HL7 V2.4 Contents

Contents
1 . Introduction
2 .Control
3 .Patient Administration
4 .Order Entry
5 .Query
6. Financial Management
7 .Observation Reporting
8 .Master Files
9 .Medical Records/Information Management (Document Management)
10 .Scheduling
11 .Patient Referral
12 .Patient Care
13 .Clinical Laboratory Automation
14 .Application Management
15 .Personnel Management
A .Data Definition Tables
B. Lower Layer Protocols
C. Version 2.4 BNF Message Descriptions
D. Glossary

V2.4 Chapter 8


8 .
Master Files


Chapter Chair:

Mark Shafarman
Oracle

Editor:

Klaus D. Veil
HL7S&S

Additional Editor:

Jim Kingsland
McKessonHBOC

The content of this chapter is "owned" by various Technical Committees as listed below:

Steward Committee

Message

Segment

Control/Query

M01

MFI, MFE, MFA

PAFM

M04, M05

LOC, LCH, LRL, LDP, LCH, LCC, CDM, PRC

Personnel Management

M02

STF, PRA, ORG

Orders/Observations

M03, M08, M09, M10, M11, M12

OM1, OM2, OM3 , OM4, OM5, OM6, OM7

Orders/Observations (Clinical Trials)

M06, M07

CM0, CM1, CM2

8.1 CHAPTER 8 CONTENTS

8.2 PURPOSE

In an open-architecture healthcare environment there often exists a set of common reference files used by one or more application systems. Such files are called master files. Some common examples of master files in the healthcare environment include:
a) staff and health practitioner master file
b) system user (and password) master file
c) location (census and clinic) master file
d) device type and location (e.g., workstations, terminals, printers, etc.)
e) lab test definition file
f) exam code (radiology) definition file
g) charge master file
h) patient status master
i) patient type master
j) service item master file
These common reference files need to be synchronized across the various applications at a given site. The Master Files Notification message provides a way of maintaining this synchronization by specifying a standard for the transmission of this data between applications.
In many implementations, one application system will "own" a particular master file such as the staff and practitioner master file. The changes (e.g., adds, deletes, updates) to this file are made available to various other applications on a routine basis. The Master Files Notification message supports this common case, but also supports the situation where an application not "owning" a particular master file, transmits update information to other systems (usually to the "owning" system), for review and possible inclusion.
The Master Files Notification message supports the distribution of changes to various master files between systems in either online or batch modes, and allows the use of either original or enhanced acknowledgment modes, as well as providing for a delayed application acknowledgment mode. These messages use the MSH segment to pass the basic event code (master files notification or acknowledgment). The MFI (master file identification) segment identifies the master file being updated as well as the initial and requested dates for "file-level" events (such as "replace file"). For each record being changed, the MFE (Master File Entry) segment carries the record-level event code (such as add, update, etc.), the initial and requested dates for the event, and the record-level key identifying the entry in the master file. The MFA (master file acknowledgment) segment returns record-specific acknowledgment information.
Note: The MFE segment is not the master file record, but only specifies its identifier, event, and event dates. The master file record so identified is contained in either Z-segments or HL7-defined segments immediately following the MFE segment. This record may be either a flat record contained in a single segment, or a complex record needing more than a single segment to carry its data and (usually hierarchical) structure.
The master file segments commonly needed across HL7 applications as well as those specific to the various application chapters, are defined in Sections 8.7, "STAFF AND PRACTITIONER MASTER FILES," through 8.11, "SERVICE ITEM MASTER FILES," of this chapter.
A given master files message concerns only a single master file. However, the provision of a record-level event code (and requested activation date) on the MFE and the MFA segments allows a single message to contain several types of changes (events) to that file.
The Master Files Notification events do not specify whether the receiving system must support an automated change of the master file in question, nor do they specify whether the receiving system must create a file in the same form as that maintained on the sending system.
In general, the way in which the receiving system processes the change notification message will depend on both the design of the receiving system and the requirements negotiated at the site. Some systems and/or sites may specify a manual review of all changes to a particular master file. Some may specify a totally automated process. Not every system at every site will need all the fields contained in the master file segment(s) following the MFE segment for a particular master file entry.
This also means that an application acknowledgment (or a deferred application acknowledgment) from a receiving system that it changed a particular record in its version of the master file does not imply that the receiving system now has an exact copy of the information and state that is on the sending system: it means only that whatever subset of that master file's data (and state) that has been negotiated at the site is kept on the receiving system in such a manner that a new Master Files Notification transaction with the same primary key can be applied unambiguously (in the manner negotiated at the site) to that subset of information.

8.3 TRIGGER EVENTS

The Master Files Change Notification message can be used for the following message-level trigger events:
Mnn: A message containing notifications of changes to a single master file.
nn defines a particular HL7 master file. Currently-defined values are (see HL7 table 0003 - Event type): M01 - master file not otherwise specified (for backward compatibility only); M02 - staff/practitioner master file; M03 - service/test/observation master file (for backward compatibility only); M04 - charge description master file; M05 - location master file; M06 - clinical study master file; M08 - M12 - service/text/observation master file; M13 - M99 - reserved for future HL7-defined master files. Site-specific master files should use a code of the form Znn. (See also Section 8.5.1.0, MFI field definitions.)
A MFN message may contain the following "file-level" events, as specified in the MFI segment:
REP: Replace current version of this master file with the version contained in this message.
UPD: Change file records as defined in the record-level event codes for each record that follows.
These are the only file-level events currently defined. REP means that every MFE segment that follows will use the MAD event code.
The replace option allows the sending system to replace a file without sending delete record-level events for each record in that file. UPD means that the events are defined according to the record-level event code contained in each MFE segment in that message.
An MFN message may contain the following "record-level" events, as specified in the MFE segments.
MAD: Add record to master file.
MDL: Delete record from master file.
MUP: Update record for master file.
MDC: Deactivate: discontinue using record in master file, but do not delete from database.
MAC: Reactivate deactivated record.
The MFD transaction is used for the following trigger event:
MFA: Master Files Delayed Application Acknowledgment.

8.4 MESSAGES

The following messages are defined for master files transactions: MFN, master files notification; MFK, master files application acknowledgment; MFD, master files delayed application acknowledgment; and MFQ, master files query.

8.4.1 MFN/MFK - master files notification

The MFN transaction is defined as follows:

MFN^M01-M06^MFN_M01

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

[Z..] }

One or more HL7 and/or Z-segments carrying the data for the entry identified in the MFE segment

(varies)


MFK^M01-M06^MFK_M01

Master File Application Acknowledgment

Chapter

MSH

Message Header

2

MSA

Acknowledgment

2

[ ERR ]

Error

2

MFI

Master File Identification

8

{ [MFA] }

Master file ACK segment

8

The master file record identified by the MFE segment is contained in either Z-segments and/or HL7-defined segments immediately following the MFE segment, and is denoted by "Z..." in the MFN abstract message definition given above. This record may be either a flat record contained in a single segment, or a complex record needing more than a single segment to carry its data and (usually hierarchical) structure.
The master file record "[Z..]" identified by the MFE segment is optional (indicated by square brackets) in the single case where the master file is a simple one which contains only a key and the text value of that key. For this case only, both values may be carried in MFE-4 - primary key value.
Note: If the file-level event code is "REP" (replace file), then each MFA segment must have a record-level event code of "MAD" (add record to master file).
The MFK message is used for an application acknowledgment in either the original or enhanced acknowledgment modes.
The MFA segment carries acknowledgment information for the corresponding MFE segment (identified by MFA-5-primary key value).

8.4.2 MFD/ACK - master files delayed application acknowledgment

The MFD transaction is the delayed application acknowledgment. It can be used to return "deferred" application-level acknowledgment statuses at the MFE level, without reference to the original MFN message. It is defined as follows:

MFD^MFA^MFD_MFA

Master File Delayed Acknowledgment

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{ [MFA] }

Master file ACK segment

8


ACK^MFA^ACK

General Acknowledgment

Chapter

MSH

Message Header

2

MSA

Acknowledgment

2

[ ERR ]

Error

2

8.4.3 MFQ/MFR - master files query

The MFQ transaction allows a system to query for a particular record or group records (defined by the primary key) in a particular master file.
The Master files query is defined as follows:

MFQ^M01-M06^MFQ_M01

Query for Master File Record

Chapter

MSH

Message Header

2

QRD

Query Definition

5

[QRF]

Query Filter

5

[DSC]

Continuation

2


MFR^M01-M06^MFR_M01

Master Files Response

Chapter

MSH

Message Header

2

MSA

Acknowledgment

2

[ ERR ]

Error

2

[QAK]

Query Acknowledgment

5

QRD

Query Definition

5

[QRF]

Query Filter

5

MFI

Master File Name

8

{MFE

Master File Entry

8

[Z..] }

One or more HL7 and/or Z-segments carrying the data for the entry identified in the MFE segment.

(varies)

[DSC]

Continuation

2

8.4.3.1 MFQ use notes

The value "MFQ" of the QRD-what subject filter of the QRD segment identifies a master files query. The QRD-what department data code of the QRD segment identifies the name of the master file in question. The QRD-what data code value qual of the QRD segment identifies the primary key (or keys, or range of keys) defining the master file MFE segments (and associated master file records, denoted by "Z") to be returned with the response. The QRF segment may be used to define time ranges, particular MFN record-level event codes etc. Unless otherwise specified, the response returns only active current record(s).

8.5 GENERAL MASTER FILE SEGMENTS

The following segments are defined for the master files messages.

8.5.1 MFI - master file identification segment

The Technical Steward for the MFI segment is CQ.
The fields in the MFI segment are defined in HL7 Attribute Table - MFI.

HL7 Attribute Table - MFI - Master File Identification

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

250

CE

R


0175

00658

Master File Identifier

2

180

HD

O



00659

Master File Application Identifier

3

3

ID

R


0178

00660

File-Level Event Code

4

26

TS

O



00661

Entered Date/Time

5

26

TS

O



00662

Effective Date/Time

6

2

ID

R


0179

00663

Response Level Code

8.5.1.0 MFI field definitions

8.5.1.1 MFI-1 Master file identifier (CE) 00658

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field is a CE data type that identifies a standard HL7 master file. This table may be extended by local agreement during implementation to cover site-specific master files (z-master files). HL7 recommends use of the HL7 assigned table number as the master file identifier code if one is not specified in Table 0175. For example, a master file of Marital Status codes would be identified by HL70002 as the MFI-1 - Master file identifier. Refer to HL7 table 0175 - Master file identifier code for valid values.

HL7 Table 0175 - Master file identifier code

Value

Description

CDM

Charge description master file

CMA

Clinical study with phases and scheduled master file

CMB

Clinical study without phases but with scheduled master file

LOC

Location master file

OMA

Numerical observation master file

OMB

Categorical observation master file

OMC

Observation batteries master file

OMD

Calculated observations master file

PRA

Practitioner master file

STF

Staff master file

CLN

Clinic master file

OME

Other basic observation/service attributes

8.5.1.2 MFI-2 Master files application identifier (HD) 00659

Components: <namespace ID (IS) ^ <universal ID (ST) ^ <universal ID type (ID)
Definition: This field contains an optional code of up to 180 characters which (if applicable) uniquely identifies the application responsible for maintaining this file at a particular site. A group of intercommunicating applications may use more than a single instance of a master file of certain type (e.g., charge master or physician master). The particular instance of the file is identified by this field.

8.5.1.3 MFI-3 File-level event code (ID) 00660

Definition: This field defines the file-level event code. Refer to HL7 table 0178 - File level event code for valid values.

HL7 Table 0178 - File level event code

Value

Description

REP

Replace current version of this master file with the version contained in this message

UPD

Change file records as defined in the record-level event codes for each record that follows

8.5.1.4 MFI-4 Entered date/time (TS) 00661

Definition: This field contains the time stamp for file-level event on originating system.

8.5.1.5 MFI-5 Effective date/time (TS) 00662

Definition: This optional field contains the effective date/time, which can be included for file-level action specified. It is the date/time the originating system expects that the event is to have been completed on the receiving system. If this field is not present, the action date/time should default to the current date/time (when the message is received).

8.5.1.6 MFI-6 Response level code (ID) 00663

Definition: These codes specify the application response level defined for a given Master File Message at the MFE segment level as defined in HL7 table 0179 - Response level. Required for MFN-Master File Notification message. Specifies additional detail (beyond MSH-15 - Accept acknowledgment type and MSH-16 - Application acknowledgment type) for application-level acknowledgment paradigms for Master Files transactions. MSH-15 - accept acknowledgment type and MSH-16 - Application acknowledgment type operate as defined in Chapter 2.

HL7 Table 0179 - Response level

Value

Description

NE

Never. No application-level response needed

ER

Error/Reject conditions only. Only MFA segments denoting errors must be returned via the application-level acknowledgment for this message

AL

Always. All MFA segments (whether denoting errors or not) must be returned via the application-level acknowledgment message

SU

Success. Only MFA segments denoting success must be returned via the application-level acknowledgment for this message

8.5.2 MFE - master file entry segment

The Technical Steward for the MFE segment is CQ.

HL7 Attribute Table - MFE - Master File Entry

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

3

ID

R


0180

00664

Record-Level Event Code

2

20

ST

C



00665

MFN Control ID

3

26

TS

O



00662

Effective Date/Time

4

200

Varies

R

Y


00667

Primary Key Value - MFE

5

3

ID

R

Y

0355

01319

Primary Key Value Type

8.5.2.0 MFE field definitions

8.5.2.1 MFE-1 Record-level event code (ID) 00664

Definition: This field defines the record-level event for the master file record identified by the MFI segment and the primary key field in this segment. Refer to HL7 table 0180 - Record level event code for valid values.

HL7 Table 0180 - Record-level event code

Value

Description

MAD

Add record to master file

MDL

Delete record from master file

MUP

Update record for master file

MDC

Deactivate: discontinue using record in master file, but do not delete from database

MAC

Reactivate deactivated record

Note: If the file-level event code is "REP" (replace file), then each MFE segment must have a record-level event code of "MAD" (add record to master file).

8.5.2.2 MFE-2 MFN control ID (ST) 00665

Definition: A number or other identifier that uniquely identifies this change to this record from the point of view of the originating system. When returned to the originating system via the MFA segment, this field allows the target system to precisely identify which change to this record is being acknowledged. It is only required if the MFI response level code requires responses at the record level (any value other than NE).
Note: Note that this segment does not contain a Set ID field. The MFE-2 - MFN control ID implements a more general concept than the Set ID. It takes the place of the SET ID in the MFE segment.

8.5.2.3 MFE-3 Effective date/time (TS) 00662

Definition: An optional effective date/time can be included for the record-level action specified. It is the date/time the originating system expects that the event is to have been completed on the receiving system. If this field is not present, the effective date/time should default to the current date/time (when the message is received).

8.5.2.4 MFE-4 Primary key value - MFE (Varies) 00667

Definition: This field uniquely identifies the record of the master file (identified in the MFI segment) to be changed (as defined by the record-level event code). The data type of field is defined by the value of MFE-5 - Value type, and may take on the format of any of the HL7 data types defined in HL7 table 0355 - Primary key value type. The PL data type is used only on Location master transactions.
The following exception to the use of the CE data type is deprecated in v 2.3.1, and left only to satisfy backwards compatibility. When the CE data type is used, the first component of this CE data field carries an optional subcomponent, the application ID, that uniquely identifies the application responsible for creating the primary key value. The application ID subcomponent can be used to guarantee uniqueness of the primary key across multiple applications.
The repetition of the primary key permits the identification of an individual component of a complex record as the object of the record-level event code. This feature allows the Master Files protocol to be used for modifications of single components of complex records. If this field repeats, the field MFE-5 - Value type must also repeat (with the same number of repetitions), and the data type of each repetition of MFE-4 - Primary key value is specified by the corresponding repetition of MFE-5 - Value type.

8.5.2.5 MFE-5 Primary key value type (ID) 01319

Definition: This field contains the HL7 data type of MFE-4 - Primary key value. The valid values for the data type of a primary key are listed in HL7 table 0355 - Primary key value type.

HL7 Table 0355 - Primary key value type

Value

Description

PL

Person location

CE

Coded element

Note: This table contains data types for MFE-4 values present in HL7 defined master files. As HL7 adopts a new master file that contains a data type for MFE-4 not defined in Table 0355, the data type will be added to Table 0355. For locally defined master files, this table can be locally extended with other HL7 data types as defined in section 2.6.6.

8.5.3 MFA - master file acknowledgment segment

The Technical Steward for the MFA segment is CQ.
The MFA segment contains the following fields as defined in HL7 Attribute Table - MFA - Master File Acknowledgment

HL7 Attribute Table - MFA - Master File Acknowledgment

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

3

ID

R


0180

00664

Record-Level Event Code

2

20

ST

C



00665

MFN Control ID

3

26

TS

O



00668

Event Completion Date/Time

4

250

CE

R


0181

00669

MFN Record Level Error Return

5

250

CE

R

Y

9999

01308

Primary Key Value - MFA

6

3

ID

R

Y

0355

01320

Primary Key Value Type - MFA

8.5.3.0 MFA field definitions

8.5.3.1 MFA-1 Record-level event code (ID) 00664

Definition: This field defines record-level event for the master file record identified by the MFI segment and the primary key in this segment. Refer to HL7 table 0180 - Record level event code for valid values.

8.5.3.2 MFA-2 MFN control ID (ST) 00665

Definition: This field contains a number or other identifier that uniquely identifies this change to this record from the point of view of the originating system. This field uniquely identifies the particular record (identified by the MFE segment) being acknowledged by this MFA segment. When returned to the originating system via the MFA segment, this field allows the target system to precisely identify which change to this record is being acknowledged. It is only required if MFI-6 - Response level code requires responses at the record level (any value other than NE).

8.5.3.3 MFA-3 Event Completion date/time (TS) 00668

Definition: This field may be required or optional depending on the site specifications for the given master file, master file event, and receiving facility.

