The Mortality Reference Group

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The Mortality Reference Group
Robert Anderson, Ph.D. Mortality Statistics
Branch Division of Vital Statistics
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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

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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

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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

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MRG Membership

• 25 members
• 11 countries
• Pan American Health Organization
• World Health Organization
• Co-Chairs
• Lars Age Johansson, Sweden
• Donna L. Hoyert, USA

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Source of MRG Issues

• Mortality Forum
• Collaborating Centers for the Family of
  International Classifications
• World Health Organization

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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

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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
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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.

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Some Considerations

• No list of valid sequences to facilitate
  automated coding
• Severity
• Multiple body regions