Reference·NK1 Segment·NK1-3
HL7 v2 Reference

HL7 v2 NK1-3 Field Guide: Relationship Codes and Common Mistakes

Jul 27, 2026 · 4 min read
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Two source systems can both send a technically valid NK1-3 value for "spouse" and still fail to match each other, because each one is drawing from its own locally customized code table.

Quick answer

NK1-3 is a coded field describing how the associated party relates to the patient — spouse, child, parent, guardian, employer, and so on. It uses a coded-element data type, so the value is really a code plus (optionally) the text it stands for, and many organizations extend or override the base code set with their own entries.

Valid code values

SPO
Spouse — the patient's spouse or domestic partner
CHD
Child — a son or daughter of the patient
PAR
Parent — a parent of the patient, common on pediatric registrations
GRD
Guardian — legal guardian, distinct from a biological parent
OTH
Other — catch-all used when no closer category fits, or when a local system hasn't mapped a finer-grained relationship

Example

Synthetic example Generated by Synthibase
NK1|1|DOE^JANE^M|SPO|482 OAK ST^^DENVER^CO^80202|3035550142|||EC

SPO in this synthetic segment marks the contact as the patient's spouse.

Where this trips people up

Because NK1-3 is coded but the code table is only loosely standardized in practice, interfaces between two systems often carry an undocumented mapping table translating one vendor's relationship codes into another's. When that mapping is incomplete, unmapped codes either get dropped silently or default to "Other," quietly losing information a care team might actually need. Test suites should include relationship codes outside the sending system's common set to confirm the mapping fails loudly instead of silently.

HL7 v2 NK1 Segment Guide: Fields, Format, and Testing Gotchas
How to Write EDI Test Cases That Actually Catch Go-Live Failures
Regression Testing for EHR Upgrades: A Complete Guide
Catch relationship-code mapping gaps before go-live
Synthibase generates NK1-3 values across a wide spread of relationship codes, including ones outside your default set, so mapping tables get tested against the full range they'll see in production.
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