Instruction Manual Part 2a 

Instructions for Classifying the Underlying Cause of Death 

Errata for Year 2012 

Due to the limited number of changes required for coding instructions in 2011, the 

2a Instruction Manual will not be reprinted this year. The 2a Errata for Year 2012 

provides replacement pages for the 2011 2a Instruction Manual. Please discard the 

pages indicated on the errata cover sheet and insert the replacement pages provided. 

This will update the coding instructions for 2012 classification purposes

 

Page# Content to be Corrected Corrections 

78 K. Intent of Certifier , last sentence in 1st paragraph add Corrected page attached 

phrase 

79 Add vertebral abscess to the title of #2. Corrected page attached 

215 Add new rare cause to Appendix A. Corrected page attached 

222 Add AKI and AMA to abbreviations Corrected page attached 

232 Add MCA to abbreviations Corrected page attached 

235 Correct the alpha order postion of the abbreviation PP Corrected page attached 

 2a January 2012 E-1
 
Section III - Editing and Interpreting Entries 

 Codes for Record 

 I (a) Cerebral hematoma with S068 I672 

 (b) cerebral arteriosclerosis 

 (c) 

 II X599 

Accident 

Code to accident NOS (X599). Cerebral hematoma is considered traumatic as 

indexed since “accident” is reported in the Manner of Death box. 

3. Some conditions are indexed directly to a traumatic category, but the Classification 

also provides a nontraumatic category. When these conditions are reported and the 

Manner of Death box is checked as Natural, consider these conditions as nontraumatic 

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 “nontraumatic” in the 

Index. 

 Code for Record 

I (a) Subdural hematoma I620 

 (b) 

 II 

Natural

Code to nontraumatic subdural hematoma (I620). The subdural hematoma is 

considered to be nontraumatic since “Natural” is reported in the Manner of Death 

box and is selected by application of General Principle. 

 

Codes for Record 

I (a) Subdural hematoma I620 

 (b) 

 (c) 

II Fracture hip S720 W19 

 Natural Fell in hospital 

Code to nontraumatic subdural hematoma (I620). The subdural hematoma is 

considered to be nontraumatic since “Natural” is reported in the Manner of Death 

box and is selected by application of General Principle. 

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Section III - Editing and Interpreting Entries 

 Codes for Record 

I (a) Subdural hematoma S065 

 (b) Open wound of head S019 

II Fell in hospital W19 

Natural 

Code to unspecified fall (W19). Even though Natural is reported in the Manner of 

Death box, the subdural hematoma is reported due to an injury. 

K. Intent of certifier 

In order to assign the most appropriate code for a given diagnostic entity, it may be 

necessary to take other recorded information and the order in which the information is 

reported into account. It is important to interpret this information properly so the meaning 

intended by the certifier is correctly conveyed. The following instructions help to 

determine the intent of the certifier. Apply Intent of Certifier instructions to “See also” 

terms in the Index and to any synonymous sites or terms as well. 

 

For the following conditions, use the causation tables to determine if the NOS code from 

the title or the alternative code listed below the title should be used in determining a 

sequence. If the alternative code forms an acceptable sequence with the condition reported 

below it, then that sequence should be accepted. 

1. Other and unspecified gastroenteritis and colitis of unspecified origin (A099) 

a. Code A090 (Gastroenteritis and colitis of infectious origin) 

When reported due to: 

 A000-B99 

R75 

Y431-Y434 

Y632 

Y842 

 

 Codes for Record 

I (a) Enteritis A090 

(b) Listeriosis A329 

Code I(a) gastroenteritis and colitis of infectious origin, A090, since enteritis is 

reported due to a condition classified to A329. 

EXCEPTION: When the enteritis is reported due to another infectious 

condition or an organism classified to A49 or B34, refer to Section III, 

6. Organisms and Infections.

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Section III - Editing and Interpreting Entries 

b. Code K529 (Noninfective gastroenteritis and colitis, unspecified) when reported 

due to conditions listed in the causation table under address code K529. 

Codes for Record 

 I (a) Enteritis K529 

(b) Abscess of intestine K630 

Code to K630. The code K630 is listed as a subaddress to K529 in the causation 

table, so this sequence is accepted. 

