ࡱ>  @\psfr5a Glenn Ba= =hZ%a8X@"1Arial1Arial1Arial1Arial16Tw Cen MT Condensed16Tw Cen MT Condensed1 Arial1$Arial16Tw Cen MT Condensed16Tw Cen MT Condensed1Arial16Tw Cen MT Condensed1Arial1Courier1& Courier New"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_) "$"#,##0"Yes";"Yes";"No""True";"True";"False""On";"On";"Off"                + ) , *         (8@ @ &8@ @ 1 ,@ @ #8@ @  (8@ @   &<@ @   ,@ @ #8@ @  &8@ @ 1#<@ @  #<@ @  &8@ @   (<@ @  (8@ @  1#<@ @ (8@ @ &8@ @  #8@ @  (@ @ #4@ @ 1#<@ @ (@ @  @ @  (@ @   @ @  @ @ 1 @ @  @ @  (@ @  (@ @  1 @ @  @ @  1(@ @ 1(@ @ (@ @  1(@ @  @ @ "@ @  "@ @  "@ @  "@ @ "@ @  &8@ @  (8@ @  ,@ @ (<@ @ &<@ @ #<@ @  (<@ @  &<@ @   ,@ @ #<@ @  #<@ @  &<@ @  (<@ @  &<@ @  (<@ @ (<@ @ &<@ @  $@ @ #4@ @ (@ @ "@ @  @ @   (`  (`  &<@ @  (<@ @   (@ @   ,@ @  #<@ @  @ @ 1 ,@ @ "8@ @ "0@ @  "8@ @ &8@ @ (8@ @ "0@ @  ,@ @ #8@ @ "@ (@ "0@  @   (@ @  (@ @  (@ @  "8@ @ "8@ @  &8@ @  (8@ @     #8@ @ &<@@ &<@@ "0 @ (<@  (<@ (<@ (<@  "@ @  (@ @  @ @  (< @ (<!@ @  "<@ @ (0@ @  (8@ @ (0@ @ (0@  #<@ @  ,@ @   ,@ @  @  @ @  @ @  @ @  @ @   @ @  "@ @  "@ @ "@ @  "@ @ "@ @  "<@ @ #@ @  #@ @  #@ @ #@ @  #@ @ #@ @ "@ @ #@ @  (8@ @  0@ @  &<@  &< @  &<  (< (<   , @ "0  @ "0   `B ACME Input?fTRANSAX TRX InputQMICAR200MICAR100 Input. SuperMICAR&  ;^  ;k  ;w  ;  ;l  ;d  ;  ;  ;  ;  ;  ;8 .PositionVariableFormat1SexMFUMaleFemaleUnknown Edit Passed'Edit Failed, Data Queried, and VerifiedADNS+Edit Failed, Data Queried, but not VerifiedXCODate of Death--YearDate of Death--MonthDate of Death--DayCause of Death--Line A, Part ICause of Death--Line B, Part ICause of Death--Line C, Part ICause of Death--Line D, Part ICause of Death--Part IIWas an Autopsy Performed?YYesNo"Were Autopsy Findings Available to! Complete the Cause of Death?$Did Tobacco Use Contribute to Death?PProbably2Not pregnant, but pregnant within 42 days of deathPregnant at the time of deathNot pregnant within past year9Not pregnant, but pregnant 43 days to 1 year before deathManner of DeathHNaturalAccidentSuicideHomicidePending InvestigationCould not be determinedMedical Examiner/CoronerDate of Injury--YearTime of InjuryPlace of Injury--LiteralInjury at Work?%Describe How Injury Occurred--Literal While engaged in sports activity#While engaged in leisure activitiesWhile working for income$While engaged in other types of workFWhile resting, sleeping, eating, or engaging in other vital activities+While engaged in other specified activitiesDuring unspecified activity#If Transportation Accident, SpecifyDriver/Operator Passenger PedestrianHospital Date of Injury--MonthDate of Injury--Day01-12 01-12, 9901-31 (based on month), 9901-314-digit year, 9999Certificate Numberleft 0 filled; 000001-999999NCHS receipt date --YearNCHS receipt date --MonthNCHS receipt date --DayState of Death coder statuslotsection numbershipment number PGM version control - SuperMICAR>=year of death1 - 4Year of Death (numeric)5 - 67 - 12Numeric, Valid codes: 0 - 914 - 17%NCHS ID Information. Numeric, 0 - 919 - 21DaysMinutesMonthsYearsAge: number of units Age: units001 - 135, 999(Cause of Death--Interval, Line D, Part I(Cause of Death--Interval, Line A, Part I(Cause of Death--Interval, Line B, Part I(Cause of Death--Interval, Line C, Part I&Literal information reported on Line aDuration Reported on Line a&Literal