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18.8.58 GT1 - Guarantor Segment (6.5.5)

The GT1 segment contains guarantor (e.g., the person or the organization with financial responsibility for payment of a patient account) data for patient and insurance billing applications.

HL7 Attribute Table - GT1 - Guarantor

Base Framework
Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData Type
GT1
100405Set ID - GT1 SHOULD[1..1][1..4]
SI

Sequence ID

200406Guarantor Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

300407Guarantor Name SHOULD[1..*] 
XPN

Extended Person Name

400408Guarantor Spouse Name MAY[0..*] 
XPN

Extended Person Name

500409Guarantor Address MAY[0..*] 
XAD

Extended Address

600410Guarantor Ph Num - Home MAY[0..*] 
XTN

Extended Telecommunication Number

700411Guarantor Ph Num - Business MAY[0..*] 
XTN

Extended Telecommunication Number

800412Guarantor Date/Time Of Birth MAY[0..1] 
DTM

Date/Time

900413Guarantor Administrative Sex MAY[0..1] repr: AdministrativeSex (CD)
CWE

Coded with Exceptions

1000414Guarantor Type MAY[0..1] GuarantorType (CD)
CWE

Coded with Exceptions

1100415Guarantor Relationship MAY[0..1] ex.:Relationship (CD)
CWE

Coded with Exceptions

1200416Guarantor SSN
=

Truncation not allowed!

MAY[0..1] 11
ST

String Data

1300417Guarantor Date - Begin MAY[0..1] 
DT

Date

1400418Guarantor Date - End MAY[0..1] 
DT

Date

1500419Guarantor Priority MAY[0..1][1..2]
NM

Numeric

1600420Guarantor Employer Name MAY[0..*] 
XPN

Extended Person Name

1700421Guarantor Employer Address MAY[0..*] 
XAD

Extended Address

1800422Guarantor Employer Phone Number MAY[0..*] 
XTN

Extended Telecommunication Number

1900423Guarantor Employee ID Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

2000424Guarantor Employment Status MAY[0..1] repr: EmploymentStatus (CD)
CWE

Coded with Exceptions

2100425Guarantor Organization Name MAY[0..*] 
XON

Extended Composite Name and Identification Number for Organizations

2200773Guarantor Billing Hold Flag MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

2300774Guarantor Credit Rating Code MAY[0..1] GuarantorCreditRatingCode (CD)
CWE

Coded with Exceptions

2400775Guarantor Death Date And Time MAY[0..1] 
DTM

Date/Time

2500776Guarantor Death Flag MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

2600777Guarantor Charge Adjustment Code MAY[0..1] PatientChargeAdjustment (CD)
CWE

Coded with Exceptions

2700778Guarantor Household Annual Income MAY[0..1] 
2800779Guarantor Household Size
=

Truncation not allowed!

MAY[0..1] 3
NM

Numeric

2900780Guarantor Employer ID Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

3000781Guarantor Marital Status Code MAY[0..1] repr: V2MaritalStatus (CD)
CWE

Coded with Exceptions

3100782Guarantor Hire Effective Date MAY[0..1] 
DT

Date

3200783Employment Stop Date MAY[0..1] 
DT

Date

3300755Living Dependency MAY[0..1] ex.:LivingDependency (CD)
CWE

Coded with Exceptions

3400145Ambulatory Status MAY[0..*] repr: AmbulatoryStatus (CD)
CWE

Coded with Exceptions

3500129Citizenship MAY[0..*] Citizenship (CD)
CWE

Coded with Exceptions

3600118Primary Language MAY[0..1] PrimaryLanguage (CD)
CWE

Coded with Exceptions

3700742Living Arrangement MAY[0..1] ex.:V2LivingArrangement (CD)
CWE

Coded with Exceptions

3800743Publicity Code MAY[0..1] ex.:PublicityCode (CD)
CWE

Coded with Exceptions

3900744Protection Indicator MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

4000745Student Indicator MAY[0..1] repr: StudentStatus (CD)
CWE

Coded with Exceptions

4100120Religion MAY[0..1] repr: Religion (CD)
CWE

Coded with Exceptions

4200109Mother's Maiden Name MAY[0..*] 
XPN

Extended Person Name

4300739Nationality MAY[0..1] Nationality (CD)
CWE

Coded with Exceptions

4400125Ethnic Group MAY[0..*] ex.:EthnicGroup (CD)
CWE

Coded with Exceptions

4500748Contact Person's Name MAY[0..*] 
XPN

Extended Person Name

4600749Contact Person's Telephone Number MAY[0..*] 
XTN

Extended Telecommunication Number

4700747Contact Reason MAY[0..1] ContactReason (CD)
CWE

Coded with Exceptions

4800784Contact Relationship MAY[0..1] ex.:Relationship (CD)
CWE

Coded with Exceptions

4900785Job Title
=

Truncation allowed.

MAY[0..1] 20
ST

String Data

5000786Job Code/Class MAY[0..1] 
JCC

Job Code/Class

5101299Guarantor Employer's Organization Name MAY[0..*] 
XON

Extended Composite Name and Identification Number for Organizations

5200753Handicap MAY[0..1] Handicap (CD)
CWE

Coded with Exceptions

5300752Job Status MAY[0..1] JobStatus (CD)
CWE

Coded with Exceptions

5401231Guarantor Financial Class MAY[0..1] 
FC

Financial Class

5501291Guarantor Race MAY[0..*] US: V2Race (CD)
CWE

Coded with Exceptions

5601851Guarantor Birth Place
=

Truncation allowed.