2. Spinal Abscess (A180) 

Vertebral Abscess (A180) 

 Code M462 (Nontuberculous spinal abscess): 

When reported due to: 

A400-A419 H650-H669 M910-M939 

A500 H950-H959 M960-M969 

A509 J00-J399 N10-N12 

A527 J950-J959 N136 

A539 K650-K659 N151 

B200-B24 K910-K919 N159 

B89 L00-L089 N288 

B99 M000-M1990 N340-N343 

C412 M320-M351 N390 

C760 M359 N700-N768 

C795 M420-M429 N990-N999 

C810-C969 M45-M519 R75 

D160-D169 M600 S000-T983 

D480 M860-M889 

D550-D589 M894 

 Codes for Record 

I (a) Spinal Abscess M462 

 (b) Staphylococcal septicemia A412 

 Code I(b) A412, staphylococcal septicemia. The code A412 is listed as a 

 subaddress to M462 in the causation table; therefore, this sequence is 

 accepted. 

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Section III - Editing and Interpreting Entries 

3. Charcot’s Arthropathy (A521) 

Code G98 (Arthropathy, neurogenic, neuropathic (Charcot’s), nonsyphilitic): 

When reported due to: 

A30 Leprosy G608 Hereditary sensory neuropathy 

E10-E14 Diabetes mellitus G901 Familial dysautonomia 

E538 Subacute combined G950 Syringomyelia 

 degeneration (of spinal Q059 Spina bifida, unspecified 

 cord) Y453 Indomethacin 

F101 Alcohol abuse Y453 Phenylbutazone 

F102 Alcoholism Y427 Corticosteroids 

G600 Hypertrophic interstitial 

 neuropathy 

G600 Peroneal muscular atrophy 

 Codes for Record 

 I (a) Charcot’s arthropathy G98 

 (b) Diabetes E149 

Code to diabetes with other specified complications (E146). Since the E149 is 

listed as a subaddress under G98 in the Causation Table, use G98 for the 

Charcot’s arthropathy. The diabetes selected by general principle links (LDC) 

with Charcot’s arthropathy.

 80 2a January 2012 E-1
APPENDIX A 

Infrequent and Rare Cause-of-Death Edits for Underlying and Multiple 

 Cause-of-Death Classification 

Conditions classifiable to A00-B99 are NOT to be considered as rare when reported with 

human immunodeficiency virus (HIV) B20-B24. 

 

A00 Cholera 

 

A01 Typhoid and paratyphoid fevers 

 

A05.1 Botulism (botulism, infant botulism, wound botulism) 

 

A07.0-.2, .8-.9 Other protozoal intestinal diseases, excluding coccidiosis 

 

A08.0 Rotaviral enteritis-less than 5 years of age 

A20 Plague 

 

A21 Tularemia 

 

A22 Anthrax 

 

A23 Brucellosis 

 

A24.0 Glanders 

 

 A24.1-.4 Melioidosis 

 

A25 Rat-bite fever 

 

A27 Leptospirosis 

 

A30 Leprosy 

 

A33 Tetanus neonatorum 

 

A34 Obstetrical tetanus 

 

A35 Other tetanus (tetanus) 

 

A36 Diphtheria 

 

A37 Whooping cough 

 

A44 Bartonellosis 

 

A49.1 Streptococcus pneumoniae - less than 5 years of age 

 

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APPENDIX A 

Infrequent and Rare Cause-of-Death Edits for Underlying and Multiple 

 Cause-of-Death Classification 

 A65 Nonvenereal syphilis 

 

A66 Yaws 

 

A67 Pinta 

 

A68 Relapsing fever 

 

A69 Other spirochetal infection 

 

A70 Chlamydia psittaci infection (ornithosis) 

 

A75 Typhus fever 

 

A77.1 Spotted fever due to Rickettsia conorii (Boutonneuse fever) 

 

A77.2 Spotted fever due to Rickettsia siberica (North Asian tick fever) 

 

A77.3 Spotted fever due to Rickettsia australis (Queensland tick typhus) 

 

A77.8 Other spotted fevers (other tick-borne rickettsioses) 

 

A77.9 Unspecified spotted fevers (unspecified tick-borne rickettsioses) 

 

A78 Q fever 

 

A79 Other rickettsioses 

 

A80 Acute poliomyelitis 

 

A81 Atypical virus infections of central nervous system 

 

A82 Rabies 

 

A84 Tick-borne viral encephalitis 

 

A85.2 Arthropod-borne viral encephalitis, unspecified (viral 

encephalitis transmitted by other and unspecified arthropods) 

 

A90 Dengue fever 

 

