HL7 Table HL70005: Race

HL70005 is the HL7-defined code table for patient race, aligned with the U.S. Office of Management and Budget (OMB) five-category model plus an "Other Race" placeholder. It draws its code values from the CDC Race & Ethnicity Code Set (PHIN VADS, OID 2.16.840.1.113883.6.238) — meaning HL70005 uses the same numeric-hyphenated codes (1002-5, 2028-9, etc.) that CDC, USCDI, and US Core publish, rather than a parallel HL7-only letter scheme. The table sits behind PID-10 Race, which is a repeating field — a patient may identify with multiple race categories on the same message.

Purpose

HL70005 records the OMB-aligned race category (or categories) the patient identifies with, for the purposes of demographic reporting, health-equity analytics, and federal program eligibility. It is deliberately coarse — six codes — because OMB and Meaningful Use reporting are coarse; finer-grained race granularity (e.g. specific tribes, specific national origins) lives in the broader CDC Race & Ethnicity Code Set (~900 codes), which can be carried in the same PID-10 CWE field by populating CWE.4–CWE.6 with the granular CDC code while CWE.1–CWE.3 carry the OMB rollup.

Where it's used

PID-10 Race — primary home of HL70005; the field repeats with ~, allowing multi-race patients.

Code list

Code	Display	Comment/Description
1002-5	American Indian or Alaska Native	OMB category; covers persons with origins in any of the original peoples of North and South America.
2028-9	Asian	OMB category; covers persons with origins in the Far East, Southeast Asia, or the Indian subcontinent.
2054-5	Black or African American	OMB category; covers persons with origins in any of the Black racial groups of Africa.
2076-8	Native Hawaiian or Other Pacific Islander	OMB category; covers persons with origins in Hawaii, Guam, Samoa, or other Pacific Islands.
2106-3	White	OMB category; covers persons with origins in any of the original peoples of Europe, the Middle East, or North Africa.
2131-1	Other Race	Used when the reported race does not fit any of the five OMB categories.

Code system OID

HL7-internal OID: 2.16.840.1.113883.18.6 — assigned to v2-0005 in HL7 Terminology.
CDC Race & Ethnicity Code Set OID: 2.16.840.1.113883.6.238 — the upstream source that defines the actual code values. Modern profiles (US Core, USCDI) cite the CDC OID, not the HL7-internal one.
Canonical URI (HL7): http://terminology.hl7.org/CodeSystem/v2-0005
Canonical URI (CDC): urn:oid:2.16.840.1.113883.6.238

HL7-defined vs user-defined

HL70005 is HL7-defined. The six codes above are the normative HL7 rollup; receivers must accept them without local extension. Sites that need granular race (specific tribes, specific national origins) do not extend HL70005 — they instead populate PID-10 with the full CDC Race & Ethnicity Code Set, citing the CDC OID in CWE.14, and let the receiver roll up to the OMB category as needed. This is the same pattern US Core uses with the ombCategory and detailed sub-extensions.

Version differences

v2.3 — HL70005 introduced as the user-defined Race table; values varied by site.
v2.5 — Table re-anchored on the OMB five-category model and the CDC Race & Ethnicity Code Set, with the six codes above adopted as the HL7-defined set. PID-10 data type widened from IS to CE.
v2.7 — PID-10 widened to CWE, enabling OID metadata in CWE.14 and value-set OIDs in CWE.15. PID-10 repeats with ~.
v2.8 – v2.8.1 — Stable. No additions to the six codes.

Common mistakes

Sending only one race when the patient identifies with multiple. PID-10 is repeating; use ~ to carry several CWE values rather than collapsing to a single rollup.
Putting the granular CDC code (e.g. 1004-1 Apache) in CWE.1 while citing HL70005 in CWE.3. CWE.3 should be CDCREC (or the CDC OID via CWE.14); the OMB rollup belongs in a separate triplet.
Treating ethnicity codes as race codes — sending 2135-2 (Hispanic or Latino) in PID-10. Hispanic origin is ethnicity, carried in PID-22 (HL70189), not race.
Defaulting unknown race to 2131-1 (Other Race). For unknown race, use a data-absent-reason extension or leave the field absent; Other Race is a positive assertion, not a placeholder.
Extending HL70005 locally with site-specific letters. The conformant extension path is the CDC Race & Ethnicity Code Set, not custom HL70005 additions.

