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Instruction Manuals
The National Center for Health Statistics (NCHS) produces a variety of instruction manuals to aid mortality medical coders, nosologists, and other individuals responsible for processing vital records. These manuals are used by both state vital statistics programs and NCHS.
The instruction manuals are split into parts to address distinct topics, such as classification and coding (i.e., underlying or multiple causes of death, geographic variables, and industry and occupation), specifications for the U.S. standard certificates and reports, and comprehensive descriptions of computer edits used by NCHS in processing natality and mortality data. Specific manuals (e.g., Part 2 – Instructions for Classification of Underlying and Multiple Causes of Death) may be updated on an annual basis.
Selected instruction manuals are also available from the CDC/FTP server in WordPerfect and ASCII format. If an instruction manual below is unavailable for downloading, you may contact NCHS to request a copy at nchsed@cdc.gov.
Part 2a
Part 2b
Part 2c
Part 2e, Volume 1
Part 2e, Volume 3
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2025. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S.
Part 2j
- Instructions for the Manual Classification of the Initiating Cause of Fetal Deaths, 2012
Part 2k
Part 2s
Part 2a
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2024
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2023
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2022
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2021
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2020
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2019
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2018
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2017. 224 pp. [PDF – 1.4 MB]
Persons with disabilities experiencing problems accessing this page should contact NCHSED through e-mail at nchsed@cdc.gov or by calling 301-458-4688 - Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2016. 211 pp. [PDF – 2 MB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2015. 222 pp. [PDF – 2 MB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2014. 218 pp. [PDF – 1.4 MB]
- 2014 Errata, 1 pp. [PDF – 16 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2013. 240 pp. [PDF – 1.4 MB]
- 2012 Errata 14 pp. [PDF – 234 KB]
- 2011 Errata 4 pp. [PDF – 37 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2011. 269 pp. [PDF – 2.9 MB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2010. 260 pp. [PDF – 2.9 MB]
- Errata for 2010. 5 pp. [PDF – 42 KB]
- Errata for 2009 36 pp. [PDF – 58 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2008. 259 pp. [PDF – 2.6 MB]
- Errata for 2008 5 pp. [PDF – 58 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2007. 260 pp. [PDF – 4.5 MB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2006. 255 pp. [PDF – 4.5 MB]
- 2006 Errata [PDF – 26 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2005. 251 pp. [PDF – 4.5 MB]
Part 2b
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2024
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2023
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2022
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2021
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2020
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2019
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2018
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2017. 330 pp. [PDF – 2.7 MB]
Persons with disabilities experiencing problems accessing this page should contact NCHSED through e-mail at nchsed@cdc.gov or by calling 301-458-4688 - Instructions for Classifying the Multiple Causes of Death, ICD-10, 2016. 305 pp. [PDF – 2 MB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2014. 320 pp. [PDF – 1.7 MB]
- 2014 Errata, 1 pp. [PDF – 28 KB]
- 2013 Errata 2 pp. [PDF – 21 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2013. 350 pp. [PDF – 1.5 MB]
- 2012 Errata 22 pp. [PDF – 96 KB]
- 2011 Errata 16 pp. [PDF – 280 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2011. 460 pp. [PDF – 4.6 MB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2010. 458 pp. [PDF – 4.7 MB]
- Errata for 2010. 15 pp. [PDF – 543 KB]
- Errata for 2009 48 pp. [PDF – 48 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2008. 452 pp. [PDF – 6.6 MB]
- Errata for 2008 5 pp. [PDF – 48 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2007. 452 pp. [PDF – 7.2 MB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2006. 448 pp. [PDF – 7.2 MB]
- 2006 Errata [PDF – 56 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2005. 442 pp. [PDF – 7.2 MB]
Part 2c
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2016. 4,424 pp. [PDF – 5.9 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2014. 4,361 pp. [PDF – 15.2 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2013. 5,377 pp. [PDF – 11.9 MB]
- 2011 Errata 1 p. [PDF – 33.75 KB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2011. 1,243 pp. [PDF – 5.2 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2010. 1,234 pp. [PDF – 4.3 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2009. 1,222 pp. [PDF – 4.3 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2008. 1,222 pp. [PDF – 4.3 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2007. 1,229 pp. [PDF – 4.1 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2006. 1,241 pp. [PDF – 4.1 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2005. 1,061 pp. [PDF – 3.7 MB]
Part 2e, Volume 1
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2024. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S.
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2023. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S.
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2022. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S.
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2017. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,524 pp. [PDF – 5.3 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2016. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,361 pp. [PDF – 5 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2015. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,359 pp. [PDF – 4.9 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2014. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,121 pp. [PDF – 4.5 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2013. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,855 pp. [PDF – 4 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2011. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,280 pp. [PDF – 2.3 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2010. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,279 pp. [PDF – 4.1 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Statistical Classification of Diseases and Related Health Problems. Tabular List, 2009. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,277 pp. [PDF – 7.4 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Tabular List, 2008. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,274 pp. [PDF – 7.4 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Tabular List, 2006. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,268 pp. [PDF – 2.6 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Tabular List, 2005. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,268 pp. [PDF – 2.6 MB]
- 2005 Errata [PDF – 26 KB]
Part 2e, Volume 3
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2024. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S.
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2023. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S.
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2022. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S.
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2021. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S.
