistant staphylococcal aureus

MRSAU听听听听听听听听听听methicillin resistant staphylococcal aureus

MS听听听听听听听听听听听听听multiple sclerosis; mitral stenosis

MSOF听听听听听听听听听听听multi-system organ failure

MT听听听听听听听听听听听听听malignant teratoma

MUA听听听听听听听听听听听听myelogram

MVP听听听听听听听听听听听听mitral valve prolapse

MVR听听听听听听听听听听听听mitral valve regurgitation; mitral valve replacement

NACD听听听听听听听听听听听no anatomical cause of death

NAFLD听听听听听听听听听听nonalcoholic fatty liver disease

NCA听听听听听听听听听听听听neurocirculatory asthenia

NDI听听听听听听听听听听听听nephrogenic diabetes insipidus

NEG听听听听听听听听听听听听negative

NFI听听听听听听听听听听听听no further information

NFTD听听听听听听听听听听听normal full-term delivery

NG听听听听听听听听听听听听听nasogastric

NH3听听听听听听听听听听听听symbol for ammonia

NIDD听听听听听听听听听听听non-insulin-dependent diabetes

NIDDI听听听听听听听听听听non-insulin-dependent diabetes

NIDDM听听听听听听听听听听non-insulin-dependent diabetes mellitus

NSTEMI听听听听听听听听听non-ST-elevation myocardial infarction

N&V听听听听听听听听听听听听nausea and vomiting

NVD听听听听听听听听听听听听nausea, vomiting, diarrhea

OA听听听听听听听听听听听听听osteoarthritis

OAD听听听听听听听听听听听听obstructive airway disease

OB听听听听听听听听听听听听听obstetrical

OBS听听听听听听听听听听听听organic brain syndrome

OBST听听听听听听听听听听听obstructive; obstetrical

OD听听听听听听听听听听听听听overdose; oculus dexter (right eye); occupational disease

OHD听听听听听听听听听听听听organic heart disease

OLT听听听听听听听听听听听听orthotopic liver transplant

OM听听听听听听听听听听听听听otitis media

OMI听听听听听听听听听听听听old myocardial infarction

OMS听听听听听听听听听听听听organic mental syndrome

ORIF听听听听听听听听听听听open reduction, internal fixation

OS听听听听听听听听听听听听听oculus sinister (left eye); occipitosacral (fetal position)

OT听听听听听听听听听听听听听occupational therapy; old TB

OU听听听听听听听听听听听听听oculus uterque (each eye); both eyes

PA听听听听听听听听听听听听听pernicious anemia; paralysis agitans; pulmonary artery; peripheral arteriosclerosis

PAC听听听听听听听听听听听听premature auricular contraction; phenacetin, aspirin, caffeine

PAF听听听听听听听听听听听听paroxysmal auricular fibrillation

PAOD听听听听听听听听听听听peripheral arterial occlusive disease; peripheral arteriosclerosis occlusive disease