8.5.3.4 MFA-4 MFN Record Level error return (CE) 00669

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the status of the requested update. Site-defined table, specific to each master file being updated via this transaction.
Refer to User-defined Table 0181 - MFN record-level error return for suggested values. All such tables will have at least the following two return code values:

User-defined Table 0181 - MFN record-level error return

Value

Description

S

Successful posting of the record defined by the MFE segment

U

Unsuccessful posting of the record defined by the MFE segment

8.5.3.5 MFA-5 Primary key value - MFA (CE) 01308

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field uniquely identifies the record of the master file (identified in the MFI segment) to be change status is being acknowledged (as defined by the field MFN-4 - Record level error return). The data type of this field is defined by the value of MFA-6 - Value type - MFA, and may take on the format of any of the HL7 data types defined in HL7 table 0355 - Primary key value type. The PL data type is used only on location master transactions.
The following exception to the use of the CE data type is deprecated in V2.3.1, and left in for backward compatibility. When the CE data type is used, the first component of this CE data field carries an optional subcomponent, the application ID, that uniquely defines the application responsible for creating the primary key value. The application ID subcomponents can be used to guarantee uniqueness of the primary key across multiple applications.
The repetition of the primary key permits the identification of an individual component of a complex record as the object of the record-level event code. This feature allows the Master Files protocol to be used for modifications of single components of complex records. If this field repeats, the field MFA-6 - Primary key value type - MFA must also repeat (with the same number of repetitions), and the data type of each repetition of MFA-5 - Primary key value - MFA is specified by the corresponding repetition of MFA-6 - Value type - MFA.

8.5.3.6 MFA-6 Primary key value type - MFA (ID) 01320

Definition: This field contains the HL7 data type of MFA-5 - Primary key value - MFA. The valid HL7 data types are listed in HL7 table 0355 - Primary key value type.

8.6 GENERIC MASTER FILE EXAMPLES

This is an example of a proposed generic method of updating a standard HL7 table. This particular example shows two records being added to HL7 table 0006 - Religion.
Note: A standard HL7 table segment can be constructed by defining two fields: a table entry field (as a CE field) and a display-sort-key field (a numeric field) as follows.

8.6.1 ZL7 segment (proposed example only)

HL7 Attribute Table - ZL7 - (proposed example only)

SEQ


LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

250

CE

R


xxxx

xxxxx

HL7 table entry for table xxxx

2

3

NM

R


xxxx

xxxxx

Display-sort-key

8.6.1.0 ZL7 field definitions

8.6.1.1 ZL7-1 HL7 table entry for table xxxx (CE) xxxxx

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains HL7 table values for identifier and text encoded as a CE data type.

8.6.1.2 ZL7-2 Display-sort-key (NM) xxxxx

Definition: This field is used to specify a non-alphabetic ordering for display or print versions of a standard HL7 table.

8.6.2 MFN message with original acknowledgment mode

MSH|^~\&|HL7REG|UH|HL7LAB|CH|19910918060544||MFN^M01|MSGID002|P|2.4
MFI|0006^RELIGION^HL7||UPD|||AL
MFE|MAD|199109051000|199110010000|U^Buddhist^HL7|CE
ZL7|U^Buddhist^HL7|3^^Sortkey
MFE|MAD|199109051015|199110010000|Z^Zen Buddhist^HL7|CE
ZL7|Z^Zen Buddhist^HL7|12^^Sortkey
In this case, the primary key contains all the data needed for this simple table, so that the HL7 segment could be constructed with ONLY the single field, "sort-key," rather than repeating the primary key value as we have done in this example.
MFK, master file application acknowledgment, as original mode acknowledgment of the HL7 message according to MFI Response Level Code of "AL."
MSH|^~\&|HL7LAB|CH|HL7ADT|UH|19910918060546||MFK|MSGID99002|P|2.4
MSA|AA|MSGID002
MFI|0006^RELIGION^HL7||UPD||AL
MFA|MAD|199109051000|19910918060545|S|U^Buddhist^HL7|CE
MFA|MAD|199109051015|19910918060545|S|Z^Zen Buddhist^HL7|CE

8.6.3 Enhanced mode application-level acknowledgment to the MFN message

8.6.3.1 Initial message with accept acknowledgment

MSH|^~\&|HL7REG|UH|HL7LAB|CH|19910918060544||MFN^M01|MSGID002|P|2.4||AL|AL
MFI|0006^RELIGION^HL7||UPD|||AL
MFE|MAD|199109051000|199110010000|U^Buddhist^HL7|CE
ZL7|U^Buddhist^HL7|3^^Sortkey
MFE|MAD|199109051015|199110010000|Z^Zen Buddhist^HL7|CE
ZL7|Z^Zen Buddhist^HL7|12^^Sortkey
MSH|^~\&|HL7LAB|CH|HL7ADT|UH|19910918060545||MSA|MSGID99002|P|2.4
MSA|CA|MSGID002

8.6.3.2 Enhanced mode application acknowledgment message

MSH|^~\&|HL7LAB|CH|HL7ADT|UH|19911001080504||MFK|MSGID99502|P|2.4||AL|
MSA|AA|MSGID002
MFI|0006^RELIGION^HL7||UPD||AL
MFA|MAD|199109051000|19910918010040|S|U^Buddhist^HL7|CE
MFA|MAD|199109051015|19910918010040|S|Z^Zen Buddhist^HL7|CE
MSH|^~\&|HL7ADT|UH|HL7LAB|CH|19911001080507||ACK|MSGID444|P|2.4
MSA|CA|MSGID5002

8.6.4 Delayed application-level acknowledgment

8.6.4.1 Initial message with accept acknowledgment

MSH|^~\&|HL7REG|UH|HL7LAB|CH|19910918060544||MFN^M01|MSGID002|P|2.4||AL|NE
MFI|0006^RELIGION^HL7||UPD|||AL
MFE|MAD|199109051000|199110010000|U^Buddhist^HL7
ZL7|U^Buddhist^HL7|3^^Sortkey
MFE|MAD|199109051015|199110010000|Z^Zen Buddhist^HL7
ZL7|Z^Zen Buddhist^HL7|12^^Sortkey
MSH|^~\&|HL7LAB|CH|HL7ADT|UH|19910918060545||ACK|MSGID99002|P|2.4
MSA|CA|MSGID002

8.6.4.2 Deferred application acknowledgment message

MSH|^~\&|HL7LAB|CH|HL7ADT|UH|19910919060545||MFD|MSGID99002|P|2.4|||AL
MFI|0006^RELIGION^HL7||UPD|||AL
MFA|MAD|199109051000|19910919020040|S|U^Buddhist^HL7
MFA|MAD|199109051015|19910919020040|S|Z^Zen Buddhist^HL7
MSH|^~\&|HL7ADT|UH|HL7LAB|CH|19910919060546||ACK|MSGID444|P|2.4
MSA|CA|MSGID500

8.7 STAFF AND PRACTITIONER MASTER FILES

8.7.1 MFN/MFK - staff/practitioner master file message

The staff identification (STF), practitioner detail (PRA), and practitioner organization unit segment (ORG) segments can be used to transmit master files information between systems. The STF segment provides general information about personnel; the PRA and ORG segments provides detailed information for a staff member who is also a health practitioner. Other segments may be defined to follow the STF segment to provide additional detail information for a particular type of staff member: the PRA and ORG segments are the first such segments. When the STF, PRA, and ORG segments are used in an MFN message, the abstract definition is as follows:

MFN^M02^MFN_M02

Master File Notification for Staff/Practitioner

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

STF

Staff Identification

15

[PRA]

Practitioner Detail

15

[ORG]

Practitioner Organization Unit Segment

15

}




MFK^M02^MFK_M01

Master File Acknowledgment

Chapter

MSH

Message Header

2

MSA

Acknowledgment

2

MFI

Master File Identification

8

[{MFA}]

Master File ACK segment

8

When the STF and PRA segments are used in the MFR message, the part of the message represented by:
{MFE
[Z..]}
is replaced by:
{MFE
STF
[PRA]
[ORG]
}
Note that the STF and PRA segments have been moved to Chapter 15 - Personnel Management. The ORG segment is defined in Chapter 15 - Personnel Management.

8.7.2 Example: staff and health practitioner master file MFN message

MSH|^~\&|HL7REG|UH|HL7LAB|CH|19910918060544||MFN^M02|MSGID002|P|2.4|||AL|NE
MFI|PRA^Practitioner Master File^HL70175||UPD|||AL
MFE|MAD|U2246|199110011230|PMF98123789182^^PLW
STF|PMF98123789182^^PLW|U2246^^^PLW~111223333^^^USSSA^SS|KILDARE^RICHARD^J^JR^DR^M.D.|P|M|19511004|A|^ICU|^MED|(206)689-1999X345CO~(206)283-3334CH(206)689-1345X789CB|214 JOHNSON ST^SUITE 200^SEATTLE^WA^98199^H~3029 24TH AVE W^^SEATTLE, WA^98198^O |19890125^UMC&University Medical Center&L01||PMF88123453334|74160.2326@COMPUSERV.COM|B
PRA|PMF98123789182^^PLW|^KILDARE FAMILY PRACTICE|ST|I|OB/GYN^STATE BOARD OF OBSTETRICS AND GYNECOLOGY^C^19790123|1234887609^UPIN~1234987^CTY^MECOSTA~223987654^TAX~1234987757^DEA~12394433879^MDD^CA|ADMIT&&ADT^MED&&L2^19941231~DISCH&&ADT^MED&&L2^19941231|

8.8 SERVICE/TEST/OBSERVATIONS MASTER FILES

8.8.1 General approach of service/test/observation master files

These segments define the format for the general information about the observations that a clinical or diagnostic service produces and sends to its "clients." This format can be used to send the producer's entire service/test/observation definition or a few of the producer's observations, such as those with procedure, technique, or interpretation changes.
In anticipation of an object-oriented organization of segments in future releases of this Standard, the attributes of observations/batteries have been grouped into six different segments:
OM1 contains the attributes that apply to all observations
OM2 applies to numerically-valued observations
OM3 applies to text or code-valued observations
OM4 applies to observations or batteries that require specimens
OM5 contains the attributes of batteries, or sets of observations or other batteries
OM6 contains the quantities (observations in a most general sense) that are calculated from one or more other observations
OM7 contains additional basic attributes that apply to the definition of most observations/services.
Thus, the full definition of a numerically-valued laboratory observation would require the transmission of OM1, OM2, and OM4.
In the following discussion, we use OMx to refer to any of the six observation-defining segments. Each instance of an OMx segment contains the information about one observation or observation battery. These OMx segments are designed to be "inclusive" and accommodate the attributes of many kinds of observations. Thus, the fact that a field is listed in a particular segment should not be construed as meaning that a producer must include information about that item in its definition transmission. Many fields will apply to some terms; others will not. One observation producer may choose to populate one set of fields; another may choose to populate a different set of fields, according to the requirements of that producer's "client."
Most of the fields of data type TX in those segments are intended to include information typically contained in a diagnostic service's user manual. Such fields should describe how the data is to be interpreted or used, and are not intended for computer interpretation.
Remember that the magnitude of a treatment can also be regarded as an observation and, as such, can be represented as an observation within these segments. Many examples exist. When a blood gas is transmitted, the requesting service usually transmits the amount of inspired O2 (a treatment) on requisition. (In an electronic transmission, the service would send this as an OBX segment, along with the electronic order for the test.) When blood levels are drawn, the amount and time of the last dose are routinely included as observations on the request for service. A pharmacy system could routinely send to a medical record system the average daily dose of each outpatient medication it dispenses. In such cases, the treatment amounts would be observations to the receiving system and would be transmitted as OBX segments. When received, they would be treated like any other observation. A medical record system could then create, for example, a flowchart of lab results, or lab results mixed with relevant treatments.

8.8.2 MFN/MFK - service/test/observation master file

The usage of the OMx segments in the Master Files MFN and MFR messages is described in Sections 8.4.1, "MFN/MFK - master files notification," and 8.4.3, "MFQ/MFR - master files query," above. Basically the segment groupings described below follow the MFI and MFE segments in those messages (replacing the [Z...] section as follows:
Note: MFN^M03 is retained for backward compatibility only.

MFN^M03^MFN_M03

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

OM1

General Segment (Fields That Apply to Most Observations)

8

???

[other segments(s)]


}



where other segments can be any of the following combinations:
MFI-1 - Master file identifier = OMA, for numeric observations (second component of MSH-9 - Message type = M08).
[
[ OM2] Numeric Observation Segment
[OM3] Categorical Service/Test/Observation Segment
[OM4] Observations that Require Specimens
]

MFN^M08^MFN_M08

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

OM1

General Segment (Fields That Apply to Most Observations)

8

[OM2]

Numeric Observation Segment

8

[OM3]

Categorical Service/Test/Observation Segment

8

[OM4]

Observations that Require Specimens

8

}



or
MFI-1 - Master file identifier = OMB, for categorical observations (second component of MSH-9 - Message type = M09).
[OM3 Categorical Service/Test/Observation Segment
[{OM4}] Observations that Require Specimens
]

MFN^M09^MFN_M09

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

OM1

General Segment (Fields That Apply to Most Observations)

8

[OM3

Categorical Service/Test/Observation Segment

8

[{OM4}]

Observations that Require Specimens

8

]



}



or
MFI-1 - Master file identifier = OMC, for observation batteries (second component of MSH-9 - Message type = M10).
[OM5 Observation Batteries
[{OM4}] Observations that Require Specimens
]

MFN^M10^MFN_M10

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

OM1

General Segment (Fields That Apply to Most Observations)

8

[OM5

Observation Batteries

8

[{OM4}]

Observations that Require Specimens

8

]



}



or
MFI-1 - Master file identifier = OMD, calculated observations (second component of MSH-9 - Message type = M11).
[OM6 Observations Calculated from Other Observations
OM2] Numeric Observation Segment

MFN^M11^MFN_M11

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

OM1

General Segment (Fields That Apply to Most Observations)

8

[OM6

Observations Calculated from Other Observations

8

OM2]

Numeric Observation Segment

8

}



or
MFI-1 - Master file identifier = OME, Additional basic observation/service attributes (second component of MSH-9 - Message type = M12).
[OM7] Other basic observation/service attributes

MFN^M12^MFN_M12

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

OM1

General Segment (Fields That Apply to Most Observations)

8

[OM7]

Other Basic Observation/Service Attributes

8

}



Note: A service/test/observation definition may have both an OM2 (numeric) and OM3 (categorical) segment included in case the value may be either numeric and/or categorical.

8.8.3 OM1 - general segment (fields that apply to most observations)

The Technical Steward for the OM1 segment is ORDERS.
The OM1 segment contains the attributes that apply to the definition of most observations. This segment also contains the field attributes that specify what additional segments might also be defined for this observation.

HL7 Attribute Table - OM1 - General Segment

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4


NM

R



00586

Sequence Number - Test/Observation Master File

2

250

CE

R


9999

00587

Producer's Service/Test/Observation ID

3

12

ID

O

Y

0125

00588

Permitted Data Types

4

1

ID

R


0136

00589

Specimen Required

5

250

CE

R


9999

00590

Producer ID

6

200

TX

O



00591

Observation Description

7

250

CE

O


9999

00592

Other Service/Test/Observation IDs for the Observation

8

200

ST

R

Y


00593

Other Names

9

30

ST

O



00594

Preferred Report Name for the Observation

10

8

ST

O



00595

Preferred Short Name or Mnemonic for Observation

11

200

ST

O



00596

Preferred Long Name for the Observation

12

1

ID

O


0136

00597

Orderability

13

250

CE

O

Y

9999

00598

Identity of Instrument Used to Perform this Study

14

250

CE

O

Y

9999

00599

Coded Representation of Method

15

1

ID

O


0136

00600

Portable Device Indicator

16

250

CE

O

Y

9999

00601

Observation Producing Department/Section

17

250

XTN

O



00602

Telephone Number of Section

18

1

IS

R


0174

00603

Nature of Service/Test/Observation

19

250

CE

O


9999

00604

Report Subheader

20

20

ST

O



00605

Report Display Order

21

26

TS

O



00606

Date/Time Stamp for any change in Definition for the Observation

22

26

TS

O



00607

Effective Date/Time of Change

23

20

NM

O



00608

Typical Turn-Around Time

24

20

NM

O



00609

Processing Time

25

40

ID

O

Y

0168

00610

Processing Priority

26

5

ID

O


0169

00611

Reporting Priority

27

250

CE

O

Y

9999

00612

Outside Site(s) Where Observation may be Performed

28

250

XAD

O

Y


00613

Address of Outside Site(s)

29

250

XTN

O



00614

Phone Number of Outside Site

30

1

IS

O


0177

00615

Confidentiality Code

31

250

CE

O


9999

00616

Observations Required to Interpret the Observation

32

65536

TX

O



00617

Interpretation of Observations

33

250

CE

O


9999

00618

Contraindications to Observations

34

250

CE

O

Y

9999

00619

Reflex Tests/Observations

35

80

TX

O



00620

Rules that Trigger Reflex Testing

36

250

CE

O


9999

00621

Fixed Canned Message

37

200

TX

O



00622

Patient Preparation

38

250

CE

O


9999

00623

Procedure Medication

39

200

TX

O



00624

Factors that may Affect Affect the Observation

40

60

ST

O

Y


00625

Service/Test/Observation Performance Schedule

41

65536

TX

O



00626

Description of Test Methods

42

250

CE

O


0254

00937

Kind of Quantity Observed

43

250

CE

O


0255

00938

Point Versus Interval

44

200

TX

O


0256/0257

00939

Challenge Information

45

250

CE

O


0258

00940

Relationship Modifier

46

250

CE

O


9999

00941

Target Anatomic Site Of Test

47

250

CE

O


0259

00942

Modality Of Imaging Measurement

8.8.3.0 OM1 field definitions

8.8.3.1 OM1-1 Sequence number - test/observation master file (NM) 00586

Definition: This field contains the first OM1 segment in a message and is described as 1, the second as 2, and so on.

8.8.3.2 OM1-2 Producer's service/test/observation ID (CE) 00587

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the producer's usual or preferred identification of the test or observation. Only three components should be included: <ID code>^<service text name/description>^<source list of code>. All components should be non-null. The source list may be any of those included in ASTM Tables 3 and 5, or a local code.

8.8.3.3 OM1-3 Permitted data types (ID) 00588

Definition: This field contains the allowed data type(s) for this observation. The codes are the same as those listed for OBX (a given observation may, under different circumstances, take on different data types). Indeed, under limited circumstances, an observation can consist of one or more fragments of different data types. When an observation may have more than one data type, e.g., coded (CE) and numeric (NM) the allowable data types should be separated by repeat delimiters. Refer to HL7 table 0125 - Value type for valid values.

8.8.3.4 OM1-4 Specimen required (ID) 00589

Definition: This field contains a flag indicating whether or not at least one specimen is required for the service/test/observation. Refer to HL7 table 0136 - Yes/no indicator as defined in Chapter 2.
Y one or more specimens are required to obtain this observation
N a specimen is not required
When a specimen is required, segment OM4 will usually be included (one per specimen is required).

