This page is part of the Vital Records Death Reporting FHIR Implementation Guide (v2.2.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Contents:
This page provides a list of the FHIR artifacts defined as part of this implementation guide.
Demographic data includes information about related persons (Mother, Father, and Spouse) and social determinants such as education level and usual occupation. The information in this profile group are provided by a decedent informant.
Birth Record Identifier |
Birth Record Identifier (Observation). This includes the record identifier, the jurisdiction, and the birth year. |
Decedent |
Decedent (USCorePatient) |
Decedent Age |
The decedent’s chronological age at the time of death (Observation). |
Decedent Education Level |
Decedent Education Level (Observation) |
Decedent Father |
Decedent Father (USCoreRelatedPerson) |
Decedent Military Service |
Decedent Military Service (Observation) |
Decedent Mother |
Decedent Mother (USCoreRelatedPerson) |
Decedent Spouse |
Decedent Spouse (USCoreRelatedPerson) |
Decedent Usual Work |
Decedent Usual Work (UsualWork) |
Emerging Issues |
Emerging Issues (Observation) |
Input Race and Ethnicity |
Input (from EDRS) Race and Ethnicity (Observation). This is information collected by jurisdictions and submitted to NCHS. This profile is only for use in a Vital Records Exchange. Systems looking to exchange this observation more broadly should reference US Core. |
Data obtained during the course of investigating a death. Many of these items are conditionally present in a death certification transaction depending on whether or not an autopsy was performed, an injury incident occurred, or a transportation event was involved. The details on the pronouncement performer can be provided using USCore Practitioner profile.
Autopsy Performed Indicator |
Autopsy Performed Indicator (Observation) |
Death Date |
Date of death (Observation). The PartialDatePartAbsent extension supports partial dates. |
Death Location |
Death Location (USCoreLocation) |
Decedent Pregnancy Status |
Decedent Pregnancy Status (Observation) |
Examiner Contacted |
Examiner Contacted (Observation) |
Injury Incident |
Injury Incident (Observation) |
Injury Location |
Injury Location (USCoreLocation) |
Surgery Date |
Date of Surgery (Observation). The PartialDate extension supports partial dates. |
Tobacco Use Contributed To Death |
Tobacco Use Contributed To Death (Observation) |
Data related to the primary concern of the VRDR IG, Death Certification. In this group, the causes of death and the causal pathway are documented and attested to by a death certifier (coroner or medical examiner).
Cause Of Death Part 1 |
Cause of death Part 1 (Observation). Cause of death prior to submission of the completed death report. Line number can be 1-4. |
Cause of Death Part 2 |
Cause of death Part 2 (Observation). Identifies factors contributing to the cause of death as asserted by the death certifier (Observation) |
Certifier |
Certifier (USCorePractitioner) |
Death Certification Procedure |
Death Certification Procedure (USCoreProcedure). The procedure where the certification of death was performed by the certifier (USCoreProcedure). |
Manner of Death |
Manner of Death (Observation) |
Data related to the disposition of the decedents remains. The data in this profile group is typically provided by the funeral home performing the disposition services. The content of this profile group is authenticated by the funeral home director. Additional content can be included using standard USCore profiles, and can be included to specify the Funeral Home Director, the Licensee, and the Mortician.
Decedent Disposition Method |
Decedent Disposition Method (Observation) |
Disposition Location |
Disposition Location (USCoreLocation) |
Funeral Home |
Funeral Home (USCoreOrganization) |
Coded Observations based on the submitted death record.