MAY[0..1] 100
ST

String Data

5700146VIP Indicator MAY[0..1] VipIndicator (CD)
CWE

Coded with Exceptions

Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData Type
GT1
100405Set ID - GT1 SHALL[1..1][1..4]
SI

Sequence ID

200406Guarantor Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

300407Guarantor Name SHALL[1..*] 
XPN

Extended Person Name

400408Guarantor Spouse Name MAY[0..*] 
XPN

Extended Person Name

500409Guarantor Address MAY[0..*] 
XAD

Extended Address

600410Guarantor Ph Num - Home MAY[0..*] 
XTN

Extended Telecommunication Number

700411Guarantor Ph Num - Business MAY[0..*] 
XTN

Extended Telecommunication Number

800412Guarantor Date/Time Of Birth MAY[0..1] 
DTM

Date/Time

900413Guarantor Administrative Sex MAY[0..1] repr: AdministrativeSex (CD) hl7VS-administrativeSex (VS) administrativeSex (CS)
CWE

Coded with Exceptions

1000414Guarantor Type MAY[0..1] GuarantorType (CD)
CWE

Coded with Exceptions

1100415Guarantor Relationship MAY[0..1] ex.:Relationship (CD) hl7VS-relationship (VS) relationship (CS)
CWE

Coded with Exceptions

1200416Guarantor SSN
=

Truncation not allowed!

MAY[0..1] 11
ST

String Data

1300417Guarantor Date - Begin MAY[0..1] 
DT

Date

1400418Guarantor Date - End MAY[0..1] 
DT

Date

1500419Guarantor Priority MAY[0..1][1..2]
NM

Numeric

1600420Guarantor Employer Name MAY[0..*] 
XPN

Extended Person Name

1700421Guarantor Employer Address MAY[0..*] 
XAD

Extended Address

1800422Guarantor Employer Phone Number MAY[0..*] 
XTN

Extended Telecommunication Number

1900423Guarantor Employee ID Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

2000424Guarantor Employment Status MAY[0..1] repr: EmploymentStatus (CD) hl7VS-employmentStatus (VS) employmentStatus (CS)
CWE

Coded with Exceptions

2100425Guarantor Organization Name MAY[0..*] 
XON

Extended Composite Name and Identification Number for Organizations

2200773Guarantor Billing Hold Flag MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

2300774Guarantor Credit Rating Code MAY[0..1] GuarantorCreditRatingCode (CD)
CWE

Coded with Exceptions

2400775Guarantor Death Date And Time MAY[0..1] 
DTM

Date/Time

2500776Guarantor Death Flag MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

2600777Guarantor Charge Adjustment Code MAY[0..1] PatientChargeAdjustment (CD)
CWE

Coded with Exceptions

2700778Guarantor Household Annual Income MAY[0..1] 
2800779Guarantor Household Size
=

Truncation not allowed!

MAY[0..1] 3
NM

Numeric

2900780Guarantor Employer ID Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

3000781Guarantor Marital Status Code MAY[0..1] repr: V2MaritalStatus (CD) hl7VS-maritalStatus (VS) maritalStatus (CS)
CWE

Coded with Exceptions

3100782Guarantor Hire Effective Date MAY[0..1] 
DT

Date

3200783Employment Stop Date MAY[0..1] 
DT

Date

3300755Living Dependency MAY[0..1] ex.:LivingDependency (CD) hl7VS-livingDependency (VS) livingDependency2 (CS)
CWE

Coded with Exceptions

3400145Ambulatory Status MAY[0..*] repr: AmbulatoryStatus (CD) hl7VS-ambulatoryStatus (VS) ambulatoryStatus (CS)
CWE

Coded with Exceptions

3500129Citizenship MAY[0..*] Citizenship (CD)
CWE

Coded with Exceptions

3600118Primary Language MAY[0..1] PrimaryLanguage (CD)
CWE

Coded with Exceptions

3700742Living Arrangement MAY[0..1] ex.:V2LivingArrangement (CD) hl7VS-livingArrangement (VS) livingArrangement (CS)
CWE

Coded with Exceptions

3800743Publicity Code MAY[0..1] ex.:PublicityCode (CD)
CWE

Coded with Exceptions

3900744Protection Indicator MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

4000745Student Indicator MAY[0..1] repr: StudentStatus (CD) hl7VS-studentStatus (VS) studentStatus (CS)
CWE

Coded with Exceptions

4100120Religion MAY[0..1] repr: Religion (CD) hl7VS-religion2 (VS) religion2 (CS)
CWE

Coded with Exceptions

4200109Mother's Maiden Name MAY[0..*] 
XPN

Extended Person Name

4300739Nationality MAY[0..1] Nationality (CD)
CWE

Coded with Exceptions

4400125Ethnic Group MAY[0..*] ex.:EthnicGroup (CD)
CWE

Coded with Exceptions

4500748Contact Person's Name MAY[0..*] 
XPN

Extended Person Name

4600749Contact Person's Telephone Number MAY[0..*] 
XTN

Extended Telecommunication Number

4700747Contact Reason MAY[0..1] ContactReason (CD)
CWE

Coded with Exceptions

4800784Contact Relationship MAY[0..1] ex.:Relationship (CD) hl7VS-relationship (VS) relationship (CS)
CWE

Coded with Exceptions

4900785Job Title
=

Truncation allowed.