8.8.3.5 OM1-5 Producer ID (CE) 00590

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field uniquely identifies the service producing the observation described in this segment. Three components should be included: an identifying code, the name of the producer, and the identity of the coding system (e.g., 323-5678^Acme Special Lab^MC). The identity of the coding system will usually be MC (Medicare provider number or HIBCC site codes) in the United States. Each country may want to specify its preferred coding system and define a coding system ID to identify it.
Remember that the magnitude of a treatment or the setting on a machine, such as a ventilator, can be regarded as an observation. Thus, pharmacy, respiratory care, and nursing may be producers of such observations.

8.8.3.6 OM1-6 Observation description (TX) 00591

Definition: This field contains a text description of this observation.

8.8.3.7 OM1-7 Other service/test/observation IDs for the observation (CE) 00592

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains all alias codes/identifiers for this observation. If more than one alias code needs to be specified, multiple three-component, CE-format entries (<code 1>^<name 1>^<code system 1>) may be given, separated by repeat delimiters. An observation may have as many names/codes as are applicable (e.g., ICD9, ACR-NEMA, SNOMED, and READ). We encourage the inclusion of as many different codes as may apply to assist cross-system mapping of terminology. All components of each triplet should be non-null (that is, names and coding system IDs within the CE data type are required in addition to codes). The source list may be any of those included in ASTM Tables 3 and 5.
Because the size (dose) of a treatment can also be an observation, codes that identify treatments (e.g., NDC, ICCS) may also be included in this field.
Note: In this field, the names within the CE data type are required.

8.8.3.8 OM1-8 Other names (recognized by the producer for the observation) (ST) 00593

Definition: This field contains any test aliases or synonyms for the name in the context of the ordering service. These are alternative names, not associated with a particular coding system, by which the battery, test, or observation (e.g., measurement, test, diagnostic study, treatment, etc.) is known to users of the system. Multiple names in this list are separated by repeat delimiters.

8.8.3.9 OM1-9 Preferred report name for the observation (ST) 00594

Definition: This field contains the preferred name for reporting the observation or battery. The name can contain up to 30 characters (including blanks). It is the preferred name for columnar reports that require a maximum name size.

8.8.3.10 OM1-10 Preferred short name or mnemonic for the observation (ST) 00595

Definition: This field contains the name that can be used in space-limited reports (e.g., specimen labels) to identify the observation for the convenience of human readers. The name can contain up to eight characters.

8.8.3.11 OM1-11 Preferred long name for the observation (ST) 00596

Definition: This field contains the fully-specified name for the observation or battery. It may include the full (unabbreviated) multiple-word names and contain up to 200 characters. It should be as scientifically precise as possible.

8.8.3.12 OM1-12 Orderability (ID) 00597

Definition: This field indicates whether or not a service/test/observation is an orderable code. Refer to HL7 table 0136 - Yes/no indicator for valid values.
Y the service/test/observation is an orderable code
N the service/test/observation is not orderable
For example, blood differential count is usually an orderable "test," MCV, contained within the differential count, is usually not independently orderable.

8.8.3.13 OM1-13 Identity of instrument used to perform this study (CE) 00598

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: When applicable, this field identifies the instrument or device that is used to generate this observation or battery. Examples are the automated instrument in the laboratory, the imaging device and model number in radiology, and the automatic blood pressure machine on the ward. The instrument is specified as a coded entry in anticipation that these identifiers could be specified as codes. Initially, we expect that most of the information about devices will be transmitted as text in the second component of the CE identifier. If more than one kind of instrument is used, all of them can be listed, separated by repeat delimiters.

8.8.3.14 OM1-14 Coded representation of method (CE) 00599

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the method(s) used to produce the observation and should be recorded in a computer-understandable (coded) form here. This field should report the same method(s) reported in narrative in the following field. More than one method may be listed, but only if they produce results that are clinically indistinguishable. Multiple methods must be separated by repeat delimiters.

8.8.3.15 OM1-15 Portable device indicator (ID) 00600

Definition: This field indicates whether or not a portable device may be used for the service/test/observation. Refer to HL7 table 0136 - Yes/no indicator for valid values.
Y the observation can be obtained with a portable device brought to the patient
N the patient or specimen must be transported to the device

8.8.3.16 OM1-16 Observation producing department/section (CE) 00601

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field permits the sorting of observation orders and values by the providing service's department/section. It provides "source oriented" reporting when required. The codes for this field should be taken from ASTM Table 15 (Diagnostic Service Codes). Free text may be used instead of these codes, but in that case, they should be recorded as the second "component" of the field to distinguish them from the standard codes. Multiple codes in this field are separated by repeat delimiters.

8.8.3.17 OM1-17 Telephone number of section (XTN) 00602

Components: [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)>
Definition: This field contains the telephone number for calling responsible parties in this section to ask results or advice about the use of this test.

8.8.3.18 OM1-18 Nature of service/test/observation (IS) 00603

Definition: This field indicates whether the definition entry identifies a test battery, an entire functional procedure or study, a single test value (observation), multiple test batteries or functional procedures as an orderable unit (profile), or a single test value (observation) calculated from other independent observations. Refer to User-defined Table 0174 - Nature of service/test/observation for suggested values.

User-defined Table 0174 - Nature of service/test/observation

Value

Description

P

Profile or battery consisting of many independent atomic observations (e.g., SMA12, electrolytes), usually done at one instrument on one specimen

F

Functional procedure that may consist of one or more interrelated measures (e.g., glucose tolerance test, creatinine clearance), usually done at different times and/or on different specimens

A

Atomic service/test/observation (test code or treatment code)

S

Superset--a set of batteries or procedures ordered under a single code unit but processed as separate batteries (e.g., routines = CBC, UA, electrolytes)
This set indicates that the code being described is used to order multiple service/test/observation batteries. For example, a client who routinely orders a CBC, a differential, and a thyroxine as an outpatient profile might use a single, special code to order all three test batteries, instead of having to submit three separate order codes.

C

Single observation calculated via a rule or formula from other independent observations (e.g., Alveolar--arterial ratio, cardiac output)

Codes P, F, and S identify sets (batteries) and should be associated with an OM5 segment that defines the list of elements. The definitions for the contained elements would have to be sent in other independent OMx segments, one for each contained element. In the ASTM context, most text reports - such as discharge summaries, admission H&Ps, and chest X-ray reports - are considered as sets, in which each section of the report (e.g., description, impression, and recommendation of an X-ray report) is considered a separate observation.
Code A identifies a single direct observation and would usually be associated with an OM2 and/or OM3 segments.
Code C identifies a derived quantity and would usually be associated with an OM6 segment.
All of these codes can be associated with one or more OM4 (specimen) segments.

8.8.3.19 OM1-19 Report subheader (CE) 00604

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains an optional string that defines the preferred header under which this observation should be listed on a standard display. For example, if the test is hemoglobin, this string might be "Complete blood count." It is represented as a coded data type so that a battery can be a header. Only the description part of the string may be included in case the subheader does not have an associated code. When a series of observations is displayed according to the sort order given below, the subheader that groups those observations is presented whenever the subheader changes.

8.8.3.20 OM1-20 Report display order (ST) 00605

Definition: This field contains an optional string that defines the sort order in which this observation is presented in a standard report or display that contains the many observations.

8.8.3.21 OM1-21 Date/time stamp for any change in definition for the observation (TS) 00606

Definition: This field contains the date and time that the last of any field change was made and in the host's record corresponding to the OM1 segment.

8.8.3.22 OM1-22 Effective date/time of change (TS) 00607

Definition: This field contains the date and time of the last change in the test procedure that would make previous results incompatible with new results, e.g., the last time that normal reference range or units changed for a numeric test/observation.
We strongly suggest that observation producers never use the same observation ID when the measurement procedures change in such a way that results produced under the new procedure are clinically different from those produced with the old procedure. Rather, the producer should try to adjust the new procedure so that its values are clinically indistinguishable from the old. Failing that, one should create a new observation ID for the observation produced under the new procedure.
In the rare circumstances when a procedure change occurs and neither of the above two options is viable, this field shall be used to transmit the effective date/time of the new procedure. The receiving system shall assume that any values that come across under this observation ID are under the new procedure after this date and take appropriate steps to distinguish the old from the new observations.
This number is included to provide a means of communicating with the observation producing service when they have questions about particular observations or results.

8.8.3.23 OM1-23 Typical turn-around time (NM) 00608

Definition: This field contains the typical processing time for single test/observation. This field indicates the time from the delivery of a specimen or transport of a patient to a diagnostic service and the completion of the study. It includes the usual waiting time. The units are measured in minutes.

8.8.3.24 OM1-24 Processing time (NM) 00609

Definition: This field contains the usual length of time (in minutes) between the start of a test process and its completion.

8.8.3.25 OM1-25 Processing priority (ID) 00610

Definition: This field contains one or more available priorities for performing the observation or test. This is the priority that can be placed in OBR-27 - Quantity/timing. For tests that require a specimen, this field may contain two components in the format <specimen priority>^<processing priority>. The first component in this case indicates the priority with which the specimen will be collected and is the priority that is specified in an OBR segment when ordering the observation. The second component indicates the corresponding priority with which the producer service will process the specimen, produce the observation, and return results, when this differs from collection priority. Refer to HL7 table 0168 - Processing priority for valid values.

HL7 Table 0168 - Processing priority

Value

Description

S

Stat (do immediately)

A

As soon as possible (a priority lower than stat)

R

Routine

P

Preoperative (to be done prior to surgery)

T

Timing critical (do as near as possible to requested time)

C

Measure continuously (e.g., arterial line blood pressure)

B

Do at bedside or portable (may be used with other codes)

The priority for obtaining the specimen is included in OM4. Multiple priorities may be given, separated by repeat delimiters. For example, S~A~R~P~T indicates that the test may be ordered using codes S, A, R, P, or T.

8.8.3.26 OM1-26 Reporting priority (ID) 00611

Definition: This field contains the available priorities reporting the test results when the user is asked to specify the reporting priority independent of the processing priority. Refer to HL7 Table 0169 - Reporting priority for valid values.

HL7 Table 0169 - Reporting priority

Value

Description

C

Call back results

R

Rush reporting

8.8.3.27 OM1-27 Outside site(s) where observation may be performed (CE) 00612

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the identification(s) of the outside service(s) that produce(s) the observation. The format of this CE field uses the producer ID (as defined in OM1-5 - Producer ID) and the name of the service separated by component delimiters. An example is ...|39221^ACME lab^MC|... If multiple services are used, they should be separated by repeat delimiter(s).

8.8.3.28 OM1-28 Address of outside site(s) (XAD) 00613

Components: In Version 2.3 and later, replaces the AD data type. <street address (SAD)> ^ <other designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code (ST)> ^ <country (ID)> ^ < address type (ID)> ^ <other geographic designation (ST)> ^ <county/parish code (IS)> ^ <census tract (IS)> ^ <address representation code (ID)> ^ <address validity range (DR)>
Definition: This field contains the address of the outside services listed in OM1-28 - Address of outside site(s) where observation may be performed. If multiple services are recorded in that field, their addresses should be separated by repeat delimiters, and the addresses should appear in the same order in which the services appear in the preceding field.

8.8.3.29 OM1-29 Phone number of outside site (XTN) 00614

Components: [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <county code (NM)> ^ <area/city code (NM)> ^ <phone number (NM) ^ <extension (NM)> ^ <any text (ST)>
Definition: This field contains the telephone number of the outside site.

8.8.3.30 OM1-30 Confidentiality code (IS) 00615

Definition: This field contains the degree to which special confidentiality protection should be applied to the observation. For example, a tighter control may be applied to an HIV test than to a CBC. Refer to User-defined Table 0177 - Confidentiality code for suggested values.

User-defined Table 0177 - Confidentiality code

Value

Description

V

Very restricted

R

Restricted

U

Usual control

EMP

Employee

UWM

Unwed mother

VIP

Very important person or celebrity

PSY

Psychiatric patient

AID

AIDS patient

HIV

HIV(+) patient

ETH

Alcohol/drug treatment patient

8.8.3.31 OM1-31 Observations required to interpret this observation (CE) 00616

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the list of variables that the diagnostic service needs to interpret the results of an ordered study. The observations specified here should be sent to the diagnostic service as OBX segments along with the order (OBR) segment.
Example for cervical pap smear:
...|2000.32^date last menstrual period^AS4~2000.33^menstrual state^AS4|...
Example for arterial blood gas:
...|94700^inspired 02^AS4|...
These examples use AS4 codes in code/text format to identify the variables. Separate multiple items by repeat delimiters.

8.8.3.32 OM1-32 Interpretation of observations (TX) 00617

Definition: This field contains the clinical information about interpreting test results. Examples are the conditions (drugs) that may cause false abnormals, and the information about the sensitivity and specificity of the test for diagnoses.

8.8.3.33 OM1-33 Contraindications to observations (CE) 00618

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the diagnosis or problem for which the test is a contraindication or of possible danger (e.g., pacemaker, pregnancy, diabetes). For example, if the test identified in OM1 was an intravenous pyelogram, this field would include warnings about the use of contrast media in diabetes. The contraindication diagnoses should be separated by repeat delimiters.
Most contraindication rules will be transmitted as free text. In such cases, the contents serve only as information for human reading. However, an alternative for machine readable contraindication rules also exists. The rule may be defined formally in the Arden Syntax (ASTM 1460-1992) which has syntax for defining algebraic and transcendental equations, as well as temporal and logical selection criteria based on patient information stored in the computer record. Reflex rules that are written in Arden Syntax should begin and end with a double semi-colon (;;), the Arden slot delimiter.

8.8.3.34 OM1-34 Reflex tests/observations (CE) 00619

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the test names as type CE (i.e., <code>^<text name>^<coding system>) that may be ordered automatically by the diagnostic service, depending on the results obtained from the ordered battery. A screening CBC might trigger a reticulocyte count if the Hgb is less than 12. Multiple reflex tests are separated by repeat delimiters.

8.8.3.35 OM1-35 Rules that trigger reflex testing (TX) 00620

Definition: This field contains the rules that trigger the reflex tests listed above. If multiple reflex tests are listed in OM1-34 - Reflex text/observations separated by repeat delimiters, a set of corresponding rules will be included in this section. The first rule will apply to the first test, the second to the second test, and so on.
Most reflex rules will usually be transmitted as free text. In such cases, the contents serve only as information for human reading. However, an alternative for machine readable rules also exists. The rule may be defined formally in the Arden Syntax (ASTM 1460-1992) which has syntax for defining algebraic and transcendental equations, as well as temporal and logical selection criteria based on patient information stored in the computer record. Reflex rules that are written in Arden Syntax should begin and end with a double semi-colon (;;), the Arden slot delimiter.

8.8.3.36 OM1-36 Fixed canned message (CE) 00621

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the codes and a fixed text message that is always associated with an abbreviation. The field may include multiple messages separated by repeat delimiters.
Most rules about patient testing will be transmitted as free text. In such cases, the contents serves only as information for human reading. However, an alternative for machine readable rules also exists. The rule may be defined formally in the Arden Syntax (ASTM 1460-1992) which has syntax for defining algebraic and transcendental equations, as well as temporal and logical selection criteria based on patient information stored in the computer record. Rules about patient preparation are written in Arden Syntax should begin and end with a double semi-colon (;;), the Arden slot delimiter.

8.8.3.37 OM1-37 Patient preparation (TX) 00622

Definition: This field contains the tests or observations that require special patient preparation, diet, or medications. For GI contrast studies, this field would contain the pretest diet, e.g., low residue for two days, NPO before study, and the preferred purgatives. Each separate med, diet, or preparation should be delimited by a repeat delimiter. Separate each requirement by a repeat delimiter. Example for a sigmoidectomy:
...|clear liquid diet full day before procedure~take 8 oz mag citrate 6pm day before procedure~take 2 ducat tabs (5m) at 4pm day before procedure~NPO past midnight.|...

8.8.3.38 OM1-38 Procedure medication (CE) 00623

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the treatments that may be needed as part of the procedure. Examples are radioactive iodine for a thyroid screen, and methacholine for a methacholine spirometry challenge. This field should be identified as a CE data type.

8.8.3.39 OM1-39 Factors that may affect the observation (TX) 00624

Definition: This field contains the text description of the foods, diagnoses, drugs, or other conditions that may influence the interpretation of the observation. Information about the direction of the effect, and any recommendation about altering the diet, conditions, or drug before initiating the test observation.
Most rules about factors that effect the test interpretation will be transmitted as free text. In such cases, the contents serves only as information for human reading. However, an alternative for machine readable rules also exists. The rule may be defined formally in the Arden Syntax (ASTM 1460-1992) which has syntax for defining algebraic and transcendental equations, as well as temporal and logical selection criteria based on patient information stored in the computer record. Rules about patient preparation are written in Arden Syntax and should begin and end with a double semi-colon (;;), the Arden slot delimiter.

8.8.3.40 OM1-40 Service/test/observation performance schedule (ST) 00625

Definition: This field contains the diagnostic studies/tests that are performed only at certain times during the course of a work day or work week. This field indicates the maximum interval between successive test performances (the test may actually be performed more frequently). The format given in Chapter 4, Section 4.3.2.1, "Repeat Pattern," should be used. If necessary, multiple codes may be given, separated by repeat delimiters. The use of multiple codes indicates that the test is performed at multiple concurrent intervals. For example, Q6H indicates that the test is performed at least once every 6 hours around the clock. QJ1 indicates that the test is performed at least every week on Mondays. QAM~QPM indicates that the test is performed at least once every morning and every evening. QJ1~QJ3~QJ5 indicates that the test is performed at least every week on Mondays, Wednesdays, and Fridays. C indicates that the test is performed continuously, 7 days per week.

8.8.3.41 OM1-41 Description of test methods (TX) 00626

Definition: This field contains the text description of the methods used to perform the text and generate the observations. Bibliographic citations may be included.

8.8.3.42 OM1-42 Kind of quantity observed (CE) 00937

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definitions: This optional attribute describes the underlying kind of property represented by this observation. This attribute distinguishes concentrations from total amounts, molar concentrations from mass concentrations, partial pressures from colors, and so forth. These are discussed more fully in the LOINC Users' Manual.[1] They are derived from the approach described in 1995 edition of the IUPAC Silver Book.[2] These distinctions are used in IUPAC and LOINC standard codes. Defined categories are listed in HL7 table 0254 - Kind of quantity.
The distinctions of true quantities in this table are based primarily on dimensional analyses. The table contains a number of "families," those related to simple counts (number, number concentration, etc.), to mass (mass, mass concentration, etc.), to enzyme activity (catalytic content, catalytic concentration, etc.), and molar or equivalents (substance content, substance concentration).
By this classification, a glucose (in the US) would be classed as a mass concentration. A sodium would be classed as a substance concentration. Within the family, a total amount should be described as the unadorned variant; e.g., the property of measure for a patient's weight would be mass, not mass content. Most chemical measures produce concentrations, as exemplified by sodium and glucose. However, a 24-hour urine protein is not a mass concentration, but a mass rate (mass per unit time). The content variants (e.g., mass content, substance content) are used to reflect an amount per mass (usually) of tissue.
This attribute would be valued in a master file only if the service sending the master file classified observations by their principle of measurement.

