DOI: 10.3886/icpsr38671
title: Mortality in Correctional Institutions: ICD-10 Diagnosis Codes for Natural Deaths Occurring in State Prison or Local Jail Custody, 2000-2019
title: Archival Version

description: The Mortality in Correctional Institutions (MCI) collection was collected annually by the Bureau of Justice Statistics (BJS) from 2000 to 2019 from the approximately 2,800 local adult jail jurisdictions nationwide, and from 2001 to 2019 from the 50 state departments of corrections. The MCI obtained national, state, and incident-level data on persons who died while in the physical custody of state prisons and local jails. The MCI began in 2000 under the Death in Custody Reporting Act of 2000 (P.L. 106-297), and continued after the law was reauthorized in 2014. BJS used MCI data to track national trends in the number and causes (or manners) of deaths occurring in state prison or local jail custody. The MCI collected data about the characteristics of the decedents as well as circumstances surrounding the death, including the cause, time and location where the death occurred, and information on whether an autopsy was conducted and the availability of results to the respondent. This data collection is comprised of two datasets (one prison, one jail) that contain all deaths from 2000-2019 with the illness (also known as natural) deaths assigned ICD-10 diagnosis codes when possible. Data on executions and deaths of persons in the custody of federal, state, and local law enforcement agencies not acting in a jail capacity were considered out-of-scope for MCI. More details on the collection, survey instruments, and publications using the MCI data can be found at the BJS website: Mortality in Correctional Institutions (MCI) (Formerly Deaths in Custody Reporting Program (DCRP)) | Bureau of Justice Statistics.
description: MCI respondents were instructed to report a final cause of death (COD) as determined by a medical examiner for each decedent (see next paragraph). As part of the collection and processing of BJS's MCI collection, a nosologist (i.e., a clinical coder trained by the National Center for Health Statistics (NCHS) at the U.S. Department of Health and Human Service's Centers for Disease Control and Prevention (CDC)) used the text associated with illness deaths on the MCI death forms to assign standard diagnosis codes from the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Based on the text provided by respondents, the nosologist assigned a maximum of five codes to each MCI death case. In the MCI collection, nosologists assigned ICD-10 diagnosis codes only to natural deaths, such as heart disease, cancer, and liver disease. Unnatural deaths, such as drug or alcohol intoxication, homicides, suicides, and accidents, were not assigned ICD codes in the MCI. For decedents who were HIV positive or have AIDS at the time of death, MCI respondents were instructed to check a box for AIDS-related deaths, but no additional COD information was captured for these deaths. For quality control, BJS required nosologists to perform intraobserver error checks on 10% of their coded cases. If the nonagreement rate exceeded 3%, BJS conducted further review on additional cases coded by that nosologist and required retraining to the nosology contract staff as needed. If only one illness was reported for a decedent, the assigned ICD-10 diagnosis code defined the underlying COD for that individual, and BJS ranked cases with single causes of death by frequency separately for male and female decedents. When a death was reportedly caused by multiple illnesses, BJS used the most common sex-specific COD among those with only one COD to designate the underlying COD. For example, a male decedent with two conditions--liver disease and cancer--is counted as a cancer death because cancer is a more common COD than liver disease among men who die from a single COD. A more complete discussion of the coding, ranking, and COD determination process can be found in this BJS publication: https://bjs.ojp.gov/content/pub/pdf/aicddcrpndi.pdf. The illness information collected in MCI should not be used to infer that decedents did not have additional medical conditions that contributed significantly to their deaths. Unlike official state death forms, which ask coroners, doctors, or medical examiners to describe the chain of events leading to the death, as well as other conditions that contributed, the MCI only requests the underlying cause of death. When the MCI decedents were matched with their official state death certificates, the mean number of medical conditions that received an ICD-10 diagnosis code was 1.06 in MCI, compared to 2.69 on the death certificates (https://bjs.ojp.gov/content/pub/pdf/aicddcrpndi.pdf).
description: Variables include decedent demographics, correctional information, circumstances of death, and up to 5 ICD-10 codes describing the underlying cause of death.
description: Response Rates: All state department of corrections and 93 to 99% of jails participated for data years 2000 through 2019.
description: Individual-level death data are collected from local jail facilities and state prisons in the United States.
description: Datasets: DS0: Study-Level Files DS1: State Prison Deaths 2001-2019 DS2: Local Jail Deaths 2000-2019
description: Deaths of individuals incarcerated in local jail facilities or in state prisons. Smallest Geographic Unit: state
description: record abstracts; paper and pencil interview (PAPI)The ICD-10 codes presented in this collection are diagnosis codes, not procedure or billing codes, and as previously stated, should not be interpreted as the sole medical condition suffered by the decedent at the time of death. ICD-10 diagnosis codes consist of a letter followed by a 2-digit number that can range from 00 to 99. Additional numerical digits after the first two digits represent modifications or specifications to the condition designated by the first two digits, and are offset by a decimal. The ICD-10 codes in the MCI data are presented without decimals. If the MCI ICD-10 diagnosis code consists of a letter and a 2-digit number, there were no modifications or specifications associated with that condition in the text provided by the respondent. For 3- and 4-digit numbers, users should place the decimal point between the second and third number. For example, C22, C220, C223, C227, and C229 would all refer to a malignant neoplasm of the liver, but the additional digits were assigned when a respondent gave greater detail: C22.0 refers to liver cell carcinoma; C22.3 refers to angiosarcoma of the liver; C22.7 refers to other specified carcinomas of the liver; and C22.9 refers to malignant neoplasm of the liver which is not specified as primary or secondary.Prior to 2015, only natural or illness deaths consistently were assigned ICD-10 diagnosis codes in the MCI collection. Unnatural deaths, including suicide, homicide, accidental injury and accidental intoxication, were assigned ICD-10 codes sporadically if enough descriptive detail was included on the individual death record submitted to BJS, and the nosologist was familiar with the ICD-10 diagnosis code. Similarly, deaths ultimately ruled to be of unknown cause received ICD-10 codes describing any medical detail prison or jail repsondents provided. From 2015 to 2019, nosologists coded all deaths with ICD-10 codes regardless of cause, although the level of detail varied based on what text was provided by the respondent (for example, many accidental intoxication deaths were coded as T50.9 - Poisoning by other and unspecified drugs, medicaments, and biological substances). While the ICD-10 diagnosis codes are provided on all records to which they were assigned during the MCI collection, BJS was specifically concerned with the medical coding of illness deaths, and data users should concentrate on analyses of ICD-10 codes for these decedents, as opposed to those who died by unnatural causes. The ICD-10 classification manual had a number of updates, culminating in a 2019 version. In some cases, ICD-10 diagnosis codes assigned to MCI decedents in the early years of the collection may no longer be found in the 2019 version. BJS suggests using Google to look for the letter and number combination to see whether earlier ICD-10 manual versions used the code listed.Users interested in looking up ICD-10 diagnosis codes can refer to the Centers for Disease Control or the World Health Organization. Note that some ICD-10 codes may have fallen out of use in in more recent versions of the ICD-10 manual.