Usage

The Death Certificate profile is a composition (bundle) comprising the core content of a death registration.

Notes:

• The DeathCertificate is the first entry in the DeathCertificateDocument, and includes references to other entries in that Bundle.

Additional content can be included in the Death Certificate Document and referenced in the Death Certificate based on standard resources and profiles. Further profiling of Practitioner and PractitionerRole may be called for in the future. At present, standard USCore profiles can be used, and these are not cited in this Implementation Guide. For example:

• Funeral Home Licensee (USCorePractitionerRole)
• Mortician (USCorePractitioner)
• Funeral Home Director (USCorePractitionerRole)
• Death Pronouncement Performer (USCorePractitioner)

The content is broken down into the following sections:

• Decedent Demographics
  • BirthRecordIdentifier
  • Decedent
  • DecedentAge
  • DecedentEducationLevel
  • DecedentFather
  • DecedentMilitaryService
  • EmergingIssues
  • DecedentMother
  • DecedentSpouse
  • DecedentUsualWork
• Death Investigation
  • AutopsyPerformedIndicator
  • DeathDate
  • DeathLocation
  • DecedentPregnancyStatus
  • ExaminerContacted
  • InjuryIncident
  • InjuryLocation
  • SurgeryDate
  • TobaccoUseContributedToDeath
• Death Certification
  • Certifier
  • DeathCertification
  • CauseOfDeathPart1
  • CauseOfDeathPart2
  • MannerOfDeath
• Decedent Disposition
  • DecedentDispositionMethod
  • DispositionLocation
  • FuneralHome
• Coded Content
  • ActivityAtTimeOfDeath
  • AutomatedUnderlyingCauseOfDeath
  • ManualUnderlyingCauseOfDeath
  • CodedRaceAndEthnicity
  • EntityAxisCauseOfDeath
  • RecordAxisCauseOfDeath
  • PlaceOfInjury
  • CodingStatusValues

Note: For NCHS submissions the replacement record status (REPLACE) has been deprecated within the VRDR IG, and this field be ignored. The replacement status of a submission is now specified as a message parameter and described in the NCHS Vital Records Messaging IG.

The profile includes:

