Information for Healthcare Providers
The handbook at the link below contains instructions for physicians on cause-of-death certification. It was prepared by the Department of Health and Human Services’ Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). Examples on properly completed cause-of-death are provided. After studying the guide, medical certifiers are encouraged to do the online exercises at the other link to test your knowledge. For your convenience, the electronic death registry application and some of the Nevada Statutes and Regulations pertaining to death certificates are given below. The complete statutes are located here: NRS 440, and the regulations are located here: NAC 440
- Electronic Death Registry Application (EDRS)
- Physicians’ Handbook on Medical Certification of Death
- Death Certification Training
- Death Certificate Exercises
- Electronic Death Registry System (EDRS)
- U.S. Standard Certificate of Death Form
- Using EBRS and EDRS in Chrome / Firefox
- Mac/Apple Computers and Netsmart Applications
Statutes and Regulations Pertaining to Death Certification
NRS 440.210 Certificates of birth and death: Examination by local health officer.Each local health officer shall carefully examine each certificate of birth or death when presented for record to see that it has been made out in accordance with the provisions of this chapter and the instructions of the Board.[Part 19:199:1911; RL § 2970; NCL § 5253]
NRS 440.220 Certificates of birth and death: Enforcement of requirements by local health officer.
1.If any certificate of death is incomplete or unsatisfactory, the local health officer shall call attention to the defects in the return and withhold issuing the burial or removal permit until the defects are corrected.
2.If any certificate of birth is incomplete, the local health officer shall immediately notify the person who produced the certificate and require him or her to supply the missing items if they can be obtained.[Part 19:199:1911; RL § 2970; NCL § 5253]—(NRS 2013, 148)
NAC 440.160 Certification of cause of death. (NRS 440.120, 440.380)
1.The person who is required to certify the cause of death shall complete the portions of the death certificate pertaining to the cause of death and the certification of death and return the certificate to the undertaker or person acting as undertaker who presented it to him or her within 48 hours after such presentation.
2.If the death did not occur in a hospital or other institution and the death was attended by a physician who will not be available within 48 hours after the death, the certificate must be presented to an associate physician who has access to the attending physician’s medical files on the deceased. The associate physician shall complete and return the death certificate.
3.If the death occurred in a hospital or other institution and the death was attended by a physician who will not be available within 48 hours after the death, the certificate must be presented to the chief medical officer of the institution or an associate physician who has access to the medical records of the deceased. The chief medical officer or associate physician shall complete and return the death certificate.[Bd. of Health, Births and Deaths Art. 7, eff. 2-24-78]
NAC 440.165 Statement of the cause of death. (NRS 440.120, 440.380, 440.410)
1.The statement of the cause of death in a medical certificate of death must be:
(a) Written legibly; and
(b) Expressed clearly and concisely.
2.The State Registrar or local registrar shall return a medical certificate of death to the certifier to be corrected or made more definite if the statement:
(a) Consists of only the term “natural causes”;
(b) Contains any other indefinite or obsolete term which denotes only the symptom of a disease or the conditions resulting from a disease;
(c) Is illogically or confusingly written; or
(d) Contains personal abbreviations or is written in shorthand.
3.Part I of the statement of the cause of death in the standard certificate of death approved by the United States Public Health Service may contain only the sequence of disease or the injury or other trauma directly resulting in death, as follows:
(a) Line “A” must show the immediate (primary) cause of death;
(b) Line “B” must show the contributory or intermediate cause of death; and
(c) Line “C” must show the underlying cause of death.
The underlying cause of death must be the last cause listed. If there is no intermediate cause, the underlying cause must be entered on line “B”. If the immediate cause and the underlying cause are synonymous, only one entry is necessary.
4.Part II of the statement of the cause of death must show the diseases, injuries or other factors which are medically or statistically significant but not directly related to the cause of death.
5.The statement of the cause of death must be submitted electronically by the certifier to an electronic death registry system approved by the Division of Public and Behavioral Health of the Department of Health and Human Services and attested to by the certifier by means of an electronic signature.
6.As used in this section, “electronic signature” means an electronic sound, symbol or process attached to or logically associated with a document and executed or adopted by a person with the intent to sign the document.
(Added to NAC by Bd. of Health, eff. 12-3-84; A by R126-12, 2-20-2013)
NAC 440.170 Attendance at death. (NRS 439.200, 440.120)Except as otherwise provided in NAC 440.180, a death shall be considered to have been attended by a physician if the deceased:
1.Had seen the physician professionally within 30 days preceding the death;
2.Was pronounced dead by a registered nurse pursuant to NRS 440.415; or
3. Was diagnosed by a physician as having an anticipated life expectancy of not more than 6 months.[Bd. of Health, Births and Deaths Art. 8 § 8.1, eff. 7-3-76]—(NAC A by R045-99, 9-27-99)
NAC 440.180 Death not attended. (NRS 439.200, 440.120)If the deceased had been under a physician’s care under the conditions set forth in NAC 440.170, but the cause of death was unrelated to the purpose for which the deceased consulted the physician, the death shall not be considered to have been attended and must be referred to the local health officer.[Bd. of Health, Births and Deaths Art. 8 §§ 8.2 & 8.2.1, eff. 7-3-76]—(NAC A by R045-99, 9-27-99)