Canonical Guide

HL7 Version 2.6

Version 1.2

Page 1 of 134

Version1.2

HL7 Version 2.6 Companion Guide

TABLE OF CONTENTS 1. INTRODUCTION ............................................................................................ 3 2. PROCESS FLOW........................................................................................... 4 3. HL7 TRANSACTION STRUCTURE ............................................................... 6
Message Segments ....................................................................................................................................................... 8 Message Definition - Segment Usage in Each transaction ..................................................................................... 94

4. SAMPLE HL7 TRANSACTION FILE.......................................................... 131

Sample ORU Transaction ......................................................................................................................................... 131 Sample ADT Transaction .......................................................................................................................................... 132

5. DOCUMENT CHANGE HISTORY .............................................................. 133

Version1.2

HL7 Version 2.6 Companion Guide

1. INTRODUCTION
1.1 Overview HL7 (Health Level Seven) is a standard application protocol for electronic data exchange in Healthcare environments. The term Level 7 refers to the highest implementation protocol level for a definition of a networking framework as presented in the Open System Interconnection (OSI) model. To add on, In the OSI conceptual model, the functions of both communications software and hardware are separated into seven layers, or levels. The HL7 Standard is primarily focused on the issues that occur within the seventh, or application, level. These are the definitions of the data to be exchanged, the timing of the exchanges, and the communication of certain applicationspecific errors between the applications. The HL7 Version 2.x Standard currently addresses the interfaces among various healthcare IT systems that send or receive patient admissions/registration, discharge or transfer (ADT) data, queries, resource and patient scheduling, orders, results, clinical observations, billing, master file update information, medical records, scheduling, patient referral, patient care, clinical laboratory automation, application management and personnel management messages. It does not try to assume a particular architecture with respect to the placement of data within applications. Instead, HL7 Version 2.x serves as a way for inherently disparate applications and data architectures operating in a heterogeneous system environment to communicate with each other. As an example, HL7 Version 2.6 is designed (and used) to support a central patient care system as well as a more distributed environment where data resides in departmental systems. 1.2 Scope The scope of this document is limited to the definitions of HL7 method with respect to the following transaction types: Lab Results Radiology Admission, Discharge and Transfer This canonical guide is unique to OneHealthPort and its interfaces. The document talks about implementation & setup, HL7 data structures along-with mandatory and optional elements within the data structures with samples, use cases and results describing the transaction set required for sending structured patient oriented clinical data from one computer system to another. The chapter consists of three sections: a general section explaining process flow section outlining message type, specific data format and content within the message types for HL7 version 2.6 a sample scenario of a Transaction that is illustrated as both a data string and mapped transaction

Version1.2

HL7 Version 2.6 Companion Guide

Version1.2

HL7 Version 2.6 Companion Guide

2. PROCESS FLOW
2.1 Transaction: Lab Results Actors Lab results sender and receivers. High Level Process Flow Lab-result Receiver Tasks
Place an order for lab results with an Lab Agency/Lab Corp. Receive Lab results electronically via OneHealthPorts HIE Systems. Consumes, verifies and sends an HL7-ACK back to HIE.

Lab-result Sender Tasks

Lab Organization generates the ORU message for transmitting laboratory results of the specimen. Receives the HL7-ACK message back via OneHealthport HIE Systems.

OneHealthPort HIE System Tasks

Receives the HL7-ORU message. Validates the Sender of the document. If sending partner is not listed as a trusted partner the document is not processed. Parsing header to get the receiver info and transmits the document to lab-result receiver. Receives an HL7-ACK message back from lab-result document receiver. Validates the ACK, parses the recipient info in the header and routes the document further.

HL7 Lab Results message types ORU^R01 - The ORU message is for transmitting laboratory results. The main segments within the ORU are OBX and OBR. The OBR provides the details related to the request and the OBX segment provides the results. One result segment (OBX) is transmitted for each component of a diagnostic report, such as an EKG or obstetrical ultrasound or electrolyte battery. ACK^R01 - When the unsolicited update is sent from one system to another, the original acknowledgment mode specifies that it be acknowledged at the application level. The reasoning is that it is not sufficient to know that the underlying communications system guaranteed delivery of the message. It is also necessary to know that the receiving application processed the data successfully at a logical application level.

Version1.2

HL7 Version 2.6 Companion Guide

2.2 Transaction: Admission, Transfer and Discharge (ADT) Actors Patient Administration System, Hospitals, Ancillary systems, High Level Process Flow

OHP HIE Systems

Pickup & Delivery Exchange to receive ADT

Patient Administration System/ Hospitals

MetaData Profile Document Service Map Transform if required

Partner Delivery to deliver ADT MetaData Profile Document Service

Ancillary Systems

Events

Administration/Configuration

Administration/Configuration/Monitoring

Sentinel Monitoring
HIE Administration

Version1.2

HL7 Version 2.6 Companion Guide

3. STRUCTURE
3.1 General Structural Notes The terms used in this document are listed below: Messages: A "message" is considered the minimal unit of data transferred between systems using HL7. Messages are comprised of two or more "segments" that act as building blocks for each message. Segments: HL7 messages are comprised of several HL7 segments. Fields: Each segment begins with a unique 3 byte message identifier field (e.g., MSH for "message header", etc.). Subsequent fields within the same segment are separated from one another by the field separator character, the "pipe" symbol, "|". Field Components and Subcomponents: A few HL7 fields are defined as having more than one portion, each of which is separated by a component separator, "^". Blank components are shown with two component separators with nothing between them: "^^". Components may divided into subcomponents, separated by the subcomponent separator, "&". Data Types: Listed below.
Data Type Code CNE CWE CQ CX DLN DR DT DTM FC HD ID IS JCC NM PL SI ST VID XAD XCN XON XPN XTN Name coded with no exceptions (Coded values from HL7 or user defined tables) coded with exceptions Composite Quantity with units (Numeric) extended composite ID with check digit Drivers License Number Date/ Time Range Date Date/ Time Financial Class hierarchic designator Identifier (Coded values from HL7 tables) Identifier (Coded values from user-defined tables) Job Code/ Class Numeric Person Location Sequence ID String Version Identifier Extended Address Extended composite ID number and name for persons Extended composite name and identification number for organizations Extended Person Name Extended Telecommunication Number

Version1.2

HL7 Version 2.6 Companion Guide

Field Requirements: R = required, O= Optional, C = Conditional (if used, these will be explained), W = Withdrawn and removed from standards and B = included for backwards compatibility with previous versions.

NOTE Following description of segments applies to all the three use cases. There are some segments which are present for all document types and exclusive to particular use case only. All such descriptions are found in the same section of this document.

Version1.2

HL7 Version 2.6 Companion Guide

Message Segments
MSH Message Header This segment defines the intent, source, destination, and some specifics of the syntax of a message. The HL7 attribute table below explains in detail each field associated with MSH segment. Read column Sequence as MSH-1, MSH-2, and MSH-3 so on. If MSH segment is present in the document, the required data elements are elaborated with definitions in the same table.
Sequence 1 Element Name Field Separator Data Types ST Length 1 Required R

The separator between the segment ID and the first real field. This field contains the separator between the segment ID and the first real field, MSH-2-encoding characters. As such it serves as the separator and defines the character to be used as a separator for the rest of the message. Recommended value is | (ASCII 124). 2 Encoding Characters ST 4 R

Four characters: the component separator, repetition separator, escape character, and subcomponent separator. Best practice is to always include all four characters. Recommended values are ^~\& (ASCII 94, 126, 92, and 38, respectively). 3 Sending Application HD 227 O

This field uniquely identifies the sending application among all other applications within the network enterprise. The network enterprise consists of all those applications that participate in the exchange of HL7 messages within the enterprise. 4 Sending Facility HD 227 O

This field further describes the sending application, MSH-3-sending application. With the promotion of this field to an HD data type, the usage has been broadened to include not just the sending facility but other organizational entities such as a) the organizational entity responsible for sending application; b) the responsible unit; c) a product or vendor's identifier, etc 5 Receiving Application HD 227 O

This field uniquely identifies the receiving application among all other applications within the network enterprise. The network enterprise consists of all those applications that participate in the exchange of HL7 messages within the enterprise. 6 Receiving Facility HD 227 O

This field identifies the receiving application among multiple identical instances of the application running on behalf of different organizations. 7 Date/Time of Message DTM 24 R

Date/time that the sending system created the message. If the time zone is specified, it will be used throughout the message as the default time zone. 8 Security ST 40 O

This field implements security features in some of the applications of HL7. 9 Message Type MSG 15 R

Contains the message type, trigger event, and the message structure ID for the message.

Version1.2

HL7 Version 2.6 Companion Guide

10

Message Control ID

ST

199

Number or other identifier that uniquely identifies the message. The receiving system echoes this ID back to the sending system in the Message acknowledgment segment (MSA). 11 Processing ID PT 3 R

This field is used to decide whether to process the message as defined in HL7 Application (level 7) Processing rules. 12 Version ID VID 60 R

This field is matched by the receiving system to its own version to be sure the message will be interpreted correctly. 13 Sequence Number NM 15 O

A non null value in this field implies that the sequence number protocol is in use. 14 Continuation Pointer ST 180 O

Only the sender of a fragmented message values this field. This numeric field is incremented by one for each subsequent value. 15 Accept Acknowledgment Type ID 2 O

This field identifies the conditions under which accept acknowledgments are required to be returned in response to this message. Required for enhanced acknowledgment mode. 16 Application Acknowledgment Type ID 2 O

Conditions under which application acknowledgments are required to be returned in response to this message. Required for enhanced acknowledgment mode. Suggested values: AL Always NE Never ER Error/reject conditions only SU Successful completion only 17 Country Code ID 3 O

The country of origin for the message. . It will be used primarily to specify default elements, such as currency denominations. The values to be used are those of ISO 3166. 18 Character Set ID 16 O

Character set for the entire message 19 Principal Language Of Message CWE 250 O

Principal language of the message 20 Alternate Character Set Handling Scheme ID 20 O

When any alternative character sets are used (as specified in the second or later iterations of MSH-18 character sets), and if any special handling scheme is needed, this component is to specify the scheme used. 21 Message Profile Identifier EI 427 O

Sites may use this field to assert adherence to, or reference, a message profile. Message profiles contain detailed explanations of grammar, syntax, and usage for a particular message or set of messages. 22 Sending Responsible Organization XON 567 O

10

Version1.2

HL7 Version 2.6 Companion Guide

Business organization that originated and is accountable for the content of the message 23 Receiving Responsible Organization XON 567 O

Business organization that is the intended receiver of the message and is accountable for acting on the data conveyed by the transaction 24 Sending Network Address HD 227 O

Identifier of the network location the message was transmitted from. Identified by an OID or text string (e.g., URI). 25 Receiving Network Address HD 227 O

Identifier of the network location the message was transmitted to. Identified by an OID or text string (e.g., URI).

11

Version1.2

HL7 Version 2.6 Companion Guide

MSA Message Acknowledgement This segment contains information sent while acknowledging another message. The HL7 attribute table below explains in detail each field associated with MSA segment. Read column Sequence as MSA-1, MSA-2, MSA-3 so on. If MSA segment is present in the document, the required data elements are elaborated with definitions in the same table.
Sequence 1 Element Name Acknowledgment Code Data Types ID Length 2 Required R

This field contains an acknowledgment code. AA Application Accept, AE Application Error, AR Application Reject, CA Commit Accept, CE Commit Error, CR Commit Reject. 2 Message Control ID ST 199 R

This field contains the message control ID of the message sent by the sending system. It allows the sending system to associate this response with the message for which it is intended 3 Text Message ST 80 B

This optional field further describes an error condition. This text may be printed in error logs or presented to an end user. 4 Expected Sequence Number NM 15 O

Delayed Acknowledgment Type

Error Condition

CE

250

Message Waiting Number

NM

Message Waiting Priority

ID

12

Version1.2

HL7 Version 2.6 Companion Guide

EVN - Event Type Segment This segment is used to communicate necessary trigger event information to receiving applications.
Sequence 1 Element Name Event Type Code Data Types ID Length 3 Required B

Field contains the events corresponding to the trigger events described in this section. 2 Recorded Date/Time DTM 24 R

System date/time when the transaction was entered and it can be overridden. 3 Date/Time Planned Event DTM 24 O

Date/time when the event is planned 4 Reason for this event. 5 Operator ID XCN 250 O Event Reason Code IS 3 O

The individual responsible for triggering the event. 6 Event Occurred DTM 24 O

Date/time when the event actually occurred. 7 Event Facility HD 241 O

The actual facility where the event occurred.

13

Version1.2

HL7 Version 2.6 Companion Guide

PID - Patient Identification Segment This segment is used for communicating patient identification and demographic information. The following HL7 attribute table explains in detail each field associated with PID segment. Read column Sequence as PID-1, PID-2, PID-3 so on. If this segment is present in the document, the required data elements are elaborated with definitions in the same table.
Sequence 1 Element Name Set ID - Patient ID Data Types SI Length 4 Required O

It contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc. 2 Patient ID (External ID) CX 20 B

From V2.3.1, this field has been retained for backward compatibility only; the arbitrary term of "external ID" has been removed from the name of this field. 3 Patient ID (Internal ID) CX 250 R

Contains the list of identifiers (one or more) used by the healthcare facility to uniquely identify a patient (e.g., medical record number, billing number, birth registry, national unique individual identifier, etc.). In Canada, the Canadian Provincial Healthcare Number should be sent in this field. The arbitrary term of "internal ID" has been removed from the name of this field for clarity. 4 Alternate Patient ID - PID CX 20 B

From V2.3.1, this field has been retained for backward compatibility only; it is recommended to use PID-3 - Patient Identifier List for all patient identifiers. When used for backward compatibility, this field contains the alternate, temporary, or pending optional patient identifier to be used if needed - or additional numbers that may be required to identify a patient. 5 Patient Name XPN 250 R

This field contains the names of the patient, the primary or legal name of the patient is reported first. For example, the name type code in this field should be "L - Legal", A Alias. 6 Mothers Maiden Name XPN 250 O

Contains the family name under which the mother was born (i.e., before marriage). It is used to distinguish between patients with the same last name. 7 Date/Time of Birth DTM 24 O

Contains the patients year, month and day of birth. 8 Patients sex. Suggested values: F Female M Male O Other U Unknown A Ambiguous N Not applicable 9 Patient Alias XPN 250 B Sex IS 1 O

From V2.4, this field has been retained for backward compatibility only; it is recommended to use PID-5 - Patient Name for all patient names.