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints
Composition			Composition
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
filingFormat		0..1	CodeableConcept	Filing Format URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/FilingFormat Binding: Filing Format ValueSet (required)
replaceStatus		0..1	CodeableConcept	Replace Status (deprecated) URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/ReplaceStatus Binding: Replacement Status VS (required)
stateSpecificField		0..1	string	State Specific Field URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/StateSpecificField
status		1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required)
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 64297-5
subject		1..1	Reference(Decedent)	Who and/or what the composition is about
date		1..1	dateTime	Date of Registration
attester
mode		1..1	code	personal | professional | legal | official Fixed Value: legal
party		0..1	Reference(Certifier)	Certifier.
event		1..1	BackboneElement	The clinical service(s) being documented
code		1..1	CodeableConcept	Code(s) that apply to the event being documented Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 103693007
detail		1..1	Reference(Death Certification Procedure)	The event(s) being documented
Slices for section		0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
code		1..1	CodeableConcept	Classification of section (recommended)
section:DecedentDemographics		0..1	BackboneElement	DecedentDemographics
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DecedentDemographics
Slices for entry		1..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:Decedent		1..1	Reference(Decedent)	Decedent
entry:Father		0..1	Reference(Decedent Father)	DecedentFather
entry:Mother		0..1	Reference(Decedent Mother)	DecedentMother
entry:Spouse		0..1	Reference(Decedent Spouse)	DecedentSpouse
entry:Age		0..1	Reference(Decedent Age)	DecedentAge
entry:BirthRecordID		0..1	Reference(Birth Record Identifier)	BirthRecordIdentifier
entry:EducationLevel		0..1	Reference(Decedent Education Level)	DecedentEducationLevel
entry:MilitaryService		0..1	Reference(Decedent Military Service)	DecedentMilitaryService
entry:UsualWork		0..1	Reference(Decedent Usual Work)	DecedentUsualWork
entry:EmergingIssues		0..1	Reference(Emerging Issues)	EmergingIssues
entry:InputRaceAndEthnicity		0..1	Reference(Input Race and Ethnicity)	InputRaceAndEthnicity
section:DeathInvestigation		0..1	BackboneElement	DeathInvestigation
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DeathInvestigation
Slices for entry		0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:ExaminerContacted		0..1	Reference(Examiner Contacted)	ExaminerContacted
entry:PregnancyStatus		0..1	Reference(Decedent Pregnancy Status)	DecedentPregnancyStatus
entry:TobaccoUse		0..1	Reference(Tobacco Use Contributed To Death)	TobaccoUse
entry:DeathLocation		0..1	Reference(Death Location)	Death Location
entry:InjuryLocation		0..1	Reference(Injury Location)	Injury Location
entry:PlaceOfInjury		0..1	Reference(Place Of Injury)	PlaceOfInjury
entry:InjuryIncident		0..1	Reference(Injury Incident)	InjuryIncident
entry:Autopsy		0..1	Reference(Autopsy Performed Indicator)	AutopsyPerformedIndicator
entry:DeathDate		0..1	Reference(Death Date)	DeathDate
entry:SurgeryDate		0..1	Reference(Surgery Date)	SurgeryDate
section:DeathCertification		0..1	BackboneElement	DeathCertification
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DeathCertification
Slices for entry		0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:Certifier		0..1	Reference(Certifier)	Certifier
entry:DeathCertification		0..1	Reference(Death Certification Procedure)	DeathCertification
entry:MannerOfDeath		0..1	Reference(Manner of Death)	MannerOfDeath
entry:CauseOfDeathPart1		0..4	Reference(Cause Of Death Part 1)	CauseOfDeathPart1
entry:CauseOfDeathPart2		0..1	Reference(Cause of Death Part 2)	CauseOfDeathPart2
section:DecedentDisposition		0..1	BackboneElement	DecedentDisposition
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DecedentDisposition
Slices for entry		0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:DispositionLocation		0..1	Reference(Disposition Location)	DispositionLocation
entry:FuneralHome		0..1	Reference(Funeral Home)	FuneralHome
entry:DispositionMethod		0..1	Reference(Decedent Disposition Method)	DispositionMethod
entry:Mortician		0..1	Reference(US Core Practitioner Profile)	Mortician
section:CodedContent		0..1	BackboneElement	CodedContent
code		0..1	CodeableConcept	Classification of section (recommended) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: CodedContent
Slices for entry		0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:ActivityAtTimeOfDeath		0..1	Reference(Activity at Time of Death)	ActivityAtTimeOfDeath
entry:AutomatedUnderlyingCauseOfDeath		0..1	Reference(Automated Underlying Cause Of Death)	AutomatedUnderlyingCauseOfDeath
entry:ManualUnderlyingCauseOfDeath		0..1	Reference(Manual Underlying Cause Of Death)	ManualUnderlyingCauseOfDeath
entry:CodedRaceAndEthnicity		0..1	Reference(Coded Race and Ethnicity)	CodedRaceAndEthnicity
entry:EntityAxisCauseOfDeath		0..20	Reference(Entity Axis Cause Of Death)	EntityAxisCauseOfDeath
entry:RecordAxisCauseOfDeath		0..20	Reference(Record Axis Cause Of Death)	RecordAxisCauseOfDeath
entry:PlaceOfInjury		0..1	Reference(Place Of Injury)	PlaceOfInjury
entry:CodingStatusValues		0..1	Reference(Coding Status Values)	CodingStatusValues
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Composition.status	required	CompositionStatus