Activity at Time of Death |
Activity at Time of Death (Observation) |
Automated Underlying Cause Of Death |
Automated Underlying Cause Of Death (Observation) |
Coded Race and Ethnicity |
Coded (from NCHS) Race and Ethnicity (Observation). This is information that is coded by NCHS and sent back to jurisdictions, and will not be processed if submitted to NCHS by jurisdictions. This profile is only for use in a Vital Records Exchange. Systems looking to exchange this observation more broadly should reference US Core. Note: NCHS stopped providing RaceRecode40 data in 2022. |
Coding Status Values |
Coding Status Values contains various status flags that result from the coding process |
Entity Axis Cause Of Death |
Entity Axis Cause Of Death (Observation): Up to 20 of instances of this profile may be included in a coding bundle. Each instance is labeled with its lineNumber, Position and e-code indicator. |
Manual Underlying Cause Of Death |
Manual Underlying Cause Of Death (Observation) |
Place Of Injury |
Place Of Injury (Observation) |
Record Axis Cause Of Death |
Record Axis Cause Of Death (Observation): Up to 20 of instances of this profile may be included in a coding bundle. Each instance is labeled with its position (1-20). |
Documents and Bundles used to transmit death record content.
Cause of Death Coded Content Bundle |
Cause of Death Coded Content Bundle (Bundle): A bundle containing instances of the resources comprising cause of death coded content. This bundle is information-content equivalent to the traditional NCHS TRX format. |
Death Certificate |
The body of the death certificate document (Composition). |
Death Certificate Document |
The resources comprising the death certificate composition (Bundle/Document). |
Demographic Coded Content Bundle |
Demographic Coded Content Bundle (Bundle): A bundle containing instances of the resources comprising demographic (race and ethnicity) coded content. This bundle is information-content equivalent to the traditional NCHS MRE format. |
Mortality Roster Bundle |
Mortality Roster Bundle (Bundle): A bundle containing instances of the resources comprising mortality roster content. This bundle is information-content equivalent to the traditional Mortality Roster. The mortality roster is a supplemental report of death for the purpose of notifying the decedent’s jurisdiction of birth that the death has occurred. The roster data points are sufficient to locate the birth certificate of the decedent but do not otherwise contain the full death record. Once received, the jurisdiction of birth uses the mortality roster data to locate the record of birth and marks it as deceased. |
Example Death Certificate, Coded Content, and Mortality Roster Bundles
CauseOfDeathCodedContentBundle-Example1 |
CauseofDeathCodedContentBundle-Example1 |
DeathCertificateDocument-Example1 |
DeathCertificateDocument-Example1 |
DeathCertificateDocument-Example2 |
DeathCertificateDocument-Example2 (with coded content) |
DeathCertificateDocument-ID-1 |
Example Record from ID |
DeathCertificateDocument-ID-5 |
Example Record from ID |
DeathCertificateDocument-NJ-1 |
Example Record from NJ |
DeathCertificateDocument-UT-1 |
Example Record from UT |
DemographicCodedContentBundle-Example1 |
DemographicCodedContentBundle-Example1 |
MortalityRosterBundle-Example1 |
MortalityRosterBundle-Example1 |
These define constraints on FHIR data types for systems conforming to this implementation guide.
Alias Status of a Death Roster |
Alias Status of a Death Roster. If true, is an alias record. |
Auxiliary State Identifier1 |
An identifier associated by the submitting jurisdiction with a specific death certificate number. Twelve digit number. |
Auxiliary State Identifier2 |
An identifier associated by the submitting jurisdiction with a specific death certificate number. Twelve digit number. |
BypassEditFlag |
Extension to hold a codeable concept from one of several valuesets. |
Certificate Number |
Death certificate number. Six digit number. Leading zeroes are optional. |
City Code |
City expressed as a numeric value. As of the date of publication, in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014. (Extension) |
Date Day |
The day portion (DD) of the partial date. (Extension) |
Date Month |
The month portion (MM) of the partial date. (Extension) |
Date Time |
The time portion (DD) of the partial date. (Extension) |
Date Year |
The year portion (YYYY) of the partial date. (Extension) |
District Code |
District expressed as a numeric value. As of the date of publication, in accordance with the NCHS Instruction Manual Part 8, Vital Records Geographic Classification, 2014. (Extension) |
Filing Format |
Filing Format Extension. |
Location Jurisdiction Id |
Location Jurisdiction Id (Extension) |
NVSS SexAtDeath |
Sex on visual inspection at the time of death by the funeral home |
Partial Date |
Provides values of a partial date (Extension) |
Partial Date Time |
Provides values of a partial dateTime (Extension) |
PostDirectional |
PostDirectional |
PreDirectional |
PreDirectional |
Replacement Status of a Death Record (deprecated) |
Replacement Status of a Death Record. The use of this extension has been deprecated and wil be ignored for NCHS submissions. See the NCHS Vital Records Messaging IG for a description of how to specify replace status at the message level. |
Spouse Is Alive |
Spouse is Alive. |
State Specific Field |
An arbitratry string included by a submitting jurisdiction |
StreetDesignator |
StreetDesignator |
StreetName |
StreetName |
StreetNumber |
StreetNumber |
UnitOrAptNumber |
UnitOrAptNumber |
Within City Limits Indicator |
Within City Limits Indicator (Extension) |
These define sets of codes used by systems conforming to this implementation guide.