14

Version1.2

HL7 Version 2.6 Companion Guide

10

Race

CWE

705

Patients race. Suggested values: 1002-5 American Indian or Alaska Native 2028-9 Asian 2054-5 Black or African American 2076-8 Native Hawaiian or Other Pacific Islander 2106-3 White 2131-1 Other Race 11 Mailing address of the patient. 12 Backward Compatibility. 13 Phone Number - Home XTN 250 O County Code IS 4 B Patient Address XAD 250 O

Patient's personal phone numbers. All personal phone numbers for the patient are sent in the following sequence. The first sequence is considered the primary number (for backward compatibility). If the primary number is not sent, then a repeat delimiter is sent in the first sequence. 14 Phone Number - Business XTN 250 O

Patient's business phone numbers. All business numbers for the patient are sent in the following sequence. The first sequence is considered the patient's primary business phone number (for backward compatibility). If the primary business phone number is not sent, then a repeat delimiter must be sent in the first sequence. 15 Patient's primary language. 16 Marital Status CWE 705 O Primary Language CWE 705 O

Patient's marital (civil) status. Suggested Values: A Separated D Divorced M Married S Single W Widowed C Common law G Living together P Domestic partner R Registered domestic partner E Legally Separated N Annulled I Interlocutory B Unmarried U Unknown O Other T Unreported 17 Religion CWE 705 O

15

Version1.2

HL7 Version 2.6 Companion Guide

Patient's religion. Suggested values: AGN Agnostic ATH Atheist BAH Baha'i BRE Brethren BUD Buddhist BMA Buddhist: Mahayana BTH Buddhist: Theravada BTA Buddhist: Tantrayana BOT Buddhist: Other CFR Chinese Folk Religionist CHR Christian ABC Christian: American Baptist Church AMT Christian: African Methodist Episcopal AME Christian: African Methodist Episcopal Zion ANG Christian: Anglican AOG Christian: Assembly of God BAP Christian: Baptist CRR Christian: Christian Reformed CHS Christian: Christian Science CMA Christian: Christian Missionary Alliance COC Christian: Church of Christ COG Christian: Church of God COI Christian: Church of God in Christ COM Christian: Community COL Christian: Congregational EOT Christian: Eastern Orthodox EVC Christian: Evangelical Church EPI Christian: Episcopalian FWB Christian: Free Will Baptist FRQ Christian: Friends FUL Christian: Full Gospel GRE Christian: Greek Orthodox JWN Christian: Jehovah's Witness MOM Christian: Latter-day Saints LUT Christian: Lutheran LMS Christian: Lutheran Missouri Synod MEN Christian: Mennonite MET Christian: Methodist NAZ Christian: Church of the Nazarene ORT Christian: Orthodox PEN Christian: Pentecostal COP Christian: Other Pentecostal PRE Christian: Presbyterian PRO Christian: Protestant PRC Christian: Other Protestant REC Christian: Reformed Church REO Christian: Reorganized Church of Jesus Christ-LDS CAT Christian: Roman Catholic

16

Version1.2

HL7 Version 2.6 Companion Guide

SAA Christian: Salvation Army SEV Christian: Seventh Day Adventist SOU Christian: Southern Baptist UCC Christian: United Church of Christ UMD Christian: United Methodist UNI Christian: Unitarian UNU Christian: Unitarian Universalist WES Christian: Wesleyan WMC Christian: Wesleyan Methodist COT Christian: Other CNF Confucian DOC Disciples of Christ ERL Ethnic Religionist HIN Hindu HSH Hindu: Shaivites HVA Hindu: Vaishnavites HOT Hindu: Other JAI Jain JEW Jewish JCO Jewish: Conservative JOR Jewish: Orthodox JRC Jewish: Reconstructionist JRF Jewish: Reform JRN Jewish: Renewal JOT Jewish: Other MOS Muslim MSH Muslim: Shiite MSU Muslim: Sunni MOT Muslim: Other NAM Native American NRL New Religionist NOE Nonreligious SHN Shintoist SIK Sikh SPI Spiritist OTH Other VAR Unknown 18 Patient Account Number CX 250 O

Patient account number assigned by accounting to which all charges are recorded. 19 SSN Number - Patient ST 16 B

From V2.3.1 onward, this field has been retained for backward compatibility only. It is recommended to use PID-3 Patient Identifier List for all patient identifiers. However, in order to maintain backward compatibility, this field should also be populated. When used for backward compatibility, this field contains the patient's social security number. This number may also be a RR retirement number. 20 Driver's License Number - Patient DLN 25 B

Backward Compatibility.

17

Version1.2

HL7 Version 2.6 Companion Guide

21

Mother's Identifier

CX

250

This field is used, for example, as a link field for newborns. Typically a patient ID or account number may be used. This field can contain multiple identifiers for the same mother. 22 Ethnic Group CWE 705 O

Patient's ancestry. Suggested values: H Hispanic or Latino N Not Hispanic or Latino U Unknown 23 Location of the patient's birth. 24 Multiple Birth Indicator ID 1 O Birth Place ST 250 O

Indicates whether the patient was part of a multiple birth Valid values: Y the patient was part of a multiple birth N the patient was a single birth 25 Birth Order NM 2 O

When a patient was part of a multiple birth, a value (number) indicating the patient's birth order is entered in this field. 26 Person's country citizenship 27 Veterans Military Status CWE 705 O Citizenship CWE 705 O

Military status assigned to a veteran. 28 Nationality CWE 705 B

From V2.4 onward, this field has been retained for backward compatibility only. It is recommended to refer to PID-10 Race, PID-22 - Ethnic group and PID-26 - Citizenship. This field contains a code that identifies the nation or national grouping to which the person belongs. 29 Patient Death Date and Time DTM 24 O

Date and time at which the patient death occurred. 30 Patient Death Indicator ID 1 O

Indicates whether the patient is deceased. Valid values: Y the patient is deceased N the patient is not deceased 31 Identity Unknown Indicator ID 1 O

Indicates whether or not the patient's/person's identity is known. Valid values: Y the patient's/person's identity is unknown N the patient's/person's identity is known 32 Identity Reliability Code IS 20 O

Indicate that certain fields on a PID segment for a given patient/person are known to be false. Valid values:

18

Version1.2

HL7 Version 2.6 Companion Guide

US Unknown/Default Social Security Number UD Unknown/Default Date of Birth UA Unknown/Default Address AL Patient/Person Name is an Alias 33 Last Update Date/Time DTM 24 O

Last update date and time for the patient's/person's identifying and demographic data. 34 Last Update Facility HD 241 O

Last update to a patient's/person's identifying and demographic data. 35 Species Code CWE 705 C

Common or scientific name of living organism. 36 Breed of animal. 37 Specific strain of living organism. 38 Production Class Code CWE 705 O Strain ST 80 O Breed Code CWE 705 C

Contains the code and/or text indicating the primary use for which the living subject was bred or grown. Suggested values: BR Breeding/genetic stock DA Dairy DR Draft DU Dual Purpose LY Layer, Includes Multiplier flocks MT Meat OT Other PL Pleasure RA Racing SH Show NA Not Applicable U Unknown 39 Person's tribal citizenship. Tribal Citizenship CWE 705 O

19

Version1.2

HL7 Version 2.6 Companion Guide

PV1 Patient Visit Segment The PV1 segment is used by Registration/ADT applications to communicate information on a visit-specific basis. This segment can be used to send multiple-visit statistic records to the same patient account or single-visit records to more than one account. This segment is used by registration/patient administration applications to communicate information on an account or visit specific basic. The default is to send account level data. The HL7 attribute table below explains in detail each field associated with PV1 segment. Read column Sequence as PV1-1, PV1-2, PV1-3 so on. If PV1 segment is present in the document, the required data elements are elaborated with definitions in the same table.
Sequence 1 Element Name Set ID - PV1 Data Types SI Length 4 Required O

This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc. 2 Patient Class IS 1 O

This field is used by systems to categorize patients by site. It does not have a consistent industry-wide definition. It is subject to site specific variations. Suggested values: E Emergency I Inpatient O Outpatient P Preadmit R Recurring patient B Obstetrics C Commercial Account N Not Applicable U Unknown 3 Assigned Patient Location PL 80 O

Patient's initial assigned location or the location to which the patient is being moved. 4 Admission Type IS 2 O

Indicates the circumstances under which the patient was or will be admitted. Valid values: A Accident E Emergency L Labor and Delivery R Routine N Newborn (Birth in healthcare facility) U Urgent C Elective 5 Preadmit Number CX 250 O

Uniquely identifies the patient's pre-admit account 6 Prior Patient Location PL 80 O

Prior patient location if the patient is being transferred.

20

Version1.2

HL7 Version 2.6 Companion Guide

Attending Doctor

XCN

250

Contains the attending physician information 8 Referring Doctor XCN 250 O

Contains the referring physician information 9 Consulting Doctor XCN 250 B

From V2.4 onward, this field has been retained for backward compatibility only. It is recommended to use the ROL Role segment for consulting physicians instead. This field contains the consulting physician information. The field sequences are used to indicate multiple consulting doctors. Depending on local agreements, either the ID or the name may be absent from this field. 10 Hospital Service IS 3 O

Contains the treatment or type of surgery that the patient is scheduled to receive. Suggested values: MED Medical Service SUR Surgical Service URO Urology Service PUL Pulmonary Service CAR Cardiac Service 11 Temporary Location PL 80 O

Contains a location other than the assigned location required for a temporary period of time 12 Preadmit Test Indicator IS 2 O

Indicates whether the patient must have pre-admission testing done in order to be admitted 13 Readmission Indicator IS 2 O

Indicates that a patient is being re-admitted to the healthcare facility. Suggested values: "R" for readmission or else null 14 Admit Source IS 6 O

Indicates where the patient was admitted. Suggested values: 1 Physician referral 2 Clinic referral 3 HMO referral 4 Transfer from a hospital 5 Transfer from a skilled nursing facility 6 Transfer from another health care facility 7 Emergency room 8 Court/law enforcement 9 Information not available 15 Ambulatory Status IS 2 O

Indicates any permanent or transient handicapped conditions. Valid values: A0 No functional limitations A1 Ambulates with assistive device A2 Wheelchair/stretcher bound

21

Version1.2

HL7 Version 2.6 Companion Guide

A3 Comatose; non-responsive A4 Disoriented A5 Vision impaired A6 Hearing impaired A7 Speech impaired A8 Non-English speaking A9 Functional level unknown B1 Oxygen therapy B2 Special equipment (tubes, IVs, catheters) B3 Amputee B4 Mastectomy B5 Paraplegic B6 Pregnant 16 Identifies the type of VIP. 17 Admitting Doctor XCN 250 O VIP Indicator IS 2 O

Contains the admitting physician information 18 Patient Type IS 2 O

19

Visit Number

CX

250

Contains the unique number assigned to each patient visit. 20 Financial Class FC 50 O

Contains the financial class(es) assigned to the patient for the purpose of identifying sources of reimbursement. 21 Charge Price Indicator IS 2 O

Code used to determine which price schedule is to be used for room and bed charges. 22 Courtesy Code IS 2 O

Indicates whether the patient will be extended certain special courtesies 23 Credit Rating IS 2 O

Contains the user-defined code to determine past credit experience. 24 Contract Code IS 2 O

Type of contract entered into by the healthcare facility and the guarantor for the purpose of settling outstanding account balances 25 Contract Effective Date DT 8 O

Contains the date that the contract is to start or started.

22

Version1.2

HL7 Version 2.6 Companion Guide

26

Contract Amount

NM

12

Contains the amount to be paid by the guarantor each period according to the contract. 27 Contract Period NM 3 O

Duration of the contract for user-defined periods. 28 Interest Code IS 2 O

Indicates the amount of interest that will be charged the guarantor on any outstanding amounts. 29 Transfer to Bad Debt Code IS 4 O

Indicates that the account was transferred to bad debts and gives the reason. 30 Transfer to Bad Debt Date DT 8 O

Contains the date that the account was transferred to a bad debt status. 31 Bad Debt Agency Code IS 10 O

Uniquely identifies the bad debt agency to which the account was transferred. 32 Bad Debt Transfer Amount NM 12 O

Contains the amount that was transferred to a bad debt status. 33 Bad Debt Recovery Amount NM 12 O

Contains the amount recovered from the guarantor on the account. 34 Delete Account Indicator IS 1 O

Indicates that the account was deleted from the file and gives the reason. 35 Delete Account Date DT 8 O

Contains the date that the account was deleted from the file. 36 Discharge Disposition IS 3 O

Contains the disposition of the patient at time of discharge. Suggested values: 01 Discharged to home or self care (routine discharge) 02 Discharged/transferred to another short term general hospital for inpatient care 03 Discharged/transferred to skilled nursing facility (SNF) 04 Discharged/transferred to an intermediate care facility (ICF) 05 Discharged/transferred to another type of institution for inpatient care or referred for outpatient services to another institution 06 Discharged/transferred to home under care of organized home health service organization 07 Left against medical advice or discontinued care 08 Discharged/transferred to home under care of Home IV provider 09 Admitted as an inpatient to this hospital 10 ... 19 Discharge to be defined at state level, if necessary 20 Expired (i.e. dead)

23

Version1.2

HL7 Version 2.6 Companion Guide

21 ... 29 Expired to be defined at state level, if necessary 30 Still patient or expected to return for outpatient services (i.e. still a patient) 31 ... 39 Still patient to be defined at state level, if necessary (i.e. still a patient) 40 Expired (i.e. died) at home 41 Expired (i.e. died) in a medical facility; e.g., hospital, SNF, ICF, or free standing hospice 42 Expired (i.e. died) - place unknown 37 Discharged to Location DLD 47 O

Indicates the healthcare facility to which the patient was discharged and the date. 38 Diet Type CWE 705 O

Indicates a special diet type for a patient. 39 Servicing Facility IS 2 O

Used in a multiple facility environment to indicate the healthcare facility with which this visit is associated. 40 Bed Status IS 1 B

This field has been retained for backward compatibility only. The information is now held in the fifth component of the PL datatype in PV1-3. This field contains the status of the bed. Suggested values: C Closed H Housekeeping O Occupied U Unoccupied K Contaminated I Isolated 41 Account Status IS 2 O

42

Pending Location

PL

80

Indicates the point of care, room, bed, healthcare facility ID, and bed status to which the patient may be moved. 43 Prior Temporary Location PL 80 O

Used to reflect the patient's temporary location (such as the operating room/theatre or x-ray) prior to a transfer from a temporary location to an actual location, or from a temporary location to another temporary location. 44 Admit Date/Time DTM 24 O

45

Discharge Date/Time

DTM

24

46 Visit balance due. 47

Current Patient Balance

NM

12

Total Charges

NM

12

24

Version1.2

HL7 Version 2.6 Companion Guide

Total visit charges. 48 Total adjustments for visit. 49 Total payments for visit. 50 Alternate Visit ID CX 250 O Total Payments NM 12 O Total Adjustments NM 12 O

Contains the alternative, temporary, or pending optional visit ID number to be used if needed. 51 Visit Indicator IS 1 O

Indicator used to send data at two levels, visit and account. Suggested values: A Account level (default) V Visit level 52 Other Healthcare Provider XCN 250 B

From V2.4 onward, this field has been retained for backward compatibility only. communicate providers not specified elsewhere.

