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Volume 2 INSTRUCTION MANUAL Instruction Instruction manual entries Source Date approved Major/ Minor update Implementation date Page iv Add Substitute phrase Table of contents 4.2.2 Interpretation of “highly improbable” Accepted and rejected sequences for the selection of?underlying cause of death?for?mortality?statistics MRG (URC:1130) October 2007 Minor January 2010 Page vi Add contents reference to new section in Volume 2 _______________________________________________________________ 5a. Recommendations 138a _______________________________________________________________ MRG (URC:0113) October 2002 Major January 2006 Page 23 Revise text 3.1.3 Two codes for certain conditions The “dagger and asterisk” system …… While the dagger and asterisk system provides alternative classifications for the presentation of statistics, it is a principle of the ICD that the dagger code is the primary code and must always be used. Provision should be made for the asterisk code to be used in addition if the alternative method of presentation may also be required. For coding, the asterisk code must never be used alone. However, for morbidity coding, the dagger and asterisk sequence may be reversed when the manifestation of a disease is the primary focus of care. Statistics incorporating the dagger codes conform with the traditional classification for presenting data on mortality and morbidity and other aspects of medical care. MbRG (URC:1237) January 2008 Major January 2010 Revise text: page 25 3.1.3 Two codes for certain conditions (iii) If neither the symbol nor the alternative code appears in the title, the rubric as a whole is not subject to dual classification but individual inclusion terms may be; if so, these terms will be marked with the symbol and their alternative codes given, e.g. A54.8 Other gonococcal infections Gonococcal: ... ? peritonitis? (K67.1*) ?