Contents
- Introduction, Methodology, and Classification of Data.
- Machine and data file characteristics.
- List of data elements and locations.
- Record layout and definition of items and codes.
- Technical Appendix for the 1999 Natality file.(PDF File)
- 1999 Mortality Technical notes.(PDF File)
Symbols Used In Tables
Symbol Explanation
--- Data not available
... Category not applicable
- Quantity zero
0.0 Quantity more than 0 but less than 0.05
* Figure does not meet standards of reliability or precision
Acknowledgments
This tape documentation was prepared in the Division of Vital Statistics. TJ
Mathews and Marian MacDorman of the Reproductive Statistics Branch, wrote the
tape documentation. Sherry Murphy, Mortality Statistics Branch, coordinated
preparation of the 1999 Mortality Technical Notes. Melissa Park and Brady
Hamilton, Reproductive Statistics Branch, coordinated preparation of the 1999
Natality Technical Appendix. The Registration Methods Branch provided
consultation to State vital statistics offices regarding collection of birth
and death certificate data. Ronald F Chamblee, Connie M. Gentry, Brenda A.
Green, Christina K. Jarman, Millie B. Johnson, David W. Justice, Virginia J.
Justice, Susan L. McBroom, Adrienne L. Rouse, Pam Stephenson, Mary M. Trotter,
Teresa M. Watkins, Faye L. Webster, Mary Whitley, Dora B. Wilkerson, and
Francine D. Winter of the Technical Services Branch processed computer edits,
reviewed data, and were responsible for receipt and processing of the basic
data file. Gail Parr, Steven Steimel, Bonita Gross, and Vanetta Harrington of
the Systems Programming and Statistical Resources Branch (SPSRB) each produced
portions of the tape documentation.
Introduction
The linked birth/infant death data set (linked file) is released in two
different formats - period data and birth cohort data. This documentation is
for the 1999 period linked file. Beginning with 1995 data, the period linked
files have formed the basis for all official NCHS linked file statistics
(except for special cohort studies). Differences between period and birth
cohort data are outlined below.
Period data - The numerator for the 1999 period linked file consists of all
infant deaths occurring in 1999 linked to their corresponding birth
certificates, whether the birth occurred in 1999 or 1998. The denominator
file for this data set is the 1999 natality file, that is, all births
occurring in 1999.
Birth cohort data - The numerator for the 1999 birth cohort linked file
consists of deaths to infants born in 1999 whether the death occurred in 1999
or 2000. The denominator file is the 1999 natality file, that is, all births
occurring in 1999.
While the birth cohort format has methodological advantages, it creates
substantial delays in data availability, since it is necessary to wait until
the close of the following data year to include all infant deaths to the birth
cohort.
The 1999 period linked birth/infant death data set includes several data
files. The first file includes all US infant deaths which occurred in the
1999 data year linked to their corresponding birth certificates, whether the
birth occurred in 1999 or in 1998 - referred to as the numerator file. The
second file contains information from the death certificate for all US infant
death records, which could not be linked to their corresponding birth
certificates - referred to as the unlinked death file. The third file is the
1999 NCHS natality file for the US in compressed format, which is used to
provide denominators for rate computations. These same three data files are
also available for Puerto Rico, the Virgin Islands, and Guam.
Changes Beginning with the 1995 Data Year
In part to correct for known biases in the data, changes were made to the
linked file beginning with the 1995 data year, and these changes are also
effective for 1999 data. A weight has been added to the linked numerator file
to correct in part for biases in percent of records linked by major
characteristics (see section on Percent of records linked below). The number
of infant deaths in the linked file are weighted to equal the sum of the
linked plus unlinked infant deaths by age at death and state. The formula for
computing the weights is as follows:
number of linked infant deaths + number of unlinked infant deaths
number of linked infant deaths.
A separate weight is computed for each State of residence of birth and each
age at death category (<1 day, 1-27 days, 28 days-1year). Thus, weights are
1.0 for states, which link all of their infant deaths. The denominator file
is not weighted. Weights have not been computed for the Puerto Rico, Virgin
Islands, and Guam file.
An imputation for not-stated birthweight has been added to the data set, to
reduce potential bias in the computation of birthweight-specific infant
mortality rates. Basically, if birthweight is not-stated and the period of
gestation is known, birthweight is assigned the value from the previous record
with the same period of gestation, race, sex, and plurality. Imputed values
are flagged. The addition of this imputation has reduced the percent of not-
stated responses for birthweight from 3.81% to 1.42% in the numerator file,
and from 0.12% to 0.06% in the denominator file, thus reducing (but not
eliminating) the potential for underestimation when computing birthweight-
specific infant mortality rates. The change from a birth cohort to a period
format was discussed in detail on page one.
Comparisons of infant mortality data from the linked file with infant
mortality data from the vital statistics mortality file
Although the time periods are the same, numbers of infant deaths and infant
mortality rates by characteristics are not identical between the 1999 period
linked file and the 1999 vital statistics mortality file. The differences
can be traced to three different causes: 1) geographic differences; 2)
additional quality control; and 3) weighting.
Geographic differences - To be included in the linked file for the 50 States
and D.C., the birth and death must both occur inside the 50 States and D.C.
In contrast, for the vital statistics mortality file, deaths which occur in
the 50 States and D.C. to infants born inside and outside of the 50 States and
D.C. are included. Similarly, to be included in the linked data file for
Puerto Rico, the Virgin Islands, and Guam, the birth and death must both occur
in Puerto Rico, the Virgin Islands or Guam. In contrast, for the vital
statistics mortality file, deaths which occurred
in Puerto Rico, the Virgin Islands, and Guam to infants born inside and
outside of Puerto Rico, the Virgin Islands and Guam are included.
Additional quality control - The second reason for differences between the two
files is that the linkage process subjects infant death records to an
additional round of quality control review. Every year, a few records are
voided from the file at this stage because they are found to be fetal deaths,
deaths at ages greater than 1 year, or duplicate death certificates.
Weighting - Beginning with 1995 data, linked file records are now weighted to
compensate for the 2-3 percent of infant death records which could not be
linked to their corresponding birth certificates. Although every effort has
been made to design weights which will accurately reflect the distribution of
deaths by characteristics, weighting may contribute to small differences in
numbers and rates by specific variables between the linked file and the vital
statistics mortality files.
In most cases, differences between numbers of infant deaths and infant
mortality rates between the linked file and those computed from the vital
statistics mortality file are negligible.
Methodology
The methodology used to create the national file of linked birth and infant
death records takes advantage of two existing data sources:
1. State linked files for the identification of linked birth and infant
death certificates; and
2. NCHS natality and mortality computerized statistical files, the source of
computer records for the two linked certificates.
Virtually all States routinely link infant death certificates to their
corresponding birth certificates for legal and statistical purposes. When the
birth and death of an infant occur in different States, copies of the records
are exchanged by the State of death and State of birth in order to effect a
link. In addition, if a third State is identified as the State of residence
at the time of birth or death, that State is also sent a copy of the
appropriate certificate by the State where the birth or death occurred.
The NCHS natality and mortality files, produced annually, include statistical
data from birth and death certificates that are provided to NCHS by States
under the Vital Statistics Cooperative Program (VSCP). The data have been
coded according to uniform coding specifications, have passed rigid quality
control standards, have been edited and reviewed, and are the basis for
official U.S. birth and death statistics.
To initiate processing, NCHS obtained matching birth certificate numbers from
States for all infant deaths that occurred in their jurisdiction. We used
this information to extract final, edited mortality and natality data from the
NCHS natality and mortality statistical files. Individual birth and death
records were selected from their respective files and linked into a single
statistical record, thereby establishing a national linked record file.
After the initial linkage, NCHS returned to the States where the death
occurred computer lists of unlinked infant death certificates for follow up
linking. If the birth occurred in a State different from the State of death,
the State of birth identified on the death certificate was contacted to obtain
the linking birth certificate. State additions and corrections were
incorporated, and a final, national linked file was produced. Characteristics
of the natality and mortality data from which the linked file is constructed
are described in detail in the Technical Appendices and Addenda included in
this document.
Characteristics of Unlinked File
For the 1999 linked file 633, or 2.3% of all infant death records could not be
linked to their corresponding birth certificates. Unlinked records are
included in a separate data file in this data set. The unlinked record file
uses the same record layout as the numerator file of linked birth and infant
death records. However, except as noted below, tape locations 1-210, reserved
for information from the matching birth certificate, are blank since no
matching birth certificate could be found for these records. The sex field
(tape location 79) contains the sex of infant as reported on the death
certificate, rather than the sex of infant from the birth certificate, which
is not available. The race field (tape location 36-37) contains the race of
the decedent as reported on the death certificate rather than the race of
mother as reported on the birth certificate as is the case with the linked
record file. The race of mother on the birth certificate is generally
considered to be more accurate than the race information from the death
certificate (see section on Comparison of race data from birth and death
certificates in the Mortality Technical Appendix included in this
documentation). Also, date of birth as reported on the death certificate is
used to generate age at death. This information is used in place of date of
birth from the birth certificate, which is not available.
Documentation table 6 shows counts of unlinked records by race and age at
death for each State of residence. The user is cautioned in using table 6
that the race and residence items are based on information reported on the
death certificate; whereas, tables 15 present data from the linked file in
which the race and residence items are based on information reported on the
birth certificate. (see section on Comparison of race data from birth and
death certificates in the Mortality Technical Appendix included in this
documentation).
Percent of Records Linked
The 1999 linked file includes 27,281 linked infant death records and 633
unlinked infant death records. The linked file is weighted to the sum of
linked plus unlinked records, thus the total number of weighted infant deaths
by place of occurrence is 27,914. While the overall percent linked for infant
deaths in the 1999 file is 97.7%, there are differences in percent linked by
certain variables. These differences have important implications for how the
data is analyzed.
Table 1 shows the percent of infant deaths linked by State of occurrence of
death. While most States link a high percentage of infant deaths, linkage
rates for some States are well below the national average. Note in particular
the percent linked for New Mexico (91.8%), Ohio (91.0%), and Oklahoma (91.0%).
When a high percentage of deaths remain unlinked, unweighted infant mortality
rates computed for these States are underestimated. It is for this reason
that weights were added to the file to correct for biases in the data due to
poor data linkage for particular states.
The percent of infant deaths linked by race and age at death is shown in Table
2. In general, a slightly higher percentage of postneonatal (98.3%) than
neonatal (97.5%) deaths were linked. Variations in percent linked by
underlying cause of death have also been noted (data not shown). While the
weighting protocol has been designed to correct for possible bias due to
variations in match rates by characteristics, no statistical method can
correct perfectly for data limitations. Therefore, variations in the percent
of records linked should be taken into consideration when comparing infant
mortality rates by detailed characteristics.
Geographic Classification
Geographic codes in this data set are based on the results of the 1990 census.