HL7 Table 0254 - Kind of quantity

Value

Description

CACT

*Catalytic Activity

CNC

*Catalytic Concentration

CCRTO

Catalytic Concentration Ratio

CCNT

*Catalytic Content

CFR

*Catalytic Fraction

CRAT

*Catalytic Rate

CRTO

Catalytic Ratio

ENT

*Entitic

ENTSUB

*Entitic Substance of Amount

ENTCAT

*Entitic Catalytic Activity

ENTNUM

*Entitic Number

ENTVOL

*Entitic Volume

MASS

*Mass

MCNC

*Mass Concentration

MCRTO

*Mass Concentration Ratio

MCNT

Mass Content

MFR

*Mass Fraction

MINC

*Mass Increment

MRAT

*Mass Rate

MRTO

*Mass Ratio

NUM

*Number

NCNC

*Number Concentration

NCNT

*Number Content

NFR

*Number Fraction

NRTO

*Number Ratio

SUB

*Substance Amount

SCNC

*Substance Concentration

SCRTO

*Substance Concentration Ratio

SCNT

*Substance Content

SCNTR

*Substance Content Rate

SFR

*Substance Fraction

SCNCIN

*Substance Concentration Increment

SRAT

*Substance Rate

SRTO

*Substance Ratio

VOL

*Volume

VCNT

*Volume Content

VFR

*Volume Fraction

VRAT

*Volume Rate

VRTO

*Volume Ratio

ACNC

Concentration, Arbitrary Substance

RLMCNC

*Relative Mass Concentration

RLSCNC

*Relative Substance Concentration

THRMCNC

*Threshold Mass Concentration

THRSCNC

*Threshold Substance Concentration

TIME

*Time (e.g. seconds)

TMDF

*Time Difference

TMSTP

*Time Stamp -- Date and Time

TRTO

*Time Ratio

RCRLTM

*Reciprocal Relative Time

RLTM

*Relative Time

ABS

Absorbance

ACT

*Activity

APER

Appearance

ARB

*Arbitrary

AREA

Area

ASPECT

Aspect

CLAS

Class

CNST

*Constant

COEF

*Coefficient

COLOR

Color

CONS

Consistency

DEN

Density

DEV

Device

DIFF

*Difference

ELAS

Elasticity

ELPOT

Electrical Potential (Voltage)

ELRAT

Electrical current (amperage)

ELRES

Electrical Resistance

ENGR

Energy

EQL

Equilibrium

FORCE

Mechanical force

FREQ

Frequency

IMP

Impression/ interpretation of study

KINV


*Kinematic Viscosity

LEN

Length

LINC

*Length Increment

LIQ

*Liquefaction

MGFLUX

Magnetic flux

MORPH

Morphology

MOTIL

Motility

OD

Optical density

OSMOL

*Osmolality

PRID

Presence/Identity/Existence

PRES

*Pressure (Partial)

PWR

Power (wattage)

RANGE

*Ranges

RATIO

*Ratios

RDEN

*Relative Density

REL

*Relative

SATFR

*Saturation Fraction

SHAPE

Shape

SMELL

Smell

SUSC

*Susceptibility

TASTE

Taste

TEMP

*Temperature

TEMPDF

*Temperature Difference

TEMPIN

*Temperature Increment

TITR

*Dilution Factor (Titer)

TYPE

*Type

VEL

*Velocity

VELRT

*Velocity Ratio

VISC

*Viscosity

*Starred items are adopted from the IUPAC Silver Book,2 non-starred items are extensions.

8.8.3.43 OM1-43 Point versus interval (CE) 00938

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This optional attribute allows master files to classify observations as measuring the patient's state at a point in time (e.g., spot urines, random urines, serum potassium), or averaged over a interval of time (e.g., concentration, total amount, or clearance over a 24-hour collection). Interval measures most often apply to urine and stool specimens (e.g., 24-hour urines, 3-day stool fats). They also apply to clinical measurements such as urine outputs, which are reported as shift totals and 24-hour totals, and event counts on physiologic monitors such as the number of PVCs on a 24-hour Holter monitor.
This field would only be valued in a transaction if the service sending this master file message classified its observation by point versus time interval. This field is not used to record the time collection interval for a particular sample. It is used to specify a characteristic of an observation which has a defined normal range and to distinguish observations of the same kind but observed over varying periods of time. A spot urine sodium would have PT stored in this field. A 24-hour urine sodium and a 24-hour Holter monitor would have 24H stored here. This attribute would only be valued if the filling service classified its observations by timing. Refer to User-defined Table 0255 - Duration categories for suggested values.

User-defined Table 0255 - Duration categories

Value

Description

PT

To identify measures at a point in time. This is a synonym for "spot" or "random" as applied to urine measurements.

*

(asterisk) Life of the "unit." Used for blood products.

30M

30 minutes

1H

1 hour

2H

2 hours

2.5H

2½ hours

3H

3 hours

4H

4 hours

5H

5 hours

6H

6 hours

7H

7 hours

8H

8 hours

12H

12 hours

24H

24 hours

2D

2 days

3D

3 days

4D

4 days

5D

5 days

6D

6 days

1W

1 week

2W

2 weeks

3W

3 weeks

4W

4 weeks

1L

1 months (30 days)

2L

2 months

3L

3 months

8.8.3.44 OM1-44 Challenge information (TX) 00939

Definition: This optional attribute provides information for classifying observations by the challenge component of the test, if a challenge does speciate the observation. For example, distinguishing tests that have a challenge component in database. There co-ascribes the physiologic or drug challenge that is intrinsic to the measurement. To identify, for example, tests that include a glucose challenge.
To construct this text string, use the following template. (Note: This field is not constructed of formally defined components; it is a free text field. Component delimiters are not used and it is not necessary to supply placeholders if some "components" are not used.)
The time delay follows the syntax: n<S|M|H|D|W> where n is a number (possibly a decimal); S denotes seconds; M denotes minutes; H denotes hours; D denotes days; and W denotes weeks. The time delay can be preceded by a `greater than' (>) sign, e.g. >4H.
HL7 Table 0256 - Time delay post challenge lists possible values for time delay.
Examples
PRE 100 GM GLUCOSE PO
PRE 100 GM GLUCOSE PO
30M POST 100 GM GLUCOSE PO
2H POST 100 GM GLUCOSE PO
TROUGH
For drug peak and trough measures the nature of the substance challenged is the same as the analyte name, and need not be included.
We denote the route of the challenge via abbreviations for medication routes (see Chapter 4, Section 4.14.2.1, "Route," HL7 table 0162 - Route of administration). An oral route of administration would be denoted by "PO," an intravenous route by "IV."
Details of the drug dose, time the dose was given, route of administration, etc., would be noted in separate OBX, and would have corresponding master observation definitions stored in the observation master file map to different records stored in the master file segments contained in the drug level message.

HL7 Table 0256 - Time delay post challeng e

Value

Description

BS

Baseline (time just before the challenge)

PEAK

The time post drug dose at which the highest drug level is reached (differs by drug)

TROUGH

The time post drug dose at which the lowest drug level is reached (varies with drug)

RANDOM

Time from the challenge, or dose not specified. (random)

1M

1 minute post challenge

2M

2 minutes post challenge

3M

3 minutes post challenge

4M

4 minutes post challenge

5M

5 minutes post challenge

6M

6 minutes post challenge

7M

7 minutes post challenge

8M

8 minutes post challenge

9M

9 minutes post challenge

10M

10 minutes post challenge

15M

15 minutes post challenge

20M

20 minutes post challenge

25M

25 minutes post challenge

30M

30 minutes post challenge

1H

1 hour post challenge

2H

2 hours post challenge

2.5H

2 1/2 hours post challenge

3H

3 hours post challenge

4H

4 hours post challenge

5H

5 hours post challenge

6H

6 hours post challenge

7H

7 hours post challenge

8H

8 hours post challenge

8H SHIFT

8 hours aligned on nursing shifts

12H

12 hours post challenge

24H

24 hours post challenge

2D

2 days

3D

3 days

4D

4 days

5D

5 days

6D

6 days

7D

7 days

1W

1 week


10D

10 days

2W

2 weeks

3W

3 weeks

4W

4 weeks

1L

1 month (30 days) post challenge

2L

2 months (60 days) post challenge

3L

3 months (90 days) post challenge

The nature of a physiologic (non-drug) challenge may also be specified, using the terms in HL7 Table 0257 - Nature of challenge.

HL7 Table 0257 - Nature of challenge

Value

Description

CFST

Fasting (no calorie intake) for the period specified in the time component of the term, e.g., 1H POST CFST

EXCZ

Exercise undertaken as challenge (can be quantified)

FFST

No fluid intake for the period specified in the time component of the term

8.8.3.45 OM1-45 Relationship modifier (CE) 00940

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This optional attribute provides a mechanism for classifying observations according to the subject, in relation to the patient whose results might be stored with as "patient" data. It is standard practice, for example, to report values for controls, donors, and blood product units as well as the patient's own values, and store them in the patient's record. (This may not be the best way to model such information, but it is the way it is usually reported.) This should be valued when two values (e.g., one for patient and one for a blood product unit) could otherwise be confused.
The default value is "Patient," and if not specified, this value is assumed. The persons sub-component can refer to HL7 Table 0258 - Relationship modifier for valid values.

HL7 Table 0258 - Relationship modifier

Value

Description

CONTROL

Control

PATIENT

Patient

DONOR

Donor

BPU

Blood product unit

8.8.3.46 OM1-46 Target anatomic site of test (CE) 00941

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This optional attribute formally indicates the site of the observation (to make it easy for a system to find all tests related to one anatomic site). It can be used to classify the observation by target site of the examination. For example, "heart" might be recorded as the target of the electrocardiogram, cardiac echo, and thallium exercise test. This attribute would be applicable to most imaging and electro-physiologic examinations. The SNOMED topology axis is an example of a coding system for anatomic sites. User-defined tables may also apply here.

8.8.3.47 OM1-47 Modality of imaging measurement (CE) 00942

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This optional attribute describes the modality used to classify the observations, e.g., radiograph, ultrasound, CT scan, NMR, etc. This attribute is especially important for imaging studies. Refer to User-defined Table 0259 - Modality for suggested values; they are adopted from DICOM C.7.3.1.1.1 Modality. If these are used, the code source ID would be DCM.

User-defined Table 0259 - Modality

Value

Description

AS

Angioscopy

BS

Biomagnetic imaging

CD

Color flow Doppler

CP

Colposcopy

CR

Computed radiography

CS

Cystoscopy

CT

Computed tomography

DD

Duplex Doppler

DG

Diapanography

DM

Digital microscopy

EC

Echocardiography

ES

Endoscopy

FA

Fluorescein angiography

FS

Fundoscopy

LP

Laparoscopy

LS

Laser surface scan

MA

Magnetic resonance angiography

MS

Magnetic resonance spectroscopy

NM

Nuclear Medicine (radioisotope study)

OT

Other

PT

Positron emission tomography (PET)

RF

Radio fluoroscopy

ST

Single photon emission computed tomography (SPECT)

TG

Thermography

US

Ultrasound

XA

X-ray Angiography

8.8.4 OM2 - numeric observation segment

The Technical Steward for the OM2 segment is ORDERS.
This segment contains the attributes of observations with continuous values (including those with data types of numeric, date, or time stamp). It can be applied to observation batteries of type A and C (see OM1-18 - Nature of service/test/observation).

HL7 Attribute Table - OM2 - Numeric Observation

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

NM

O



00586

Sequence Number- Test/Observation Master File

2

250

CE

O


9999

00627

Units of Measure

3

10

NM

O

Y


00628

Range of Decimal Precision

4

250

CE

O


9999

00629

Corresponding SI Units of Measure

5

60

TX

O



00630

SI Conversion Factor

6

250

CM

O



00631

Reference (Normal) Range - Ordinal and Continuous Observations

7

205

CM

O



00632

Critical Range for Ordinal and Continuous Observations

8

250

CM

O



00633

Absolute Range for Ordinal and Continuous Observations

9

250

CM

O

Y


00634

Delta Check Criteria

10

20

NM

O



00635

Minimum Meaningful Increments

8.8.4.0 OM2 field definitions

8.8.4.1 OM2-1 Sequence number - test/observation master file (NM) 00586

Definition: This field contains the same value as the sequence number of the associated OM1 segment.

8.8.4.2 OM2-2 Units of measure (CE) 00627

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the single tests/observations (those with a nature code of A or C, as described in OM1-18 - Nature of service/test/observation) that have numeric values. This field contains their customary units of measure.

8.8.4.3 OM2-3 Range of decimal precision (NM) 00628

Definition: This field contains the numerically valued single observations (code A or C as described in OM1-18 - Nature of service/test/observation), specifies the total length in characters of the field needed to display the observation, and the number of digits displayed to the right of the decimal point. This is coded as a single number in the format <length>.<decimal-digits>. For example, a value of 6.2 implies 6 characters total (including the sign and decimal point) with 2 digits after the decimal point. For integer values, the period and <decimal-digits> portion may be omitted (that is, 5.0 and 5 are equivalent). More than one such mask may be transmitted (separated by repeat delimiters) when it is necessary to define multiple display formats that are possible.

8.8.4.4 OM2-4 Corresponding SI units of measure (CE) 00629

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the single tests/observations - the corresponding SI units of measure in the format, when these differ from the customary units of measure given in the previous field.

8.8.4.5 OM2-5 SI conversion factor (TX) 00630

Definition: This field contains the continuous, numerically valued tests/observations, with a nature code of A or C (see OM1-18 - Nature of service/test/observation). This is a factor for converting the customary units to SI units.
In the case that the observation units are not SI units, this field provides the formula needed to convert from the reported units to SI units, this shall include the equation needed to convert from the reporting to the SI units.
In the case that the relation is simply multiplicative, this field shall include only the conversion factor. For example., if (results SI units) = c * (results reporting units),then only c would be stored in this field. In the case of any other functional relationship, the entire equation would be stored as a test.

8.8.4.6 OM2-6 Reference (normal) range for ordinal and continuous observations (CM) 00631

Definition: This field contains the reference (normal) ranges for "numeric" observations/tests with a nature code of A or C (see OM1-18 - Nature of service/test/observation). It can identify different reference (normal) ranges for different categories of patients according to age, sex, race, and other conditions.
The general format is:
<ref. (normal) range1>^<sex1>^<age range1>^<age gestation1>^<species1>^<race/subspecies1>^<text condition1>~
<ref. (normal) range2>^<sex2>^<age range2>^<age gestation2>^<species2>^<race/subspecies2>^<text condition2>~
·
·
·
<ref. (normal) rangen>^<sexn>^<age rangen>^<age gestationn>^<speciesn>^<race/subspeciesn>^<text conditionn>
The components are defined in the following sections.

8.8.4.6.1 The reference (normal) range (CM)

Components: <low value (NM)> & <high value (NM)>
Definition: This subcomponent contains the reference (normal) range. The format of this field is where the range is taken to be inclusive (i.e., the range includes the end points). In this specification, the units are assumed to be identical to the reporting units given in OM2-2 - Units of measure).

8.8.4.6.2 Administrative Sex (IS)

Definition: This subcomponent contains the sex of the patient. Refer to User-defined Table 0001 - Administrative Sex for suggested values.

8.8.4.6.3 Age range (CM)

Subcomponents: <low value (NM)> & <high value (NM)>
Definition: This component contains the age range (in years or fractions thereof) specified as two values separated by a subcomponent delimiter (in order to allow a simple and consistent machine interpretation of this component). Ages of less than one year should be specified as a fraction (e.g., 1 month = 0.0830, 1 week = 0.01920, 1 day = 0.0027300). However, for most purposes involving infants, the gestational age (measured in weeks) is preferred. The lower end of the range is not indicated; the upper end is, assuring that series of ranges do not overlap.

8.8.4.6.4 Gestational age range (CM)

Subcomponents: <low value (NM)> & <high value (NM)>
Definition: This component contains the gestational age and is relevant only when the reference range is influenced by the stage of pregnancy. A range of values is required. The gestational age is measured in weeks from conception. For example, <1&10> implies that the normals apply to gestational ages from 1 week to 4 weeks inclusive (1&4). The lower end of the range is not included; the upper end is, assuring that series of age ranges do not overlap.

8.8.4.6.5 Species (TX)

Definition: This component is assumed to be human unless otherwise stated. The species should be represented as text (e.g., rabbit, mouse, rat).

8.8.4.6.6 Race/subspecies (ST)

Definition: In the case of humans (the default), the race is specified when race influences the reference range. When normal ranges for animals are being described, this component can be used to describe subspecies or special breeds of animals.

8.8.4.6.7 Conditions (TX)

Definition: This component contains the condition as simply free text. This component allows for definition of normal ranges based on any arbitrary condition, e.g., phase of menstrual cycle or dose of a particular drug. It is provided as a way to communicate the normal ranges for special conditions. It does not allow automatic checking of these text conditions.

8.8.4.6.8 Examples

A range that applies unconditionally, such as albumin, is transmitted as:
3.0 & 5.5
A normal range that depends on sex, such as Hgb, is transmitted as:
13.5 & 18^M~
12.0 & 16^F
A normal range that depends on age, sex, and race (a concocted example) is:
10 & 13 ^M^0 & 2 ^^^B
11 & 13.5 ^M^2 & 20 ^^^B~
12 & 14.5 ^M^20 & 70 ^^^B~
13 & 16.0 ^M^70 & ^^^B
When no value is specified for a particular component, the range given applies to all categories of that component. For example, when nothing is specified for race/species, the range should be taken as the human range without regard to race. If no age range is specified, the normal range given is assumed to apply to all ages. If the upper or lower end of a range is left out, it is assumed to be +infinity or -infinity, respectively.
When two different methods result in two different reference ranges, two different observations and corresponding OMx segments should be defined.

8.8.4.7 OM2-7 Critical range for ordinal and continuous observations (CM) 00632

Components: <low value (NM)> ^ <high value (NM)>
Definition: This field applies only to single tests/observations (i.e., a nature code of A or C, as described in OM1-18 - Nature of service/test/observation) with numeric results. When a critical range is defined for such observations, it should be recorded here in the same format as the normal range (see OM2-6 - Reference (normal) range - ordinal and continuous observations).

