Section title: Requests for Interpretation
(270/271) Wondering about Legal Sex of X and if there are any standards

Wondering about Legal Sex of X and if there are any standards. 21 states, and soon Passports, have Legal Sex of X as an option. Specifically for the 270/271 transactions.


Patient indicates Legal Sex of X.

RFI Response

The current 5010 TR3s for the 270/271 transactions support the below gender code sets:

270B1_2100C_DMG 3 and 270B1_2100D_DMG03

F - Female

M - Male

271B1_2100C_DMG03 and 271B1_2100D_DMG03 

F - Female

M - Male

U - Unknown   

RFI Recommendation

See related RFI 2311

If this is functionality that is needed for your business and is not currently supported in a published TR3, submit an X12 maintenance request at

Research background

The 5010 X12 base standard has six values to report gender. The individual TR3 guides determine if a gender element is needed and if so, which values may be used for the specific transaction.  

Base Standard Values:

A Not Provided

B Not Applicable

F Female

M Male

U Unknown

N Non-sexed Gender is not known because observation or examination for such was not recorded or requested by the protocol

X Unsexable Gender could not be determined because of ambiguity in external or internal genitalia

Currently some TR3s use F and M, others use F, M, and U, other TR3s do not report gender.