Because of confidentiality concerns, only those counties and cities with a
population size of 250,000 or more are separately identified in this data set.
Users should refer to the geographic code outline in this document for the
list of available areas and codes.
For events to be included in the linked file, both the birth and death must
occur inside the 50 States and D.C. in the case of the 50 States and D.C.
file; or in Puerto Rico, the Virgin Islands or Guam in the case of the Puerto
Rico, Virgin Islands and Guam file. In tabulations of linked data and
denominator data events occurring in each of the respective areas to
nonresidents are included in tabulations that are by place of occurrence, and
excluded from tabulations by place of residence. These exclusions are based on
the usual place of residence of the mother. This item is
contained in both the denominator file and the birth section of the numerator
(linked) file. Nonresidents are identified by a code 4 in location 11 of
these files.
Table 1. Percent of infant deaths linked by state of occurrence of death:
United States, 1999 linked file
United States 97.8% Nebraska 99.4%
Alabama 100.0% Nevada 97.4%
Alaska 98.0% New Hampshire 100.0%
Arizona 98.4% New Jersey 96.2%
Arkansas 98.5% New Mexico 91.8%
California 97.1% New York State 95.7%
Colorado 99.1% New York City 97.3%
Connecticut 100.0% North Carolina 99.8%
Delaware 99.1% North Dakota 98.3%
District of Columbia 94.8% Ohio 91.0%
Florida 99.2% Oklahoma 91.0%
Georgia 99.9% Oregon 99.6%
Hawaii 96.7% Pennsylvania 97.8%
Idaho 99.1% Rhode Island 00.0%
Illinois 97.5% South Carolina 99.8%
Indiana 98.6% South Dakota 100.0%
Iowa 100.0% Tennessee 100.0%
Kansas 98.3% Texas 97.3%
Kentucky 98.6% Utah 96.3%
Louisiana 97.6% Vermont 100.0%
Maine 98.4% Virginia 98.5%
Maryland 99.4% Washington 99.0%
Massachusetts 97.1% West Virginia 98.8%
Michigan 97.3% Wisconsin 100.0%
Minnesota 100.0% Wyoming 100.0%
Mississippi 100.0% Puerto Rico 99.4%
Missouri 98.7% Virgin Islands 100.0%
Montana 98.5% Guam 100.0%
Table 2. Percent of infant deaths linked by age at death: United States, 1999
linked file (Infant deaths are under 1 year; neonatal, under 28 days, and
postneonatal, 28 days-under 1 year)
Infant 97.7%
Neonatal 97.5%
Postneonatal 98.3%
Demographic and Medical Classification
The documents listed below describe in detail the procedures employed for
demographic classification on both the birth and death records and medical
classification on death records. These documents, while not absolutely
essential to the proper interpretation of the data for a number of general
applications, should nevertheless be studied carefully prior to any detailed
analysis of demographic or medical data variables. In particular, there are a
number of exceptions to the ICD rules in multiple cause-of-death coding which,
if not treated properly, may result in faulty analysis of the data. Volumes 1,
2 and 3 of the ICD-10 may be purchased from the World Health Organization
(WHO) Publication Center USA, 49 Sheridan Avenue, Albany, New York, 12210 (
http://www.who.int/whosis/icd10/index.html). Many of the instruction manuals
listed below are available electronically on the NCHS website at:
http://www.cdc.gov/nchs/about/major/dvs/im.htm. In addition, users who do not
already have access to these documents may request them from the Chief,
Mortality Medical Classification Branch, Division of Vital Statistics,
National Center for Health Statistics, 4105 Hopson Road, Research Triangle
Park, North Carolina 27709. The technical appendices for natality and
mortality included in this document also provide information on the source of
data, coding procedures, quality of the data, etc.
National Center for Health Statistics. Vital statistics, Instructions for
Classifying the Underlying Cause-of-Death, 1999. NCHS Instruction
Manual, Part 2a. Hyattsville, Maryland: Public Health Service.
National Center for Health Statistics. Vital statistics, Instructions for
Classifying Multiple Cause-of-Death, 1999. NCHS Instruction Manual, Part
2b. Hyattsville, Maryland: Public Health Service.
National Center for Health Statistics. Vital statistics, ICD-10 ACME Decision
Tables for Classifying Underlying Causes-of-Death, 1999. NCHS
Instruction Manual, Part 2c. Hyattsville, Maryland: Public Health
Service.
National Center for Health Statistics. Vital statistics, NCHS Procedures for
Mortality Medical Data System File Preparation and Maintenance,
Effective 1999. NCHS Instruction Manual, Part 2d. Hyattsville, Maryland:
Public Health Service.
National Center for Health Statistics. Vital statistics, ICD-10 TRANSAX
Disease Reference Tables for Classifying Multiple Causes-of-Death, 1999.
NCHS Instruction Manual, Part 2f. Hyattsville, Maryland: Public Health
Service.
National Center for Health Statistics. Vital statistics, Classification and
Coding Instructions for Live Birth Records, 1999. NCHS Instruction
Manual, Part 3a. Hyattsville, Maryland: Public Health Service.
National Center for Health Statistics. Vital statistics, Demographic
Classification and Coding Instructions for Death Records, 1999. NCHS
Instruction Manual, Part 4. Hyattsville, Maryland: Public Health
Service.
National Center for Health Statistics. Vital statistics, Computer Edits for
Natality Data, Effective 1993. NCHS Instruction Manual Part 12.
Hyattsville, Maryland: Public Health Service.
National Center for Health Statistics. Vital statistics, Computer Edits for
Mortality Data, Effective 1999. NCHS Instruction Manual Part 11.
Hyattsville, Maryland: Public Health Service.
Change in Cause-of-Death Classification
For data year 1999, a new classification system for coding causes of death was
implemented in the United States: the Tenth Revision of the
International Classification of Diseases (ICD-10), developed by the
World Health Organization (WHO). Information about the new system can
be obtained at the following address:
http://www.cdc.gov/nchs/about/major/dvs/icd10des.htm
Underlying Cause of Death Data
Mortality statistics by cause of death are compiled from entries on the
medical certification portion of the death certificate. The U.S.
Standard Certificate of Death is shown in the Mortality Technical
Appendix which is included in this documentation. Causes of death
include "all those diseases, morbid conditions or injuries which either
resulted in or contributed to death and the circumstances of the
accident or violence which produced these injuries". The medical
certification of death is divided into two sections. In Part I, the
physician is asked to provide the causal chain of morbid conditions that
led to death, beginning with the condition most proximate to death on
line (a) and working backwards to the initiating condition. The lines
(a) through (d) in Part I are connected by the phrase "due to, or as a
consequence of." They were designed to encourage the physician to
provide the causally related sequence of medical conditions that
resulted in death. Thus, the condition on line (a) should be due to the
condition on line (b), and the condition on line (b) should be a
consequence of the condition on line (c), etc., until the full sequence
is described back to the originating or initiating condition. If only
one step in the chain of morbid events is recorded, a single entry on
line (a) is adequate. Part I of the medical certification is designed
to facilitate the selection of the underlying cause of death when two or
more causes are recorded on the certificate. The underlying cause of
death is defined by the WHO in the ICD-10 as "(a) the disease or injury
which initiated the chain of morbid events leading directly to death, or
(b) the circumstances of the accident or violence that produced the
fatal injury" and is generally considered the most useful cause from a
public health standpoint. Part II of the cause-of-death section of the
death certificate solicits other conditions that the certifier believed
contributed to death, but were not in the causal chain. While some
details of the death certificate vary by State, all States use the same
general format for medical certification outlined in the U.S. Standard
Certificate. The U.S. Standard Certificate, in turn, closely follows
the format recommended by the WHO.
If the death certificate is properly completed, the disease or condition
listed on the lowest used line in Part I is usually accepted as the
underlying cause of death. This is an application of "The General
Principle." The General Principle is applied unless it is highly
improbable that the condition on the lowest line used could have given
rise to all of the diseases or conditions listed above it. In some
cases, the sequence of morbid events entered on the death certificate is
not specified correctly. A variety of errors may occur in completing
the medical certification of death. Common problems include the
following: The causal chain may be listed in reverse order; the
distinction between Part I and Part II may have been ignored so that the
causal sequence in Part I is simply extended unbroken into Part II; or
the reported underlying cause is unlikely, in an etiological sense, to
have caused the condition listed above it. In addition, sometimes the
certifier attributes the death to uninformative causes such as cardiac
arrest or pulmonary arrest.
To resolve the problems of incorrect or implausible cause-of-death statements,
the WHO designed standardized rules to select an underlying cause of
death from the information available on the death certificate that is
most informative from a public health perspective. The rules for the
Tenth Revision as updated by WHO since the publication of ICD-10 are
described in NCHS instruction manual Part 2A. Coding rules beyond the
General Principle are invoked if the cause-of-death section is completed
incorrectly or if their application can improve the specificity and
characterization of the cause of death in a manner consistent with the
ICD. The rules are applied in two steps: selection of a tentative
underlying cause of death, and modification of the tentative underlying
cause in view of the other conditions reported on the certificate in
either Part I or Part II. Modification involves several considerations
by the medical coder: determining whether conditions in Part II could
have given rise to the underlying cause, giving preference to specific
terms over generalized terms, and creating linkages of conditions that
are consistent with the terminology of the ICD.
For a given death, the underlying cause is selected from the condition or
conditions recorded by the certifier in the cause-of-death section of
the death certificate. NCHS is bound by international agreement to make
the selection of the underlying cause through the use of the ICD-10
classification structure, and the selection and modification rules
contained in this revision of the ICD. These rules are contained in a
computer software program called ACME (Automated Classification of
Medical Entities). ACME does exactly what a coder would do to select the
underlying cause of death. The ACME program has been used for final
mortality data since 1968.
The WHO selection rules take into account the certifier's ordering of
conditions and their causal relationships to systematically identify the
underlying cause of death. The intent of these rules is to improve the
usefulness of mortality statistics by giving preference to certain
classification categories over others and consolidating two or more
conditions on the certificate into a single classification category.
Multiple Cause of Death Data
The limitations of the underlying cause concept and the need for more
comprehensive data suggested the need for coding and tabulating all
conditions listed on the death certificate. Coding all listed
conditions on the death certificate was designed with two objectives in
mind. First, to facilitate studies of the relationships among conditions
reported on the death certificate, which require presenting each
condition and its location on the death certificate in the exact manner
given by the certifier. Secondly, the coding needed to be carried out in
a manner by which the underlying cause-of-death could be assigned using
the WHO coding rules. Thus, the approach in developing multiple cause
data was to provide two fields: 1) entity axis and 2) record axis. For
entity axis, NCHS suspends the provisions of the ICD that create
linkages between conditions for the purpose of coding each individual
condition, or entity, with minimum regard to other conditions present on
the death certificate.