MAY[0..1] 20
ST

String Data

5000786Job Code/Class MAY[0..1] 
JCC

Job Code/Class

5101299Guarantor Employer's Organization Name MAY[0..*] 
XON

Extended Composite Name and Identification Number for Organizations

5200753Handicap MAY[0..1] Handicap (CD)
CWE

Coded with Exceptions

5300752Job Status MAY[0..1] JobStatus (CD) hl7VS-jobStatus (VS) jobStatus (CS)
CWE

Coded with Exceptions

5401231Guarantor Financial Class MAY[0..1] 
FC

Financial Class

5501291Guarantor Race MAY[0..*] US: V2Race (CD) PHVS_Race_HL7_2x (VS)
CWE

Coded with Exceptions

5601851Guarantor Birth Place
=

Truncation allowed.

MAY[0..1] 100
ST

String Data

5700146VIP Indicator MAY[0..1] VipIndicator (CD)
CWE

Coded with Exceptions

Base FrameworkBase Standard Profile
Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData TypeImplementVocabulary
GT1 
100405Set ID - GT1 SHOULD[1..1][1..4]
SI

Sequence ID

SHALL
200406Guarantor Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

MAY
300407Guarantor Name SHOULD[1..*] 
XPN

Extended Person Name

SHALL
400408Guarantor Spouse Name MAY[0..*] 
XPN

Extended Person Name

MAY
500409Guarantor Address MAY[0..*] 
XAD

Extended Address

MAY
600410Guarantor Ph Num - Home MAY[0..*] 
XTN

Extended Telecommunication Number

MAY
700411Guarantor Ph Num - Business MAY[0..*] 
XTN

Extended Telecommunication Number

MAY
800412Guarantor Date/Time Of Birth MAY[0..1] 
DTM

Date/Time

MAY
900413Guarantor Administrative Sex MAY[0..1] repr: AdministrativeSex (CD)
CWE

Coded with Exceptions

MAYhl7VS-administrativeSex (VS) administrativeSex (CS)
1000414Guarantor Type MAY[0..1] GuarantorType (CD)
CWE

Coded with Exceptions

MAY
1100415Guarantor Relationship MAY[0..1] ex.:Relationship (CD)
CWE

Coded with Exceptions

MAYhl7VS-relationship (VS) relationship (CS)
1200416Guarantor SSN
=

Truncation not allowed!

MAY[0..1] 11
ST

String Data

MAY
1300417Guarantor Date - Begin MAY[0..1] 
DT

Date

MAY
1400418Guarantor Date - End MAY[0..1] 
DT

Date

MAY
1500419Guarantor Priority MAY[0..1][1..2]
NM

Numeric

MAY
1600420Guarantor Employer Name MAY[0..*] 
XPN

Extended Person Name

MAY
1700421Guarantor Employer Address MAY[0..*] 
XAD

Extended Address

MAY
1800422Guarantor Employer Phone Number MAY[0..*] 
XTN

Extended Telecommunication Number

MAY
1900423Guarantor Employee ID Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

MAY
2000424Guarantor Employment Status MAY[0..1] repr: EmploymentStatus (CD)
CWE

Coded with Exceptions

MAYhl7VS-employmentStatus (VS) employmentStatus (CS)
2100425Guarantor Organization Name MAY[0..*] 
XON

Extended Composite Name and Identification Number for Organizations

MAY
2200773Guarantor Billing Hold Flag MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

MAY 
2300774Guarantor Credit Rating Code MAY[0..1] GuarantorCreditRatingCode (CD)
CWE

Coded with Exceptions

MAY
2400775Guarantor Death Date And Time MAY[0..1] 
DTM

Date/Time

MAY
2500776Guarantor Death Flag MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

MAY 
2600777Guarantor Charge Adjustment Code MAY[0..1] PatientChargeAdjustment (CD)
CWE

Coded with Exceptions

MAY
2700778Guarantor Household Annual Income MAY[0..1] MAY
2800779Guarantor Household Size
=

Truncation not allowed!

MAY[0..1] 3
NM

Numeric

MAY
2900780Guarantor Employer ID Number MAY[0..*] 
CX

Extended Composite ID with Check Digit

MAY
3000781Guarantor Marital Status Code MAY[0..1] repr: V2MaritalStatus (CD)
CWE

Coded with Exceptions

MAYhl7VS-maritalStatus (VS) maritalStatus (CS)
3100782Guarantor Hire Effective Date MAY[0..1] 
DT

Date

MAY
3200783Employment Stop Date MAY[0..1] 
DT

Date

MAY
3300755Living Dependency MAY[0..1] ex.:LivingDependency (CD)
CWE

Coded with Exceptions

MAYhl7VS-livingDependency (VS) livingDependency2 (CS)
3400145Ambulatory Status MAY[0..*] repr: AmbulatoryStatus (CD)
CWE

Coded with Exceptions

MAYhl7VS-ambulatoryStatus (VS) ambulatoryStatus (CS)
3500129Citizenship MAY[0..*] Citizenship (CD)
CWE

Coded with Exceptions

MAY
3600118Primary Language MAY[0..1] PrimaryLanguage (CD)
CWE

Coded with Exceptions

MAY
3700742Living Arrangement MAY[0..1] ex.:V2LivingArrangement (CD)
CWE

Coded with Exceptions

MAYhl7VS-livingArrangement (VS) livingArrangement (CS)
3800743Publicity Code MAY[0..1] ex.:PublicityCode (CD)
CWE

Coded with Exceptions

MAY
3900744Protection Indicator MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

MAY 
4000745Student Indicator MAY[0..1] repr: StudentStatus (CD)
CWE

Coded with Exceptions

MAYhl7VS-studentStatus (VS) studentStatus (CS)
4100120Religion MAY[0..1] repr: Religion (CD)
CWE

