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The Importance of Knowing Exactly Why We Die

Cheryl Clark, for HealthLeaders Media, September 22, 2010

The folks who think about how we categorize causes of death are already thinking about the coming age of ICD-11. Lucky them.

Morbid aspects aside, this undertaking involves an intellectually challenging and fascinating pursuit: the formulation of the International Classification of Diseases mortality codes, Volume 11.

ICD-10 diagnostic designations for death, about 8,000 of them developed in 1992, have been in place since 1999. Now, explains Robert Anderson, chief of mortality statistics for the National Center for Health Statistics, "it's time for an update." 

For sure, there will be more causes of death to code. After all, humans die in a growing assortment of ways, some of them bizarre.

Before this causes a fatal hypertensive episode in people who are barely able to fathom ICD-10 clinical codes, realize Anderson is not talking about codes soon to be implemented for clinical diagnoses. This ICD-11 edition will deal first with mortality, or the acceptable words doctors attending dying patients can write on certificates of death. (Yes, an ICD-11 clinical version is planned, but not in the near future.)

It's critically important. Until we know exactly why and how people die, how can we quantify these deaths and prioritize prevention?

Anderson notes that the last 20 years have seen the growth of new pharmaceutical products that can kill. Oxycodone overdoses, for example. Currently, deaths from oxycodone are labeled deaths from opiods. "Now, the only way to differentiate is to go back to the original text of the death certificate," Anderson says.

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