Record axis is designed for the generation of person-based multiple cause
statistics. Person-based analysis requires that each condition be coded
within the context of every other condition on the same death
certificate and modified or linked to such conditions as provided by
ICD-10. By definition, the entity data cannot meet this requirement
since the linkage provisions modify the character and placement of the
information originally recorded by the certifier. Essentially, the axis
of the classification has been converted from a entity basis to a record
(or person) basis. The record axis codes are assigned in terms of the
set of codes that best describe the overall medical certification
portion of the death certificate.
This translation is accomplished by a computer system called TRANSAX
(Translation of Axis). TRANSAX selectively uses the traditional linkage
and modification rules for mortality coding. Underlying cause linkages
which simply prefer one code over another for purposes of underlying
cause selection are not included. Each entity code on the record is
examined and modified or deleted as necessary to create a set of codes
that are free of contradictions and are the most precise within the
constraints of ICD-10 and medical information on the record. Repetitive
codes are deleted. The process may 1) combine two entity axis categories
together to a new category thereby eliminating a contradiction or
standardizing the data; or 2) eliminate one category in favor of another
to promote specificity of the data or resolve contradictions. The
following examples from ICD-10 illustrate the effect of this
translation:
Case 1: When reported on the same record as separate entities, cirrhosis
of liver and alcoholism are coded to K74.6 (Other and unspecified
cirrhosis of liver) and F10.2 (Mental and behavioral disorders due
to use of alcohol; dependence syndrome), respectively. Tabulation
of records with K74.6 would imply that such records had no mention
of alcohol. A preferable code would be K70.3 (Alcoholic cirrhosis
of liver) in lieu of both K74.6 and F10.2.
Case 2: If "gastric ulcer" and "bleeding gastric ulcer" are reported on a
record they are coded to K25.9 (Gastric ulcer, unspecified as
acute or chronic, without mention of hemorrhage or perforation)
and K25.4 (Gastric ulcer, chronic or unspecified with hemorrhage),
respectively. A more concise code is K25.4 which shows both the
gastric ulcer and the bleeding.
Entity Axis Codes
The original conditions coded for selection of the underlying cause-of-death
are reformatted and edited prior to creating the public-use data file. The
following paragraphs describe the format and application of entity axis data.
1. Format. Each entity-axis code is displayed as an overall seven byte code
with subcomponents as follows:
1. Line indicator: The first byte represents the line of the death
certificate on which the code appears. Six lines (1-6)
are allowable with the fourth and fifth denoting one
or two written in "due to"s beyond the three lines
provided in Part I of the U.S. standard death
certificate. Line "6" represents Part II of the death
certificate.
2. Position indicator: The next byte indicates the position of
the code on the line, i.e., it is the first (1),
second (2), third (3) .... eighth (8) code on the
line.
3. Cause category: The next four bytes represent the ICD-10 cause
code.
4. The last byte is blank.
A maximum of 20 of these seven byte codes are captured on a record for
multiple cause purposes. This may consist of a maximum of 8 codes on any given
line with up to 20 codes distributed across three or more lines depending on
where the subject conditions are located on the certificate. Codes may be
omitted from one or more lines, e.g., line 1 with one or more codes, line 2
with no codes, line 3 with one or more codes.
In writing out these codes, they are ordered as follows: line 1 first code,
line 1 second code, etc. ----- line 2 first code, line 2 second code, etc. ---
-- line 3 ---- line 4 ----- line 5 ----- line 6. Any space remaining in the
field is left blank. The specifics of locations are contained in the record
layout given later in this document.
2. Edit. The original conditions are edited to remove invalid codes, reverify
the coding of certain rare causes of death, and assure age/cause and sex/cause
compatibility. Detailed information relating to the edit criteria and the sets
of cause codes which are valid to underlying cause coding and multiple cause
coding are provided in NCHS Instruction Manual Part 11.
3. Entity Axis Applications. The entity axis multiple cause data file is
appropriate for analyses that require that each condition be coded as a stand
alone entity without linkage to other conditions and/or require information on
the placement of such conditions in the death certificate. Within this
framework, the entity data are appropriate to examine relationships among
conditions and the validity of traditional assumptions in underlying cause
selection. Additionally, the entity data provide in certain categories a more
detailed code assignment that could be excluded in creating record axis data.
Where such detail is needed for a study, the user should use entity data.
Finally, the researcher may not wish to be bound by the assumptions used in
the axis translation process.
The main limitation of entity axis data is that it does not necessarily
reflect the best code for a condition when considered within the context of
the medical certification as a whole. As a result, certain entity codes can be
misleading or even contradict other codes in the record. For example, category
K80.2 is titled "Calculus of gallbladder without cholecystitis." Within the
framework of entity codes this is interpreted to mean that the codable entity
itself contained no mention of cholecystitis rather than that cholecystitis
was not mentioned anywhere on the record. Tabulation of records with a "K80.2"
as a count of persons having Calculus of gallbladder without cholecystitis
would therefore be erroneous. This illustrates the fact that under entity
coding the ICD-10 titles cannot be taken literally. The user should study the
rules for entity coding as they relate to his/her research prior to use of
entity data. The user is further cautioned that the inclusion notes in ICD-10
that relate to modifying and combining categories are seldom applicable to
entity coding (except where provided NCHS Instruction Manual Part 2b).
In tabulating the entity axis data, one may count codes with an individual
code representing the number of times the condition(s) appears in the file. In
this kind of tabulation of morbid conditions, the counts among categories may
be added together to produce counts for groups of codes. Alternatively,
subject to the limitations given above, one may count persons having mention
of the disease represented by a code or codes. In this instance it is not
correct to add counts for individual codes to create person counts for groups
of codes. Since more than one code in the researcher's interest may appear
together on the certificate, totaling must account for higher order
interactions among codes. Up to 20 codes may be assigned on a record;
therefore, a 20-way interaction is theoretically possible. All totaling must
be based on mention of one or more of the categories under investigation.
Record Axis Codes
The following paragraphs describe the format and application of record-axis
data. Part 2f of the Instruction Manual Series (ICD-10 TRANSAX Disease
Reference Tables for classifying Multiple Causes-of-Death, 1999) describes the
TRANSAX process for creating record axis data from entity axis data.
1. Format. Each record (or person) axis code is displayed in five bytes.
Location information is not relevant. The Code consists of the following
components:
1. Cause category: The first four bytes represent the ICD-10 cause
code.
2. The last byte is blank.
Again, a maximum of 20 codes are captured on a record for multiple cause
purposes. The codes are written in a 100-byte field in ascending code number
(5 bytes) order with any unused bytes left blank.
2. Edit. The record axis codes are edited for rare causes and age/cause and
sex/cause compatibility. Likewise, individual code validity is checked. The
valid code set for record axis coding is the same as that for entity coding.
3. Record Axis Applications. The record axis multiple cause data are the
basis for NCHS core multiple cause tabulations. Location of codes is not
relevant to this data, and conditions have been linked into the most
meaningful categories for the certification. The most immediate consequence
for the user is that the codes on the record already represent mention of a
disease assignable to that particular ICD-10 category. This is in contrast to
the entity code which is assigned each time such a disease is reported on
different lines of the certification. Secondly, the linkage implies that
within the constraints of ICD-10 the most meaningful code has been assigned.
The translation process creates for the user a data file that is edited for
contradictions, duplicate codes, and imprecisions. In contrast to entity axis
data, record axis data are classified in a manner comparable to underlying
cause of death classification thereby facilitating joint analysis of these
variables. A potential disadvantage of record axis data is that some detail is
sacrificed in a number of the linkages.
The user can take the record axis codes as literally representing the
information conveyed in ICD-10 category titles. While knowledge of the rules
for combining and linking and coding conditions is useful, it is not a
prerequisite to meaningful analysis of the data as long as one is willing to
accept the assumptions of the axis translation process. The user is cautioned,
however, that due to special rules in mortality coding, not all linkage notes
in ICD-10 are used. (NCHS Instruction Manual Part 2f).
The user should proceed with caution in using record axis data to count
conditions as opposed to people with conditions, since linkages have been
invoked and duplicate codes have been eliminated. As with entity data, person-
based tabulations that combine individual cause categories must take into
account the possible interaction of up to 20 codes on a single certificate.
Additional Information
In using the NCHS multiple cause data files, the user is urged to review the
information in this document and its references. The instructional material
does change from year to year and ICD revision to ICD revision. The user is
cautioned that coding of specific ICD-10 categories should be checked in the
appropriate instruction manual. What may appear on the surface to be the
correct code by ICD-10 may in fact not be correct as given in the instruction
manuals.
If on the surface it is not obvious whether entity axis or record axis data
should be employed in a given application, detailed examination of NCHS
Instruction Manual Part 2f and its attachments will probably provide the
necessary information to make a decision. It allows the user to determine the
extent of the trade-offs between the two sets of data in terms of specific
categories and the assumption of axis translation. In certain situations, a
combination of entity and record axis data may be the more appropriate
alternative.
1999 Period Linked Birth/Infant Death Data Set
Data File Characteristics:
The data were processed using the SAS language on an IBM 9672.
The data are recorded in IBM/EBCDIC 8-bit code for each character.
Codes may be numeric, alphabets, or blank.
The record type is blocked, fixed format.
The last block for the data year may be a short block.