Coded with Exceptions

MAYhl7VS-religion2 (VS) religion2 (CS)
4200109Mother's Maiden Name MAY[0..*] 
XPN

Extended Person Name

MAY
4300739Nationality MAY[0..1] Nationality (CD)
CWE

Coded with Exceptions

MAY
4400125Ethnic Group MAY[0..*] ex.:EthnicGroup (CD)
CWE

Coded with Exceptions

MAY
4500748Contact Person's Name MAY[0..*] 
XPN

Extended Person Name

MAY
4600749Contact Person's Telephone Number MAY[0..*] 
XTN

Extended Telecommunication Number

MAY
4700747Contact Reason MAY[0..1] ContactReason (CD)
CWE

Coded with Exceptions

MAY
4800784Contact Relationship MAY[0..1] ex.:Relationship (CD)
CWE

Coded with Exceptions

MAYhl7VS-relationship (VS) relationship (CS)
4900785Job Title
=

Truncation allowed.

MAY[0..1] 20
ST

String Data

MAY
5000786Job Code/Class MAY[0..1] 
JCC

Job Code/Class

MAY
5101299Guarantor Employer's Organization Name MAY[0..*] 
XON

Extended Composite Name and Identification Number for Organizations

MAY
5200753Handicap MAY[0..1] Handicap (CD)
CWE

Coded with Exceptions

MAY
5300752Job Status MAY[0..1] JobStatus (CD)
CWE

Coded with Exceptions

MAYhl7VS-jobStatus (VS) jobStatus (CS)
5401231Guarantor Financial Class MAY[0..1] 
FC

Financial Class

MAY
5501291Guarantor Race MAY[0..*] US: V2Race (CD)
CWE

Coded with Exceptions

MAYPHVS_Race_HL7_2x (VS)
5601851Guarantor Birth Place
=

Truncation allowed.

MAY[0..1] 100
ST

String Data

MAY
5700146VIP Indicator MAY[0..1] VipIndicator (CD)
CWE

Coded with Exceptions

MAY
Base Framework Base Standard Profile
Seq# Data Element Description Flags Optionality Repetition Length C.LEN Table Data Type Optionality Table
GT1  
1 00405 Set ID - GT1   O   [1..4]  
SI

Sequence ID

R  
2 00406 Guarantor Number   O Y    
CX

Extended Composite ID with Check Digit

   
3 00407 Guarantor Name   O Y    
XPN

Extended Person Name

R  
4 00408 Guarantor Spouse Name   O Y    
XPN

Extended Person Name

   
5 00409 Guarantor Address   O Y    
XAD

Extended Address

   
6 00410 Guarantor Ph Num - Home   O Y    
XTN

Extended Telecommunication Number

   
7 00411 Guarantor Ph Num - Business   O Y    
XTN

Extended Telecommunication Number

   
8 00412 Guarantor Date/Time Of Birth   O      
DTM

Date/Time

   
9 00413 Guarantor Administrative Sex   O      
CWE

Coded with Exceptions

  (0001)
10 00414 Guarantor Type   O      
CWE

Coded with Exceptions

  (0068)
11 00415 Guarantor Relationship   O      
CWE

Coded with Exceptions

  (0063)
12 00416 Guarantor SSN   O     11=  
ST

String Data

   
13 00417 Guarantor Date - Begin   O      
DT

Date

   
14 00418 Guarantor Date - End   O      
DT

Date

   
15 00419 Guarantor Priority   O   [1..2]  
NM

Numeric

   
16 00420 Guarantor Employer Name   O Y    
XPN

Extended Person Name

   
17 00421 Guarantor Employer Address   O Y    
XAD

Extended Address

   
18 00422 Guarantor Employer Phone Number   O Y    
XTN

Extended Telecommunication Number

   
19 00423 Guarantor Employee ID Number   O Y    
CX

Extended Composite ID with Check Digit

   
20 00424 Guarantor Employment Status   O      
CWE

Coded with Exceptions

  (0066)
21 00425 Guarantor Organization Name   O Y    
XON

Extended Composite Name and Identification Number for Organizations

   
22 00773 Guarantor Billing Hold Flag   O   [1..1]  
ID

Coded Value for HL7 Defined Tables

  (0136)
23 00774 Guarantor Credit Rating Code   O      
CWE

Coded with Exceptions

  (0341)
24 00775 Guarantor Death Date And Time   O      
DTM

Date/Time

   
25 00776 Guarantor Death Flag   O   [1..1]  
ID

Coded Value for HL7 Defined Tables

  (0136)
26 00777 Guarantor Charge Adjustment Code   O      
CWE

Coded with Exceptions

  (0218)
27 00778 Guarantor Household Annual Income   O          
28 00779 Guarantor Household Size   O     3=  
NM