Use the ROL-Role Segment to

25

Version1.2

HL7 Version 2.6 Companion Guide

PV2 Patient Visit - Additional Information Segment

Sequence 1 Element Name Prior Pending Location Data Types PL Length 80 Required C

Required for cancel pending transfer (A26) messages. 2 Accommodation Code CWE 705 O

The specific patient accommodations for this visit 3 Admit Reason CWE 705 O

Short description of the reason for patient admission 4 Transfer Reason CWE 705 O

Description of the reason for location change (patient). 5 Patient Valuables ST 25 O

Description of patient valuables checked in during admission. 6 Patient Valuables Location ST 25 O

Description of Patient Valuables Location. 7 Suggested values: TE Teaching HO Home MO Mobile Unit PH Phone 8 Expected Admit Date/Time DTM 24 O Visit User Code IS 2 O

Expected Patient Admission Date/Time. 9 Expected Discharge Date/Time DTM 24 O

Expected Patient Discharge Date/Time. 10 Estimated Length of Inpatient Stay NM 3 O

11

Actual Length of Inpatient Stay

NM

12

Visit Description

ST

50

26

Version1.2

HL7 Version 2.6 Companion Guide

13

Referral Source Code

XCN

250

Name and the identification numbers of the person or organization that made the referral. 14 Previous Service Date DT 8 O

The date of previous service for the same persistent condition 15 Employment Illness Related Indicator ID 1 O

Indicates whether a patient's illness was job-related. Valid values: Y the patient's illness was job-related N the patient's illness was not job-related 16 Purge Status Code IS 1 O

Purge status code for the account. Suggested value: P Marked for purge. User is no longer able to update the visit. D The visit is marked for deletion and the user cannot enter new data against it. I The visit is marked inactive and the user cannot enter new data against it. 17 Purge Status Date DT 8 O

Date when data would be purged. 18 Special Program Code IS 2 O

Specific health insurance program for a visit required for healthcare reimbursement. Suggested values: CH Child Health Assistance ES Elective Surgery Program FP Family Planning O Other U Unknown 19 Retention Indicator ID 1 O

Allows preserving demographic and financial data on specific, high priority visits. Valid values: Y retain data N normal purge processing 20 Expected Number of Insurance Plans NM 1 O

Number of insurance plans that may provide coverage for this visit. 21 Visit Publicity Code IS 1 O

Level of publicity allowed for a specific visit. Suggested values: F Family only N No Publicity O Other U Unknown 22 Visit Protection Indicator ID 1 B

Suggested values: Y protect access to patient information N normal access

27

Version1.2

HL7 Version 2.6 Companion Guide

23 organization name 24

Clinic Organization Name

XON

250

Patient Status Code

IS

Status of patient. Suggested values: AI Active Inpatient DI Discharged Inpatient 25 Visit Priority Code IS 1 O

Priority of visit. Suggested values: 1 Emergency 2 Urgent 3 Elective 26 Previous Treatment Date DT 8 O

The date that the patient last had treatment. 27 Expected Discharge Disposition IS 2 O

Patient's disposition is expected to be at the end of the visit 28 Signature date. 29 First Similar Illness Date DT 8 O Signature on File Date DT 8 O

30

Patient Charge Adjustment Code

CWE

705

31

Recurring Service Code

IS

Indicates whether the treatment is continuous. 32 Billing Media Code ID 1 O

Indicates if the account is to be rejected from tape billing. Valid values: Y reject account from tape billing N normal processing 33 Expected Surgery Date and Time DTM 24 O

Date and time on which the surgery is expected to occur. 34 Military Partnership Code ID 1 O

Indicates that a military healthcare facility has contracted with a non-military healthcare facility for the use of its services. Suggested values: Y contract(s) exist N no contract(s) exist

28

Version1.2

HL7 Version 2.6 Companion Guide

35

Military Non-Availability Code

ID

Patient has permission to use a non-military healthcare facility for treatment. Valid values: Y the patient has permission to use a non-military healthcare facility N the patient does not have permissions to use a non-military healthcare facility 36 Valid values: Y the patient is a baby N the patient is not a baby 37 Baby Detained Indicator ID 1 O Newborn Baby Indicator ID 1 O

Indicates if the baby is detained after the mother's discharge. Valid values: Y the baby was detained N normal discharge of mother and baby 38 Mode of Arrival Code CWE 705 O

Patient was brought to the healthcare facility. Suggested values: A Ambulance C Car F On foot H Helicopter P Public Transport O Other U Unknown 39 Recreational Drug Use Code CWE 705 O

Indicates what recreational drugs the patient uses. Suggested values: A Alcohol K Kava M Marijuana T Tobacco - smoked C Tobacco - chewed O Other U Unknown 40 Admission Level of Care Code CWE 705 O

Indicates the acuity level assigned to the patient at the time of admission. Suggested values: AC Acute CH Chronic CO Comatose CR Critical IM Improved MO Moribund 41 Precaution Code CWE 705 O

Precautions that need to be taken while dealing with the patient. Suggested values: A Aggressive B Blind

29

Version1.2

HL7 Version 2.6 Companion Guide

C Confused D Deaf I On IV N "No-code" (i.e. Do not resuscitate) P Paraplegic O Other U Unknown 42 Patient Condition Code CWE 705 O

Patient's current medical condition. Suggested values: A Satisfactory C Critical P Poor S Stable O Other U Unknown 43 Living Will Code IS 2 O

Suggested values: Y Yes, patient has a living will F Yes, patient has a living will but it is not on file N No, patient does not have a living will and no information was provided I No, patient does not have a living will but information was provided U Unknown 44 Organ Donor Code IS 2 O

Suggested values: Y Yes, patient is a documented donor and documentation is on file F Yes, patient is a documented donor, but documentation is not on file N No, patient has not agreed to be a donor I No, patient is not a documented donor, but information was provided R Patient leaves organ donation decision to relatives P Patient leaves organ donation decision to a specific person U Unknown 45 Advance Directive Code CWE 705 C

Patient's instructions to the healthcare facility. Suggested values: DNR Do not resuscitate N No directive 46 Patient Status Effective Date DT 8 O

47

Expected LOA Return Date/Time

DTM

24

Date/time that the patient is expected to return from LOA. 48 Expected Pre-admission Testing Date/Time DTM 24 O

30

Version1.2

HL7 Version 2.6 Companion Guide

49

Notify Clergy Code

IS

20

Indicate whether the clergy should be notified. Suggested values: Y Yes N No L Last Rites only O Other U Unknown 50 Advance Directive Last Verified Date DT 8 O

31

Version1.2

HL7 Version 2.6 Companion Guide

ORC Common Order Segment The Common Order segment (ORC) is used to transmit fields that are common to all orders (all types of services that are requested).
Sequence 1 Element Name Order Control Data Types ID Length 2 Required R

Determines the function of the order segment 2 Placer Order Number EI 427 C

placer application's order number 3 Filler Order Number EI 427 O

order number associated with the filling application 4 Placer Group Number EI 22 O

This field allows an order placing application to group sets of orders together and subsequently identify them. 5 Order Status ID 2 O

Suggested values: A Some, but not all, results available CA Order was canceled CM Order is completed DC Order was discontinued ER Error, order not found HD Order is on hold IP In process, unspecified RP Order has been replaced SC In process, scheduled 6 Response Flag ID 1 O

This field allows the placer (sending) application to determine the amount of information to be returned from the filler. Suggested values: E Report exceptions only R Same as E, also Replacement and Parent-Child D Same as R, also other associated segments F Same as D, plus confirmations explicitly N Only the MSA segment is returned 7 Quantity/Timing TQ 705 B

Parent

EIP

200

Date/Time of Transaction

DTM

24

32

Version1.2

HL7 Version 2.6 Companion Guide

Date and time of the event that initiated the current transaction as reflected in ORC-1 Order Control Code 10 Entered By XCN 3220 O

Identity of the person who actually keyed the request into the application 11 Verified By XCN 250 O

Identity of the person who verified the accuracy of the entered request 12 Ordering Provider XCN 3220 O

The identity of the person who is responsible for creating the request (i.e., ordering physician). 13 Enterer's Location PL 80 O

Specifies the location (e.g., nurse station, ancillary service location, clinic, floor) where the person who entered the request was physically located when the order was entered. 14 Call Back Phone Number XTN 250 O

Telephone number to call for clarification of a request or other information regarding the order 15 Order Effective Date/Time DTM 24 O

Date/time that the changes to the request took effect or are supposed to take effect. 16 Order Control Code Reason CWE 250 O

17

Entering Organization

CWE

250

Organization that the enterer belonged to at the time he/she enters/maintains the order, such as medical group or department 18 Entering Device CWE 250 O

Physical device (terminal, PC) used to enter the order. 19 Action By XCN 250 O

The identity of the person who initiated the event represented by the corresponding order control code 20 Advanced Beneficiary Notice Code CWE 250 O

Status of the patient's or the patient's representative's consent for responsibility to pay for potentially uninsured services. 21 Ordering Facility Name XON 250 O

Name of the facility placing the order. 22 Ordering Facility Address XAD 250 O

Address of the facility placing the order. 23 Ordering Facility Phone Number XTN 250 O

33

Version1.2

HL7 Version 2.6 Companion Guide

24

Ordering Provider Address

XAD

250

Address of the care provider requesting the order. 25 Order Status Modifier CWE 250 O

Modifier or refiner of the ORC-5-Order status field. 26 Advanced Beneficiary Notice Override Reason CWE 60 O

Contains the reason why the patient did not sign an Advanced Beneficiary Notice. 27 Filler's Expected Availability Date/Time DTM 24 O

Date/time the filler expects the services to be available 28 Confidentiality Code CWE 250 O

The level of security and/or sensitivity surrounding the order 29 Order Type CWE 250 O

: This field indicates whether the order is to be executed in an inpatient setting or an outpatient setting. Suggested values: I Inpatient Order O Outpatient Order 30 Enterer Authorization Mode CNE 250 O

Form of authorization a recorder had from the responsible practitioner to create or change an order. Suggested values: EL Electronic EM E-mail FX Fax IP In Person MA Mail PA Paper PH Phone RE Reflexive (Automated system) VC Video-conference VO Voice 31 Parent Universal Service Identifier CWE 250 O

Identifier code for the parent order which caused this reflex observation/test/battery to be performed.

34

Version1.2

HL7 Version 2.6 Companion Guide

NK1 - Next of Kin Segment The NK1 segment contains information about the patients spouse, parents or other relatives.
Sequence 1 Transaction Identifier number 2 Name XPN 250 O Element Name Set ID NK1 Data Types SI Length 4 Required R

Name of the next of kin or associated party 3 Relationship CWE 705 O

Relation between NOK and Patient. Suggested values: SEL Self SPO Spouse DOM Life partner CHD Child GCH Grandchild NCH Natural child SCH Stepchild FCH Foster child DEP Handicapped dependent WRD Ward of court PAR Parent MTH Mother FTH Father CGV Care giver GRD Guardian GRP Grandparent EXF Extended family SIB Sibling BRO Brother SIS Sister FND Friend OAD Other adult EME Employee EMR Employer ASC Associate EMC Emergency contact OWN Owner TRA Trainer MGR Manager NON None UNK Unknown OTH Other 4 Address XAD 250 O

35

Version1.2

HL7 Version 2.6 Companion Guide

Phone Number

XTN

250

Business Phone Number

XTN

250

Contact Role

CWE

705

Specific contact role. Suggested values: E Employer C Emergency Contact F Federal Agency I Insurance Company N Next-of-Kin S State Agency O Other U Unknown 8 Start Date DT 8 O

End Date

DT

10

Next of Kin / Associated Parties Job Title

ST

60

11

Next of Kin / Associated Parties Job Code/Class

JCC

20

12

Next of Kin / Associated Parties Employee Number

CX

250

Number that the employer assigns to the employee that is acting as next of kin/associated parties. 13 Organization Name NK1 XON 250 O

Name of the organization that serves as a next of kin/associated party or as the next of kin of the patient. 14 Marital Status CWE 705 O

15

Administrative Sex

IS

16

Date/Time of Birth

DTM

24

36

Version1.2

HL7 Version 2.6 Companion Guide

17

Living Dependency

IS

Specific living conditions that are relevant to an evaluation of the patient's healthcare needs 18 Ambulatory Status IS 2 O

The transient rate of mobility for the NOK. 19 Citizenship CWE 705 O

20

Primary Language

CWE

705

21

Living Arrangement

IS

Situation that the associated party lives. Suggested values: A Alone F Family I Institution R Relative U Unknown S Spouse Only 22 Level of publicity allowed 23 Protection Indicator ID 1 O Publicity Code CWE 705 O

Suggested values: Y protect access to next-of-kin information N normal access 24 Student Indicator IS 2 O

Identifies whether the NOK is currently a student or not 25 Religion CWE 705 O

Type of religion practiced by the NOK. 26 Mothers Maiden Name XPN 250 O

27

Nationality

CWE

705

28

Ethnic Group

CWE

705

37

Version1.2

HL7 Version 2.6 Companion Guide

29

Contact Reason

CWE

705

Identifies how the contact should be used. 30 Contact Persons Name XPN 250 O

31

Contact Persons Telephone Number

XTN

250

32

Contact Persons Address

XAD

250

33

Next of Kin/Associated Partys Identifiers

CX

250

The identifiers for NOK. 34 Suggested values: P Permanent T Temporary O Other U Unknown 35 Race CWE 705 O Job Status IS 2 O

36

Handicap

IS

37

Contact Person Social Security Number

ST

16

38

Next of Kin Birth Place

ST

250

39

VIP Indicator

IS

38

Version1.2

HL7 Version 2.6 Companion Guide

NTE Notes and Comments Segment

Sequence 1 Element Name Set Id Notes and Comments Data Types SI Length 4 Required O

This field may be used where multiple NTE segments are included in a message. Their numbering must be described in the application message definition. 2 Source of Comment ID 8 O

This field is used when source of comment must be identified. This table may be extended locally during implementation. 3 Comment FT 65536 O

This field contains the comment contained in the segment. 4 Comment Type CWE 250 O

This field contains a value to identify the type of comment text being sent in the specific comment record. 5 Entered By XCN 3220 O

This field contains the identity of the person who actually keyed the comment into the application. It provides an audit trail in case the comment is entered incorrectly and the ancillary department needs to clarify the comment. By local agreement, either the ID number or name component may be omitted. 6 Entered Date/Time DTM 24 O

This field contains the actual date the comment was keyed into the application 7 Effective Start Date DTM 24 O

This field contains the date the comment becomes or became effective. 8 Expiration Date DTM 24 O

This field contains the date the comment becomes or became non-effective.

