
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.
Current Manuals
Part 2a
Part 2b
Part 2c
Part 2e, Volume 1
Part 2e, Volume 3
Part 2j
- Instructions for the Manual Classification of the Initiating Cause of Fetal Deaths, 2012
Part 2k
Part 2s
Historic Manuals – ICD-10
Part 2a
- 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 icon[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 icon[PDF – 2 MB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2015. 222 pp. pdf icon[PDF – 2 MB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2014. 218 pp. pdf icon[PDF – 1.4 MB]
- 2014 Errata, 1 pp. pdf icon[PDF – 16 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2013. 240 pp. pdf icon[PDF – 1.4 MB]
- 2012 Errata 14 pp. pdf icon[PDF – 234 KB]
- 2011 Errata 4 pp. pdf icon[PDF – 37 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2011. 269 pp. pdf icon[PDF – 2.9 MB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2010. 260 pp. pdf icon[PDF – 2.9 MB]
- Errata for 2010. 5 pp. pdf icon[PDF – 42 KB]
- Errata for 2009 36 pp. pdf icon[PDF – 58 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2008. 259 pp. pdf icon[PDF – 2.6 MB]
- Errata for 2008 5 pp. pdf icon[PDF – 58 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2007. 260 pp. pdf icon[PDF – 4.5 MB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2006. 255 pp. pdf icon[PDF – 4.5 MB]
- 2006 Errata pdf icon[PDF – 26 KB]
- Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2005. 251 pp. pdf icon[PDF – 4.5 MB]
Part 2b
- 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 icon[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 icon[PDF – 2 MB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2014. 320 pp. pdf icon[PDF – 1.7 MB]
- 2014 Errata, 1 pp. pdf icon[PDF – 28 KB]
- 2013 Errata 2 pp. pdf icon[PDF – 21 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2013. 350 pp. pdf icon[PDF – 1.5 MB]
- 2012 Errata 22 pp. pdf icon[PDF – 96 KB]
- 2011 Errata 16 pp. pdf icon[PDF – 280 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2011. 460 pp. pdf icon[PDF – 4.6 MB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2010. 458 pp. pdf icon[PDF – 4.7 MB]
- Errata for 2010. 15 pp. pdf icon[PDF – 543 KB]
- Errata for 2009 48 pp. pdf icon[PDF – 48 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2008. 452 pp. pdf icon[PDF – 6.6 MB]
- Errata for 2008 5 pp. pdf icon[PDF – 48 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2007. 452 pp. pdf icon[PDF – 7.2 MB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2006. 448 pp. pdf icon[PDF – 7.2 MB]
- 2006 Errata pdf icon[PDF – 56 KB]
- Instructions for Classifying the Multiple Causes of Death, ICD-10, 2005. 442 pp. pdf icon[PDF – 7.2 MB]
Part 2c
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2014. 4,361 pp. pdf icon[PDF – 15.2 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2013. 5,377 pp. pdf icon[PDF – 11.9 MB]
- 2011 Errata 1 p. pdf icon[PDF – 33.75 KB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2011. 1,243 pp. pdf icon[PDF – 5.2 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2010. 1,234 pp. pdf icon[PDF – 4.3 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2009. 1,222 pp. pdf icon[PDF – 4.3 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2008. 1,222 pp. pdf icon[PDF – 4.3 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2007. 1,229 pp. pdf icon[PDF – 4.1 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2006. 1,241 pp. pdf icon[PDF – 4.1 MB]
- ICD-10 ACME Decision Tables for Classifying Underlying Causes of Death, 2005. 1,061 pp. pdf icon[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, 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 icon[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 icon[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 icon[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 icon[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 icon[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 icon[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 icon[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 icon[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 icon[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 icon[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 icon[PDF – 2.6 MB]
- 2005 Errata pdf icon[PDF – 26 KB]
Part 2e, Volume 3