8.8.4.8 OM2-8 Absolute range for ordinal and continuous observations (CM) 00633

Components: <range> ^ <numeric change> ^ <%/a change> ^ <days>
Definition: This field applies only to single tests/observations with a nature code of A or C (see OM1-18 - Nature of service/test/observation). It defines the range of possible results. Results outside this range are not possible. The field should be recorded in the same format as the normal and critical ranges.

8.8.4.9 OM2-9 Delta check criteria (CM) 00634

Components: <low & high (CM)> ^ <numeric threshold (NM)> ^ <change (ST)> ^ <length of time-days (NM)>
Definition: This field applies to numeric tests/observations with a nature code of A or C (see OM1-18 - Nature of service/test/observation). The field describes the information that controls delta check warnings and includes four components.
1) The range to which the following applies: <low & high>.
All the ranges are defined in terms of the customary reporting units given in OM2-2-units of measure. If no value range is given, the check applies to all values.
2) The numeric threshold of the change that is detected, e.g., 10.
3) Whether the change is computed as a percent change or an absolute change. This component can have two possible values:
% Indicates a percent change
a Absolute change
4) The length of time that the service retains a value for computing delta checks. This is recorded in number of days.
More than one delta check rule can apply. 13&16^10^%^100~16.1&20^2^a^100 implies that the delta check will trigger on a 10% change when the value of the observation is between 13 and 16. The check will trigger on an absolute change of 2 when the value is between 16.1 and 20. In both cases, the system will keep the last result for 100 days. In this example, beyond 100 days, the computer will not compute a delta check because it will not have a comparison value.

8.8.4.10 OM2-10 Minimum meaningful increments (NM) 00635

Definition: This field contains the numerically valued single observations (a nature code of A or C, as described in OM1-18 - Nature of service/test/observation) and specifies the smallest meaningful difference between reported values (the effective resolution of the measuring instrument or technique for continuous data, or the smallest discrete interval that can occur for discrete data).

8.8.5 OM3 - categorical service/test/observation segment

The Technical Steward for the OM3 segment is ORDERS.
This segment applies to free text and other non-numeric data types.

HL7 Attribute Table - OM3 - Categorical Service/Test/Observation

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

NM

O



00586

Sequence Number- Test/Observation Master File

2

250

CE

O


9999

00636

Preferred Coding System

3

250

CE

O


9999

00637

Valid Coded "Answers"

4


250

CE

O

Y

9999


00638

Normal Text/Codes for Categorical Observations

5

250

CE

O


9999

00639

Abnormal Text/Codes for Categorical Observations

6

250

CE

O


9999

00640

Critical Text/Codes for Categorical Observations

7

2

ID

O


0125

00570

Value Type

8.8.5.0 OM3 field definitions

8.8.5.1 OM3-1 Sequence number - test/observation master file (NM) 00586

Definition: This field contains the same value as the sequence number of the associated OM1 segment.

8.8.5.2 OM3-2 Preferred coding system (CE) 00636

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the observations whose categorical responses are taken from a specified table of codes (e.g., CE data types). Record the preferred coding system for this observation (e.g., ICD9, SNOMED III). Take the codes from ASTM Table 3 or 5, or specify a local code.

8.8.5.3 OM3-3 Valid coded "answers" (CE) 00637

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains a list of valid coded answers. In the case that the list of coded answers is easily enumerated, list the valid coded answers for this observation here using the preferred coding system given in OM3-2 - Preferred coding system. If, for example, the given observation was VDRL, the valid answers might be non-reactive, 86^ intermediate, and 87^ reactive.

8.8.5.4 OM3-4 Normal text/codes for categorical observations (CE) 00638

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: Certain observations/tests with a nature code of A or C (see OM1-18 - Nature of service/test/observation) have text (alpha) results (e.g., reactive, nonreactive). Alpha normals for those tests should be entered in this field (e.g., "nonreactive").
The format of this field is:
The first component is a code taken from a standard code source list. The second component is the text associated with the code. The third component is the identification of the code table source. When only a text description of a possible answer is available, it is recorded as ^<text>.
Care should be taken to transmit only those results that are considered normal for that test. A drug screen may have possible results of "negative" and "positive." However, only a result of "negative" is considered to be normal. When an observation has more than one "normal" result, multiple values in this field should be separated with a repeat delimiter.

8.8.5.5 OM3-5 Abnormal text/codes for categorical observations (CE) 00639

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the list of the text answers that are abnormal for the test.

8.8.5.6 OM3-6 Critical text/codes for categorical observations (CE) 00640

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the list of coded results that are critically abnormal for this observation.

8.8.5.7 OM3-7 Value type (ID) 00570

Definition: This field contains the allowed data type for a single categorical observation (code A or C in OM1-18 - Nature of observation). Refer to HL7 table 0125 - Value type for valid values.

8.8.6 OM4 - observations that require specimens segment

The Technical Steward for the OM4 segment is ORDERS.
This segment applies to observations/batteries that require a specimen for their performance. When an observation or battery requires multiple specimens for their performance (e.g., creatinine clearance requires a 24-hour urine specimen and a serum specimen), multiple segments may be included, one for each specimen type.

HL7 Attribute Table - OM4 - Observations that Require Specimens

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM #

ELEMENT NAME

1

4

NM

O



00586

Sequence Number- Test/Observation Master File

2

1

ID

O


0170

00642

Derived Specimen

3

60

TX

O



00643

Container Description

4

20

NM

O



00644

Container Volume

5

250


CE

O


9999

00645

Container Units

6

250

CE

O


9999

00646

Specimen

7

250

CE

O


0371

00647

Additive

8

10240

TX

O



00648

Preparation

9

10240

TX

O



00649

Special Handling Requirements

10

20

CQ

O



00650

Normal Collection Volume

11

20

CQ

O



00651

Minimum Collection Volume

12

10240

TX

O



00652

Specimen Requirements

13

1

ID

O

Y

0027

00653

Specimen Priorities

14

20

CQ

O



00654

Specimen Retention Time

8.8.6.0 OM4 field definitions

8.8.6.1 OM4-1 Sequence number - test/observation master file (NM) 00586

Definition: This field contains the same value as the sequence number of the associated OM1 segment.

8.8.6.2 OM4-2 Derived specimen (ID) 00642

Definition: This field contains the codes that identify the parents and children for diagnostic studies -- especially in microbiology -- where the initial specimen (e.g., blood) is processed to produce results (e.g., the identity of the bacteria grown out of the culture). The process also produces new "specimens" (e.g., pure culture of staphylococcus, and E. Coli), and these are studied by a second order process (bacterial sensitivities). The parents (e.g., blood culture) and children (e.g., penicillin MIC) are identified in such cases. Refer to HL7 Table 0170 - Derived specimen for valid values:

HL7 Table 0170 - Derived specimen

Value

Description

P

Parent Observation

C

Child Observation

N

Not Applicable

8.8.6.3 OM4-3 Container description (TX) 00643

Definition: This field contains the physical appearance, including color of tube tops, shape, and material composition (e.g., red-top glass tube). Note that the color is not necessarily a unique identifier of the additive and/or use of the tube. This is especially true for black and some blue tube tops, as can be seen above. Color is included here for user convenience.

8.8.6.4 OM4-4 Container volume (NM) 00644

Definition: This field indicates the capacity of the container.

8.8.6.5 OM4-5 Container units (CE) 00645

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the units of measure of the container volume. If the units are ISO+ units, they should be recorded as single case abbreviations. If the units are ANS+ or L (local), the units and the source code table must be recorded, except that in this case, component delimiters should be replaced by subcomponent delimiters. For example, 1 indicates liters, whereas pt&&ANS+ indicates pints (ANSI units). The default unit is milliliters (ml), which should be assumed if no units are reported.

8.8.6.6 OM4-6 Specimen (CE) 00646

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field reports the specimen as one of the specimen codes described in ASTM Table 14 of 1238-91. If multiple kinds of specimen are associated with this observation (as in the case for a creatinine clearance), separate them with repeat delimiters.

8.8.6.7 OM4-7 Additive (CE) 00647

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the codes that should be those provided by NCCLS[3]. Refer to HL7 table 0371 - Additive for valid values. The table's values are taken from NCCLS AUTO4. The value set can be extended with user specific values.

HL7 Table 0371 - Additive

Value

Description

EDTK

Potassium/K EDTA

EDTN

Sodium/Na EDTA

HEPL

Lithium/Li Heparin

HEPN

Sodium/Na Heparin

C32

3.2% Citrate

C38

3.8% Citrate

BOR

Borate

HCL6

6N HCL

This table was not specified in previous versions and thus sites may choose to use other site-specific tables.

8.8.6.8 OM4-8 Preparation (TX) 00648

Definition: This field contains the special processing that should be applied to the container, e.g., add acidifying tablets before sending.

8.8.6.9 OM4-9 Special handling requirements (TX) 00649

Definition: This field contains the special handling requirements here (e.g., ice specimen, deliver within two hours of obtaining).

8.8.6.10 OM4-10 Normal collection volume (CQ) 00650

Components: <quantity (NM)> ^ <units (CE)>
Definition: This field contains the normal specimen volume required by the lab. This is the amount used by the normal methods and provides enough specimens to repeat the procedure at least once if needed. The default unit is milliliters (ml).

8.8.6.11 OM4-11 Minimum collection volume (CQ) 00651

Components: <quantity (NM)> ^ <units (CE)>
Definition: This field contains the amount of specimen needed by the most specimen sparing method (e.g., using micro techniques). The minimum amount allows for only one determination. The default unit is milliliters (ml).

8.8.6.12 OM4-12 Specimen requirements (TX) 00652

Definition: This field contains the other requirements for specimen delivery and special handling (e.g., delivery within one hour, iced).

8.8.6.13 OM4-13 Specimen priorities (ID) 00653

Definition: This field contains the allowed priorities for obtaining the specimen. Note that they may be different from the processing priorities given in OM1-25 - Processing priority. When a test is requested, the specimen priority given in OBR-27 - Quantity/timing should be one of the priorities listed here. Multiple priorities are separated by repeat delimiters. Refer to HL7 Table 0027 - Priority for valid values.

HL7 Table 0027 - Priority

Value

Description

S

Stat (do immediately)

A

As soon as possible (a priority lower than stat)

R

Routine

P

Preoperative (to be done prior to surgery)

T

Timing critical (do as near as possible to requested time)

8.8.6.14 OM4-14 Specimen retention time (CQ) 00654

Components: <quantity (NM)> ^ <units (CE)>
Definition: This field contains the usual time that a specimen for this observation is retained after the observation is completed, for the purpose of additional testing. The first component is the duration, and the second component is an ISO time unit.

8.8.7 OM5 - observation batteries (sets) segment

The Technical Steward for the OM5 segment is ORDERS.
This segment contains the information about batteries and supersets (a nature code of F, P or S, as described in OM1-18 - Nature of service/test/observation).

HL7 Attribute Table - OM5 - Observation Batteries (Sets)

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

NM

O



00586

Sequence Number- Test/Observation Master File

2

250

CE

O

Y

9999

00655

Test/Observations Included within an Ordered Test Battery

3

250

ST

O



00656

Observation ID Suffixes

8.8.7.0 OM5 field definitions

8.8.7.1 OM5-1 Sequence number - test/observation master file (NM) 00586

Definition: This field contains the same value as the sequence number of the associated OM1 segment.

8.8.7.2 OM5-2 Tests/observations included within an ordered test battery (CE) 00655

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the codes and names of all tests/observations included within a single battery (nature code P, as described in OM1-18 - Nature of service/test/observation), a single functional procedure (nature code F), or a given superset (nature code S). When a segment includes a list of component elements, the sending system should be sure that the segments defining all of the components are sent before the segment that references them. An entry in this list can itself be a battery.
The individual service/test/observation IDs should be recorded as type CE, i.e., in the standard format for coded observation identifiers. Multiple observations should be separated by repeat delimiters.
If the definition segment defined serum electrolytes, this field might look like the following:
84132^potassium^AS4~
84295^sodium^AS4~
82435^chloride^AS4~
82374^HCO3^^AS4~
For S (superset) parameters, this field contains the batteries that are included within the "super" battery. For example, ROUTINES might be defined as:
402^Electrolytes~352^Urinalysis~432^CBC~520^SMA12

8.8.7.3 OM5-3 Observation ID suffixes (ST) 00656

Definition: This field contains the tests or procedures that produce a type which uses observation ID suffixes following the service/test/observation ID code. This field lists the possible options. The applicable three-character mnemonics given in ASTM Table 20 (or others appropriate to the application) are listed, separated by repeat delimiters. For example, a chest X-ray may use the suffixes IMP, REC, DEV, or others. Each of the expected suffixes should be listed here.

8.8.8 OM6 - Observations that are calculated from other observations segment

The Technical Steward for the OM6 segment is ORDERS.
This segment contains the information about quantities that are derived from one or more other quantities or direct observations by mathematical or logical means.

HL7 Attribute Table - OM6 - Observations that are Calculated from Other Observations

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

NM

O



00586

Sequence Number- Test/Observation Master File

2

10240

TX

O



00657

Derivation Rule

8.8.8.0 OM6 field definitions

8.8.8.1 OM6-1 Sequence number -test/observation master file (NM) 00586

Definition: This field contains the same value as the sequence number of the associated OM1 segment.

8.8.8.2 OM6-2 Derivation rule (TX) 00657

Definition: This field is used when there are patient variables that are derived from one or more other patient variables (e.g., creatinine clearance, ideal weight, maximum daily temperature, average glucose, framingham risk). This field contains the rules for deriving the value of this variable (i.e., nature code C, as given in OM1-18 - Nature of service/test/observation). These can be described in terms of humanly understandable formulas or descriptions.
When possible, however, they should be defined in terms of the Arden Syntax for specifying selection and transcendative functions and algebraic operations, ASTM E1460-92. Derivation rules that are represented in Arden Syntax should begin and end with an Arden slot delimiter (;;). Within this syntax, variables should be identified by OM1-2 - Producer's service/test/observation ID. We recommend the use of the Arden Syntax because it permits the unambiguous specification of most such derived values and is a published standard for medical logic modules.

8.8.9 OM7 - additional basic attributes (fields that apply to most observations/services)

The OM7 segment contains additional basic attributes that apply to the definition of most observations/services.

HL7 Attribute Table - OM7 - Additional Basic Attributes

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

NM

R



00586

Sequence Number - Test/Observation Master File

2

250

CE

R



00238

Universal Service Identifier

3

250

CE

O

Y

0412

01481

Category Identifier

4

200

TX

O



01482

Category Description

5

200

ST

O

Y


01483

Category Synonym

6

26

TS

O



01484

Effective Test/Service Start Date/Time

7

26

TS

O



01485

Effective Test/Service End Date/Time

8

5

NM


O



01486

Test/Service Default Duration Quantity

9

250

CE

O


9999

01487

Test/Service Default Duration Units

10

60

IS

O


0335

01488

Test/Service Default Frequency

11

1

ID

O


0136

01489

Consent Indicator

12

250

CE

O


0413

01490

Consent Identifier

13

26

TS

O



01491

Consent Effective Start Date/Time

14

26

TS

O



01492

Consent Effective End Date/Time

15

5

NM

O



01493

Consent Interval Quantity

16

250

CE

C


0414

01494

Consent Interval Units

17

5

NM

O



01495

Consent Waiting Period Quantity

18

250

CE

C


0414

01496

Consent Waiting Period Units

19

26

TS

O



00607

Effective Date/Time of Change

20

250

XCN

O



00224

Entered By

21

200

PL

O

Y


01497

Orderable-at Location

22

1

IS

O


0473

01498

Formulary Status

23

1

ID

O


0136

01499

Special Order Indicator

24

250

CE

O

Y

0132

01306

Primary Key Value - CDM

8.8.9.0 OM7 field definitions

8.8.9.1 OM7-1 Sequence number -test/observation master file (NM) 00586

Definition: This field contains the value as the sequence number.

8.8.9.2 OM7-2 Universal service identifier (CE) 00238

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the producer's usual or preferred identification of the test or service. The test/service ID may be any of those included in ASTM tables 3 and 5, or a local code.

8.8.9.3 OM7-3 Category identifier (CE) 01481

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the category name (term given to a group of service items for the purpose of classification). Examples: Laboratory, Pharmacy, Diagnostic Imaging, etc. Refer to User-defined Table 0412 - Category identifier for suggested values.

User-defined Table 0412 - Category identifier

Value

Description


No suggested values defined

8.8.9.4 OM7-4 Category description (TX) 01482

Definition: This field contains a text description for the category of the test/service item.
Example: The category "Pathology" may be described as a specialty practice concerned with all aspects of disease, with special reference to the essential natural cause and development of abnormal conditions, as well as the structural and functional changes that result from the disease process.

8.8.9.5 OM7-5 Category synonym (ST) 01483

Definition: This field contains an alternate name(s) for the category of the test/service. Example: The category "Radiology" is a synonym name for the category " Diagnostic Imaging".

8.8.9.6 OM7-6 Effective test/service start date/time (TS) 01484

Definition: This field contains the date and time that the service item is available to be ordered, performed, etc.

8.8.9.7 OM7-7 Effective test/service end date/time (TS) 01485

Definition: This field contains the date and time that the service item is no longer authorized to be ordered, performed, etc.

8.8.9.8 OM7-8 Test/service default duration quantity (NM) 01486

Definition: This field indicates the default duration quantity for the service.

8.8.9.9 OM7-9 Test/service default duration units (CE) 01487

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field indicates the default duration units for the service.

8.8.9.10 OM7-10 Test/service default frequency (IS) 01488

Definition: This field indicates the default frequency (how often) the service would be ordered for or performed on.

8.8.9.11 OM7-11 Consent indicator (ID) 01489

Definition: This field indicates if a consent is needed for the service item. Refer to HL7 Table 0136 - Yes/no indicator.
Y A consent is required for service item to be ordered/performed.
N No consent is needed for service item to be ordered/performed

8.8.9.12 OM7-12 Consent identifier (CE) 01490

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the identifier for the consent specified for the service item. Refer to User-defined Table 0413 - Consent identifier for suggested values.

User-defined Table 0413 - Consent identifier

Value

Description


No suggested values defined

8.8.9.13 OM7-13 Consent effective start date/time (TS) 01491

Definition: This field contains the date and time the consent is valid for the service item.

8.8.9.14 OM7-14 Consent effective end date/time (TS) 01492

Definition: This field contains the date and time the consent is no longer valid for the test/service.

8.8.9.15 OM7-15 Consent interval quantity (NM) 01493

Definition: This field specifies the period of time for which a consent is valid for a specific service item.

8.8.9.16 OM7-16 Consent interval units (CE) 01494

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field specifies the unit of time for OM7-15 - Consent interval quantity. Refer to User-defined Table 0414 - Units of time for suggested values.