Examples

A PID with a single race (White):

PID|1||10456^^^MRN^MR||DOE^JANE^A||19850412|F||2106-3^White^HL70005|123 MAIN ST^^BOSTON^MA^02118

A multi-race PID (American Indian or Alaska Native AND White):

PID|1||10456^^^MRN^MR||DOE^JANE^A||19850412|F||1002-5^American Indian or Alaska Native^HL70005~2106-3^White^HL70005|123 MAIN ST^^BOSTON^MA^02118

Granular CDC code (Cherokee) with OMB rollup as alternate:

PID|1||10456^^^MRN^MR||DOE^JANE||19850412|F||1026-1^Cherokee^CDCREC^1002-5^American Indian or Alaska Native^HL70005

Same White value translated to a FHIR US Core Race extension:

{
  "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
  "extension": [
    {
      "url": "ombCategory",
      "valueCoding": {
        "system": "urn:oid:2.16.840.1.113883.6.238",
        "code": "2106-3",
        "display": "White"
      }
    },
    {
      "url": "text",
      "valueString": "White"
    }
  ]
}

Mapping failure example — unknown vendor code:

PID|1||10456^^^MRN^MR||DOE^JANE||19850412|F||CAUC^Caucasian^MERCYRACE

CAUC is a vendor extension. A conformant engine should map CAUC to 2106-3 (White) via a curation rule, preserve the original MERCYRACE code in a secondary Coding, and emit a curation alert so the rule can be audited.

FHIR mapping

There is no FHIR core ValueSet at HL70005's granularity. The standard target is the US Core Race extension (http://hl7.org/fhir/us/core/StructureDefinition/us-core-race), which carries:

ombCategory — bound to the six OMB-aligned codes (the same code values as HL70005).
detailed — bound to the full CDC Race & Ethnicity Code Set.
text — a free-text representation.

HL7 v2 (HL70005)	FHIR (US Core Race `ombCategory`)
1002-5	1002-5 American Indian or Alaska Native
2028-9	2028-9 Asian
2054-5	2054-5 Black or African American
2076-8	2076-8 Native Hawaiian or Other Pacific Islander
2106-3	2106-3 White
2131-1	2131-1 Other Race

The mapping is identity because both sides cite the same CDC code set; what differs is the system URI (urn:oid:2.16.840.1.113883.6.238 on the FHIR side). The HL7 v2-to-FHIR IG provides field-level guidance for PID-10 to the US Core extension rather than a standalone ConceptMap.

Engine considerations

Repeating field — PID-10 repeats with ~. Engines that flatten to a single value silently drop multi-race patients; this is a known data-loss bug in older parsers.
System URI dual identity — both HL70005 and CDCREC (or 2.16.840.1.113883.6.238) are acceptable in CWE.3 / CWE.14. Engines must accept both and normalize to a single internal system on ingest.
Granular-to-rollup — when the source sends a granular CDC code, the engine should compute the OMB rollup automatically using the CDC hierarchy so the FHIR ombCategory slot is always populated.
Absence semantics — empty PID-10 means "race not collected"; do not default to 2131-1.

How Vorro handles HL70005

Vorro accepts PID-10 in any of the common shapes — single OMB code, multiple OMB codes via ~, granular CDC code with OMB alternate, or vendor-specific code requiring curation. Vendor codes route to the terminology curation queue, where Vorro either creates a remap rule (CAUC → 2106-3) or surfaces the original code as text while flagging for review. The CDC Race & Ethnicity hierarchy is loaded at startup, so granular codes automatically resolve to their OMB rollup before FHIR translation.

On outbound, Vorro emits PID-10 as repeating CWE values with CWE.3 set to HL70005 for OMB rollups and CDCREC for granular codes; OID metadata in CWE.14 / CWE.15 is populated when the destination profile advertises support.

Sources

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