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
filingFormat		0..1	CodeableConcept	Filing Format URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/FilingFormat Binding: Filing Format ValueSet (required)
replaceStatus		0..1	CodeableConcept	Replace Status (deprecated) URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/ReplaceStatus Binding: Replacement Status VS (required)
stateSpecificField		0..1	string	State Specific Field URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/StateSpecificField
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required)
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 64297-5
subject	Σ	1..1	Reference(Decedent)	Who and/or what the composition is about
date	Σ	1..1	dateTime	Date of Registration
author	Σ	1..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
event	Σ	1..1	BackboneElement	The clinical service(s) being documented
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 103693007
detail	Σ	1..1	Reference(Death Certification Procedure)	The event(s) being documented
Slices for section	C	0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
section:DecedentDemographics	C	0..1	BackboneElement	DecedentDemographics
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DecedentDemographics
Slices for entry	C	1..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:Decedent	C	1..1	Reference(Decedent)	Decedent
entry:Father	C	0..1	Reference(Decedent Father)	DecedentFather
entry:Mother	C	0..1	Reference(Decedent Mother)	DecedentMother
entry:Spouse	C	0..1	Reference(Decedent Spouse)	DecedentSpouse
entry:Age	C	0..1	Reference(Decedent Age)	DecedentAge
entry:BirthRecordID	C	0..1	Reference(Birth Record Identifier)	BirthRecordIdentifier
entry:EducationLevel	C	0..1	Reference(Decedent Education Level)	DecedentEducationLevel
entry:MilitaryService	C	0..1	Reference(Decedent Military Service)	DecedentMilitaryService
entry:UsualWork	C	0..1	Reference(Decedent Usual Work)	DecedentUsualWork
entry:EmergingIssues	C	0..1	Reference(Emerging Issues)	EmergingIssues
entry:InputRaceAndEthnicity	C	0..1	Reference(Input Race and Ethnicity)	InputRaceAndEthnicity
section:DeathInvestigation	C	0..1	BackboneElement	DeathInvestigation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DeathInvestigation
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:ExaminerContacted	C	0..1	Reference(Examiner Contacted)	ExaminerContacted
entry:PregnancyStatus	C	0..1	Reference(Decedent Pregnancy Status)	DecedentPregnancyStatus
entry:TobaccoUse	C	0..1	Reference(Tobacco Use Contributed To Death)	TobaccoUse
entry:DeathLocation	C	0..1	Reference(Death Location)	Death Location
entry:InjuryLocation	C	0..1	Reference(Injury Location)	Injury Location
entry:PlaceOfInjury	C	0..1	Reference(Place Of Injury)	PlaceOfInjury
entry:InjuryIncident	C	0..1	Reference(Injury Incident)	InjuryIncident
entry:Autopsy	C	0..1	Reference(Autopsy Performed Indicator)	AutopsyPerformedIndicator
entry:DeathDate	C	0..1	Reference(Death Date)	DeathDate
entry:SurgeryDate	C	0..1	Reference(Surgery Date)	SurgeryDate
section:DeathCertification	C	0..1	BackboneElement	DeathCertification
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DeathCertification
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:Certifier	C	0..1	Reference(Certifier)	Certifier
entry:DeathCertification	C	0..1	Reference(Death Certification Procedure)	DeathCertification
entry:MannerOfDeath	C	0..1	Reference(Manner of Death)	MannerOfDeath
entry:CauseOfDeathPart1	C	0..4	Reference(Cause Of Death Part 1)	CauseOfDeathPart1
entry:CauseOfDeathPart2	C	0..1	Reference(Cause of Death Part 2)	CauseOfDeathPart2
section:DecedentDisposition	C	0..1	BackboneElement	DecedentDisposition
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DecedentDisposition
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:DispositionLocation	C	0..1	Reference(Disposition Location)	DispositionLocation
entry:FuneralHome	C	0..1	Reference(Funeral Home)	FuneralHome
entry:DispositionMethod	C	0..1	Reference(Decedent Disposition Method)	DispositionMethod
entry:Mortician	C	0..1	Reference(US Core Practitioner Profile)	Mortician
section:CodedContent	C	0..1	BackboneElement	CodedContent
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: CodedContent
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:ActivityAtTimeOfDeath	C	0..1	Reference(Activity at Time of Death)	ActivityAtTimeOfDeath
entry:AutomatedUnderlyingCauseOfDeath	C	0..1	Reference(Automated Underlying Cause Of Death)	AutomatedUnderlyingCauseOfDeath
entry:ManualUnderlyingCauseOfDeath	C	0..1	Reference(Manual Underlying Cause Of Death)	ManualUnderlyingCauseOfDeath
entry:CodedRaceAndEthnicity	C	0..1	Reference(Coded Race and Ethnicity)	CodedRaceAndEthnicity
entry:EntityAxisCauseOfDeath	C	0..20	Reference(Entity Axis Cause Of Death)	EntityAxisCauseOfDeath
entry:RecordAxisCauseOfDeath	C	0..20	Reference(Record Axis Cause Of Death)	RecordAxisCauseOfDeath
entry:PlaceOfInjury	C	0..1	Reference(Place Of Injury)	PlaceOfInjury
entry:CodingStatusValues	C	0..1	Reference(Coding Status Values)	CodingStatusValues
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.status	required	CompositionStatus
Composition.type	preferred	Pattern: LOINC code 64297-5
Composition.event.code	example	Pattern: SNOMED CT code 103693007
Composition.section.code	example	DocumentSectionCodes
Composition.section:DecedentDemographics.code	example	Pattern: DecedentDemographics
Composition.section:DeathInvestigation.code	example	Pattern: DeathInvestigation
Composition.section:DeathCertification.code	example	Pattern: DeathCertification
Composition.section:DecedentDisposition.code	example	Pattern: DecedentDisposition
Composition.section:CodedContent.code	example	Pattern: CodedContent

