This document describes certification and classification (coding) of deaths related to COVID-19. The primary goal is to identify all deaths due to COVID-19. Again this document provides information about the ICD-10 codes for COVID-19 and includes mortality classification (coding) instructions for statistical tabulation in the context of COVID-19. It includes a reference to the WHO case definitions for surveillance.
A simplified section specifically addresses the persons that fill in the medical certificate of cause of death. It should be distributed to certifiers separate from the coding instructions.
The use of official terminology, COVID-19, should be used for all certification of this cause of death. As there are many types of coronaviruses, it is recommended not to use “coronavirus” in place of COVID-19. This helps to reduce uncertainty for the classification or coding and to correctly monitor these deaths.
There is increasing evidence that people with existing chronic conditions or compromised immune systems due to disability are at higher risk of death due to COVID-19.
Persons with COVID-19 may die of other diseases or accidents, such cases are not deaths due to COVID-19 and should not be certified as such. In case you think that COVID-19 aggravated the consequences of the accident, you may report COVID-19
DEFINITION FOR DEATHS DUE TO COVID-19
A death due to COVID-19 is defined for [surveillance purposes]as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case*, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). There should be no period of complete recovery from COVID-19 between illness and death.
A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of preexisting conditions that are suspected of triggering a severe course of COVID-19.
Examples of terms used by certifiers to describe COVID-19 and that can be coded as synonyms of COVID-19:
- COVID Positive
- Coronavirus Pneumonia
- COVID-19 Infection
- Sars-Cov-2 Infection (Coronavirus Two Infection)
- COVID-19 Coronavirus
- Infection – COVID-19 (Coroner Informed)
- Hospital Acquired Pneumonia – COVID-Positive
- Corona Virus two infection (SARS-Cov-2)
- Corona Virus Pneumonia (COVID-19)
- Coronavirus-Two Infection
- Novel coronavirus
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Refer International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)-WHO Version for;2019.Chapter XXII Codes for special purposes (U00-U85)
Confirmed case: a case that is classified as confirmed for reporting purposes.
Probable case: a case that is classified as probable for reporting purposes.
Laboratory-confirmed case: a case that is confirmed by one or more of the laboratory methods listed in the case definition under “Laboratory criteria for diagnosis.” Although other laboratory methods may be used in clinical diagnosis, only those listed are accepted for laboratory confirmation for reporting purposes.
Clinically compatible case: a clinical syndrome generally compatible with the disease, but no specific clinical criteria need to be met unless they are noted in the case classification.
Haemophilus influenzae (Invasive Disease)
Invasive disease due to Haemophilus influenzae may produce any of several clinical syndromes, including meningitis, bacteremia, epiglottitis, or pneumonia
Laboratory criteria for diagnosis
Isolation of H. influenzae from a normally sterile site
Probable: a clinically compatible illness with detection of H. influenzae type b antigen in cerebrospinal fluid
Confirmed: a clinically compatible illness that is culture confirmed
Antigen test results in urine or serum are unreliable for diagnosis of H. influenzae disease. [CDS]
*Case definitions can also change over time as more information is obtained. The first case definition for SARS, based on clinical symptoms and either contact with a case or travel to an area with SARS transmission, was published in CDC’s Morbidity and Mortality Weekly Report (MMWR) on March 21, 2003. Two weeks later it was modified slightly. On March 29, after a novel coronavirus was determined to be the causative agent, an interim surveillance case definition was published that included laboratory criteria for evidence of infection with the SARS-associated coronavirus. By June, the case definition had changed several more times. In anticipation of a new wave of cases in 2004, a revised and much more complex case definition was published in December 2003.