2.

Control
Chapter Chair Grahame Grieve
Kestral Computing Pty Ltd.
Chapter Chair and Editor: (2) Anthony Julian
Mayo Clinic
Chapter Chair Scott Robertson
Kaiser Permanente
Chapter Chair and Editor (2A) Doug Pratt
Siemens Medical Solutions Health Services
Chapter Chair René Spronk
Ringholm GmbH
Implementation/Conformance TC Lisa Carnahan
Co-Chair National Institute of Standards and Technology (NIST)
Implementation/Conformance TC Frank Oemig
Co-Chair Agfa HealthCare GmbH
Implementation/Conformance TC Charlie McCay
Co-Chair Ramsey Systems
Implementation/Conformance TC John Lyons
Co-Chair Siemens Medical Solutions Health Services

2.1 CHAPTER 2 CONTENTS

2.1 CHAPTER 2 CONTENTS............................................................................................................................. 1
2.2 INTRODUCTION .......................................................................................................................................... 3
2.3 CONCEPTUAL APPROACH ....................................................................................................................... 3
2.3.1 TRIGGER EVENTS ...................................................................................................................................... 3
2.3.2 ACKNOWLEDGMENTS: ORIGINAL MODE ................................................................................................... 4
2.3.3 ACKNOWLEDGMENTS: ENHANCED MODE .................................................................................................. 4
2.3.4 QUERIES ................................................................................................................................................... 4
2.4 COMMUNICATIONS ENVIRONMENT.................................................................................................... 5
2.5 MESSAGE FRAMEWORK .......................................................................................................................... 6
2.5.1 MESSAGES ................................................................................................................................................ 6
2.5.2 SEGMENTS AND SEGMENT GROUPS ............................................................................................................ 6
2.5.3 FIELDS ...................................................................................................................................................... 7
2.5.4 MESSAGE DELIMITERS ............................................................................................................................ 11
2.6 MESSAGE CONSTRUCTION RULES..................................................................................................... 12
2.6.1 RULES FOR THE SENDER .......................................................................................................................... 12
2.6.2 RULES FOR THE RECIPIENT ...................................................................................................................... 16
2.6.3 ENCODING RULES NOTES ........................................................................................................................ 16
2.7 USE OF ESCAPE SEQUENCES IN TEXT FIELDS................................................................................ 16

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2.7.1 FORMATTING CODES................................................................................................................................16

2.7.2 ESCAPE SEQUENCES SUPPORTING MULTIPLE CHARACTER SETS................................................................16
2.7.3 HIGHLIGHTING ........................................................................................................................................17
2.7.4 SPECIAL CHARACTER ..............................................................................................................................17
2.7.5 HEXADECIMAL ........................................................................................................................................17
2.7.6 USAGE AND EXAMPLES OF FORMATTED TEXT.........................................................................................18
2.7.7 LOCAL.....................................................................................................................................................18
2.8 VERSION COMPATIBILITY DEFINITION............................................................................................18
2.8.1 ADDING MESSAGES OR MESSAGE CONSTITUENTS ....................................................................................19
2.8.2 CHANGING MESSAGES OR MESSAGE CONSTITUENTS................................................................................19
2.8.3 DEPRECATING MESSAGES OR MESSAGE CONSTITUENTS ...........................................................................21
2.8.4 REMOVING MESSAGES OR MESSAGE CONSTITUENTS ...............................................................................21
2.8.5 EARLY ADOPTION OF HL7 CHANGES .......................................................................................................22
2.8.6 TECHNICAL CORRECTION RULES .............................................................................................................22
2.9 MESSAGE PROCESSING RULES ............................................................................................................23
2.9.1 MESSAGE INITIATION ..............................................................................................................................23
2.9.2 MESSAGE RESPONSE USING THE ORIGINAL PROCESSING RULES ...............................................................24
2.9.3 RESPONSE USING ENHANCED ACKNOWLEDGEMENT ................................................................................25
2.10 SPECIAL HL7 PROTOCOLS.....................................................................................................................27
2.10.1 SEQUENCE NUMBER PROTOCOL ...............................................................................................................27
2.10.2 CONTINUATION MESSAGES AND SEGMENTS .............................................................................................28
2.10.3 HL7 BATCH PROTOCOL ............................................................................................................................31
2.10.4 PROTOCOL FOR INTERPRETING REPEATING SEGMENTS OR SEGMENT GROUPS IN AN UPDATE
MESSAGE ................................................................................................................................................33
2.10.5 PROTOCOL FOR INTERPRETING REPEATING FIELDS IN AN UPDATE MESSAGE .............................................36
2.11 LOCAL EXTENSION ..................................................................................................................................37
2.11.1 MESSAGES ..............................................................................................................................................37
2.11.2 TRIGGER EVENTS ....................................................................................................................................37
2.11.3 SEGMENT GROUPS ...................................................................................................................................38
2.11.4 SEGMENTS ..............................................................................................................................................39
2.11.5 DATA TYPES .............................................................................................................................................39
2.11.6 TABLES ...................................................................................................................................................39
2.12 CHAPTER FORMATS FOR DEFINING HL7 MESSAGES ...................................................................40
2.12.1 MESSAGE REPRESENTATION ....................................................................................................................40
2.12.2 HL7 ABSTRACT MESSAGE SYNTAX EXAMPLE ..........................................................................................41
2.13 ACKNOWLEDGMENT MESSAGES........................................................................................................42
2.13.1 ACK - GENERAL ACKNOWLEDGMENT .....................................................................................................42
2.14 MESSAGE CONTROL SEGMENTS .........................................................................................................42
2.14.1 ADD - ADDENDUM SEGMENT ..................................................................................................................43
2.14.2 BHS - BATCH HEADER SEGMENT .............................................................................................................43
2.14.3 BTS - BATCH TRAILER SEGMENT .............................................................................................................45
2.14.4 DSC - CONTINUATION POINTER SEGMENT ...............................................................................................46
2.14.5 ERR - ERROR SEGMENT ...........................................................................................................................46
2.14.6 FHS - FILE HEADER SEGMENT .................................................................................................................51
2.14.7 FTS - FILE TRAILER SEGMENT .................................................................................................................52
2.14.8 MSA - MESSAGE ACKNOWLEDGMENT SEGMENT .....................................................................................53
2.14.9 MSH - MESSAGE HEADER SEGMENT ........................................................................................................55
2.14.10 NTE - NOTES AND COMMENTS SEGMENT .................................................................................................64
2.14.11 OVR – OVERRIDE SEGMENT ....................................................................................................................66
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2.14.12 SFT – SOFTWARE SEGMENT .................................................................................................................... 69

2.14.13 UAC - USER AUTHENTICATION CREDENTIAL SEGMENT ......................................................................... 71
2.15 DATA TYPES................................................................................................................................................ 72
2.16 MISCELLANEOUS HL7 TABLES USED ACROSS ALL CHAPTERS ................................................ 75
2.16.1 MESSAGE TYPE TABLE ............................................................................................................................ 75
2.16.2 EVENT TYPE TABLE ................................................................................................................................. 78
2.16.3 MESSAGE STRUCTURE TABLE .................................................................................................................. 83
2.16.4 CODING SYSTEM TABLE .......................................................................................................................... 87
2.16.5 YES/NO INDICATOR TABLE....................................................................................................................... 95
2.16.6 EXPANDED YES/NO INDICATOR TABLE ..................................................................................................... 95
2.17 SAMPLE CONTROL MESSAGES ............................................................................................................ 96
2.17.1 GENERAL ACKNOWLEDGMENT ................................................................................................................ 96
2.17.2 GENERAL ACKNOWLEDGEMENT, ERROR RETURN .................................................................................... 96
2.17.3 MESSAGE USING SEQUENCE NUMBER: PROTOCOL ................................................................................... 96
2.17.4 MESSAGE FRAGMENTATION .................................................................................................................... 96
2.17.5 ACKNOWLEDGEMENT MESSAGE USING ORIGINAL MODE PROCESSING ..................................................... 99
2.17.6 ACKNOWLEDGEMENT MESSAGE USING ENHANCED MODE PROCESSING .................................................. 99
2.18 OUTSTANDING ISSUES ............................................................................................................................ 99

2.2 INTRODUCTION
The Control chapter of this Standard defines the generic rules that apply to all messages.
Subsequent sections define functionally specific messages to be exchanged among certain
applications. The specific aspects of message definition that are addressed herein are:
a) the form to be used in functional chapters for describing messages. This includes their purpose,
their contents, and the interrelationships among them. This form is called an abstract message
definition because it is purely a level 7 (application) definition.
b) the HL7 encoding rules for converting an abstract message into a string of characters that
comprises an actual message.
c) the programming procedures required to exchange messages using the HL7 specifications.
d) the anticipated relationship with lower level protocols.
e) certain message segments that are components of all messages.
f) a single message, the acknowledgment message, that may be used unchanged in multiple
applications.

2.3 CONCEPTUAL APPROACH

2.3.1 Trigger events
The Standard is written from the assumption that an event in the real world of healthcare creates the need
for data to flow among systems. The real-world event is called the trigger event. For example, the trigger
event a patient is admitted may cause the need for data about that patient to be sent to a number of other
systems. The trigger event, an observation (e.g., a CBC result) for a patient is available, may cause the
need for that observation to be sent to a number of other systems. When the transfer of information is
initiated by the application system that deals with the triggering event, the transaction is termed an
unsolicited update.

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Note: No assumption is made about the design or architecture of the application system creating the unsolicited
update. The scope of HL7 is restricted to the specification of messages between application systems and the events
triggering them.
HL7 allows the use of trigger events at several different levels of data granularity and inter-relationships.
For example, most Patient Administration (ADT) trigger events concern single objects (such as an admit
event, which creates a message that contains data about a single person and/or account). Other ADT trigger
events are concerned with relationships between more than one object (e.g., the merge events, which
specify patient or account merges). Some ADT trigger events pertain to a collection of objects that may
have no significant inter-relationships (e.g., a record-oriented location-based query, whose response
contains data about a collection of inpatients who are related only temporarily, by local geography).

2.3.2 Acknowledgments: original mode

When the unsolicited update is sent from one system to another, this acknowledgment mode specifies that it
be acknowledged at the application level. The reasoning is that it is not sufficient to know that the
underlying communications system guaranteed delivery of the message. It is also necessary to know that
the receiving application processed the data successfully at a logical application level.
The acknowledgment may contain data of interest to the system that initiated the exchange. For example, if
a patient care system has processed the trigger event a lab test is ordered for a patient, it may send an
unsolicited update to a lab application identifying the patient, the test ordered, and various other
information about the order. The ancillary system will acknowledge the order when it has processed it
successfully. For some pairings of patient care and ancillary department systems the acknowledgment may
also include the ancillary identification number that was assigned (HL7 does not require Order Entry and
Results Reporting applications to interface in this manner, but it supports those that do).
The HL7 Standard makes no assumptions about the ownership of data. It also makes no requirements of its
own on the subsequent action of the recipient of data, nor does it make any assumption about the design or
architecture of the receiving application system. The scope of HL7 is restricted to the specification of
messages between application systems, and the events triggering them. HL7 does not explicitly support, but
can be used with, systems that support store and forward and data broadcast facilities (see the HL7
Implementation Support Guide).
The HL7 Standard makes no functional interpretation of the requirement that a system commit the data in a
message to its database before acknowledging it. All that is required is that the receiving system accept
responsibility for the data, providing the same integrity test that it would apply to data from any source. To
continue the prior example, the ancillary system may acknowledge the order after placing it in an input
queue, expecting to fully process the order into its database at a future time. The only assumption is that the
input queue is maintained at the same level of integrity as the database.
Instances of messages are transient by nature, and can not be expected by transmitter and/or receiver to be
persistent after acknowledgement.

2.3.3 Acknowledgments: enhanced mode

The HL7 acknowledgment paradigm has been extended to distinguish both accept and application
acknowledgments, as well the conditions under which each is required. With a positive accept
acknowledgment, the receiving system commits the message to safe storage in a manner that releases the
sending system from the need to resend the message. After the message has been processed by the
receiving system, an application acknowledgment may be used to return the resultant status to the sending
system.

2.3.4 Queries
Query documentation including messages, segments, special protocols, implementation considerations and
examples have been moved to chapter 5. The unsolicited display messages were also moved because their
message syntax is query-like in nature.

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2.4 COMMUNICATIONS ENVIRONMENT

The HL7 Standard defines the messages as they are exchanged among application entities and
the procedures used to exchange them. As such, it conceptually operates at the seventh level of
the ISO model for Open System Interconnection (OSI). It is primarily concerned with the data
content and interrelationship of messages and with communicating certain application-level error
conditions.
Since the OSI protocols are not universally implemented, the HL7 Working Group is interested
in providing standards that will be useful in the interim. It is also recognized that there is now,
and will continue to be, interest in communicating health data among systems operating in
communications environments that provide a high level of functionality, but use protocols other
than ISO OSI. The universe of environments of interest to HL7 includes, but is not restricted to:
a) ad hoc environments that do not provide even basic transport reliability. Such environments consist
of point-to-point RS-232 links, modems, and even LANs, if their connection to host computers is
made via RS-232 communications links. Until OSI high level standards become truly prevalent,
many healthcare interfaces will be implemented over such links. In such an environment, the HL7
Lower Level Protocols (LLP) may be used between systems to enhance the capabilities of the
communications environment. The HL7 Lower Level Protocols are defined in the HL7
Implementation Guide, which is not an official part of the Standard.
b) environments that support a robust transport level, but do not meet the high level requirements.
This includes environments such as TCP/IP, DECNET, and SNA.
c) ISO and proprietary networks that implement up to presentation and other high level services.
IBM's SNA LU6.2 and SUN Microsystems's NFS are examples of complete proprietary networks.
d) two or more applications running on the same physical and/or logical machine that are not tightly
integrated. In these environments, the messaging capabilities may be provided by inter-process
communications services (e.g., Pipes in a UNIX System).
The HL7 Standard assumes that the communications environment will provide the following
capabilities:
a) error free transmission. Applications can assume that they correctly received all of the transmitted
bytes in the order in which they were sent. This implies that error checking is done at a lower level.
However, sending applications may not assume that the message was actually received without
receiving an acknowledgment message.
b) character conversion. If the two machines exchanging data use different representations of the same
character set, the communications environment will convert the data from one representation to the
other.
c) message length. HL7 sets no limits on the maximum size of HL7 messages. The Standard assumes
that the communications environment can transport messages of any length that might be
necessary. In practice, sites may agree to place some upper bound on the size of messages and may
use the message continuation protocol, described later in this chapter, for messages that exceed the
upper limit.
Note: Just as HL7 makes no assumptions about the design or architecture of the application systems sending and
receiving HL7 messages, it makes no assumptions about the communications environment beyond those listed
above. In particular, aside from the above assumptions, the communications environment, including its architecture,
design and implementation, is outside the scope of HL7.

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2.5 MESSAGE FRAMEWORK

This section defines the constituents of messages and provides the methodology for defining
abstract messages that are used in later chapters. Message construction rules can be found in
section 2.6.

2.5.1 Messages
A message is the atomic unit of data transferred between systems. It is comprised of a group of segments in
a defined sequence. Each message has a message type that defines its purpose. For example the ADT
Message type is used to transmit portions of a patient's Patient Administration (ADT) data from one system
to another. A three-character code contained within each message identifies its type. These are listed in the
Message Type list, Appendix A.
The real-world event that initiates an exchange of messages is called a trigger event. See Section 2.3.1,
"Trigger events," for a more detailed description of trigger events. Refer to HL7 Table 0003 – Event type for
a listing of all defined trigger events. These codes represent values such as A patient is admitted or An
order event occurred. There is a one-to-many relationship between message types and trigger event codes.
The same trigger event code may not be associated with more than one message type; however a message
type may be associated with more than one trigger event code.
All message types and trigger event codes beginning with the letter "Z" are reserved for locally defined
messages. No such codes will be defined within the HL7 Standard.

2.5.2 Segments and segment groups

A segment is a logical grouping of data fields. Segments of a message may be required or optional. They
may occur only once in a message or they may be allowed to repeat. Each segment is given a name. For
example, the ADT message may contain the following segments: Message Header (MSH), Event Type
(EVN), Patient ID (PID), and Patient Visit (PV1).
Each segment is identified by a unique three-character code known as the Segment ID. Although the actual
segments are defined in various chapters, the ID codes assigned to the various segments are listed in
Appendix A.
All segment ID codes beginning with the letter Z are reserved for locally defined segments. No such codes
will be defined within the HL7 Standard.
Two or more segments may be organized as a logical unit called a segment group. A segment group may be
required or optional and might or might not repeat. As of v 2.5, the first segment in a newly defined
segment group will be required to help ensure that unparsable messages will not be inadvertently defined.
This required first segment is known as the anchor segment.
A segment group is assigned a name that represents a permanent identifier that may not be changed.
A named segment X may occur more than once in an abstract message syntax. This differs from repetition
described earlier in this section. When this occurs, the following rules must be adhered to:
If, within an abstract message syntax, a named segment X appears in two individual or group locations, and
a) Either appearance is optional or repeating in an individual location;
b) or, either appearance is optional or repeating, in a group location
then, the occurrences of segment X must be separated by at least one required segment of a different name
so that no ambiguity can exist as to the individual or group location of any occurrence of segment X in a
message instance.

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Examples of proper segment grouping

Example 1 Example 2 Example 3

{ SEG 1} [ SEG1 ] SEG1

SEG2 { [ SEG2 ]
[ SEG1 ] SEG2 SEG3
[ SEG1 ] { SEG1 }
}

Examples of unparsable segment grouping

Example 1 Example 2 Example 3 Example 4

{ SEG 1} { SEG1 } [ SEG1 ] { SEG1 }

[ SEG1 ] [ SEG2 ] { [ SEG2
SEG1 [ SEG2 ] SEG3 ]
SEG1 SEG1
SEG3
}
In each of these examples it is not possible to tell which part of the message SEG1 belongs.

