Centers for Disease Control and PreventionNational Center for Health Statistics

Robert Anderson, Ph.D. Mortality Statistics BranchDivision of Vital Statistics

The Mortality Reference The Mortality Reference GroupGroup

Updating ICD-10

• ICD-10 updates

•Minor updates every year

•Major updates every 3 years

•Two key updating groups:

•Update and Revision Committee [URC]

•Mortality Reference Group [MRG]

Mortality Reference Group (MRG)

•Established in 1997

•Objective: To improve international comparability of mortality data by establishing standardized application and interpretation of the ICD-10

Mortality Reference Group (MRG)

•Primary function: To identify and solve problems related to the interpretation and application of ICD-10 to coding and classification of mortality.

•Forwards decisions to URC

MRG Membership

•~25 members

•11 countries

•Pan American Health Organization

•World Health Organization

•Co-Chairs:

•Lars Age Johansson, Sweden

•Donna L. Hoyert, USA

Source of MRG Issues

•Mortality Forum

•Collaborating Centers for the Family of International Classifications

•World Health Organization

Why Select a Main Injury?

•Parallel to underlying cause

• Intuitive appeal – one injury per death

•Countries that code manually do not typically code all conditions or injuries

•Need for consistency and comparability

Current Guidelines

•Where more than one kind of injury to a single body region is mentioned and there is no clear indication as to which caused death, the General Principle and the Selection Rules should be applied in the normal way.

•When more than one body region is involved, coding should be made to the relevant category of Injuries involving multiple body regions.

Source: ICD-10, Volume 2, Section 4.2.10

Current Guidelines

•Where more than one kind of injury to a single body region is mentioned and there is no clear indication as to which caused death, the General Principle and the Selection Rules should be applied in the normal way.

•When more than one body region is involved, coding should be made to the relevant category of Injuries involving multiple body regions.

Some Considerations

•No list of valid sequences to facilitate automated coding

•Severity

•Multiple body regions