PAP听听听听听听听听听听听听primary atypical pneumonia

PAS听听听听听听听听听听听听pulmonary artery stenosis

PAT听听听听听听听听听听听听pregnancy at term; paroxysmal auricular tachycardia

Pb听听听听听听听听听听听听听chemical symbol for lead

PCD听听听听听听听听听听听听polycystic disease

PCF听听听听听听听听听听听听passive congestive failure

PCP听听听听听听听听听听听听pentachlorophenol; pneumocystis carinii pneumonia

PCT听听听听听听听听听听听听porphyria cutanea tarda

PCV听听听听听听听听听听听听polycythemia vera

PDA听听听听听听听听听听听听patent ductus arteriosus

PE听听听听听听听听听听听听听pulmonary embolism; pleural effusion; pulmonary edema

PEG听听听听听听听听听听听听percutaneous endoscopic gastrostomy; pneumoencephalography

PEGT听听听听听听听听听听听percutaneous endoscopic gastrostomy tube

PET听听听听听听听听听听听听pre-eclamptic toxemia

PG听听听听听听听听听听听听听pregnant; prostaglandin

PGH听听听听听听听听听听听听pituitary growth hormone

PH听听听听听听听听听听听听听past history; prostatic hypertrophy; pulmonary hypertension

PI听听听听听听听听听听听听听pulmonary infarction

PID听听听听听听听听听听听听pelvic inflammatory disease; prolapsed intervertebral disc

PIE听听听听听听听听听听听听pulmonary interstitial emphysema

PIP听听听听听听听听听听听听proximal interphalangeal joint

PKU听听听听听听听听听听听听phenylketonuria

PMD听听听听听听听听听听听听progressive muscular dystrophy

PMI听听听听听听听听听听听听posterior myocardial infarction; point of maximum impulse

PML听听听听听听听听听听听听progressive multifocal leukoencephalopathy

PN听听听听听听听听听听听听听pneumonia; periarteritis nodosa; pyelonephritis

PO听听听听听听听听听听听听听postoperative; by mouth

POC听听听听听听听听听听听听product of conception

POE听听听听听听听听听听听听point (or portal) of entry

PP听听听听听听听听听听听听听postpartum

POSS听听听听听听听听听听听possible; possibly

PPD听听听听听听听听听听听听purified protein derivative test for tuberculosis

PPH听听听听听听听听听听听听postpartum hemorrhage

PPLO听听听听听听听听听听听pleuropneumonia-like organism

PPROM听听听听听听听听听听preterm premature rupture of membranes

PPS听听听听听听听听听听听听postpump syndrome

PPT听听听听听听听听听听听听precipitated; prolonged prothrombin time

PREM听听听听听听听听听听听prematurity

PROB听听听听听听听听听听听probably

PROM听听听听听听听听听听听premature rupture of membranes

PSVT听听听听听听听听听听听paroxysmal supraventricular tachycardia

PT听听听听听听听听听听听听听paroxysmal tachycardia; pneumothorax; prothrombin time

PTA听听听听听听听听听听听听persistent truncus arteriosus

PTC听听听听听听听听听听听听plasma thromboplastin component

PTCA听听听听听听听听听听听percutaneous transluminal coronary angioplasty

PTL听听听听听听听听听听听听preterm labor

PTLA听听听听听听听听听听听percutaneous transluminal laser angioplasty

PU听听听听听听听听听听听听听peptic ulcer

PUD听听听听听听听听听听听听peptic ulcer disease; pulmonary disease

PUO听听听听听听听听听听听听pyrexia of unknown origin

P&V听听听听听听听听听听听听pyloroplasty and vagotomy

PVC听听听听听听听听听听听听premature ventricular contraction

PVD听听听听听听听听听听听听peripheral vascular disease; pulmonary vascular disease

PVI听听听听听听听听听听听听peripheral vascular insufficiency

PVL听听听听听听听听听听听听periventricular leukomalacia

PVT听听听听听听听听听听听听paroxysmal ventricular tachycardia

PVS听听听听听听听听听听听听premature ventricular systole (contraction)