2.5.3 Fields
Definition: A field is a string of characters. Fields for use within HL7 segments are defined by HL7. A
comprehensive data dictionary of all HL7 fields is provided in Appendix A.
HL7 does not care how systems actually store data within an application. When fields are transmitted, they
are sent as character strings
A field may exist in one of three population states in an HL7 message:
Populated. (Synonyms: valued, non-blank, not blank, not empty.) The sending system sends a value in the
field. For example, if a sending system includes medical record number, that would be communicated as
|1234567^^^MR^KP-CA|. Note that the field might be populated with a code that means "no information"
or "unknown".
Not populated. (Synonyms: unpopulated, not valued, unvalued, blank, empty, not present, missing.) The
sending system does not supply a value for the field. The Sender might or might not have a value for the
field. The receiving system can make no inference regarding the absence of an element value if there is not
a conformance profile governing the implementation. However, if there is a Conformance Message Profile
in effect, then special rules apply; see section 2.B, "Conformance Using Message Profiles".
Null. Any existing value for the corresponding data base element in the receiving application should be
deleted. This is symbolically communicated as two double-quotes between the delimiters (i.e.,
|""|).Employing consecutive double quote characters as the only content of a field for other purposes is
prohibited.
Refer to Section 2.6, "Message Construction Rules" for information on data fields with a null value.
Refer to section 2.10.4, "Protocol for interpreting repeating segments or segment groups in an update
Message" for information on updating records in a database.
Version control rules regarding fields can be found in section 2.8, "Version compatibility definition".
Local extension rules regarding fields can be found in section 2.11, "Local Extension".
The various chapters of the Standard contain segment attribute tables. These tables list and describe the data
fields in the segment and characteristics of their usage. In defining a segment, the following information is
specified about each field:

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2.5.3.1 Position (sequence within the segment)

Definition: Ordinal position of the data field within the segment. This number is used to refer to the data
field in the text comments that follow the segment definition table.
In the segment attribute tables this information is provided in the column labeled SEQ.
2.5.3.2 Maximum length
Definition: Maximum number of characters that one occurrence of the data field may occupy.
In the segment attribute tables this information is in a column labeled LEN.
The maximum length is not of conceptual importance in the abstract message or the HL7 coding rules. The
length of a field is normative. Changes to the field length may be negotiated by a site agreement such as a
conformance profile. See section 2.B, "Conformance Using Message Profiles". When this is done, it shall
not render the implementation non-conformant. The receiver must be able to receive up to the maximum
field length, and the sender can send up to the maximum field length.
Field length is determined based on the data type lengths, and should fall between the lower and the upper
bounds for the corresponding data types. It is calculated to include the component and subcomponent
separators. Because the maximum length is that of a single occurrence, the repetition separator is not
included in calculating the maximum length See Section 2.5.3.5, "Repetition".
The following conventions have been applied:
a) The maximum length of the data field shall be expressed as a number.
b) If the maximum length needs to convey the notion of a Very Large Number, the number 65536
should be displayed to alert the user. This convention takes the place of the practice in versions
prior to 2.4 of abbreviating this expression as 64K.
c) If the maximum length cannot be definitively expressed because the data type for the field is
variable, the symbolic number 99999 should be displayed. This convention takes the place of the
practice in versions prior to 2.4 of displaying the notation "varies" or some other non-numeric
description.
In v 2.5 maximum lengths are being assigned to data types. See HL7 Table 0440 - Data Types.
2.5.3.3 Data type
Definition: The basic building block used to construct or restrict the contents of a data field.
In the segment attribute tables this information is provided in the column labeled DT. If the data type of the
field is variable, the notation "varies" will be displayed.
There are a number of data types defined by HL7. See section 2.15, "Data types"
2.5.3.4 Optionality
Definition: Whether the field is required, optional, or conditional in a segment.
In the segment attribute tables this information is provided in the column labeled OPT.
The designations for optionality are:
R - required
O - optional
C - conditional on the trigger event or on some other field(s). The field
definitions following the segment attribute table should specify the
algorithm that defines the conditionality for this field.
X - not used with this trigger event
B - left in for backward compatibility with previous versions of HL7.
The field definitions following the segment attribute table should
denote the optionality of the field for prior versions.

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W - withdrawn
Note: For Versions 2.3 and higher: the optionality of fields should be explicitly documented in the segment field
definitions that follow each segment definition table; if the optionality of fields within a segment changes depending on
the trigger event, that optionality should also be explicitly documented.
For version 2.5 and higher, the optionality, table references, and lengths of data type components are
supplied in component tables of the data type definition. The component definitions that follow the
component table will elaborate on the optionality and table references. Where needed, additional detailed
field definitions will follow the formal segment attribute tables. (See also Sections 2.5.4, "Message
delimiters," 2.6, "Message construction rules," 2.15, "Data types").
2.5.3.5 Repetition
Definition: Whether the field may repeat. The value that appears in the repetitions column is the maximum
number of allowed occurrences, e.g., a value of '3' would mean that the field can have '3 occurrences'; if
unspecified, there is only one occurrence, i.e., cannot repeat.
In the segment attribute tables this information is provided in the column labeled RP/#.
The designations for Repetition are:
N or blank - no repetition
Y - the field may repeat an indefinite or site-determined number of times
(integer) - the field may repeat up to the number of times specified by the
integer
Each occurrence may contain the number of characters specified by the field's maximum length. See
Section 2.5.3.2, "Maximum length".
Usage Note: For improved readability some technical committees opt to leave the Repetition fields blank to
indicate that the field may NOT repeat. A blank may NOT be construed to mean that the field may
optionally repeat.
As of v2.5 the Repetition column is to be left blank if the field may NOT repeat.
2.5.3.6 Table
Note: The Vocabulary T.C. is the steward of this section.
Definition: The table attribute of the data field definition specifies the HL7 identifier for a set of coded
values.
In the segment attribute tables, the table identifier is provided in the column labeled TBL#. If this attribute
is not valued or blank, there is not a table of values defined for the field.
A number of conventions have been applied to this attribute of the data field definition.
a) If more than one table is applicable, the format xxxx/yyyy will be used to so designate multiple
tables. Details on multiple tables will be specified in field or data type notes.
b) If the field is of data type ID or IS a table number will be allocated even if, in the case of IS, there
may be a notation "No Suggested values".
c) If the field is of data type CF, CNE or CWE and one or more externally or locally defined tables
may be used, the symbolic number 9999 will appear in the column. This is to indicate that table
values are used, but no HL7/User-defined table can be allocated. The narrative may constrain
which external tables can be used.
d) Tables embedded in field components or subcomponents will not be cited in the attribute column.
1) Tables embedded in data types are defined, save for the exceptions in point 2 below, in the data
type's component table in section 2.A Data Types. They may, however, be constrained in the
field note section. The field note definition supersedes the definition in the data type section.
2) Tables embedded in fields with a data type of CF, CNE, or CWE are only defined in the field
notes section.
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e) Values for HL7 tables shall not contain the embedded "suggested delimiters" delineated in section,
2.5.4, "Message delimiters".
HL7 defines four table types, reflecting content ownership: HL7 defined, User-defined, Imported and
Externally defined. Local implementation may further constrain the table.
User-defined Tables: A user-defined table is a set of values that are locally or site defined. This
accommodates certain fields, like PV1-3 - Assigned patient location, that will have values that vary from
institution to institution. Even though these tables are not defined in the Standard, they are given a user-
defined table number to facilitate implementations. HL7 sometimes publishes suggested values that a site
may use as a starter set (e.g., Table 0001- Sex). The IS data type is often used to encode values for these
tables. Note that some of these tables (e.g., Table 0302 - Point of care) may reference common master files.
There are some user-defined tables that contain values that might be standardized across institutions but for
which no applicable official standard exists. For these a set of suggested values may be listed in Appendix
A. These suggested values appear in the text in a standard box format (e.g., HL7 Table 0062 - Event Reason
in Section 3.4.1.4, "Event reason code"). It is recommended that these values be used where applicable
within an institution and serve as a basis for extensions as required. These values may, however, be
redefined locally. The appropriate functional committee within HL7 solicits suggestions for additional
values from institutions that are applying the Standard.
HL7 Tables: An HL7 table is a set of values defined and published by HL7. They are a part of the HL7
Standard because they affect the interpretation of the messages that contain them. These values may not be
redefined locally; however, the table itself may be extended to accommodate locally defined values. This is
particularly applicable in the case of HL7 table 0003 – Event Type. The ID data type is most often used to
encode values for HL7 tables. The values are listed in Appendix A. These HL7 tables also appear in the text
in a standard box format (e.g., HL7 table 0003 Event Type).
External Tables: An External table is a set of coded values defined and published by another standards
organization. External tables are used to populate fields like FT1-19-Diagnosis Code - FT1. Another
example is the encoding of clinical observations using LOINC codes. The CF, CNE and CWE data type are
used to represent values for these fields.
External tables arise from applications where the concepts and possibly the codes are established by
external agencies due to regulatory requirements or agreements between HL7 and other Standards
Developing Organizations..
For user convenience, an External table will be assigned a number by HL7. Although the set of allowable
codes (the code sets) are supplied by an external organization, the coding system code is assigned by HL7
in HL7 Table 0396 - Coding System. When the value is an HL7 extension to the table, the HL7 number
should be used as the coding scheme.
The data type for the field will be CWE if 1) other tables are allowed in the field or 2) the external table
may be locally extended or 3) when the code may be replaced by local text.
The data type for the field will be CNE if 1) no other table is allowed in the field and 2) the external table
may not be locally extended and 3) text may not replace the code. A CNE field must have an HL7 defined
or external table associated with it. A CNE field may be context sensitive such that a choice of explicit
coding systems or value sets might be designated.
Imported Tables: An Imported table is a set of coded values defined and published by another standards
organization. Imported tables are published by HL7 on behalf of other organizations. Their contents are not
subject to approval by HL7 ballot. Such tables will be published with HL7 Standards. However, they may
be updated more frequently than HL7 Standards.
Imported tables differ from External tables in that they have been imported into the HL7 standard subject to
specific license or copyright requirements of the supplier/author. HL7 users will need to abide by the
licensing and copyright requirements of the source when applicable.
For user convenience, an Imported table will be assigned a number by HL7. However, the coding system
will be designated as that assigned by the supplier, and will be a member of HL7 Table 0396 - Coding

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System. An exception to this convention occurs when the value is an HL7 extension to the table; in that case
the HL7 number should be used as the coding scheme.
Table 0292 - Vaccines administered is an example of an Imported table.
The data type rules apply as defined for the External table.
Local Tables: A local table is a table with a non-HL7 assigned table identifier and which contains a set of
locally or site defined values. It may be locally assigned to local fields in Z segments or to HL7 fields
having a CWE data type.
2.5.3.7 ID number
Definition: a small integer that uniquely identifies the data item throughout the Standard. In the segment
definition this information is provided in the column labeled ITEM #.
2.5.3.8 Name
Definition: Descriptive name for the data item. In the segment attribute tables this information is provided
in the column labeled ELEMENT NAME.
When the same name is used in more than one segment, it must have the same data type and semantic
meaning in each segment as well as the same ID number. To deal with any ambiguities arising from this
convention, whenever a field is referenced herein, the segment name and position must always be included.

2.5.4 Message delimiters

In constructing a message, certain special characters are used. They are the segment terminator, the field
separator, the component separator, subcomponent separator, repetition separator, and escape character. The
segment terminator is always a carriage return (in ASCII, a hex 0D). The other delimiters are defined in the
MSH segment, with the field delimiter in the 4th character position, and the other delimiters occurring as in
the field called Encoding Characters, which is the first field after the segment ID. The delimiter values used
in the MSH segment are the delimiter values used throughout the entire message. In the absence of other
considerations, HL7 recommends the suggested values found in Figure 2-1 delimiter values.
At any given site, the subset of the possible delimiters may be limited by negotiations between applications.
This implies that the receiving applications will use the agreed upon delimiters, as they appear in the
Message Header segment (MSH), to parse the message.
Note: The binary representation of the delimiter characters will vary with the character set used in the message.

Warning: Receivers should be made aware that while it is not best practice, the sender may omit the escape and
subcomponent delimiters.

Figure 2-1. Delimiter values

Delimiter Suggested Encoding Usage
Value Character Position

Segment Terminator <cr> - Terminates a segment record. This value cannot be changed by implementers.
Field Separator | - Separates two adjacent data fields within a segment. It also separates the segment
ID from the first data field in each segment.
Component Separator ^ 1 Separates adjacent components of data fields where allowed.
Repetition Separator ~ 2 Separates multiple occurrences of a field where allowed.
Escape Character \ 3 Escape character for use with any field represented by an ST, TX or FT data type,
or for use with the data (fourth) component of the ED data type. If no escape
characters are used in a message, this character may be omitted. However, it must
be present if subcomponents are used in the message. Best practice is to always
include this character.
Subcomponent & 4 Separates adjacent subcomponents of data fields where allowed. If there are no

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Separator subcomponents, this character may be omitted. Best practice is to always include
this character.

2.6 MESSAGE CONSTRUCTION RULES

This section addresses HL7 general rules for composing messages. Both the sender and receiver of the data
must have predictable rules for how they will process the data. The reader is also referred to Section 2.B,
"Conformance Using Message Profiles", where procedures for ensuring messaging integrity are discussed
in detail.
Note: These message construction rules define the standard HL7 encoding rules, creating variable length delimited
messages. Although only one set of encoding rules has been defined as a standard since HL7 Version 2.3, other
encoding rules are possible (but since they are non-standard, they may only be used by a site-specific agreement).

2.6.1 Rules for the sender

2.6.1.1 Message Construction Pseudocode

procedure construct_message ( data ) {

identify_message_needed;
validate( data );
order_segments( data, segment_list );

foreach segment in ( segment_list ) {

insert segment.name; /* e.g., MSH */

/* gather all data for fields */

foreach field in ( fields_of( segment ) ) {
insert field separator; /* e.g., | */
/* gather occurrences (may be multiple only for fields that are allowed to repeat */
foreach occurrence in ( occurrences_of( field ) ) {
construct_occurrence( occurrence );
if not last ( populated occurrence ) insert repetition_separator; /* e.g., ~ */
}
break if last ( populated field );

insert segment_terminator; /* always<cr>! */

}

return;
}

procedure construct_occurrence ( occurrence ) {

/* gather populated components */

foreach component in ( components_of( occurrence ) ) {
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get_subcomponent_data( component );

/* gather all data for subcomponents */

foreach subcomponent in ( subcomponents_of( component ) ) {
/* escape the field separator */
substitute( field_separator, \F\ );
/* escape the encoding characters */
substitute( component_separator, \S\ );
substitute( repetition_separator, \R\ );
substitute( escape_character, \E\ );
substitute( subcomponent_separator, \T\ );
insert subcomponent;
if not last ( populated subcomponent ) insert subcomponent_separator; /* e.g., & */
}

if not last ( populated component ) insert component_separator; /* e.g., ^ */

}

return;
}

2.6.1.2 Message Construction Flow Chart

The flow charts on the following pages represent another view of the message construction rules. The first
shows the rules for transmitting a message; the second shows transmitting field occurrences.

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This step will also validate

ConstructMessage data types, repeating fields,
and other element
constraints not related to the
encoding.
Identify the message needed and order
the segments accordingly

for (eachSegment)

Get all field data for this segment

Add the segment name

for (eachField)

Add the field

separator

for (eachFieldOcc)

ConstructFieldOcc

Any more occurrences Add the repetition

Yes
of this field separator

No

loop

Any more fields

populated in this
segment

Yes

loop
No

Add the segment terminator

loop

Stop

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ConstructFieldOcc

Get all component data for this

occurrence of the field

for (eachComponent)

Get all subcomponent data for this

component of the field

for (eachSubComponent)

Any MSH.1 or MSH.2

Yes Escape them
characters in the data

No

Send the data

Is this the last populated Add the subcomponent

No
subcomponent separator

Yes

loop

Is this the last populated Add the component

No
component separator

Yes

loop

Return

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2.6.2 Rules for the recipient

The following rules apply to receiving HL7 messages and converting their contents to data values:
a) ignore segments, fields, components, subcomponents, and extra repetitions of a field that are
present but were not expected.
b) treat optional segments that were expected but are not present as consisting entirely of fields that
are not present.
c) treat fields and components that are expected but were not included in a segment as not present.

2.6.3 Encoding rules notes

If a segment is to be continued across messages, use the extended encoding rules. These rules are defined in
terms of the more general message continuation protocol (see Section 2.10.2, "Continuation messages and
segments").

2.7 USE OF ESCAPE SEQUENCES IN TEXT FIELDS

2.7.1 Formatting codes
When a field of type TX, FT, or CF is being encoded, the escape character may be used to signal certain
special characteristics of portions of the text field. The escape character is whatever display ASCII
character is specified in the <escape character> component of MSH-2-encoding characters. For purposes of
this section, the character \ will be used to represent the character so designated in a message. An escape
sequence consists of the escape character followed by an escape code ID of one character, zero (0) or more
data characters, and another occurrence of the escape character.
The escape sequences for field separator, component separator, subcomponent separator, repetition
separator, and escape character are also valid within an ST data field.
The following escape sequences are defined:
\H\ start highlighting
\N\ normal text (end highlighting)
\F\ field separator
\S\ component separator
\T\ subcomponent separator
\R\ repetition separator
\E\ escape character
\Xdddd...\ hexadecimal data
\Zdddd...\ locally defined escape sequence
No escape sequence may contain a nested escape sequence.

2.7.2 Escape sequences supporting multiple character sets

The following HL7 escape sequences are defined to support multiple character sets for fields, components
and sub-components that are defined as data types FT, ST, and TX. They allow HL7 parsers to use escape
codes (defined in the standards used below), without breaking, and without being non-conformant to the
HL7 escape paradigm defined in this section.
\Cxxyy\ single-byte character set escape sequence with two hexadecimal values,
xx and yy, that indicate the escape sequence defined for one of the
character repertoires supported for the current message (i.e., ISO-IR
xxx).

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\Mxxyyzz\ multi-byte character set escape sequence with three hexadecimal

values, xx, yy and zz. zz is optional.
Common character set escape sequences include the following which are defined in the standards
mentioned:
Single-byte character sets:
\C2842\ ISO-IR6 G0 (ISO 646 : ASCII)
\C2D41\ ISO-IR100 (ISO 8859 : Latin Alphabet 1)
\C2D42\ ISO-IR101 (ISO 8859 : Latin Alphabet 2)
\C2D43\ ISO-IR109 (ISO 8859 : Latin Alphabet 3)
\C2D44\ ISO-IR110 (ISO 8859 : Latin Alphabet 4)
\C2D4C\ ISO-IR144 (ISO 8859 : Cyrillic)
\C2D47\ ISO-IR127 (ISO 8859 : Arabic)
\C2D46\ ISO-IR126 (ISO 8859 : Greek)
\C2D48\ ISO-IR138 (ISO 8859 : Hebrew)
\C2D4D\ ISO-IR148 (ISO 8859 : Latin Alphabet 5)
\C284A\ ISO-IR14 (JIS X 0201 -1976: Romaji)
\C2949\ ISO-IR13 (JIS X 0201 : Katakana)
Multi-byte codes:
\M2442\ ISO-IR87 (JIS X 0208 : Kanji, hiragana and katakana)
\M242844\ ISO-IR159 (JIS X 0212 : Supplementary Kanji)

2.7.3 Highlighting
In designating highlighting, the sending application is indicating that the characters that follow somehow
should be made to stand out, but leaving the method of doing so to the receiving application. Depending on
device characteristics and application style considerations, the receiving application may choose reverse
video, boldface, underlining, blink, an alternate color or another means of highlighting the displayed data.
For example the message fragment:
DSP| TOTAL CHOLESTEROL \H\240*\N\ [90 - 200]
might cause the following data to appear on a screen or report:
TOTAL CHOLESTEROL 240* [90 - 200]
whereas another system may choose to show the 240* in red.

2.7.4 Special character

The special character escape sequences (\F\, \S\, \R\, \T\, and \E\) allow the corresponding characters to be
included in the data in a text field, though the actual characters are reserved. For example, the message
fragment
DSP| TOTAL CHOLESTEROL 180 \F\90 - 200\F\
DSP| \S\----------------\S\
would cause the following information to be displayed, given suitable assignment of separators:
TOTAL CHOLESTEROL 180 |90 - 200|
^----------------^

2.7.5 Hexadecimal
When the hexadecimal escape sequence (\Xdddd...\) is used the X should be followed by 1 or more pairs of
hexadecimal digits (0, 1, . . . , 9, A, . . . , F). Consecutive pairs of the hexadecimal digits represent 8-bit
binary values. The interpretation of the data is entirely left to an agreement between the sending and
receiving applications that is beyond the scope of this Standard.

