took some time to read the WHO ICD-10 code and the ICMR released 'guidance for appropriate recording of Covid-19 related deaths in india' (which is based on ICD-10). the words that are repeated the most in these guidelines are COD (cause of death) and MCCD (medical certificate of cause of death). as per the rules of the registration of births and deaths act (india), 1969, the attending medical practitioner issues the MCCD using Form 4 for institutional deaths and Form 4a for non-institutional deaths. the MCCD form contains two parts, part 1 to 'record the immediate and antecedent causes'; and part 2 to 'record the significant conditions that contributed to the death but were not part of the sequence of events leading to death'. covid 19 is confirmed only on Code U07.1 which means test and symptoms should be positive. 1.3 states that: [deaths result from a combined effect or two or more related conditions (meaning, a sequence of conditions)]. in such sequences, the disease or injury which initiated the sequence is the COD; all the morbid conditions or injuries consequent to the COD are termed as antecedent and immediate cause. the guideline goes on to explain that the medical practitioner should fill in the logical sequence leading to the death. 2.2 states that: [even if a person has pre-existing morbid conditions (chronic obstructive pulmonary disease/asthma, chronic bronchitis, ischemic heart disease, cancer, diabetes mellitus) that can increase the risk of developing respiratory infections leading to complications in a covid-19 positive individual, only those that contributed to death should be recorded in part 2. 3.4 ii states that: [record the logical sequence of events. there may be many medical conditions in a person. based on the most logical events that caused death, these conditions must be mentioned in the MCCD form] after that, the MCCD should be sent to DMO who has a board of doctors assigned to look into it, study the logical sequence and determine whether the death should be recorded as covid related or not. all covid reports (irrespective of covid-19 being COD or not) should be recorded in the ICMR-NCDIR e-mortality software, a software which aids in recording and reporting cause of deaths as per national standards of death reporting laid down by the office of registrar general of india (ORGI). stating the sequence of morbid conditions in order, allows selection of the cause of death that is considered as 'underlying COD' - this is coded with ICD-10 codes and counted for statistical purposes.