39

Version1.2

HL7 Version 2.6 Companion Guide

AL1 - Patient Allergy Information Segment The AL1 segment contains patient allergy information of various types.
Sequence 1 Transaction Identifier 2 Allergen Type Code CWE 705 O Element Name Set ID - AL1 Data Types SI Length 4 Required R

Suggested values: DA Drug allergy FA Food allergy MA Miscellaneous allergy MC Miscellaneous contraindication EA Environmental Allergy AA Animal Allergy PA Plant Allergy LA Pollen Allergy 3 Allergen Code/Mnemonic/Description CWE 705 R

Identifies a particular allergen. 4 Suggested values: SV Severe MO Moderate MI Mild U Unknown 5 Allergy Reaction Code ST 15 O Allergy Severity Code CWE 705 O

Identifies the specific allergic reaction that was documented 6 Identification Date DT 8 B

Date that the allergy was identified

40

Version1.2

HL7 Version 2.6 Companion Guide

DSC Continuation Pointer Segment

Sequence 1 Element Name Continuation Pointer Data Types ST Length 180 Required

41

Version1.2

HL7 Version 2.6 Companion Guide

DG1 - Diagnosis Segment The DG1 segment contains patient diagnosis information of various types.
Sequence 1 Transaction Identifier 2 Diagnosis Coding Method W Element Name Set ID - DG1 Data Types SI Length 4 Required R

Withdrawn and removed from standards. 3 Diagnosis Code - DG1 CWE 250 R

Diagnosis Code assigned to this diagnosis 4 Diagnosis Description W

Diagnosis Date/Time

DTM

24

Date/time that the diagnosis was determined 6 Diagnosis Type IS 2 R

Identifies the type of diagnosis being sent. Suggested values: A Admitting W Working F Final 7 Major Diagnostic Category W

Diagnostic Related Group

DRG Approval Indicator

10

DRG Grouper Review Code

11

Outlier Type

12

Outlier Days

42

Version1.2

HL7 Version 2.6 Companion Guide

13

Outlier Cost

14

Grouper Version And Type

15

Diagnosis Priority

ID

Number that identifies the significance or priority of the diagnosis code. Suggested values: 0 Not included in diagnosis ranking 1 The primary diagnosis 2 For ranked secondary diagnoses 16 Diagnosing Clinician XCN 250 O

Individual responsible for generating the diagnosis information 17 Diagnosis Classification IS 3 O

Patient information is for a diagnosis or a non-diagnosis code. Suggested values: C Consultation D Diagnosis M Medication (antibiotic) O Other R Radiological scheduling (not using ICDA codes) S Sign and symptom T Tissue diagnosis I Invasive procedure not classified elsewhere (I.V., catheter, etc.) 18 Confidential Indicator ID 1 O

Valid values: Y the diagnosis is a confidential diagnosis N the diagnosis does not contain a confidential diagnosis 19 Attestation Date/Time DTM 24 O

Date and time that the attestation was signed. 20 Diagnosis Identifier EI 427 C

Uniquely identifies a single diagnosis for an encounter 21 Diagnosis Action Code ID 1 C

Action to be taken for this diagnosis 22 Parent Diagnosis EI 427 C

Entity identifier for the parent diagnosis 23 DRG CCL Value Code CWE 705 O

CCL value for the determined DRG for this diagnosis. Suggested values:

43

Version1.2

HL7 Version 2.6 Companion Guide

0 1 2 3 4 24

Nothing obvious Low Moderate High Very high DRG Grouping Usage ID 20 O

Suggested values: Y Yes - Indicates that the diagnosis has been used for the DRG determination N No Indicates that the diagnosis has not been used for the DRG determination 25 DRG Diagnosis Determination Status IS 20 O

Status of this particular diagnosis for the DRG determination. Suggested values: 0 Valid code 1 Invalid code 2 Two primary diagnosis codes 3 Invalid for this gender 4 Invalid for this age 26 Present On Admission (POA) Indicator IS 1 O

The present on admission indicator for this particular diagnosis. Suggested values: Y Yes N No U Unknown W Not applicable E Exempt

44

Version1.2

HL7 Version 2.6 Companion Guide

OBR Observation Request Segment This segment is used in the message when a set of observations is ordered. However observations can be collected and reported without an antecedent order. There can be more observations reported which is notified by including more OBR segments in the message. So, one can say that OBR segment is like a turn-around. Some fields in the OBR segment apply only to ordering message and some to reporting message. It contains many of the attributes that apply to all of the included observations. Read column Sequence as OBR-1, OBR-2, OBR-3 so on. If OBR segment is present in the document, the required data elements are elaborated with definitions in the same table.
Sequence 1 Element Name Set ID OBR Data Types SI Length 4 Required O

For the first order transmitted, the sequence number shall be 1; for the second order, it shall be 2; and so on 2 Placer Order Number EI 427 C

Filler Order Number

EI

427

Order number associated with the filling application 4 Universal Service Identifier CWE 705 R

This field contains the identifier code for the requested observation/test/battery. This can be based on local and/or "universal" codes. 5 Priority ID 2 B

This field has been retained for backward compatibility only. It is not used. Previously priority (e.g., STAT, ASAP), but that information is carried as the sixth component of OBR-27-quantity/timing. 6 Requested Date/Time DTM 24 C

This field has been retained for backward compatibility only. It is not used. Previously requested date/time. That information is carried as the fourth component of OBR-27-quantity/timing. 7 Observation Date/Time DTM 24 O

This field is the clinically relevant date/time of the observation. In the case of observations taken directly from a subject, it is the actual date and time the observation was obtained. 8 Observation End Date/Time DTM 24 O

The end date and time of a study or timed specimen collection 9 Collection Volume CQ 722 O

The collection volume is the volume of a specimen 10 Collector Identifier XCN 3220 O

When a specimen is required for the study, this field will identify the person, department, or facility that collected the specimen. Either name or ID code, or both, may be present. 11 Specimen Action Code ID 1 O

45

Version1.2

HL7 Version 2.6 Companion Guide

Action to be taken with respect to the specimens that accompany or precede this order 12 Danger Code CWE 705 O

Code and/or text indicating any known or suspected patient or specimen hazards 13 Relevant Clinical Information ST 300 O

Additional clinical information about the patient or specimen 14 Specimen Received Date/Time DTM 24 B

For observations requiring a specimen, the specimen received date/time is the actual login time at the diagnostic service. 15 Specimen Source SPS 300 B

This field identifies the site where the specimen should be obtained or where the service should be performed. 16 Ordering Provider XCN 3220 O

The provider who ordered the test 17 Order Callback Phone Number XTN 2743 O

Telephone number for reporting a status or a result using the standard format with extension and/or beeper number when applicable. 18 Placer Field 1 ST 199 O

19

Placer Field 2

ST

199

20

Filler Field 1

ST

199

21

Filler Field 2

ST

199

22

Results Rpt/Status Change - Date/Time

DTM

24

This field specifies the date/time results reported or status changed. This field is used to indicate the date and time that the results are composed into a report and released 23 Charge to Practice MOC 504 O

Charge to the ordering entity for the studies performed when applicable 24 Diagnostic Service Sect ID ID 10 O

Diagnostic service where the observation was performed. 25 Result Status ID 1 C

46

Version1.2

HL7 Version 2.6 Companion Guide

This field is the status of results for this order. This conditional field is required whenever the OBR is contained in a report message. It is not required as part of an initial order. 26 Parent Result PRL 977 O

27

Quantity/Timing

TQ

705

This field contains information about how many services to perform at one service time and how often the service times are repeated, and to fix duration of the request. 28 Result Copies To XCN 3220 O

Individuals who are to receive copies of the results 29 Parent EIP 855 O

30

Transportation Mode

ID

20

This field identifies how (or whether) to transport a patient, when applicable 31 Reason for Study CWE 705 O

32

Principal Result Interpreter

NDL

831

This field identifies the physician or other clinician who interpreted the observation and is responsible for the report content. 33 Assistant Result Interpreter NDL 831 B

This field identifies the clinical observer who assisted with the interpretation of this study. 34 Technician NDL 831 B

This field identifies the performing technician. 35 Transcriptionist NDL 831 B

This field identifies the report transcriber. 36 Scheduled Date/Time DTM 24 O

The date/time the filler scheduled an observation, when applicable. 37 Number of Sample Containers NM 16 O

Number of containers for a given sample 38 Transport Logistics of Collected Sample CWE 705 O

Means by which a sample reaches the diagnostic service provider 39 Collector's Comment CWE 705 O

47

Version1.2

HL7 Version 2.6 Companion Guide

Additional comments related to the sample 40 Transport Arrangement Responsibility CWE 705 O

An indicator of who is responsible for arranging transport to the planned diagnostic service. 41 Transport Arranged ID 30 O

Indicator of whether transport arrangements are known to have been made 42 Escort Required ID 1 O

An indicator that the patient needs to be escorted to the diagnostic service department. 43 Planned Patient Transport Comment CWE 705 O

Code or free text comments on special requirements for the transport of the patient to the diagnostic service department 44 Procedure Code CNE 705 O

Unique identifier assigned to the procedure, if any, associated with the charge 45 Procedure Code Modifier CNE 705 O

Procedure code modifier to the procedure code reported in OBR-44-procedure code, when applicable. 46 Placer Supplemental Service Information CWE 705 O

Supplemental service information sent from the placer system to the filler system for the universal procedure code reported in OBR-4 Universal Service ID. 47 Filler Supplemental Service Information CWE 705 O

Supplemental service information sent from the filler system to the placer system for the procedure code reported in OBR-4 Universal Service ID. Medically Necessary Duplicate Procedure CWE 705 C Reason This field is used to document why the procedure found in OBR-44 - Procedure Code is a duplicate of one ordered/charged previously for the same patient within the same date of service and has been determined to be medically necessary. The reason may be coded or it may be a free text entry. 48 49 Result Handling IS 2 O

Transmits information regarding the handling of the result 50 Parent Universal Service Identifier CWE 705 O

48

Version1.2

HL7 Version 2.6 Companion Guide

OBX Observation/Result Segment The OBX segment is used to transmit a single observation or observation fragment.
Sequence 1 Sequence Number 2 Value Type ID 3 C Element Name Set ID OBX Data Types SI Length 4 Required O

Format of the observation value in OBX. Suggested values: AD Address CWE Coded Entry CF Coded Element With Formatted Values CK Composite ID With Check Digit CN Composite ID And Name CP Composite Price CX Extended Composite ID With Check Digit DT Date ED Encapsulated Data FT Formatted Text (Display) MO Money NM Numeric PN Person Name RP Reference Pointer SN Structured Numeric ST String Data. TM Time TN Telephone Number DTM Time Stamp (Date & Time) TX Text Data (Display) XAD Extended Address XCN Extended Composite Name And Number For Persons XON Extended Composite Name And Number For Organizations XPN Extended Person Name XTN Extended Telecommunications Number 3 Observation Identifier CWE 705 R

Unique identifier for the observation 4 Observation Sub-ID ST 20 C

Used to distinguish between multiple OBX segments with the same observation ID organized under one OBR 5 Observation Value Varies 99999 C

Value observed by the observation producer 6 Units CWE 705 O

49

Version1.2

HL7 Version 2.6 Companion Guide

References Range

ST

60

When the observation quantifies the amount of a toxic substance, then the upper limit of the range identifies the toxic limit. 8 Abnormal Flags IS 5 O

Table lookup indicating the normalcy status of the result. Suggested values: L Below low normal H Above high normal LL Below lower panic limits HH Above upper panic limits < Below absolute low-off instrument scale > Above absolute high-off instrument scale N Normal (applies to non-numeric results) A Abnormal (applies to non-numeric results) AA Very abnormal (applies to non-numeric units, analogous to panic limits for numeric units) null No range defined, or normal ranges don't apply U Significant change up D Significant change down B Better--use when direction not relevant W Worse--use when direction not relevant S Susceptible. Indicates for microbiology susceptibilities only. R Resistant. Indicates for microbiology susceptibilities only. I Intermediate. Indicates for microbiology susceptibilities only. MS Moderately susceptible. Indicates for microbiology susceptibilities only. VS Very susceptible. Indicates for microbiology susceptibilities only. 9 Probability NM 5 O

Probability of a result being true for results with categorical values 10 Nature of Abnormal Test ID 2 O

Nature of the abnormal test. Suggested values: A An age-based population N None - generic normal range R A race-based population S A sex-based population SP Species B Breed ST Strain 11 Observation Result Status ID 1 R

Suggested values: C Record coming over is a correction and thus replaces a final result D Deletes the OBX record F Final results; Can only be changed with a corrected result. I Specimen in lab; results pending N Not asked; used to affirmatively document that the observation identified in the OBX was not sought when the universal service ID in OBR-4 implies that it would be sought. O Order detail description only (no result)

50

Version1.2

HL7 Version 2.6 Companion Guide

P Preliminary results R Results entered -- not verified S Partial results. Deprecated. Retained only for backward compatibility as of V2.6. X Results cannot be obtained for this observation U Results status change to final without retransmitting results already sent as preliminary. changes status from preliminary to final W Post original as wrong, e.g., transmitted for wrong patient 12 Effective Date of Reference Range DTM 24

E.g., radiology

Date and time on which the values in OBX-7-reference range went into effect. 13 User Defined Access Checks ST 20 O

The producer to record results-dependent codes for classifying the observation at the receiving system 14 Date/Time of the Observation DTM 24 O

15

Producer's ID

CWE

705

Unique identifier of the responsible producing service 16 Responsible Observer XCN 3220 O

17

Observation Method

CWE

705

18

Equipment Instance Identifier

EI

427

The Equipment Instance responsible for the production of the observation 19 Date/Time of the Analysis DTM 24 O

Time stamp associated with generation of the analytical result by the instrument specified in Equipment Instance Identifier 20 Observation Site CWE 705 O

Body site(s) where the measurement being reported was obtained 21 Observation Instance Identifier EI 427 O

Unique identifier for this observation 22 Mood Code CNE 705 C

23

Performing Organization Name

XON

570

Name of the organization/service responsible for performing the service

51

Version1.2

HL7 Version 2.6 Companion Guide

24

Performing Organization Address

XAD

2915

Address of the organization/service responsible for performing the service. 25 Performing Organization Medical Director XCN 3220 O

Medical director of the organization/service responsible for performing the service.

