Table 2.

Consensus classification of unexplained sudden deaths in infants and children

Proposed ICD-11 Code	Current ICD-10 Code	Proposed ICD-11 Stem Code/Classification	ICD-10 Classification	Notes for Death Certifiers
MH11	R95	Unexplained sudden death in infancy or Sudden Infant Death Syndrome	Sudden Infant Death Syndrome	a
MH11.0	R95.0	Unexplained sudden death in infancy or Sudden Infant Death Syndrome, with mention of autopsy	Sudden Infant Death Syndrome	a
MH11.1	R95.9	Unexplained Sudden Death in Infancy or Sudden Infant Death Syndrome, without mention of autopsy	Sudden Infant Death Syndrome	a
MH12	R96	Unexplained sudden death in children and adults	Other sudden death, cause unknown	b
MH12.0		Unexplained sudden death in children and adults, with mention of autopsy		b
MH12.1		Unexplained sudden death in children and adults, without mention of autopsy		b
MH14	R99	Other Ill-Defined or Unspecified Causes of Death (Undetermined)	Other Ill-Defined or Unspecified Causes of Death	c, d
PB00-PB0Z	W75-W84	Unintentional threat to breathing (accidental asphyxia)	Unintentional threat to breathing by external compression of airways or chest; Unintentional threat to breathing by unspecified means	e, f

a:The sudden unexpected death of an apparently healthy infant under one year of age that remains unexplained after a thorough case investigation, including performance of a complete autopsy with ancillary testing, examination of the death scene, and review of the clinical history

b: The sudden unexpected death of a person one year of age or older that remains unexplained after a thorough case investigation, including performance of a complete autopsy with ancillary testing, and review of the clinical history and circumstances of death

c: Cases may be certified as undetermined when: the investigation, death scene examination, or autopsy was substantially limited, incomplete or insufficient, for example legal/religious restrictions, delayed report of death that limits scene investigation, or decomposition; or when inconsistent accounts or other findings raise competing conclusions about the cause of death

d: Infant deaths with adequate death scene investigation and autopsy, with a history of bed/sleep surface sharing, soft bedding, or non-supine sleep, and without physical evidence of asphyxia, may be more appropriately certified as unexplained sudden death in infancy or sudden infant death syndrome

e: Certification of asphyxia: Adequate evidence must be documented to substantiate asphyxiation, given the decedent’s age and stage of development. There cannot be a reasonable competing cause of death after a complete autopsy with ancillary testing, examination of the death scene (with a doll re-enactment when appropriate), and review of the clinical history

f: In infants, bed/sleep surface sharing, soft bedding, or prone sleep, without adequate evidence for airway obstruction or chest wall compression, are insufficient to certify a death as due to asphyxia. These deaths may be more appropriately certified as unexplained sudden death or SIDS. The use of “possible” or “probable” asphyxia will result in the death being classified as asphyxia