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Data Element Name:  Patient Residence Address - Address Line 1
Format-Length:  A/N - 18 Required For:  AS, ED, IP
Effective Date:  1/1/94 Revision Date:  September 2003

National Standard Mapping:

Electronic - 837I

X12 Loop

Ref. Des.

Data Element

Code

Description
Version 4050R 2010BA N301 166 Address Information

2010CA N301 166 Address Information

Paper Form Locator Code Qualifier
Institutional - UB-04 09a N/A

Definition:

The street address of the patient's principal residence at the time of admission.

Codes and Values:

  1. Use standard abbreviations as listed in Address Abbreviations in the Official United States Postal Service (USPS) Abbreviations Web site: www.usps.com/ncsc/lookups/usps_abbreviations.html

  2. For homeless patients, "HOMELESS" should be coded.

  3. Must not be blank.

Edit Applications:

  1. Must be a valid entry.
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