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2.7.6 Usage and Examples of Formatted Text

If the field is of the formatted text (FT) data type, formatting commands also may be surrounded by the
escape character. Each command begins with the "." (period) character. The following formatting
commands are available:
.sp <number> End current output line and skip <number> vertical spaces. <number> is a positive integer or absent. If
<number> is absent, skip one space. The horizontal character position remains unchanged. Note that only for
purposes of compatibility with previous versions of HL7, "^\.sp\" is equivalent to "\.br\."
.br Begin new output line. Set the horizontal position to the current left margin and increment the vertical
position by 1.
.fi Begin word wrap or fill mode. This is the default state. It can be changed to a no-wrap mode using the .nf
command.
.nf Begin no-wrap mode.
.in <number> Indent <number> of spaces, where <number> is a positive or negative integer. This command cannot
appear after the first printable character of a line.
.ti <number> Temporarily indent <number> of spaces where number is a positive or negative integer. This command
cannot appear after the first printable character of a line.
.sk < number> Skip <number> spaces to the right.
.ce End current output line and center the next line.
The component separator that marks each line defines the extent of the temporary indent command (.ti),
and the beginning of each line in the no-wrap mode (.nf). Examples of formatting instructions that are NOT
included in this data type include: width of display, position on page or screen, and type of output devices.
Figure 2-3 is an example of the FT data type from a radiology impression section of a radiology report:

Figure 2-3. Formatted text as transmitted

\.in+4\\.ti-4\ 1. The cardiomediastinal silhouette is now within normal
limits.\.br\\.ti-4\ 2. Lung fields show minimal ground glass appearance.\.br\\.ti-4\
3. A loop of colon visible in the left upper quadrant is distinctly abnormal with the
appearance of mucosal effacement suggesting colitis.\.in-4\|
Figure 2-4 shows one way of presenting the data in Figure 2-3. The receiving system can create many
other interpretations by varying the right margin.

Figure 2-4. Formatted text in one possible presentation

The cardiomediastinal silhouette is now within normal limits.
Lung fields show minimal ground glass appearance.
A loop of colon visible in the left upper quadrant is distinctly
abnormal with the appearance of mucosal effacement suggesting
colitis.

2.7.7 Local
When the local escape sequence (\Zdddd...\) is used the Z should be followed by characters that are valid in
a TX field. The interpretation of the data is entirely left to an agreement between the sending and receiving
applications that is beyond the scope of this Standard.

2.8 VERSION COMPATIBILITY DEFINITION

The rules, described in section 2.6, "Message construction rules", for receiving HL7 messages and
converting their contents to data values allow the following definition of a backward compatibility
requirement between the 2.x versions of HL7:
Note: If an issue is not covered explicitly under these rules, no assumption should be made that the change is
allowed.
The keys to understanding version compatibility are the following 2 axioms, plus the processing rules
which state that unexpected information should be discarded.
• Old receivers receiving new messages should be able to continue receiving messages without error.
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• New receivers should be able to understand old messages.

This section elaborates on what the kinds of changes can be done that satisfies these axioms. Only HL7
changes introduced in new versions are included. Local extensions are discussed in section 2.11, "Local
Extension".

2.8.1 Adding messages or message constituents

A new message or a new constituent of an HL7 message may be introduced as described below. A sending
system should be able to send a new message or new constituent; the receiver, regardless of its version
level, must ignore any message or message constituent it is not expecting without generating an application
failure. This does not preclude a receiver notifying the sender that additional element was ignored, but the
receiving application should not fail just from the existence of additional element.
a) New messages may be introduced.
b) A new segment group may be defined.
c) The first segment in a newly-defined segment group, as of v 2.5, must be marked as required.
d) New segments may be introduced to an existing message. In general these will be introduced at the
end of a message or a segment group, but they may be introduced elsewhere within the message if
the segment hierarchy makes this necessary. Unless needed as a technical correction or for
regulatory reporting purposes, a new segment may not be added to a deprecated message. As of
v2.6 all new segments, except for those pertaining only to message transmission or control, must
include an Action Code field as the first or second field as appropriate.
e) Care must be taken when introducing a new segment if this results in a situation in which a named
segment X appears in two individual or group locations. See section 2.6, "Message Construction
Rules".
f) New fields may be added at the end of a segment. A field that changes the semantic meaning of a
segment (e.g., an Acton Code, or Mood code) may only be introduced in a pre-existing segment if
the usage of the field is conditional on it not being used in messages with pre-existing trigger
events. This is to avoid the risk of reversing the intent of the segment as it is known to the recipient
of an earlier version. For example, if the Sender were to send the segment with a delete action
code, the recipient would not understand that the information should be deleted.
g) A new data type may be introduced.
h) New components may be added at the end of a data type.
i) A new table may be introduced.

2.8.2 Changing messages or message constituents

Allowable changes to messages or message constituents can be categorized as name, data type, optionality,
repeatability, length or definition changes.
a) The descriptive text name of a message or message constituent (except for segment group name)
may be changed. This should have no impact on either the sender's ability to transmit a message or
the receiver's ability to receive and understand the message. Reasons for changing the descriptive
text name include: 1) clarify a misleading name, and 2) encompassing a broader use without
jeopardizing current use.
b) The data type of a field or data type component may be changed. A sending system should be able
to send the modified field or data type; the receiver, regardless of its version level, should be able to
understand the message and to ignore any message constituent it is not expecting.
1) The data type of the field may be changed provided that the components of the new data type
have the same structure and interpretation as the old data type. For example, an IS data type
may be changed to a CE, but a PPN data type cannot be changed to a PN. An NM data type
cannot be changed to an ST data type.

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2) For existing fields in existing segments, data types may be changed if the leftmost (prior
version) part of the field has the same meaning as it had in the prior version of HL7. This is in
accordance with the rules governing the addition of new components and subcomponents
described in the section above. In other words, if the new parts of the field (those that are part
of the new data type) are ignored, what remains is the old field (defined by the old data type),
which has the same meaning as it had in the prior version of HL7.
3) If a data type component has its data type changed, the structure and interpretation must
remain the same as the pre-existing component. Any new component is added at the end of the
data type.
c) The optionality of a message constituent may be changed. A sending system should be able to send
the modified field; the receiver, regardless of its version level, should be able to understand the
message. This pertains as follows:
1) Existing optional segment groups may be made required.
2) Existing optional segments may be made conditional or required.
3) Existing optional fields may be made conditional or required.
4) Existing required fields may be made conditional if a new trigger event has been applied. The
condition must be specified such that the field remains required for the pre-existing trigger
events.
5) Existing optional components of a data type may be made conditional or required.
d) The repeatability of a message constituent may be changed. A sending system should be able to
send the modified message constituent; the receiver, regardless of its version level, should be able
to understand the message. Note that if a non-repeating message constituent is made repeating,
information sent in the new repetitions may be lost to the recipient who is not expecting them.
If HL7 has given, or will give, semantic meaning to the first instance, to allow backward
compatibility, the first instance of the repeating constituent shall have the same meaning as the non-
repeating constituent had in the prior version of HL7. In this way, a receiving application that
interprets the message based upon the prior standard would continue to find the same intent
communicated in the message.
If HL7 has not given, and will/can not give, semantic meaning to the first instance, and one or more
implementation-applied business rules exist to select one of several occurrences to populate a non-
repeating constituent, those same rules should be applied when a newer version of the standard
allows for repetition of the constituent. By applying the prior business rules to determine the first
occurrence of a repeating constituent, a receiving application that interprets the message based
upon the prior standard would continue to find the same intent communicated in the message.
If, in the judgment of the owner/author of the standard section in question, changing a message
constituent from non-repeating to repeating poses logical, parsing, business, or other compatibility
issues, the owner/author may elect to create a new structure to eliminate the compatibility concern.
For example, if allowing a segment to repeat implies a change to the business intent of the
message, the technical committee responsible can elect to define a new message structure (as a new
message/trigger) and retain the old structure for backward compatibility.
This pertains as follows:
1) A segment group may change from non-repeating to repeating, subject to the backward
compatibility concerns expressed above.
2) A segment group may NOT be changed from repeating to non-repeating.
3) A segment may be changed from non-repeating to repeating, subject to the backward
compatibility concerns expressed above.
4) A segment may NOT be changed from repeating to non-repeating.

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5) A field may be changed from non-repeating to repeating, subject to the backward compatibility
concerns expressed above. A field may NOT be changed from repeating to non-repeating.
e) The length of a field, data type or data type component may be increased.
f) Table definition may change.
1) A table may be changed from user-defined to HL7 defined or externally defined.
2) A table may be changed from HL7 defined to an externally defined table. When this occurs,
the data type of the field should be changed to a CNE or CWE.

2.8.3 Deprecating messages or message constituents

Any required, optional or conditional constituent of an HL7 message, including the message itself, may be
deprecated. This means that one of the following situations has occurred:
• The message or message constituent no longer has a meaningful purpose
• The message or message constituent has been replaced by a better method
Language will be inserted stating the fact of deprecation, the version in which the deprecation occurred,
and what message or message constituent, if any, replaces it. The phrase "Retained for backward
compatibility only in version 2.x; refer to section n.m instead" will be the standard language for such an
occurrence.
The fact of deprecation should not affect either the sender or the receiver because the message or message
constituent is retained for backward compatibility. Implementers, by site agreement, may agree to not
support deprecated message constituents.
The following are allowed:
a) A message may be deprecated.
c) A trigger event may be deprecated.
d) A message structure may be deprecated.
e) A segment in an existing message may be deprecated. Implementers, by site agreement, may agree
to not support deprecated segments. If the segment that is to be deprecated has dependents the
entire segment group must be deprecated. For example, in a group [{ABC[DEF][{GHI}]], DEF
and/or GHI may be deprecated, but ABC cannot be deprecated without deprecating the whole.
f) A field may be deprecated by HL7. Implementers, by site agreement, may agree to not use
deprecated fields.
g) A data type may be deprecated provided all fields referencing it have been deprecated or there is an
explicit statement that the data type is not to be used in any field defined in the future.
h) A data type component may be deprecated.
i) A table may be deprecated. This includes HL7 tables, user-defined tables, imported external tables
and reference to external tables.
j) An entry in an HL7-defined table may be deprecated. The table itself should be reviewed if it
contains a substantial number of deprecated members.
k) An entry in an imported external table may not be deprecated.

2.8.4 Removing messages or message constituents

A message or message constituent may be removed from the standard when criteria described in this
section are met. HL7 will track old names so they are not re-used.
Note: To refer to the detail of a withdrawn message constituent, the reader will need to review the appropriate earlier
version of the standard. By site agreement senders and receivers may agree to continue to use messages and/or
message constituents that have been removed.
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a) A message constituent may be immediately removed from the standard based on the following
criteria (immediately means in the same version in which the criteria are met.).
1) A message structure may be removed immediately provided no message references it in the
standard. Care must be taken lest a message structure is prematurely removed if the associated
trigger event that contributed to its name is removed. For example, if a message structure
ABC_D01 is associated with trigger events D01, D02 and D03 and D01 is changed and
becomes associated with another existing message structure DEF_E01, the message structure
ABC_D01 is still active and valid for trigger events D02 and D03.
2) A segment may be removed immediately provided no message references it in the standard.
3) A data type may be removed immediately provided no fields reference it. This occurs when the
data type for a field is changed to a new data type that incorporates the components of the old
one.
4) A table may be removed provided all fields and components, where the table has been used
have been removed. This applies to HL7, user-defined and external tables. It is recognized that
this might have a ripple effect.
b) A message constituent, except as noted in points c, d and e below, will be withdrawn and removed,
no sooner than, after 2 versions in a deprecated state. For example, if a message was originally
deprecated in v 2.3.1, its definition can be removed when v 2.6 is published.
1) A message type and its definition may be removed.
2) A trigger event and its definition may be removed.
3) A segment group in an existing message may be removed.
4) A segment in an existing message may be removed.
c) A deprecated field in an existing segment may NOT be removed from the standard. However, no
sooner than, after 2 versions in a deprecated state, the field will be marked as withdrawn and all
explanatory narrative will be removed
d) A deprecated component in an existing data type may NOT be removed from the standard.
However, no sooner than, after 2 versions in a deprecated state, the component will be marked as
withdrawn and all explanatory narrative will be removed.
e) A deprecated member of an existing HL7 table may NOT be removed from the standard. However,
no sooner than, after 2 versions in a deprecated state, the table member will be marked as
withdrawn and all explanatory narrative will be removed from the description and comment
column.

2.8.5 Early adoption of HL7 changes

Early adoption of HL7 changes that have been approved by the technical committee for the next
membership ballot is a common practice and is not prohibited, but carries risk. Such changes may be
rejected or modified in the balloting process. One example is that the change may pass but may be
positioned differently in the segment or data type.

2.8.6 Technical correction rules

Technical corrections may be applied between versions on a case-by-case basis. These corrections will be
published on the HL7 website. The following meet criteria for technical correction:
a) Spelling correction
b) Incorrect section reference
c) Transcription error in an imported external table
d) Correction of an inconsistency between a segment attribute table and the field narrative
e) Erroneous examples
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f) Erroneous/misleading descriptions

2.9 MESSAGE PROCESSING RULES

The processing rules described here apply to all exchanges of messages, whether or not the HL7 encoding
rules or Lower Layer Protocols are used. They represent the primary message processing mode. The user
may use either the original processing rules, described in section 2.9.2 or the enhanced processing rules,
described in section 2.9.3.
Note: The MCF – Delayed Acknowledgement message has been removed from the standard. It was deprecated in v
2.2. Accordingly, the narrative notes regarding deferred processing have been removed from this section.
Certain variants exist and are documented elsewhere:
a) an optional sequence number protocol. Refer to section 2.10.1.
b) an optional protocol for continuing a very long message. Refer to section 2.10.2.
Because the protocol describes an exchange of messages, it is described in terms of two entities, the
initiating and responding systems. Each is both a sender and receiver of messages. The initiating system
sends first and then receives, while the responding system receives and then sends.
In overview this exchange proceeds as follows:

Message Exchange
Step Process Comment

Step 1 Initiator constructs an HL7 message from application

data and sends it to the responding system
Step 2 Responder receives message and processes it based on The rules differ based on whether
rules the original acknowledge mode or
the enhanced acknowledgement
mode is followed
Step 3 Responder sends response message
Step 4 Initiator processes response message

2.9.1 Message initiation

The initiating application creates a message with data values as defined in the appropriate chapter of this
Standard. The fields shown below should be valued in the MSH segment (as defined under the MSH
segment definition of this chapter). The message is encoded according to the applicable rules and sent to
the lower level protocols, which will attempt to deliver it to the responding application. (For definitions of
the MSH fields see Section 2.14.9, "MSH - message header segment")
Field Notes

MSH-3-sending application

MSH-4-sending facility
MSH-5-receiving application

MSH-6-receiving facility
MSH-7-date/time of message

MSH-9-message type
MSH-10-message control ID Unique identifier used to relate the response to the initial
message.

MSH-11-processing ID
MSH-12-version ID
MSH-13-sequence number

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Field Notes

MSH-14-continuation pointer Used in implementation of message continuation protocol. See

Section 2.10.2, "Continuation messages and
segments". Also see chapter 5.
Certain other fields in the MSH segment are required for the operation of the HL7 encoding rules; they will
not be relevant if other encoding rules are employed.
The event code in the second component of MSH-9-message type is redundantly shown elsewhere in some
messages. For example, the same information is in the EVN segment of the ADT message. This is for
compatibility with prior versions of the HL7 protocol. Newly defined messages should only show the event
code in MSH-9-message type.

2.9.2 Message response using the original processing rules

2.9.2.1 Accept and validate the message in responding system
Upon receipt of the message, when the Original Acknowledgement rules are used, the protocol software in
the responding system validates it against at least the following criteria:
Note: Both MSH-15 - accept acknowledgment type and MSH-16 - application acknowledgment type are null or not
present.

a) the value in MSH-9-message type is one that is acceptable to the receiver.

b) the value in MSH-12-version ID is acceptable to the receiver.
c) the value in MSH-11-processing ID is appropriate for the application process handling the message.
If any of these edits fail, the protocol software rejects the message. That is, it creates an ACK message with
AR in MSA-1-acknowledgment code.
If successful, the process moves to the next step.
2.9.2.2 Accept and validate/process the message in the receiving application
Upon successful validation by the responding system, the message is passed to the receiving application,
which performs one of these functions:
a) process the message successfully, generating the functional response message with a value of AA
in MSA-1-acknowledgment code.
b) send an error response, providing error information in functional segments to be included in the
response message with a value of AE in MSA-1-acknowledgment code.
c) fail to process (reject) the message for reasons unrelated to its content or format (system down,
internal error, etc.). For most such problems it is likely that the responding system will be able to
accept the same message at a later time. The implementers must decide on an application-specific
basis whether the message should be automatically sent again. The response message contains a
value of AR in MSA-1-acknowledgment code.
The MSH segment in the response is constructed anew following the rules used to create the initial message
described above. In particular, MSH-7-date/time of message and MSH-10-message control ID refer to the
response message; they are not echoes of the fields in the initial message. MSH-5-receiving application,
MSH-6-receiving facility, and MSH-11-processing ID contain codes that are copied from MSH-3-sending
application, MSH-4-sending facility and MSH-11-processing ID in the initiating message.
In all the responses described above, the following values are put in the MSA segment. Note that the field
definitions for the MSA segment fields are in Section 2.14.8.
Field Notes

MSA-1-acknowledgment code As described above.

MSA-2-message control ID MSH-10-message control ID from MSH segment of

incoming message.

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MSA-4-expected sequence number As described in Section 2.10.1, "Sequence number

protocol," (if the sequence number protocol is being
used).
ERR segment fields Refer to section 2.15.5.
The receiving application then passes the response message back to the responding system for the next step
in the process.
2.9.2.3 Transmit the response message
Upon receiving the response message from the receiving application, the responding system transmits it to
the initiating system.
The initiator processes the response message.

2.9.3 Response using enhanced acknowledgement

a) the responding system receives the message and commits it to safe storage. This means that the
responding system accepts the responsibility for the message in a manner that releases the sending
system from any obligation to resend the message. The responding system now checks the message
header record to determine whether or not the initiating system requires an accept acknowledgment
message indicating successful receipt and secure storage of the message. If it does, the accept
acknowledgment message is constructed and returned to the initiator.
b) at this point, the requirements of the applications involved in the interface determine whether or not
more information needs to be exchanged. This exchange is referred to as an application
acknowledgment and includes information ranging from simple validation to a complex
application-dependent response. If the receiving system is expected to return application-dependent
information, it initiates another exchange when this information is available. This time, the roles of
initiator and responder are reversed.
2.9.3.1 Accept and validate the message in responding system
Upon receipt of the message, when the Enhanced Acknowledgement rules are used, the protocol software
in the responding system makes an initial determination as to whether or not the message can be accepted,
based on factors such as:
Note: At least one of MSH-15-accept acknowledgment type or MSH-16-application acknowledgment type is not null.
a) the status of the interface
b) the availability of safe storage onto which the message can be saved
c) the syntactical correctness of the message, if the design of the receiving system includes this type
of validation at this phase
d) the values of MSH-9-message type, MSH-12-version ID, and MSH-11-processing ID, if the design
of the receiving system includes this type of validation at this phase
It then examines the Message Header segment (MSH) to determine whether or not the initiating system
requires an accept acknowledgment.
2.9.3.2 Transmit general acknowledgement message
A general acknowledgement message is not always required by the initiating system, but if it is the
responding system sends one of the following:
a) a commit accept (CA) in MSA-1-acknowledgment code if the message can be accepted for
processing
b) a commit reject (CR) in MSA-1-acknowledgment code if the one of the values of MSH-9-message
type, MSH-12-version ID or MSH-11-processing ID is not acceptable to the receiving application
c) a commit error (CE) in MSA-1-acknowledgment code if the message cannot be accepted for any
other reason (e.g., sequence number error)

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The MSH segment in the response is constructed anew following the rules used to create the initial message
described above. In particular, MSH-7-date/time of message and MSH-10-message control ID refer to the
response message; they are not echoes of the fields in the initial message. MSH-5-receiving application,
MSH-6-receiving facility, and MSH-11-processing ID contain codes that are copied from MSH-3-sending
application, MSH-4-sending facility and MSH-11-processing ID in the initiating message.
For this response, the following values are put in the MSA segment. Note that the field definitions for the
MSA segment fields are in Section 2.14.8, 'MSA - message acknowledgment segment":
Field Notes

MSA-2-message control ID MSH-10-message control ID from the incoming

message.