PWI听听听听听听听听听听听听posterior wall infarction

PWMI听听听听听听听听听听听posterior wall myocardial infarction

PX听听听听听听听听听听听听听pneumothorax

R听听听听听听听听听听听听听听right

RA听听听听听听听听听听听听听rheumatoid arthritis; right atrium; right auricle

RAAA听听听听听听听听听听听ruptured abdominal aortic aneurysm

RAD听听听听听听听听听听听听rheumatoid arthritis disease; radiation absorbed dose

RAI听听听听听听听听听听听听radioactive iodine

RBBB听听听听听听听听听听听right bundle branch block

RBC听听听听听听听听听听听听red blood cells

RCA听听听听听听听听听听听听right coronary artery

RCS听听听听听听听听听听听听reticulum cell sarcoma

RD听听听听听听听听听听听听听Raynaud disease; respiratory disease

RDS听听听听听听听听听听听听respiratory distress syndrome

RE听听听听听听听听听听听听听regional enteritis

REG听听听听听听听听听听听听radioencephalogram

RESP听听听听听听听听听听听respiratory

RHD听听听听听听听听听听听听rheumatic heart disease

RLF听听听听听听听听听听听听retrolental fibroplasia

RLL听听听听听听听听听听听听right lower lobe

RLQ听听听听听听听听听听听听right lower quadrant

RMCA听听听听听听听听听听听right middle cerebral artery

RMCAT听听听听听听听听听听right middle cerebral artery thrombosis

RML听听听听听听听听听听听听right middle lobe

RMLE听听听听听听听听听听听right mediolateral episiotomy

RNA听听听听听听听听听听听听ribonucleic acid

RND听听听听听听听听听听听听radical neck dissection

R/O听听听听听听听听听听听听rule out

RSA听听听听听听听听听听听听reticulum cell sarcoma

RSR听听听听听听听听听听听听regular sinus rhythm

Rt听听听听听听听听听听听听听right

RT听听听听听听听听听听听听听recreational therapy; right

RTA听听听听听听听听听听听听renal tubular acidosis

RUL听听听听听听听听听听听听right upper lobe

RUQ听听听听听听听听听听听听right upper quadrant

RV听听听听听听听听听听听听听right ventricle

RVH听听听听听听听听听听听听right ventricular hypertrophy

RVT听听听听听听听听听听听听renal vein thrombosis

RX听听听听听听听听听听听听听drugs or other therapy or treatment

SA听听听听听听听听听听听听听sarcoma; secondary anemia

SACD听听听听听听听听听听听subacute combined degeneration

SARS听听听听听听听听听听听severe acute respiratory syndrome

SBE听听听听听听听听听听听听subacute bacterial endocarditis

SBO听听听听听听听听听听听听small bowel obstruction

SBP听听听听听听听听听听听听spontaneous bacterial peritonitis

SC听听听听听听听听听听听听听sickle cell

SCC听听听听听听听听听听听听squamous cell carcinoma

SCI听听听听听听听听听听听听subcoma insulin; spinal cord injury

SD听听听听听听听听听听听听听spontaneous delivery; septal defect; sudden death

SDAT听听听听听听听听听听听senile dementia Alzheimer type

SDII听听听听听听听听听听听sudden death in infancy

SDS听听听听听听听听听听听听sudden death syndrome

SEPT听听听听听听听听听听听septicemia

SF听听听听听听听听听听听听听scarlet fever

SGA听听听听听听听听听听听听small for gestational age

SH听听听听听听听听听听听听听serum hepatitis

SI听听听听听听听听听听听听听saline injection

SIADH听听听听听听听听听听syndrome of inappropriate antidiuretic hormone

SICD听听听听听听听听听听听sudden infant crib death

SID听听听听听听听听听听听听sudden infant death

SIDS听听听听听听听听听听听sudden infant death syndrome

SIRS听听听听听听听听听听听systemic inflammatory response syndrome

SLC听听听听听听听听听听听听short leg cast

SLE听听听听听听听听听听听听systemic lupus erythematosus; Saint Louis encephalitis

SMR听听听听听听听听听听听听submucous resection

SNB听听听听听听听听听听听听scalene node biopsy

SO or S&O听听听听听听salpingo-oophorectomy

SOB听听听听听听听听听听听听shortness of breath

SOM听听听听听听听听听听听听secretory otitis media

SOR听听听听听听听听听听听听suppurative otitis, recurrent

S/P听听听听听听听听听听听听status post

SPD听听听听听听听听听听听听sociopathic personality disturbance

SPP听听听听听听听听听听听听suprapubic prostatectomy

SQ听听听听听听听听听听听听听subcutaneous

S/R听听听听听听听听听听听听schizophrenic reaction; sinus rhythm

S/p P/T听听听听听听听听schizophrenic reaction, paranoid type

SSE听听听听听听听听听听听听soapsuds enema

SSKI听听听听听听听听听听听saturated solution potassium iodide

SSPE听听听听听听听听听听听subacute sclerosing panencephalitis

STAPH听听听听听听听听听听staphylococcal; staphylococcus

STB听听听听听听听听听听听听stillborn

STREP听听听听听听听听听听streptococcal; streptococcus

STS听听听听听听听听听听听听serological test for syphilis

STSG听听听听听听听听听听听split thickness skin graft

SUBQ听听听听听听听听听听听subcutaneous

SUD听听听听听听听听听听听听sudden unexpected death

SUDI听听听听听听听听听听听sudden unexplained death of an infant

SUID听听听听听听听听听听听sudden unexpected infant death

SVC听听听听听听听听听听听听superior vena cava

SVD听听听听听听听听听听听听spontaneous vaginal delivery

SVT听听听听听听听听听听听听superventricular tachycardia

Sx听听听听听听听听听听听听听symptoms

SY听听听听听听听听听听听听听syndrome

T&A听听听听听听听听听听听听tonsillectomy and adenoidectomy

TAH听听听听听听听听听听听听total abdominal hysterectomy

TAL听听听听听听听听听听听听tendon achilles lengthening

TAO听听听听听听听听听听听听triacetyloleandomycin (antibiotic); thromboangiitis obliterans

TAPVR听听听听听听听听听听total anomalous pulmonary venous return

TAR听听听听听听听听听听听听thrombocytopenia absent radius (syndrome)

TAT听听听听听听听听听听听听tetanus anti-toxin

TB听听听听听听听听听听听听听tuberculosis; tracheobronchitis

TBC, Tbc听听听听听听听tuberculosis

TCI听听听听听听听听听听听听transient cerebral ischemia

TEF听听听听听听听听听听听听tracheoesophageal fistula

TF听听听听听听听听听听听听听tetralogy of Fallot

TGV听听听听听听听听听听听听transposition great vessels

THA听听听听听听听听听听听听total hip arthroplasty

TI听听听听听听听听听听听听听tricuspid insufficiency

TIA听听听听听听听听听听听听transient ischemic attack

TIE听听听听听听听听听听听听transient ischemic episode

TL听听听听听听听听听听听听听tubal ligation

TM听听听听听听听听听听听听听tympanic membrane

TOA听听听听听听听听听听听听tubo-ovarian abscess

TP听听听听听听听听听听听听听thrombocytopenic purpura

TR听听听听听听听听听听听听听tricuspid regurgitation, transfusion reaction

TSD听听听听听听听听听听听听Tay-Sachs disease

TTP听听听听听听听听听听听听thrombotic thrombocytopenic purpura

TUI听听听听听听听听听听听听transurethral incision

TUR听听听听听听听听听听听听transurethral resection (NOS) (prostate)

TURP听听听听听听听听听听听transurethral resection of prostate

TVP听听听听听听听听听听听听total anomalous venous return

UC听听听听听听听听听听听听听ulcerative colitis

UGI听听听听听听听听听听听听upper gastrointestinal

UL听听听听听听听听听听听听听upper lobe

UNK听听听听听听听听听听听听unknown

UP听听听听听听听听听听听听听ureteropelvic

UPJ听听听听听听听听听听听听ureteropelvic junction

URI听听听听听听听听听听听听upper respiratory infection

UTI听听听听听听听听听听听听urinary tract infection

VAMP听听听听听听听听听听听vincristine, amethopterine, 6-mercaptopurine, and prednisone

VB听听听听听听听听听听听听听vinblastine

VC听听听听听听听听听听听听听vincristine

VD听听听听听听听听听听听听听venereal disease

VDRL听听听听听听听听听听听venereal disease research lab

VEE听听听听听听听听听听听听Venezuelan equine encephalomyelitis

VF听听听听听听听听听听听听听ventricular fibrillation

VH听听听听听听听听听听听听听vaginal hysterectomy; viral hepatitis

VL听听听听听听听听听听听听听vas ligation

VM听听听听听听听听听听听听听viomycin

V&P听听听听听听听听听听听听vagotomy and pyloroplasty

VPC, VPCS听听听听听听ventricular premature contractions

VR听听听听听听听听听听听听听valve replacement

VSD听听听听听听听听听听听听ventricular septal defect

VT听听听听听听听听听听听听听ventricular tachycardia

WBC听听听听听听听听听听听听white blood cell

WC听听听听听听听听听听听听听whooping cough

WE听听听听听听听听听听听听听Western encephalomyelitis

W/O听听听听听听听听听听听听without

WPW听听听听听听听听听听听听Wolfe-Parkinson-White syndrome

YF听听听听听听听听听听听听听yellow fever

ZE听听听听听听听听听听听听听Zollinger-Ellison (syndrome)

'听听听听听听听听听听听听听听minute

"听听听听听听听听听听听听听听second(s)

<听听听听听听听听听听听听听听less than

>听听听听听听听听听听听听听听greater than

猬囂齞ecreased

猬喬齣ncreased, elevated

c听听听听听听听听听听听听听听with

s听听听听听听听听听听听听听听without

00听听听听听听听听听听听听听secondary to

11 to

99听听听听听听听听听听听听听means unknown when reported in duration block, such as "99 years" = unknown number of years

APPENDIX B
Synonymous Sites/Terms

When a condition of a stated anatomical site is indexed in Volume 3, code condition of stated site as indexed. If stated site is not indexed, code condition of synonymous site.