Numeric

   
29 00780 Guarantor Employer ID Number   O Y    
CX

Extended Composite ID with Check Digit

   
30 00781 Guarantor Marital Status Code   O      
CWE

Coded with Exceptions

  (0002)
31 00782 Guarantor Hire Effective Date   O      
DT

Date

   
32 00783 Employment Stop Date   O      
DT

Date

   
33 00755 Living Dependency   O      
CWE

Coded with Exceptions

  (0223)
34 00145 Ambulatory Status   O Y    
CWE

Coded with Exceptions

  (0009)
35 00129 Citizenship   O Y    
CWE

Coded with Exceptions

  (0171)
36 00118 Primary Language   O      
CWE

Coded with Exceptions

  (0296)
37 00742 Living Arrangement   O      
CWE

Coded with Exceptions

  (0220)
38 00743 Publicity Code   O      
CWE

Coded with Exceptions

  (0215)
39 00744 Protection Indicator   O   [1..1]  
ID

Coded Value for HL7 Defined Tables

  (0136)
40 00745 Student Indicator   O      
CWE

Coded with Exceptions

  (0231)
41 00120 Religion   O      
CWE

Coded with Exceptions

  (0006)
42 00109 Mother's Maiden Name   O Y    
XPN

Extended Person Name

   
43 00739 Nationality   O      
CWE

Coded with Exceptions

  (0212)
44 00125 Ethnic Group   O Y    
CWE

Coded with Exceptions

  (0189)
45 00748 Contact Person's Name   O Y    
XPN

Extended Person Name

   
46 00749 Contact Person's Telephone Number   O Y    
XTN

Extended Telecommunication Number

   
47 00747 Contact Reason   O      
CWE

Coded with Exceptions

  (0222)
48 00784 Contact Relationship   O      
CWE

Coded with Exceptions

  (0063)
49 00785 Job Title   O     20#  
ST

String Data

   
50 00786 Job Code/Class   O      
JCC

Job Code/Class

   
51 01299 Guarantor Employer's Organization Name   O Y    
XON

Extended Composite Name and Identification Number for Organizations

   
52 00753 Handicap   O      
CWE

Coded with Exceptions

  (0295)
53 00752 Job Status   O      
CWE

Coded with Exceptions

  (0311)
54 01231 Guarantor Financial Class   O      
FC

Financial Class

   
55 01291 Guarantor Race   O Y    
CWE

Coded with Exceptions

  (0005)
56 01851 Guarantor Birth Place   O     100#  
ST

String Data

   
57 00146 VIP Indicator   O      
CWE

Coded with Exceptions

  (0099)
Seq# Data Element Description Optionality Repetition Length C.LEN Table Data Type
GT1
1 00405 Set ID - GT1 R   [1..4]  
SI

Sequence ID

2 00406 Guarantor Number O Y    
CX

Extended Composite ID with Check Digit

3 00407 Guarantor Name R Y    
XPN

Extended Person Name

4 00408 Guarantor Spouse Name O Y    
XPN

Extended Person Name

5 00409 Guarantor Address O Y    
XAD

Extended Address

6 00410 Guarantor Ph Num - Home O Y    
XTN

Extended Telecommunication Number

7 00411 Guarantor Ph Num - Business O Y    
XTN

Extended Telecommunication Number

8 00412 Guarantor Date/Time Of Birth O      
DTM

Date/Time

9 00413 Guarantor Administrative Sex O     (0001)
CWE

Coded with Exceptions

10 00414 Guarantor Type O     (0068)
CWE

Coded with Exceptions

11 00415 Guarantor Relationship O     (0063)
CWE

Coded with Exceptions

12 00416 Guarantor SSN O     11=  
ST

String Data

13 00417 Guarantor Date - Begin O      
DT

Date

14 00418 Guarantor Date - End O      
DT

Date

15 00419 Guarantor Priority O   [1..2]  
NM

Numeric

16 00420 Guarantor Employer Name O Y    
XPN

Extended Person Name

17 00421 Guarantor Employer Address O Y    
XAD

Extended Address

18 00422 Guarantor Employer Phone Number O Y    
XTN

Extended Telecommunication Number

19 00423 Guarantor Employee ID Number O Y    
CX

Extended Composite ID with Check Digit

20 00424 Guarantor Employment Status O     (0066)
CWE

Coded with Exceptions

21 00425 Guarantor Organization Name O Y    
XON

Extended Composite Name and Identification Number for Organizations

22 00773 Guarantor Billing Hold Flag O   [1..1] (0136)
ID

Coded Value for HL7 Defined Tables

23 00774 Guarantor Credit Rating Code O     (0341)
CWE

Coded with Exceptions

24 00775 Guarantor Death Date And Time O      
DTM

Date/Time

25 00776 Guarantor Death Flag O   [1..1] (0136)
ID

Coded Value for HL7 Defined Tables

26 00777 Guarantor Charge Adjustment Code O     (0218)
CWE

Coded with Exceptions

27 00778 Guarantor Household Annual Income O      
28 00779 Guarantor Household Size O     3=  
NM