I. Denominator File:
United States Data Set
A. File Organization: One file, multiple tapes
B. Record count: 3,963,465
C. Record length: 210
D. Blocksize: 32130
E. Data counts: a. By occurrence: 3,963,465
b. By residence: 3,959,417
c. To foreign residents: 4,048
Territories Data Set
A. File Organization: One file, one tape
B. Record count: 65,493
C. Record length: 210
D. Blocksize: 32130
Puerto Rico
Data counts: a. By occurrence: 59,684
b. By occurrence and
residence: 59,563
c. To foreign residents: 121
Virgin Islands
Data counts: a. By occurrence: 1,772
b. By occurrence and
residence: 1,671
c. To foreign residents: 101
Guam
Data counts: a. By occurrence: 4,037
b. By occurrence and
residence: 4,021 c. To foreign residents: 16
II. Numerator File:
United States Data Set
A. File Organization: One of multiple files on a tape
B. Record count: 27,281
C. Record length: 535
D. Blocksize: 32635
E. Data counts: a. By occurrence: 27,281
b. By residence: 27,261
c. To foreign residents: 20
Territories Data Set
A. File Organization: One of multiple files on a tape
B. Record count: 678
C. Record length: 535
D. Blocksize: 32635
Puerto Rico
Data counts: a. By occurrence: 627
b. By occurrence and
residence: 627
c. To foreign residents: 0
Virgin Islands
Data counts: a. By occurrence: 16
b. By occurrence and residence: 16
c. To foreign residents: 0
Guam
Data counts: a. By occurrence: 35
b. By occurrence and residence: 35
c. To foreign residents: 0
III. Unlinked File:
United States Data Set
A. File Organization: one file of multiple files on a tape
B. Record count: 633
C. Record length: 535
D. Blocksize: 32635
E. Data counts: a. By occurrence: 633
b. By residence: 627
c. To foreign residents: 6
Territories Data Set
A. File Organization: one file of multiple files on a tape
B. Record count: 4
C. Record length: 535
D. Blocksize: 32635
Puerto Rico
Data counts: a. By occurrence: 4
b. By occurrence and residence: 2
c. To foreign residents: 2
Virgin Islands
Data counts: a. By occurrence: 0
b. By occurrence and residence: 0
c. To foreign residents: 0
Guam
Data counts: a. By occurrence: 0
b. By occurrence and residence: 0
c. To foreign residents: 0
1999 Period Linked Birth/Infant Death Data Set
List of Data Elements and Locations
Denominator Numerator File Unlinked
Data Items File Birth Death File
1. General
a. Year of birth 7-10 7-10 -- --
b. Year of death -- -- 524-527 524-527
c. Resident status 11 11 505 505
d. Record weight -- -- 223-230 --
e. Flag for records included in 210 -- -- --
both numerator and denominator
2. Occurrence
a. FIPS state 14-15 14-15 508-509 508-509
b. FIPS county 16-18 16-18 510-512 510-512
3. Residence
a. FIPS state 19-20 19-20 513-514 513-514
b. FIPS county 21-23 21-23 515-517 515-517
c. FIPS place 24-28 24-28 518-522 518-522
d. NCHS state 12-13 12-13 506-507 506-507
4. Infant
a. Age -- -- 211-214 211-214+
b. Race -- -- -- 35-38*
c. Sex 78-79 78-79 -- 78-79*
d. Gestation 70-77 70-77 -- --
e. Birthweight 80-87 80-87 -- --
f. Plurality 88-89 88-89 -- --
g. Apgar score 90-91 90-91 -- --
h. Day of week of birth/death 209 209 532 532
i. Month of birth/death 205-206 205-206 528-529 528-529
5. Mother
a. Age 29-32 29-32 -- --
b. Race 35-38 35-38 -- --
c. Education 39-41 39-41 -- --
d. Marital status 42-43 42-43 -- --
e. Place of birth 44-46 44-46 -- --
f. Hispanic origin 33-34 33-34 -- --
6. Father
a. Age 60-62 60-62 -- --
b. Race 65-66 65-66 -- --
c. Hispanic origin 63-64 63-64 -- --
7. Pregnancy items
a. Month prenatal care began 51-53 51-53 -- --
b. Number of prenatal visits 54-55 54-55 -- --
c. Adequacy of care recode 56 56 -- --
d. Total birth order 47-48 47-48 -- --
e. Live birth order 49-50 49-50 -- --
8. Medical and Health Data
a. Method of delivery 92-99 92-99 -- --
b. Medical risk factors 100-117 100-117 -- --
c. Other risk factors
Tobacco 118-121 118-121 -- --
Alcohol 122-125 122-125 -- --
Weight gain during pregnancy 126-128 126-128 -- --
d. Obstetric procedures 129-136 129-136 -- --
e. Complications of labor and/or
delivery 137-153 137-153 -- --
f. Abnormal conditions of the
newborn 154-163 154-163 -- --
g. Congenital anomalies 164-186 164-186 -- --
h. Underlying cause of death 216-219 216-219
i. 130 Infant cause recode 220-222 220-222
j. Multiple conditions 261-504 261-504
9. Other items
a. Place of delivery 67 67 -- --
b. Attendant at birth 68 68 -- --
c. Hospital and patient status -- -- 523 523
e. Place of accident -- -- 215 215
f. Residence reporting flags 187-203 187-203 -- --
+ For the unlinked file, date of birth as reported on the death certificate
is used to generate age at death. See section on Changes Beginning with the 1995
Data Year for explanation.
* For the unlinked file, these items are from the death certificate. See
section on Changes Beginning with the 1995 Data Year for explanation.
Denominator Record and Natality Section of Numerator (Linked) Record
Locations 7-210 of the linked file contain data from the Birth Certificate.
Locations 211-535 of linked file contain data from the Death Certificate.
Residence items in the Denominator Record and in the natality section of the
Numerator (linked) Record refer to the usual place of residence of the Mother;
whereas in the mortality section of the Numerator (Linked) Record, these items
refer to the residence of the Decedent.
Item Item Variable Name,
Location Length Item and Code Outline
1-6 6 R0
Reserved Positions
7-10 4 BIRYR
Year of Birth
1998 ... Born in 1998 (This code valid
for numerator (linked) file
file only).
1999 ... Born in 1999
11 1 RESSTATB
Resident Status - Birth
United States Occurrence
1 ... RESIDENTS: State and county of
occurrence and residence are the same.
2 ... INTRASTATE NONRESIDENTS: State of
occurrence and residence are the same, but
county is different.
3 ... INTERSTATE NONRESIDENTS: State of
occurrence and residence are different, but
both are in the 50 States and D.C.
4 ... FOREIGN RESIDENTS: State of
occurrence is one of
the 50 States or the District of
Columbia, but place of
residence of mother is outside of
the 50 States and D.C.
Puerto Rico Occurrence
1 ... RESIDENTS: State and county of
occurrence and residence are the same.
2 ... INTRASTATE NONRESIDENTS: State of
occurrence and residence are the same, but
county is different.
4 ... FOREIGN RESIDENTS: Occurred in
Puerto Rico to a
resident of any other place.
Virgin Islands Occurrence
1 ... RESIDENTS: State and county of
occurrence and residence are the same.
2 ... INTRASTATE NONRESIDENTS: State of
occurrence and residence are the same, but
county is different.
4 ... FOREIGN RESIDENTS: Occurred in the
Virgin Islands to a
resident of any other place.
Guam Occurrence
1 ... RESIDENTS: Occurred in Guam to a
resident of Guam or to a resident of
the U.S.
4 ... FOREIGN RESIDENTS: Occurred in Guam
to a resident of any place other
than Guam or the U.S.
12-13 2 BRSTATE
Expanded State of Residence - NCHS Codes - Birth
This item is designed to separately identify
New York City records from other New York State
records.
United States Occurrence
01 ... Alabama
02 ... Alaska
03 ... Arizona
04 ... Arkansas
05 ... California
06 ... Colorado
07 ... Connecticut
08 ... Delaware
09 ... District of Columbia
10 ... Florida
11 ... Georgia
12 ... Hawaii
13 ... Idaho
14 ... Illinois
15 ... Indiana
16 ... Iowa
17 ... Kansas
18 ... Kentucky
19 ... Louisiana
20 ... Maine
21 ... Maryland
22 ... Massachusetts
23 ... Michigan
24 ... Minnesota
25 ... Mississippi
26 ... Missouri
27 ... Montana
28 ... Nebraska
29 ... Nevada
30 ... New Hampshire
31 ... New Jersey
32 ... New Mexico
33 ... New York
34 ... New York city
35 ... North Carolina
36 ... North Dakota
37 ... Ohio
38 ... Oklahoma
39 ... Oregon
40 ... Pennsylvania
41 ... Rhode Island
42 ... South Carolina
43 ... South Dakota
44 ... Tennessee
45 ... Texas
46 ... Utah
12-13 2 BRSTATE
Expanded State of Residence - NCHS Codes - Birth
(Cont'd)
This item is designed to separately identify
New York City records from other New York State
records.
United States Occurrence
47 ... Vermont
48 ... Virginia
49 ... Washington
50 ... West Virginia
51 ... Wisconsin
52 ... Wyoming
53-58,
60 ... Foreign Residents
53 ... Puerto Rico
54 ... Virgin Islands
55 ... Guam
56 ... Canada
57 ... Cuba
58 ... Mexico
60 ... Remainder of the World
Puerto Rico Occurrence
53 ... Puerto Rico
01-52,54-58,
60 ... Foreign Residents:
Refer to U.S. for specific code
structure.
Virgin Islands Occurrence
54 ... Virgin Islands
01-53,55-58,
60 ... Foreign Residents:
Refer to U.S. for specific code
structure.
Guam Occurrence
55 ... Guam
01-52...U.S. resident is also
considered a resident of
Guam.
53,54,58,
60 ... Foreign Residents:
Refer to U.S. for specific code
structure.
FIPSOCCB
Federal Information Processing Standards
(FIPS) Geographic Codes (Occurrence) - Birth
Refer to the Geographic Code Outline further
back in this document for a
detailed list of areas and codes. For an
explanation of FIPS codes, reference
should be made to various National Institute of
Standards and Technology (NIST) publications.
14-15 2 STOCCFIPB
State of Occurrence (FIPS) - Birth
United States
01 ... Alabama
02 ... Alaska
04 ... Arizona
05 ... Arkansas
06 ... California
08 ... Colorado
09 ... Connecticut
10 ... Delaware
11 ... District of Columbia
12 ... Florida
13 ... Georgia
15 ... Hawaii
16 ... Idaho
17 ... Illinois
18 ... Indiana
19 ... Iowa
20 ... Kansas
21 ... Kentucky
22 ... Louisiana
23 ... Maine
24 ... Maryland
25 ... Massachusetts
26 ... Michigan
27 ... Minnesota
28 ... Mississippi
29 ... Missouri
30 ... Montana
31 ... Nebraska
32 ... Nevada
33 ... New Hampshire
34 ... New Jersey
35 ... New Mexico
36 ... New York
37 ... North Carolina
38 ... North Dakota
39 ... Ohio
40 ... Oklahoma
41 ... Oregon
42 ... Pennsylvania
44 ... Rhode Island
45 ... South Carolina
46 ... South Dakota
47 ... Tennessee
48 ... Texas
14-15 2 STOCCFIPB
State of Occurrence (FIPS) - Birth (Cont'd)
United States
49 ... Utah
50 ... Vermont
51 ... Virginia
53 ... Washington
54 ... West Virginia
55 ... Wisconsin
56 ... Wyoming
Puerto Rico
72 ... Puerto Rico
Virgin Islands
78 ... Virgin Islands
Guam
66 ... Guam
16-18 3 CNTOCFIPB
County of Occurrence (FIPS) - Birth
001-nnn ... Counties and county
equivalents (independent and
coextensive cities) are
numbered alphabetically within
each State. (Note: To
uniquely identify a county,
both the State and county
codes must be used.)
999 ... County with less than 250,000
population
19-23 5 FIPSRESB
Federal Information Processing Standards (FIPS)
Geographic Codes (Residence) - Birth
Refer to the Geographic Code Outline further
back in this document for a
detailed list of areas and codes. For an
explanation of FIPS codes, reference
should be made to various National Institute
of Standards and Technology
(NIST) publications.