听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听Alimentary canal听听听听听听听听听听听Gastrointestinal tract听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Body听听听听听听听听听听听听听听听听听听听听听听Torso, trunk听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Brain听听听听听听听听听听听听听听听听听听听听听Anterior fossa, basal ganglion, central nervous听

听听听听听听听听听听听听听听听听听听听听听听听听听听听system, cerebral, cerebrum, frontal, occipital,听

听听听听听听听听听听听听听听听听听听听听听听听听听听听parietal, pons, posterior fossa, prefrontal,听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听temporal, III and IV ventricle听听听听听听听听听听听听听听听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听Note: Do not use brain when ICD provides for听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听CNS under the reported condition.听听听听听听听听听听听听听听听

听听Cardiac听听听听听听听听听听听听听听听听听听听听Heart听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Chest听听听听听听听听听听听听听听听听听听听听听Thorax听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Geriatric听听听听听听听听听听听听听听听听听Senile听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Greater sac听听听听听听听听听听听听听听听Peritoneum听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Hepatic听听听听听听听听听听听听听听听听听听听Liver听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Hepatocellular听听听听听听听听听听听听Liver听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听Intestine听听听听听听听听听听听听听听听听听听Bowel, colon听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Kidney听听听听听听听听听听听听听听听听听听听听Renal听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Larynx听听听听听听听听听听听听听听听听听听听听Epiglottis, glottis, subglottis, supraglottis,听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听vocal cords听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Lesser sac听听听听听听听听听听听听听听听听Peritoneum听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Nasopharynx, pharynx听听听听听听Throat听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听听Pulmonary听听听听听听听听听听听听听听听听听听Lung听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Right\left hemispheric听听听听Code brain听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Hemispheric NOS听听听听听听听听听听听Do not assume brain听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Right\left ventricle听听听听听听Heart听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听Third\fourth ventricle听听听听Brain听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听

听LLL, LUL, RLL, RML, RUL听听听Lobes of the lungs when reported with听听听听听听听听听听听

听听听听听听听听听听听听听听听听听听听听听听听听听听听lobectomy, pneumonia, etc听听听听听听听听听听听听听听听听听听听听听听听

听

APPENDIX C
Code for Place of Occurrence of Fetal Death Injuries and External Causes

0.听听听听听听 Home

Excludes:听听听听听听听 Abandoned or derelict house (8)
Home under construction, but not yet occupied (6)
Institutional place of residence (1)
Office in home (5)

About home

Apartment

Bed and breakfast

Boarding house

Cabin (any type)

Caravan (trailer) park - residential

Condominium

Farm house

Dwelling

Hogan

Home premises

Home sidewalk

Home swimming pool

House (residential) (trailer)

Noninstitutional place of residence

Penthouse

Private driveway to home

Private garage

Private garden to home

Private walk to home

Private wall to home

Residence

Rooming house

Storage building at apartment

Swimming pool in private home, private garden, apartment or residence

Townhome

Trailer camp or court

Yard (any part) (area) (front) (residential)

Yard to home

1.听听听听听听 Residential institution

Almshouse

Army camp

Assisted Living

Board and care facility

Children鈥檚 home

Convalescent home

Correctional center

Detox center

Dormitory

Fraternity house

Geriatric center

Halfway house

Home for the sick

Hospice

Institution (any type)

Jail

Mental Hospital

Military (camp) (reservation)

Nurse鈥檚 home

Nursing home

Old people鈥檚 home

Orphanage

Penitentiary

Pensioner鈥檚 home

Prison

Prison camp

Reform school

Retirement home

Sorority house

State hospital

2.听听听听听听 School, other institution and public administrative area

Excludes:听听听听听听听 Building under construction (6)
Residential institution (1)
Sports and athletic areas (3)

听听听听听听听听听 Armory听听听听听听听听听听听听听听听听听听听听听听听听听听听Police station or cell

听听听听听听听听听 Assembly hall听听听听听听听听听听听听听听听听听听听听Post office

听听听听听听听听听 Campus听听听听听听听听听听听听听听听听听听听听听听听听听听听Private club

听听听听听听听听听 Child center听听听听听听听听听听听听听听听听听听听听听Public building

听听听听听听听听听 Church听听听听听听听听听听听听听听听听听听听听听听听听听听听Public hall

听听听听听听听听听 Cinema听听听听听听听听听听听听听听听听听听听听听听听听听听听Salvation army

听听听听听听听听听 Clubhouse听听听听听听听听听听听听听听听听听听听听听听听听School (grounds) (yard)

听听听听听听听听听 College听听听听听听听听听听听听听听听听听听听听听听听听听听School (private) (public) (state)

听听听听听听听听听 Country club (grounds)听听听听听听听听听听听Theatre

听听听听听听听听听 Court house听听听听听听听听听听听听听听听听听听听听听听Turkish bath

听听听听听听听听听 Dance hall听听听听听听听听听听听听听听听听听听听听听听听University

听听听听听听听听听 Day nursery (day care)听听听听听听听听听听听YMCA

听听听听听听听听听 Drive in theater听听听听听听听听听听听听听听听听听Youth center

听听听听听听听听听 Fire house听听听听听听听听听听听听听听听听听听听听听听听YWCA

听听听听听听听听听 Gallery

听听听听听听听听听 Health club

听听听听听听听听听 Health resort

听听听听听听听听听 Health spa

听听听听听听听听听 Hospital (parking lot)

听听听听听听听听听 Institute of higher learning

听听听听听听听听听 Kindergarten

听听听听听听听听听 Library

听听听听听听听听听 Mission

听听听听听听听听听 Movie house

听听听听听听听听听 Museum

听听听听听听听听听 Music hall

听听听听听听听听听 Night club

听听听听听听听听听 Opera house

听听听听听听听听听 Playground, school

听听听听听听听听听 Police precinct

听

3.听听听听听听 Sports and athletics area

Excludes:听听听听听听听 Swimming pool or tennis court in private home or garden (0)

