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Data Element Name:  Patient Ethnicity
Format-Length:  A/N - 1 (4010), A/N - 2 (4050) Required For:  AS, ED, IP
Effective Date:  1/1/94 Revision Date:  January 2007

NOTE: This data element is defined in the 4050 Data Reporting Guide. The applicable mapping is defined in the Inpatient and Outpatient 837 Addenda.
This data element is not defined in the 4010 Institutional Guide. It is a SPARCS extension defined in the Inpatient and Outpatient 837 Addenda.

National Standard Mapping:

Electronic - 837I

X12 Loop

Ref. Des.

Data Element

Code

Description
Version 4050R 2010BA DMG05 - 2 1270 RET Ethnicity Qualifier
DMG05 - 3 1271 Ethnicity Value

2010CA DMG05 - 2 1270 RET Ethnicity Qualifier
DMG05 - 3 1271 Ethnicity Code

Version 4010AI 2300 NTE01 363 UPI Updated Information
NTE02 352 Ethnicity Code

Paper Form Locator Code Qualifier
Institutional - UB-04 81 B1

Definition:

The code which best describes the ethnic origin of the patient.

Codes and Values:

  1. For 4050 in DMG segment use the following:
    • E1 = Hispanic or Latino Ethnicity

      E2 = Non Hispanic or Latino Ethnicity

      Example:DMG*D8*19880208*F**:RET:R5^:RET:E2*****REC*2~

  2. For 4010 in NTE segment use the following:
    • 1 = Spanish/Hispanic Origin

      2 = Not of Spanish/Hispanic Origin

      9 = Unknown

      Example: NTE*UPI*06100120ALR012072125080~

Edit Applications:

  1. Must be a valid entry.
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