User-defined Table 0414 - Units of time

Value

Description


No suggested values defined

Note: If Consent Interval Quantity is specified, then Consent Interval Unit is required.

8.8.9.17 OM7-17 Consent waiting period quantity (NM) 01495

Definition: This field contains the time period between the time the consent is signed and the procedure can be performed.

8.8.9.18 OM7-18 Consent waiting period unit (CE) 01496

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field specifies the unit of time for OM7-17 - Consent waiting period quantity. Refer to User-defined Table 0414 - Units of time for suggested values.
Note: If Consent Waiting Period Quantity is specified, then Consent Waiting Period Unit is required.

8.8.9.19 OM7-19 Effective date/time of change (TS) 00607

Definition: This field contains the date and time of the last change in the test procedure that would make previous results incompatible with new results.

8.8.9.20 OM7-20 Entered by (XCN) 00224

Components: <ID number (ST)> ^ <family name (FN)> ^ <given name (ST)> ^ <second or further given names or initials thereof (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code (ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ <identifier type code (IS)> ^ <assigning facility (HD)> ^ <name representation code (ID)> ^ <name context (CE)> ^ <name validity range (DR)> ^ < name assembly order (ID)>
Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)
Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)
Definition: This field contains the identity of the person who actually keyed the service item into the application. It provides an audit trail in case the request is entered incorrectly and the ancillary department needs to clarify the request.

8.8.9.21 OM7-21 Orderable-at location (PL) 01497

Components: <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ < location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>
Subcomponents of facility: <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>
Definition: This field contains the location(s) where the test/service can be ordered.

8.8.9.22 OM7-22 Formulary status (IS) 01498

Definition: This field indicates whether or not the service (pharmaceutical) is in the formulary. Refer to User-defined Table 0473 - Formulary status for valid values.

User Table 0473 - Formulary status

Value

Description

G

This observation/service is on the formulary, and has guidelines

N

This observation/service is not on the formulary

R

This observation/service is on the formulary, but is restricted

Y

This observation/service is on the formulary

8.8.9.23 OM7-23 Special order indicator (ID) 01499

Definition: This field indicates whether or not the service (pharmaceutical) is a special order. Refer to HL7 Table 0136 - Yes/no indicator for valid values.
Y This is a special order.
N This is not a special order

8.8.9.24 OM7-24 Primary key value - CDM (CE) 01306

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: Allows the ability to associate a Service/Test/Observation item with a CIM (charge item master). It is possible to allow multiple charge items to a single SIM item.

8.9 LOCATION MASTER FILES

8.9.1 Patient location master file message (MFN/MFK)

This section is specifically concerned with describing a master file message that should be used to transmit information which identifies the inventory of healthcare patient locations, such as nursing units, rooms, beds, clinics, exam rooms, etc. In a network environment, this segment can be used to define patient locations to other applications. The segment also includes the readiness states and support locations for the patient locations.
The LOC, LCH, LRL, LDP, and LCC segments must be preceded by the MFI and MFE segments, as described in Sections 8.9.2, "LOC - location identification segment," through 8.9.68.4." In the following message, the MFI-1 - Master file identifier field should equal "LOC"

MFN^M05^MFN_M05

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

LOC

Patient Location Master

8

[{LCH}]

Location Characteristic

8

[{LRL}]

Location Relationship

8

{ LDP

Location Department

8

[{LCH}]

Location Characteristic

8

[{LCC}]

Location Charge Code

8

}



}



When the LCH segment appears immediately following the LOC segment, it communicates characteristics which are the same across multiple departments that may use the same room. When the LCH segment appears immediately following the LDP segment, it communicates characteristics which differ for different departments that may use the same room.

MFK^M05^MFK_M01

Master File Acknowledgment

Chapter

MSH

Message Header

2

MSA

Acknowledgment

2

MFI

Master File Identification

8

[{MFA}]

Master File ACK

8

Master Files Query Response: When the LOC segment is used in the MFR message, the part of the message represented by:

{MFE




[Z..]}


is replaced by:

{MFE

Master File Entry


LOC

Patient Location Master


[{LCH}]

Location Characteristic


[{LRL}]

Location Relationship


{LDP

Location Department


[{LCH}]

Location Characteristic





[{LCC}]

Location Charge Code }}


8.9.2 LOC - location identification segment

The Technical Steward for the LOC segment is PAFM.
The LOC segment can identify any patient location referenced by information systems. This segment gives physical set up information about the location. This is not intended to include any current occupant or current use information. There should be one LOC segment for each patient location. If desired, there can also be one LOC segment for each nursing unit and room.

HL7 Attribute Table - LOC - Location Identification

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

200

PL

R



01307

Primary Key Value - LOC

2

48

ST

O



00944

Location Description

3

2

IS

R

Y

0260

00945

Location Type - LOC

4

250

XON

O

Y


00947

Organization Name - LOC

5

250

XAD

O

Y


00948

Location Address

6

250

XTN

O

Y


00949

Location Phone

7

250

CE

O

Y

0461

00951

License Number

8

3

IS

O

Y

0261

00953

Location Equipment

9

1

IS

O


0442

01583

Location Service Code

8.9.2.0 LOC field definitions

8.9.2.1 LOC-1 Primary key value - LOC (PL) 01307

Components: <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ <location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>
Subcomponents of facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field contains the institution's identification code for the location. The identifying key value. Must match MFE-4 -Primary key value. This field has the same components as the patient location fields in the PV1 segment (except that bed status is not included here).
At least the first component of this field is required. The first component can be an identifying code for the nursing station for inpatient locations, or clinic, department or home for patient locations other than inpatient ones.

8.9.2.2 LOC-2 Location description (ST) 00944

Definition: This field contains the optional free text description of the location, to elaborate upon LOC primary key value.

8.9.2.3 LOC-3 Location type - LOC (IS) 00945

Definition: This field contains the code identifying what type of location this is. Refer to User-defined Table 0260 - Patient location type for suggested values.

User-defined Table 0260 - Patient location type

Value

Description

N

Nursing Unit

R

Room

B

Bed

E

Exam Room

O

Operating Room

C

Clinic

D

Department

L

Other Location

8.9.2.4 LOC-4 Organization name - LOC (XON) 00947

Components: <organization name (ST)> ^ <organization name type code (IS)> ^ <ID number (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ <assigning authority (HD)> ^ <identifier type code (IS)> ^ <assigning facility ID (HD)> ^ <name representation code (ID)>
Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field contains the organization(s) of which this location is a part. For inpatient locations, this can be the hospital or institution name. For outpatient locations, this can be the clinic or office name.

8.9.2.5 LOC-5 Location address (XAD) 00948

Components: In Version 2.3 and later, replaces the AD data type. <street address (SAD)> ^ <other designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code (ST)> ^ <country (ID)> ^ < address type (ID)> ^ <other geographic designation (ST)> ^ <county/parish code (IS)> ^ <census tract (IS)> ^ <address representation code (ID)> ^ <address validity range (DR)>
Definition: This field contains the address of the patient location, especially for use for outpatient clinic or office locations.

8.9.2.6 LOC-6 Location phone (XTN) 00949

Components: [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <county code (NM)> ^ <area/city code (NM)> ^ <phone number (NM) ^ <extension (NM)> ^ <any text (ST)>
Definition: This field contains the phone number within the patient location, if any. For example, the room or bed phone for use by the patient.

8.9.2.7 LOC-7 License number (CE) 00951

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the multiple license numbers for the facility. Refer to User-defined Table 0461 - License number for suggested values.

User-defined Table 0461 - License number

Value

Description


No suggested values

8.9.2.8 LOC-8 Location equipment (IS) 00953

Definition: This repeating field indicates what types of equipment are built in. Applies only to room or bed locations. If LOC-3 - Location type indicates that this is a room, this will be the equipment in the room which can be used by more than one bed. If LOC-3 - Location type indicates this is a bed, this will be the bedside devices available to this bed. Refer to User-defined Table 0261 - Location equipment for suggested values.

User-defined Table 0261 - Location equipment

Value

Description

OXY

Oxygen

SUC

Suction

VIT

Vital signs monitor

INF

Infusion pump

IVP

IV pump

EEG

Electro-Encephalogram

EKG

Electro-Cardiogram

VEN

Ventilator

8.9.2.9 LOC-9 Location service code (IS) 01583

Definition: This field categorizes the types of services provided by the location. Refer to User-defined Table 0442 - Location service code for suggested values.

User-defined Table 0442 - Location service code

Value

Description

D

Diagnostic

T

Therapeutic

P

Primary Care

E

Emergency Room Casualty

8.9.3 LCH - location characteristic segment

The Technical Steward for the LCH segment is PAFM.
The LCH segment is used to identify location characteristics which determine which patients will be assigned to the room or bed. It contains the location characteristics of the room or bed identified in the preceding LOC segment. There should be one LCH segment for each attribute.
When the LCH segment appears immediately following the LOC segment, it communicates characteristics which are the same across multiple departments that may use the same room. When the LCH segment appears immediately following the LDP segment, it communicates characteristics which differ for different departments that may use the same room. For example, the following characteristics are more likely to vary by which department is using the room: teaching, gender, staffed, set up, overflow, whereas the other characteristics are likely to remain the same.

HL7 Attribute Table - LCH - Location Characteristic

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

200

PL

R



01305

Primary Key Value - LCH

2

3

ID

O


0206

00763

Segment Action Code

3

80

EI

O



00764

Segment Unique Key

4

250

CE

R


0324

01295

Location Characteristic ID

5

250

CE

R


0136/ 0262/ 0263

01294

Location Characteristic Value-LCH

8.9.3.0 LCH field definitions

8.9.3.1 LCH-1 Primary key value - LCH (PL) 01305

Components: <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ <location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>
Subcomponents of facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field contains the institution's identification code for the location. The identifying key value. This field has the same components as the patient location fields in the PV1 segment (except that bed status is not included here). At least the first component of this field is required. The contents of this field must exactly match the content of its preceding MFE (MFE-4 - Primary key value - MFE), its preceding LOC (LOC-1 - Primary key value - LOC), and its preceding LDP (LDP-1 - Primary key value - LDP).

8.9.3.2 LCH-2 Segment action code (ID) 00763

Definition: This field indicates whether this repetition of the segment is being added, changed or deleted. -- The action code adds a validation check to indicate, from the point of view of the sending system, whether this repetition of a segment is being added, changed or deleted. This and the following field are used to implement the "unique key" mode of updating repeating segments. (See Chapter 2, Section 2.23.4.2, "Action code/unique identifier mode update definition.") Refer to HL7 Table 0206 - Segment action code for valid values.

8.9.3.3 LCH-3 Segment unique key (EI) 00764

Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>
Definition: This field contains a unique identifier for one of the multiple repetitions of this segment, to be used in conjunction with the preceding field. Each of the repetitions of the segment will be uniquely identified by this unique key field for the purposes of updates.

8.9.3.4 LCH-4 Location characteristic ID (CE) 01295

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains an identifier code to show WHICH characteristic is being communicated with this segment. Refer to User-defined Table 0324 - Location characteristic ID for suggested values.

User-defined Table 0324 - Location characteristic ID

Value

Description

SMK

Smoking

LIC

Licensed

IMP

Implant: can be used for radiation implant patients

SHA

Shadow: a temporary holding location that does not physically exist

INF

Infectious disease: this location can be used for isolation

PRL

Privacy level: indicating the level of private versus non-private room

LCR

Level of care

OVR

Overflow

STF

Bed is staffed

SET

Bed is set up

GEN

Gender of patient(s)

TEA

Teaching location

8.9.3.5 LCH-5 Location characteristic value - LCH (CE) 01294

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the value of the above field's characteristic. The expected coded values for this field will depend upon the previous field. For example, if the previous field is SMK, IMP, INF, the values would be "Y" or "N".
When LCH-4-location characteristic ID contains "SHA"- Shadow, refer to HL7 Table 0136 - Yes/no indicator for valid values for LRL-5 - Organizational location relationship value.
Y not a real bed, but a temporary holding location that does not physically exist in the census
N this is a real bed
When LCH-4 - Location characteristic ID contains "PRL"- Privacy level (CE), then LRL-5 - Organizational location relationship value indicates how the room is set up and intended to be used, disregarding different uses under special circumstances. Refer to User-defined Table 0262 - Privacy level for suggested values.

User-defined Table 0262 - Privacy level

Value

Description

F

Isolation

P

Private room

J

Private room - medically justified

Q

Private room - due to overflow

S

Semi-private room

W

Ward

When LCH-4 - Location characteristic ID contains "LCR"- Level of care, then LRL-5 - Organizational location relationship value contains the code which indicates what severity of the patient's medical condition which this location is designed to handle. This indicates how the room is set up and intended to be used, disregarding different uses under special circumstances. Refer to User-defined Table 0263 - Level of care for suggested values.

User-defined Table 0263 - Level of care

Value

Description

A

Ambulatory

E

Emergency

F

Isolation

N

Intensive care

C

Critical care

R

Routine

S

Surgery

When LCH-4 - Location characteristic ID contains "IFD"- Infectious disease, refer to HL7 Table 0136 - Yes/no indicator for valid values for LRL-5 - Organizational location relationship value.
Y patients with infectious diseases can be admitted to this location, that is, this location can be used for isolation
N this location cannot be used for isolation
When LCH-4 - Location characteristic ID contains "SMO"- Smoking, refer to HL7 Table 0136 - Yes/no indicator for valid values for LRL-5 - Organizational location relationship value.
Y this is a smoking location
N this is a non-smoking location
When LCH-4 - Location characteristic ID contains "IMP"- Implant, refer to HL7 Table 0136 - Yes/no indicator for valid values for LRL-5 - Organizational location relationship value.
Y this location can be used by radiation implant patients
N this location can not be used by radiation implant patients
When LCH-4 - Location characteristic ID contains "LIC"- Licensed, refer to HL7 Table 0136 - Yes/no indicator for valid values for LRL-5 - Organizational location relationship value.
Y this location is licensed
N this location is not licensed

8.9.4 LRL - location relationship segment

The Technical Steward for the LRL segment is PAFM.
The LRL segment is used to identify one location's relationship to another location, the nearest lab, pharmacy, etc.

HL7 Attribute Table - LRL - Location Relationship

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

200

PL

R



00943

Primary Key Value - LRL

2

3

ID

O


0206

00763

Segment Action Code

3

80

EI

O



00764

Segment Unique Key

4

250

CE

R


0325

01277

Location Relationship ID

5

250

XON

C

Y


01301


Organizational Location Relationship Value

6

80

PL

C



01292

Patient Location Relationship Value

8.9.4.0 LRL field definitions

8.9.4.1 LRL-1 Primary key value - LRL (PL) 00943

Components: <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ <location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>
Subcomponents of facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field contains the institution's identification code for the location. The identifying key value. This field has the same components as the patient location fields in the PV1 segment (except that bed status is not included here). At least the first component of this field is required. The contents of this field must exactly match the content of its preceding MFE (MFE-4 - Primary key value - MFE), its preceding LOC (LOC-1 - Primary key value - LOC), and its preceding LDP (LDP-1 - Primary key value - LDP).

8.9.4.2 LRL-2 Segment action code (ID) 00763

Definition: This field indicates whether this repetition of the segment is being added, changed or deleted. The action code adds a validation check to indicate, from the point of view of the sending system, whether this repetition of a segment is being added, changed or deleted. This and the following field are used to implement the "unique key" mode of updating repeating segments. (See Chapter 2, Section 2.23.4.2, "Action code/unique identifier mode update definition.") Refer to HL7 Table 0206 - Segment action code for valid values.

8.9.4.3 LRL-3 Segment unique key (EI) 00764

Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>
Definition: This field contains a unique identifier for one of the multiple repetitions of this segment, to be used in conjunction with the preceding field. Each of the repetitions of the segment will be uniquely identified by this unique key field for the purposes of updates.

8.9.4.4 LRL-4 Location relationship ID (CE) 01277

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains an identifier code to show WHICH relationship is being communicated with this segment. Refer to User-defined Table 0325 - Location relationship ID for suggested values.

User-defined Table 0325 - Location relationship ID

Value

Description

RX

Nearest pharmacy

RX2

Second nearest pharmacy

LAB

Nearest lab

LB2

Second nearest lab

DTY

Nearest dietary location

ALI

Location Alias(es)

PAR

Parent location

8.9.4.5 LRL-5 Organizational location relationship value (XON) 01301

Components: <organization name (ST)> ^ <organization name type code (IS)> ^ <ID number (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ <assigning authority (HD)> ^ <identifier type code (IS)> ^ <assigning facility ID (HD)> ^ <name representation code(ID)
Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field is conditional on the value of LRL-4 - Location relationship ID. When LRL-4 -Location relationship ID contains "RX"- Nearest Pharmacy, "RX2"- Other Pharmacy, "LAB"- Nearest Lab, "LB2"- Other Lab, or "DTY"- Dietary, this field holds that organization's extended name i.e., the value of this field is conditional on the value of LRL-4 - Location relationship ID. For example, for an inpatient location, this could be an in-house department ID code using only the third component of this data type. For an outpatient location, this could be the nearest external pharmacy.

8.9.4.6 LRL-6 Patient location relationship value (PL) 01292

Components: <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ <location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>
Subcomponents of facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field is conditional on the value of LRL-4 - Location relationship ID. When LRL-4 -Location relationship ID contains "ALI"- Location aliases or "PAR"- Parent location this field holds the value of the associated patient location.
When LRL-4 - Location relationship ID contains "PAR"- Parent, this field holds the value of the parent location to allow for nested entries. For example, a bed entry can point to its containing room or nurse unit. The value for the parent location should match the LOC-1 - Primary key value - LOC of the parent entry. Not intended to be used for multiple designations of the same physical location, but for identifying the larger physical locations (supersets) which include this physical location as a subset.

8.9.5 LDP - location department segment

The Technical Steward for the LDP segment is PAFM.
The LDP segment identifies how a patient location room is being used by a certain department. Multiple departments can use the same patient location, so there can be multiple LDP segments following an LOC segment. There must be at least one LDP segment for each LOC segment. This is not intended to include any current occupant information.