19-20 2 STRESFIPB
State of Residence (FIPS) - Birth
United States Occurrence
00 ... Foreign residents
01 ... Alabama
02 ... Alaska
04 ... Arizona
05 ... Arkansas
06 ... California
08 ... Colorado
09 ... Connecticut
10 ... Delaware
11 ... District of Columbia
12 ... Florida
13 ... Georgia
15 ... Hawaii
16 ... Idaho
17 ... Illinois
18 ... Indiana
19 ... Iowa
20 ... Kansas
21 ... Kentucky
22 ... Louisiana
23 ... Maine
24 ... Maryland
25 ... Massachusetts
26 ... Michigan
27 ... Minnesota
28 ... Mississippi
29 ... Missouri
30 ... Montana
31 ... Nebraska
32 ... Nevada
33 ... New Hampshire
34 ... New Jersey
35 ... New Mexico
36 ... New York
37 ... North Carolina
38 ... North Dakota
39 ... Ohio
40 ... Oklahoma
41 ... Oregon
42 ... Pennsylvania
44 ... Rhode Island
45 ... South Carolina
46 ... South Dakota
47 ... Tennessee
19-20 2 STRESFIPB
State of Residence (FIPS) - Birth Cont'd)
United States Occurrence
48 ... Texas
49 ... Utah
50 ... Vermont
51 ... Virginia
53 ... Washington
54 ... West Virginia
55 ... Wisconsin
56 ... Wyoming
Puerto Rico Occurrence
00-56,66,
78 ... Foreign Residents:
Refer to U.S. for
specific code structure
72 ... Puerto Rico
Virgin Islands Occurrence
00-56,66,
72 ... Foreign Residents:
Refer to U.S. for
specific code structure
78 ... Virgin Islands
Guam Occurrence
00,72,78... Foreign Residents: Refer to
U.S. for specific code
structure
01-56 ... U.S. Resident is also
considered a resident of
Guam. Refer to U.S. for
specific code structure
66 ... Guam
21-23 3 CNTYRFPB
County of Residence (FIPS) - Birth
000 ... Foreign residents
001-nnn ... Counties and county
equivalents (independent and
coextensive cities) are
numbered alphabetically within
each State (Note: To uniquely
identify a county, both the
State and county codes must be
used.)
999 ... County with less than 250,000
population
24-28 5 PLRES
Place (City) of Residence (FIPS)
A complete list of cities is shown in the
Geographic Code Outline further back in this
document.
00000 ... Foreign residents
00001-nnnnn...Code range
99999 ... Balance of
county; or city less than
250,000 population
29 1 MAGEFLG
Age of Mother Flag
This position is flagged whenever age is
imputed or the mother's reported age is used.
The reported age is used, if valid, when computed
age derived from the date of birth is not available or
when it is outside the 10-54 code range.
Blank ... Not imputed and reported
age is not used
1 ... Reported age is used
2 ... Age is imputed
30-31 2 DMAGE
Age of Mother
This item is: a) computed using dates of birth
of mother and of delivery;
b) reported; or c) imputed. This is the age
item used in NCHS publications.
10-54 ... Age in single years
32 1 MAGER9
Age of Mother Recode 9
1 ... Under 15 years
2 ... 15 - 19 years
3 ... 20 - 24 years
4 ... 25 - 29 years
5 ... 30 - 34 years
6 ... 35 - 39 years
7 ... 40 - 44 years
8 ... 45 - 49 years
9 ... 50 - 54 years
33 1 ORMOTH
Hispanic Origin of Mother
Hispanic origin is reported for all areas
except Puerto Rico.
0 ... Non-Hispanic
1 ... Mexican
2 ... Puerto Rican
3 ... Cuban
4 ... Central or South American
5 ... Other and unknown Hispanic
9 ... Origin unknown or not stated
34 1 ORRACEM
Hispanic Origin and Race of Mother Recode
Hispanic origin is reported for all areas
except Puerto Rico.
1 ... Mexican
2 ... Puerto Rican
3 ... Cuban
4 ... Central or South American
5 ... Other and unknown Hispanic
6 ... Non-Hispanic White
7 ... Non-Hispanic Black
8 ... Non-Hispanic other races
9 ... Origin unknown or not stated
35 1 MRACEIMP
Race of Mother Imputation Flag
Blank ... Race is not imputed
1 ... Race is imputed
2 ... All other races, formerly code
09, is imputed
36-37 2 MRACE
Race of Mother - Birth Record or for Unlinked
Records Race of Decedent
from Death Record
Beginning with 1992 data, some areas started
reporting additional Asian or
Pacific Islander codes for race. Codes 18-68
replace old code 08 for these
areas. Code 78 replaces old code 08 for all
other areas. For consistency with
Census race code 09 (all other races) used
prior to 1992 has been imputed.
United States Occurrence
01 ... White
02 ... Black
03 ... American Indian (includes
Aleuts and Eskimos)
04 ... Chinese
05 ... Japanese
06 ... Hawaiian (includes part-
Hawaiian)
07 ... Filipino
18 ... Asian Indian
28 ... Korean
38 ... Samoan
48 ... Vietnamese
58 ... Guamanian
68 ... Other Asian or Pacific
Islander in areas reporting
codes 18-58
78 ... Combined other Asian or
Pacific Islander, includes
codes 18-68 for areas that do
not report them
separately
36-37 2 MRACE
Race of Mother - Birth Record or for Unlinked
Records Race of Decedent
from Death Record (Cond't)
Puerto Rico Occurrence
00 ... Other races
01 ... White
02 ... Black
Virgin Islands Occurrence
01 ... White
02 ... Black
03 ... American Indian
(includes Aleuts and Eskimos)
04 ... Chinese
05 ... Japanese
06 ... Hawaiian (includes part-
Hawaiian)
07 ... Filipino
08 ... Other Asian or Pacific
Islander
Guam Occurrence
01 ... White
02 ... Black
03 ... American Indian (includes
Aleuts and Eskimos)
04 ... Chinese
05 ... Japanese
06 ... Hawaiian (includes part-
Hawaiian)
07 ... Filipino
08 ... Other Asian or Pacific
Islander
58 ... Guamanian
38 1 MRACE3
Race of Mother Recode
1 ... White
2 ... Races other than White or
Black
3 ... Black
39-40 2 DMEDUC
Education of Mother Detail
All areas report education of mother.
00 ... No formal education
01-08 ... Years of elementary
school
09 ... 1 year of high school
10 ... 2 years of high school
11 ... 3 years of high school
12 ... 4 years of high school
13 ... 1 year of college
14 ... 2 years of college
15 ... 3 years of college
16 ... 4 years of college
17 ... 5 or more years of college
99 ... Not stated
41 1 MEDUC6
Education of Mother Recode
1 ... 0 - 8 years
2 ... 9 - 11 years
3 ... 12 years
4 ... 13 - 15 years
5 ... 16 years and over
6 ... Not stated
42 1 DMARIMP
Marital Status of Mother Imputation Flag
Blank ... Marital status is not
imputed
1 ... Marital status is imputed
43 1 DMAR
Marital Status of Mother
Marital status is not reported by all
areas. See reporting flags.
United States/Virgin Islands/Guam Occurrence
1 ... Married
2 ... Unmarried
9 ... Unknown or not stated
Puerto Rico Occurrence
1 ... Married
2 ... Unmarried parents living
together
3 ... Unmarried parents not living
together
9 ... Unknown or not stated
44-45 2 MPLBIR
Place of Birth of Mother
01 ... Alabama
02 ... Alaska
03 ... Arizona
04 ... Arkansas
05 ... California
06 ... Colorado
07 ... Connecticut
08 ... Delaware
09 ... District of Columbia
10 ... Florida
11 ... Georgia
12 ... Hawaii
13 ... Idaho
14 ... Illinois
15 ... Indiana
16 ... Iowa
17 ... Kansas
18 ... Kentucky
19 ... Louisiana
20 ... Maine
21 ... Maryland
22 ... Massachusetts
23 ... Michigan
24 ... Minnesota
25 ... Mississippi
26 ... Missouri
27 ... Montana
28 ... Nebraska
29 ... Nevada
30 ... New Hampshire
31 ... New Jersey
32 ... New Mexico
33 ... New York
34 ... North Carolina
35 ... North Dakota
36 ... Ohio
37 ... Oklahoma
38 ... Oregon
39 ... Pennsylvania
40 ... Rhode Island
41 ... South Carolina
42 ... South Dakota
43 ... Tennessee
44 ... Texas
45 ... Utah
46 ... Vermont
47 ... Virginia
48 ... Washington
49 ... West Virginia
44-45 2 MPLBIR
Place of Birth of Mother (Cont'd)
50 ... Wisconsin
51 ... Wyoming
52 ... Puerto Rico
53 ... Virgin Islands
54 ... Guam
55 ... Canada
56 ... Cuba
57 ... Mexico
59 ... Remainder of the World
99 ... Not Classifiable
46 1 MPLBIRR
Place of Birth of Mother Recode
United States Occurrence
1 ... Born in the 50 States and D.C.
2 ... Born outside the 50 States and
DC
3 ... Unknown or not stated
Puerto Rico/Virgin Island/ Guam Occurrence
Blank ... This item not recorded
47-48 2 DTOTORD
Detail Total Birth Order
Sum of live birth order and other terminations
of pregnancy. If either item is
unknown, this item is made unknown.
01-40 ... Total number of live
births and other terminations
of pregnancy
99 ... Unknown
49-50 2 DLIVORD
Detail Live Birth Order
Sum of live births now living and now dead
plus one. If either item is unknown, this
item is made unknown.
00-31 ... Number of children born
alive to mother
99 ... Unknown
51-52 2 MONPRE
Detail Month of Pregnancy Prenatal Care Began
00 ... No prenatal care
01 ... 1st month
02 ... 2nd month
03 ... 3rd month
04 ... 4th month
05 ... 5th month
06 ... 6th month
07 ... 7th month
08 ... 8th month
09 ... 9th month
99 ... Unknown or not stated
53 1 MPRE5
Month Prenatal Care Began Recode 5
1 ... 1st Trimester (1st-3rd month)
2 ... 2nd Trimester (4th-6th month)
3 ... 3rd Trimester (7th-9th month)
4 ... No prenatal care
5 ... Unknown or not stated
54-55 2 NPREVIST
Total Number of Prenatal Visits
00 ... No prenatal visits
01-48 ... Stated number of visits
49 ... 49 or more visits
99 ... Unknown or not stated
56 1 ADEQUACY
Adequacy of Care Recode (Kessner Index)
This code is based on a modified Kessner
criterion. Month Prenatal Care Began, Number of
Prenatal Visits, and Gestation are the items used to
generate this recode.
1 ... Adequate
2 ... Intermediate
3 ... Inadequate
4 ... Unknown
57-59 3 R1
Reserved Positions
60 1 FAGERFLG
Reported Age of Father Used Flag
This position is flagged whenever the Father's
reported age in years is used.
