This page documents all terminology artifacts defined in this IG — code systems, value sets, and LOINC codes — together with guidance for member countries on ICD-version-agnostic coding and national terminology extensions.

Local Code Systems

This IG defines the following local code systems for concepts where no suitable internationally recognised code system exists for the exact WHO MCCoD concept. Member countries SHALL NOT add codes to these code systems at the regional level; extensions are national only.

Code System	Id	Purpose	Codes
MCCoD Manner of Death	mccod-manner-of-death	Nine WHO MCCoD manner of death categories from Frame B	9
MCCoD Place of Occurrence of External Cause	mccod-place-of-injury	Ten WHO MCCoD place of occurrence codes from Frame B	10
MCCoD Pregnancy Timing Relative to Death	mccod-pregnancy-timing	Four timing categories for pregnancy relative to death, from Frame B Women of Reproductive Age	4
MCCoD Condition Category	mccod-condition-category	Distinguishes Condition profile types within a MCCoD document for unambiguous querying	2
MCCoD Local Observation Codes	mccod-observation-codes	Observation type codes for Frame B Observations where no suitable LOINC code exists	7
MCCoD Composition Section Codes	mccod-section-codes	Section codes for Frame B sub-sections in MCCoDComposition	3
MCCoD Cause of Death Line Position	mccod-line-position	Identifies the line position (a/b/c/d) of a Condition in the causal chain	4

Value Sets

Value Set	Id	Binding Strength	Used In
MCCoD Cause of Death Codes	mccod-cause-of-death-codes	Extensible	MCCoDCauseOfDeathCondition.code, MCCoDUnderlyingCauseOfDeath.code, MCCoDContributingCondition.code
MCCoD Manner of Death Codes	mccod-manner-of-death-codes	Required	MCCoDMannerOfDeath.valueCodeableConcept
MCCoD Place of Occurrence Codes	mccod-place-of-injury-codes	Required	MCCoDInjuryIncident.component[placeOfOccurrence].valueCodeableConcept
MCCoD Pregnancy Timing Codes	mccod-pregnancy-status-codes	Required	MCCoDPregnancyStatus.component[pregnancyTiming].valueCodeableConcept
MCCoD Yes/No/Unknown	mccod-yes-no-unknown	Required	All binary (Yes/No/Unknown) elements across Frame B Observations: surgery, autopsy, multiple pregnancy, stillborn, pregnant within year, pregnancy contributed to death
MCCoD Line Position Codes	mccod-line-position-codes	Required	MCCoDCauseOfDeathCondition.extension[linePosition].valueCode

Cause of Death ValueSet — ICD-Agnostic Design

The mccod-cause-of-death-codes ValueSet uses an extensible binding and includes the following coding systems:

System	Canonical URI	Notes
ICD-10 (WHO reference)	http://hl7.org/fhir/sid/icd-10	WHO reference version of ICD-10
ICD-10-CM	http://hl7.org/fhir/sid/icd-10-cm	US clinical modification — used in some AeHIN countries
ICD-11 MMS	http://id.who.int/icd/release/11/mms	ICD-11 Mortality and Morbidity Statistics. Use with DORIS.
SNOMED CT	http://snomed.info/sct	Permitted for countries with SNOMED licensing

The extensible binding means that codes from national ICD variants not listed above (e.g. ICD-10-AM used in Australia and New Zealand) are also permitted. Member countries SHOULD declare the system URI for their national ICD variant in their national implementation guide, extending this IG.

Text is always required regardless of whether a coded value is present. This is enforced by error-level invariants on all three Condition profiles. The text element preserves the certifying practitioner's original clinical language and supports countries without electronic coding capability.

LOINC Codes Used in This IG

The following LOINC codes are used across the profiles in this IG. LOINC is used where an internationally recognised code exists for the concept. Local codes are used only where no suitable LOINC code exists for the exact WHO MCCoD concept — these are documented in the Observation Codes section below.