Baseball field

Basketball court

Cricket ground

Dude ranch

Fives court

Football field

Golf course

Gymnasium

Hockey field

Ice palace

Racecourse

Riding school

Rifle range - NOS

Skating rink

Sports ground

Sports palace

Squash court

Stadium

Swimming pool (private) (public)

Tennis court

4.听听听听听听 Street and highway

Alley

Border crossing

Bridge NOS

Freeway

Interstate

Motorway

Named street/highway/interstate

Pavement

Road (public)

Roadside

Sidewalk NOS

听听听听听听听听听 Walkway

听

5.听听听听听听 Trade and service area

Excludes:听听听听听听听 Garage in private home (0)

Airport

Animal hospital

Bank

Bar

Body shop

Cafe

Car dealership

Casino

Electric company

Filling station

Funeral home

Garage - place of work

Garage away from highway except home

Garage building (for car storage)

Garage NOS

Gas station

Hotel (pool)

Laundry Mat

Loading platform - store

Mall

Market (grocery or other commodity)

Motel

Office (building) (in home)

Parking garage

Radio/television broadcasting station

Restaurant

Salvage lot, named

Service station

Shop, commercial

Shopping center (shopping mall)

Spa

Station (bus) (railway)

Storage Unit

Store

Subway (stairs)

Tourist court

Tourist home

Warehouse

6.听听听听听听 Industrial and construction areas

Building under construction

Coal pit

Coal yard

Construction (area, job or site)

Dairy processing plant

Dockyard

Dry dock

Electric tower

Factory (building) (premises)

Foundry

Gas works

Grain elevator

Gravel pit

Highway under construction

Industrial yard

Loading platform - factory

Logging operation area

Lumber yard

Mill pond

Oil field

Oil rig and other offshore installations

Oil well

Plant, industrial

Power-station (coal) (nuclear) (oil)

Produce building

Railroad track or trestle

Railway yard

Sand pit

Sawmill

Sewage disposal plant

Shipyard

Shop

Substation (power)

Subway track

Tannery

Tunnel under construction听听听听听听听听听听听听听

Water filtration plant

Wharf听听

Workshop听听听听听听听听听

7.听听听听听听 Farm

Excludes:听听听听听听听 Farm house and home premises of farm (0)

Barn NOS

Barnyard

Corncrib

Cornfield

Dairy (farm) NOS

Farm buildings

Farm pond or creek

Farmland under cultivation

Field, numbered or specialized

Gravel pit on farm

Orange grove

Orchard

Pasture

Ranch NOS

Range NOS

Silo

State Farm

8.听听听听听听 Other specified places

Abandoned gravel pit听听听听听听听听听听听听听听听听听听Military training ground

Abandoned public building or home听听听听听Mountain

Air force firing range听听听听听听听听听听听听听听听听Mountain resort

Balcony听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Named city

Bar pit or ditch听听听听听听听听听听听听听听听听听听听听听听Named lake

Beach NOS (named) (private)听听听听听听听听听听听Named room

Beach resort听听听听听听听听听听听听听听听听听听听听听听听听听听Named town

Boy鈥檚 camp听听听听听听听听听听听听听听听听听听听听听听听听听听听听Nursery NOS

Building NOS听听听听听听听听听听听听听听听听听听听听听听听听听听Open field

Bus stop听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Park (amusement) (any) (public)

Camp听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Parking lot

Camping grounds听听听听听听听听听听听听听听听听听听听听听听听Parking place

Campsite听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Pier

Canal听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Pipeline (oil)

Caravan site NOS听听听听听听听听听听听听听听听听听听听听听听Place of business NOS

Cemetery听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Playground NOS

City dump听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Pond or pool (natural)

Community jacuzzi听听听听听听听听听听听听听听听听听听听听听Porch

Creek (bank) (embankment)听听听听听听听听听听听听听Power line pole

Damsite听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Prairie

Derelict house听听听听听听听听听听听听听听听听听听听听听听听听Private property

Desert听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Public place NOS

Ditch听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Public property

Dock NOS听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Railway line

Driveway听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Reservoir (water)

Excavation site听听听听听听听听听听听听听听听听听听听听听听听Resort NOS

Fairgrounds听听听听听听听听听听听听听听听听听听听听听听听听听听听River

Field NOS听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Room (any)

Forest听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Sea

Fort听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Seashore NOS

Hallway听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Seashore resort

Harbor听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Sewer

Hill听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Specified address

Holiday camp听听听听听听听听听听听听听听听听听听听听听听听听听听Stream

Irrigation canal or ditch听听听听听听听听听听听听听Swamp

Junkyard听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Trail (bike)

Kitchen听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Vacation resort

Lake NOS听听听听听听听听听听听听听听听听听听听听听听听听听听听听听听Woods

Lake resort听听听听听听听听听听听听听听听听听听听听听听听听听听听Zoo

Manhole

Marsh

听

9.听听听听听听 Unspecified place

Bathtub

Bed

Camper (trailer)

Commode

Country

Downstairs

Fireplace

Hot tub

Jobsite

Near any place

On job

Outdoors NOS

Parked car

Rural

Sofa

Table

Tree

Vehicle (any)

