Cause of death certification guide

The purpose of this guide is to assist certifiers in understanding how to accurately complete the Medical Certificate of Cause of Death (MCCD) to increase the quality of the national mortality dataset, and expedite the processing of death certificates and aggregation of cause of death data. Information and examples for the most common issues encountered are identified later in this guide. 

There is also a separate section for guidance on how to complete a Medical Certificate of Cause of Perinatal Death (MCCPD).

This guide provides advice on the completion of the MCCD and MCCPD only. It does not extend to other reporting requirements such as notifiable conditions or adverse effects reporting. Please seek advice from relevant health authorities for such requirements. 

The information provided is not intended as a guide to the legal requirements of death certification, notification of death or of cases that require reporting to the coroner. These requirements differ between jurisdictions. For advice on your legal obligations please contact your state or territory Coroner's Office.

The MCCD completed by medical practitioners is the major source of Australia's mortality statistics. The use of mortality statistics for demographic and health purposes supports understanding of Australian society now and in the future. These statistics guide the formulation and monitoring of health and lifestyle policies and impact on the funding of medical and health research. Accurate cause of death information is also important to family members to understand what caused a loved one’s death and to be aware of conditions that may occur in other family members. 

After registration of the death:

• The Registrar of Births, Deaths and Marriages in each state or territory provides the information on the MCCD to the Australian Bureau of Statistics (ABS).
• ABS staff code the conditions listed on the MCCD according to the International Statistical Classification of Diseases and Related Health Problems (ICD). The 10th revision of the ICD is currently used by the ABS (ICD-10). The ICD is produced by the World Health Organization, and is the international standard diagnostic classification used to classify diseases and other health problems recorded on many types of health and vital records including death certificates and hospital records. 
• An ICD-10 code is assigned to every condition on the death certificate. In a large proportion of deaths, a sequence of morbid events will have led to death. From the standpoint of prevention, the objective is to break the sequence as early as possible, hence information on every condition is required. 
• Coding rules are applied to assign an underlying cause of death. 
• The ABS compiles the national mortality dataset utilising the coded data from the MCCD.
• Causes of death for doctor certified deaths are processed monthly and are released in the Provisional Mortality Statistics publication. The collective causes of death dataset including both doctor and coroner certified deaths are released annually in Causes of Death, Australia. This publication includes summaries of the dataset. Special tabulations are also available upon request from the ABS.
• The data produced by the ABS is used by government bodies, researchers, clinicians, educational institutions and many other organisations. 

This guide is provided to assist medical practitioners to report accurate information to support coding of cause of death. If you have any questions or would like further information, please contact the Australian Bureau of Statistics on phone toll free: 1800 620 963.

The ABS is unable to provide blank medical certificates. Please contact the Registrar of Births, Deaths and Marriages in your state or territory (see contact details below).

The ABS is unable to provide blank medical certificates. Blank MCCDs for completion may be requested from the Registrar of Births, Deaths and Marriages in your state or territory.

What constitutes a 'reportable death' varies by jurisdiction. In general, a death must be reported to a coroner in the following instances:

• where the person died unexpectedly, and the cause of death is unknown
• where the death resulted, directly or indirectly, from an accident or injury, even if there has been a prolonged interval between the incident and death
• where the person died in a violent or unnatural manner
• where the person died during, or as a result of, a medical procedure
• where the person was held in care or in custody immediately before they died (noting that ‘in care’ excludes facilities such as residential aged care)
• where a doctor has been unable to sign a death certificate giving the cause of death
• where the identity of the person who has died is not known.

If you are unsure whether a death should be reported to the coroner, please contact the Coroner's Office in your state or territory for further advice.

If you are in any doubt as to whether a death should be reported to the coroner, please contact the Coroner's Office in your state or territory for further advice. 

The ABS would like to acknowledge the assistance provided by Dr Mitchell Shaw, Dr Amy Weber and Dr Ian Holme of Clinical Excellence Queensland.