Release Notes:
Data Element
Version 2010B1
Data Element Name: | Sex |
Collected For: | All Records |
Definition: | The patient's documented sex on arrival at the hospital. |
Suggested Data Collection Question: | What is the patient’s sex? |
Format: | Length: | 1 | Type: | Character | Occurs: | 1 |
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Allowable Values: |
M = Male
F = Female
U = Unknown
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Notes for Abstraction: |
- Collect the documented patient’s sex at admission or the first documentation after arrival.
- Consider the sex to be unable to be determined and select “Unknown” if:
- The patient refuses to provide their sex.
- Documentation is contradictory.
- Documentation indicates the patient is a Transexual.
- Documentation indicates the patient is a Hermaphrodite.
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Suggested Data Sources: |
Consultation notes
Emergency department record
History and physical
Face sheet
Progress notes
UB-04 Field Location: 11
Nursing admission notes |
Additional Notes: |
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Guidelines for Abstraction: |
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Sex
Specifications Manual for Joint Commission National Quality Measures (v2010B1)
Discharges 10-01-10 (4Q10) through 03-31-11 (1Q11)
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