MSA-1-acknowledgment code As described above.

MSA-4-expected sequence number As described in Section 2.10.1, "Sequence
number protocol" (if the sequence number
protocol is being used).
ERR segment fields Refer to section 2.15.5.

Note: MSH-15-accept acknowledgment type and MSH-16-application acknowledgment type are not valued (not
present or null). At this point, the accept portion of this message exchange is considered complete.

2.9.3.3 Transmit application acknowledgement

If the message header segment indicates that the initiating system also requires an application
acknowledgment, this will be returned as the initial message of a later exchange.
For this message, the receiving system acts as the initiator. Since the message it sends is
application-specific, the layouts of these application-level response messages are defined in the relevant
application-specific chapter. If needed, this application acknowledgment message can itself require (in
MSH-15-accept acknowledgment type) an accept acknowledgment message (MSA). MSH-16-application
acknowledgment type, however, is always null, since the protocol does not allow the application
acknowledgment message to have an application acknowledgment.
For this response, the following values are put in the MSA segment. Note that the field definitions for the
MSA segment fields are in Section 2.14.8, "MSA - message acknowledgment segment".
Field Notes

MSA-2-message control ID Identifies the initial message from the original initiating
system as defined in Section 2.9.1, "Message initiation".

MSA-1-acknowledgment code Uses the application (processing) acknowledgment codes as

described in Section 2.14.8.1.

MSA-3-text message Text description of error.

ERR-1-Error Code and As described in section 2.14.5.1. Populated if an error
Location condition is found.
At this point, the application acknowledgment portion of this message exchange is considered complete.
If the processing on the receiving system goes through multiple stages, chapter-defined messages may be
used to relay status or informational changes to other systems (including the original initiating system).
Such messages are not part of the acknowledgment scheme for the original message, but are considered to
be independent messages triggered by events on the (original) responding system.
Note: The original acknowledgment protocol is equivalent to the enhanced acknowledgment protocol with MSH-
15-accept acknowledgment type = NE and MSH-16-application acknowledgment type = AL, and with the application
acknowledgment message defined so that it never requires an accept acknowledgment (MSH-15-accept
acknowledgment type = NE).

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2.10 SPECIAL HL7 PROTOCOLS

This section contains several extensions to the basic HL7 message protocol. These extensions
represent implementation choices, and are to be used on a site-specific and application-specific
basis as needed.

2.10.1 Sequence number protocol

For certain types of data transactions between systems the issue of keeping databases synchronized is
critical. An example is an ancillary system such as lab, which needs to know the locations of all inpatients
to route stat results correctly. If the lab receives an ADT transaction out of sequence, the census/location
information may be incorrect. Although it is true that a simple one-to-one acknowledgment scheme can
prevent out-of-sequence transactions between any two systems, only the use of sequence numbers can
prevent duplicate transactions.
Note: Although this sequence number protocol is limited to the use of sequence numbers on a single transaction
stream between two applications, this sequencing protocol is sufficiently robust to allow the design of HL7-compatible
store-and-forward applications.

a) initial conditions:
1) the system receiving the data stream is expected to store the sequence number of the most
recently accepted transaction in a secure fashion before acknowledging that transaction. This
stored sequence number allows comparison with the next transaction's sequence number, and
the implementation of fault-tolerant restart capabilities.
2) the initiating system keeps a queue of outgoing transactions indexed by the sequence number.
The length of this queue must be negotiated as part of the design process for a given link. The
minimum length for this queue is one.
3) the sequence number is a positive (non-zero) integer; and it is incremented by one (by the
initiating system) for each successive transaction.
b) starting the link:
1) the value of 0 (zero) for a sequence number is reserved: it is allowed only when the initiating
system (re-)starts the link.
2) if the receiving system gets a transaction with a 0 (zero) in the sequence number field, it should
respond with a general acknowledgment message whose MSA contains a sequence number one
greater than the sequence number of the last transaction it accepted in the Expected Sequence
Number field. If this value does not exist (as on the first startup of a given link), the MSA
should contain a sequence number of -1, meaning that the receiving system will use the
positive, non-zero sequence number of the first transaction it accepts as its initial sequence
number (see re-synching the link, item e below).
3) the initiating system then sends the transaction indexed by the expected sequence number (if
that expected transaction is still on its queue). Otherwise the link is frozen until an operator
intervenes.
c) normal operation of the link:
As it accepts each transaction, the receiving system securely stores the sequence number (which agrees
with its expected sequence number), and then acknowledges the message by echoing the sequence
number in MSA-4-expected sequence number.
d) error conditions (from point of view of initiating system). These are generated by the receiving
system, by its comparison of the sequence number sent out (with the MSH in MSH-13-sequence
number) with the expected sequence number (MSA-4-expected sequence number received with the
MSA).
1) expected sequence number is one greater than current value. The previous acknowledgment
was lost. That transaction was sent again. Correct by sending next transaction.
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2) expected sequence number less than current value. Initiating system can try starting again by
issuing a transaction with a sequence number of zero; or freeze the link for operator
intervention.
3) other errors: freeze the link for operator intervention
e) forcing resynchronization of sequence numbers across the link. The value of -1 for a sequence
number is reserved: it is allowed only when the initiating system is re-synchronizing the link. Thus
if the receiving system gets a value of -1 in the sequence number field, it should return a general
acknowledgment message with a -1 in the expected sequence number field. The receiving system
then resets its sequence number, using the non-zero positive sequence number of the next
transaction it accepts.
f) notes
When the initiating system sends a message with a sequence number of 0 or -1 (see b or e above),
the segments beyond the MSH need not be present in the message, or, if present, all fields can be
null. In terms of the responding system, for these two cases, only a General acknowledgment
message is needed.

2.10.2 Continuation messages and segments

Sometimes, implementation limitations require that large messages or segments be broken into manageable
chunks. We use the term "fragmentation" to describe how a logical message is broken into one or more
separate HL7 messages. HL7 consciously identifies two situations where this may happen.
• First, a single segment may be too large. HL7 uses the "ADD" segment to handle breaking a single
segment into several smaller segments.
• Second, a single HL7 message may be too large. HL7 uses the DSC segment and the continuation
protocol to handle message fragmentation.
Note: HL7 does not define what "too large" means. Acceptable values are subject to site negotiations.
See chapter 5 for a discussion of the continuation pointer segment and the continuation pointer field, and
their use in the continuation of responses to queries and in the continuation of unsolicited update messages.
2.10.2.1 Segment fragmentation/continuation using the ADD segment
Beginning with version 2.4, the ADD segment can be used within a message to break a long segment into
shorter segments within a single HL7 message.
Note: Unless some explicit agreement exists between systems, a receiving application should not infer semantic
meaning from the placement of the ADD segment.
To break a large segment,
a) the segment being continued (call it ANY for this example) is ended at an arbitrary character
position and terminated with the standard segment terminator (carriage return).
b) the following segment is the ADD segment. All characters after the ADD and field separator ("|")
are logically part of the preceding segment. All succeeding consecutive ADD segments contribute
characters to the ANY segment until a non ADD segment is found.
c) an ADD segment with no field separator takes on special meaning. See Section 2.10.2.3, "Segment
fragmentation across messages".
For example, segment "C" can be fragmented within an HL7 message as follows:
A|1
B|2
C|34
ADD|5|678|
ADD|90
D|1
This is logically the same as

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A|1
B|2
C|345|678|90
D|1
Note that the "|" at the end of the first ADD segment is part of the value, while the first "|" of each ADD is
not.
2.10.2.2 Segment fragmentation/continuation using the DSC segment
When a message itself must be fragmented and sent as several HL7 messages, the DSC segment is used.
a) First, the logical message is broken after an arbitrary segment.
b) Next, a DSC segment is sent. The DSC-1-Continuation pointer field will contain a unique value
that is used to match a subsequent message with this specific value.
c) The DSC terminates the first fragment of the logical message.
d) A subsequent message will contain in MSH-14-Continuation pointer, a value that matches the value
from DSC-1. (The presence of a value in MSH-14 indicates that the message is a fragment of an
earlier message.). Each subsequent message will have its own unique value for MSH-10-Message
control ID. Coordination between DSC-1-Continuation pointer and the subsequent message's
MSH-14-Continuation pointer is used to link the fragments in their proper order.
e) The logical message is the concatenation of the contents of the first message (which while having
no value in MSH-14, did end with DSC, and hence was actually a message fragment), plus all
subsequent fragments (as identified by values in MSH-14).
f) If enhanced mode acknowledgments are used to request an accept ACK, then the receiver will
acknowledge each fragment with an ACK message. Since each fragment has its own Message
Control ID, each fragment level accept ACK will use the Message Control ID from the fragment it
is acknowledging.
g) If enhanced mode acknowledgments are used to request an application level ACK, then the receiver
will send an acknowledgment after receiving the final fragment.
Note: The application level ACK should refer to the message by the Message Control ID of the first fragment.

Note: The receiver can tell that a given incoming message is a fragment by the presence of the trailing DSC.
Subsequent HL7 messages are identified as fragments by the presence of an MSH-14 value. The presence of a DSC
in a fragment indicates that more fragments are to follow.
It is a protocol error to end a message with DSC, and then never send a fragment.
For example, a single logical message may be fragmented into three HL7 messages:
---- Sender HL7 message (incomplete,fragment1)---
MSH|||||||||1001||2.4|123||..
A|...
B|...
DSC|W4xy

---- Sender HL7 message (fragment 2)---

MSH|||||||||2106||2.4|124|W4xy|
C|...
D|...
DSC|V292
----- another HL7 message(fragment 3, final)---
MSH|||||||||2401||2.4|125|V292
E|...

Such a sequence is logically the same as the single message:

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MSH|...|2.4|123||..
A|...
B|...
C|...
D|...
E|...

See example in section 2.17.4 for a more elaborate example.

2.10.2.3 Segment fragmentation across messages
If the last segment of a fragment itself needs to be broken, then the following idiomatic use of ADD shall
apply.
a) the segment being continued (call it ANY for this example) is ended at an arbitrary character
position and terminated with the standard segment terminator (carriage return).
b) the following segment is the ADD segment. It will contain no characters other than "ADD". (The
lack of characters signals the receiver that ANY will be continued.)
c) The second following segment will be the DSC, used as described above in Section 2.10.2.2,
"Segment fragmentation/continuation using the DSC segment".
d) The first segment of the following fragment will be an ADD segment. The characters of this ADD
segment are logically part of the ANY segment of the previous fragment.
For example
MSH|...|2.4|
ANY|12
ADD
DSC|JR97
--------- (fragment 2)
MSH|...|2.4|JR97
ADD|345
is logically the same as
MSH|...|2.4
ANY|12345

e) transaction flow for a continued unsolicited message with a continued segment.

First unsolicited message and acknowledgment:

MSH
URD
[ URS ]
{DSP} (last DSP is incomplete)
ADD (contains no fields)
DSC (Continuation segment)

MSH (General acknowledgment)

MSA
[ { ERR } ]

Second unsolicited message and acknowledgment:

MSH (contains continuation pointer from DSC segment of prior message)
ADD (contains remainder of data from continued DSP segment from prior message)
{DSP}

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Note: This second message could itself be continued with a second DSC and (if needed) a second ADD segment
prior to it.
MSH (General acknowledgment)
[ { SFT } ]
MSA
[ { ERR } ]

2.10.3 HL7 batch protocol

There are instances when it is convenient to transfer a batch of HL7 messages. Common examples would
be a batch of financial posting detail transactions (DFT's) sent from an ancillary to a financial system. Such
a batch could be sent online using a common file transfer protocol, or offline via tape or diskette.
2.10.3.1 HL7 batch file structure
The structure of an HL7 batch file is given by the following (using the HL7 abstract message syntax)
[FHS] (file header segment)
{ --- BATCH begin
[BHS] (batch header segment)
{ [ --- MESSAGE begin
MSH (zero or more HL7 messages)
....
....
....
] } --- MESSAGE end
[BTS] (batch trailer segment)
} --- Batch end
[FTS] (file trailer segment)
Notes:
The sequence numbering protocol has a natural application in batch transfers. See the discussion of batch
acknowledgments that follows.
Although a batch will usually consist of a single type of message, there is nothing in the definition that
restricts a batch to only one message type.
The HL7 file and batch header and trailer segments are defined in exactly the same manner as the HL7
message segments. Hence the HL7 message construction rules of Section 2.6, "Message construction
rules," can be used to encode and decode HL7 batch files.
There are only two cases in which an HL7 batch file may contain zero HL7 messages:
a) a batch containing zero HL7 messages may be sent to meet a requirement for periodic submission
of batches when there are no messages to send.
b) a batch containing zero negative acknowledgment messages may be sent to indicate that all the
HL7 messages contained in the batch being acknowledged are implicitly acknowledged. See
Section 2.10.3.3, "Acknowledging batches."
2.10.3.2 Related segments and data usage
The following segments relate to the HL7 Batch Protocol:
• BHS Batch Header (See section 2.14.2)
• BTS Batch Trailer (See section 2.14.3)

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• FHS File Header (See section 2.14.6)

• FTS File Trailer (See section 2.14.7)
The BTS segment contains a field, BTS-3-batch totals, which may have one or more totals drawn from
fields within the individual messages. The method for computing such totals will be determined on a site or
application basis unless explicitly stated in a functional chapter.
2.10.3.3 Acknowledging batches
In general, the utility of sending batches of data is that the data is accepted all at once, with errors
processed on an exception basis. However, it is a permissible application of HL7 to acknowledge all
messages. Several options for acknowledgment are given and will be chosen on an application basis. In
these cases, the sequence numbering protocol can be useful to the applications processing the batch.
The options are:
a) all messages are acknowledged in the response batch.
b) the receiving system prints some form of batch control report, which is then dealt with manually by
personnel at the sending system. No acknowledgments are performed by the protocol software.
c) an automated acknowledgment batch is created containing acknowledgment messages only for
those messages containing errors. In this mode an empty acknowledgment batch may be created
(i.e., an HL7 batch file without any HL7 acknowledgment messages).
In each case where there is a response batch, its format is a batch of individual messages. Each individual
message is in the format defined for an online response in the chapters. Consider, for example, a batch that
might be constructed to respond to a batch of Detailed Financial Transactions (Chapter 6). The messages in
the response batch would consist entirely of ACK messages, since ACK is the response shown in Chapter 6.
When batches are retransmitted after the correction of errors, BHS-12-reference batch control ID should
contain the batch control ID of the original batch.
2.10.3.4 Batch message as a query response
NOTE: The QRD and QRF segments were retained for backward compatibility only as of v 2.4. The reader is referred
to chapter 5, section 5.4, for the current query/response message structure.
The HL7 query also can be used to query for a batch in the following manner:
a) use the value BB or BL of QRD-5-deferred response type to specify a batch response. The query
will be acknowledged with a general acknowledgment as in the Deferred Access example above
(see chapter 5)
b) in addition, insert into the batch file the QRD and QRF segments as follows:
[FHS] (file header segment)
{ [BHS] (batch header segment)
[QRD] (the QRD and QRF define the
[QRF] query that this batch is a response to)
{ MSH (one or more HL7 messages)
....
....
....
}
[BTS] (batch trailer segment)
}
[FTS] (file trailer segment)

c) the acknowledgment of a batch is described in this chapter (see Section 2.10.3.3, "Acknowledging

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batches").

2.10.4 Protocol for interpreting repeating segments or segment groups in an

update Message
This section describes the protocol for interpreting repeating segments or segment groups in an update
message. Common examples of repeating segments are NK1 and OBX shown as [{NK1}] and [{OBX}] in
the abstract message syntax. Common examples of segment groups are displayed as {ORC RXO [{RXC}]}
or [{IN1 [IN2] [{IN3}]}] in the abstract message syntax
There are 2 methods of update: the "snapshot" and the "action code/unique identifier" modes. These are
defined in sections 2.10.4.1 and 2.10.4.2 below.
If a particular repeating segment can be updated by either of these two modes, the parties concerned will
determine by agreement among messaging partners whether an interface will use the "snapshot" mode or
the "action code/unique identifier" mode.
Both the sender and receiver of the data must have predictable rules for how they will process the data in
repeating segments or segment groups regardless of which mode is used. This should be documented in the
Conformance Profile. It is critical to know, for instance, if the Sender is the System of Record.
2.10.4.1 Snapshot mode update definition
For segments that do not contain unique identifiers and action codes (mainly NTE and patient
administration segments), the only option is to treat the information in the repeating segments and segment
groups as a whole.
When an HL7 abstract message syntax includes these repeating units or sets, there is no implicit indication
of how they interact with a similar set in a prior or subsequent message. Interpretation is not obvious from
the message syntax particularly if the requirement is to update only part of the information previously sent.
The existence of a segment, and possibly the lack of existence of a segment, may serve to add, update,
replace, or delete information passed in similar segments in prior messages. Special consideration is
warranted in the case where multiple instances of a segment exist in a message.
In the "snapshot" mode, the information contained in the set of repeating segments or segment groups from
the incoming message replaces the corresponding information in the receiving application. This is
equivalent to a deletion of the prior information followed by the addition of the newly supplied
information. In this mode, everything (all repeating segments and segment groups) must be sent with every
subsequent message in the series of messages. There is no other way to indicate which ones changed and
which ones did not.
To specify "delete all of the segments in this repeating group" in the snapshot mode, send a single segment
with "delete data" (indicated by a value of "") in all fields. This actively signals the receiver that there is
information that needs to be deleted. If no segment were sent, this would equate to "no information." No
information should not signal the receiver to take an action. There would be risk that the receiver might
misinterpret the sender's intent.
To support assertions made in some chapters, e.g., chapter 6, and common practice at implementation sites,
as of v2.6, the signal methods have been extended. By agreement among messaging partners or
Conformance Profile, a sender may opt to signal deletion of data in the following manner:
Transmit the null value only:
• in the key identifier field if the segment has an explicit one – all other fields have no data
• in the first field of the segment to indicate that all are to be deleted
• in any combination of fields that the Sender customarily sends to the recipient - all other fields have
no data
• in all required fields all - other fields have no data
This obviates the need for the Sender to populate fields ordinarily not sent and not expected by the receiver.

