Central Distributor SASD: Description of Data Elements

MARITALSTATUSUB04 - Patient's marital status, UB-04 standard coding

Documentation Sections:

General Notes

Uniform Values

State Specific Notes

General Notes

MaritalStatusUB04 indicates the patient's marital status and uses the same coding as the marital status data element on the UB-04 claim form.

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Uniform Values

Variable Description Value Value Description MARITALSTATUSUB04 Patient's marital status, UB-04 standard coding I Single M Married A Common Law B Registered Domestic Partner S Separated X Legally Separated D Divorced W Widowed U Unmarried (single or divorced or widowed) Blank Unknown, not applicable, missing, or invalid

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State Specific Notes

Georgia Georgia MaritalStatus_X MaritalStatusUB04 Value Description Value Description M Married M Married S Single I Single P Life Partner B Life Partner X Legally Separated X Legally Separated D Divorced D Divorced W Widowed W Widowed U Unknown blank missing blank missing blank missing Any undocumented values invalid blank missing Maryland Maryland MaritalStatus_X MaritalStatusUB04 Value Description Value Description 2 Married M Married 1 Single I Single 4 Divorced D Divorced 3 Separated X Legally Separated 5 Widow/Widower W Widowed 9 Unknown Missing . Other Minnesota Minnesota MaritalStatus_X MaritalStatusUB04 Value Description Value Description M Married M Married S Single I Single P Life Partner B Life Partner X Legally Separated X Legally Separated D Divorced D Divorced W Widowed W Widowed U Unknown blank Missing blank missing Any undocumented values invalid Nebraska Nebraska MaritalStatus_X MaritalStatusUB04 Value Description Value Description M, m Married M Married S,s Single I Single P Life Partner B Life Partner X Legally Separated X Legally Separated D Divorced D Divorced W,w Widowed W Widowed U Unknown blank missing blank missing blank missing Any undocumented values invalid blank missing Nevada Nevada MARITALSTATUS_X MARITALSTATUSUB04 Value Description Value Description 2 Married M Married 1 Single I Single 5 Divorced D Divorced 4 Legally Separated X Legally Separated 3 Life Partner B Life Partner 6 Widowed W Widowed 9, blank Unknown blank Missing Any other undocumented values Invalid New Jersey New Jersey MaritalStatus_X MaritalStatusUB04 Value Description Value Description A Common Law A Common Law B Registered Domestic Partner B Registered Domestic Partner / Life Partner P Life Partner D Divorced D Divorced I Single I Single M Married/Civil Union M Married S Separated S Separated U Unmarried U Unmarried W Widowed W Widowed X Legally Separated X Legally Separated C, K, R, Blank, or any other values Not Applicable, Unknown, Unreported Blank Missing New York New York MaritalStatus_X MaritalStatusUB04 Value Description Value Description A Common Law A Common Law B Registered Domestic Partner B Registered Domestic Partner D Divorced D Divorced I Single I Single M Married M Married S Separated S Separated U Unmarried (single, divorced, widowed) U Unmarried (single, divorced, widowed) W Widowed W Widowed X Legally Separated X Legally Separated C, K, R, blank, or any other values Not applicable, unknown, unreported Blank Unknown, not applicable, missing or invalid Utah Utah (Valid beginning 2018) MaritalStatus_X MaritalStatusUB04 Value Description Value Description S Never Married I Single M Married M Married P Polygamous -- -- A Common Law T Domestic Partner B Registered Domestic Partner -- -- S Separated D Divorced D Divorced I Interlocutory W Widowed W Widowed A Annulled U Unmarried U Unmarried blank blank Missing Other Any undocumented values

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