The reported age is used, if valid, when age
derived from date of birth is not
available or when it is less than 10.
Blank ... Reported age is not used
1 ... Reported age is used
61-62 2 DFAGE
Age of Father
This item is either computed from date of
birth of father and of child or is the reported
age. This is the age item used in NCHS publications.
10-98 ... Age in single years
99 ... Unknown or not stated
63 1 ORFATH
Hispanic Origin of Father
Hispanic origin is reported for all areas
except Puerto Rico.
0 ... Non-Hispanic
1 ... Mexican
2 ... Puerto Rican
3 ... Cuban
4 ... Central or South American
5 ... Other and unknown Hispanic
9 ... Origin unknown or not stated
64 1 ORRACEF
Hispanic Origin and Race of Father Recode
Hispanic origin is reported for all areas
except Puerto Rico.
1 ... Mexican
2 ... Puerto Rican
3 ... Cuban
4 ... Central or South American
5 ... Other and unknown Hispanic
6 ... Non-Hispanic White
7 ... Non-Hispanic Black
8 ... Non-Hispanic other or unknown
race
9 ... Origin unknown or not stated
65-66 2 FRACE
Race of Father
Beginning with 1992 data, some areas started
reporting additional Asian or
Pacific Islander codes for race. See
reporting flags. Codes 18 -68 replace old code
08 for these areas. Code 78 replaces old code 08 for
all other areas.
Code 09 (all other races) has been changed to
99.
United States Occurrence
01 ... White
02 ... Black
03 ... American Indian (includes
Aleuts and Eskimos)
04 ... Chinese
05 ... Japanese
06 ... Hawaiian (includes
part-Hawaiian)
07 ... Filipino
18 ... Asian Indian
28 ... Korean
38 ... Samoan
48 ... Vietnamese
58 ... Guamanian
68 ... Other Asian or Pacific
Islander in areas reporting codes 18-58
78 ... Combined other Asian or
Pacific Islander, includes
codes 18-68 for areas that do
not report them separately
99 ... Unknown or not stated
Puerto Rico Occurrence
00 ... Other races
01 ... White
02 ... Black
99 ... Unknown or not stated
Virgin Islands Occurrence
01 ... White
02 ... Black
03 ... American Indian (includes
Aleuts and Eskimos)
04 ... Chinese
05 ... Japanese
06 ... Hawaiian (includes part-
Hawaiian)
07 ... Filipino
08 ... Other Asian or Pacific
Islander
99 ... Unknown or not stated
65-66 2 FRACE
Race of Father (Cont'd)
Guam Occurrence
01 ... White
02 ... Black
03 ... American Indian (includes
Aleuts and Eskimos)
04 ... Chinese
05 ... Japanese
06 ... Hawaiian (includes part-
Hawaiian)
07 ... Filipino
08 ... Other Asian or Pacific
Islander
58 ... Guamanian
99 ... Unknown or not stated
67 1 PLDEL
Place or Facility of Delivery
1 ... Hospital
2 ... Freestanding Birthing Center
3 ... Clinic or Doctor's Office
4 ... A Residence
5 ... Other
9 ... Unknown or not stated
68 1 BIRATTND
Attendant at Delivery
1 ... Doctor of Medicine (M.D.)
2 ... Doctor of Osteopathy (D.O.)
3 ... Certified Nurse Midwife(C.N.M.)
4 ... Other Midwife
5 ... Other
9 ... Unknown or not stated
69 1 R2
Reserved position
70 1 GESTESTM
Clinical Estimate of Gestation Used Flag
This position is flagged whenever the clinical
estimate of gestation is used. It is used when
gestation could not be computed or when the computed
gestation is outside the 17-47 code range.
Blank ... Clinical Estimate is not used
1 ... Clinical Estimate is used
71-72 2 CLINGEST
Clinical Estimate of Gestation
Clinical estimate is not reported by all
areas.
See reporting flags.
17-47 ... Estimated gestation in
weeks
99 ... Unknown or not stated
73 1 GESTIMP
Gestation Imputation Flag
Blank ... Gestation is not imputed
1 ... Gestation is imputed
74-75 2 GESTAT
Gestation - Detail in Weeks
This item is: a) computed using dates of birth
of child and last normal menses; b)
imputed from LMP date; c) the clinical estimate;
or d) unknown when there is insufficient data
to impute or no valid clinical estimate.
This is the gestation item used in NCHS
publications.
17-47 ... 17th through 47th week
of gestation
99 ... Unknown
76-77 2 GESTAT 10
GESTATION RECODE 10
01 ... Under 20 weeks
02 ... 20 - 27 weeks
03 ... 28 - 31 weeks
04 ... 32 - 35 weeks
05 ... 36 weeks
06 ... 37 - 39 weeks
07 ... 40 weeks
08 ... 41 weeks
09 ... 42 weeks and over
10 ... Not stated
78 1 CSEXIMP
Sex Imputation Flag
Blank ... Sex is not imputed
1 ... Sex is imputed
79 1 CSEX
Sex
1 ... Male
2 ... Female
80-87 8 BIRTHWEIGHT
Beginning in 1995, an imputation for not-
stated birthweight was added to
reduce potential bias in the data (see section
on changes beginning with the
1995 data year in the introductory text to
this documentation). The following
imputation flag can be used to delete imputed
values for those researchers
wishing to use only reported birthweight data.
80 1 BWIF
Birthweight Imputation Flag
Blank ... Birthweight is not
imputed
1 ... Birthweight is imputed
81-84 4 DBIRWT
Birthweight Detail in Grams (Imputed)
0227-8165... Number of grams
9999 ... Not stated birth weight
85-86 2 BIRWT12
Birthweight Recode 12 (Imputed)
01 ... 499 grams or less
02 ... 500-999 grams
03 ... 1000-1499 grams
04 ... 1500-1999 grams
05 ... 2000-2499 grams
06 ... 2500-2999 grams
07 ... 3000-3499 grams
08 ... 3500-3999 grams
09 ... 4000-4499 grams
10 ... 4500-4999 grams
11 ... 5000-8165 grams
12 ... Unknown or not stated
87 1 BIRWT4
Birthweight Recode 4 (Imputed)
1 ... 1499 grams or less
2 ... 1500-2499 grams
3 ... 2500 grams or more
4 ... Unknown or not stated
88 1 PLURIMP
Plurality Imputation Flag
Blank ... Plurality is not imputed
1 ... Plurality is imputed
89 1 DPLURAL
Plurality
1 ... Single
2 ... Twin
3 ... Triplet
4 ... Quadruplet
5 ... Quintuplet or higher
90-91 2 FMAPS
Five-Minute Apgar Score
Apgar score is not reported by all areas. See
reporting flags.
00-10 ... A score of 0-10
99 ... Unknown or not stated
92-186 95 MEDINFO
Medical and Health Data
Some States do not report an entire item while
other States do not report all of the
categories within an item. If an item is not
reported, it is indicated by
code zero in the appropriate reporting flag.
If a category within an item is not reported it
is indicated by code 8 in the position for
that category.
92-99 8 DELMETH
Method of Delivery
Each method is assigned a separate position,
and the code structure for each
method (position) is:
1 ... The method was used
2 ... The method was not used
8 ... Method not on certificate
9 ... Method unknown or not stated
92 1 VAGINAL
Vaginal
93 1 VBAC
Vaginal Birth After Previous C-Section
94 1 PRIMAC
Primary C-Section
95 1 REPEAC
Repeat C-Section
96 1 FORCEP
Forceps
97 1 VACUUM
Vacuum
98 1 R3
Reserved Position
99 1 DELMETH5
Method of Delivery Recode
1 ... Vaginal (excludes Vaginal
after previous C-section)
2 ... Vaginal birth after previous C-
section
3 ... Primary C-section
4 ... Repeat C-Section
5 ... Not stated
100-117 18 MEDRISK
Medical Risk Factors
Each risk factor is assigned a separate
position, and the code structure for
each risk factor (position) is:
1 ... Factor reported
2 ... Factor not reported
8 ... Factor not on certificate
9 ... Factor not classifiable
100 1 MRFLAG
No Medical Risk Factors Reported Flag
Blank ... One or more medical risk
factors coded, one, eight, or nine
2 ... No medical risk factors
reported. Each factor is coded a two.
101 1 ANEMIA
Anemia (Hct.<30/Hgb.<10)
102 1 CARDIAC
Cardiac disease
103 1 LUNG
Acute or chronic lung disease
104 1 DIABETES
Diabetes
105 1 HERPES
Genital herpes
106 1 HYDRA
Hydramnios/Oligohydramnios
107 1 HEMO
Hemoglobinopathy
108 1 CHYPER
Hypertension, chronic
109 1 PHYPER
Hypertension, pregnancy-associated
110 1 ECLAMP
Eclampsia
111 1 INCERVIX
Incompetent cervix
112 1 PRE4000
Previous infant 4000+ grams
113 1 PRETERM
Previous preterm or small-for-gestational-age
infant
114 1 RENAL
Renal disease
115 1 RH
Rh sensitization
116 1 UTERINE
Uterine bleeding
117 1 OTHERMR
Other Medical Risk Factors
118-128 11 OTHERRSK
Other Risk Factors for this Pregnancy
118-121 4 TOBACRSK
Tobacco Risks
118 1 TOBACCO
Tobacco Use During Pregnancy
1 ... Yes
2 ... No
9 ... Unknown or not stated
119-120 2 CIGAR
Average Number of Cigarettes Per Day
00-97 ... As stated
98 ... 98 or more cigarettes per day
99 ... Unknown or not stated
121 1 CIGAR6
Average Number of Cigarettes Per Day Recode
0 ... Nonsmoker
1 ... 1-5 cigarettes per day
2 ... 6-10 cigarettes per day
3 ... 11-20 cigarettes per day
4 ... 21-40 cigarettes per day
5 ... 41 or more cigarettes per day
6 ... Unknown or not stated
122-125 4 ALCOHRSK
Alcohol
122 1 ALCOHOL
Alcohol Use During Pregnancy
1 ... Yes
2 ... No
9 ... Unknown or not stated
123-124 2 DRINK
Average Number of Drinks Per Week
00-97 ... As stated
98 ... 98 or more drinks per week
99 ... Unknown or not stated
125 1 DRINK5
Average Number of Drinks Per Week Recode
0 ... Non drinker
1 ... 1 drink per week
2 ... 2 drinks per week
3 ... 3-4 drinks per week
4 ... 5 or more drinks per week
5 ... Unknown or not stated
126-128 3 WTGANRSK
Weight Gain During Pregnancy
126-127 2 WTGAIN
Weight Gain
00-97 ... Stated number of pounds
98 ... 98 pounds or more
99 ... Unknown or not stated
128 1 WTGAIN9
Weight Gain Recode
1 ... Less than 16 pounds
2 ... 16-20 pounds
3 ... 21-25 pounds
4 ... 26-30 pounds
5 ... 31-35 pounds
6 ... 36-40 pounds
7 ... 41-45 pounds
8 ... 46 or more pounds
9 ... Unknown or not stated
129-136 8 OBSTETRC
Obstetric Procedures
Each procedure is assigned a separate
position, and the code structure for each
procedure (position) is:
1 ... Procedure reported
2 ... Procedure not reported
8 ... Procedure not on certificate
9 ... Procedure not classifiable
129 1 OBFLAG
Obstetric Flag
Blank ... One or more obstetric
procedures coded, one, eight,
or nine
2 ... No obstetric procedures
reported. Each factor is
coded a two.
