National Vital Statistics System

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

Current Manuals

Historic Manuals – ICD-10

Historic Manuals – Prior to ICD-10