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2017. 94 pp. [PDF – 368 KB]
Persons with disabilities experiencing problems accessing this page should contact NCHSED through e-mail at nchsed@cdc.gov or by calling 301-458-4688 - ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2017. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,333 pp. [PDF – 6.6 MB]
Persons with disabilities experiencing problems accessing this page should contact NCHSED through e-mail at nchsed@cdc.gov or by calling 301-458-4688 - ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2016. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,045 pp. [PDF – 4.6 MB]
Persons with disabilities experiencing problems accessing this page should contact NCHSED through e-mail at nchsed@cdc.gov or by calling 301-458-4688 - Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2015. 77 pp. [PDF – 696 KB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2015. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,389 pp. [PDF – 7 MB]
Persons with disabilities experiencing problems accessing this page should contact NCHSED through e-mail at nchsed@cdc.gov or by calling 301-458-4688 - Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2015. 77 pp. [PDF – 696 KB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2014. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,264 pp. [PDF – 5 MB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2014. 90 pp. [PDF – 255 KB]
- 2013 Errata, 1 pp. [PDF – 55 KB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2013. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 2,023 pp. [PDF – 7.1 MB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2013. 120 pp. [PDF – 181 KB]
- 2011 Errata 2, 18 pp. [PDF – 128 KB]
- 2011 Errata 11 pp. [PDF – 124 KB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2011. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,135 pp. [PDF – 3.0 MB]
- 2011 Errata 23 pp. [PDF – 154 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2011. 60 pp. [PDF – 5.3 KB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2010. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,131 pp. [PDF – 6.5 MB]
- Errata for 2010. 6 pp. [PDF – 107 KB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2009. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,131 pp. [PDF – 2.9 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2008. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,115 pp. [PDF – 2.9 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2006. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,101 pp. [PDF – 2.6 MB]
- ICD-10, International Statistical Classification of Diseases and Related Health Problems. Alphabetical Index, 2005. Modified by the National Center for Health Statistics for use in the classification and analysis of medical mortality data in the U.S. 1,102 pp. [PDF – 2.9 MB]
- 2005 Errata [PDF – 287 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2010. 60 pp. [PDF – 421 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2008. 59 pp. [PDF – 398 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2007. 46 pp. [PDF – 298 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2006. 46 pp. [PDF – 298 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2005. 45 pp. [PDF – 307 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2005 Errata [PDF – 22 KB]
Part 2j
- Instructions for the Manual Classification of the Initiating Cause of Fetal Deaths, 2011
Part 2k
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2024
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2023
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2022
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2021
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2020
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2018
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2016. 155 pp. [PDF – 592 KB]
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2014. 161 pp. [PDF – 1 MB]
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2013. 200 pp. [PDF – 366 KB]
- Errata 18 pp. [PDF – 386 KB]
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2012. 81 pp. [PDF – 684 KB]
Part 2s
- SuperMICAR Data Entry Instructions, 2010. 362 pp. [PDF – 13.9 MB]
- 2009 Errata [PDF – 48 KB]
- SuperMICAR Data Entry Instructions, 2008 367 pp. [PDF – 18.3 MB]
- SuperMICAR Data Entry Instructions, 2007 363 pp. [PDF – 16 MB]
- SuperMICAR Data Entry Instructions, 2006 365 pp. [PDF – 16 MB]
- SuperMICAR Data Entry Instructions, 2005 [PDF – 16 MB]
- 2005 Errata [PDF – 479 KB]
Part 9
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated September 2018. [PDF – 1.2 MB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated March 2011. [PDF – 427 KB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated March 2009. [PDF – 657 KB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated for data 2007. [PDF – 657 KB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated for data year 2006. [PDF – 550 KB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated for data year 2003. 89 pp. [PDF – 288 KB]
Part 11
- ICD-10 Computer Edits for Mortality Data, Including Separate Section for Fetal Deaths Effective 2020 [PDF – 778 KB]
- ICD-10 Computer Edits for Mortality Data Effective 2014. 89 pp. [PDF – 772 KB]
- ICD-10 Computer Edits for Mortality Data Effective 2012. 88 pp. [PDF – 732 KB]
- ICD-10 Computer Edits for Mortality Data Effective 2011. 88 pp. [PDF – 3.7 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2010. 88 pp. [PDF – 2.8 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2008 and 2009. 85 pp. [PDF – 1.2 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2007. 84 pp. [PDF – 1.2 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2006. 81 pp. [PDF – 151 KB]
- ICD-10 Computer Edits for Mortality Data Effective 2005. 76 pp. [PDF – 1.5 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2004. 83 pp. [PDF – 243 KB]
Part 1
- Source Records and Control Specifications, 1995
Part 2a
Part 2b
Part 2c
Part 2d
- NCHS Procedures for Mortality Medical Data System File Preparation and Maintenance, 1985. 65 pp. [PDF – 24 MB]
- NCHS Procedures for Mortality Medical Data System File Preparation and Maintenance, 1979. 71 pp. [PDF – 27 MB]
Part 2e
Part 2f
- ICD-9 TRANSAX Disease Reference Tables for Classifying Multiple Causes of Death
Part 2g
Part 2h
- Dictionary of Valid Terms for MICAR
Part 2i
Part 9
- Underlying Cause-of-Death Lists for Tabulating Mortality Statistics.
- Guidelines for Implementing Field and Query Programs for Registration of Births and Deaths, 1993
Part 20
- Cause-of-Death Querying
Last Reviewed: March 22, 2024