HL7 Attribute Table - LDP - Location Department

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

200

PL

R



00963

Primary Key Value - LDP

2

250

CE

R


0264

00964

Location Department

3

3

IS

O

Y

0069

00965

Location Service

4

250

CE

O

Y

0265

00966

Specialty Type

5

1

IS

O

Y

0004

00967

Valid Patient Classes

6

1

ID

O


0183

00675

Active/Inactive Flag

7

26

TS

O



00969

Activation Date LDP

8

26

TS

O



00970

Inactivation Date - LDP

9

80

ST

O



00971

Inactivated Reason

10

80

VH

O

Y

0267

00976

Visiting Hours

11

250

XTN

O



00978

Contact Phone

12

250

CE

O


0462

01584

Location Cost Center

8.9.5.0 LDP field definitions

8.9.5.1 LDP-1 Primary key value - LDP (PL) 00963

Components: <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ < location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>
Subcomponents of facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field contains the institution's identification code for the location. The identifying key value. This field has the same components as the patient location fields in the PV1 segment (except that bed status is not included here). At least the first component of this field is required. The contents of this field must exactly match the content of its preceding MFE (MFE-4 - Primary key value - MFE) and its preceding LOC (LOC-1 - primary key value - LOC).

8.9.5.2 LDP-2 Location department (CE) 00964

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the institution's department to which this location belongs, or its cost center. Refer to User-defined Table 0264 - Location department for suggested values.

User-defined Table 0264 - Location department

Value

Description


No suggested values defined

8.9.5.3 LDP-3 Location service (IS) 00965

Definition: This field contains the hospital or ancillary service with which this location is associated. Depends on institution use. Repeats for rooms that can be used, for example, by different services on different days. These values should match the values used for PV1-10 - Hospital service, which is site defined. Refer to User-defined Table 0069 - Hospital service for suggested values.

User-defined Table 0069 - Hospital service

Value

Description


No suggested values defined

8.9.5.4 LDP-4 Specialty type (CE) 00966

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the specialty type (if any) of the department or clinic. This may also be considered a bed type. Specialty type is a physical accommodation type, whereas `accommodation type' (LCC-3 - Accommodation type) is a financial accommodation type. Refer to User-defined Table 0265 - Specialty type for suggested values. See also LCH-4 - Location characteristic ID and LHC-5 - Location characteristic value.

User-defined Table 0265 - Specialty type

Value

Description

AMB

Ambulatory

PSY

Psychiatric

PPS

Pediatric psychiatric

REH

Rehabilitation

PRE

Pediatric rehabilitation

ISO

Isolation

OBG

Obstetrics, gynecology

PIN

Pediatric/neonatal intensive care

INT

Intensive care

SUR

Surgery

PSI

Psychiatric intensive care

EDI

Education

CAR

Coronary/cardiac care

NBI

Newborn, nursery, infants

CCR

Critical care

PED

Pediatrics

EMR

Emergency

OBS

Observation

WIC

Walk-in clinic

PHY

General/family practice

ALC

Allergy

FPC

Family planning

CHI

Chiropractic

CAN

Cancer

NAT

Naturopathic

OTH

Other specialty

8.9.5.5 LDP-5 Valid patient classes (IS) 00967

Definition: This field contains the patient types that are allowed to be assigned to this bed. For example, Inpatient, Outpatient, Series, Clinic, ER, Ambulatory, Observation, etc. These values should be the same set of values as those used for PV1-2 - Patient class. Refer to User-defined Table 0004 - Patient class for suggested values.

8.9.5.6 LDP-6 Active/inactive flag (ID) 00675

Definition: This field indicates whether the entry for this location is currently an active, that is, valid, usable entry (disregarding whether it's waiting to be maintained by housekeeping). Refer to HL7 Table 0183 - Active/inactive for valid values.

8.9.5.7 LDP-7 Activation date - LDP (TS) 00969

Definition: This field contains the date and time when the location became active or "in service" for a department (disregarding whether it is waiting to be maintained by housekeeping).

8.9.5.8 LDP-8 Inactivation date - LDP (TS) 00970

Definition: This field contains the date when the location became inactive or "out of service" for this department (disregarding whether it is waiting to be maintained by housekeeping).

8.9.5.9 LDP-9 Inactivated reason (ST) 00971

Definition: This field contains the reason the location was put out of service. It is used when LDP-8 - Inactivation date-LDP is sent.

8.9.5.10 LDP-10 Visiting hours (VH) 00976

Components: <start day range (ID)> ^ <end day range (ID)> ^ <start hour range (TM)> ^ <end hour range (TM)>
Definition: This field contains the hours when this location is open for visiting. Refer to HL7 Table 0267 - Days of the week for valid values for the first two components.

HL7 Table 0267 - Days of the Week

Value

Description

SAT

Saturday

SUN

Sunday

MON

Monday

TUE

Tuesday

WED

Wednesday

THU

Thursday

FRI

Friday

8.9.5.11 LDP-11 Contact phone (XTN) 00978

Components: [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <county code (NM)> ^ <area/city code (NM)> ^ <phone number (NM) ^ <extension (NM)> ^ <any text (ST)>
Definition: This field contains the phone number to use to contact facility personnel about the patient location, in case of inquiries about the location. This phone is not necessarily within the named patient location.

8.9.5.12 LDP-12 Location cost center (CE) 01584

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the cost center to which this location belongs. Refer to User-defined Table 0462 - Location cost center for suggested values.

User-defined Table 0462 - Location cost center

Value

Description


No suggested values defined

8.9.6 LCC - location charge code segment

The Technical Steward for the LCC segment is PAFM.
The optional LCC segment identifies how a patient location room can be billed by a certain department. A department can use different charge codes for the same room or bed, so there can be multiple LCC segments following an LDP segment.

HL7 Attribute Table - LCC - Location Charge Code

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

200

PL

R



00979

Primary Key Value - LCC

2

250

CE

R


0264

00964

Location Department

3

250

CE

O

Y

0129

00980

Accommodation Type

4

250

CE

R

Y

0132

00981

Charge Code

8.9.6.0 LCC field definitions

8.9.6.1 LCC-1 Primary key value - LCC (PL) 00979

Components: <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ <location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>
Subcomponents of facility: <namespace ID (IS)> & <universal ID (ST) & <universal ID Type (ID)
Definition: This field contains the institution's identification code for the location. The identifying key value. This field has the same components as the patient location fields in the PV1 segment (except that bed status is not included here). At least the first component of this field is required. The content of this field must exactly match the content of its preceding MFE (MFE-4 - Primary key value - MFE), its preceding LOC (LOC-1 - LOC primary key value), and its preceding LDP (LDP-1 - Primary key value - LDP).

8.9.6.2 LCC-2 Location department (CE) 00964

Definition: This field contains the institution's department to which this location belongs, or its cost center. It may match the value in its preceding LDP (LDP-2 - Location department or LDP-12 - Location cost center. Refer to User-defined Table 0264 - Location department for suggested values.

8.9.6.3 LCC-3 Accommodation type (CE) 00980

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the financial accommodation type of the bed or room which implies the rate to be used when occupied by a patient under specific medical conditions, which determines how it is billed. Not the same as specialty type. Used for general ledger categories. Specialty type is a physical accommodation type, whereas this field is a financial accommodation type. Repeating coded value. Refer to User-defined Table 0129 - Accommodation code for suggested values.

User-defined Table 0129 - Accommodation code

Value

Description


No suggested values defined

8.9.6.4 LCC-4 Charge code (CE) 00981

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the repeating coded entry for codes identifying how the use of this location is to be charged. For cross-referencing beds master files with the charge master files, or for generating charges when a patient is assigned to a bed. These should be the same set of values used in FT1-7 -Transaction code. Refer to User-defined Table 0132 - Transaction code for suggested values.

8.9.7 Example: MFN location master file message

MSH|^~\&|HL7REG|UH|HL7LAB|CH|19910918060544||MFN^M05|MSGID002|P|2.4||AL|NE<cr>
MFI|LOC||UPD|||AL<cr>
MFE|MAD|PMF98123789182|199110011230|3A^RM17^17-2^FAC1<cr>
LOC|3A^RM17^17-2^FAC1|BEST BED IN UNIT|B|UNIVERSITY HOSPITAL|54326 SAND P0INT WAY^^SEATTLE^WA^98199|(206)689-1329|92837465998|OXY<cr>
LCH|3A^RM17^17-2^FAC1|||IMP|Y<cr>
LRL|3A^RM17^17-2^FAC1|||LAB|3WEST PATH LAB<cr>
LDP|3A^RM17^17-2^FAC1|PED|MED|PIN|I|A|19941004||||(206)689-1363<cr>
LCC|3A^RM17^17-2^FAC1|PED|PIC|R38746<cr>

8.10 CHARGE DESCRIPTION MASTER FILES

8.10.1 Charge description master file message (MFN/MFK)

The charge description (CDM) master file segment should be used in conjunction with the general master file segments in Section 8.5, "GENERAL MASTER FILE SEGMENTS." Interfacing systems often need not only to communicate data about a patient's detailed charges, but also to communicate the charge identification entries by which an application knows how to handle a particular charge code. The charge description master is a master file. The CDM segment below is a specially designed master file segment for interfacing charge description masters. In the following message, the MFI-master file identifier should equal "CDM." When the CDM segment is used in an MFN message, the abstract definition is as follows:

MFN^M04^MFN_M04

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{MFE

Master File Entry

8

CDM

Charge Description Master

8

{ [PRC] }

Price Segment

8

}





MFK^M04^MFK_M01

Master File Acknowledgment

Chapter

MSH

Message Header

2

MSA

Acknowledgment

2

MFI

Master File Identification

8

{ [MFA] }

Master File ACK segment

8

Master File Response Message: When the CDM segment is used in the MFR message, the part of the message represented by:

{MFE



[Z..] }



is replaced by:

{MFE



CDM


{ [PRC] }


}



8.10.2 CDM - charge description master segment

The Technical Steward for the CDM segment is PAFM.
The CDM segment contains the fields for identifying anything which is charged to patient accounts, including procedures, services, supplies. It is intended to be used to maintain a list of valid chargeable utilization items. Its purpose is to keep billing codes synchronized between HIS, Patient Accounting, and other departmental systems. It is not intended to completely support materials management, inventory, or complex pricing structures for which additional complex fields would be required. Given an identifying charge code, the associated fields in the charge description master file will provide basic pricing and billing data. All the additional information necessary for patient accounting systems to do billing and claims is not intended to be included in this segment; those should be part of insurance or billing profile tables.
The CDM segment contains the fields which, for one chargeable item, remain the same across facilities, departments, and patient types. The following PRC segment contains the fields which, for the same chargeable item, vary depending upon facility or department or patient type.

HL7 Attribute Table - CDM - Charge Description Master

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

250

CE

R


0132

01306

Primary Key Value - CDM

2

250

CE

O

Y

9999

00983

Charge Code Alias

3

20

ST

R



00984

Charge Description Short

4

250

ST

O



00985

Charge Description Long

5

1

IS

O


0268

00986

Description Override Indicator

6

250

CE

O

Y

9999

00987

Exploding Charges

7

250

CE

O

Y

0088

00393

Procedure Code

8

1

ID

O


0183

00675

Active/Inactive Flag

9

250

CE

O

Y

0463

00990

Inventory Number

10

12

NM

O



00991

Resource Load

11

250

CK

O

Y


00992

Contract Number

12

250

XON

O

Y


00993

Contract Organization

13

1

ID

O


0136

00994

Room Fee Indicator

8.10.2.0 CDM field definitions

8.10.2.1 CDM-1 Primary key value - CDM (CE) 01306

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the code assigned by the institution for the purpose of uniquely identifying the thing that can be charged. The key field of the entry. For example, this field would be used to uniquely identify a procedure, item, or test for charging purposes. Probably the same set of values as used in FT1-7- Transaction code in financial messages. Must match MFE-4 - Primary key value - MFE. Refer to User-defined Table 0132 - Transaction for suggested values. See Chapter 7 for discussion of the universal service ID.

8.10.2.2 CDM-2 Charge code alias (CE) 00983

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains an alternative charge code. For example, points to another charge description master entry in cases where one code supersedes or overrides another code. Repeating field allows for different codes used by different systems which should be handled as if they were the same; for example, the general ledger code may differ from the billing code. Or, in a multi-facility environment which does facility-specific pricing, there may be more than one of these master file entries for one charge description, each with a different facility.

8.10.2.3 CDM-3 Charge description short (ST) 00984

Definition: This field contains the text abbreviations or code that is associated with this CDM entry.

8.10.2.4 CDM-4 Charge description long (ST) 00985

Definition: This field contains the full text description of this CDM entry.

8.10.2.5 CDM-5 Description override indicator (IS) 00986

Definition: This field indicates whether this CDM entry's description can be overridden. Refer to User-defined Table 0268 - Override for suggested values.

User-defined Table 0268 - Override

Value

Description

X

Override not allowed

A

Override allowed

R

Override required

8.10.2.6 CDM-6 Exploding charges (CE) 00987

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the repeating occurrences for a list of other CDM entry charge codes identifying the other charges which should be generated from this CDM entry. If non-null, posting a charge to this CDM entry should result in posting the charges identified here. These are sometimes called "linked items."
In the case of "chained" charges where the "lead" charge must be included in the exploded charges, the "lead" charge should be included in the list of exploding charges. If the price of this parent charge is included in the message, then it overrides the sum of the exploded charges prices.

8.10.2.7 CDM-7 Procedure code (CE) 00393

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the procedure code for procedure, if any, associated with this charge description. Repeating field allows for different procedure coding systems such as CPT4, ASTM, ICD9. Coded entry made up of code plus coding schema. Refer to User defined Table 0088 - Procedure code for suggested values.

8.10.2.8 CDM-8 Active/inactive flag (ID) 00675

Definition: This field indicates whether this is a usable CDM entry. Refer to HL7 table 0183 - Active/inactive for valid values.

8.10.2.9 CDM-9 Inventory number (CE) 00990

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This optional field contains an identifying stock number, if any, which might be used, for example, as a cross reference for materials management. Refer to User-defined Tabl e 0463 - Inventory number for suggested values.

User-defined Table 0463 - Inventory number

Value

Description


No suggested values

8.10.2.10 CDM-10 Resource load (NM) 00991

Definition: This field contains the Relative Value Unit (RVU) minutes and ATS, a factor related to CPT4 coding and to pricing structure for physical billing.

8.10.2.11 CDM-11 Contract number (CK) 00992

Components: <ID number (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ <assigning authority (HD)>
Type Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST) & <universal ID (ID)
Definition: This field contains any contract number pertaining to this chargeable item. For example, supplier contract or service contract.

8.10.2.12 CDM-12 Contract organization (XON) 00993

Components: <organization name (ST)> ^ <organization name type code (IS)> ^ <ID number (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ <assigning authority (HD)> ^ <identifier type code (IS)> ^ <assigning facility ID (HD)> ^ <name representation code (ID)>
Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Subcomponents of assigning facility ID: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field contains the organization with whom there is a contractual arrangement for providing the service or material used for this chargeable item.

8.10.2.13 CDM-13 Room fee indicator (ID) 00994

Definition: This field contains a room fee indicator. Refer to HL7 Table 0136 - Yes/no indicator for valid values.
Y this is a component of the room fees
N this is any other chargeable item other than room fees

8.10.3 PRC - pricing segment

The Technical Steward for the PRC segment is PAFM.
The PRC segment contains the pricing information for the preceding CDM segment's chargeable item. It contains the fields which, for the same chargeable item, might vary depending upon facility or department or patient type. The preceding CDM segment contains the fields which, for one chargeable item, remain the same across facilities, departments, and patient types.

HL7 Attribute Table - PRC - Pricing

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

250

CE

R


0132

00982

Primary Key Value - PRC

2

250

CE

O

Y

0464

00995

Facility ID - PRC

3

250

CE

O

Y

0184

00676

Department

4

1

IS

O

Y

0004

00967

Valid Patient Classes

5

12

CP

C

Y


00998

Price

6

200

ST

O

Y


00999

Formula

7

4

NM

O



01000

Minimum Quantity

8

4

NM

O



01001

Maximum Quantity

9

12

MO

O



01002

Minimum Price

10

12

MO

O



01003

Maximum Price

11

26

TS

O



01004

Effective Start Date

12

26

TS

O



01005

Effective End Date

13

1

IS

O


0268

01006

Price Override Flag

14

250

CE

O

Y

0293

01007

Billing Category

15

1

ID

O


0136

01008

Chargeable Flag

16

1

ID

O


0183

00675

Active/Inactive Flag

17

12

MO

O



00989

Cost

18

1

IS

O


0269

01009

Charge On Indicator

8.10.3.0 PRC fields definitions

8.10.3.1 PRC-1 Primary key value - PRC (CE) 00982

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the code assigned by the institution for the purpose of uniquely identifying the thing that can be charged. The key field of the entry. For example, this field would be used to uniquely identify a procedure, item, or test for charging purposes. Probably the same set of values as used in FT1-7 - Transaction code in financial messages. Must match MFE-4 - Primary key - MFE and CDM-1 - Primary key - CDM. Refer to User-defined Table 0132 - Transaction code for suggested values. See Chapter 7 for discussion of the universal service ID.

8.10.3.2 PRC-2 Facility ID - PRC (CE) 00995

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the facility of the institution for which this price (for the preceding CDM entry) is valid. For use when needing multi-facility pricing. If null, assume all facilities. In a multi-facility environment, the facility associated with this chargeable item may not be the same as the sending or receiving facility identified in the MSH segment. Use only when the price is not the same for all facilities, that is, a null value indicates that this pricing is valid for all facilities.
When two PRC segments are sent with the same key values but different facility identifiers, the second is sent in addition to the first, not to replace the first. The effective unique identifier is the charge code (PRC-1 - Primary key value - PRC) plus the facility ID (PRC-2 - Facility ID). Multiple facility identifiers can be sent in the same segment to indicate that those facilities use the same pricing. Refer to User-defined Table 0464 - Facility ID for suggested values.

User-defined Table 0464 - Facility ID

Value

Description


No suggested values defined

8.10.3.3 PRC-3 Department (CE) 00676

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the department of the facility which accrues revenue/cost for this type of charge. When pricing is different for different departments within the same facility, this will indicate for which department the following pricing information is valid. Use only when the price is not the same for all departments, that is, a null value indicates that this pricing is valid for all departments.
When two PRC segments are sent the same key values but with different departments, the second is sent in addition to the first, not to replace the first. The effective unique identifier is the charge code (PRC-1 - Primary key - PRC) plus the facility ID (PRC-2 - Facility ID) plus the department (PRC-3 - Department). Multiple departments can be sent in the same segment to indicate that those departments use the same pricing. Refer to User-defined Table 0184 - Department for suggested values.