Numeric

29 00780 Guarantor Employer ID Number O Y    
CX

Extended Composite ID with Check Digit

30 00781 Guarantor Marital Status Code O     (0002)
CWE

Coded with Exceptions

31 00782 Guarantor Hire Effective Date O      
DT

Date

32 00783 Employment Stop Date O      
DT

Date

33 00755 Living Dependency O     (0223)
CWE

Coded with Exceptions

34 00145 Ambulatory Status O Y   (0009)
CWE

Coded with Exceptions

35 00129 Citizenship O Y   (0171)
CWE

Coded with Exceptions

36 00118 Primary Language O     (0296)
CWE

Coded with Exceptions

37 00742 Living Arrangement O     (0220)
CWE

Coded with Exceptions

38 00743 Publicity Code O     (0215)
CWE

Coded with Exceptions

39 00744 Protection Indicator O   [1..1] (0136)
ID

Coded Value for HL7 Defined Tables

40 00745 Student Indicator O     (0231)
CWE

Coded with Exceptions

41 00120 Religion O     (0006)
CWE

Coded with Exceptions

42 00109 Mother's Maiden Name O Y    
XPN

Extended Person Name

43 00739 Nationality O     (0212)
CWE

Coded with Exceptions

44 00125 Ethnic Group O Y   (0189)
CWE

Coded with Exceptions

45 00748 Contact Person's Name O Y    
XPN

Extended Person Name

46 00749 Contact Person's Telephone Number O Y    
XTN

Extended Telecommunication Number

47 00747 Contact Reason O     (0222)
CWE

Coded with Exceptions

48 00784 Contact Relationship O     (0063)
CWE

Coded with Exceptions

49 00785 Job Title O     20#  
ST

String Data

50 00786 Job Code/Class O      
JCC

Job Code/Class

51 01299 Guarantor Employer's Organization Name O Y    
XON

Extended Composite Name and Identification Number for Organizations

52 00753 Handicap O     (0295)
CWE

Coded with Exceptions

53 00752 Job Status O     (0311)
CWE

Coded with Exceptions

54 01231 Guarantor Financial Class O      
FC

Financial Class

55 01291 Guarantor Race O Y   (0005)
CWE

Coded with Exceptions

56 01851 Guarantor Birth Place O     100#  
ST

String Data

57 00146 VIP Indicator O     (0099)
CWE

Coded with Exceptions

18.8.58.1 GT1 Field Definitions (6.5.5.0)

18.8.58.2 GT1-1 Set ID - GT1 (SI) 00405 (6.5.5.1)

Definition: GT1-1 - Set ID contains a number that identifies this transaction. For the first occurrence of the segment the sequence shall be 1, for the second occurrence it shall be 2, etc.

18.8.58.3 GT1-2 Guarantor Number (CX) 00406 (6.5.5.2)

Definition: This field contains the primary identifier, or other identifiers, assigned to the guarantor. The assigning authority and identifier type code are strongly recommended for all CX data types.

18.8.58.4 GT1-3 Guarantor Name (XPN) 00407 (6.5.5.3)

Definition: This field contains the name of the guarantor. Multiple names for the same guarantor may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

Beginning with version 2.3, if the guarantor is an organization, send a Delete Indication value ("") in GT1-3 - Guarantor Name and put the organization name in GT1-21 - Guarantor Organization Name. Either guarantor name or guarantor organization name is required.

18.8.58.5 GT1-4 Guarantor Spouse Name (XPN) 00408 (6.5.5.4)

Definition: This field contains the name of the guarantor's spouse. Multiple names for the same guarantor spouse may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

18.8.58.6 GT1-5 Guarantor Address (XAD) 00409 (6.5.5.5)

Definition: This field contains the guarantor's address. Multiple addresses for the same person may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

18.8.58.7 GT1-6 Guarantor Ph Num - Home (XTN) 00410 (6.5.5.6)

Definition: This field contains the guarantor's home phone number. All personal phone numbers for the guarantor may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated. .

18.8.58.8 GT1-7 Guarantor Ph Num - Business (XTN) 00411 (6.5.5.7)

Definition: This field contains the guarantor's business phone number. All business phone numbers for the guarantor may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

18.8.58.9 GT1-8 Guarantor Date/Time of Birth (DTM) 00412 (6.5.5.8)

Definition: This field contains the guarantor's date of birth.

18.8.58.10 GT1-9 Guarantor Administrative Sex (CWE) 00413 (6.5.5.9)

Definition: This field contains the guarantor's gender. Refer to User-defined Table 0001 - Administrative Sex in Chapter 2C, Code Tables, for suggested values.

18.8.58.11 GT1-10 Guarantor Type (CWE) 00414 (6.5.5.10)

Definition: This field indicates the type of guarantor, e.g., individual, institution, etc. Refer to User-defined Table 0068 - Guarantor Type in Chapter 2C, Code Tables, for suggested values.

18.8.58.12 GT1-11 Guarantor Relationship (CWE) 00415 (6.5.5.11)

Definition: This field indicates the relationship of the guarantor with the patient, e.g., parent, child, etc. Refer to User-defined Table 0063 - Relationship in Chapter 2C, Code Tables, for suggested values.

18.8.58.13 GT1-12 Guarantor SSN (ST) 00416 (6.5.5.12)

Definition: This field contains the guarantor's social security number.

18.8.58.14 GT1-13 Guarantor Date - Begin (DT) 00417 (6.5.5.13)

Definition: This field contains the date that the guarantor becomes responsible for the patient's account.

18.8.58.15 GT1-14 Guarantor Date - End (DT) 00418 (6.5.5.14)

Definition: This field contains the date that the guarantor stops being responsible for the patient's account.

18.8.58.16 GT1-15 Guarantor Priority (NM) 00419 (6.5.5.15)

Definition: This field is used to determine the order in which the guarantors are responsible for the patient's account.

18.8.58.17 GT1-16 Guarantor Employer Name (XPN) 00420 (6.5.5.16)

Definition: This field contains the name of the guarantor's employer, if the employer is a person. When the guarantor's employer is an organization, use GT1-51 - Guarantor Employer's Organization Name. Multiple names for the same person may be sent in this field, not multiple employers. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

18.8.58.18 GT1-17 Guarantor Employer Address (XAD) 00421 (6.5.5.17)

Definition: This field contains the guarantor's employer's address. Multiple addresses for the same employer may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

18.8.58.19 GT1-18 Guarantor Employer Phone Number (XTN) 00422 (6.5.5.18)

Definition: This field contains the guarantor's employer's phone number. Multiple phone numbers for the same employer may be sent in this field. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated. .

18.8.58.20 GT1-19 Guarantor Employee ID Number (CX) 00423 (6.5.5.19)

Definition: This field contains the guarantor's employee number. The assigning authority and identifier type code are strongly recommended for all CX data types.