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
filingFormat		0..1	CodeableConcept	Filing Format URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/FilingFormat Binding: Filing Format ValueSet (required)
replaceStatus		0..1	CodeableConcept	Replace Status (deprecated) URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/ReplaceStatus Binding: Replacement Status VS (required)
stateSpecificField		0..1	string	State Specific Field URL: http://hl7.org/fhir/us/vrdr/StructureDefinition/StateSpecificField
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Version-independent identifier for the Composition
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required)
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 64297-5
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	Σ	1..1	Reference(Decedent)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(Encounter)	Context of the Composition
date	Σ	1..1	dateTime	Date of Registration
author	Σ	1..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the composition
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Fixed Value: legal
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(Certifier)	Certifier.
custodian	Σ	0..1	Reference(Organization)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	1..1	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 103693007
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	1..1	Reference(Death Certification Procedure)	The event(s) being documented
Slices for section	C	0..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:DecedentDemographics	C	0..1	BackboneElement	DecedentDemographics
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DecedentDemographics
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	1..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:Decedent	C	1..1	Reference(Decedent)	Decedent
entry:Father	C	0..1	Reference(Decedent Father)	DecedentFather
entry:Mother	C	0..1	Reference(Decedent Mother)	DecedentMother
entry:Spouse	C	0..1	Reference(Decedent Spouse)	DecedentSpouse
entry:Age	C	0..1	Reference(Decedent Age)	DecedentAge
entry:BirthRecordID	C	0..1	Reference(Birth Record Identifier)	BirthRecordIdentifier
entry:EducationLevel	C	0..1	Reference(Decedent Education Level)	DecedentEducationLevel
entry:MilitaryService	C	0..1	Reference(Decedent Military Service)	DecedentMilitaryService
entry:UsualWork	C	0..1	Reference(Decedent Usual Work)	DecedentUsualWork
entry:EmergingIssues	C	0..1	Reference(Emerging Issues)	EmergingIssues
entry:InputRaceAndEthnicity	C	0..1	Reference(Input Race and Ethnicity)	InputRaceAndEthnicity
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:DeathInvestigation	C	0..1	BackboneElement	DeathInvestigation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DeathInvestigation
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:ExaminerContacted	C	0..1	Reference(Examiner Contacted)	ExaminerContacted
entry:PregnancyStatus	C	0..1	Reference(Decedent Pregnancy Status)	DecedentPregnancyStatus
entry:TobaccoUse	C	0..1	Reference(Tobacco Use Contributed To Death)	TobaccoUse
entry:DeathLocation	C	0..1	Reference(Death Location)	Death Location
entry:InjuryLocation	C	0..1	Reference(Injury Location)	Injury Location
entry:PlaceOfInjury	C	0..1	Reference(Place Of Injury)	PlaceOfInjury
entry:InjuryIncident	C	0..1	Reference(Injury Incident)	InjuryIncident
entry:Autopsy	C	0..1	Reference(Autopsy Performed Indicator)	AutopsyPerformedIndicator
entry:DeathDate	C	0..1	Reference(Death Date)	DeathDate
entry:SurgeryDate	C	0..1	Reference(Surgery Date)	SurgeryDate
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:DeathCertification	C	0..1	BackboneElement	DeathCertification
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DeathCertification
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:Certifier	C	0..1	Reference(Certifier)	Certifier
entry:DeathCertification	C	0..1	Reference(Death Certification Procedure)	DeathCertification
entry:MannerOfDeath	C	0..1	Reference(Manner of Death)	MannerOfDeath