information reported on Line bDuration Reported on Line b&Literal information reported on Line cDuration Reported on Line d&Literal information reported on Line d'Literal information reported in Part IIBlank$Unknown if pregnant within last year"Not Applicable: Computer generated#If Female--Edit Flag: From EDR only26 - 291Computer Generated. Version number of SuperMICAR Units of TimeAMPMMilitary Time (24 hour clock)Full text for Place of InjuryDRPAPEEnter Full Text6COMPUTER GENERATED: Information entered is incomplete"Due to" deleted by certifierBlank otherwisePart II "due to" flagTitle of CertifierDate of surgery -- monthDate of surgery -- dayDate of surgery -- yearBEGIJKLQ$Place of Injury - Computer Generated-Activity at Time of death: Computer GeneratedHomeFarmResidential InstitutionMilitary ResidenceGarage/WarehouseTrade and Service Area Mine/QuarryStreet/HighwayPublic Recreation AreaInstitutional Recreation AreaOther buildingOther specified PlaceUnspecified Place/School, Other Institutions, Administrative AreaIndustrial and ConstructionSports and Recreation Area22 - 2324 - 2530 - 3334 - 3536 - 3738 163 - 182 183 - 302 443 - 462 583 - 602 603 - 842QNCHS ID Information. Alpha\Numeric. Usually month of death or month of receiptsPGM version control - MICAR20034 - 37"PGM version control - ACME\TRANSAX38 - 41Intentional rejectACME system reject codesMICAR Reject - dictionary match ACME rejectMICAR Reject - Rule Application Not Rejected Industrial and Construction Areamanual underlying cause codeZFrom Input; blank of not coded. 5th position reserved for use if ICD becomes 5-digit codeACME underlying cause codebACME selected underlying cause. 5th position reserved for future use of ICD becomes 5-digit code.Entity Axis CodesDMaximum of 20 codes. 8 positions each. Format for each 8 positions:1. Part\line numberPart I. Line aPart I. Line cPart I. Line dPart I. Line ePart II2. Sequence within line&1 - 8 maximum number of codes per line3 - 6. ICD code7. Reserved position Used for NCHS "created" codes; blank for all other codes. NOTE: created codes should be converted to actual ICD-10 code if the EA field is moved to the final mortality data record8. E-code indication& Ampersandblank[The value coded in the 8th position should not be moved to the final mortality data record.+TRANSAX conversion flag: Computer Generated-conversion using non-ambivalent table entries)Conversion using ambivalent table entries=Duplicate entity-axis codes deleted; no other action involved+Artificial code conversion; no other actionNo Action: blankBMaximum of 20 codes, 5 positions each: format for each 5 positions1 - 4. ICD code5. Reserved position5th position blank. Reserved for use if five digit codes are implemented. (NCHS "created" codes are converted to actual ICD-10 codes.) 46 - 5051 - 5556 - 215 217 - 316 322 - 323 324 - 325 326 - 329 330 - 333State Specific DataIOptional. Any information entered through SuperMICAR for state use only.:Alpha - see FIPS table 5-2; NCHS Part 8 Instruction Manual40 - 4243 - 162Maximum Conditions FlagConditions and durations44 - 343 348 - 349 352 - 355 356 - 359Describe How Injury Occurred 361 - 420Condition Codes (ERN)Position 1 - 2Position 3 - 4Position 5 - 10Entity-Refernce Number (ERN)<More than 20 conditions reported or incomplete in SuperMICARBlank - not at maximum/Maximum of 15 code, 10 positions for each code.Duration Codes .Maximum of 15 code, 7 positions for each code.Line Number (01 - 10)Position 5 - 7DurationNumber of codes on each line2412 2-digit codesLowest Used Line in Part I2Numeric, 01 - 09Absolute Lowest Used LineNumeric, 01 - 12Instruction Flag (1)Cancer SecondaryInstruction Flag (2),Part II Information from Manner of Death BoxInstruction Flag (3)Reserved44 - 193 194 - 298 303 - 304 305 - 306 307 - 310 311 - 314 221 - 222 225 - 228 229 - 232 223 - 224 350 - 351 303 - 322 323 - 442 463 - 582 847 - 848 849 - 850 851 - 854 855 - 858 860 - 909 911 - 1160 1161 - 1190 PregnancyWeeksHours Certifier Coder statusLotSection numberShipment numberIncomplete data flagLine Ib "due to" flagLine Ic "due to" flagLine Id "due to" flag 1193 - 1222 1223 - 1224 1225 - 1226 1227 - 1230Certifying Physician$Pronouncing and Certifying Physician@Enter Full Text for Other Individual Legally Allowed to Certify PNCHS ID Information. Alpha\Numeric. Usually month of death or month of receiptReceipt Date Inserted at NCHS01-12, 99, blank01-31, 99, blank4-digit year, 9999, blank0000-2400,9999, blank9Literal information reported in How Injury Occurred BlockUnknown: Computer generatedReceipt Date Inserted by NCHS3Computer Generated. Version number of MICAR100\2003Computer Generated. Version number of ACME\TRANSAXRecord Reviewed Position on the line (1 - 8) 318 - 347/Computer Generated. Version number of MICAR200ReviewedPNCHS ID Information. Numeric, 0001 - 9999. (States commonly use "book number")LDate of Surgery: Applicable to States with a surgery block, blank otherwise.ONCHS ID Information. Numeric, 0001 - 9999. (States commonly use "book number"ZFrom Input; blank if not coded. 5th position reserved for use if ICD becomes 5-digit code01-12, 99, Blank XCOMPUTER GENERATED: Information entered is incomplete. Reject record for manual reviewItem#NameCode Structure DescriptionAuxiliary State file numberAUXNO< 000000000001-999999999999; blank 1238 - 1249 1250 - 1279 423 - 452 453 - 454 455 - 456 457 - 460 463 - 474Place of Injury2Computer generated if file generated by SuperMICAR .Codes assigned by system other then SuperMICARActivity at Time of deathwFree format field, see MICAR Instruction Manual 2g. Information provided through use of Entity-Reference Numbers (ERN)0Computer generated if file generated by MICAR200 5Codes assigned manually or by system other then MICARPlace of Injury (ICD10 codes)01 - 12, 99 blank 01-12, blank 01-31, blank>=year of death, blank Lot numberRecord-Axis CodesEntity-Axis CodesUknown01 - 31, 99. Blank4-digit, 9999, blankAGETYPEAGESEXDOD_MODOD_DYCODIaCODIbCODIcCODIdINTIaINTIbINTIcINTIdCODIIAUTOPAUTOPFTOBACPREG PREG_BYPASSMANNERCERTLDOI_YRDOI_MODOI_DYINJPLLINJPLWORKINJLINJURYTRANSPLSUR_MOSUR_DYSUR_YRTOI_HRINACTSTATESPINC_DTDUE2IbDUE2IcDUE2IdDUE2IIREC_MOREC_DYREC_YRSHIPSECTCSCERT_#ST_OCC0000-2399, 9999, blankbACME selected underlying cause. 5th position reserved for future use if ICD becomes 5-digit code.