18.8.58.21 GT1-20 Guarantor Employment Status (CWE) 00424 (6.5.5.20)

Definition: This field contains the code that indicates the guarantor's employment status. Refer to User-Defined Table 0066 - Employment Status in Chapter 2C, Code Tables, for suggested values.

18.8.58.22 GT1-21 Guarantor Organization Name (XON) 00425 (6.5.5.21)

Definition: This field contains the name of the guarantor when the guarantor is an organization. Multiple names for the same guarantor may be sent in this field, not multiple guarantors. .Specification of meaning based on sequence is deprecated

Beginning with version 2.3, if the guarantor is a person, send a Delete Indication value ("") in GT1-21 - Guarantor Organization Name and put the person name in GT1-3 - Guarantor Name. Either guarantor person name or guarantor organization name is required.

18.8.58.23 GT1-22 Guarantor Billing Hold Flag (ID) 00773 (6.5.5.22)

Definition: Refer to HL7 Table 0136 - Yes/no Indicator in Chapter 2C, Code Tables, for valid values. This field indicates whether or not a system should suppress printing of the guarantor's bills.

18.8.58.24 GT1-23 Guarantor Credit Rating Code (CWE) 00774 (6.5.5.23)

Definition: This field contains the guarantor's credit rating. Refer to User-defined Table 0341 - Guarantor Credit Rating Code in Chapter 2C, Code Tables, for suggested values.

18.8.58.25 GT1-24 Guarantor Death Date and Time (DTM) 00775 (6.5.5.24)

Definition: This field is used to indicate the date and time at which the guarantor's death occurred.

18.8.58.26 GT1-25 Guarantor Death Flag (ID) 00776 (6.5.5.25)

Definition: This field indicates whether or not the guarantor is deceased. Refer to HL7 Table 0136 - Yes/no Indicator in Chapter 2C, Code Tables, for valid values.

18.8.58.27 GT1-26 Guarantor Charge Adjustment Code (CWE) 00777 (6.5.5.26)

Definition: This field contains user-defined codes that indicate which adjustments should be made to this guarantor's charges. For example, when the hospital agrees to adjust this guarantor's charges to a sliding scale. Refer to User-defined Table 0218 - Patient Charge Adjustment in Chapter 2C, Code Tables, for suggested values.

Example: This field would contain the value used for sliding-fee scale processing.

18.8.58.28 GT1-27 Guarantor Household Annual Income (CP) 00778 (6.5.5.27)

Definition: This field contains the combined annual income of all members of the guarantor's household.

18.8.58.29 GT1-28 Guarantor Household Size (NM) 00779 (6.5.5.28)

Definition: This field specifies the number of people living at the guarantor's primary residence.

18.8.58.30 GT1-29 Guarantor Employer ID Number (CX) 00780 (6.5.5.29)

Definition: This is a code that uniquely identifies the guarantor's employer when the employer is a person. It may be a user-defined code or a code defined by a government agency (Federal Tax ID#).

When further breakdowns of employer information are needed, such as a division or plant, it is recommended that the coding scheme incorporate the relationships (e.g., define separate codes for each division). The assigning authority and identifier type code are strongly recommended for all CX data types.

18.8.58.31 GT1-30 Guarantor Marital Status Code (CWE) 00781 (6.5.5.30)

Definition: This field contains the marital status of the guarantor. Refer to User-defined Table 0002 - Marital Status in Chapter 2C, Code Tables, for suggested values.

18.8.58.32 GT1-31 Guarantor Hire Effective Date (DT) 00782 (6.5.5.31)

Definition: This field contains the date that the guarantor's employment began.

18.8.58.33 GT1-32 Employment Stop Date (DT) 00783 (6.5.5.32)

Definition: This field indicates the date on which the guarantor's employment with a particular employer ended.

18.8.58.34 GT1-33 Living Dependency (CWE) 00755 (6.5.5.33)

Definition: Identifies the specific living conditions of the guarantor. Refer to User-defined Table 0223 - Living Dependency in Chapter 2C, Code Tables, for suggested values.

18.8.58.35 GT1-34 Ambulatory Status (CWE) 00145 (6.5.5.34)

Definition: Identifies the transient state of mobility for the guarantor. Refer to User-defined Table 0009 - Ambulatory Status in Chapter 2C, Code Tables, for suggested values.

18.8.58.36 GT1-35 Citizenship (CWE) 00129 (6.5.5.35)

Definition: This field contains the code to identify the guarantor's citizenship. HL7 recommends using ISO table 3166 as the suggested values in User-defined Table 0171 - Citizenship in Chapter 2C, Code Tables.

18.8.58.37 GT1-36 Primary Language (CWE) 00118 (6.5.5.36)

Definition: This field identifies the guarantor's primary speaking language. HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language defined in Chapter 2C, Code Tables.

18.8.58.38 GT1-37 Living Arrangement (CWE) 00742 (6.5.5.37)

Definition: This field identifies the situation in which the person lives at his residential address. Refer to User-defined Table 0220 - Living Arrangement in Chapter 2C, Code Tables, for suggested values.

18.8.58.39 GT1-38 Publicity Code (CWE) 00743 (6.5.5.38)

Definition: This field contains a user-defined code indicating what level of publicity is allowed (e.g., No Publicity, Family Only) for a guarantor. Refer to User-defined Table 0215 - Publicity Code in Chapter 2C, Code Tables, for suggested values.

