| | | | | | | | | | | |
| | _Ref_ | Id | _________Element Name__________ | Req | Type | Min/Max | | |
| | PAT01 | 1069 | Individual Relationship Code | O | ID | 2/2 | | |
| | | | Description: Code indicating the relationship between two individuals or entities |
| | | | | Code | Name_______________________________ |
| | | | | 01 | Spouse |
| | | | | 04 | Grandfather or Grandmother |
| | | | | 05 | Grandson or Granddaughter |
| | | | | 07 | Nephew or Niece |
| | | | | 10 | Foster Child |
| | | | | 15 | Ward |
| | | | | 17 | Stepson or Stepdaughter |
| | | | | 19 | Child |
| | | | | | Description: Dependent between the ages of 0 and 19; age qualifications may vary depending on policy |
| | | | | 20 | Employee |
| | | | | 21 | Unknown |
| | | | | 22 | Handicapped Dependent |
| | | | | 23 | Sponsored Dependent |
| | | | | | Description: Dependents between the ages of 19 and 25 not attending school; age qualifications may vary depending on policy |
| | | | | 24 | Dependent of a Minor Dependent |
| | | | | | Description: A child not legally of age who has been granted adult status |
| | | | | 29 | Significant Other |
| | | | | 32 | Mother |
| | | | | 33 | Father |
| | | | | 36 | Emancipated Minor |
| | | | | | Description: A person who has been judged by a court of competent jurisdiction to be allowed to act in his or her own interest; no adult is legally responsible for this minor; this may be declared as a result of marriage |
| | | | | 39 | Organ Donor |
| | | | | | Description: Individual receiving medical service in order to donate organs for a transplant |
| | | | | 40 | Cadaver Donor |
| | | | | | Description: Deceased individual donating body to be used for research or transplants |
| | | | | 41 | Injured Plaintiff |
| | | | | 43 | Child Where Insured Has No Financial Responsibility |
| | | | | | Description: Child is covered by the insured but the insured is not the legal guardian |
| | | | | 53 | Life Partner |
| | | | | G8 | Other Relationship |
| | PAT07 | 355 | Unit or Basis for Measurement Code | C | ID | 2/2 | | |
| | | | Description: Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken |
| | | | | Code | Name_______________________________ |
| | | | | GR | Gram |
| | PAT08 | 81 | Weight | C | R | 1/10 | | |
| | | | Description: Numeric value of weight |
| | PAT09 | 1073 | Yes/No Condition or Response Code | O | ID | 1/1 | | |
| | | | Description: Code indicating a Yes or No condition or response |
| | | | | Code | Name_______________________________ |
| | | | | Y | Yes |