- 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 icon[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 icon[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 icon[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 icon[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 icon[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 icon[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 icon[PDF – 5 MB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2014. 90 pp. pdf icon[PDF – 255 KB]
- 2013 Errata, 1 pp. pdf icon[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 icon[PDF – 7.1 MB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2013. 120 pp. pdf icon[PDF – 181 KB]
- 2011 Errata 2, 18 pp. pdf icon[PDF – 128 KB]
- 2011 Errata 11 pp. pdf icon[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 icon[PDF – 3.0 MB]
- 2011 Errata 23 pp. pdf icon[PDF – 154 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2011. 60 pp. pdf icon[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 icon[PDF – 6.5 MB]
- Errata for 2010. 6 pp. pdf icon[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 icon[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 icon[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 icon[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 icon[PDF – 2.9 MB]
- 2005 Errata pdf icon[PDF – 287 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2010. 60 pp. pdf icon[PDF – 421 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2008. 59 pp. pdf icon[PDF – 398 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2007. 46 pp. pdf icon[PDF – 298 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2006. 46 pp. pdf icon[PDF – 298 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2005. 45 pp. pdf icon[PDF – 307 KB]
- Alphabetical Index to Diseases and Nature of Injury for use with Perinatal Conditions (P00-P96). 2005 Errata pdf icon[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, 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 icon[PDF – 592 KB]
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2014. 161 pp. pdf icon[PDF – 1 MB]
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2013. 200 pp. pdf icon[PDF – 366 KB]
- Errata 18 pp. pdf icon[PDF – 386 KB]
- Instructions for the Automated Classification of the Initiating and Multiple Causes of Fetal Deaths, 2012. 81 pp. pdf icon[PDF – 684 KB]
Part 2s
- SuperMICAR Data Entry Instructions, 2010. 362 pp. pdf icon[PDF – 13.9 MB]
- 2009 Errata pdf icon[PDF – 48 KB]
- SuperMICAR Data Entry Instructions, 2008 367 pp. pdf icon[PDF – 18.3 MB]
- SuperMICAR Data Entry Instructions, 2007 363 pp. pdf icon[PDF – 16 MB]
- SuperMICAR Data Entry Instructions, 2006 365 pp. pdf icon[PDF – 16 MB]
- SuperMICAR Data Entry Instructions, 2005 pdf icon[PDF – 16 MB]
- 2005 Errata pdf icon[PDF – 479 KB]
Part 9
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated September 2018. pdf icon[PDF – 1.2 MB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated March 2011. pdf icon[PDF – 427 KB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated March 2009. pdf icon[PDF – 657 KB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated for data 2007. pdf icon[PDF – 657 KB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated for data year 2006. pdf icon[PDF – 550 KB]
- ICD-10 Underlying Cause-of-Death Lists for Tabulating Mortality Statistics. Updated for data year 2003. 89 pp. pdf icon[PDF – 288 KB]
Part 11
- ICD-10 Computer Edits for Mortality Data Effective 2014. 89 pp. pdf icon[PDF – 772 KB]
- ICD-10 Computer Edits for Mortality Data Effective 2012. 88 pp. pdf icon[PDF – 732 KB]
- ICD-10 Computer Edits for Mortality Data Effective 2011. 88 pp. pdf icon[PDF – 3.7 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2010. 88 pp. pdf icon[PDF – 2.8 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2008 and 2009. 85 pp. pdf icon[PDF – 1.2 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2007. 84 pp. pdf icon[PDF – 1.2 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2006. 81 pp. pdf icon[PDF – 151 KB]
- ICD-10 Computer Edits for Mortality Data Effective 2005. 76 pp. pdf icon[PDF – 1.5 MB]
- ICD-10 Computer Edits for Mortality Data Effective 2004. 83 pp. pdf icon[PDF – 243 KB]
Historic Manuals – Prior to ICD-10
Part 1
- Source Records and Control Specifications, 1995
Part 2a
Part 2b
Part 2c
- ICD-9 ACME Decision Tables for Classifying Underlying Causes of Death. 290 pp. pdf icon[PDF – 31 MB]
Part 2d
- NCHS Procedures for Mortality Medical Data System File Preparation and Maintenance, 1985. 65 pp. pdf icon[PDF – 24 MB]
- NCHS Procedures for Mortality Medical Data System File Preparation and Maintenance, 1979. 71 pp. pdf icon[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