To ensure harmonization with HL7®, NCPDP added to the RTPB Standard Version 12 (published in October 2021) an optional field for communicating a patient’s sex assigned at birth on the request transaction. This data element is in addition to NCPDP’s existing patient gender code field.

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Business Need/Purpose

There is a business need to identify the sex assigned at birth for medications when someone’s gender is different from their sex assigned at birth to help patients obtain their medication without delays in treatment for gender mismatch edits that may occur. This new element will be used as an optional element in the event the patient’s sex assigned at birth differs from their gender.

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Information about data elements from NCPDP Data Dictionary:

Definition: A label given at birth based on medical factors, including hormones, chromosomes and genitals. Most patients are assigned male or female at birth based on the appearance of their external genitalia.

Field format: x(1); field length: 1

Valid NCPDP External Code List (ECL) Values:

Sex Assigned at Birth

0 = Unknown

1 = Male

2 = Female

4 = Intersex: An individual born with any of several variations in sex characteristics, including chromosomes, gonads, sex hormones or genitals that do not fit the typical definitions of male or female.

Patient Gender Code

0 = Unknown

1 = Male

2 = Female

3 = Non-Binary: An umbrella term for people with gender identities that fall somewhere outside of the traditional conceptions of strictly either female or male.