Vital Records FHIR Messaging (VRFM) IG
2.0.0-Preview4 - ci-build

Vital Records FHIR Messaging (VRFM) IG, published by CDC NCHS. This guide is not an authorized publication; it is the continuous build for version 2.0.0-Preview4 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/nightingaleproject/vital_records_fhir_messaging_ig/ and changes regularly. See the Directory of published versions

Business Rules for Death Record Submissions

Business Rules for Death Record Submissions

Version 2.2

Last updated : June 11, 2024

Table of Content

Required Fields

Additional Logic Checks

Validation Errors

Internal Validation Errors

Required Fields

The following fields are required for a valid death record submission. An Error Message with a format of "Error: Unable to find IJE Field required element" will be returned for each missing field.

Field Description IJE Field FHIR Profile FHIR Field
State, U.S. Territory or Canadian Province of Death - code DSTATE DeathLocation address.state or address.state.extension[nationalReportingJurisdictionId]

If both are provided, the extension will override. Unless you are NYC, recommend using address.state only.
Certificate Number FILENO DeathCertificateDocument identifier.extension[certificateNumber].value
Decedent's Legal Name–Last LNAME Decedent name.family, name.use = official
Decedent's Sex at Death SEX Decedent extension[NVSS-SexAtDeath]
Decedent's Age-Type AGETYPE DecedentAge valueQuantity.code
Decedent's Age-Units AGE DecedentAge valueQuantity.value
Date of Birth DOB_YR, DOB_MO, DOB_DY Decedent birthDate
Decedent's Residence–Inside City Limits LIMITS Decedent address.city.extension[withinCityLimits]
Marital Status MARITAL Decedent maritalStatus
Place of Death DPLACE DeathDate component[placeOfDeath].value
County of Death Occurence COD DeathLocation address.district.extension[countyCode]
Method of Disposition DISP DecedentDispositionMethod value
Date of Death DOD_YR, DOD_MO, DOD_DY DeathDate value
Decedent's Education DEDUC DecedentEducationLevel value
Decedent of Hispanic Origin?–Mexican DETHNIC1 InputRaceAndEthnicity component[HispanicMexican].valueCoding
Decedent of Hispanic Origin?–Puerto Rican DETHNIC2 InputRaceAndEthnicity component[HispanicPuertoRican].valueCoding
Decedent of Hispanic Origin?–Cuban DETHNIC3 InputRaceAndEthnicity component[HispanicCuban].valueCoding
Decedent of Hispanic Origin?–Other DETHNIC4 InputRaceAndEthnicity component[HispanicOther].valueCoding
Decedent's Race–White RACE1 InputRaceAndEthnicity component[White].valueBoolean
Decedent's Race–Black or African American RACE2 InputRaceAndEthnicity component[BlackOrAfricanAmerican].valueBoolean
Decedent's Race–American Indian or Alaska Native RACE3 InputRaceAndEthnicity component[AmericanIndianOrAlaskanNative].valueBoolean
Decedent's Race–Asian Indian RACE4 InputRaceAndEthnicity component[AsianIndian].valueBoolean
Decedent's Race–Chinese RACE5 InputRaceAndEthnicity component[Chinese].valueBoolean
Decedent's Race–Filipino RACE6 InputRaceAndEthnicity component[Filipino].valueBoolean
Decedent's Race–Japanese RACE7 InputRaceAndEthnicity component[Japanese].valueBoolean
Decedent's Race–Korean RACE8 InputRaceAndEthnicity component[Korean].valueBoolean
Decedent's Race–Vietnamese RACE9 InputRaceAndEthnicity component[Vietnamese].valueBoolean
Decedent's Race–Other Asian RACE10 InputRaceAndEthnicity component[OtherAsian].valueBoolean
Decedent's Race–Native Hawaiian RACE11 InputRaceAndEthnicity component[NativeHawaiian].valueBoolean
Decedent's Race–Guamanian or Chamorro RACE12 InputRaceAndEthnicity component[GuamanianOrChamorro].valueBoolean
Decedent's Race–Samoan RACE13 InputRaceAndEthnicity component[Samoan].valueBoolean
Decedent's Race–Other Pacific Islander RACE14 InputRaceAndEthnicity component[OtherPacificIslander].valueBoolean
Decedent's Race–Other RACE15 InputRaceAndEthnicity component[OtherRace].valueBoolean
Manner of Death MANNER MannerOfDeath value
Was Autopsy performed AUTOP AutopsyPerformedIndicator value
Were Autopsy Findings Available to Complete the Cause of Death AUTOPF AutopsyPerformedIndicator component[autopsyResultsAvailable].value
Did Tobacco Use Contribute to Death? TOBAC TobaccoUseContributedToDeath value

Additional Logical Checks

The following combinations of field values will also result in an error being returned for a submission. An Error Message with a format of "Error: Invalid combination of Field 1 and Field 2" will be returned for each invalid combination reported.