Activity at Time of Death VS |
Activity at Time of Death. Mapping to IJE codes here. |
Administrative Gender PHVS_Sex_MFU |
The gender of a person used for administrative purposes. Mapping to IJE codes here. |
Birthplace Country Value Set |
2 Letter Birthplace Country Codes from GEC and ISO 3166-1. Includes historic countries that no longer exist. |
Canadian Provinces Value Set |
2 Letter Canadian Provinces Value Set |
Certifier Types VS |
Certifier Types Value Set Mapping to IJE codes here. |
Contributory Tobacco Use VS |
Did Tobacco Use Contribute to Death Mapping to IJE codes here. |
Date of Death Determination Methods Value Set |
Date of Death Determination Methods Value Set. The method of date of death determination is not used for the Death Record submission process. The binding to this value set is included for compatibility with the Medicolegal Death Investigation (MDI) Implementation Guide. The valueset only includes the values used by MDI, but is bound extensibly. If a jurisdiction chooses to use this field, and requires additional values (e.g., ‘presumed’), these values can be used while remaining in full conformance with the VRDR IG. |
Edit Bypass 01 |
A subset of code values (0 and 1) use to indicate the outcome of data validation assessment for unusual data values. |
Edit Bypass 012 |
A subset of code values (0, 1, and 2) use to indicate the outcome of data validation assessment for unusual data values. |
Edit Bypass 01234 |
A subset of code values (0, 1, 2, 3, and 4) use to indicate the outcome of data validation assessment for unusual data values. |
Edit Bypass 0124 |
A subset of code values (0, 1, 2, and 4) use to indicate the outcome of data validation assessment for unusual data values. |
Education Level |
Highest educational level achieved. Mapping to IJE codes here. |
Filing Format ValueSet |
Filing Format Mapping to IJE codes here. |
Hispanic(Yes) No Unknown |
Value set with Hispanic(Yes), No and Unknown. Mapping to IJE codes here. |
HispanicOrigin Value Set |
NCHS HispanicOrigin Value Set. Mapping to IJE codes here. |
ICD10 Causes of Death VS |
ICD10 Causes of Death VS |
Intentional Reject ValueSet |
Intentional Reject ValueSet. Mapping to IJE codes here. |
Jurisdictions Value Set |
2 Letter Codes for all 57 Jurisdictions Reporting Deaths to NCHS |
Jurisdictions and Provinces Value Set |
2 Letter Jurisdictions and Provinces Value Set |
Manner of Death VS |
A set of code used to indicate a classification of the manner of death. Mapping to IJE codes here. |
Marital Status Value Set |
The set of codes used to indicate the marital status of the decedent Mapping to IJE codes here. |
Method of Disposition VS |
The set of codes used to indicate the method used to dispose of the decedents remains. Mapping to IJE codes here. |
Place of Death VS -- PHVS_PlaceOfDeath_NCHS |
Code values reflecting the death location of the decedent (e.g., hospital, home, hospice). Mapping to IJE codes here. |
Place of Injury VS |
Place of Injury from NCHS TRX Format. This contains all of the codes from https://loinc.org/LL1051-3/ except for LA14087-3 (Public Institution). Mapping to IJE codes here. |
Pregnancy Status |
Pregnancy Status based on PHVS_PregnancyStatus_NCHS Mapping to IJE codes here. |
Race Code Value Set |