130 1 AMNIO
Amniocentesis
131 1 MONITOR
Electronic fetal monitoring
132 1 INDUCT
Induction of labor
133 1 STIMULA
Stimulation of labor
134 1 TOCOL
Tocolysis
135 1 ULTRAS
Ultrasound
136 1 OTHEROB
Other Obstetric Procedures
137-153 17 LABOR
Complications of Labor and/or Delivery
Each complication is assigned a separate
position, and the code structure for
each complication (position) is:
1 ... Complication reported
2 ... Complication not reported
8 ... Complication not on
certificate
9 ... Complication not classifiable
137 1 FBFLAG
Labor Flag
Blank ... One or more labor and/or
delivery complications
coded, one, eight, or nine
2 ... No labor and/or delivery
complication reported.
Each factor is coded a two.
138 1 FEBRILE
Febrile (>100 degrees F. or 38 degrees C.)
139 1 MECONIUM
Meconium, moderate/heavy
140 1 RUPTURE
Premature rupture of membrane (>12 hours)
141 1 ABRUPTIO
Abruptio placenta
142 1 PREPLACE
Placenta previa
143 1 EXCEBLD
Other excessive bleeding
144 1 SEIZURE
Seizures during labor
145 1 PRECIP
Precipitous labor (<3 hours)
146 1 PROLONG
Prolonged labor (>20 hours)
147 1 DYSFUNC
Dysfunctional labor
148 1 BREECH
Breech/Malpresentation
149 1 CEPHALO
Cephalopelvic disproportion
150 1 CORD
Cord prolapse
151 1 ANESTHE
Anesthetic complications
152 1 DISTRESS
Fetal distress
153 1 OTHERLB
Other Complications of Labor and/or Delivery
154-163 10 NEWBORN
Abnormal conditions of the Newborn
Each condition is assigned a separate
position, and the code structure for each
condition (position)is:
1 ... Condition reported
2 ... Condition not reported
8 ... Condition not on certificate
9 ... Condition not classifiable
154 1 NBFLAG
Newborn Flag
Blank ... One or more abnormal
conditions of the newborn
coded, one, eight, or nine
2 ... No abnormal condition of the
newborn reported.
Each factor is coded a two.
155 1 NANEMIA
Anemia Hct.>39/Hgb.<13)
156 1 INJURY
Birth injury
157 1 ALCOSYN
Fetal alcohol syndrome
158 1 HYALINE
Hyaline membrane disease
159 1 MECONSYN
Meconium aspiration syndrome
160 1 VENL30
Assisted ventilation, less than 30 minutes
161 1 VEN30M
Assisted ventilation, 30 minutes or more
162 1 NSEIZ
Seizures
163 1 OTHERAB
Other Abnormal Conditions of the Newborn
164-186 23 CONGENIT
Congenital Anomalies
Each anomaly is assigned a separate position,
and the code structure for
each anomaly (position) is:
1 ... Anomaly reported
2 ... Anomaly not reported
8 ... Anomaly not on certificate
9 ... Anomaly not classifiable
164 1 CGFLAG
Congenital Flag
Blank ... One or more congenital
anomalies coded, one,eight, or
nine
2 ... No congenital anomaly is
reported. Each factor is
coded a two.
165 1 ANEN
Anencephalus
166 1 SPINA
Spina bifida/Meningocele
167 1 HYDRO
Hydrocephalus
168 1 MICROCE
Microcephalus
169 1 NERVOUS
Other central nervous system anomalies
170 1 HEART
Heart malformations
171 1 CIRCUL
Other circulatory/respiratory anomalies
172 1 RECTAL
Rectal atresia/stenosis
173 1 TRACHEO
Tracheo-esophageal fistula/Esophageal atresia
174 1 OMPHALO
Omphalocele/Gastroschisis
175 1 GASTRO
Other gastrointestinal anomalies
176 1 GENITAL
Malformed genitalia
177 1 RENALAGE
Renal agenesis
178 1 UROGEN
Other urogenital anomalies
179 1 CLEFTLP
Cleft lip/palate
180 1 ADACTYLY
Polydactyly/Syndactyly/Adactyly
181 1 CLUBFOOT
Club foot
182 1 HERNIA
Diaphragmatic hernia
183 1 MUSCULO
Other musculoskeletal/integumental anomalies
184 1 DOWNS
Down's syndrome
185 1 CHROMO
Other chromosomal anomalies
186 1 OTHERCON
Other congenital anomalies
187-203 17 FLRES
Reporting Flags for Place of Residence
These positions contain flags to indicate
whether or not the specified item is
included on the birth certificate of the State
of residence or of the SMSA of
residence. The code structure of each flag
(position) is:
0 ... The item is not reported
1 ... The item is reported or
partially reported.
187 1 ORIGM
Origin of mother
188 1 ORIGF
Origin of father
189 1 EDUCM
Education of mother
190 1 R4
Reserved Position
191 1 GESTE
Clinical estimate of gestation
192 1 R5
Reserved position
193 1 FMAPSRF
5-minute Apgar score
194 1 DELMETRF
Method of delivery
195 1 MEDRSK
Medical risk factors
196 1 TOBUSE
Tobacco use
197 1 ALCUSE
Alcohol use
198 1 WTGN
Weight gain
199 1 OBSTRC
Obstetric procedures
200 1 CLABOR
Complications of labor and/or delivery
201 1 ABNML
Abnormal conditions of newborn
202 1 CONGAN
Congenital anomalies
203 1 API flag
Race codes 18-68 reported (beginning with 1992
data)
204 1 CDOBMIMP
Month of Birth of Child Imputation Flag
Blank ... Month is not imputed
1 ... Month is imputed
205-206 2 BIRMON
Month of Birth
01 ... January
02 ... February
03 ... March
04 ... April
05 ... May
06 ... June
07 ... July
08 ... August
09 ... September
10 ... October
11 ... November
12 ... December
207-208 2 R6
Reserved Position
209 1 WEEKDAYB
Day of Week Child Born
1 ... Sunday
2 ... Monday
3 ... Tuesday
4 ... Wednesday
5 ... Thursday
6 ... Friday
7 ... Saturday
210 1 FLGND
Flag Indicating Records Included in Both
Numerator and Denominator Files
This variable is included in the denominator
file only, and identifies a record which is also
included in the numerator file. Please note that
not all infant deaths in the numerator file are
represented in the denominator file, because
some of the infants who died in 1999 were born
in 1998.
1 ... Record also included in
numerator file
Blank ... Record not included in
numerator file
Here ends the Denominator file. Documentation for the Mortality Section of
the Numerator (Linked) file follows.
Locations 211-535 contain data from the Death Certificate. Residence items
in the Denominator Record and in the natality section of the Numerator (Linked)
Record refer to the usual place of residence of the Mother; whereas in the
mortality section of the Numerator (Linked)Record, these items refer to the
place of residence of the Decedent.
Item Item Variable Name,
Location Length Item and Code Outline
211-213 3 AGED
Age at Death in Days
The generated age at death in days is
calculated from the date of death on the
death certificate minus the date of birth on
the birth certificate unless the
reported age of death is less than 2 days,
then the reported age is used. If the
exact date of birth and/or death is unknown,
the age is imputed.
000-364 ... Number of days
214 1 AGER5
Infant Age Recode 5
1 ... Under 1 hour
2 ... 1-23 hours
3 ... 1-6 days
4 ... 7-27 days (late neonatal)
5 ... 28 days and over
(postneonatal)
215 1 ACCIDPL
Place of Injury for Causes W00-Y34, except
Y06.- and Y07.-
0 ... Home
1 ... Residential institution
2 ... School, other institution and
public administrative area
3 ... Sports and athletics area
4 ... Street and highway
5 ... Trade and service area
6 ... Industrial and construction
area
7 ... Farm
8 ... Other Specified Places
9 ... Unspecified place
Blank ... Causes other than W00-Y34,
except Y06.- and Y07.-
216-219 4 UCOD
ICD Code (10th Revision)
See the International Classification of
Diseases, 1992 Revision, Volume 1.
220-222 3 UCODR130
130 Infant Cause Recode
A recode of the ICD cause code into 130 groups
for NCHS publications. Further back in this
document is a complete list of recodes and the causes
included.
001-158 ... Code range (not inclusive)
223-230 8 RECWT
Record weight
Beginning in 1995, a record weight was added
to the linked file to adjust for the
approximately 2-3% of records each year which
cannot be linked to their corresponding birth
certificates (see introduction to this tape
documentation for further details). These
weights are used to produce all NCHS linked file
tables, including Documentation tables 1-5
included in this tape documentation. The
general format for this record weight is the
number one followed by a decimal point and six
decimal places as follows:
1.XXXXXX
261-504 244 MULTCOND
Multiple Conditions
See the "International Classification of
Diseases", 1992 Revision, Volume 1.
Both the entity-axis and record-axis
conditions are coded according to this
revision (10th).
261-262 2 EANUM
Number of Entity-Axis Conditions
00-20 ... Code range
263-402 140 ENTITY
ENTITY - AXIS CONDITIONS
Space has been provided for a maximum of 20
conditions. Each condition
takes 7 positions in the record. The 7th
position will be blank. Records that do not
have 20 conditions are blank in the unused area.
Position 1: Part/line number on
certificate
1 ... Part I, line 1 (a)
2 ... Part I, line 2 (b)
3 ... Part I, line 3 (c)
4 ... Part I, line 4 (d)
5 ... Part I, line 5 (e)
6 ... Part II,
Position 2: Sequence of condition within
part/line
1-7 ... Code range
Positions 3 - 6: Condition code (ICD 10th
Revision)
263-269 7 1st Condition
270-276 7 2nd Condition
277-283 7 3rd Condition
284-290 7 4th Condition
291-297 7 5th Condition
298-304 7 6th Condition
305-311 7 7th Condition
312-318 7 8th Condition
319-325 7 9th Condition
326-332 7 10th Condition
333-339 7 11th Condition
340-346 7 12th Condition
347-353 7 13th Condition
354-360 7 14th Condition
361-367 7 15th Condition
368-374 7 16th Condition
375-381 7 17th Condition
382-388 7 18th Condition
389-395 7 19th Condition
396-402 7 20th Condition
RANUM
403-404 2 Number of Record-Axis Conditions
00-20 ... Code range
405-504 100 RECORD
RECORD - AXIS CONDITIONS
Space has been provided for a maximum of 20
conditions. Each condition takes 5 positions
in the record. The 5th position will be blank.