18.8.58.40 GT1-39 Protection Indicator (ID) 00744 (6.5.5.39)

Definition: This field identifies the guarantor's protection, which determines whether or not access to information about this enrollee should be restricted from users who do not have adequate authority. Refer to HL7 Table 0136 - Yes/no Indicator for valid values.

18.8.58.41 GT1-40 Student Indicator (CWE) 00745 (6.5.5.40)

Definition: This field indicates whether the guarantor is currently a student, and whether the guarantor is a full-time or part-time student. This field does not indicate the degree level (high school, college) of the student, or his/her field of study (accounting, engineering, etc.). Refer to User-defined Table 0231- Student Status in Chapter 2C, Code Tables, for suggested values.

18.8.58.42 GT1-41 Religion (CWE) 00120 (6.5.5.41)

Definition: This field indicates the type of religion practiced by the guarantor. Refer to User-defined Table 0006 - Religion in Chapter 2C, Code Tables, for suggested values.

18.8.58.43 GT1-42 Mother's Maiden Name (XPN) 00109 (6.5.5.42)

Definition: This field indicates the guarantor's mother's maiden name.

18.8.58.44 GT1-43 Nationality (CWE) 00739 (6.5.5.43)

Definition: This field contains a code that identifies the nation or national grouping to which the person belongs. This may be different from a person's citizenship in countries in which multiple nationalities are recognized (for example, Spain: Basque, Catalan, etc.). HL7 recommends using ISO table 3166 as suggested values in User-defined Table 0212 - Nationality in Chapter 2C, Code Tables.

18.8.58.45 GT1-44 Ethnic Group (CWE) 00125 (6.5.5.44)

Definition: This field contains the guarantor's ethnic group. Refer to User-defined Table 0189 - Ethnic Group in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes. In the US, a current use is to report ethnicity in line with US federal standards for Hispanic origin.

18.8.58.46 GT1-45 Contact Person's Name (XPN) 00748 (6.5.5.45)

Definition: This field contains the name of the person who should be contacted regarding the guarantor bills, etc. This may be someone other than the guarantor. (E.g., Contact guarantor's wife regarding all bills - guarantor lives out of country.)

This is a repeating field that allows for multiple names for the same person. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

18.8.58.47 GT1-46 Contact Person's Telephone Number (XTN) 00749 (6.5.5.46)

Definition: This field contains the telephone number of the guarantor (person) to contact regarding guarantor bills, etc. Multiple phone numbers for that person may be sent in this sequence. As of v 2.7, no assumptions can be made based on position or sequence. Specification of meaning based on sequence is deprecated.

18.8.58.48 GT1-47 Contact Reason (CWE) 00747 (6.5.5.47)

Definition: This field contains a user-defined code that identifies the reason for contacting the guarantor, for example, to phone the guarantor if payments are late. Refer to User-defined Table 0222 - Contact reason in Chapter 2C, Code Tables, for suggested values.

18.8.58.49 GT1-48 Contact Relationship (CWE) 00784 (6.5.5.48)

Definition: Identifies the guarantor relationship to the contact person specified above. Refer to User-defined Table 0063 - Relationship in Chapter 2C, Code Tables, for suggested values. Examples include wife, attorney, power of attorney, self, and organization.

18.8.58.50 GT1-49 Job Title (ST) 00785 (6.5.5.49)

Definition: This field contains a descriptive name of the guarantor's occupation (e.g., Sr. Systems Analyst, Sr. Accountant).

18.8.58.51 GT1-50 Job Code/Class (JCC) 00786 (6.5.5.50)

Definition: This field contains the guarantor's job code and employee classification.

18.8.58.52 GT1-51 Guarantor Employer's Organization Name (XON) 01299 (6.5.5.51)

Definition: This field contains the name of the guarantor's employer when the guarantor's employer is an organization. When the guarantor's employer is a person, use GT1-16 - Guarantor Employer Name. Multiple names for the same guarantor may be sent in this field Specification of meaning based on sequence is deprecated.

18.8.58.53 GT1-52 Handicap (CWE) 00753 (6.5.5.52)

Definition: This field contains a code to describe the guarantor's disability. Refer to User-defined Table 0295 - Handicap in Chapter 2C, Code Tables, for suggested values.

18.8.58.54 GT1-53 Job Status (CWE) 00752 (6.5.5.53)

Definition: This field contains a code that identifies the guarantor's current job status. Refer to User-defined Table 0311 - Job Status in Chapter 2C, Code Tables, for suggested values.

18.8.58.55 GT1-54 Guarantor Financial Class (FC) 01231 (6.5.5.54)

Definition: This field contains the financial class (FC) assigned to the guarantor for the purpose of identifying sources of reimbursement. It can be different than that of the patient. When the FC of the guarantor is different than the FC of the patient, and the guarantor's coverage for that patient has been exhausted, the source of reimbursement falls back onto the FC of the patient.

18.8.58.56 GT1-55 Guarantor Race (CWE) 01291 (6.5.5.55)

Definition: This field refers to the guarantor's race. Refer to User-defined Table 0005 - Race in Chapter 2C, Code Tables, for suggested values. The second triplet of the CE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

18.8.58.57 GT1-56 Guarantor Birth Place (ST) 01851 (6.5.5.56)

Definition: This field contains the description of the guarantor's birth place, for example "St. Francis Community Hospital of Lower South Side." The actual address is reported in GT1-5 - Guarantor Address with an identifier of "N".

18.8.58.58 GT1-57 VIP Indicator (CWE) 00146 (6.5.5.57)

Definition: This field identifies the type of VIP for the guarantor. Refer to User-defined Table 0099 - VIP Indicator in Chapter 2C, Code Tables, for suggested values.