NCHS Race Codes. Mapping to IJE codes here. |
Race Missing Value Reason |
A set of code values used to indicate the reason decedent race data is absent. Mapping to IJE codes here. |
Race Recode 40 Value Set |
NCHS Race Recode 40 Valueset. NCHS will stop delivering this coded data in this representation in 2022. Mapping to IJE codes here. |
Replacement Status VS |
Replacement Status Value Set. NCHS will not process original or update submissions flagged ‘updated_notforNCHS’. Mapping to IJE codes here. |
Residence Country Value Set |
2 Letter Residence Country Codes from GEC and ISO 3166-1. Excludes historic countries that no longer exist |
Spouse Alive Value Set |
The set of codes used to indicate whether the decedent’s spouse is alive. Mapping to IJE codes here. |
States, Territories and Provinces Value Set |
2 Letter States and Provinces Value Set |
System Reject ValueSet |
System Reject ValueSet. Mapping to IJE codes here. |
Transax Conversion ValueSet |
Transax Conversion ValueSet. Mapping to IJE codes here. |
Transportation Incident Role |
Role of the decedent in a transportation incident resulting in a death-related injury. Mapping to IJE codes here. |
US States, Territories Value Set |
2 Letter States and Territories Value Set |
Units of Age |
Units of Age. Mapping to IJE codes here. |
Yes No Unknown |
Value set with Yes, No and Unknown. Mapping to IJE codes here. |
Yes No Unknown NotApplicable |
Valueset with Yes, No, Unknown, and Not Applicable. Mapping to IJE codes here. |
These define new code systems used by systems conforming to this implementation guide.
Activity at Time of Death Codesystem |
Activity at Time of Death Codesystem based on PHVS_ActivityType_NCHS |
Bypass Edit Flag Code System |
Bypass Edit Flag Code System |
Canadian Provinces |
Canadian Provinces |
Country Codes |
2 Letter Country Codes from GEC and ISO 3166-1 |
Date of Death Determination Methods |
Date of Death Determination Methods |
Document Section Code System |
Document Section Code System |
Filing Formats CodeSystem |
Death Certificate Filing Formats |
HispanicOrigin CS |
HispanicOrigin from Appendix_D_Excel_Hispanic_Origin_Code_List_Update_2011 |
Intentional Reject CodeSystem |
Intentional Reject CodeSystem |
Jurisdictions that are not US States or Territories |
NVSS Jurisdictions that are not US States or Territories |
Local Component Codes |
Local Component Codes for observation components that lack an appropriate LOINC code |
Local Observation Codes |
Local Observation Codes for observations that lack an appropriate LOINC code |
Local Organization Type |
Local Organization Types |
Location Type Code System |
Location Type Code System |
Missing Value Reason Codesystem |
Missing Value Reason Codesystem |
Pregnancy Status Codes |
PHVS_PregnancyStatus_NCHS codes from PH_PHINVS_CDC |
Race Code CS |
RaceCode from Appendix E Excel Race Code List Update 2001 |
Race Recode 40 CS |
Race Recode 40 |
Replacement Status of Death Record Submission |
Replacement Status of Death Record Submission |
System Reject Code System |
System Reject Code System |
Transax Conversion Code System |
Transax Conversion Code System |
These define transformations to convert between codes by systems conforming with this implementation guide.