Records that do not have 20 conditions are blank
in the unused area.
Positions 1-4: Condition code (ICD10th
Revision)
405-409 5 1st Condition
410-414 5 2nd Condition
415-419 5 3rd Condition
420-424 5 4th Condition
425-429 5 5th Condition
430-434 5 6th Condition
435-439 5 7th Condition
440-444 5 8th Condition
445-449 5 9th Condition
450-454 5 10th Condition
455-459 5 11th Condition
460-464 5 12th Condition
465-469 5 13th Condition
470-474 5 14th Condition
475-479 5 15th Condition
480-484 5 16th Condition
485-489 5 17th Condition
490-494 5 18th Condition
495-499 5 19th Condition
500-504 5 20th Condition
505 1 RESSTATD
Resident Status - Death
United States Occurrence
1 ... RESIDENTS: State and county of
occurrence and residence are the
same.
2 ... INTRASTATE NONRESIDENTS: State of
occurrence and residence are the
same, but county is different.
3 ... INTERSTATE NONRESIDENTS: State of
occurrence and residence are
different, but both are in the 50
States and D.C.
4 ... FOREIGN RESIDENTS: State of
occurrence is one of the 50 States
or the District of Columbia, but
place of residence is outside of the
50 States and D.C.
505 1 RESSTATD
Resident Status - Death (Cont'd)
Puerto Rico Occurrence
1 ... RESIDENTS: State and county of
occurrence and residence are the
same.
2 ... INTRASTATE NONRESIDENTS: State of
occurrence and residence are the
same, but county is different.
4 ... FOREIGN RESIDENTS: Occurred in
Puerto Rico to a resident of any
other place.
Virgin Islands Occurrence
1 ... RESIDENTS: State and county of
occurrence and residence are
the same.
2 ... INTRASTATE NONRESIDENTS:
State of occurrence and
residence are the same, but
county is different.
4 ... FOREIGN RESIDENTS: Occurred
in the Virgin Islands to a
resident of any other place.
Guam Occurrence
1 ... RESIDENTS: Occurred in Guam to
a resident of Guam or to a
resident of the U.S.
4 ... FOREIGN RESIDENTS: Occurred
in Guam to a resident of any
place other than Guam or the
U.S.
506-507 2 DRSTATE
Expanded State of Residence - NCHS Codes -
Deaths
This item is designed to separately identify
New York City records from other New York State
records.
United States Occurrence
01 ... Alabama
02 ... Alaska
03 ... Arizona
04 ... Arkansas
05 ... California
06 ... Colorado
07 ... Connecticut
08 ... Delaware
09 ... District of Columbia
10 ... Florida
11 ... Georgia
12 ... Hawaii
13 ... Idaho
14 ... Illinois
15 ... Indiana
16 ... Iowa
17 ... Kansas
18 ... Kentucky
19 ... Louisiana
20 ... Maine
506-507 2 DRSTATE
Expanded State of Residence - NCHS Codes -
Deaths (Cont'd)
United States Occurrence
21 ... Maryland
22 ... Massachusetts
23 ... Michigan
24 ... Minnesota
25 ... Mississippi
26 ... Missouri
27 ... Montana
28 ... Nebraska
29 ... Nevada
30 ... New Hampshire
31 ... New Jersey
32 ... New Mexico
33 ... New York
34 ... New York City
35 ... North Carolina
36 ... North Dakota
37 ... Ohio
38 ... Oklahoma
39 ... Oregon
40 ... Pennsylvania
41 ... Rhode Island
42 ... South Carolina
43 ... South Dakota
44 ... Tennessee
45 ... Texas
46 .. Utah
47 ... Vermont
48 ... Virginia
49 ... Washington
50 ... West Virginia
51 ... Wisconsin
52 ... Wyoming
53-58,
60 ... Foreign Residents
53 ... Puerto Rico
54 ... Virgin Islands
55 ... Guam
56 ... Canada
57 ... Cuba
58 ... Mexico
60 ... Remainder of the World
Puerto Rico Occurrence
53 ... Puerto Rico
01-52,
54-58,60... Foreign Residents:
Refer to U.S. for specific code
structure.
506-507 2 DRSTATE
Expanded State of Residence - NCHS Codes -
Deaths (Cont'd)
Virgin Islands Occurrence
54 ... Virgin Islands
01-53,55-58,
60 ... Foreign Residents:
Refer to U.S. for specific code
structure.
Guam Occurrence
55 ... Guam
01-52 ... U.S. resident is also
considered a resident of
Guam.
53,54,58,
60 ... Foreign Residents:
Refer to U.S. for specific code
structure.
508-512 5 FIPSOCCD
Federal Information Processing Standards
(FIPS) Geographic Codes (Occurrence) - Death
Refer to the Geographic Code Outline further
back in this document for a
detailed list of areas and codes. For an
explanation of FIPS codes, reference
should be made to various National Institute
of Standards and Technology
(NIST) publications.
508-509 2 STOCCFIPD
State of Occurrence (FIPS) - Death
United States
01 ... Alabama
02 ... Alaska
04 ... Arizona
05 ... Arkansas
06 ... California
08 ... Colorado
09 ... Connecticut
10 ... Delaware
11 ... District of Columbia
12 ... Florida
13 ... Georgia
15 ... Hawaii
16 ... Idaho
17 ... Illinois
18 ... Indiana
19 ... Iowa
20 ... Kansas
21 ... Kentucky
22 ... Louisiana
23 ... Maine
24 ... Maryland
25 ... Massachusetts
26 ... Michigan
27 ... Minnesota
28 ... Mississippi
29 ... Missouri
30 ... Montana
508-509 2 STOCCFIPD
State of Occurrence (FIPS) - Death (Cont'd)
United States
31 ... Nebraska
32 ... Nevada
33 ... New Hampshire
34 ... New Jersey
35 ... New Mexico
36 ... New York
37 ... North Carolina
38 ... North Dakota
39 ... Ohio
40 ... Oklahoma
41 ... Oregon
42 ... Pennsylvania
44 ... Rhode Island
45 ... South Carolina
46 ... South Dakota
47 ... Tennessee
48 ... Texas
49 ... Utah
50 ... Vermont
51 ... Virginia
53 ... Washington
54 ... West Virginia
55 ... Wisconsin
56 ... Wyoming
Puerto Rico
72 ... Puerto Rico
Virgin Islands
78 ... Virgin Islands
Guam
66 ... Guam
510-512 3 CNTOCFIPD
County of Occurrence (FIPS) - Death
001-nnn ... Counties and county
equivalents (independent and
coextensive cities) are
numbered alphabetically within
each State. (Note: To
uniquely identify a county,
both the State and county
codes must be used.)
999 ... County with less than 250,000
population
513-517 5 FIPSRESD
Federal Information Processing Standards (FIPS)
Geographic Codes (Residence) - Death
Refer to the Geographic Code Outline further
back in this document for a
detailed list of areas and codes. For an
explanation of FIPS codes, reference
should be made to various National Institute
of Standards and Technology
(NIST) publications.
513-514 2 STRESFIPD
State of Residence (FIPS) - Death
United States Occurrence
00 ... Foreign residents
01 ... Alabama
02 ... Alaska
04 ... Arizona
05 ... Arkansas
06 ... California
08 ... Colorado
09 ... Connecticut
10 ... Delaware
11 ... District of Columbia
12 ... Florida
13 ... Georgia
15 ... Hawaii
16 ... Idaho
17 ... Illinois
18 ... Indiana
19 ... Iowa
20 ... Kansas
21 ... Kentucky
22 ... Louisiana
23 ... Maine
24 ... Maryland
25 ... Massachusetts
26 ... Michigan
27 ... Minnesota
28 ... Mississippi
29 ... Missouri
30 ... Montana
31 ... Nebraska
32 ... Nevada
33 ... New Hampshire
34 ... New Jersey
35 ... New Mexico
36 ... New York
37 ... North Carolina
38 ... North Dakota
39 ... Ohio
40 ... Oklahoma
513-514 2 STRESFIPD
State of Residence (FIPS) - Death (Cont'd)
United States Occurrence
41 ... Oregon
42 ... Pennsylvania
44 ... Rhode Island
45 ... South Carolina
46 ... South Dakota
47 ... Tennessee
48 ... Texas
49 ... Utah
50 ... Vermont
51 ... Virginia
53 ... Washington
54 ... West Virginia
55 ... Wisconsin
56 ... Wyoming
Puerto Rico Occurrence
72 ... Puerto Rico
00-56,
66,78 ... Foreign resident: Refer
to U.S. for specific code
structure.
Virgin Islands Occurrence
78 ... Virgin Islands
00-56,
66,72 ... Foreign resident: Refer
to U.S. for specific code
structure.
Guam Occurrence
66 ... Guam
01-56,
00,72,78... Foreign resident: Refer to
U.S. for specific code
structure.
515-517 3 CNTYRFPD
County of Residence (FIPS) - Death
000 ... Foreign residents
001-nnn ... Counties and county
equivalents (independent and
coextensive cities) are
numbered alphabetically within
each State (Note: To uniquely
identify a county, both the
State and county codes must be
used.) A complete list of
counties is shown in the
Geographic Code Outline
further back in this document.
999 ... County with less than 250,000
population
518-522 5 PLRES
Place (City) of Residence (FIPS)
A complete list of cities is shown in the
Geographic code outline further back in this
document.
00000 ... Foreign residents
00001-nnnnn..Code range
99999 ... Balance of county; or
city less than 250,000
population
523 1 HOSPD
Hospital and Patient Status
1 ... Hospital, Clinic or Medical
Center - Inpatient
2 ... Hospital, Clinic or Medical
Center - Outpatient or
admitted to Emergency Room
3 ... Hospital, Clinic or Medical
Center - Dead on arrival
4 ... Hospital, Clinic or Medical
Center - Patient status
unknown
5 ... Nursing home
6 ... Residence
7 ... Other
9 ... Place of death unknown
524-527 4 DTHYR
Year of Death
1999 ... Death occurred in 1999
528-529 2 DTHMON
Month of Death
01 ... January
02 ... February
03 ... March
04 ... April
05 ... May
06 ... June
07 ... July
08 ... August
09 ... September
10 ... October
11 ... November
12 ... December
530-531 2 R9
Reserved Position
532 1 WEEKDAYD
Day of Week of Death
1 ... Sunday
2 ... Monday
3 ... Tuesday
5 ... Thursday
6 ... Friday
7 ... Saturday
9 ... Unknown
533-535 3 R10
Reserved positions