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2.10.4.1.1 Snapshot Mode and Repeating Segments - Example

Example A: if a patient record indicated a 2 sisters and a brother as next of kin, this would be represented
as follows in the add person/patient information message:
MSH||||||||ADT^A28^ADT_A05|...<cr>
EVN|...<cr>
PID|...<cr>
NK1|1|Nuclear^Nancy^D|SIS^Sister^HL70063|...<cr>
NK1|2|Nuclear^Nelda^W|SIS^Sister^HL70063|...<cr>
NK1|3|Nuclear^Neville^S|BRO^Brother^HL70063|...<cr>
PV1|...<cr>
If, subsequently, the one of the sisters was delisted as next of kin, it would be necessary to send both the
remaining "brother" and "sister" records in order to form a complete replacement set in an update person
information message:
MSH|||||||||ADT^A31^ADT_A05|...<cr>
EVN|...<cr>
PID|...<cr>
NK1|1|Nuclear^Nancy^D|SIS^Sister^HL70063|...<cr>
NK1|2|Nuclear^Neville^S|BRO^Brother^HL70063|...<cr>
PV1|...<cr>
If all next of kin were to be subsequently delisted, an update message with a single null populated segment
would instruct the receiving system to delete information represented by any prior set:
MSH||||||||ADT^A31^ADT_A05|...<cr>
EVN|...
PID|...
NK1|""|""|""|""|<cr>
PV1|...<cr>
Alternatively, as of v2.6, the deletion could be signaled by sending a Null in the first field of the NK1
segment. This is its only required field.
MSH||||||||ADT^A31^ADT_A05|...<cr>
EVN|...
PID|...
NK1|""|<cr>
PV1|...<cr>

2.10.4.1.2 Snapshot Mode and Repeating Segment Groups

Treatment of the repeating segment group is analogous to the handling of the repeating segment described
above. To indicate deletion of all of the information in a repeating segment group, it is only necessary to
delete the anchoring segment of the segment group. This is accomplished just as described above for
deleting a repeating segment. This pertains to segments governed by snapshot mode, not action code.
Example: An account is created for Adam Everyman. He is insured under plan ID A357 with an insurance
company known to both systems as BCMD, with a company ID of 1234. He is also covered by his wife's
insurance under plan ID A789 with an insurance company known to both systems as VGMC, with a
company ID of 6789.
MSH||||||||BAR^P01^BAR_P01|...<cr>
EVN|
PID|
IN1|1|A357|1234|BCMD
IN2|
IN3|
IN1|2|A789|6789|VGMC
IN2|
IN3|
Subsequently it is learned that his wife has changed insurance plans. Her new plan is now C45. The
insurance company and company ID have remained the same. A BAR^P05 might be sent.

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MSH||||||||BAR^P05^BAR_P05|...<cr>
EVN|
PID|
IN1|1|A357|1234|BCMD
IN2|
IN3|
IN1|2|C45|6789|VGMC
IN2|
IN3|
It is later discovered that the patient is not covered by either plan and now has no insurance at all. A
BAR^P05 is again sent. In accordance with chapter 6, this can be signaled by showing Null in the plan
field.
MSH||||||||BAR^P05^BAR_P05|...<cr>
EVN|
PID|
IN1|""|""
If, on the other hand, the patient still had his coverage, and only the wife's insurance had been dropped, a
fully populated IN1 segment group would be transmitted. The presence of only one IN1 in a subsequent
message conveys the "full group replacement" notion. The BAR^P05 would be transmitted and would be
interpreted to mean "retain plan A357; delete and other plans":
MSH||||||||BAR^P05^BAR_P05|...<cr>
EVN|
PID|
IN1|1|A357|1234|BCMD
IN2|
IN3|

2.10.4.2 Action code/unique identifier mode update definition

In the "action code/unique identifier" mode (action code mode), each member of a segment or segment
group can be acted upon independently of the other members. Thus, it is possible to delete or update a
member of the set without including the other members of the set. The choice of delete/update/insert is
determined by the action code (or an equivalent such as result status in an ORU Observation Report
message). Refer to HL7 Table 0206 - Segment action code for valid values.

HL7 Table 0206 - Segment action code

Value Description Comment
A Add/Insert
D Delete
U Update
X No Change

The unique identifier unambiguously identifies one of multiple repetitions of the repeating segment or
segment group in a way that does not change over time. It is not dependent on any particular message
identifier level (MSH) fields; it functions across messages, not just within a message. For a single segment
repetition, the unique identifier may be an explicit field (e.g., IAM-7 Allergy Unique Identifier) or a
combination of fields (IAM suggests IAM-3 Allergen Identifier in the context of the particular patient). For
a repeating segment group, an identifier in the anchoring segment would identify the repeating set. For
MFN messages, MFI-1 Master File Identifier and MFE-4 Primary Key Value identify the particular table
and record.
Example 1: If a patient is allergic to penicillin and shellfish, the following message would be sent showing
an Action code of "A(dd) in IAM-6:
MSH|||||||||ADT^A60^ADT_A60|...<cr>
EVN|...<cr>
PID|...<cr>
IAM|1||peni|||A<cr>
IAM|2||shell||A<cr>
Subsequently, if it is learned that the patient is not allergic to shellfish, the following message would be sent
showing an Action code of "D(elete) in IAM-6:

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MSH|||||||||ADT^A60^ADT_A60|...<cr>
EVN|...<cr>
PID|...<cr>
IAM|1||shell||D<cr>
Some messages, Orders and Observations, in particular, do not use table 0206. Order control codes are used
to unambiguously specify the action to be taken.
Example 2: if a set of orders had been sent as
MSH|||||||||OML^O21^OML_O21|...<cr>
PID|...
ORC|NW|987654^CIS|...<cr>
ORC|NW|876543^CIS|...<cr>
ORC|NW|765432^CIS|...<cr>
and subsequently order 876543 was cancelled, the following message would target that specific segment
instance without affecting the other orders. ORC-1 contains order control code "CA" for cancel. ORC-2
identifies the specific order number.
MSH|||||||||OML^O21^ OML_O21|...<cr>
PID|
ORC|CA|876543^CIS|...<cr>
Example 3: Add staff person to Provider master:
MSH|^~\&|HL7REG|UH|HL7LAB|CH|200102280700||MFN^M02^MFN_M02|MSGID002|P|2.5|||AL|NE
MFI|PRA^Practitioner Master File^HL70175||UPD|||AL
MFE|MAD|U2246|200102280700|PMF98123789182^^PLW
STF|PMF98123789182^^PLW|U2246^^^PLW
|SEVEN^HENRY^L^JR^DR^M.D.|P|M|19511004|A|^ICU|^MED|(555)555-
1002X345CO~(955)555-1002CH(206)689-1345X789CB|1002 Healthcare Drive^SUITE
227^AnnArbor^MI^48104^H~1012 Healthcare Drive^^AnnArbor, MI^48104^O
|19890125^GHH&Good Health
Hospital&L01||PMF88123453334|[email protected]|B
The birth date was discovered to be in error. An MFN^M02 message is sent with the MFE-1 having a value
of MUP for Update Record for master File. The corrected birth date (19521004) appears in STF-6:
MSH|^~\&|HL7REG|UH|HL7LAB|CH|200102280700||MFN^M02^MFN_M02|MSGID002|P|2.5|||AL|NE
MFI|PRA^Practitioner Master File^HL70175||UPD|||AL
MFE|MUP|U2246|200102280700|PMF98123789182^^PLW
STF|PMF98123789182^^PLW|U2246^^^PLW
|SEVEN^HENRY^L^JR^DR^M.D.|P|M|19521004|A|^ICU|^MED|(555)555-
1002X345CO~(955)555-1002CH(206)689-1345X789CB|1002 Healthcare Drive^SUITE
227^AnnArbor^MI^48104^H~1012 Healthcare Drive^^AnnArbor, MI^48104^O
|19890125^GHH&Good Health
Hospital&L01||PMF88123453334|[email protected]|B

2.10.5 Protocol for interpreting repeating fields in an update message

With repeating fields, the segment action codes are not relevant. Action codes cannot be applied to
individual field repetitions, because they cannot be uniquely identified. Therefore, they must all be there,
i.e., send a full list for each transaction. If the intent is to delete an element, it is left off the list. This is
analogous to the snapshot mode for repeating segments and segment groups. If the intent is to delete the
whole list, the field is transmitted once with a Null in the first component. In effect, the Sender must make
a statement about what action the receiver is expected to take: omitting, or not populating, the field is not a
clear signal according to field state definition as described in section 2.5.3.
At the same time, it is not incorrect to be precise about specific information that is to be deleted if the data
type supports this capability. Note, however, that data types without components, e.g., IS or ST do not
support this capability. There is no way to tie the Null value to an actual element instance in the persistent
data store. See the example below.
Special consideration is warranted when implementing multiple interfaces. While the same processing rules
(snapshot or update) can be applied to multiple systems and interfaces, desynchronization can occur if any
one system is receiving similar information from multiple sources. Business rules and processes need to be
considered in these cases to determine if there is a single authoritative source for the information (a
"System of Record"), or if other business logic exists to resolve the possibility that information from the
two (or more) sources are not in agreement.

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Example: Repeating field of data type ID or IS: A patient is added to the Master Patient Index. The patient
has two specific living conditions: "spouse dependent" and "medical supervision required". This is
transmitted as:
MSH|^~\&||||||||ADT^A28^ADT_A05|1|P|2.6...<cr>
EVN|...<cr>
PID|||1234567^^^^MRN| <cr>
PV1|...<cr>
PD1|S~M|
Subsequently, the "medical supervision required" living condition is dropped.
MSH|^~\&||||||||ADT^A31^ADT_A31|1|P|2.6...<cr>
EVN|...<cr>
PID|||1234567^^^^MRN|<cr>
PV1|...<cr>
PD1|S||||||||||||||||||||||
The data type for PD1-1 is a data types without components. There is no way to tie the Null value to an
actual element instance in the persistent data store. Therefore the following is ambiguous and not good
practice.
MSH|^~\&||||||||ADT^A31^ADT_A31|1|P|2.6...<cr>
EVN|...<cr>
PID|||1234567^^^^MRN|<cr>
PV1|...<cr>
PD1|S~""||||||||||||||||||||||

2.11 LOCAL EXTENSION

The following section specifies where local extensions to a message and its constituent parts are
allowed, where they are not, and where they are ill-advised. Inter-version compatibility rules
must be followed plus there are certain restrictions and prohibitions outlined in the sections that
follow. In general, basic structures should not be altered.
The reader is advised to review the Conformance mechanism defined in section 2B,
"Conformance Using Message Profiles" before applying local extensions. Using the
conformance mechanism may eliminate the need for local extension.

2.11.1 Messages
Messages may be locally extended as follows:
a) Users may develop local Z messages to cover areas not already covered by existing HL7 messages.
These should be composed of HL7 segments where possible.
b) A local Z message may consist entirely of Z segments except that it must begin with a MSH
segment.
c) A local Z Acknowledgement message must begin with an MSH segment followed by an MSA
segment, an optional SFT segment and a conditional ERR segment.
d) Users may develop Z segments and add them to Z messages.
e) Users may develop Z segments and add them to HL7 messages. The trigger event may remain the
same if the intent of the message has remained unchanged.
f) The practice of adding additional HL7 segments, like NTE, to existing HL7 messages locally is ill-
advised. HL7 may move or change the segment in a future release; this will render the message
unparsible.

2.11.2 Trigger events

Users may develop local Z trigger events for messages.

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2.11.3 Segment groups

a) The practice of turning a single segment or segments into a segment group locally is not allowed
within an HL7 event. It will have a negative impact on XML and any component-based encoding
schemes. Note that HL7, on other hand, can do this.
b) A segment group may not be ungrouped locally.
Fox example, if there is an HL7 group as follows:
{
ABC
[DEF
[GHI]]
}
one cannot change it in a local implementation to be as follows:
{[ABC]}
[DEF]
[GHI]
Example 2:
If the original definition was:
GROUP1 ::= ABC, GROUP2?
GROUP2 ::= DEF, GHI?

and someone wished to constrain the segments in GROUP2 to be mandatory

(i.e., the HL7 grammar would look like:
{[
ABC
DEF
[GHI]
]}

Their message instance would need to still look like:

<GROUP1>
<ABC/>
<GROUP2>
<DEF/>
<GHI/>
</GROUP2>
</GROUP1>

It would be an error if they instead sent it as:

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<GROUP1>
<ABC/>
<DEF/>
<GHI/>
</GROUP1>

c) A segment group can repeat locally. The 1st repetition needs to mean what it does in HL7
d) The practice of incorporating a Z segment into a segment group locally is allowed.

2.11.4 Segments
2.11.4.1 Local extension rules for segments
Users may not modify an existing segment, except as specified in section 2.8.2.
Locally defined fields may be defined for use in locally defined segments, although HL7 defined fields are
a better choice when available. The practice of extending an HL7 segment with locally defined fields, while
not prohibited, is ill-advised.
HL7 also recognizes that sites may have locally defined fields where the users believe the enhancement
may be of interest to the HL7 community as a whole and are moving forward with a proposal to HL7.
2.11.4.2 Caveats for locally extending segments
Locally extending an HL7 segment with locally defined fields will likely cause conformance problems with
the next release of the HL7 standard. There are, however, certain circumstances where HL7 has, itself,
directed the membership to add Z fields as an interim measure between versions to accommodate
regulatory agency requirements. These are fields that HL7 has reserved for official introduction in the next
release.
If the local site intends to add a proposed field early, there is a risk that it may collide with another field
when HL7 officially approves or rejects the proposed additions. Some sites have employed the practice of
assigning a high sequence number locally, i.e., leaving a gap between the last official HL7 field and the
proposed new field. The user–defined fields should be deleted or deprecated when HL7 officially approves
or rejects the proposed additions so that the fields do not collide. It must be understood that the local
implementation will have to adjust if a collision occurs and they want to conform.

2.11.5 Data types

The following rules apply for locally extending data types:
a) Locally defined data types may be defined for use in locally defined segment fields, although HL7
defined data types are a better choice when available.
b) Locally redefining existing data type components, e.g., changing a component from NM to ST, is
prohibited.
c) Data types may be locally extended by adding new components at the end. This action creates a Z
data type.
Note: The practice of extending an HL7 data type with locally defined components is particularly ill-advised and may
cause conformance problems with the next release of the HL7 standard.

2.11.6 Tables
Rules for locally extending tables are the same as discussed in section 2.5.3.6, "Table":
a) Users may redefine suggested values in User-defined tables.
b) Local tables may be defined for Z fields.
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c) Local tables may be assigned to HL7 fields with data type CWE.

2.12 CHAPTER FORMATS FOR DEFINING HL7 MESSAGES

Subsequent chapters of this document describe messages that are exchanged among applications
in functionally-specific situations. Each chapter is organized as follows:
a) purpose. This is an overview describing the purpose of the chapter, general information and
concepts.
b) trigger events and messages. There is a list of the trigger events.
c) message segments. The segments defined in a chapter are then listed in a functional order designed
to maximize conceptual clarity.
d) examples. Complete messages are included.
e) implementation considerations. Special supplementary information is presented here. This includes
issues that must be addressed in planning an implementation.
f) outstanding issues. Issues still under consideration or requiring consideration are listed here.

2.12.1 Message representation

For each trigger event the messages that are exchanged when the trigger event occurs are defined using the
HL7 abstract message syntax as follows:
Each message is defined in special notation that lists the segment IDs in the order they would appear in the
message. Braces, { . . . }, indicate one or more repetitions of the enclosed group of segments. Of course, the
group may contain only a single segment. Brackets, [ . . . ], show that the enclosed group of segments is
optional. If a group of segments is optional and may repeat it should be enclosed in brackets and braces,
[{...}].
Note: [{...}] and {[...]} are equivalent.
Whenever braces or brackets enclose more than one segment ID a special stylistic convention is used to
help the reader understand the hierarchy of repetition. For example, the first segment ID appears on the
same line as the brace, two columns to the right. The subsequent segment IDs appear under the first. The
closing brace appears on a line of its own in the same column as the opening brace. This convention is an
optional convenience to the user. If there is conflict between its use and the braces that appear in a message
schematic, the braces define the actual grouping of segments that is permitted.
A choice of one segment from a group of segments is indicated by using angle brackets to delimit the group
and vertical bar delimiters between the several segments.
Example: The ORM^O01, as described in chapter 4 section 4.4.1, allows a choice of order detail segments.
The choice would be represented as follows:
<OBR|RQD|RQ1|RXO|ODS|ODT>
Consider the hypothetical triggering event a widget report is requested. It might be served by the Widget
Request (WRQ) and Widget Report (WRP) messages. These would be defined in the Widget chapter (say
Chapter XX). The Widget Request message might consist of the following segments: Message Header
(MSH), Software Segment (SFT), User Authentication Credentials (UAC), and Widget ID (WID). The
Widget Report message might consist of the following segments: Message Header (MSH), Software
Segment (SFT), Message acknowledgment (MSA), Error Segment (ERR) and one or more Widget
Description (WDN) Segments each of which is followed by a single Widget Portion segment (WPN)
followed by zero or more Widget Portion Detail (WPD) segments.
The ADD and DSC segments follow special rules or protocol as defined in section 2.10.2. They are not
represented in the message grammar in the domain chapters as their presence is context sensitive.

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2.12.2 HL7 abstract message syntax example

The schematic form for this hypothetical exchange of messages is shown in Figure 2-5:
Figure 2-5. Hypothetical schematic message
Trigger Event: WIDGET REPORT IS REQUESTED
WRQ Widget Request Status Chapter

MSH Message Header 2

[{SFT}] Software Segment 2
[UAC] User Authentication Credential 2
WID Widget ID XX

WRP Widget Report Status Chapter

MSH Message Header 2

[{SFT}] Software Segment 2
[UAC] User Authentication Credential 2
MSA Message Acknowledgment 2
[{ERR}] Error Segment 2
{ ---Widget begin
WDN Widget Description XX
WPN Widget Portion XX
} ---Widget end
The WID, WDN, WPN, and WPD segments would be defined by the widget committee in the widget
chapter, as designated by the Arabic numeral XX in the right column. The MSH and MSA segments,
although included in the widget messages, are defined in another chapter. They are incorporated by
reference into the widget chapter by the chapter number XX.
On the other hand, the widget committee might decide that the WPN and WPD segments should appear in
pairs, but the pairs are optional and can repeat. Then the schematic for the WRP message would be as
shown in Figure 2-6.

Figure 2-6. WPN and WPD segments in pairs

WRF Widget Report Status Chapter

MSH Message Header 2

[{SFT}] Software Segment 2
[UAC] User Authentication Credential 2
MSA Message Acknowledgment 2
[{ERR}] Error Segment 2
{ --Widget begin
WDN Widget Description XX
[{ ---WidgetDetailA begin
WPN Widget Portion XX
WPD Widget Portion Detail XX
}] ---WidgetDetailA end
} ---Widget end

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If the widget committee determined that at least one pair of WPN and WPD segments must follow a WDN,
then the notation would be as shown in Figure 2-7.

Figure 2-7. At least one pair of WPN and WPD

WRP Widget Report Status Chapter

MSH Message Header 2

[{SFT}] Software Segment 2
[UAC] User Authentication Credential 2
MSA Message Acknowledgment 2
[{ERR}] Error Segment 2
{ --Widget begin
WDN Widget Description XX
{ ---WidgetDetailB begin
WPN Widget Portion XX
WPD Widget Portion Detail XX
} ---WidgetDetailB begin
} ---Widget end

2.13 ACKNOWLEDGMENT MESSAGES

Acknowledgment messages may be defined on an application basis. However the simple general
acknowledgment message (ACK) may be used where the application does not define a special
message (application level acknowledgment) and in other cases as described in Section 2.9,
"Message Processing Rules".