52

Version1.2

HL7 Version 2.6 Companion Guide

QRD Query Definition Segment The QRD segment is used to define a query.
Sequence 1 Element Name Query Date/Time Data Types DTM Length 24 Required R

Date the query was generated by the application program 2 Query Format Code ID 1 R

Suggested values: D Response is in display format R Response is in record-oriented format T Response is in tabular format 3 Query Priority ID 1 R

Time frame in which the response is expected. Suggested values: D Deferred I Immediate 4 Unique identifier for the query 5 Deferred Response Type ID 1 O Query ID ST 10 R

Valid values: B Before the Date/Time specified L Later than the Date/Time specified 6 Deferred Response Date/Time DTM 24 O

Date/time before or after which to send a deferred response. 7 Quantity Limited Request CQ 10 R

Maximum length of the response that can be accepted by the requesting system. Suggested values: CH Characters LI Lines PG Pages RD Records ZO Locally defined 8 Who Subject Filter XCN 250 R

Identifies the subject, or who the inquiry is about. 9 What Subject Filter CWE 250 R

What kind of information that is required to satisfy the request. Suggested values: ADV Advice/diagnosis ANU Nursing unit lookup (returns patients in beds, excluding empty beds) APN Patient name lookup APP Physician lookup

53

Version1.2

HL7 Version 2.6 Companion Guide

ARN APM APA CAN DEM FIN GID GOL MRI MRO NCK NSC NST ORD OTH PRB PRO RES RAR RER RDR RGR ROR SAL SBK SBL SOF SOP SSA SSR STA VXI XID 10

Nursing unit lookup (returns patients in beds, including empty beds) Medical record number query, returns visits for a medical record number Account number query, return matching visit Cancel. Used to cancel a query Demographics Financial Generate new identifier Goals Most recent inpatient Most recent outpatient Network clock Network status change Network statistic Order Other Problems Procedure Result Pharmacy administration information Pharmacy encoded order information Pharmacy dispense information Pharmacy give information Pharmacy prescription information All schedule related information, including open slots, booked slots, blocked slots Booked slots on the identified schedule Blocked slots on the identified schedule First open slot on the identified schedule after the start date/tiem Open slots on the identified schedule between the begin and end of the start date/time range Time slots available for a single appointment Time slots available for a recurring appointment Status Vaccine Information Get cross-referenced identifiers What Department Data Code CWE 250 R

The contents of this field are determined by the contents of the previous field. 11 What Data Code Value Qualifier VR 20 O

Start and stop values separated by a component separator 12 Query Results Level ID 1 O

Control level of detail in results. Suggested values: O Order plus order status R Results without bulk text S Status only T Full results

54

Version1.2

HL7 Version 2.6 Companion Guide

QRF Query Filter Segment The QRF segment is used with the QRD segment to further refine the content of an original style query.
Sequence 1 Element Name Where Subject Filter Data Types ST Length 20 Required R

Department, system, or subsystem to which the query pertains 2 When Data Start Date/Time DTM 24 B

Dates and times equal to or after which this value should be included 3 When Data End Date/Time DTM 24 B

Dates and times equal to or before which this date should be included. 4 What User Qualifier ST 60 O

An identifier to further define characteristics of the data of interest 5 Other QRY Subject Filter ST 60 O

A filter defined locally for use between two systems 6 Which Date/Time Qualifier ID 12 O

The type of date referred to in QRF-2-When data start date/time and QRF-3-When data end date/time. Suggested values: ANY Any date/time within a range COL Collection date/time, equivalent to film or sample collection date/time ORD Order date/time RCT Specimen receipt date/time, receipt of specimen in filling ancillary (Lab) REP Report date/time, report date/time at filing ancillary (i.e., Lab) SCHED Schedule date/time 7 Which Date/Time Status Qualifier ID 12 O

Status type of objects selected in date range defined by QRF-2-When data start date/time and QRF-3-When data end date/time. Suggested values: ANY Any status CFN Current final value, whether final or corrected COR Corrected only (no final with corrections) FIN Final only (no corrections) PRE Preliminary REP Report completion date/time 8 Date/Time Selection Qualifier ID 12 O

Specification of certain types of values within the date/time range. Suggested values: 1ST First value within range ALL All values within the range LST Last value within the range REV All values within the range returned in reverse chronological order (This is the default if not otherwise specified.)

55

Version1.2

HL7 Version 2.6 Companion Guide

When Quantity/Timing Qualifier

TQ

60

Allows an interval definition to be used for specifying multiple responses to a query 10 Search Confidence Threshold NM 10 O

Numeric value used to establish the minimum threshold match. The value instructs the responding system to return no records for patients whose "match weight" on the look-up was lower than this user-defined value.

56

Version1.2

HL7 Version 2.6 Companion Guide

PR1 Procedures Segment The PR1 segment contains information relative to various types of procedures that can be performed on a patient.
Sequence 1 Transaction Identifier. 2 Procedure Coding Method W Element Name Set ID - PR1 Data Types SI Length 4 Required R

Procedure Code

CNE

705

Unique identifier assigned to the procedure 4 Procedure Description W

Procedure Date/Time

DTM

24

Date/time that the procedure was performed. 6 Procedure Functional Type IS 2 O

Optional code that further defines the type of procedure. Suggested values: A Anesthesia P Procedure for treatment (therapeutic, including operations) I Invasive procedure not classified elsewhere (e.g., IV, catheter, etc.) D Diagnostic procedure 7 Procedure Minutes NM 4 O

Indicates the length of time in whole minutes that the procedure took to complete. 8 Anesthesiologist W

Anesthesia Code

IS

Unique identifier of the anesthesia used during the procedure 10 Anesthesia Minutes NM 4 O

Length of time in minutes that the anesthesia was administered. 11 Surgeon W

12

Procedure Practitioner

57

Version1.2

HL7 Version 2.6 Companion Guide

13

Consent Code

CWE

250

Type of consent that was obtained for permission to treat the patient. 14 Procedure Priority ID 2 O

Number that identifies the significance or priority of the procedure code. Suggested values: 0 the admitting procedure 1 the primary procedure 2 for ranked secondary procedures 15 Associated Diagnosis Code CWE 250 O

Diagnosis that is the primary reason this procedure was performed 16 Procedure Code Modifier CNE 705 O

Procedure code modifier to the procedure code reported in field 3, when applicable 17 Procedure DRG Type IS 20 O

Procedures priority ranking relative to its DRG. Suggested values: 1 1st non-Operative 2 2nd non-Operative 3 Major Operative 4 2nd Operative 5 3rd Operative 18 Tissue Type Code CWE 250 O

Type of tissue removed from a patient during this procedure. Suggested values: 1 Insufficient Tissue 2 Not abnormal 3 Abnormal-not categorized 4 Mechanical abnormal 5 Growth alteration 6 Degeneration & necrosis 7 Non-acute inflammation 8 Non-malignant neoplasm 9 Malignant neoplasm 0 No tissue expected B Basal cell carcinoma C Carcinoma-unspecified type G Additional tissue required 19 Procedure Identifier EI 427 C

A value that uniquely identifies a single procedure for an encounter. 20 Procedure Action Code ID 1 C

The action to be taken for this procedure

58

Version1.2

HL7 Version 2.6 Companion Guide

21

DRG Procedure Determination Status

IS

20

Status of the use of this particular procedure for the DRG determination. Suggested values: 0 Valid code 1 Invalid code 2 Not used 3 Invalid for this gender 4 Invalid for this age 22 DRG Procedure Relevance IS 20 O

The relevance of this particular procedure for the DRG determination. Suggested values: 0 Neither operation relevant nor non-operation relevant procedure 1 Operation relevant procedure 2 Non-operation relevant procedure

59

Version1.2

HL7 Version 2.6 Companion Guide

GT1 Procedures Segment The GT1 segment contains information relative to various types of procedures that can be performed on a patient.
Sequence 1 Transaction Identifier. 2 Guarantor Number CX 250 O Element Name Set ID - GT1 Data Types SI Length 4 Required R

The primary identifier assigned to the guarantor 3 Name of the guarantor 4 Guarantor Spouse Name XPN 250 O Guarantor Name XPN 250 R

Name of the guarantors spouse 5 Guarantor Address XAD 250 O

Guarantor Phone Number - Home

XTN

250

Guarantor Phone Number - Business

XTN

250

Guarantor Date/Time Of Birth

DTM

24

9 Guarantors gender 10

Guarantor Administrative Sex

IS

Guarantor Type

IS

Type of guarantor, e.g., individual, institution 11 Guarantor Relationship CWE 250 O

Relationship of the guarantor with the patient 12 Guarantor SSN ST 11 O

13

Guarantor Date - Begin

DT

60

Version1.2

HL7 Version 2.6 Companion Guide

Date that the guarantor becomes responsible for the patients account 14 Guarantor Date - End DT 8 O

Date that the guarantor stops being responsible for the patients account 15 Guarantor Priority NM 2 O

Determine the order in which the guarantors are responsible for the patients account. Suggested values: 1 primary guarantor 2 secondary guarantor 16 Guarantor Employer Name XPN 250 O

17

Guarantor Employer Address

XAD

250

18

Guarantor Employer Phone Number

XTN

250

19

Guarantor Employee ID Number

CX

250

20

Guarantor Employment Status

IS

Suggested values: 1 Full time employed 2 Part time employed 4 Self-employed, C Contract, per diem L Leave of absence (e.g., family leave, sabbatical, etc.) T Temporarily unemployed 3 Unemployed 5 Retired 6 On active military duty O Other 9 Unknown 21 Guarantor Organization Name XON 250 O

The name of the guarantor when the guarantor is an organization. 22 Guarantor Billing Hold Flag ID 1 O

Indicates whether or not a system should suppress printing of the guarantors bills. Suggested values: Y a system should suppress printing of guarantors bills N a system should not suppress printing of guarantors bills 23 Guarantor Credit Rating Code CWE 250 O

61

Version1.2

HL7 Version 2.6 Companion Guide

Guarantors credit rating 24 Guarantor Death Date And Time DTM 24 O

Date and time at which the guarantors death occurred 25 Guarantor Death Flag IS 1 O

Indicates whether or not the guarantor is deceased. Valid values: Y the guarantor is deceased N the guarantor is living 26 Guarantor Charge Adjustment Code CWE 250 O

Indicate which adjustments should be made to this guarantors charges. 27 Guarantor Household Annual Income CP 10 O

Combined annual income of all members of the guarantors household 28 Guarantor Household Size NM 3 O

Number of people living at the guarantors primary residence 29 Guarantor Employer ID Number CX 250 O

Uniquely identifies the guarantors employer when the employer is a person 30 Guarantor Marital Status Code CWE 250 O

Marital status of the guarantor 31 Guarantor Hire Effective Date DT 8 O

Date that the guarantors employment began 32 Employment Stop Date DT 8 O

Date on which the guarantors employment with a particular employer ended. 33 Living Dependency IS 2 O

Specific living conditions of the guarantor 34 Ambulatory Status IS 2 O

The transient state of mobility for the guarantor 35 Citizenship CWE 705 O

36

Primary Language

CWE

705

37

Living Arrangement

IS

62

Version1.2

HL7 Version 2.6 Companion Guide

Situation in which the person lives at his residential address 38 Publicity Code CWE 705 O

Level of publicity allowed for a guarantor. 39 Protection Indicator ID 1 O

Whether or not access to information about this enrollee should be restricted from users who do not have adequate authority. Valid values: Y restrict access N do not restrict access 40 Suggested values: F Full-time student P Part-time student N Not a student 41 Religion CWE 705 O Student Indicator IS 2 O

42

Mothers Maiden Name

XPN

250

43

Nationality

CWE

705

44

Ethnic Group

CWE

705

45

Contact Persons Name

XPN

250

46

Contact Persons Telephone Number

XTN

250

47

Contact Reason

CWE

705

The reason for contacting the guarantor 48 Contact Relationship IS 3 O

Guarantor relationship to the contact person 49 Job Title ST 20 O

50

Job Code/Class

JCC

20

63

Version1.2

HL7 Version 2.6 Companion Guide

51

Guarantor Employers Organization Name

XON

250

Name of the guarantors employer when the guarantors employer is an organization 52 Handicap IS 2 O

Code to describe the guarantors disability 53 Job Status IS 2 O

Code to describe the guarantors job status 54 Guarantor Financial Class FC 50 O

55

Guarantor Race

CWE

250

56

Guarantor Birth Place

ST

250

57

VIP Indicator

IS

64

Version1.2

HL7 Version 2.6 Companion Guide

IN1 Procedures Segment The IN1 segment contains insurance policy coverage information necessary to produce properly pro-rated and patient and insurance bills.
Sequence 1 Transaction Identifier 2 Unique Id for Insurance plan 3 Insurance Company ID CX 250 R Insurance Plan ID CWE 250 R Element Name Set ID - IN1 Data Types SI Length 4 Required R

Unique identifiers for the insurance company 4 Insurance Company Name XON 250 O

Insurance Company Address

XAD

250

Insurance Co Contact Person

XPN

250

Name of the contact person from the insurance company 7 Insurance Co Phone Number XTN 250 O

Group Number

ST

12

Group number of the insureds insurance 9 Group Name XON 250 O

Group name of the insureds insurance 10 Insureds Group Employee ID CX 250 O

Group employer ID for the insureds insurance 11 Insureds Group Employee Name XON 250 O

