DO NOT REPORT

The death certificate should not be used to document the deceased’s entire medical history for posterity. DO NOT REPORT IN PART 20 I OR II diseases, injuries, other conditions, or circumstances that did not cause or contribute to death.

DO NOT REPORT the following in Part 20 I or II if they did not cause or contribute to death:

Medical care (surgery, procedures, tests, medication, treatment etc.)

The reason the patient was admitted to the facility (hospital, nursing home, hospice etc.),

Incidental, old, healed or former conditions,

EXCEPTION: If you cannot determine the cause of death, it is a good idea to include a statement on the certificate to explain why the cause was unknown. These statements may be reported even though they are not actually “causes of death.” See also UNKNOWN AND UNCERTAIN CAUSES OF DEATH

ITEMS 25A-G ARE FOR EXTERNALLY-CAUSED INJURIES ONLY. If no injury is reported on the death certificate, leave 25a-g blank.