2.13.1 ACK - general acknowledgment

The simple general acknowledgment (ACK) can be used where the application does not define a special
application level acknowledgment message or where there has been an error that precludes application
processing. It is also used for accept level acknowledgments. The details are described in Section 2.9,
"Message Processing Rules".
ACK^varies^ACK General Acknowledgment Status Chapter
MSH Message Header 2
[{ SFT }] Software segment 2
[ UAC ] User Authentication Credential 2
MSA Message Acknowledgment 2
[{ ERR }] Error 2

Note: For the general acknowledgment (ACK) message, the value of MSH-9-2-Trigger event is equal to the value of
MSH-9-2-Trigger event in the message being acknowledged. The value of MSH-9-3-Message structure for the
general acknowledgment message is always ACK.

2.14 MESSAGE CONTROL SEGMENTS

The following segments are necessary to support the functionality described in this chapter.
Note: The HL7 message construction rules define the standard HL7 encoding rules, creating variable length
delimited messages from the segments defined below. Although only one set of encoding rules is defined as a
standard in HL7 Version 2.3, other encoding rules are possible (but since they are non-standard, they may only used
by a site-specific agreement).

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The segments in this section are listed in alphabetical order. The following chart shows a
summary of the segments listed by category.
Figure 2-8. HL7 message segments
Segment Category Segment Name HL7 Section Reference

Control
ADD 2.14.1
BHS 2.14.2
BTS 2.14.3
DSC 2.14.4
ERR 2.14.5
FHS 2.14.6
FTS 2.14.7
MSA 2.14.8
MSH 2.14.9
General Purpose
NTE 2.14.10
OVR 2.14.10.5
SFT 2.14.12
UAC 2.14.13

2.14.1 ADD - addendum segment

The ADD segment is used to define the continuation of the prior segment in a continuation message. See
Section 2.10.2, "Continuation messages and segments," for details.

HL7 Attribute Table - ADD – Addendum

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME
1-n 65536 ST O 00066 Addendum Continuation Pointer

2.14.1.1 ADD-1 Addendum Continuation Pointer (ST) 00066

Definition: This field is used to define the continuation of the prior segment in a continuation message. See
section 2.10.2, "Continuation messages and segments" for details. When the ADD is sent after the segment
being continued, it contains no fields. It is only a marker that the previous segment is being continued in a
subsequent message. Thus fields 1-N are not present. The sequence designation, 1-N, means the remainder
of the fields in the segment being continued. These remainder of the segment being continued fields are
present only when the ADD is sent with a continuation message.

2.14.2 BHS - batch header segment

The BHS segment defines the start of a batch.

HL7 Attribute Table - BHS – Batch Header

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 1 ST R 00081 Batch Field Separator
2 4 ST R 00082 Batch Encoding Characters
3 227 HD O 00083 Batch Sending Application
4 227 HD O 00084 Batch Sending Facility

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SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME

5 227 HD O 00085 Batch Receiving Application
6 227 HD O 00086 Batch Receiving Facility
7 24 DTM O 00087 Batch Creation Date/Time
8 40 ST O 00088 Batch Security
9 20 ST O 00089 Batch Name/ID/Type
10 80 ST O 00090 Batch Comment
11 20 ST O 00091 Batch Control ID
12 20 ST O 00092 Reference Batch Control ID
13 227 HD O 02271 Batch Sending Network Address
14 227 HD O 02272 Batch Receiving Network Address

2.14.2.0 BHS field definitions

2.14.2.1 BHS-1 Batch Field Separator (ST) 00081
Definition: This field contains the separator between the segment ID and the first real field, BHS-2-batch
encoding characters. As such it serves as the separator and defines the character to be used as a separator
for the rest of the message. Recommended value is | (ASCII 124).
2.14.2.2 BHS-2 Batch Encoding Characters (ST) 00082
Definition: This field contains the four characters in the following order: the component separator,
repetition separator, escape characters, and subcomponent separator. Recommended values are ^~\&
(ASCII 94, 126, 92, and 38, respectively). See Section 2.5.4, "Message ".
2.14.2.3 BHS-3 Batch Sending Application (HD) 00083
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field uniquely identifies the sending application among all other applications within the
network enterprise. The network enterprise consists of all those applications that participate in the exchange
of HL7 messages within the enterprise. Entirely site-defined.
2.14.2.4 BHS-4 Batch Sending Facility (HD) 00084
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field contains the address of one of several occurrences of the same application within the
sending system. Absent other considerations, the Medicare Provider ID might be used with an appropriate
sub-identifier in the second component. Entirely site-defined.
2.14.2.5 BHS-5 Batch Receiving Application (HD) 00085
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field uniquely identifies the receiving applications among all other applications within the
network enterprise. The network enterprise consists of all those applications that participate in the exchange
of HL7 messages within the enterprise. Entirely site-defined.
2.14.2.6 BHS-6 Batch Receiving Facility (HD) 00086
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field identifies the receiving application among multiple identical instances of the
application running on behalf of different organizations. See comments BHS-4-batch sending facility.
Entirely site-defined.
2.14.2.7 BHS-7 Batch Creation Date/Time (DTM) 00087
Definition: This field contains the date/time that the sending system created the message. If the time zone is
specified, it will be used throughout the message as the default time zone.

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2.14.2.8 BHS-8 Batch Security (ST) 00088

Definition: In some applications of HL7, this field is used to implement security features. Its use is not yet
further specified.
2.14.2.9 BHS-9 Batch Name/ID/Type (ST) 00089
Definition: This field can be used by the application processing the batch. It can have extra components if
needed.
Note: the text regarding "extra components" has been retained for backward compatibility, but it is not currently an
accepted format for the ST data type.

2.14.2.10 BHS-10 Batch Comment (ST) 00090

Definition: This field is a comment field that is not further defined in the HL7 protocol.
2.14.2.11 BHS-11 Batch Control ID (ST) 00091
Definition: This field is used to uniquely identify a particular batch. It can be echoed back in BHS-12-
reference batch control ID if an answering batch is needed.
2.14.2.12 BHS-12 Reference Batch Control ID (ST) 00092
Definition: This field contains the value of BHS-11-batch control ID when this batch was originally
transmitted. Not present if this batch is being sent for the first time. See definition for BHS-11-batch
control ID.
2.14.2.13 BHS-13 Batch Sending Network Address (HD) 02271
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: Identifier of the network location the message was transmitted from. Identified by an OID or
text string (e.g., URI). The reader is referred to the "Report from the Joint W3C/IETF URI Planning
Interest Group: Uniform Resource Identifiers (URIs), URLs, and Uniform Resource Names (URNs):
Clarifications and Recommendations".1
As with the Sending/Receiving Responsible Organization, the Sending Network Address provides a more
detailed picture of the source of the message. This information is lower than the application layer, but is
often useful/necessary for routing and identification purposes. This field should only be populated when the
underlying communication protocol does not support identification of sending network locations.
The specific values and usage must be site negotiated
2.14.2.14 BHS-14 Batch Receiving Network Address (HD) 02272
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: Identifier of the network location the message was transmitted to. Identified by an OID or text
string. (e.g., URL).
This is analogous with the Sending Network Address, however in the receiving role.
This field should only be populated when the underlying communication protocol does not support
identification receiving network locations.

2.14.3 BTS - batch trailer segment

The BTS segment defines the end of a batch.

HL7 Attribute Table - BTS – Batch Trailer

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 10 ST O 00093 Batch Message Count
2 80 ST O 00090 Batch Comment

1
The URI is: http://www.ietf.org/rfc/rfc3305.txt. Note: All IETF documents are available online, and RFCs are available through URIs
using this format.
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SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME

3 100 NM O Y 00095 Batch Totals

2.14.3.0 BTS field definitions

2.14.3.1 BTS-1 Batch Message Count (ST) 00093
Definition: This field contains the count of the individual messages contained within the batch.
2.14.3.2 BTS-2 Batch Comment (ST) 00090
Definition: This field is a comment field that is not further defined in the HL7 protocol.
2.14.3.3 BTS-3 Batch Totals (NM) 00095
Definition: We encourage new users of this field to use the HL7 Version 2.3 data type of NM and to define
it as "repeating." This field contains the batch total. If more than a single batch total exists, this field may
be repeated.
Prior to v2.5 this field may have been defined as a CM data type for backward compatibility with HL7
Versions 2.2 and 2.1 with each total being carried as a separate component. Each component in this case is
an NM data type.

2.14.4 DSC - continuation pointer segment

The DSC segment is used in the continuation protocol.

HL7 Attribute Table - DSC – Continuation Pointer

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 180 ST O 00014 Continuation Pointer
2 1 ID O 0398 01354 Continuation Style

2.14.4.0 DSC field definitions

2.14.4.1 DSC-1 Continuation Pointer (ST) 00014
Definition: This field contains the continuation pointer. In an initial query, this field is not present. If the
responder returns a value of null or not present, then there is no more data to fulfill any future continuation
requests. For use with continuations of unsolicited messages, see chapter 5 and section 2.10.2,
"Continuation messages and segments". Note that continuation protocols work with both display- and
record-oriented messages.
2.14.4.2 DSC-2 Continuation Style (ID) 01354
Definition: Indicates whether this is a fragmented message (see Section 2.10.2, "Continuation messages
and segments"), or if it is part of an interactive continuation message (see Section 5.6.3, "Interactive
continuation of response messages").
Refer to HL7 Table 0398 – Continuation Style Code for valid values.

HL7 Table 0398 - Continuation style code

Value Description Comment
F Fragmentation
I Interactive Continuation

2.14.5 ERR - error segment

The ERR segment is used to add error comments to acknowledgment messages.
Use Cases:
Severity: A receiving application needs to communicate 2 "error or exception statements." One is an
"error;" the other is a "warning". To accomplish this, an acknowledgement message with 2 ERR segments

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is sent. Upon receipt, the sending application can display both, including the appropriate severity, to the
user.
Application Error Code: A receiving application generates an error that reports an application error code
and returns this information in its response. This code in turn is used by helpdesk staff to pinpoint the exact
cause of the error, or by the application to prompt an appropriate response from the user. (Ex. Deceased
date must be greater than or equal to birth date).
Application Error Parameter: A receiving application encounters an error during processing of a
transaction. In addition to an error code, the application provides an error parameter that gives greater detail
as to the exact nature of the error. The receiving application looks up the message corresponding to the
error code, substitutes in the parameter, and displays the resulting message to the user.
Diagnostic Information: While processing a transaction, a receiving application encounters an exception.
When the exception is thrown, it provides a volume of detailed information relating to the error
encountered. The receiving application captures the information and sends it in its response. The user
reports the error to the help desk, and on request, faxes a copy of the diagnostic information to assist
analyzing the problem.
User Message: A user executes an application function that generates a transaction that is sent to another
application for further processing. During this processing, the receiving application encounters an error
and, as part of the error handling routine, retrieves a User Message that it returns in its response. The
originating application receives the error and displays it to the end user with the intent that the error
condition can be resolved and the user can re-execute the function without error.
Inform Person Code: After submitting a dispense transaction, a response is returned to the user indicating
that the patient may be abusing drugs. Given the sensitivity of this warning, the error is returned with an
indicator stating that the patient should not be informed of the error with the implication that steps should
be taken to rule out or confirm the warning.
Override Type: If a business rule states that a prescription on hold cannot be dispensed, an override type
might be "Dispense Held Prescription" to allow the prescription to be dispensed in exception to the rule.
Override Reason Codes: A patient is given a prescription; however, before completing the prescription, the
remaining pills are spoiled. The patient returns to their pharmacy and explains the situation to their
pharmacist. The pharmacist decides to replace the spoiled drugs; however, when attempting to record the
event, a message is returned indicating that the dispense would exceed the maximum amount prescribed.
The pharmacist overrides the rule and specifies an Override Reason Code indicating a replacement of lost
product.
Help Desk Contact: Help desk contact information is stored in a database. When an application error is
encountered, the database is queried and the most current help desk contact information is returned in the
error message. This is displayed to the user by the receiving application.
Better Error Location Information: Receiving system detects an error with the 3rd repetition of the ROL.4
(Role Person - XCN).16 (Name Context – CE).4(Alternate Identifier – IS). The application identifies the
specific repetition and component when raising the error, simplifying diagnosis of the problem.
Support for multiple Error Locations: Two fields are marked as conditional, with the condition that one of
the two must be specified. The sending application leaves both blank. The receiving application detects the
problem, and sends back a single error indicating that one of the fields must be filled in. The ERR segment
identifies both positions within the message that relate to the error.

HL7 Attribute Table - ERR – Error

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 493 ELD B Y 00024 Error Code and Location
2 18 ERL O Y 01812 Error Location
3 705 CWE R 0357 01813 HL7 Error Code
4 2 ID R 0516 01814 Severity

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SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME

5 705 CWE O 0533 01815 Application Error Code
6 80 ST O Y/10 01816 Application Error Parameter
7 2048 TX O 01817 Diagnostic Information
8 250 TX O 01818 User Message
9 20 IS O Y 0517 01819 Inform Person Indicator
10 705 CWE O 0518 01820 Override Type
11 705 CWE O Y 0519 01821 Override Reason Code
12 652 XTN O Y 01822 Help Desk Contact Point

2.14.5.0 ERR field definition

2.14.5.1 ERR-1 Error Code and Location (ELD) 00024
Components: <Segment ID (ST)> ^ <Segment Sequence (NM)> ^ <Field Position (NM)> ^
<Code Identifying Error (CWE)>
Subcomponents for Code Identifying Error (CWE): <Identifier (ST)> & <Text (ST)> &
<Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate
Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System
Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original
Text (ST)>

Definition: This field identifies an erroneous segment in another message. Retained for backward
compatibility only as of v 2.5; refer to ERR-2 and ERR-3 instead.
Refer to HL7 Table 0357 - Message Error Condition Codes for valid values.
2.14.5.2 ERR-2 Error Location (ERL) 01812
Components: <Segment ID (ST)> ^ <Segment Sequence (NM)> ^ <Field Position (NM)> ^
<Field Repetition (NM)> ^ <Component Number (NM)> ^ <Sub-Component Number
(NM)>

Definition: Identifies the location in a message related to the identified error, warning or message. If
multiple repetitions are present, the error results from the values in a combination of places.
2.14.5.3 ERR-3 HL7 Error Code (CWE) 01813
Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: Identifies the HL7 (communications) error code. Refer to HL7 Table 0357 – Message Error
Condition Codes for valid values.

HL7 Table 0357 - Message error condition codes

Value Description Comment
0 Message accepted Success. Optional, as the AA conveys success. Used for systems that must
always return a status code.
100 Segment sequence error Error: The message segments were not in the proper order, or required
segments are missing.
101 Required field missing Error: A required field is missing from a segment
102 Data type error Error: The field contained data of the wrong data type, e.g., an NM field
contained "FOO".
103 Table value not found Error: A field of data type ID or IS was compared against the corresponding
table, and no match was found.
200 Unsupported message type Rejection: The Message Type is not supported.
201 Unsupported event code Rejection: The Event Code is not supported.
202 Unsupported processing id Rejection: The Processing ID is not supported.
203 Unsupported version id Rejection: The Version ID is not supported.
204 Unknown key identifier Rejection: The ID of the patient, order, etc., was not found. Used for
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Value Description Comment

transactions other than additions, e.g., transfer of a non-existent patient.
205 Duplicate key identifier Rejection: The ID of the patient, order, etc., already exists. Used in response
to addition transactions (Admit, New Order, etc.).
206 Application record locked Rejection: The transaction could not be performed at the application storage
level, e.g., database locked.
207 Application internal error Rejection: A catchall for internal errors not explicitly covered by other codes.

2.14.5.4 ERR-4 Severity (ID) 01814

Definition: Identifies the severity of an application error. Knowing if something is Error, Warning or
Information is intrinsic to how an application handles the content. Refer to HL7 Table 0516 - Error severity
for valid values. If ERR-3 has a value of "0", ERR-4 will have a value of "I".
Example: a Warning could be used to indicate that notes were present, but ignored because they could not
be automatically processed, and therefore information could have been missed.
Example of Information: When submitting a claim, a payor might indicate remaining coverage under limit.

HL7 Table 0516 – Error severity

Value Description Comment
W Warning Transaction successful, but there may issues
I Information Transaction was successful but includes information e.g., inform patient
E Error Transaction was unsuccessful
F Fatal Error Message not processed due to application or network failure condition

2.14.5.5 ERR-5 Application Error Code (CWE) 01815

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: Application specific code identifying the specific error that occurred. Refer to User-Defined
Table 0533 – Application Error Code for suggested values.
If the message associated with the code has parameters, it is recommended that the message be indicated in
the format of the java.text.MessageFormat approach.2 This style provides information on the parameter
type to allow numbers, dates and times to be formatted appropriately for the language.

User-defined Table 0533 – Application error code

Value Description Comment
No suggested values.

2.14.5.6 ERR-6 Application Error Parameter (ST) 01816

Definition: Additional information to be used, together with the Application Error Code, to understand a
particular error condition/warning/etc. This field can repeat to allow for up to 10 parameters.
Example: If the application error code specified in ERR.5 corresponded with the English message "The
patient has a remaining deductible of {0, number, currency} for the period ending {1, date, medium}.", and
the first two repetitions of ERR.6 were "250" and "20021231", then a receiving application in the U.S.
would display the message as "The patient has a remaining deductible of $250.00 for the period ending Dec
31, 2002."
2.14.5.7 ERR-7 Diagnostic Information (TX) 01817
Definition: Information that may be used by help desk or other support personnel to diagnose a problem.
2.14.5.8 ERR-8 User Message (TX) 01818
Definition: The text message to be displayed to the application user.

2
Details on MessageFormat can be found at http://java.sun.com/products/jdk/1.2/docs/api/java/text/MessageFormat.html.
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Example:
|This program is having trouble communicating with another system. Please contact
the help desk.|
This differs from the actual error code and may provide more diagnostic information.
2.14.5.9 ERR-9 Inform Person Indicator (IS) 01819
Definition: A code to indicate who (if anyone) should be informed of the error. This field may also be used
to indicate that a particular person should NOT be informed of the error (e.g., Do not inform patient). Refer
to User-defined table 0517- Inform Person Code for suggested values.

User-defined Table 0517 – Inform person code

Value Description Comment
PAT Inform patient
NPAT Do NOT inform patient
USR Inform User
HD Inform help desk

2.14.5.10 ERR-10 Override Type (CWE) 01820

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: Identifies what type of override can be used to override the specific error identified. Refer to
User-defined table 0518 Override Type for suggested values.

User-defined Table 0518 – Override type

Value Description Comment
EXTN Extension Override Identifies an override where a service is being performed for longer than
the ordered period of time.
INLV Interval Override Identifies an override where a repetition of service is being performed
sooner than the ordered frequency.
EQV Equivalence Identifies an override where a service is being performed against an order
Override that the system does not recognize as equivalent to the ordered service.

2.14.5.11 ERR-11 Override Reason Code (CWE) 01821

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: Provides a list of potential override codes that can be used to override enforcement of the
application rule that generated the error. Refer to User-defined table 0519 – Override Reason for suggested
values.