entry:CauseOfDeathPart1	C	0..4	Reference(Cause Of Death Part 1)	CauseOfDeathPart1
entry:CauseOfDeathPart2	C	0..1	Reference(Cause of Death Part 2)	CauseOfDeathPart2
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:DecedentDisposition	C	0..1	BackboneElement	DecedentDisposition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DecedentDisposition
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:DispositionLocation	C	0..1	Reference(Disposition Location)	DispositionLocation
entry:FuneralHome	C	0..1	Reference(Funeral Home)	FuneralHome
entry:DispositionMethod	C	0..1	Reference(Decedent Disposition Method)	DispositionMethod
entry:Mortician	C	0..1	Reference(US Core Practitioner Profile)	Mortician
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:CodedContent	C	0..1	BackboneElement	CodedContent
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: CodedContent
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	C	0..*	Reference(Resource)	A reference to data that supports this section Slice: Unordered, Open by profile:$this.resolve()
entry:ActivityAtTimeOfDeath	C	0..1	Reference(Activity at Time of Death)	ActivityAtTimeOfDeath
entry:AutomatedUnderlyingCauseOfDeath	C	0..1	Reference(Automated Underlying Cause Of Death)	AutomatedUnderlyingCauseOfDeath
entry:ManualUnderlyingCauseOfDeath	C	0..1	Reference(Manual Underlying Cause Of Death)	ManualUnderlyingCauseOfDeath
entry:CodedRaceAndEthnicity	C	0..1	Reference(Coded Race and Ethnicity)	CodedRaceAndEthnicity
entry:EntityAxisCauseOfDeath	C	0..20	Reference(Entity Axis Cause Of Death)	EntityAxisCauseOfDeath
entry:RecordAxisCauseOfDeath	C	0..20	Reference(Record Axis Cause Of Death)	RecordAxisCauseOfDeath
entry:PlaceOfInjury	C	0..1	Reference(Place Of Injury)	PlaceOfInjury
entry:CodingStatusValues	C	0..1	Reference(Coding Status Values)	CodingStatusValues
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Composition.status	required	CompositionStatus
Composition.type	preferred	Pattern: LOINC code 64297-5
Composition.category	example	DocumentClassValueSet
Composition.confidentiality	required	v3.ConfidentialityClassification
Composition.attester.mode	required	Fixed Value: legal
Composition.relatesTo.code	required	DocumentRelationshipType
Composition.event.code	example	Pattern: SNOMED CT code 103693007
Composition.section.code	example	DocumentSectionCodes
Composition.section.mode	required	ListMode
Composition.section.orderedBy	preferred	ListOrderCodes
Composition.section.emptyReason	preferred	ListEmptyReasons
Composition.section:DecedentDemographics.code	example	Pattern: DecedentDemographics
Composition.section:DecedentDemographics.mode	required	ListMode
Composition.section:DecedentDemographics.orderedBy	preferred	ListOrderCodes
Composition.section:DecedentDemographics.emptyReason	preferred	ListEmptyReasons
Composition.section:DeathInvestigation.code	example	Pattern: DeathInvestigation
Composition.section:DeathInvestigation.mode	required	ListMode
Composition.section:DeathInvestigation.orderedBy	preferred	ListOrderCodes
Composition.section:DeathInvestigation.emptyReason	preferred	ListEmptyReasons
Composition.section:DeathCertification.code	example	Pattern: DeathCertification
Composition.section:DeathCertification.mode	required	ListMode
Composition.section:DeathCertification.orderedBy	preferred	ListOrderCodes
Composition.section:DeathCertification.emptyReason	preferred	ListEmptyReasons
Composition.section:DecedentDisposition.code	example	Pattern: DecedentDisposition
Composition.section:DecedentDisposition.mode	required	ListMode
Composition.section:DecedentDisposition.orderedBy	preferred	ListOrderCodes
Composition.section:DecedentDisposition.emptyReason	preferred	ListEmptyReasons
Composition.section:CodedContent.code	example	Pattern: CodedContent
Composition.section:CodedContent.mode	required	ListMode
Composition.section:CodedContent.orderedBy	preferred	ListOrderCodes
Composition.section:CodedContent.emptyReason	preferred	ListEmptyReasons