Name of the employer that provides the employees insurance 12 Plan Effective Date DT 8 O

13

Plan Expiration Date

ST

65

Version1.2

HL7 Version 2.6 Companion Guide

14

Authorization Information

AUI

239

Date and source of authorization for some coverage plans that require an authorization number or code. 15 Plan Type IS 3 O

16 Name of the insured person 17

Name Of Insured

XPN

250

Insureds Relationship To Patient

CWE

250

Insureds relationship to the patient 18 Date of birth of the insured 19 Address of the insured person 20 Assignment Of Benefits IS 2 O Insureds Address XAD 250 O Insureds Date Of Birth DTM 24 O

Indicates whether the insured agreed to assign the insurance benefits to the healthcare provider. Suggested values: Y Yes N No M Modified assignment 21 Coordination Of Benefits IS 2 O

Indicates whether this insurance works in conjunction with other insurance plans or is it provides independent coverage. Suggested values: CO Coordination IN Independent 22 Coordination Of Benefit Priority ST 2 O

If the insurance works in conjunction with other insurance plans, this field contains priority sequence 23 Notice Of Admission Flag IS 1 O

Indicates whether the insurance company requires a written notice of admission from the healthcare provider. Suggested values: Y written notice of admission required N no notice required 24 Notice sent date 25 Report Of Eligibility Flag ID 1 O Notice Of Admission Date ST 8 O

66

Version1.2

HL7 Version 2.6 Companion Guide

Indicates whether this insurance carrier sends a report that indicates that the patient is eligible for benefits and whether it identifies those benefits. Suggested values: Y eligibility report is sent N no eligibility report is sent 26 Report Of Eligibility Date DT 8 O

Indicates whether a report of eligibility (ROE) was received, and also indicates the date that it was received. 27 Release Information Code IS 2 O

Indicates whether a report of eligibility (ROE) was received, and also indicates the date that it was received. Suggested values: Y Yes N No 28 Pre-Admit Cert (PAC) ST 15 O

pre admission certification code 29 Verification Date/Time DTM 24 O

Date/time that the healthcare provider verified that the patient has the indicated benefits. 30 Person who verified the benefits 31 Type Of Agreement Code IS 2 O Verification By XCN 250 O

Identification of an insurance plan. Suggested values: S Standard U Unified M Maternity 32 Billing Status IS 2 O

Indicates whether the particular insurance has been billed 33 Lifetime Reserve Days NM 4 O

Number of days left for a certain service to be provided or covered under an insurance policy. 34 Delay Before Lifetime Reserve Day NM 4 O

Delay before lifetime reserve days 35 Company Plan Code IS 20 O

36

Policy Number

ST

15

Individual policy number of the insured to uniquely identify this patients plan 37 Policy Deductible CP 12 O

67

Version1.2

HL7 Version 2.6 Companion Guide

Amount specified by the insurance plan that is the responsibility of the guarantor. 38 Policy Limit - Amount W

39

Policy Limit - Days

NM

Maximum number of days that the insurance policy will cover 40 Room Rate - Semi-Private W

41

Room Rate - Private

42

Insureds Employment Status

CWE

250

Employment status of the insured. 43 Gender of the insured 44 Insureds Employers Address XAD 250 O Insureds Administrative Sex IS 1 O

Address of the insured employees employer 45 Verification Status ST 2 O

Status of this patients relationship with this insurance carrier 46 Prior Insurance Plan ID IS 8 O

Identifies the prior insurance plan when the plan ID changes 47 Coverage Type IS 3 O

Coding structure that identifies the type of insurance coverage. Suggested values: H Hospital/institutional P Physician/professional B Both hospital and physician RX Pharmacy 48 Handicap IS 2 O

Code to describe the insureds disability 49 Insureds ID Number CX 250 O

Healthcare institutions identifiers for the insured 50 Signature Code IS 1 O

68

Version1.2

HL7 Version 2.6 Companion Guide

Indicate how the patient/subscriber authorization signature was obtained and how it is being retained by the provider. Suggested values: C Signed CMS-1500 claim form on file, e.g., authorization for release of any medical or other information necessary to process this claim and assignment of benefits. S Signed authorization for release of any medical or other information necessary to process this claim on file. M Signed authorization for assignment of benefits on file. P Signature generated by provider because the patient was not physically present for services. 51 Signature Code Date DT 8 O

Date on which patient/subscriber authorization signature was obtained 52 Insureds Birth Place ST 250 O

53

VIP Indicator

IS

69

Version1.2

HL7 Version 2.6 Companion Guide

IN2 Procedures Segment The IN2 segment contains additional insurance policy coverage and benefit information necessary for proper billing and reimbursement.
Sequence 1 Employee ID of the insured 2 Insureds Social Security Number ST 11 O Element Name Insureds Employee ID Data Types CX Length 250 Required O

Insureds Employers Name and ID

XCN

250

Employer Information Data

IS

Mail Claim Party

IS

Party to which the claim should be mailed. Suggested values: E Employer G Guarantor I Insurance company O Other P Patient 6 Medicare Health Ins Card Number ST 15 O

Medicare Health Insurance Number (HIN), defined by CMS or other regulatory agencies. 7 Medicaid Case Name XPN 250 O

Medicaid case name, defined by CMS or other regulatory agencies 8 Medicaid Case Number ST 15 O

Medicaid case number, defined by CMS or other regulatory agencies 9 Military Sponsor Name SPN 250 O

Multiple names for the same person may be sent in this field 10 Military ID Number ST 20 O

military ID number, defined by CMS or other regulatory agencies 11 Dependent Of Military Recipient CWE 250 O

12

Military Organization

ST

25

70

Version1.2

HL7 Version 2.6 Companion Guide

13

Military Station

ST

25

14

Military Service

IS

14

15

Military Rank/Grade

IS

16

Military Status

IS

17

Military Retire Date

DT

18

Military Non-Avail Cert On File

ID

Suggested values: Y Certification on file N Certification not on file 19 Suggested values: Y Baby coverage N No baby coverage 20 Valid values: Y Combine bill N Normal billing 21 Blood Deductible ST 1 O Combine Baby Bill ID 1 O Baby Coverage ID 1 O

Blood deductible can be associated with the specific insurance plan via this field. 22 Special Coverage Approval Name XPN 250 O

name of the individual who approves any special coverage 23 Special Coverage Approval Title ST 30 O

the title of the person who approves special coverage 24 Non-Covered Insurance Code IS 8 O

code that describes why a service is not covered 25 Payor ID CX 250 O

71

Version1.2

HL7 Version 2.6 Companion Guide

26

Payor Subscriber ID

CX

250

27

Eligibility Source

IS

Source of information about the insureds eligibility for benefits . Suggested values: 1 Insurance company 2 Employer 3 Insured presented policy 4 Insured presented card 5 Signed statement on file 6 Verbal information 7 None 28 Room Coverage Type/Amount RMC 82 O

Room type, amount type and amount covered by the insurance 29 Policy Type/Amount PTA 56 O

Policy type and amount covered by the insurance 30 Daily Deductible DDI 25 O

The number of days after which the daily deductible begins, the amount of the deductible, and the number of days to apply the deductible. 31 Living Dependency IS 2 O

Specific living conditions for the insured 32 Insureds state of mobility 33 Citizenship CWE 705 O Ambulatory Status IS 2 O

34

Primary Language

CWE

705

35

Living Arrangement

IS

Situation in which the insured person lives at his primary residence. 36 Publicity Code CWE 705 O

37

Protection Indicator

ID

72

Version1.2

HL7 Version 2.6 Companion Guide

Suggested values: Y Restrict access N Do not restrict access 38 Student Indicator IS 2 O

Identifies whether the insured is currently a student or not, and whether the insured is a full-time or a part-time student. 39 Religion CWE 705 O

The type of religion practiced by the insured 40 Mothers Maiden Name XPN 250 O

41

Nationality

CWE

705

42

Ethnic Group

CWE

705

43

Marital Status

CWE

705

44

Insureds Employment Start Date

DT

45

Employment Stop Date

DT

46

Job Title

ST

20

47

Job Code/Class

JCC

20

Code that identifies the insureds job code 48 Job Status IS 2 O

Code that identifies the insureds current job status 49 Employer Contact Person Name XPN 250 O

50

Employer Contact Person Phone Number

XTN

250

51

Employer Contact Reason

IS

73

Version1.2

HL7 Version 2.6 Companion Guide

52

Insureds Contact Persons Name

XPN

250

53

Insureds Contact Person Phone Number

XTN

250

54

Insureds Contact Person Reason

IS

The reason(s) the person should be contacted regarding the insured. 55 Relationship to the Patient Start Date DT 8 O

56

Relationship to the Patient Stop Date

DT

57

Insurance Co Contact Reason

IS

User-defined code that specifies how the contact should be used. Suggested values: 01 Medicare claim status 02 Medicaid claim status 03 Name/address change 58 Insurance Co Contact Phone Number XTN 250 O

59

Policy Scope

IS

User-defined code designating the extent of the coverage for a participating member. 60 Policy Source IS 2 O

Identifies how the policy information got established. 61 Patient Member Number CX 250 O

Identifying number assigned by the payor for each individual covered by the insurance policy issued to the insured. 62 Guarantors Relationship to Insured CWE 250 O

The guarantor to the insurance subscriber. 63 Insureds Phone Number - Home XTN 250 O

64

Insureds Employer Phone Number

XTN

250

74

Version1.2

HL7 Version 2.6 Companion Guide

65

Military Handicapped Program

CWE

250

Military program for the handicapped in which the patient is enrolled. 66 Suspend Flag ID 1 O

Indicates whether charges should be suspended for a patient. Suggested values: Y charges should be suspended N charges should NOT be suspended 67 Copay Limit Flag ID 1 O

Indicates if the patient has reached the co-pay limit so that no more co-pay charges should be calculated for the patient. Suggested values: Y the patient is at or exceeds the co-pay limit N the patient is under the co-pay limit 68 Stoploss Limit Flag ID 1 O

Indicates if the patient has reached the stoploss limit established in the Contract Master. Suggested values: Y the patient has reached the stoploss limit N the patient has not reached the stoploss limit 69 Insured Organization Name and ID XON 250 O

Name of the insured if the insured is an organization 70 Insured Employer Organization Name and ID XON 250 O

Name of the insureds employer, or the organization that purchased the insurance for the insured, if the employer is an organization 71 Race CWE 705 O

72

Patients Relationship to Insured

CWE

705

Relationship of the patient to the insured. Suggested values: 01 Patient is insured 02 Spouse 03 Natural child/insured financial responsibility 04 Natural child/Insured does not have financial responsibility 05 Step child 06 Foster child 07 Ward of the court 08 Employee 09 Unknown 10 Handicapped dependent 11 Organ donor 12 Cadaver donor 13 Grandchild 14 Niece/nephew 15 Injured plaintiff 16 Sponsored dependent

75

Version1.2

HL7 Version 2.6 Companion Guide

17 18 19

Minor dependent of a minor dependent Parent Grandparent

76

Version1.2

HL7 Version 2.6 Companion Guide

IN3 Procedures Segment The IN3 segment contains additional insurance information for certifying the need for patient care.
Sequence 1 Transaction Identifier 2 Certification Number CX 250 O Element Name Set ID - IN3 Data Types SI Length 4 Required R

number assigned by the certification agency 3 Certified By XCN 250 O

Party that approved the certification 4 Certification Required ID 1 O

Indicates whether certification is required. Suggested value: Y certification required N certification not required 5 Penalty MOP 23 O

Penalty, in dollars or a percentage that will be assessed if the pre-certification is not performed. 6 Certification Date/Time DTM 24 O

Date and time stamp that indicates when insurance was certified to exist for the patient. 7 Certification Modify Date/Time DTM 24 O

Date/time that the certification was modified 8 Operator XCN 250 O

Name party who is responsible for sending this certification information 9 Certification Begin Date DT 8 O

10

Certification End Date

DT

11

Days

DTN

Number of days for which this certification is valid 12 Non-Concur Code/Description CWE 250 O

The non-concur code and description for a denied request

77

Version1.2

HL7 Version 2.6 Companion Guide

13

Non-Concur Effective Date/Time

DTM

24

Effective date of the non-concurrence classification 14 Physician Reviewer XCN 250 O

Physician who works with and reviews cases that are pending physician review for the certification agency. 15 Certification Contact ST 48 O

Name of the party contacted at the certification agency who granted the certification and communicated the certification number. 16 Certification Contact Phone Number XTN 250 O

Phone number of the certification contact 17 Appeal Reason CWE 250 O

Reason that an appeal was made on a non-concur for certification 18 Certification Agency CWE 250 O

19

Certification Agency Phone Number

XTN

250

20

Pre-Certification Requirement

ICD

40

Indicates whether pre-certification is required for particular patient types, and the time window for obtaining the certification. Suggested values: Y pre-certification required N no pre-certification required 21 Case Manager ST 48 O

Name of the entity, which is handling this particular patients case 22 Second Opinion Date DT 8 O

23

Second Opinion Status

IS

24

Second Opinion Documentation Received

IS

Use this field if accompanying documentation has been received by the provider. 25 Second Opinion Physician XCN 250 O

Identifier and name of the physician who provided the second opinion

78

Version1.2

HL7 Version 2.6 Companion Guide

IAM - Patient Adverse Reaction Information Segment The IAM segment contains person/patient adverse reaction information of various types.
Sequence 1 Transaction Identifier 2 General allergy category 3 Allergen Code/Mnemonic/Description CWE 705 R Allergen Type Code CWE 705 O Element Name Set ID - IAM Data Types SI Length 4 Required R

4 General severity of the allergy 5

Allergy Severity Code

CWE

705

Allergy Reaction Code

ST

15

Specific allergic reaction that was documented 6 Allergy Action Code CNE 250 R

Code defining the status of the record. Valid values: A Add/Insert D Delete U Update X No change 7 Allergy Unique Identifier EI 427 C

Uniquely identifies a single allergy for a person 8 Reason for IAM 6. 9 Sensitivity to Causative Agent Code CWE 705 O Action Reason ST 60 O

Reason why the patient should not be exposed to a substance. Suggested values: AD Adverse Reaction AL Allergy CT Contraindication IN Intolerance 10 Allergen Group Code/Mnemonic/Description CWE 705 O

