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Official guidance, educational resources and scholarly articles for medical certifiers seeking to better understand the importance of a thorough consideration of the medical facts, upholding investigative integrity and accuracy in cause-of-death reporting.

Click on the link below to complete a few minute online training from the CDC explaining the improvements needed in death reporting and the need for increased accuracy in cause-of-death-determinations.

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Guidance For Certifying Deaths Due To Covid

From: Vital Statistics Reporting Guidance Report #3, April 2020

Due to the recent emphasis on COVID-19 in death certificates based on the National Vital Statistics System April 2020 COVID Reporting Guidance, it's important to keep in mind the historic precedence on reporting contagious disease and vaccine-preventable diseases from the Panel to Evaluate U.S. Standard Certificates

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Report of The Panel to Evaluate The U.S. Standard Certificates 

From: National Center for Health Statistics, April 2000

"..These risk factors do not have to relate to the cause of death. In a previous discussion of risk factors, the Subgroup agreed that it was important that there be a direct connection between conditions/risk factors and the cause of death. The death certificate is not a medical record, and it is not intended to collect prevalence data."         

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Instructions For Completing The Cause of Death Section of the Death Certificate

From: National Center for Health Statistics

"Part II is for reporting all other significant diseases, conditions, or injuries that contributed to death but which did not result in the underlying cause of death given in Part I. The cause-of-death information should be YOUR best medical OPINION. A condition can be listed as “probable” even if it has not been definitively diagnosed."

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A Guide For Manner of Death Classification

From: National Association of Medical Examiners, Feb. 2002

"It is important to remember that these “facts” only represent the certifier’s opinion and are not written in stone or legally binding. Information on the death certificate may be changed, if needed."

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Cause Of Death Statements and Certification of Natural and Unnatural Deaths

From: College of American Pathologists 1997

"There are a number of situations in which the complications of an underlying cause of death may clinically overshadow the underlying condition itself, resulting in the certifier forgetting to include the underlying cause in the cause-of-death statement.

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Possible Solutions to Common Problems in Death Certification

From: National Center for Health Statistics, January 1997

"Cause-of-death data is important for surveillance, research, design of public health and medical interventions, and funding decisions for research and development.

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From: The App Store and Google Play

The Cause of Death Mobile Application is a quick reference guide designed to acquaint physicians, medical students, and others with the vital registration system in the United States.

  • Provides instructions and examples of how to fill out a death certificate.

  • Emphasizes the certification of medical information, the primary responsibility of the physician and a critical piece of information on the death certificate.

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Medical Examiners' and Coroners' Handbook on Death Registration and Fetal Death Reporting

From: CDC

"...These mortality data are valuable to physicians indirectly by influencing funding that supports medical and health research (which may alter clini­cal practice) and directly as a research tool."

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Physicians' Handbook on Medical Certification of Death

From: CDC

"If completed properly, the cause of death will communicate the same essential information that a case history would...

...In some cases, the physician will be contacted to verify information reported on a death certificate or to provide additional information to clarify what was meant. The original cause-of-death statement may not be wrong from a clinical standpoint, but may not include sufficient information for assigning codes for statistical purposes. Following guidelines in this handbook should minimize the frequency with which a physician will need to spend additional time answering follow-up questions about a patient’s cause of death."

More scholarly articles can be found in our educational archive:

If a death certificate you have certified is inaccurate and you would like to create an amendment to that record, you can find state-specific guidance on how to amend an inaccurate death certificate, including the direct contact information to the State Vital Records representative that can help you navigate the process:

If you would like to speak to one of our accuracy advocates about any 
difficulties you are having in creating an accurate cause-of-death report, feel free to reach out:

Please learn more about our nonprofit vision and support our mission to create high quality educational content and community forums on this issue so that medical certifiers can 
receive the information and support they need to increase post-mortem investigation integrity and accuracy in cause-of death determinations.


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