A91 Dengue hemorrhagic fever 

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 APPENDIX C 

 Geographic Codes

State FIPS Alpha State FIPS Alpha 

Alabama AL Nebraska NE 

Alaska AK Nevada NV 

Arizona AZ New Hampshire NH 

Arkansas AR New Jersey NJ 

California CA New Mexico NM 

Colorado CO New York NY 

Connecticut CT North Carolina NC 

Delaware DE North Dakota ND 

District of Columbia DC Ohio OH 

Florida FL Oklahoma OK 

Georgia GA Oregon OR 

Hawaii HI Pennsylvania PA 

Idaho ID Puerto Rico PR 

Illinois IL Rhode Island RI 

Indiana IN South Carolina SC 

Iowa IA South Dakota SD 

Kansas KS Tennessee TN 

Kentucky KY Texas TX 

Louisiana LA Utah UT 

Maine ME Vermont VT 

Maryland MD Virginia VA 

Massachusetts MA Virgin Islands VI 

Michigan MI Washington WA 

Minnesota MN West Virginia WV 

Mississippi MS Wisconsin WI 

Missouri MO Wyoming WY 

Montana MT 

Territories and Outlying Areas 

American Samoa AS US Minor Outlying Islands UM* 

Federated States of Micronesia FM Baker Island 

Guam GU Howland Island 

Marshall Islands MH Jarvis Island 

Northern Mariana Islands MP Johnston Atoll 

Palau PW Kingman Reef 

Puerto Rico PR Midway Islands 

Virgin Islands (US) VI Navassa Island 

 Palmyra Atoll 

 Wake Island 

*Not recognized as a valid USPS State abbreviation 

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APPENDIX D 

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. 

AAA abdominal aortic aneurysm AFB acid-fast bacillus 

 

AAS aortic arch syndrome AGG agammaglobulinemia 

 

AAT alpha-antitrypsin AGL acute granulocytic leukemia 

 

AAV AIDS-associated virus AGN acute glomerulonephritis 

 

AB abdomen; abortion; asthmatic AGS adrenogenital syndrome 

bronchitis 

 AHA acquired hemolytic anemia; 

ABD abdomen autoimmune hemolytic anemia 

 

ABE acute bacterial endocarditis AHD arteriosclerotic heart disease 

 

ABS acute brain syndrome AHHD arteriosclerotic hypertensive heart 

 disease 

ACA adenocarcinoma 

 AHG anti-hemophilic globulin deficiency 

ACD arteriosclerotic coronary disease 

 AHLE acute hemorrhagic leukoencephalitis 

ACH adrenal cortical hormone 

 AI aortic insufficiency; additional 

ACT acute coronary thrombosis information 

 

ACTH adrenocorticotrophic hormone AIDS acquired immunodeficiency syndrome 

 

ACVD arteriosclerotic cardiovascular AKA above knee amputation 

disease 

 AKI acute kidney injury 

ADEM acute disseminated 

encephalomyelitis ALC alcoholism 

 

ADH antidiuretic hormone ALL acute lymphocytic leukemia 

 

ADS antibody deficiency syndrome ALS amyotrophic lateral sclerosis 

 

AEG air encephalogram AMA advanced maternal age; against 

 medical advice; antimitochondrial 

AF auricular or atrial fibrillation; acid antibody(ies 

fast 

AMI acute myocardial infarction 

 222 2a January 2012 E-1
APPENDIX D 

Standard Abbreviations and Symbols

IGA immunoglobin A IUP intrauterine pregnancy 

 

IHD ischemic heart disease IV intervenous; intravenous 

 

IHSS idiopathic hypertrophic subaortic IVC intravenous cholangiography; 

stenosis inferior vena cava 

 

ILD ischemic leg disease IVCC intravascular consumption 

 coagulopathy 

IM intramuscular; intramedullary; 

infectious mononucleosis IVD intervertebral disc 

 

IMPP intermittent positive pressure IVH intraventricular hemorrhage 

 

INAD infantile neuroaxonal dystrophy IVP intravenous pyelogram 

 

INC incomplete IVSD intraventricular septal defect 

 

INE infantile necrotizing IVU intravenous urethrography 

encephalomyelopathy 

 IWMI inferior wall myocardial infarction 

INF infection; infected; infantile; 

infarction JBE Japanese B encephalitis 

 

INH isoniazid; inhalation KFS Klippel-Feil syndrome 

 

INS idiopathic nephrotic syndrome KS Klinefelter’s syndrome 

 

IRDM insulin resistant diabetes mellitus KUB kidney, ureter, bladder 

 

IRHD inactive rheumatic heart disease K-W Kimmelstiel-Wilson disease 

 or syndrome 

ISD interatrial septal defect 

 LAP laparotomy 

ITP idiopathic thrombocytopenic 

purpura LAV lymphadenopathy-associated 

 virus 

IU intrauterine 

 LAV/HTLV- lymphadenopathy-associated 

IUCD intrauterine contraceptive device III virus/human T-cell lymphotrophic 

 virus-III 

IUD intrauterine device 

(contraceptive); 

intrauterine death 

 231 2a January 2012 E-1
APPENDIX D 

Standard Abbreviations and Symbols

LBBB left bundle branch block LOMCS left otitis media chronic serous 

LBNA lysis bladder neck adhesions LP lumbar puncture 

 

