The Relevance of Queries and Coding Procedures to the Writing of Cause-of-Death Statements

A cause-of-death statement may result in a query by the vital records registrar to clarify cause of death information or to educate the certifier of death in recommended death certification procedures. The level of querying depends on local need and resources, and is usually conducted at one of six query priority levels. When applying International Classification of Disease (ICD) coding to cause-of-death information, nosologists use a General Rule and 12 additional rules, as needed, to identify an underlying cause of death for statistical purposes. Incorrectly or poorly written cause-of-death statements, and even well-written ones, may result in queries that could have been avoided, or in codes for the underlying cause of death that differ from those intended by either the certifier of death. In an attempt to foster improvement in cause-of-death statements and to facilitate coding, this article presents basic information about queries and coding rules so that certifiers of death will be aware of potential problems and coding issues. In general, cause-of-death statements that are complete, specific, timely, correct in temporal sequence, and written according to guidelines reduce the need for queries and facilitate the ICD coding process.