8.10.3.4 PRC-4 Valid patient classes (IS) 00967

Definition: This field contains the patient types for which this charge description is valid. For example, Inpatient, Outpatient, Series, Clinic, ER, Ambulatory, Observation, etc. These values should be the same set of values as those used for PV1-3 - Patient class, which is site defined. Use only when the price is not valid for all patient types, that is, a null value indicates that this pricing is valid for all patient classes. Refer to User-defined Table 0004 - Patient class for suggested values.
When two PRC segments are sent the same key values but with different valid patient classes, the second is sent in addition to the first, not to replace the first. The effective unique identifier is the charge code (PRC-1 - PRC primary key) plus the facility ID (PRC-2 - Facility ID) plus the department (PRC-3 - Department) plus the patient class (PRC-4 - Valid patient classes). Multiple patient classes can be sent in the same segment to indicate that those patient classes use the same pricing.

8.10.3.5 PRC-5 Price (CP) 00998

Components: <price (MO)> ^ <price type (ID)> ^ <from value (NM)> ^ <to value (NM)> ^ <range units (CE)> ^ <range type (ID)>
Subcomponents of price: <quantity (NM)> & <denomination (ID)>
Subcomponents of range nits: <identifier (ST)> & <text (ST) & <name of coding system (IS)> & <alternate identifier (ST)> & <alternate text (ST)> & <name of alternate coding system (ST)>
Definition: This field contains the price to be charged for service, item, or procedure. If CDM price will always be overridden when charges are posted, then this field is optional. Otherwise, price would be a required field. The formula or calculation that is to be used to get total price from these price components is left to implementation negotiations agreed upon by the participating institutions. See Chapter 2, Section 2.8.8, "CP - composite price," for a description of the use of the composite price (CP) data type.

8.10.3.6 PRC-6 Formula (ST) 00999

Definition: This field contains the mathematical formula to apply to PRC-5 - Price in order to compute total price. The syntax of this formula must conform to Arden Syntax rules.

8.10.3.7 PRC-7 Minimum quantity (NM) 01000

Definition: This field contains the minimum number of identical charges allowed on one patient account for this CDM entry.

8.10.3.8 PRC-8 Maximum quantity (NM) 01001

Definition: This field contains the maximum number of identical charges allowed on one patient account for this CDM entry.

8.10.3.9 PRC-9 Minimum price (MO) 01002

Components: <quantity (NM)> ^ <denomination (ID)>
Definition: This field contains the minimum total price (after computation of components of price) that can be charged for this item.

8.10.3.10 PRC-10 Maximum price (MO) 01003

Components: <quantity (NM)> ^ <denomination (ID)>
Definition: This field contains the maximum total price (after computation of components of price) that can be charged for this item.

8.10.3.11 PRC-11 Effective start date (TS) 01004

Definition: This field contains the date/time when this CDM entry becomes effective.

8.10.3.12 PRC-12 Effective end date (TS) 01005

Definition: This field contains the date/time when this CDM entry is no longer effective.

8.10.3.13 PRC-13 Price override flag (IS) 01006

Definition: This field indicates whether this CDM entry's price can be overridden. Refer to User-defined Table 0268 - Override for suggested values.

8.10.3.14 PRC-14 Billing category (CE) 01007

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains the billing category codes for any classification systems needed, for example, general ledger codes and UB92 categories. Repeating field with coded entry made up of category code plus category system. Refer to User-defined Table 0293 - Billing category for suggested values.

User-defined Table 0293 - Billing category

Value

Description


No suggested values defined

8.10.3.15 PRC-15 Chargeable flag (ID) 01008

Definition: This field contains a chargeable indicator. Refer to HL7 Table 0136 - Yes/no indicator for valid values.
N charge is not billable, that is, do not create charges for this CDM entry; this is zero price item
Y item is billable (this is also the default when NULL)

8.10.3.16 PRC-16 Active/inactive flag (ID) 00675

Definition: This indicates whether this is a usable CDM entry. Refer to HL7 Table 0183 - Active/inactive for valid values.

8.10.3.17 PRC-17 Cost (MO) 00989

Components: <quantity (NM)> ^ <denomination (ID)>
Definition: This field contains the institution's calculation of how much it costs to provide this item, that is, what the institution had to pay for the material plus any specified payment expenditure, effort or loss due to performing or providing the chargeable item.

8.10.3.18 PRC-18 Charge on indicator (IS) 01009

Definition: This field contains the user-defined table of values which indicates when a charge for services or procedures should be accrued. Refer to User-defined Table 0269 - Charge on indicator for suggested values.

User-defined Table 0269 - Charge on indicator

Value

Description

O

Charge on Order

R

Charge on Result

8.10.4 Example: MRN message charge description master file

MSH|^~\&|HL7REG|UH|HL7LAB|CH|19910918060544||MFN^M04|MSGID002|P|2.4||AL|NE<cr>
MFI|CDM||UPD|||AL<cr>
MFE|MAD|CDM98123789182|199110011230|P2246^^PLW<cr>
CDM|P2246^^PLW |2445||APPENDECTOMY|X||244.34|A|2321||||N<cr>
PRC|P2246^^PLW |FAC3|SURG|O~A|100.00^UP |formula |1|1 |100.00^USD|1000.00^USD|19941031||Y|GL545|Y|A|<cr>

8.11 CLINICAL TRIALS MASTER FILES

8.11.1 Clinical trials master file message (MFN/MFK)

The CM0 (Clinical Study Master), CM1 (Clinical Study Phase), and CM2 (Clinical Study Schedule) segments can be used to transmit master files information between systems. The CM0 segment contains the information about the study itself; the CM1 contains the information about one phase of the study identified in the preceding CM0; and the CM2 contains the information about the scheduled time points for the preceding study or phase-related treatment or evaluation events. When these segments are used in an MFN message, the abstract definition is described below.
Case 1: MFN message for Clinical Study with phases and schedules
MFI-1 - master file identifier code = CMA

MFN^M06^MFN_M06

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{ MFE

Master File Entry

8

CM0

Clinical Study Master

8

[{ CM1

Clinical Study Phase

8

[{CM2}] }]

Clinical Study Schedule

8

}




MFK^M06^MFK_M01

Master File Acknowledgment

Chapter

MSH

Message Header

2

MSA

Acknowledgment

2

MFI

Master File Identification

8

{ [MFA] }

Master file ACK

8


Case 2: MFN message for Clinical Study without phases but with schedules
MFI-1 - master file identifier code = CMB

MFN^M07^MFN_M07

Master File Notification

Chapter

MSH

Message Header

2

MFI

Master File Identification

8

{ MFE

Master File Entry

8

CM0

Clinical Study Master

8

[ {CM2}]

Clinical Study Schedule

8

}




MFK^M07^MFK_M01

Master File Acknowledgment

Chapter

MSH

Message Header

2

MSA

Acknowledgment

2

MFI

Master File Identification

8

{ [MFA] }

Master file ACK

8

When the Clinical Trials master segments are used in the MFR message, the part of the message represented by:
MFE
[Z..] }
is replaced by, in case 1 above:
{ MFE
CM0
[{ CM1
[ {CM2}]
}
In case 2 above, the corresponding segments in the MFR message represented by:
{MFE
[Z..] }
are replaced by
{ MFE
CM0
[ {CM2}] }]
}

8.11.2 CM0 - clinical study master segment

The Technical Steward for the CM0 segment is ORDERS.
The Clinical Study Master (CM0) segment contains the information about the study itself. The sending application study number for each patient is sent in the CSR segment. The optional CM0 enables information about the study at the sending application that may be useful to the receiving systems. All of the fields in the segment describe the study status at the sending facility unless otherwise agreed upon.

HL7 Attribute Table - CM0 - Clinical Study Master

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

SI

O



01010

Set ID - CM0

2

60

EI

R



01011

Sponsor Study ID

3

60

EI

O

Y/3


01036

Alternate Study ID

4

300

ST

R



01013

Title of Study

5

250

XCN

O

Y


01014

Chairman of Study

6

8

DT

O



01015

Last IRB Approval Date

7

8

NM

O



01016

Total Accrual to Date

8

8

DT

O



01017

Last Accrual Date

9

250

XCN

O

Y


01018

Contact for Study

10

250

XTN

O



01019

Contact's Telephone Number

11

250

XAD

O

Y


01020

Contact's Address

8.11.2.0 CM0 field definitions

8.11.2.1 CM0-1 Set ID - CM0 (SI) 01010

Definition: This field contains a number that uniquely identifies this transaction for the purpose of adding, changing, or deleting the transaction. For those messages that permit segments to repeat, the Set ID field is used to identify the repetitions.

8.11.2.2 CM0-2 Sponsor study ID (EI) 01011

Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>
Definition: This field contains the study number established by the study sponsor. Please see discussion in Section 7.7.1.1, "Sponsor study ID."

8.11.2.3 CM0-3 Alternate study ID (EI) 01036

Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>
Definition: This field contains the local or collaborators' cross-referenced study numbers.

8.11.2.4 CM0-4 Title of study (ST) 01013

Definition: This field contains the sending institution's title for the clinical trial. It gives recipients further identification of the study.

8.11.2.5 CM0-5 Chairman of study (XCN) 01014

Components: <ID number (ST)> ^ <family name (FN)> ^ <given name (ST)> ^ <second or further given names or initials thereof (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code (ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ <identifier type code (IS)> ^ <assigning facility (HD)> ^ <name representation code (ID)> ^ <name context (CE)> ^ <name validity range (DR)> ^ < name assembly order (ID)>
Subcomponents of family name: <family name (ST)> & <own family name prefix (ST)> & <own family name (ST)> & <family name prefix from partner/spouse (ST)> & <family name from partner/spouse (ST)>
Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Subcomponents of assigning facility ID: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field contains the sending institution's chairman. It further identifies the study. The chairman's name may be needed for communication purposes.

8.11.2.6 CM0-6 Last IRB approval date (DT) 01015

Definition: This field contains an institution's Internal Review Board approval dates which are required annually to continue participation in a clinical trial.

8.11.2.7 CM0-7 Total accrual to date (NM) 01016

Definition: This field is a quality control field to enable checks that patient data have been transmitted on all registered patients.

8.11.2.8 CM0-8 Last accrual date (DT) 01017

Definition: This field contains the status information on the patient registration activity for quality control and operations purposes.

8.11.2.9 CM0-9 Contact for study (XCN) 01018

Components: <ID number (ST)> ^ <family name (FN)> ^ <given name (ST)> ^ <second or further given names or initials thereof (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code (ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ <identifier type code (IS)> ^ <assigning facility (HD)> ^ <name representation code (ID)> ^ <name context (CE)> ^ <name validity range (DR)> ^ < name assembly order (ID)>
Subcomponents of family name: <family name (ST)> & <own family name prefix (ST)> & <own family name (ST)> & <family name prefix from partner/spouse (ST)> & <family name from partner/spouse (ST)>
Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Subcomponents of assigning facility ID: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>
Definition: This field contains the name of the individual who should be contacted for inquiries about data transmitted for this study.

8.11.2.10 CM0-10 Contact's telephone number' (XTN) 01019

Components: [NNN] [(999)]999-9999 [X9999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <county code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)>
Definition: This field contains the phone number of the study contact identified in CM0-9 - Contact for study.

8.11.2.11 CM0-11 Contact's address (XAD) 01020

Components: In Version 2.3 and later, replaces the AD data type. <street address (SAD)> ^ <other designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code (ST)> ^ <country (ID)> ^ < address type (ID)> ^ <other geographic designation (ST)> ^ <county/parish code (IS)> ^ <census tract (IS)> ^ <address representation code (ID)> ^ <address validity range (DR)>
Subcomponents of street address: <street address (ST)> & <street name (ST)> & <dwelling number (ST)>
Definition: This field contains the address of the study contact identified in CM0-9 - Contact for study.

8.11.3 CM1 - clinical study phase master segment

The Technical Steward for the CM1 segment is ORDERS.
Each Clinical Study Phase Master (CM1) segment contains the information about one phase of a study identified in the preceding CM0. This is an optional structure to be used if the study has more than one treatment or evaluation phase within it. The identification of study phases that the patient enters are sent in the CSP segment: sequence 2. The CM1 segment describes the phase in general for the receiving system.

HL7 Attribute Table - CM1 - Clinical Study Phase Master

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

SI

R



01021

Set ID - CM1

2

250

CE

R



01022

Study Phase Identifier

3

300

ST

R



01023

Description of Study Phase

8.11.3.0 CM1 field definitions

8.11.3.1 CM1-1 Set ID - CM1 (SI) 01021

Definition: This field contains a number that uniquely identifies this transaction for the purpose of adding, changing, or deleting the transaction. For those messages that permit segments to repeat, the Set IF field is used to identify the repetitions.

8.11.3.2 CM1-2 Study phase identifier (CE) 01022

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field should correspond to the study phase ID coding system in Section 7.7.2.1, "Study phase ID."

8.11.3.3 CM1-3 Description of study phase (ST) 01023

Definition: This field contains a brief explanation for recipients to understand what the phase represents.

8.11.4 CM2 - clinical study schedule master segment

The Technical Steward for the CM2 segment is ORDERS.
The Clinical Study Schedule Master (CM2) contains the information about the scheduled time points for study or phase-related treatment or evaluation events. The fact that a patient has data satisfying a scheduled time point is sent in the CSS segment, sequence 2. The CM2 segment describes the scheduled time points in general.

HL7 Attribute Table - CM2 - Clinical Study Schedule Master

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

SI

O



01024

Set ID- CM2

2

250

CE

R


9999

01025

Scheduled Time Point

3

300

ST

O



01026

Description of Time Point

4

250

CE

R

Y/200

9999

01027

Events Scheduled This Time Point

8.11.4.0 CM2 field definitions

8.11.4.1 CM2-1 Set ID - CM2 (SI) 01024

Definition: This field contains a number that uniquely identifies this transaction for the purpose of adding, changing, or deleting the transaction. For those messages that permit segments to repeat, the Set ID field is used to identify the repetitions.

8.11.4.2 CM2-2 Scheduled time point (CE) 01025

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field should correspond to the scheduled time point coding system in Section 7.7.3.1, "Study scheduled time point."

8.11.4.3 CM2-3 Description of time point (ST) 01026

Definition: This field contains a brief explanation so recipients will understand what the time point represents.

8.11.4.4 CM2-4 Events scheduled this time point (CE) 01027

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>
Definition: This field contains a study-specific event. Coding systems may be developed for this field or applications may use facility-wide or standardized orders and procedures coding systems. This enables integration of procedures or events ordered for clinical trials with medical order entry systems.

8.12 EXAMPLES

Master file update examples: with original and enhanced acknowledgment protocol

This example shows the lab system using the Master Files specification to send two update test dictionary entries to an ICU system. The OM1 (observation dictionary) segment, currently under development by HL7 and ASTM, carries the dictionary information. Several varieties of acknowledgement are shown. The choice of acknowledgment mode is site-specific.
Original mode example:
MSH|^~\&|LABxxx|ClinLAB|ICU||19910918060544||MFN^M03|MSGID002|P|2.2
MFI|LABxxx^Lab Test Dictionary^L|UPD|||AL
MFE|MUP|199109051000|199110010000|12345^WBC^L
OM1|...
MFE|MUP|199109051015|199110010000|6789^RBC^L
OM1|...
Original mode acknowledgment of the HL7 message according to MFI Response Level Code of AL.
MSH|^~\&|ICU||LABxxx|ClinLAB|19910918060545||MFK|MSGID99002|P|2.2
MSA|AA|MSGID002
MFI|LABxxx^Lab Test Dictionary^L|UPD|||MFAA
MFA|MUP|199110010000|199110010040|S|12345^WBC^L
MFA|MUP|199110010000|199110010041|S|6789^RBC^L
Enhanced mode example
Initial message with accept acknowledgment
MSH|^~\&|LABxxx|ClinLAB|ICU||19910918060544||MFN^M03|MSGID002|P|2.2|||AL|AL
MFI|LABxxx^Lab Test Dictionary^L|UPD|||AL
MFE|MUP|199109051000|199110010000|12345^WBC^L
OM1|...
MFE|MUP|199109051015|199110010000|6789^RBC^L
OM1|...
MSH|^~\&|ICU||LABxxx|ClinLAB|19910918060545||MSA|MSGID99002|P|2.2
MSA|CA|MSGID002
Application acknowledgment message
MSH|^~\&|ICU||LABxxx|ClinLAB|19911001080504||MFK|MSGID5002|P|2.2|||AL|
MSA|AA|MSGID002
MFI|LABxxx^Lab Test Dictionary^L|UPD|||MFAA
MFA|MUP|199109051000|199110010040|S|12345^WBC^L
MFA|MUP|199109051015|199110010041|S|6789^RBC^L
MSH|^~\&|LABxxx|ClinLAB|ICU||19911001080507||ACK|MSGID444|P|2.2
MSA|CA|MSGID5002
Delayed application acknowledgment
Note: If the MFN message in Section 8.12, "Original mode example:," had not required an application acknowledgment at the message level (i.e., the application acknowledgment code of the MSH segment = NE), the (Master Files Chapter defined) MFD message could be used to provide a delayed application level acknowledgment not tied to the original MFN message.
The following example includes an acknowledgment for an MFE segment not in the original message. This additional MFE was sent via another MFN message.
Initial message with accept acknowledgment
MSH|^~\&|LABxxx|ClinLAB|ICU||19910918060544||MFN^M03|MSGID002|P|2.2|||AL|NE
MFI|LABxxx^Lab Test Dictionary^L|UPD|||AL
MFE|MUP|199109051000|199110010000|12345^WBC^L
OM1|...
MFE|MUP|199109051015|199110010000|6789^RBC^L
OM1|...
MSH|^~\&|ICU||LABxxx|ClinLAB|19910918060545||MSA|MSGID99002|P|2.2
MSA|CA|MSGID002
Delayed application acknowledgment
MSH|^~\&|ICU||LABxxx|ClinLAB|19911001080504||MFD|MSGID65002|P|2.4|||AL|
MFI|LABxxx^Lab Test Dictionary^L|UPD|||MFAA
MFA|MUP|199109051000|199110010040|S|12345^WBC^L
MFA|MUP|199109051015|199110010041|S|6789^RBC^L
MFA|MUP|199109051025|199110010041|S|4339^HGB^L
MSH|^~\&|LABxxx|ClinLAB|ICU||19911001080507||ACK|MSGID444|P|2.4
MSA|CA|MSGID65002

8.13 OUTSTANDING ISSUES

We invite proposals for the specification of other HL7-wide master files segments.


[1]

LOINC Committee. Logical Observation identifier Names and Codes. Indianapolis: Regenstrief Institute and LOINC Committee, 1995.
[2] International Union of Pure and Applied Chemistry/International Federation of Clinical Chemistry. The Silver Book: Compendium of terminology and nomenclature of properties in clinical laboratory sciences. Oxford: Blackwell Scientific Publishers, 1995.
[3] NCCLS Document H1-A3: Evacuated tubes for blood specimen collection -- Third Edition, Volume 11, Number 9, Approved standard. July 1991.