11 Date of first reaction.

Onset Date

DT

79

Version1.2

HL7 Version 2.6 Companion Guide

12

Onset Date Text

ST

60

Text description of the above date. 13 Reported Date/Time DTM 8 O

Date/time the allergy was reported to a caregiver. 14 Reported By XPN 250 O

Person reporting the allergy to a caregiver 15 Relationship to Patient Code CWE 705 O

Relationship that the person reporting the allergy has to the patient. Suggested values: SEL Self SPO Spouse DOM Life partner CHD Child GCH Grandchild NCH Natural child SCH Stepchild FCH Foster child DEP Handicapped dependent WRD Ward of court PAR Parent MTH Mother FTH Father CGV Care giver GRD Guardian GRP Grandparent EXF Extended family SIB Sibling BRO Brother SIS Sister FND Friend OAD Other adult EME Employee EMR Employer ASC Associate EMC Emergency contact OWN Owner TRA Trainer MGR Manager NON None UNK Unknown OTH Other 16 Alert Device Code CWE 705 O

Allergy alert device. Suggested values: B Bracelet

80

Version1.2

HL7 Version 2.6 Companion Guide

N Necklace W Wallet Card 17 Allergy Clinical Status Code CWE 705 O

Verification status for the allergy. Suggested values: U Unconfirmed P Pending S Suspect C Confirmed or verified I Confirmed but inactive E Erroneous D Doubt raised 18 Statused by Person XCN 250 O

Identifies the provider who assigned the clinical status to the allergy 19 Statused by Organization XON 250 O

Name of the organization providing the update to the allergy 20 Statused at Date/Time DTM 8 O

81

Version1.2

HL7 Version 2.6 Companion Guide

NPU Bed Status Update Segment The NPU segment allows the updating of census (bed status) data without sending patientspecific data.
Sequence 1 Valid Bed location. 2 Bed Status IS 1 O Element Name Bed Location Data Types PL Length 80 Required R

82

Version1.2

HL7 Version 2.6 Companion Guide

MRG Merge Patient Information Segment The MRG segment provides receiving applications with information necessary to initiate the merging of patient data as well as groups of records.
Sequence 1 Element Name Prior Patient Identifier List Data Types CX Length 250 Required R

Prior Alternate Patient ID

CX

250

Prior Patient Account Number

CX

250

Prior Patient ID

CX

250

Prior Visit Number

CX

250

Prior Alternate Visit ID

CX

250

Prior Patient Name

XPN

250

83

Version1.2

HL7 Version 2.6 Companion Guide

PD1 Patient Additional Demographic Segment The PD1 segment consists of demographic information that is likely to change about the patient.
Sequence 1 Element Name Living Dependency Data Types IS Length 2 Required O

Specific living conditions for evaluation of the patient's healthcare needs. Suggested values: S Spouse Dependent M Medical Supervision Required C Small Children Dependent O Other U Unknown 2 Living Arrangement IS 2 O

Situation in which the patient lives 3 Patient Primary Facility XON 250 O

Name and identifier for the "primary care" healthcare facility 4 Patient Primary Care Provider Name & ID No. XCN 250 B

5 Patient is a student or not. 6

Student Indicator

IS

Handicap

IS

Living Will Code

IS

Indicates whether or not the patient has a living will and the copy should be there with healthcare. 8 Organ Donor Code IS 2 O

Indicates whether the patient wants to donate his/her organs and the documentation should be with healthcare. 9 Separate Bill ID 1 O

Charges for this patient are to be billed separately from other patient bills with the same guarantor. Valid values: Y Bill separately N normal processing 10 Duplicate Patient CX 250 O

Patient is the same or a duplicate of another patient found on the sending system 11 Level of publicity Publicity Code CWE 705 O

84

Version1.2

HL7 Version 2.6 Companion Guide

12 Suggested values: Y protect access to information N normal access 13

Protection Indicator

ID

Protection Indicator Effective Date

DT

14

Place of Worship

XON

250

15

Advance Directive Code

CWE

705

16

Immunization Registry Status

IS

Immunization registry status of the patient. Suggested values: A Active I Inactive L Inactive - Lost to follow-up (cancel contract) M Inactive - Moved or gone elsewhere (cancel contract) P Inactive - Permanently inactive (Do not reactivate or add new entries to the record) O Other U Unknown 17 Immunization Registry Status Effective Date DT 8 O

18

Publicity Code Effective Date

DT

19

Military Branch

IS

Field defined by CMS or other regulatory services. Suggested values: USA US Army USN US Navy USAF US Air Force USMC US Marine Corps USCG US Coast Guard USPHS US Public Health Service NOAA National Oceanic and Atmospheric Administration NATO North Atlantic Treaty Organization AUSA Australian Army AUSN Australian Navy AUSAF Australian Air Force 20 Suggested values: Military Rank/Grade IS 2 O

85

Version1.2

HL7 Version 2.6 Companion Guide

E1... E9 Enlisted O1 ... O9 Officers W1 ... W4 Warrant Officers 21 Suggested values: ACT Active duty RET Retired DEC Deceased 22 Advance Directive Last Verified Date DT 8 O Military Status IS 3 O

86

Version1.2

HL7 Version 2.6 Companion Guide

DB1 - Disability Segment The DB1 segment contains information related to the disability of a person.
Sequence 1 Transaction Identifier 2 Suggested values: PT Patient GT Guarantor IN Insured AP Associated party 3 Disabled Person Identifier CX 250 O Disabled Person Code IS 2 O Element Name Set ID - DB1 Data Types SI Length 4 Required R

Disability Indicator

ID

Indicates if the person's visit is a disability visit. Suggested values: Y a disability visit N not a disability visit 5 Disability Start Date DT 8 O

Disability End Date

DT

Disability Return to Work Date

DT

Authorized date on which the patient can return to work 8 Disability Unable to Work Date DT 8 O

Authorized date span on which the patient is unable to work

87

Version1.2

HL7 Version 2.6 Companion Guide

PDA Patient Death and Autopsy Segment The PDA segment contains information on a patient's death and possible autopsy.
Sequence 1 Reason of the death. 2 Death Location PL 80 O Element Name Death Cause Code Data Types CWE Length 705 Required O

Death Certified Indicator

ID

Suggested values: Y death has been certified N death has not been certified 4 Death Certificate Signed Date/Time DTM 24 O

Death Certified By

XCN

250

Autopsy Indicator

ID

Suggested values: Y an autopsy was performed N an autopsy was not performed 7 Autopsy Start and End Date/Time DR 53 O

Autopsy Performed By

XCN

250

Coroner Indicator

ID

Suggested values: Y Has been assigned to the coroner. N Has not been assigned to the coroner.

88

Version1.2

HL7 Version 2.6 Companion Guide

ARV Access Restrictions Segment The ARV segment is used to communicate the requested/required type of access restrictions from system to system, at both the person/patient and the encounter/visit level.
Sequence 1 Transaction Identifier 2 Access Restriction Action Code CNE 705 R Element Name Set ID Data Types SI Length 4 Required O

Action to be taken for this segment. Suggested values: A Add/Insert D Delete U Update X No change 3 Access Restriction Value CNE 705 R

Information to which access is restricted. Suggested values: ALL All DEM All demographic data LOC Patient Location PID-7 Date of Birth PID-17 Religion HIV HIV status and results STD Sexually transmitted diseases PSY Psychiatric Mental health DRG Drug SMD Sensitive medical data NO None OO Opt out all registries (HIPAA) OI Opt in all registries (HIPAA) 4 Access Restriction Reason CWE 705 O

Reason for the restricted access. Suggested values: PAT Patient Request PHY Physician Request REG Regulatory requirement ORG Organizational policy or requirement EMP Employee of this organization DIA Diagnosis-related VIP Very important person or celebrity 5 Special Access Restriction Instructions ST 250 O

Special instructions about the protection of the patient's data. 6 Access Restriction Date Range DR 49 O

89

Version1.2

HL7 Version 2.6 Companion Guide

ACC Accident Segment The ACC segment contains patient information relative to an accident in which the patient has been involved.
Sequence 1 Element Name Accident Date/Time Data Types DTM Length 24 Required O

2 Type of accident 3

Accident Code

CWE

250

Accident Location

ST

25

Auto Accident State

CWE

250

Accident Job Related Indicator

ID

Suggested values: Y the accident was job related N the accident was not job related 6 Accident Death Indicator ID 12 O

Suggested values: Y the accident was job related N the accident was not job related 7 Entered By XCN 3220 O

Identifies the person entering the accident information 8 Description of the accident 9 Brought In By ST 80 O Accident Description ST 25 O

Person or organization that brought in the patient. 10 Police Notified Indicator ID 1 O

Suggested values: Y the police were notified N the police were not notified. 11 Accident Address XAD 250 O

90

Version1.2

HL7 Version 2.6 Companion Guide

UB1 Uniform Billing 1 Segment

Sequence 1 Transaction Identifier 2 Blood Deductible W Element Name Set ID UB1 Data Types SI Length 4 Required O

Blood Furnished Pints

NM

Amount of blood furnished to the patient for this visit 4 Blood Replaced Pints NM 2 O

The total number of pints of whole blood or units of packed red cells furnished to the patient that were replaced 5 Blood Not Replaced Pints NM 2 O

Blood not replaced, as measured in pints 6 Co Insurance Days NM 2 B

Condition Code

IS

14

Covered Days

NM

Non Covered Days

NM

10

Value Amount & Code

UVC

41

11

Number Of Grace Days

NM

Number of days necessary to arrange for the patients post-discharge care following provider review organization/utilization review (PRO/UR) determination. 12 Special Program Indicator CWE 250 O

An indicator for special funding programs, such as physically handicapped childrens program, family planning, and disability 13 PSRO/UR Approval Indicator CWE 250 O

Code for the provider service review organization/utilization review (PSRO/UR) approval indicator.

91

Version1.2

HL7 Version 2.6 Companion Guide

14

PSRO/UR Approved Stay Fm

DT

PSRO/UR approved stay date (from) 15 PSRO/UR Approved Stay To DT 8 O

PSRO/UR approved stay date (to) 16 Occurrence OCD 259 B

17

Occurrence Span

CWE

250

18

Occur Span Start Date

DT

19

Occur Span End Date

DT

20

UB 82 Locator 2

ST

30

21

UB 82 Locator 9

ST

22

UB 82 Locator 27

ST

23

UB 82 Locator 45

ST

17

92

Version1.2

HL7 Version 2.6 Companion Guide

UB2 UB92 Data Segment The UB2 segment contains data necessary to complete UB92 bills specific to the United States.
Sequence 1 Transaction Identifier 2 Co Insurance Days (9) ST 3 O Element Name Set ID UB1 Data Types SI Length 4 Required O

Number of inpatient days exceeding defined benefit coverage 3 Condition Code (24-30) IS 2 O

Code reporting conditions that may affect payer processing 4 UB92 field 7 5 UB92 field 8 6 Value Amount & Code UVC 41 O Non Covered Days (8) ST 4 O Covered Days (7) ST 3 O

monetary amount and an associated billing code 7 Occurrence Code & Date (32-35) OCD 259 O

UB92 fields 32a, 32b, 33a, 33b, 34a, 34b, 35a, and 35b 8 Occurrence Span Code/Dates (36) OSP 268 O

UB92 Locator 2 (State)

ST

29

10

UB92 Locator 11 (State)

ST

12

11

UB92 Locator 31 (National)

ST

12

Document Control Number

ST

23

13

UB92 Locator 49 (National)

ST

93

Version1.2

HL7 Version 2.6 Companion Guide

14

UB92 Locator 56 (State)

ST

14

15

UB92 Locator 57 (National)

ST

27

16

UB92 Locator 78 (State)

ST

17

Special Visit Count

NM

Total number of special therapy visits.

94

Version1.2

HL7 Version 2.6 Companion Guide

Message Definition - Segment Usage in Each transaction

ORU Unsolicited Observation Message (Event R01) The ORU message is for transmitting laboratory results to other systems. Following are the segments that are generally present in an Lab Result type of transmissions. The elements are explained in detail within this OneHealthport use case. First table identifies ORU^R01 and second identifies ACK^R01 message.
Segments MSH { [ PID [{ NTE }] [ PV1 ] ] { [ ORC ] OBR [ { NTE } ] [ { OBX [ { NTE } ] } ] } } [ DSC ] --- OBSERVATION end --- ORDER_OBSERVATION end --- PATIENT_RESULT end Continuation Pointer Notes and Comments Description Message Header --- PATIENT_RESULT begin --- PATIENT begin Patient Identification Notes and Comments Patient Visit --- PATIENT end --- ORDER_OBSERVATION begin Order common Observations Request Notes and Comments --- OBSERVATION begin

A common use of these transaction sets will be to transmit observations and results of diagnostic studies from the producing system (e.g., clinical laboratory system, EKG system) (the filler), to the ordering system (e.g., HIS order entry, physicians office system) (the placer).