ActivityAtTimeOfDeath Concept Map |
Concept Map for ActivityAtTimeOfDeath Value Set. |
AdministrativeGender Concept Map |
A mapping between NCHS IJE and FHIR AdministrativeGender Value Sets |
CertifierTypes Concept Map |
A mapping between NCHS IJE and FHIR CertifierTypes Value Sets |
ContributoryTobaccoUse Concept Map |
A mapping between NCHS IJE and FHIR ContributoryTobaccoUse Value Sets |
EditBypass01 Concept Map |
A mapping between NCHS IJE and FHIR EditBypass01 Value Sets |
EditBypass012 Concept Map |
A mapping between NCHS IJE and FHIR EditBypass012 Value Sets |
EditBypass01234 Concept Map |
A mapping between NCHS IJE and FHIR EditBypass01234 Value Sets |
EditBypass0124 Concept Map |
A mapping between NCHS IJE and FHIR EditBypass0124 Value Sets |
EducationLevel Concept Map |
A mapping between NCHS IJE and FHIR EducationLevel Value Sets |
FilingFormat Concept Map |
A mapping between NCHS IJE and FHIR FilingFormat Value Sets |
HispanicNoUnknown Concept Map |
A mapping between NCHS IJE and FHIR HispanicNoUnknown Value Sets |
HispanicOrigin Concept Map |
A mapping between NCHS MRE and FHIR HispanicOrigin Value Sets |
IntentionalReject Concept Map |
A mapping between NCHS TRX and FHIR IntentionalReject Value Sets |
MannerOfDeath Concept Map |
A mapping between NCHS IJE and FHIR MannerOfDeath Value Sets |
MaritalStatus Concept Map |
A mapping between NCHS IJE and FHIR MaritalStatus Value Sets |
MethodOfDisposition Concept Map |
A mapping between NCHS IJE and FHIR MethodOfDisposition Value Sets |
PlaceOfDeath Concept Map |
A mapping between NCHS IJE and FHIR PlaceOfDeath Value Sets |
PlaceOfInjury Concept Map |
A mapping between NCHS TRX and FHIR PlaceOfInjury Value Sets |
PregnancyStatus Concept Map |
A mapping between NCHS IJE and FHIR PregnancyStatus Value Sets |
RaceCodes Concept Map |
A mapping between NCHS MRE and FHIR RaceCodes Value Sets |
RaceMissingValueReason Concept Map |
A mapping between NCHS IJE and FHIR RaceMissingValueReason Value Sets |
RaceRecode40 Concept Map |
A mapping between NCHS MRE and FHIR RaceRecode40 Value Sets |
ReplaceStatus Concept Map |
A mapping between NCHS IJE and FHIR ReplaceStatus Value Sets |
SpouseAlive Concept Map |
A mapping between NCHS IJE and FHIR SpouseAlive Value Sets |
SystemReject Concept Map |
A mapping between NCHS TRX and FHIR SystemReject Value Sets |
TransaxConversion Concept Map |
A mapping between NCHS TRX and FHIR TransaxConversion Value Sets |
TransportationIncidentRole Concept Map |
A mapping between NCHS IJE and FHIR TransportationIncidentRole Value Sets |
UnitsOfAge Concept Map |
A mapping between NCHS IJE and FHIR UnitsOfAge Value Sets |
YesNoUnknown Concept Map |
A mapping between NCHS IJE and FHIR YesNoUnknown Value Sets |
YesNoUnknownNotApplicable Concept Map |
A mapping between NCHS IJE and FHIR YesNoUnknownNotApplicable Value Sets |
These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.