$300000 - 2359, 9999, blankDOD_YRLOTVER_SMCODT0I_HRHOWIOMAX_CONDCONDDURINJWORKCODE_LNALULLULIINS_1INS_2INS_3VER_200VER_ACTRINT_REJSYS_REJMAN_UCACME_UCBLANKEACTRX_FLGRACEAC_FFAUTOPYPart I. Line b120 positions. For coding instructions, refer to Part 2b manual; for data entry instructions refer to Part 2d Instructional ManualNot on certificate01-12, 99 (for unknown), blank0000-2359, 9999, blank01-31, 99, Blank01 - 31, 99, blank01 - 12, 99, blank39-41 475 - 504INC_DATA 358 - 381382-383384-385389-400401-430335-364366-377378-407 234 - 263265-276277-30651 - 170176-177178-179 180 - 183 184 - 187 189 - 218 220 - 231 232 - 261GEnter Full Text for Other Individual Legally Allowed to Certify, blank L1 - 5, 9, or blank. See NCHS instruction Manual Part 2b for code structureE1 - 5, 9 or blank. See NCHS Instruction Manual 2b for code structure A}6X"Fhg! 0F!h ;"] " # # $ =%_ %&?'a(l)*W,yE-g.?./O0q011B2d293[o45L7n%8'86:8:;O;Q;;*<,j<l*=,m=o== ?k?m?X@Z @ _GR:\e  dMbP?_*+%[X&L&D&CACME Input Record Format 2003 Generated by MICAR200 or Manually Coded &RPage &PMHP LaserJet IIID4C od,,LetterDINU"4Ql"d,,??U} $ >} I.} .} I .} X} /} m(._u      ~  J K  L ?X 0~ 0=@ 0~ @2 0Y @Z 0Q~ 00@ 0~ @3 0 @[ 0L0 0~ @3 0M~ A*@ 0R0 0~ ?3 0\ A] 0S0 0~ @3 0E~ A2@ 0T0 0~ ?3 0^ @_ 0U0 0~ @3 0! 4c`M" @ 0O 0 0~ @ 3 5` @ 0P 0 0~ @ 3 6a @w 0N 0 0~ @ 3 6b @ 0V 0 0~ @ 7 0x A 0 0 0~ @ 7 0A~ CC@ e~ c@ `iE?? cc`E~ @ bc`E~ @ !c`E~ @ `c`E~ @ "c`E~ @ ac`E~ "@   d~ c@ `i~ K@ f~ >E@ .*~ .B@ .|~ ? / ., / .- / .. /+ ./ /$ .0 / .1 .s~ AE@ 44 4~ ?8 9~ AF@ 44 4?1? 9A444 D~ 1@ 9D l^^^ZZZZZ,ZZZZZ\000000^bZX !"#$%  &'()*+,-./0123456789:;<=>? 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Z Z[cE [ [ \cE \ \ ]cE ]s^cE ^ ^u _A _0~ _0F@ _0}~ _>@ _* _0D> l00bDbbX00$TTTTb00$0`abcdefghijk+l`A000 `*$ `1aA000 a* a2bA000* b2~ cAv@ c0c0 c0c?4 c08dA000~ d4? d09eA000~ e4@ e0:fA000~ f4@ f0;gA000~ g4@ g0<hA000~ h4 @ h0=iA000~ i4"@ i0>jA0004 j0s kr knMkn knN~ k(@k" knO l> l. l.~ l>@ l.00$X000000$Z> @7 @  e28  dMbP?_*+%TQ&L&D&CTRANSAX Input Record Format 2003 Temporary File Generated by ACME &RPage &PMHP LaserJet IIID4C od,,LetterDINU"4Ql"_,,??U} $ >} #.} .} $ .} } /} $#.eu      ~  J K  L ?X 0~ 0=@ 0~ @2 0Y @Z 0Q~ 00@ 0~ @3 0 @[ 0L0 0~ @3 0M~ A*@ 0R0 0~ ?3 0\ A] 0c0 0~ @3 0E~ A2@ 0&0 0~ ?3 0^ @_ 0'0 0~ @3 0! 4c`M" @ 0O 0 0~ @ 3 5` @ 0P 0 0~ @ 3 6a @w 0N 0 0~ @ 3 6b @ 0V 0 0~ @ 7 0x A 0 0 0~ @ 7 0A @ 00 0~ @7 0=~ >E@ .*~ .B@ .|~ ? / ., / .- / .. /+ ./ /$ .0 / .1 .s~ AE@ 44 4~ ?8 9~ AF@ 44 4?1? 9A444 D~ 1@ 9A444~ 1@ 9A444~ 1@ :BA444~ 1 :A4441 :~ AF@ 0~ 0D@ 0?1 0B;;;~ 1? 0B;;;~ 1@ 0D l^^^ZZZZZ,ZZZZZZbZX<000$\0 !"#$%&'()*+,-./0123456789:;<=>? 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R RScE S S TcE T T UcE UsVcE V Vu WA W0~ W0F@ W0}~ W>@ W* W0XA000 X*$ X1YA000 Y* Y2ZA000* Z2~ [Ap@ [0[0 [0[?4 [08\A000~ \4? \09]A000~ ]4@ ]0:^A000~ ^4@ ^0;_A000~ _4@ _0<D@ l\X00$^^^^b00$0b00$X000`abc+d`A000~ `4 @ `0=aA000~ a4"@ a0>bA0004 b0s cr cnMcn cnN~ cM(@c" cnO d> d. d. d d.P00$Z> @7 @  x*,  dMbP?_*+%YV&L&D&CMICAR200 Input Record Format 2003 Temporary File Generated by MICAR100 &RPage &PMHP LaserJet IIID0C od,,LetterDINU"0Ql"_,,??U} I } !} I`} } mE} $} ,xu      s t ]J K ^v tL X ~ =@ ~ K@ Y !Z Q~ `0@ ~ @"  ![ L ~ M@" M~ $*@ R ~ M?" \ $] So ~ M@" C~ $2@ T ~ M?" ^ !_ U ~ @" ! 4rM" ! O ~ @ " %` ! P ~ @ " &a !w N ~ @ " &b ! V ~ M@ ' x C ~ `=@ l~ K@ DH C ~ `=@ m~ K@ DI C ~ `@ k~ ?  CK   K   ~ CC@ e~ `@ iE?? c~ @ b~ @ !~ @ `~ @ "~ @ a~ "@   d~ `@ j~ K@ f~ E@  ??     ~ `@@ ~ b@  ~ E@  ~ E@ ? ~ E@ D l^^^PPZPP,PPPPTTb0&\TNT** !"#$%&'()*+,-./0123456789:;<=>?   ~ `@@ ~ @Z@  !~ !E@ ! 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