Example 1:      

Patient #1 is admitted with sputum-positive, microscopically confirmed, pulmonary tuberculosis and dies in the ward.

The death certificate for this patient would be as follows:

Example 2:      

Patient #2 is admitted with acute gastroenteritis and dehydration and then dies in the ward.

The same death certificate after ICD coding would be as follows:

Example 3:

Patient #3 is brought with myocardial infarction and then develops arrythmia and heart failure and then dies in the Coronary Care Unit (CCU).

The same death certificate after ICD coding would be as follows:

Example 4:

Patient #4 aged 25 years was admitted to a hospital after being hit by a bus on the road. She underwent surgery for severe head injury. She developed acute pulmonary embolism and died a week later. 

The same death certificate after ICD coding would be as follows:

Example 5:

Patient #5 aged 30 years was diagnosed with Plasmodium falciparum malaria. She was admitted to hospital. Later she developed acute respiratory distress syndrome and ultimately died of acute renal failure.

The same death certificate after ICD coding would be as follows:

Example 6:

Patient #6 aged 60 years was being treated for pneumonia in a hospital. He is a chronic smoker for past 25 years. This acute lung infection occurred on his underlying emphysema. His lung infection worsened and he finally expired.

The same death certificate after ICD coding would be as follows:

Example 7: Case scenario with time intervals

Patient #7 suffering from Respiratory tuberculosis, (bacteriologically and histologically confirmed) from past 6 months is brought to emergency. He is diagnosed with bacterial meningitis which lasts for 5 days. His condition worsens and he dies due to hydrocephalus 24 hours later.

The same death certificate after ICD coding would be as follows:

Why should all causes of death (immediate, intermediate and underlying) be coded on a death certificate?

It is important to assign ICD codes to not just the underlying cause of death but to all causes of death listed on the death certificate. During tabulation of data, the government will collate all the codes for the underlying causes of death and use that to depict the disease burden in populations. 

However, hospitals in addition, can tabulate underlying and immediate (or intermediate) causes of deaths in order to be able to identify causal pathways for preventing avoidable causes of death.