95

Version1.2

HL7 Version 2.6 Companion Guide

ACK Acknowledgement (Event R01) When the unsolicited update is sent from one system to another, the original acknowledgment mode specifies that it be acknowledged at the application level. The reasoning is that it is not sufficient to know that the underlying communications system guaranteed delivery of the message. It is also necessary to know that the receiving application processed the data successfully at a logical application level.
Segments MSH MSA [ ERR ] Description Message Header Message Acknowledgement Error Segment

96

Version1.2

HL7 Version 2.6 Companion Guide

ADT - Admit/Visit Notification (Event A01) In this event, the patient has been admitted and has been assigned to a location (room or bed).
Segments MSH EVN PID [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

97

Version1.2

HL7 Version 2.6 Companion Guide

ADT - Transfer a Patient (Event A02) In this event, a patient has been transferred from one location to another one.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

98

Version1.2

HL7 Version 2.6 Companion Guide

ADT - Discharge a Patient (Event A03) This event marks the end of the patients day in a healthcare facility.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

99

Version1.2

HL7 Version 2.6 Companion Guide

ADT Register a Patient (Event A04) This event denotes that the patient has arrived or checked in as a one-time, or recurring outpatient, and is not assigned to a bed.
Segments MSH EVN PID [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

100

Version1.2

HL7 Version 2.6 Companion Guide

ADT Pre-Admit a Patient (Event A05) This event occurs when a patient undergoes the pre-admission process.
Segments MSH EVN PID [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

101

Version1.2

HL7 Version 2.6 Companion Guide

ADT Transfer an Outpatient to Inpatient (Event A06) This event occurs when a when a patient who was present for a non-admitted visit is being admitted after an evaluation of the seriousness of the patient's condition.
Segments MSH EVN PID [ MRG ] [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Merge Information Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

102

Version1.2

HL7 Version 2.6 Companion Guide

ADT Transfer an Inpatient to Outpatient (Event A07) A "change inpatient to outpatient" message (A07 event) is sent when an inpatient becomes an outpatient and is still receiving care/services.
Segments MSH EVN PID [ MRG ] [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Merge Information Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

103

Version1.2

HL7 Version 2.6 Companion Guide

ADT Update Patient Information (Event A08) This event is used when any patient information has changed but when no other ADT event has occurred.
Segments MSH EVN PID [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

104

Version1.2

HL7 Version 2.6 Companion Guide

ADT Patient Departing (Event A09) The A09 and A10 - patient arriving-tracking events are used when there is a change in a patient's physical location (inpatient or outpatient).
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] [{ DG1 }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result Diagnosis Information

ADT Patient Arriving (Event A10)

Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] [{ DG1 }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result Diagnosis Information

105

Version1.2

HL7 Version 2.6 Companion Guide

ADT Cancel Admit (Event A11) For inpatients, the "cancel admission" message (A11 event) is sent when an earlier "admission" message (A01 event) is canceled, either because of an erroneous entry or because of a revised decision to not admit the patient. For outpatients/ER patients, the message is sent when an earlier "register outpatient" message (A04 event) is canceled for similar reasons. If the patient has orders on file, the patient will be discharged by the application. If no orders are on file, the patient's record will be deleted.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] [{ DG1 }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result Diagnosis Information

106

Version1.2

HL7 Version 2.6 Companion Guide

ADT Cancel Transfer (Event A12) The event is intended to reverse an earlier "transfer" message, either because of an erroneous entry or because of a revised decision to not transfer the patient.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] [{ DG1 }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result Diagnosis Information

107

Version1.2

HL7 Version 2.6 Companion Guide

ADT Cancel Discharge (Event A13) The event is sent when an earlier "discharge patient" message (A03 event) is canceled, either because of erroneous entry or because of a revised decision to not discharge, or end the visit of, the patient.
Segments MSH EVN PID [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

108

Version1.2

HL7 Version 2.6 Companion Guide

ADT Pending Admit (Event A14) This event notifies other systems of a planned admission, when there is a reservation or when patient admission is to occur imminently.
Segments MSH EVN PID [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

109

Version1.2

HL7 Version 2.6 Companion Guide

ADT Pending Transfer (Event A15) This event notifies other systems of a plan to transfer a patient to a new location when the patient has not yet left the old location.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] [{ DG1 }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result Diagnosis Information

110

Version1.2

HL7 Version 2.6 Companion Guide

ADT Pending Discharge (Event A16) This event notifies other systems of a plan to transfer a patient when the patient has not yet left the healthcare facility.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] [{ DG1 }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result Diagnosis Information

111

Version1.2

HL7 Version 2.6 Companion Guide

ADT Swap Patients (Event A17) This event is used to identify two patients that have exchanged beds. The interface will process inbound A17 events, but does not support this event for outbound messages.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

112

Version1.2

HL7 Version 2.6 Companion Guide

QRY - Patient Query (Event A19) This event is used to get Patient Administration data about a patient by sending a query to the Patient Administration system.
Segments MSH QRD [ QRF ] Description Message Header Query Definition Query Filter

113

Version1.2

HL7 Version 2.6 Companion Guide

ADT Bed Status Update (Event A20) This event is used by nursing/census applications to update the Patient Administration system's bed status.
Segments MSH EVN NPU Description Message Header Event Type Non-Patient Update

114

Version1.2

HL7 Version 2.6 Companion Guide

ADT Leave of Absence - Out (Event A21) This event is sent to notify systems that an admitted patient has left the healthcare institution temporarily.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

115

Version1.2

HL7 Version 2.6 Companion Guide

ADT Leave of Absence - In (Event A22) This event is sent to notify systems that an admitted patient has returned to the healthcare institution after a temporary "leave of absence."
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

116

Version1.2

HL7 Version 2.6 Companion Guide

ADT Delete a Patient Record (Event A23) The "delete record" message (A23 event) is recognized by the interface for inbound messages and processed in the same manner as a "cancel admission" (A11 event) message. The "delete record" (A23) event is not supported for outbound ADT messages.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

117

Version1.2

HL7 Version 2.6 Companion Guide

ADT Link Patient Information (Event A24) The A24 event is used when the first PID segment needs to be linked to the second PID segment and when both patient identifiers identify the same patient.
Segments MSH EVN PID [ PV1 ] PID [ PV1 ] Description Message Header Event Type Patient Identification Patient Visit Patient Identification Patient Visit

118

Version1.2

HL7 Version 2.6 Companion Guide

ADT Cancel Pending Discharge (Event A25) This event is sent when an A16 (pending discharge) event is cancelled, either because of erroneous entry of the A16 event or because of a decision not to discharge the patient after all.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

119

Version1.2

HL7 Version 2.6 Companion Guide

ADT Cancel Pending Transfer (Event A26) This event is sent when an A15 (pending transfer) event is cancelled, either because of erroneous entry of the A15 event or because of a decision not to transfer the patient after all.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

120

Version1.2

HL7 Version 2.6 Companion Guide

ADT Cancel Pending Admit (Event A27) This event is sent when an A14 (pending admit) event is cancelled, either because of erroneous entry of the A14 event or because of a decision not to admit the patient after all.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

121

Version1.2

HL7 Version 2.6 Companion Guide

ADT Add Person Information (Event A28) This event can be used to add all demographic information related to a given person.
Segments MSH EVN PID [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

122

Version1.2

HL7 Version 2.6 Companion Guide

ADT Delete Person Information (Event A29) This event can be used to delete all demographic information related to a given person.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

123

Version1.2

HL7 Version 2.6 Companion Guide

ADT Merge Person Information (Event A30) This event can be used to merge information on an MPI.
Segments MSH EVN PID MRG Description Message Header Event Type Patient Identification Merge Information

124

Version1.2

HL7 Version 2.6 Companion Guide

ADT Update Person Information (Event A31) This event can be used to update demographic information related on an MPI.
Segments MSH EVN PID [{ NK1 }] PV1 [ PV2 ] [{ OBX }] [{ AL1 }] [{ DG1 }] [{PR1}] [{ GT1 }] [{ IN1 [ IN2 ] [{ IN3 }] }] [ ACC ] [ UB1 ] [ UB2 ] Description Message Header Event Type Patient Identification Next of Kin / Associated Parties Patient Visit Patient Visit - Additional Info. Observation/Result Allergy Information Diagnosis Information Procedures Guarantor --- INSURANCE begin Insurance Insurance Additional Info. Insurance Additional Info - Cert. --- INSURANCE end Accident Information Universal Bill Information Universal Bill 92 Information

125

Version1.2

HL7 Version 2.6 Companion Guide

ADT Cancel Patient Arriving (Event A32) This event is sent when an A10 (patient arriving-tracking) event is cancelled.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

126

Version1.2

HL7 Version 2.6 Companion Guide

ADT Cancel Patient Departing (Event A33) This event is sent when an A09 (patient departing-tracking) event is cancelled.
Segments MSH EVN PID PV1 [ PV2 ] [{ OBX }] Description Message Header Event Type Patient Identification Patient Visit Patient Visit - Additional Info. Observation/Result

127

Version1.2

HL7 Version 2.6 Companion Guide

ADT Merge Patient Information Patient Only (Event A34) This event was intended for merging or changing patient identifiers.
Segments MSH EVN PID MRG Description Message Header Event Type Patient Identification Merge Information

128

Version1.2

HL7 Version 2.6 Companion Guide

ADT Merge Patient Information Account Number Only (Event A35) This event was intended for merging or changing an account number.
Segments MSH EVN PID MRG Description Message Header Event Type Patient Identification Merge Information

129

Version1.2

HL7 Version 2.6 Companion Guide

ADT Merge Patient Information Patient ID and Account Number (Event A36) This event has been retained for backward compatibility only.
Segments MSH EVN PID MRG Description Message Header Event Type Patient Identification Merge Information

130

Version1.2

HL7 Version 2.6 Companion Guide

ADT - Unlink Patient Information (Event A37) This event has been retained for backward compatibility only.
Segments MSH EVN PID [ PV1 ] PID [ PV1 ] Description Message Header Event Type Patient Identification Patient Visit Patient Identification Patient Visit

131

Version1.2

HL7 Version 2.6 Companion Guide

4. SAMPLE TRANSACTION
ORU^R01 Transaction
Message Header Segment MSH|^~\&|GHH LAB|ELAB-3|GHH OE|BLDG4|200202150930||ORU^R01|CNTRL-3456|P|2.4 Patient Identification Segment PID|||555-44-4444||EVERYWOMAN^EVE^E^^^^L|JONES|19620320|F|||153 FERNWOOD DR.^^STATESVILLE^OH^35292||(206)3345232|(206)752-121||||AC555444444||67-A4335^OH^20030520 Observation Request Segment OBR|1|845439^GHH OE|1045813^GHH LAB|15545^GLUCOSE|||200202150730|||||||||555-555555^PRIMARY^PATRICIA P^^^^MD^^|||||||||F||||||444-44-4444^HIPPOCRATES^HOWARD H^^^^MD Observation/Result Segment OBX|1|SN|1554-5^GLUCOSE^POST 12H CFST:MCNC:PT:SER/PLAS:QN||^182|mg/dl|70_105|H|||F

Radiology Transaction
Message Header Segment MSH|^~\&|HOSPITAL|ST ANTHONY|ELYSIUM||20090825160711||ORU^R01|2009-08-25T16:07:11|P|2.2 Patient Identification Segment PID|1||980000002^^^SAH||FHSTEST^DAY||19370201|M||||||||||0906108048^^^SAH Patient Visit Segment PV1|1|O|||||980000002^^^^^^^FHS|22810^JEFFREY^ROSE^S.^^^^FHS||||||||||||||||||||||||||||||||||||| Common Order Segment ORC|OR Observation Request Segment OBR|1|-1|6158675^RADIOLOGY|UL41054^SAH - US ECHO PRE/POST STRESS WO|20090821082913|20090821082913|20090821082913||||||||||||||20090825160712|||F|||22810^ROSE MD^JEFFREY^^^^^FHS|||||&ROSE MD&JEFFREY&&&&&FHS Notes & Events Segment NTE|1|NOTE1|MEDICAL RECORD NUMBER: 980000002\.br\ACCOUNT NUMBER: 0906108048\.br\ Observation/Result Segment OBX|1|SN|1554-5^GLUCOSE^POST 12H CFST:MCNC:PT:SER/PLAS:QN||^182|mg/dl|70_105|H|||F OBX|2|TX|UL41054^SAH - US ECHO PRE/POST STRESS WO||Stress Echocardiography Report\.br\ Demographics\.br\ Patient name FHSTEST DAY MPI # 01300891\.br\ Date of birth 02/01/1937 MRN # 980000002\.br\ Sex Male Race Caucasian\.br\ Height \.br\ Weight \.br\ BSA \.br\ Interpreting physician: JEFFREY ROSE MD\.br\< FMG Cardiologists>\.br\ Referring physician: JEFFREY ROSE MD\.br\ Sonographer: T B\.br\Type of study:\.br\ Stress procedure:\.br\ Patient status: Pending Discharge\.br\ Rhythm:Normal sinus rhythm\.br\\.br\ Indications: Angina\.br\\.br\ Conclusions\.br\\.br\ Summary\.br\\.br\ This is a test study. Baseline echocardiographic images were obtained and\.br\ were normal, no regional motion abnormalities.\.br\ No stress images were acquired due to acquisition/gating problem.\.br\\.br\ Signature\.br\\.br\ ----------------------------------------------------------------\.br\ Electronically signed by JEFFREY ROSE MD(Interpreting\.br\ physician) on 08/25/2009 04:07 PM\.br\ ---------------------------------------------------------------\.br\\.br\\.br\\.br\Stress\.br\\.br\Predicted HR:148\.br\\.br\||||||F

132

Version1.2

HL7 Version 2.6 Companion Guide

ADT Transaction (Register a Patient)

Message Header Segment MSH|^~\&|HOSPITAL|ENUMCLAW REGIONAL|ELYSIUM|ERH|201104132056||ADT^A04|WWAADTOUT2224623|P|2.1 Event Type Segment EVN|A04|201104132056 Patient Identification Segment PID|1||987654321^^^ERH||LNAME^FNAME^I||19010101|F|||2103 40TH AVE^^TACOMA^WA^98402||(697)8888888^|||M|JEH|EC0000000^^^ERH|555555550 Next of Kin / Associated Parties NK1|1||HU|2103 40TH AVE^^TACOMA^WA^98402|(697)888-8888^| Patient Visit Segment PV1|1|E|EMR^^^|UR||EMREC.EMR^^^|GHEBE^Ghermay^Berhan^^^^^ECH|||||||A||||ER||MDCR|||||||||||||||||||EC||||| 201104132056| Diagnosis Information Segment DG1|1|TX||SORE ON RT ARM||ADMITTING Guarantor Segment GT1|1||LNAME^FNAME^I^||2103 40TH AVE^^TACOMA^WA^98402|(697)888-8888^|||||SP||||||^^^^||| Insurance Segment IN1|1|MDCR TRBL||MEDICARE TRAILBLAZER|EXECUTIVE CENTER III^8330 LBJ FREEWAY^DALLAS^TX^75243^|||||||||||LNAME^FNAME^I^|SP|||||||||||||||||||555555550A Insurance Segment IN1|2|TRIC LIFE||TRICARE FOR LIFE|PO BOX 77028^^MADISON^WI^53707-7028^||(800)5551212^|CPO/E7|USN/RET|||||||LNAME^FNAME^I^|HU|||||||||||||||||||555555

133

Version1.2

HL7 Version 2.6 Companion Guide

5. DOCUMENT CHANGE HISTORY

Document Name: HL7 Version 2.6 Canonical Guide

Version 1.0 1.1 1.2 Issue Date 04/18/2011 04/25/2011 5/16/2011 Modified By Ravi Kadur Ganesh Prabhu, Ravi Kadur Sue Merk Comments/Reason Version Released for Comment Lab Results Use case Added HL7 ADT & Radiology transactions. Added new segments, message definitions and sample transactions. Modified the format of the document, headers, index and front page. Naming convention change to Canonical Guide

134