听

APPENDIX D
ICD-10 Codes Valid for Causes of Fetal Death

A000

A001

A009

A010

A011

A012

A013

A014

A020

A021

A022

A028

A029

A030

A031

A032

A033

A038

A039

A040

A041

A042

A043

A044

A045

A046

A047

A048

A049

A050

A051

A052

A053

A058

A059

A060

A061

A062

A063

A064

A065

A066

A067

A068

A069

A072

A073

A078

A079

A082

A083

A084

A085

A090

A099

A162

A163

A164

A165

A167

A168

A169

A170

A171

A178

A179

A180

A181

A182

A183

A184

A185

A186

A187

A188

A190

A191

A192

A198

A199

A200

A201

A202

A203

A207

A208

A209

A210

A211

A212

A213

A217

A218

A219

A220

A221

A222

A227

A228

A229

A230

A231

A232

A233

A238

A239

A240

A241

A242

A243

A244

A250

A251

A259

A260

A267

A268

A269

A270

A278

A279

A280

A281

A282

A288

A289

A300

A301

A303

A305

A308

A309

A310

A311

A318

A319

A320

A321

A327

A328

A329

A360

A361

A362

A363

A368

A369

A370

A371

A378

A379

A38

A390

A391

A392

A393

A394

A395

A398

A399

A420

A421

A422

A427

A428

A429

A430

A431

A438

A439

A440

A441

A448

A449

A46

A480

A482

A483

A484

A488

A490

A491

A492

A493

A498

A499

A500

A502

A503

A504

A505

A509

A540

A541

A542

A543

A544

A545

A546

A548

A549

A600

A601

A609

A65

A660

A661

A662

A663

A664

A665

A666

A667

A669

A670

A671

A673

A679

A680

A681

A689

A690

A691

A692

A698

A699

A70

A750

A751

A752

A753

A759

A770

A771

A772

A773

A778

A779

A78

A790

A791

A798

A799

A800

A802

A803

A804

A809

A810

A811

A812

A818

A819

A820

A821

A829

A830

A831

A832

A833

A834

A835

A836

A838

A839

A840

A841

A848

A849

A850

A851

A852

A858

A86

A870

A871

A872

A878

A879

A880

A881

A888

A89

A90

A91

A920

A921

A922

A923

A924

A928

A929

A930

A931

A932

A938

A94

A950

A951

A959

A960

A961

A962

A968

A969

A980

A981

A982

A983

A984

A985

A988

A99

B000

B001

B002

B003

B004

B005

B007

B008

B009

B010

B011

B012

B018

B019

B020

B021

B022

B023

B027

B028

B029

B03

B04

B050

B051

B052

B053

B054

B058

B059

B080

B150

B159

B160

B161

B162

B169

B170

B171

B178

B179

B180

B181

B182

B188

B189

B190

B199

B200

B201

B202

B203

B204

B205

B206

B208

B209

B210

B211

B212

B220

B221

B222

B230

B231

B232

B238

B24

B250

B251

B252

B258

B259

B260

B261

B262

B263

B268

B269

B270

B271

B278

B279

B330

B331

B332

B333

B334

B338

B340

B341

B342

B343

B344

B348

B349

B380

B381

B382

B383

B384

B387

B388

B389

B390

B391

B392

B393

B394

B395

B399

B400

B401

B402

B403

B407

B408

B409

B410

B417

B418

B419

B420

B421

B427

B428

B429

B430

B431

B432

B438

B439

B440

B441

B442

B447

B448

B449

B450

B451

B452

B453

B457

B458

B459

B460

B461

B462

B463

B464

B465

B468

B469

B470

B471

B479

B480

B481

B482

B483

B484

B487

B488

B49

B500

B508

B509

B510

B518

B519

B520

B528

B529

B530

B531

B538

B54

B550

B551

B552

B559

B560

B561

B569

B570

B571

B572

B573

B574

B575

B580

B581

B582

B583

B588

B589

B59

B600

B601

B602

B608

B64

B650

B651

B652

B653

B658

B659

B660

B661

B662

B663

B664

B665

B668

B669

B670

B671

B672

B673

B674

B675

B676

B677

B678

B679

B680

B681

B689

B690

B691

B698

B699

B700

B701

B710

B711

B718

B719

B72

B73

B740

B741

B743

B744

B748

B749

B75

B760

B761

B768

B769

B770

B778

B779

B780

B781

B787

B789

B79

B80

B810

B811

B812

B813

B814

B818

B820

B829

B830

B831

B832

B833

B834

B838

B839

B870

B871

B872

B873

B874

B878

B879

B880

B881

B882

B883

B888

B889

B89

B99

C000

C001

C002

C003

C004

C005

C006

C008

C009

C01

C020

C021

C022

C023

C024

C028

C029

C030

C031

C039

C040

C041

C048

C049

C050

C051

C052

C058

C059

C060

C061

C062

C068

C069

C07

C080

C081

C088

C089

C090

C091

C098

C099

C100

C101

C102

C103

C104

C108

C109

C110

C111

C112

C113

C118

C119

C12

C130

C131

C132

C138

C139

C140

C142

C148

C150

C151

C152

C153

C154

C155

C158

C159

C160

C161

C162

C163

C164

C165

C166

C168

C169

C170

C171

C172

C173

C178

C179

C180

C181

C182

C183

C184

C185

C186

C187

C188

C189

C19

C20

C210

C211

C212

C218

C220

C221

C222

C223

C224

C227

C229

C23

C240

C241

C248

C249

C250

C251

C252

C253

C254

C257

C259

C260

C261

C268

C269

C300

C301

C310

C311

C312

C313

C318

C319

C321

C322

C323

C328

C329

C33

C340

C341

C342

C343

C348

C349

C37

C380

C381

C382

C383

C384

C388

C390

C398

C399

C400

C401

C402

C403

C408

C409

C410

C411

C412

C413

C414

C419

C430

C431

C432

C433

C434

C435

C436

C437

C438

C439

C440