LBW low birth weight LRI lower respiratory infection 

LBWI low birth weight infant LS lumbosacral; lymphosarcoma 

LCA left coronary artery LSD lysergic acid diethylamide 

LDH lactic dehydrogenase LSK liver, spleen, kidney 

LE lupus erythematosus; lower LUL left upper lobe 

extremity; left eye 

LUQ left upper quadrant 

LKS liver, kidney, spleen 

LV left ventricle 

LL lower lobe 

 LVF left ventricular failure 

LLL left lower lobe 

LVH left ventricular hypertrophy 

LLQ lower left quadrant 

 MAC mycobacterium avium complex 

LMA left mentoanterior (position of 

fetus) MAI mycobacterium avium intracellulare 

LML left middle lobe; left mesiolateral MAL malignant 

LMCAT left middle cerebral artery MBAI mycobacterium avium intracellulare 

thrombosis 

MBD minimal brain damage 

LML left mesiolateral; 

left mediolateral (episiotomy) MCA metastatic cancer; middle cerebral 

artery 

LMP last menstrual period; left 

mento- posterior (position of MD muscular dystrophy; manic 

fetus) depressive; myocardial damage 

LN lupus nephritis MDA methylene dioxyamphetamine 

LOA left occipitoanterior MEA multiple endocrine adenomatosis 

MF myocardial failure; myocardial 

fibrosis; mycosis fungoides 

 232 2a January 2012 E-1
APPENDIX D 

Standard Abbreviations and Symbols

POC product of conception PUD peptic ulcer disease; pulmonary 

 disease 

POE point (or portal) of entry 

 PUO pyrexia of unknown origin 

POSS possible; possibly 

 P&V pyloroplasty and vagotomy 

PP postpartum 

 PVC premature ventricular contraction 

PPD purified protein derivative test for 

tuberculosis PVD peripheral vascular disease; 

 pulmonary vascular disease 

PPH postpartum hemorrhage 

 PVI peripheral vascular insufficiency 

PPLO pleuropneumonia-like organism 

 PVL periventricular leukomalacia 

PPS postpump syndrome 

 PVT paroxysmal ventricular 

PPT precipitated; prolonged prothrombin tachycardia 

time 

 PVS premature ventricular systole 

PREM prematurity (contraction) 

 

PROB probably PWI posterior wall infarction 

 

PROM premature rupture of membranes PWMI posterior wall myocardial 

 infarction 

PSVT paroxysmal supraventricular 

tachycardia PX pneumothorax 

 

PT paroxysmal tachycardia; R right 

pneumothorax; 

prothrombin time RA rheumatoid arthritis; right 

 atrium; right auricle 

PTA persistent truncus arteriosus 

 RAAA ruptured abdominal aortic 

PTC plasma thromboplastin component aneurysm 

 

PTCA percutaneous transluminal coronary RAD rheumatoid arthritis disease; 

 angioplasty radiation absorbed dose 

 

PTLA percutaneous transluminal laser RAI radioactive iodine 

 angioplasty 

 RBBB right bundle branch block 

PU peptic ulcer 

 

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APPENDIX D 

Standard Abbreviations and Symbols

RBC red blood cells RSR regular sinus rhythm 

RCA right coronary artery Rt right 

RCS reticulum cell sarcoma RT recreational therapy; right 

RD Raynaud’s disease; respiratory RTA renal tubular acidosis 

disease 

RUL right upper lobe 

RDS respiratory distress syndrome 

RUQ right upper quadrant 

RE regional enteritis 

RV right ventricle 

REG radioencephalogram 

RVH right ventricular hypertrophy 

RESP respiratory 

RVT renal vein thrombosis 

RHD rheumatic heart disease 

RX drugs or other therapy or 

RLF retrolental fibroplasia treatment 

RLL right lower lobe SA sarcoma; secondary anemia 

RLQ right lower quadrant SACD subacute combined degeneration 

RMCA right middle cerebral artery SARS severe acute respiratory syndrome 

RMCAT right middle cerebral artery SBE subacute bacterial endocarditis 

thrombosis 

SBO small bowel obstruction 

RML right middle lobe 

SBP spontaneous bacterial peritonitis 

RMLE right mediolateral episiotomy 

SC sickle cell 

RNA ribonucleic acid 

SCC squamous cell carcinoma 

RND radical neck dissection 

SCI subcoma insulin; spinal cord 

R/O rule out injury 

RSA reticulum cell sarcoma SD spontaneous delivery; septal 

defect; sudden death 

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