User-defined Table 0519 – Override reason

Value Description Comment
... No suggested values

2.14.5.12 ERR-12 Help Desk Contact Point (XTN) 01822

Components: <WITHDRAWN Constituent> ^ <Telecommunication Use Code (ID)> ^
<Telecommunication Equipment Type (ID)> ^ <Communication Address (ST)> ^
<Country Code (NM)> ^ <Area/City Code (NM)> ^ <Local Number (NM)> ^
<Extension (NM)> ^ <Any Text (ST)> ^ <Extension Prefix (ST)> ^ <Speed Dial
Code (ST)> ^ <Unformatted Telephone number (ST)> ^ <Effective Start Date
(DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Protection
Code (CWE)> ^ <Shared Telecommunication Identifier (EI)> ^ <Preference
Order (NM)>

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Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of
Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)>
& <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)>
& <Alternate Coding System Version ID (ST)> & <Original Text (ST)>
Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of
Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)>
& <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)>
& <Alternate Coding System Version ID (ST)> & <Original Text (ST)>
Subcomponents for Shared Telecommunication Identifier (EI): <Entity Identifier (ST)>
& <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: Lists phone, e-mail, fax, and other relevant numbers for helpdesk support related to the
specified error.

2.14.6 FHS - file header segment

The FHS segment is used to head a file (group of batches) as defined in Section 2.10.3, "HL7 batch
protocol".

HL7 Attribute Table - FHS - File Header

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 1 ST R 00067 File Field Separator
2 4 ST R 00068 File Encoding Characters
3 227 HD O 00069 File Sending Application
4 227 HD O 00070 File Sending Facility
5 227 HD O 00071 File Receiving Application
6 227 HD O 00072 File Receiving Facility
7 24 DTM O 00073 File Creation Date/Time
8 40 ST O 00074 File Security
9 20 ST O 00075 File Name/ID
10 80 ST O 00076 File Header Comment
11 20 ST O 00077 File Control ID
12 20 ST O 00078 Reference File Control ID
13 227 HD O 02269 File Sending Network Address
14 227 HD O 02270 File Receiving Network Address

2.14.6.0 FHS field definitions

2.14.6.1 FHS-1 File Field Separator (ST) 00067
Definition: This field has the same definition as the corresponding field in the MSH segment.
2.14.6.2 FHS-2 File Encoding Characters (ST) 00068
Definition: This field has the same definition as the corresponding field in the MSH segment.
2.14.6.3 FHS-3 File Sending Application (HD) 00069
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field has the same definition as the corresponding field in the MSH segment.
2.14.6.4 FHS-4 File Sending Facility (HD) 00070
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field has the same definition as the corresponding field in the MSH segment.

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2.14.6.5 FHS-5 File Receiving Application (HD) 00071

Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field has the same definition as the corresponding field in the MSH segment.
2.14.6.6 FHS-6 File Receiving Facility (HD) 00072
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field has the same definition as the corresponding field in the MSH segment.
2.14.6.7 FHS-7 File Creation Date/Time (DTM) 00073
Definition: This field has the same definition as the corresponding field in the MSH segment.
2.14.6.8 FHS-8 File Security (ST) 00074
Definition: This field has the same definition as the corresponding field in the MSH segment.
2.14.6.9 FHS-9 File Name/ID (ST) 00075
Definition: This field can be used by the application processing file. Its use is not further specified.
2.14.6.10 FHS-10 File Header Comment (ST) 00076
Definition: This field contains the free text field, the use of which is not further specified.
2.14.6.11 FHS-11 File Control ID (ST) 00077
Definition: This field is used to identify a particular file uniquely. It can be echoed back in FHS-12-
reference file control ID.
2.14.6.12 FHS-12 Reference File Control ID (ST) 00078
Definition: This field contains the value of FHS-11-file control ID when this file was originally transmitted.
Not present if this file is being transmitted for the first time.
2.14.6.13 FHS-13 File Sending Network Address (HD) 02269
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: Identifier of the network location the message was transmitted from. Identified by an OID or
text string (e.g., URI). The reader is referred to the "Report from the Joint W3C/IETF URI Planning
Interest Group: Uniform Resource Identifiers (URIs), URLs, and Uniform Resource Names (URNs):
Clarifications and Recommendations".3
2.14.6.14 FHS-14 File Receiving Network Address (HD) 02270
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: Identifier of the network location the message was transmitted to. Identified by an OID or text
string. (e.g., URL).
This is analogous with the Sending Network Address, however in the receiving role.
This field should only be populated when the underlying communication protocol does not support
identification receiving network locations.

2.14.7 FTS - file trailer segment

The FTS segment defines the end of a file.

HL7 Attribute Table - FTS - File Trailer

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 10 NM O 00079 File Batch Count
2 80 ST O 00080 File Trailer Comment

3
The URI is: http://www.ietf.org/rfc/rfc3305.txt. Note: All IETF documents are available online, and RFCs are available through URIs using this
format.
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2.14.7.0 FTS field definitions

2.14.7.1 FTS-1 File Batch Count (NM) 00079
Definition: This field contains the number of batches contained in this file.
2.14.7.2 FTS-2 File Trailer Comment (ST) 00080
Definition: The use of this free text field is not further specified.

2.14.8 MSA - message acknowledgment segment

The MSA segment contains information sent while acknowledging another message.

HL7 Attribute Table - MSA - Message Acknowledgment

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 2 ID R 0008 00018 Acknowledgment Code
2 199 ST R 00010 Message Control ID
3 80 ST B 00020 Text Message
4 15 NM O 00021 Expected Sequence Number
5 W 00022 Delayed Acknowledgment Type
6 250 CE B 0357 00023 Error Condition
7 5 NM O 01827 Message Waiting Number
8 1 ID O 0520 01828 Message Waiting Priority

2.14.8.0 MSA field definitions

2.14.8.1 MSA-1 Acknowledgment Code (ID) 00018
Definition: This field contains an acknowledgment code, see message processing rules. Refer to HL7 Table
0008 - Acknowledgment code for valid values.

HL7 Table 0008 - Acknowledgment code

Value Description Comment
AA Original mode: Application Accept - Enhanced mode: Application acknowledgment: Accept
AE Original mode: Application Error - Enhanced mode: Application acknowledgment: Error
AR Original mode: Application Reject - Enhanced mode: Application acknowledgment: Reject
CA Enhanced mode: Accept acknowledgment: Commit Accept
CE Enhanced mode: Accept acknowledgment: Commit Error
CR Enhanced mode: Accept acknowledgment: Commit Reject

2.14.8.2 MSA-2 Message Control ID (ST) 00010

Definition: This field contains the message control ID of the message sent by the sending system. It allows
the sending system to associate this response with the message for which it is intended.
2.14.8.3 MSA-3 Text Message (ST) 00020
Definition: This optional field further describes an error condition. This text may be printed in error logs or
presented to an end user.
The MSA-3 was deprecated as of v 2.4. The reader is referred to the ERR segment. The ERR segment
allows for richer descriptions of the erroneous conditions.
2.14.8.4 MSA-4 Expected Sequence Number (NM) 00021
Definition: This optional numeric field is used in the sequence number protocol.
2.14.8.5 MSA-5 Delayed Acknowledgment Type 00022
Attention: The MSA-5 was deprecated as of v2.2 and the detail was withdrawn and removed from the
standard as of v 2.5.

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2.14.8.6 MSA-6 Error Condition (CE) 00023

Components: <WITHDRAWN Constituent> ^ <WITHDRAWN Constituent> ^ <WITHDRAWN
Constituent> ^ <WITHDRAWN Constituent> ^ <WITHDRAWN Constituent> ^
<WITHDRAWN Constituent>

Definition: This field allows the acknowledging system to use a user-defined error code to further specify
AR or AE type acknowledgments.
The MSA-6 was deprecated as of v2.4. The reader is referred to the ERR segment. The ERR segment
allows for richer descriptions of the erroneous conditions.
Editors Note: In the original 2.6 document the datatype for this field was changed to CWE. Since the
MSA-6 was deprecated in V2.4, the datatype change from CE to CWE cannot be done.
Refer to HL7 Table 0357 - Message Error Condition Codes for valid values.
2.14.8.7 MSA-7 Message Waiting Number (NM) 01827
Definition: If present, indicates the number of messages the Acknowledging Application has waiting on a
queue for the Requesting Application. These messages would then need to be retrieved via a query. This
facilitates receiving applications that cannot receive unsolicited message (i.e., polling).
For example, if there are 3 low priority messages, 1 medium priority message and 1 high priority message,
the message waiting number would be 5, because that is the total number of messages.
Use Case: An application that is playing a "requesting" role has limited network access to a centralized
application playing a receiving role. When the requesting application contacts the acknowledging
application with a regular update or query message, the acknowledging application replies with the
appropriate response message, along with an indication that there are urgent messages waiting. The
requesting application submits a query to retrieve the queued messages.

2.14.8.8 MSA-8 Message Waiting Priority (ID) 01828

Definition: If present, indicates that the Sending Application has messages waiting on a queue for the
Receiving Application. These messages would then need to be retrieved via a query. This facilitates
receiving applications that cannot receive unsolicited messages (i.e., polling). The code specified identifies
how important the most important waiting message is (and may govern how soon the receiving application
is required to poll for the message).
For example, if there are 3 low priority messages, 1 medium priority message and 1 high priority message,
the message waiting priority would be 'high', because that is the highest priority of any message waiting.
With some applications, there is no guarantee that the sending application will be running. The receiving
application is therefore unable to submit unsolicited messages. To mitigate this, a polling approach is used
where the receiving application requests any queued messages when it is connected. To avoid the network
overhead of continuous polling, the sending application needs a way to indicate that there are queued
messages awaiting retrieval. It is also useful to provide an indication of the importance of those messages
to indicate how quickly they should be retrieved.
Refer to HL7 Table 0520 - Message Waiting Priority for valid values.

HL7 Table 0520 - Message waiting priority

Value Description Comment
H High
M Medium
L Low

See MSA-7 above for Use Case.

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2.14.9 MSH - message header segment

The MSH segment defines the intent, source, destination, and some specifics of the syntax of a message.

HL7 Attribute Table - MSH - Message Header

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 1 ST R 00001 Field Separator
2 4 ST R 00002 Encoding Characters
3 227 HD O 0361 00003 Sending Application
4 227 HD O 0362 00004 Sending Facility
5 227 HD O 0361 00005 Receiving Application
6 227 HD O 0362 00006 Receiving Facility
7 24 DTM R 00007 Date/Time of Message
8 40 ST O 00008 Security
9 15 MSG R 00009 Message Type
10 199 ST R 00010 Message Control ID
11 3 PT R 00011 Processing ID
12 60 VID R 00012 Version ID
13 15 NM O 00013 Sequence Number
14 180 ST O 00014 Continuation Pointer
15 2 ID O 0155 00015 Accept Acknowledgment Type
16 2 ID O 0155 00016 Application Acknowledgment Type
17 3 ID O 0399 00017 Country Code
18 16 ID O Y 0211 00692 Character Set
19 250 CWE O 00693 Principal Language Of Message
20 20 ID O 0356 01317 Alternate Character Set Handling Scheme
21 427 EI O Y 01598 Message Profile Identifier
22 567 XON O 01823 Sending Responsible Organization
23 567 XON O 01824 Receiving Responsible Organization
24 227 HD O 01825 Sending Network Address
25 227 HD O 01826 Receiving Network Address

2.14.9.0 MSH field definitions

2.14.9.1 MSH-1 Field Separator (ST) 00001
Definition: This field contains the separator between the segment ID and the first real field, MSH-2-
encoding characters. As such it serves as the separator and defines the character to be used as a separator
for the rest of the message. Recommended value is | (ASCII 124).
2.14.9.2 MSH-2 Encoding Characters (ST) 00002
Definition: This field contains two to four characters in the following order: the component separator,
repetition separator, escape character, and subcomponent separator. Best practice is to always include all
four characters. Recommended values are ^~\& (ASCII 94, 126, 92, and 38, respectively). See Section
2.5.4, "Message delimiters'.
2.14.9.3 MSH-3 Sending Application (HD) 00003
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

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Definition: This field uniquely identifies the sending application among all other applications within the
network enterprise. The network enterprise consists of all those applications that participate in the exchange
of HL7 messages within the enterprise. Entirely site-defined. User-defined Table 0361- Application is used
as the user-defined table of values for the first component.

User-defined Table 0361 –Application

Value Description Comment
No suggested values defined

Note: By site agreement, implementers may continue to use User-defined Table 0300 – Namespace ID for the first
component.

2.14.9.4 MSH-4 Sending Facility (HD) 00004

Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field further describes the sending application, MSH-3-sending application. With the
promotion of this field to an HD data type, the usage has been broadened to include not just the sending
facility but other organizational entities such as a) the organizational entity responsible for sending
application; b) the responsible unit; c) a product or vendor's identifier, etc. Entirely site-defined. User-
defined Table 0362 - Facility is used as the HL7 identifier for the user-defined table of values for the first
component.

User-defined Table 0362 –Facility

Value Description Comment
No suggested values defined

Note: By site agreement, implementers may continue to use User-defined Table 0300 – Namespace ID for the first
component.

2.14.9.5 MSH-5 Receiving Application (HD) 00005

Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field uniquely identifies the receiving application among all other applications within the
network enterprise. The network enterprise consists of all those applications that participate in the exchange
of HL7 messages within the enterprise. Entirely site-defined User-defined Table 0361- Application is used
as the HL7 identifier for the user-defined table of values for the first component.
Note: By site agreement, implementers may continue to use User-defined Table 0300 – Namespace ID for the first
component.

2.14.9.6 MSH-6 Receiving Facility (HD) 00006

Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field identifies the receiving application among multiple identical instances of the
application running on behalf of different organizations. User-defined Table 0362 - Facility is used as the
HL7 identifier for the user-defined table of values for the first component. Entirely site-defined.
Note: By site agreement, implementers may continue to use User-defined Table 0300 – Namespace ID for the first
component.

2.14.9.7 MSH-7 Date/Time of Message (DTM) 00007

Definition: This field contains the date/time that the sending system created the message. If the time zone is
specified, it will be used throughout the message as the default time zone.
Note: This field was made required in version 2.4. Messages with versions prior to 2.4 are not required
to value this field. This usage supports backward compatibility.
2.14.9.8 MSH-8 Security (ST) 00008
Definition: In some applications of HL7, this field is used to implement security features. Its use is not yet
further specified.

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2.14.9.9 MSH-9 Message Type (MSG) 00009

Components: <Message Code (ID)> ^ <Trigger Event (ID)> ^ <Message Structure (ID)>

Definition: This field contains the message type, trigger event, and the message structure ID for the
message.
Refer to HL7 Table 0076 - Message type for valid values for the message type code. This table contains
values such as ACK, ADT, ORM, ORU etc.
Refer to HL7 Table 0003 - Event type for valid values for the trigger event. This table contains values like
A01, O01, R01 etc.
Refer to HL7 Table 0354 - Message structure for valid values for the message structure. This table contains
values such as ADT_A01, ORU_R01, SIU_S12, etc.
The receiving system uses this field to recognize the data segments, and possibly, the application to which
to route this message. For certain queries, which may have more than a single response event type, the
second component may, in the response message, vary to indicate the response event type. See the
discussion of the display query variants in chapter 5.
2.14.9.10 MSH-10 Message Control ID (ST) 00010
Definition: This field contains a number or other identifier that uniquely identifies the message. The
receiving system echoes this ID back to the sending system in the Message acknowledgment segment
(MSA).
2.14.9.11 MSH-11 Processing ID (PT) 00011
Components: <Processing ID (ID)> ^ <Processing Mode (ID)>

Definition: This field is used to decide whether to process the message as defined in HL7 Application (level
7) Processing rules.
2.14.9.12 MSH-12 Version ID (VID) 00012
Components: <Version ID (ID)> ^ <Internationalization Code (CWE)> ^ <International
Version ID (CWE)>
Subcomponents for Internationalization Code (CWE): <Identifier (ST)> & <Text (ST)> &
<Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate
Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System
Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original
Text (ST)>
Subcomponents for International Version ID (CWE): <Identifier (ST)> & <Text (ST)> &
<Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate
Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System
Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original
Text (ST)>

Definition: This field is matched by the receiving system to its own version to be sure the message will be
interpreted correctly. Beginning with Version 2.3.1, it has two additional "internationalization"
components, for use by HL7 international affiliates. The <internationalization code> is CE data type (using
the ISO country codes where appropriate) which represents the HL7 affiliate. The <internal version ID> is
used if the HL7 Affiliate has more than a single 'local' version associated with a single US version. The
<international version ID> has a CE data type, since the table values vary for each HL7 Affiliate.

HL7 Table 0104 - Version ID

Value Description Comment (Date)
2.0 Release 2.0 September 1988
2.0D Demo 2.0 October 1988
2.1 Release 2. 1 March 1990
2.2 Release 2.2 December 1994
2.3 Release 2.3 March 1997
2.3.1 Release 2.3.1 May 1999
2.4 Release 2.4 November 2000

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Value Description Comment (Date)

2.5 Release 2.5 May 2003
2.5.1 Release 1.5.1 January 2007
2.6 Release 2.6 July 2007

2.14.9.13 MSH-13 Sequence Number (NM) 00013

Definition: A non-null value in this field implies that the sequence number protocol is in use. This numeric
field is incremented by one for each subsequent value.
2.14.9.14 MSH-14 Continuation Pointer (ST) 00014
Definition: This field is used to define continuations in application-specific ways.
Only the sender of a fragmented message values this field.
2.14.9.15 MSH-15 Accept Acknowledgment Type (ID) 00015
Definition: This field identifies the conditions under which accept acknowledgments are required to be
returned in response to this message. Required for enhanced acknowledgment mode. Refer to HL7 Table
0155 - Accept/application acknowledgment conditions for valid values.
2.14.9.16 MSH-16 Application Acknowledgment Type (ID) 00016
Definition: This field contains the conditions under which application acknowledgments are required to be
returned in response to this message. Required for enhanced acknowledgment mode.
The following table contains the possible values for MSH-15-accept acknowledgment type and MSH-16-
application acknowledgment type:

HL7 Table 0155 - Accept/application acknowledgment conditions

Value Description Comment
AL Always
NE Never
ER Error/reject conditions only
SU Successful completion only

Note: If MSH-15-accept acknowledgment type and MSH-16-application acknowledgment type are omitted (or are
both null), the original acknowledgment mode rules are used.

2.14.9.17 MSH-17 Country Code (ID) 00017

Definition: This field contains the country of origin for the message. It will be used primarily to specify
default elements, such as currency denominations. The values to be used are those of ISO 3166,.4. The ISO
3166 table has three separate forms of the country code: HL7 specifies that the 3-character (alphabetic)
form be used for the country code.
Refer to External Table 0399 - Country Code for the 3-character codes as defined by ISO 3166-1.

External Table 0399 – Country Code

Value Description Comment
use 3-character (alphabetic) form of ISO 3166

2.14.9.18 MSH-18 Character Set (ID) 00692

Definition: This field contains the character set for the entire message. Refer to HL7 Table 0211 - Alternate
character sets for valid values.
An HL7 message uses field MSH-18-character set to specify the character set(s) in use. Valid values for this
field are specified in HL7 Table 0211, "Alternate Character Sets". MSH-18-character set may be left blank,
or may contain one or more values delimited by the repetition separator. If the field is left blank, the
character set in use is understood to be the 7-bit ASCII set, decimal 0 through decimal 127 (hex 00 through
hex 7F). This default value may also be explicitly specified as ASCII.