C441

C442

C443

C444

C445

C446

C447

C448

C449

C450

C451

C452

C457

C459

C460

C461

C462

C463

C467

C468

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S091

S092

S097

S098

S099

S100

S101

S107

S108

S109

S110

S111

S112

S117

S118

S119

S120

S121

S122

S127

S128

S129

S130

S131

S132

S133

S134

S135

S136

S140

S141

S142

S143

S144

S145

S146

S150

S151

S152

S153

S157

S158

S159

S16

S170

S178

S179

S18

S197

S198

S199

S200

S201

S202

S203

S204

S207

S208

S210

S211

S212

S217

S218

S219

S220

S221

S222

S223

S224

S225

S228

S229

S230

S231

S232

S233

S234

S235

S240

S241

S242

S243

S244

S245

S246

S250

S251

S252

S253

S254

S255

S257

S258

S259

S260

S268

S269

S270

S271

S272

S273

S274

S275

S276

S277

S278

S279

S280

S281

S290

S297

S298

S299

S300

S301

S302

S307

S308

S309

S310

S311

S315

S317

S318

S320

S321

S322

S323

S324

S325

S327

S328

S330

S331

S332

S333

S334

S335

S336

S337

S340

S341

S342

S343

S344

S345

S346

S348

S350

S351

S352

S353

S354

S355

S357

S358

S359

S360

S361

S362

S363

S364

S365

S366

S367

S368

S369

S370

S371

S372

S373

S377

S378

S379

S380

S381

S382

S383

S390

S396

S397

S398

S399

S400

S407

S408

S409

S410

S411

S417

S418

S420

S421

S422

S423

S424

S427

S428

S429

S430

S431

S432

S433

S434

S435

S436

S437

S440

S441

S442

S443

S444

S445

S447

S448

S449

S450

S451

S452

S453

S457

S458

S459

S460

S461

S462

S463

S467

S468

S469

S47

S480

S481

S489

S497

S498

S499

S500

S501

S507

S508

S509

S510

S517

S518

S519

S520

S521

S522

S523

S524

S525

S526

S527

S528

S529

S530

S531

S532

S533

S534

S540

S541

S542

S543

S547

S548

S549

S550

S551

S552

S557

S558

S559

S560

S561

S562

S563

S564

S565

S567

S568

S570

S578

S579

S580

S581

S589

S597

S598

S599

S600

S601

S602

S607

S608

S609

S610

S611

S617

S618

S619

S620

S621

S622

S623

S624

S625

S626

S627

S628

S630

S631

S632

S633

S634

S635

S636

S637

S640

S641

S642

S643

S644

S647

S648

S649

S650

S651

S652

S653

S654

S655

S657

S658

S659

S660

S661

S662

S663

S664

S665

S666

S667

S668

S669

S670

S678

S680

S681

S682

S683

S684

S688

S689

S697

S698

S699

S700

S701

S707

S708

S709

S710

S711

S717

S718

S720

S721

S722

S723

S724

S727

S728

S729

S730

S731

S740

S741

S742

S747

S748

S749

S750

S751

S752

S757

S758

S759

S760

S761

S762

S763

S764

S767

S770

S771

S772

S780

S781

S789

S797

S798

S799

S800

S801

S807

S808

S809

S810

S817

S818

S819

S820

S821

S822

S823

S824

S825

S826

S827

S828

S829

S830

S831

S832

S833

S834

S835

S836

S837

S840

S841

S842

S847

S848

S849

S850

S851

S852

S853

S854

S855

S857

S858

S859

S860

S861

S862

S863

S867

S868

S869

S870

S878

S880

S881

S889

S897

S898

S899

S900

S901

S902

S903

S907

S908

S909

S910

S911

S912

S913

S917

S920

S921

S922

S923

S924

S925

S927

S929

S930

S931

S932

S933

S934

S935

S936

S940

S941

S942

S943

S947

S948

S949

S950

S951

S952

S957

S958

S959

S960

S961

S962

S967

S968

S969

S970

S971

S978

S980

S981

S982

S983

S984

S997

S998

S999

T002

T003

T008

T009

T012

T013

T019

T021

T022

T023

T024

T025

T028

T029

T031

T032

T033

T038

T039

T041

T042

T043

T048

T049

T050

T052

T053

T055

T058

T059

T062

T063

T064

T065

T07

T08

T090

T091

T092

T093

T094

T095

T096

T098

T099

T10

T110

T111

T112

T113

T114

T115

T116

T118

T119

T12

T130

T131

T132

T133

T134

T135

T136

T138

T139

T140

T141

T142

T143

T144

T145

T146

T147

T148

T149

T150

T151

T158

T159

T16

T170

T171

T172

T173

T174

T175

T178

T179

T180

T181

T182

T183

T184

T185

T188

T189

T190

T191

T192

T193

T198

T199

T200

T201

T202

T203

T204

T205

T206

T207

T210

T211

T212

T213

T214

T215

T216

T217

T220

T221

T222

T223

T224

T225

T226

T227

T230

T231

T232

T233

T234

T235

T236

T237

T240

T241

T242

T243

T244

T245

T246

T247

T250

T251

T252

T253

T254

T255

T256

T257

T260

T261

T262

T263

T264

T265

T266

T267

T268

T269

T270

T271

T272

T273

T274

T275

T276

T277

T280

T281

T282

T283

T284

T285

T286

T287

T288

T289

T300

T301

T302

T303

T304

T305

T306

T307

T310

T311

T312

T313

T314

T315

T316

T317

T318

T319

T320

T321

T322

T323

T324

T325

T326

T327

T328

T329

T330

T331

T332

T333

T334

T335

T336

T337

T338

T339

T340

T341

T342

T343

T344

T345

T346

T347

T348

T349

T350

T351

T352

T353

T354

T355

T356

T357

T360

T361

T362

T363

T364

T365

T366

T367

