Although analysis of hospital discharge data (HDD) can provide important information about severe nonfatal injuries, HDD often do not include information about the causes of these injuries (e.g., motor-vehicle crashes and assaults). Inconsistent reporting of causes of injury has limited the usefulness of HDD for injury surveillance. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) includes codes for classifying external causes of injury (E-codes). This report describes progress in implementing E-code reporting in states.