ActivityAtTimeOfDeath-Example1 |
ActivityAtTimeOfDeath-Example1 |
AutomatedUnderlyingCauseOfDeath-Example1 |
AutomatedUnderlyingCauseOfDeath-Example1 |
AutopsyPerformedIndicator-Example1 |
AutopsyPerformedIndicator-Example1 |
BirthRecordIdentifier-Example1 |
BirthRecordIdentifier-Example1 |
CauseOfDeathPart1-Example1 |
CauseOfDeathPart1-Example1 |
CauseOfDeathPart1-Example2 |
CauseOfDeathPart1-Example2 |
CauseOfDeathPart2-Example1 |
CauseOfDeathPart2-Example1 |
Certifier-Example1 |
Certifier-Example1 |
CodedRaceAndEthnicity-Example1 |
CodedRaceAndEthnicity-Example1 |
CodingStatusValues-Example1 |
CodingStatusValues-Example1 |
DeathCertificate Example1 |
DeathCertificate-Example1 |
DeathCertificate Example2 |
DeathCertificate-Example2 (with coded content) |
DeathCertification-Example1 |
DeathCertification Example1 |
DeathCertification-Example2 |
DeathCertification Example2 |
DeathDate-Example1 |
DeathDate-Example1 |
DeathDate-Example2 |
DeathDate-Example1 |
DeathDate-Example3 |
DeathDate-Example3 - Stripped down for Mortality Roster |
DeathDate-Example4 |
DeathDate-Example4 - an example with only a death time |
DeathLocation-Example1 |
DeathLocation-Example1 - State = Jurisdiction |
DeathLocation-Example2 |
DeathLocation-Example2 - State != Jurisdiction |
DeathLocation-Example3 |
DeathLocation-Example3 - Stripped Down for Mortality Roster |
Decedent-Example1 |
Decedent-Example1 |
Decedent-Example2 |
Decedent-Example2 - with birth jurisdiction |
Decedent-Example3 |
Decedent-Example3 - Stripped down for Mortality Roster |
DecedentAge-Example1 |
DecedentAge-Example1 |
DecedentDispositionMethod-Example1 |
DecedentDispositionMethod-Example1 |
DecedentEducationLevel-Example1 |
DeathDate-Example1 |
DecedentFather-Example1 |
DecedentFather-Example1 |
DecedentMilitaryService-Example1 |
DecedentMilitaryService-Example1 |
DecedentMother-Example1 |
DecedentFather-Example1 |
DecedentPregnancyStatus-Example1 |
DecedentPregnancyStatus-Example1 |
DecedentSpouse-Example1 |
DecedentSpouse-Example1 |
DecedentUsualWork-Example1 |
DecedentUsualWork-Example1 - without coded values |
DecedentUsualWork-Example2 |
DecedentUsualWork-Example2 - with coded values |
DispositionLocation-Example1 |
DispositionLocation-Example1 |
EmergingIssues-Example1 |
EmergingIssues-Example1 make sure it is example |
EntityAxisCauseOfDeath-Example1 |
EntityAxisCauseOfDeath-Example1 |
EntityAxisCauseOfDeath-Example2 |
EntityAxisCauseOfDeath-Example2 |
EntityAxisCauseOfDeath-Example3 |
EntityAxisCauseOfDeath-Example3 |
EntityAxisCauseOfDeath-Example4 |
EntityAxisCauseOfDeath-Example3 |
ExaminerContacted-Example1 |
AutopsyPerformedIndicator-Example1 |
FuneralHome-Example1 |
FuneralHome-Example1 |
InjuryIncident-Example1 |
InjuryIncident-Example1 (with literal transportationRole) |
InjuryIncident-Example2 |
InjuryIncident-Example2 (with coded transportationRole) |
InjuryLocation-Example1 |
InjuryLocation-Example1 |
InputRaceAndEthnicity-Example1 |
InputRaceAndEthnicity-Example1 |
MannerOfDeath-Example1 |
MannerOfDeath-Example1 |
ManualUnderlyingCauseOfDeath-Example1 |
ManualUnderlyingCauseOfDeath-Example1 |
Mortician-Example1 |
Mortician-Example1 |
PlaceOfInjury-Example1 |
PlaceOfInjury-Example1 |
RecordAxisCauseOfDeath-Example1 |
RecordAxisCauseOfDeath-Example1 |
RecordAxisCauseOfDeath-Example2 |
RecordAxisCauseOfDeath-Example2 |
SurgeryDate-Example1 |
SurgeryDate-Example1 |
TobaccoUseContributedToDeath-Example1 |
TobaccoUseContributedToDeath-Example1 |