T368

T369

T370

T371

T372

T373

T374

T375

T378

T379

T380

T381

T382

T383

T386

T387

T388

T389

T390

T391

T392

T393

T394

T398

T399

T400

T401

T402

T403

T404

T405

T406

T407

T408

T409

T410

T411

T412

T413

T414

T415

T420

T421

T422

T423

T424

T425

T426

T427

T428

T430

T431

T432

T433

T434

T435

T436

T438

T439

T440

T441

T442

T443

T444

T445

T446

T447

T448

T449

T450

T451

T452

T453

T454

T455

T456

T457

T458

T459

T460

T461

T462

T463

T464

T465

T466

T467

T468

T469

T470

T471

T472

T473

T474

T475

T476

T477

T478

T479

T480

T481

T482

T483

T484

T485

T486

T487

T490

T491

T492

T493

T494

T495

T496

T497

T498

T499

T500

T501

T502

T503

T504

T505

T506

T507

T508

T509

T510

T511

T512

T513

T518

T519

T520

T521

T522

T523

T524

T528

T529

T530

T531

T532

T533

T534

T535

T536

T537

T539

T540

T541

T542

T543

T549

T55

T560

T561

T562

T563

T564

T565

T566

T567

T568

T569

T570

T571

T572

T573

T578

T579

T58

T590

T591

T592

T593

T594

T595

T596

T597

T598

T599

T600

T601

T602

T603

T604

T608

T609

T610

T611

T612

T618

T619

T620

T621

T622

T628

T629

T630

T631

T632

T633

T634

T635

T636

T638

T639

T64

T650

T651

T652

T653

T654

T655

T656

T658

T659

T66

T670

T671

T672

T673

T674

T675

T676

T677

T678

T679

T68

T690

T691

T698

T699

T700

T701

T702

T703

T704

T708

T709

T71

T730

T731

T732

T733

T738

T739

T740

T741

T742

T743

T748

T749

T750

T751

T752

T753

T754

T758

T780

T781

T782

T783

T784

T788

T789

T790

T791

T792

T793

T794

T795

T796

T797

T798

T799

T800

T801

T802

T803

T804

T805

T806

T808

T809

T810

T811

T812

T813

T814

T815

T816

T817

T818

T819

T820

T821

T822

T823

T824

T825

T826

T827

T828

T829

T830

T831

T832

T834

T835

T836

T838

T839

T840

T841

T842

T843

T844

T845

T846

T847

T848

T849

T850

T851

T852

T853

T854

T855

T856

T857

T858

T859

T860

T861

T862

T863

T864

T868

T869

T870

T871

T872

T873

T874

T875

T876

T880

T881

T882

T883

T884

T885

T886

T887

T888

T889

T900

T901

T902

T903

T904

T905

T908

T909

T910

T911

T912

T913

T914

T915

T918

T919

T920

T921

T922

T923

T924

T925

T926

T928

T929

T930

T931

T932

T933

T934

T935

T936

T938

T939

T940

T941

T950

T951

T952

T953

T954

T958

T959

T96

T97

T980

T981

T982

T983

V191

V195

V201

V205

V211

V215

V221

V225

V231

V235

V241

V245

V251

V255

V261

V265

V271

V275

V281

V285

V291

V295

V301

V306

V311

V316

V321

V326

V331

V336

V341

V346

V351

V356

V361

V366

V371

V376

V381

V386

V391

V395

V401

V406

V411

V416

V421

V426

V431

V436

V441

V446

V451

V456

V461

V466

V471

V476

V481

V486

V491

V495

V501

V506

V511

V516

V521

V526

V531

V536

V541

V546

V551

V556

V561

V566

V571

V576

V581

V586

V591

V595

V601

V606

V611

V616

V621

V626

V631

V636

V641

V646

V651

V656

V661

V666

V671

V676

V681

V686

V691

V695

V701

V706

V711

V716

V721

V726

V731

V736

V741

V746

V751

V756

V761

V766

V771

V776

V781

V786

V791

V795

V800

V801

V802

V803

V804

V805

V806

V807

V808

V809

V810

V811

V812

V813

V815

V816

V817

V818

V819

V820

V821

V822

V823

V825

V826

V827

V828

V829

V831

V836

V841

V846

V851

V856

V861

V866

V870

V871

V872

V873

V874

V875

V876

V877

V878

V879

V880

V881

V882

V883

V884

V885

V886

V887

V888

V889

V890

V891

V892

V893

V899

V910

V911

V912

V913

V914

V915

V916

V917

V918

V919

V930

V931

V932

V933

V934

V935

V936

V937

V938

V939

V940

V941

V942

V943

V944

V945

V946

V947

V948

V949

V950

V951

V952

V953

V954

V958

V959

V960

V961

V962

V968

V969

V970

V973

V978

V98

V99

W20

W21

W22

W23

W24

W25

W26

W27

W28

W29

W30

W31

W32

W33

W34

W35

W36

W37

W38

W39

W40

W41

W42

W43

W44

W45

W49

W50

W51

W52

W55

W58

W64

W85

W86

W87

W88

W89

W90

W91

W92

W93

W99

X19

X30

X31

X32

X33

X340

X341

X348

X349

X35

X36

X37

X39

X40

X41

X42

X43

X44

X45

X46

X47

X48

X49

X52

X57

X58

X590

X599

X85

X87

X88

X89

X90

X93

X94

X95

X96

X97

X98

X99

Y00

Y02

Y18

Y19

Y22

Y23

Y24

Y25

Y26

Y27

Y28

Y29

Y32

Y33

Y34

Y360

Y361

Y362

Y364

Y365

Y366

Y367

Y368

Y369

*U010

*U011

*U012

*U013

*U014

*U015

*U016

*U017

*U018

*U019

U071

听

APPENDIX E
Invalid and Substitute Fetal Death Codes

The following categories are invalid for NCHS fetal cause of death coding. Substitute code(s) for fetal cause of death coding appears to the right.

Use the substitute codes when conditions classifiable to the following codes are reported