(a) A person required to file a death certificate or fetal death certificate shall obtain the required medical certification from the decedent‘s attending physician, or a physician assistant or advanced practice registered nurse of the decedent, if the death occurred under the care of the person in connection with the treatment of the condition or disease process that contributed to the death.
(a-1) Repealed by Acts 2021, 87th Leg., R.S., Ch. 733 (H.B. 4048), Sec. 2, eff. June 15, 2021.

(b) The attending physician, physician assistant, or advanced practice registered nurse shall complete the medical certification not later than five days after receiving the death certificate.
(c) An associate physician, the chief medical officer of the institution where the death occurred, or the physician who performed an autopsy on the decedent may complete the medical certification if:
(1) the attending physician, the physician assistant, and the advanced practice registered nurse described by Subsection (a) are unavailable;
(2) the attending physician, the physician assistant, or the advanced practice registered nurse described by Subsection (a) approves; and
(3) the person completing the medical certification has access to the medical history of the case and the death is due to natural causes.
(d) If a death or fetal death occurs without medical attendance or is otherwise subject to Chapter 49, Code of Criminal Procedure, the person required to file the death or fetal death certificate shall notify the appropriate authority of the death.
(e) A person conducting an inquest required by Chapter 49, Code of Criminal Procedure, shall:
(1) complete the medical certification not later than five days after receiving the death or fetal death certificate; and
(2) state on the medical certification the disease that caused the death or, if the death was from external causes, the means of death and whether the death was probably accidental, suicidal, or homicidal, and any other information required by the state registrar to properly classify the death.
(e-1) The medical certification on a death certificate must include either the term “Fentanyl Poisoning” or the term “Fentanyl Toxicity” if:
(1) a toxicology examination reveals a controlled substance listed in Penalty Group 1-B present in the body of the decedent in an amount or concentration that is considered to be lethal by generally accepted scientific standards; and
(2) the results of an autopsy performed on the decedent are consistent with an opioid overdose as the cause of death.
(f) If the identity of the decedent is unknown, the person conducting the inquest shall obtain and forward to the Department of Public Safety:
(1) the decedent’s fingerprints;
(2) information concerning the decedent’s hair color, eye color, height, weight, deformities, and tattoo marks; and
(3) other facts required for assistance in identifying the decedent.
(g) If the medical certification cannot be completed in a timely manner, the person required to complete the medical certification shall give the funeral director or the person acting as funeral director notice of the reason for the delay. Final disposition of the body may not be made unless specifically authorized by the person responsible for completing the medical certification.
(h) The person completing the medical certification shall submit the information and attest to its validity using an electronic process approved by the state registrar.
(i) On receipt of autopsy results or other information that would change the information in the medical certification on the death certificate, the appropriate certifier shall immediately report the change in a manner prescribed by the department to amend the death certificate.
(j) The death certificate of a decedent who was an inmate of the Texas Department of Criminal Justice at the time of death and who was lawfully executed shall classify the manner of death as death caused by judicially ordered execution.