Field 1 Field 2
Description IJE Field Value Description IJE Field Value
Sex SEX Male Pregnancy Status PREG Not 'Not Applicable'
Was Autopsy performed AUTOP Yes Were Autopsy Findings Available to Complete the Cause of Death? AUTOPF 'Not Applicable'
Was Autopsy performed AUTOP No Were Autopsy Findings Available to Complete the Cause of Death? AUTOPF Not'Not Applicable'
Date of Injury DOI_YR, DOI_MO, DOI_DY Greater than Date of Death Date of Death DOD_YR, DOD_MO, DOD_DY Less than Date of Injury
Manner of Death MANNER Accident, Suicide, Homicide Date of Injury DOI_YR, DOI_MO, DOI_DY Not Provided (1)
Manner of Death MANNER Accident, Suicide, Homicide Place of Injury Literal POILTRL Not Provided (2)
Manner of Death MANNER Accident, Suicide, Homicide Describe How Injury Occurred HOWINJ Not Provided (2)

The fields DOI_YR, DOI_MO, DOI_DY, POILTRL and HOWINJ all map to the VRDR InjuryIncident profile. These fields are considered 'not provided' if no instance of the InjuryIncident profile is provided as part of the DeathRecord submission. If the Manner of Death requires information about an injury incident, and none is available, providing an instance of an Injury Incident profile with 'unknown' values for the required fields satisfies the data requirement.

If an InjuryIncident profile instance is provided, fields can be considered 'not provided' if:
1) The date of injury is considered ‘not provided’ if the effective time value is missing, or it includes a PartialDateTime extension and any component of the date has a data absent reason of “temp-unknown” (equivalent to an IJE blank). A data absent reason with the code “unknown” (equivalent to all 9’s in IJE) will not cause this data validation check to fail.
2) The literal string fields HOWINJ and POILTRL are considered 'not provided' if an instance of the profile is provided, and the value (HOWINJ) or the component[ placeOfInjury].value (POILTRL) are not provided, or their value is blank.

Validation Errors

For many fields, the value provided must be one that is found in the corresponding VRDR Value Set for the field. Otherwise, an Error Message with a format of "Error: Unable to find IJE Field mapping for FHIR Component field value 'string'" will be returned for each violation.

There are additional Errors that may be returned when a record cannot be accepted, including some IJE fields that are not retained by NCHS, but must be valid if provided.

IJE Field Error Message Clarification
BSTATE Error: FHIR field BirthRecordState too long for IJE field BSTATE of length 2 The birth state must be a valid 2-character (alphabetic) state/jurisdiction (without special characters and blanks). https://hl7.org/fhir/us/vrdr/ValueSet/vrdr-jurisdictions-provinces-vs
COD1A and OTHERCONDITION The record is uncodeable. The record is missing important cause of death information. When manner of death is not 'Pending' or 'Could Not Be Determined', then cause of death information must be included in the record by providing literal text for fields COD1A and/or OTHERCONDITION.
DETHNICE Error: Unable to find IJE DETHNICE mapping for FHIR HispanicCode field value 'string' DETHNICE is a field that is returned to the jurisdictions in the multi-race file. If including in records to share as part of IJE, the values reported must be valid. https://hl7.org/fhir/us/vrdr/ValueSet/vrdr-hispanic-origin-vs
DINSTI Error: FHIR field DeathLocationName contains string too long for IJE field DINSTI of length 30 The location of death string exceeds the 30-character limit for this field.
DSTATE Error: FHIR field DeathLocationJurisdiction contains string too long for IJE field DSTATE of length 2 DSTATE is a required field, and the value must be a valid 2-character (alphabetic) state/jurisdiction (without special characters and blanks).
Error: JurisdictionID was not identified
DOD_YR 4 digits number are expected The year of the event must be a valid 4 numeric digit year (YYYY) without special characters or blanks.
Event Year FHIR cannot process records from EventYear year; please resubmit via IJE Until the 2022 data year is closed, NVSS may not be able to process older years via FHIR.
FHIR Bundle Event Year FHIR BUNDLE Parameter event year should match the death record Death Year. DOD_YR must agree with the year included in the FHIR BUNDLE parameter.
FHIR Bundle Source Endpoint FHIR Bundle Source Endpoint is missing The actual message source address or id needs to be specified for the endpoint.
FILENO (certificate number) Certificate Number is missing, or the certificate length is greater than 6 FILENO is a required field and must be exactly 6 digits in length. Only positive numbers are allowed for this field.
Certificate Number exceeds expected value Unexpected high Certificate Numbers may be accepted for Medical Processing, but then rejected for Demographic Processing if the Certificate Number is not within the typical range for the Jurisdiction/Year/Event being submitted. You must first contact your VSS to adjust your expected ranges before re-submitting these records in order for them to be included in your Demographic File.
IDOB_YR Error: FHIR field BirthRecordYear contains string too long for IJE field IDOB_YR of length 4 The year of birth must be a valid 4-digit numeric year (YYYY).
INDUST Error: FHIR field UsualIndustry contains string …. too long for IJE field INDUST of length 40 The decedent's industry literal exceeds the 40-character limit for this field.
OCCUP Error: FHIR field UsualOccupation contains string … too long for IJE field OCCUP of length 40 The decedent's occupation literal exceeds the 40-character limit for this field.
Record Length The IJE version of the FHIR message did not reach the 1025 bytes characters required. Some fields are missing. The Death Record is missing several important FHIR elements required to generate a complete IJE record. Review the record to determine which fields are missing.
SSN Error: FHIR field SSN contains string …. which is not the expected length (without dashes or spaces) for IJE field SSN of length 9 The Social Security Number (SSN) must be 9 numeric digits long (without dashes or spaces) to be accepted.

Internal Validation Errors

The following error messages are internal validation errors and if you receive any of these, please contact NCHS.

Error Message
An unexpected network error occurred.
Exception has been thrown by the target of an invocation.
Object reference not set to an instance of an object.
The network path was not found.
Unable to find the specified file.