LOINC Code	Display Name	Used As	Profile / Element
64297-5	Death certificate	Composition.type	MCCoDComposition
79378-6	Cause of death	Composition.section.code	MCCoDComposition — Frame A section
69449-7	Manner of death	Observation.code	MCCoDMannerOfDeath
69440-6	Disease onset to death interval	Extension reference (informative)	MCCoDOnsetToDeathInterval extension
85699-7	Autopsy was performed	Observation.code	MCCoDAutopsyPerformed
55752-0	Clinical information	Observation.component.code	MCCoDSurgeryPerformed — reason component
74496-1	Injury location ICD code	Observation.component.code	MCCoDInjuryIncident — place of occurrence component
82810-3	Pregnancy status	Observation.code	MCCoDPregnancyStatus
69442-2	Timing of recent pregnancy in relation to death	Observation.component.code	MCCoDPregnancyStatus — pregnancyTiming component
57722-1	Birth plurality of Pregnancy	Observation.component.code	MCCoDFetalOrInfantDeath — multiplePregnancy component
8339-4	Birth weight Measured	Observation.component.code	MCCoDFetalOrInfantDeath — birthWeight component
11884-4	Gestational age Estimated	Observation.component.code	MCCoDFetalOrInfantDeath — gestationalAge component
63900-5	Current age or age at death	Observation.component.code	MCCoDFetalOrInfantDeath — motherAge component (applied to mother)

Local Observation Codes

The following concepts from the WHO MCCoD form do not have a suitable internationally recognised LOINC code. Local codes from mccod-observation-codes are used and documented here for national IG authors who may wish to substitute more specific national or future LOINC codes:

Local Code	Concept	Reason No LOINC Used
#surgery-within-4-weeks	Surgery performed within last 4 weeks of death	No LOINC code exists for surgery specifically within 4 weeks of death as a distinct concept
#injury-incident	External cause injury incident (composite)	No single LOINC code covers the composite external cause concept as defined on the WHO MCCoD form
#fetal-or-infant-death	Fetal or infant death details (composite)	No single LOINC code covers the composite fetal/infant death concept
#stillborn	Stillborn (Yes/No/Unknown question)	No LOINC code exists for this as a discrete Yes/No question
#hours-survived	Hours survived if death within 24 hours	No LOINC code exists for this exact concept
#perinatal-maternal-conditions	Perinatal maternal conditions affecting fetus/newborn	No LOINC code exists for this as a discrete concept
#pregnancy-status-at-death	Pregnancy status at or near time of death (composite)	LOINC 82810-3 is used for the parent Observation; local code for the composite concept

Yes / No / Unknown Pattern

All binary (Yes/No/Unknown) questions across Frame B use a consistent pattern via the mccod-yes-no-unknown ValueSet, avoiding the creation of multiple local code systems for the same pattern:

• Yes — http://terminology.hl7.org/CodeSystem/v2-0136#Y
• No — http://terminology.hl7.org/CodeSystem/v2-0136#N
• Unknown — http://terminology.hl7.org/CodeSystem/data-absent-reason#asked-unknown (the question was asked but the answer is not known)

Guidance for Member Countries

Member countries extending this IG nationally SHOULD:

• Declare which ICD system URI they use for cause-of-death coding in their national implementation guide (e.g. http://hl7.org/fhir/sid/icd-10 for ICD-10 WHO, or http://id.who.int/icd/release/11/mms for ICD-11 MMS)
• Declare whether DORIS is used for underlying cause selection, and set the dorisDerived extension accordingly
• Define national ConceptMaps to map local manner of death administrative codes to the mccod-manner-of-death-codes ValueSet for cross-border comparability
• Replace local Observation codes (mccod-observation-codes) with more specific national or future LOINC codes where available, documenting the substitution in the national IG
• Declare whether text-only entries (no code) are permitted in their jurisdiction for cause-of-death coding, and under what conditions