4
Available from ISO 1 Rue de Varembe, Case Postale 56, CH 1211, Geneve, Switzerland
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More than one character set may be used in a message. The first occurrence, if supplied, of the MSH-18
must indicate the default encoding of the message. The second and subsequent occurrences of MSH-18-
character set are used to specify additional character sets that are used.
The repetitions of this field to specify different character sets apply only to fields of the FT, ST and TX data
types. See also section 2.7.2, "Escape sequences supporting multiple character sets".
Any encoding system, single-byte or multi-byte, may be specified as the default character encoding in
MSH-18-character set. If the default encoding is other than 7-bit ASCII, sites shall document this usage in
the dynamic conformance profile or other implementation agreement. This is particularly effective in
promoting interoperability between nations belonging to different HL7 Affiliates, while limiting the amount
of testing required to determine the encoding of a message.
By using built-in language functions for string and character manipulation, parsers and applications need
not be concerned whether a single or double byte character set is in use, provided it is applied to the entire
message. Using a built in function to extract the fourth CHARACTER will always yield the field separator
character, regardless of coding set. On the other hand, if the parser looks at the fourth BYTE, it is then
limited to single byte character sets, since the fourth byte would contain the low order 8 bits of the
character S in a double-byte system.
Note: When describing encoding rules, this standard always speaks in terms of character position, not byte offset.
Similarly, comparisons should be done on character values, not their byte equivalents. For this reason, delimiter
characters should always have representation in the standard 7-bit ASCII character set, regardless of the actual
character set being used, so that a search for the character CR (carriage return) can be performed.

HL7 Table 0211 - Alternate character sets

Value Description Comment
ASCII The printable 7-bit ASCII character set. (This is the default if this field is omitted)
8859/1 The printable characters from the ISO 8859/1
Character set
8859/2 The printable characters from the ISO 8859/2
Character set
8859/3 The printable characters from the ISO 8859/3
Character set
8859/4 The printable characters from the ISO 8859/4
Character set
8859/5 The printable characters from the ISO 8859/5
Character set
8859/6 The printable characters from the ISO 8859/6
Character set
8859/7 The printable characters from the ISO 8859/7
Character set
8859/8 The printable characters from the ISO 8859/8
Character set
8859/9 The printable characters from the ISO 8859/9
Character set
8859/15 The printable characters from the ISO 8859/15
(Latin-15)
ISO IR14 Code for Information Exchange (one byte)(JIS Note that the code contains a space, i.e., "ISO
X 0201-1976). IR14".
ISO IR87 Code for the Japanese Graphic Character set Note that the code contains a space, i.e., "ISO
for information interchange (JIS X 0208-1990), IR87".

The JIS X 0208 needs an escape sequence. In

Japan, the escape technique is ISO 2022. From
basic ASCII, escape sequence "escape" $ B (in
HEX, 1B 24 42) lets the parser know that following
bytes should be handled 2-byte wise. Back to ASCII
is 1B 28 42.
ISO IR159 Code of the supplementary Japanese Graphic Note that the code contains a space, i.e., "ISO
Character set for information interchange (JIS IR159".
X 0212-1990).

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Value Description Comment

GB 18030-2000 Code for Chinese Character Set (GB 18030- Does not need an escape sequence.
2000)
KS X 1001 Code for Korean Character Set (KS X 1001)
CNS 11643-1992 Code for Taiwanese Character Set (CNS Does not need an escape sequence.
11643-1992)
BIG-5 Code for Taiwanese Character Set (BIG-5) Does not need an escape sequence.

BIG-5 does not need an escape sequence. ASCII is

a 7 bit character set, which means that the top bit of
the byte is "0". The parser knows that when the top
bit of the byte is "0", the character set is ASCII.
When it is "1", the following bytes should be handled
as 2 bytes (or more). No escape technique is
needed. However, since some servers do not
correctly interpret when they receive a top bit "1", it
is advised, in internet RFC, to not use these kind of
non-safe non-escape extension.
UNICODE The world wide character standard from Deprecated. Retained for backward compatibility
ISO/IEC 10646-1-19935 only as v 2.5. Replaced by specific Unicode
encoding codes.
UNICODE UTF-8 UCS Transformation Format, 8-bit form UTF-8 is a variable-length encoding, each code
value is represented by 1,2 or 3 bytes, depending on
the code value. 7 bit ASCII is a proper subset of
UTF-8. Note that the code contains a space before
UTF but not before and after the hyphen.
UNICODE UTF-16 UCS Transformation Format, 16-bit form UTF-16 is identical to ISO/IEC 10646 UCS-2. Note
that the code contains a space before UTF but not
before and after the hyphen.
UNICODE UTF-32 UCS Transformation Format, 32-bit form UTF-32 is defined by Unicode Technical Report #19,
and is an officially recognized encoding as of
Unicode Version 3.1. UTF-32 is a proper subset of
ISO/IEC 10646 UCS-4. Note that the code contains
a space before UTF but not before and after the
hyphen.

a) if the field is not valued, the default single-byte character set (ASCII ("ISO IR6")) should be
assumed. No other character sets are allowed in the message.
b) if the field repeats, but the first element is NULL (i.e., present but unvalued), the single-byte ASCII
("ISO IR6") is assumed as the default character set.
c) elements in the remainder of the sequence (i.e., elements 2..n) are alternate character sets that may
be used.
The reader is referred to the following references for background information on character sets and
encodings:
• Unicode Technical Report #17 - Character Encoding Model
(http://www.unicode.org/unicode/reports/tr17/)
• Extensible Markup Language (XML) 1.0 (Second Edition), Section F Autodetection of Character
Encodings (http://www.w3.org/TR/REC-xml#sec-guessing)
2.14.9.18.1 Alphabetic Languages Other Than English
The first occurrence of MSH-18-character set may reference a character set other than 7-bit ASCII. Western
alphabetic languages other than English are accommodated by the ISO 8859 series of character encodings.
For example, if MSH-18-character set is valued 8859/1, the ISO character set commonly known as "8-bit
ASCII" is in use in the message. This includes all values from decimal 0 through decimal 127 (hex 00

5
Available from The Unicode Consortium, P.O. Box 700519, San Jose, CA 95170-0519. See
http://www.unicode.org/unicode/consortium/consort.html
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through hex 7F), plus an additional 128 values from decimal 128 through decimal 255 (hex 80 through hex
FF). The latter values include the accented Latin letters used in common Western European languages, plus
some symbolic values such as the paragraph mark (¶) and the trademark symbol (™).
Other ISO character sets in the 8859 series accommodate non-Latin character sets. For example, MSH-18-
character set may be valued 8859/2 to specify the default character encoding in use in Eastern Europe,
while 8859/6 indicates the use of the Arabic alphabet.
The ASCII and ISO character sets all allow the specification of any character in a single byte.
2.14.9.18.2 Non-Alphabetic Languages
HL7 Table 0211 includes values for languages that do not use alphabets. These include ideographic written
languages, such as the Japanese Graphic Character Set which is specified as ISO IR87.
There are non-alphabetic encoding systems for which HL7 Table 0211 does not provide specific entries.
One of these is the Traditional Chinese character set, CNS 11643, which is used in Taiwan. This character
set can, however, be encoded using the Unicode Standard, which does have a value in HL7 0211.
The Unicode Standard (which is now coordinated with ISO 10646) permits the specification of multiple-
byte characters in a much larger range than is available in a single-byte ASCII or ISO character set.
Unicode Version 3.1 (http://www.unicode.org) includes almost 100,000 characters, including many
Chinese, Japanese, and Korean ideographs. This is particularly valuable to implementers who need to
encode messages in more than one character set, as for example to accommodate the use of both alphabetic
and ideographic characters.
Non-alphabetic encoding systems do not restrict characters to a length of one byte. Unicode incorporates
three encoding forms that allow for the use of multiple bytes to encode a message. The most flexible
Unicode encoding form is UTF-8, which uses high-order bits to specify the number of bytes (from one to
six) used to encode each character.
Interestingly, Unicode UTF-8 incorporates the 7-bit ASCII character set as single-byte codes. This means
that a message encoded in 7-bit ASCII can be submitted to a destination using Unicode UTF- 8 with no
modification.
2.14.9.19 MSH-19 Principal Language of Message (CWE) 00693
Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: This field contains the principal language of the message. Codes come from ISO 639.
2.14.9.20 MSH-20 Alternate Character Set Handling Scheme (ID) 01317
Definition: When any alternative character sets are used (as specified in the second or later iterations of
MSH-18 character sets), and if any special handling scheme is needed, this component is to specify the
scheme used, according to HL7 Table 0356- Alternate character set handling scheme as defined below:

HL7 Table 0356 - Alternate character set handling scheme

Value Description Comment
ISO 2022- This standard is titled "Information Technology - This standard specifies an escape sequence from basic one
1994 Character Code Structure and Extension byte character set to specified other character set, and vice
Technique". . versa. The escape sequence explicitly specifies what
alternate character set to be evoked. Note that in this mode,
the actual ASCII escape character is used as defined in the
referenced ISO document. As noted in 1.7.1, escape
sequences to/from alternate character set should occur within
HL7 delimiters. In other words, HL7 delimiters are basic one
byte characters only, and just before and just after delimiters,
character encoding status should be the basic one byte set.

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Value Description Comment

2.3 The character set switching mode specified in Note that the escape sequences used in this mode do not
HL7 2.5, section 2.7.2, "Escape sequences use the ASCII "esc" character, as defined in ISO 2022-1994.
They are "HL7 escape sequences" as first defined in HL7 2.3,
supporting multiple character sets" and
sec. 2.9.2. (Also, note that sections 2.8.28.6.1and 2.9.2 in
section 2.A.46, "XPN – extended person name".
HL7 2.3 correspond to sections 2.16.93 and 2.7.2 in HL7 2.
5.)
<null> This is the default, indicating that there is no This is the default.
character set switching occurring in this message.

2.14.9.21 MSH-21 Message Profile Identifier (EI) 01598

Components: <Entity Identifier (ST)> ^ <Namespace ID (IS)> ^ <Universal ID (ST)> ^
<Universal ID Type (ID)>

Definition: Sites may use this field to assert adherence to, or reference, a message profile. Message profiles
contain detailed explanations of grammar, syntax, and usage for a particular message or set of messages.
See section 2B, "Conformance Using Message Profiles".
Repetition of this field allows more flexibility in creating and naming message profiles. Using repetition,
this field can identify a set of message profiles that the message conforms to. For example, the first
repetition could reference a vendor's message profile. The second could reference another compatible
provider's profile or a later version of the first vendor profile.
As of v2.5, the HL7 message profile identifiers might be used for conformance claims and/or
publish/subscribe systems. Refer to sections 2B.1.1"Message profile identifier" and 2.B.1.2, "Message
profile publish/subscribe topics" for details of the message profile identifiers. Refer to sections 2.B.4.1,
"Static definition identifier" and 2.B.4.2, "Static definition publish/subscribe topics" for details of the static
definition identifiers.
Prior to v2.5, the field was called Conformance Statement ID. For backward compatibility, the
Conformance Statement ID can be used here. Examples of the use of Conformance Statements appear in
Chapter 5, "Query."
2.14.9.22 MSH-22 Sending Responsible Organization (XON) 01823
Components: <Organization Name (ST)> ^ <Organization Name Type Code (IS)> ^
<DEPRECATED-ID Number (NM)> ^ <Identifier Check Digit (NM)> ^ <Check Digit
Scheme (ID)> ^ <Assigning Authority (HD)> ^ <Identifier Type Code (ID)> ^
<Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^
<Organization Identifier (ST)>
Subcomponents for Assigning Authority (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>
Subcomponents for Assigning Facility (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>

Definition: Business organization that originated and is accountable for the content of the message.
Currently, MSH provides fields to transmit both sending/receiving applications and facilities (MSH.3 –
MSH.6). However, these levels of organization do not necessarily relate to or imply a legal entity such as a
business organization. As such, multiple legal entities (organizations) may share a service bureau, with the
same application and facility identifiers. Another level of detail is required to delineate the various
organizations using the same service bureau.
Therefore, the Sending Responsible Organization field provides a complete picture from the application
level to the overall business level. The Business Organization represents the legal entity responsible for the
contents of the message.
Use Case #1: A centralized system responsible for recording and monitoring instances of communicable
diseases enforces a stringent authentication protocol with external applications that have been certified to
access its information base. In order to allow message exchange, the centralized system mandates that
external applications must provide the identity of the business organization sending the message (Sending
Responsible Organization), the organization it is sending the message to (Receiving Responsible
Organization, in this case the "owner" of the communicable diseases system), the network address from

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which the message has originated (Sending Network Address), the network address the message is being
transmitted to (Receiving Network Address). The organization responsible for protecting the information
stored within the communicable disease system requires this authentication due to the sensitive nature of
the information it contains.
2.14.9.23 MSH-23 Receiving Responsible Organization (XON) 01824
Components: <Organization Name (ST)> ^ <Organization Name Type Code (IS)> ^
<DEPRECATED-ID Number (NM)> ^ <Identifier Check Digit (NM)> ^ <Check Digit
Scheme (ID)> ^ <Assigning Authority (HD)> ^ <Identifier Type Code (ID)> ^
<Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^
<Organization Identifier (ST)>
Subcomponents for Assigning Authority (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>
Subcomponents for Assigning Facility (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>

Definition: Business organization that is the intended receiver of the message and is accountable for acting
on the data conveyed by the transaction.
This field has the same justification as the Sending Responsible Organization except in the role of the
Receiving Responsible Organization. The receiving organization has the legal responsibility to act on the
information in the message.
See MSH-22 above for Use Case.
2.14.9.24 MSH-24 Sending Network Address (HD) 01825
Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: Identifier of the network location the message was transmitted from. Identified by an OID or
text string (e.g., URI). The reader is referred to the "Report from the Joint W3C/IETF URI Planning
Interest Group: Uniform Resource Identifiers (URIs), URLs, and Uniform Resource Names (URNs):
Clarifications and Recommendations".6
As with the Sending/Receiving Responsible Organization, the Sending Network Address provides a more
detailed picture of the source of the message. This information is lower than the application layer, but is
often useful/necessary for routing and identification purposes. This field should only be populated when the
underlying communication protocol does not support identification of sending network locations.
An agreement about the specific values and usage must exist among messaging partners. Use Case:
Dr. Hippocrates works for the ''Good Health Clinic" (Sending facility) with a laptop running application
XYZ (Sending App). He needs to talk to the provincial pharmacy system. He dials in and is assigned a
network address. He then sends a message to the pharmacy system, which transmits a response back to
him. Because the underlying network protocol does not have a place to communicate the sender and
receiver network addresses, it therefore requires these addresses to be present in a known position in the
payload.
There may be many doctors running application XYZ. In addition, the network address assigned to the
laptop may change with each dial-in. This means there is not a 1..1 association between either the facility
or the application and the network address.
MSH||RX|GHC|||||OMP^O09^OMP_O09||||||||||||||||05782|
Example 1: The Lone Tree Island satellite clinic transmits a notification of patient registration to its parent
organization Community Health and Hospitals. The communication protocol does not support the
identification of sending network location, so the sending network location is identified in the message by
using its enterprise-wide network identifier "HNO2588".

6
The URI is: http://www.ietf.org/rfc/rfc3305.txt. Note: All IETF documents are available online, and RFCs are available through URIs using this
format.
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MSH||Reg|Lone|||||ADT^A04^ADT_A04||||||||||||||||HN02588|
Example 2: The Stone Mountain satellite clinic transmits a notification of patient registration to its
parent organization Community Health and Hospitals. The sending network location is identified by using
its URI.
MSH||Reg|Stone|||||ADT^A04^ADT_A04||||||||||||||||
^ftp://www.goodhealth.org/somearea/someapp^URI|
Example 3: The Three Rivers satellite clinic transmits a notification of patient registration to its parent
organization Community Health and Hospitals. The sending network location is identified by using its Ipv4
address, port 5123 at node 25.152.27.69. The following example shows how to represent a port and DNS
address using HD as the scheme
MSH||Reg|TRC||||| ADT^A04^ADT_A04||||||||||||||||5123^25.152.27.69^DNS|
Example 4: The Bayview satellite clinic transmits a notification of patient registration to its parent
organization Community Health and Hospitals. The sending network location is identified by using
"4086::132:2A57:3C28" its IPv6 address.
MSH||REG|BAY||||| ADT^A04^ADT_A04||||||||||||||||^4086::132:2A57:3C28^IPv6|

2.14.9.25 MSH-25 Receiving Network Address (HD) 01826

Components: <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: Identifier of the network location the message was transmitted to. Identified by an OID or text
string (e.g., URL).
This is analogous with the Sending Network Address, however in the receiving role.
This field should only be populated when the underlying communication protocol does not support
identification receiving network locations.

2.14.10 NTE - notes and comments segment

The NTE segment is defined here for inclusion in messages defined in other chapters. It is commonly used
for sending notes and comments.
The technical committees define the meaning of the NTE segments within the context of the messages in
their chapters. For each NTE, the description in the message attribute table should include an indication of
the segment associated with the NTE, for example "Notes and Comments for the PID".

HL7 Attribute Table - NTE - Notes and Comments

SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME
1 4 SI O 00096 Set ID - NTE
2 8 ID O 0105 00097 Source of Comment
3 65536 FT O Y 00098 Comment
4 250 CWE O 0364 01318 Comment Type
5 3220 XCN O 00224 Entered By
6 24 DTM O 00661 Entered Date/Time
7 24 DTM O 01004 Effective Start Date
8 24 DTM O 02185 Expiration Date

2.14.10.0 NTE field definitions

2.14.10.1 NTE-1 Set ID - NTE (SI) 00096
Definition: This field may be used where multiple NTE segments are included in a message. Their
numbering must be described in the application message definition.
2.14.10.2 NTE-2 Source of Comment (ID) 00097
Definition: This field is used when source of comment must be identified. This table may be extended
locally during implementation. Refer to HL7 Table 0105 - Source of comment for valid values.
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HL7 Table 0105 - Source of comment

Value Description Comment
L Ancillary (filler) department is source of comment
P Orderer (placer) is source of comment
O Other system is source of comment

2.14.10.3 NTE-3 Comment (FT) 00098

Definition: This field contains the comment contained in the segment.
Note: As of v2.2, this field uses the FT rather than a TX data type. Since there is no difference between an FT data
type without any embedded formatting commands, and a TX data type, this change is compatible with the previous
version.

2.14.10.4 NTE-4 Comment Type (CWE) 01318

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: This field contains a value to identify the type of comment text being sent in the specific
comment record. Refer to User-Defined Table 0364 - Comment Type for suggested values.

User-defined Table 0364 - Comment type

Value Description Comment
PI Patient Instructions
AI Ancillary Instructions
GI General Instructions
1R Primary Reason
2R Secondary Reason
GR General Reason
RE Remark
DR Duplicate/Interaction Reason

Note: A field already exists on the NTE record that identifies the Sources of Comment (e.g., ancillary, placer,
other). However some applications need to support other types of comment text (e.g., instructions, reason, remarks,
etc.). A separate NTE segment can be used for each type of comment (e.g., instructions are on one NTE and remarks
on another NTE).

2.14.10.5 NTE-5 Entered By (XCN) 00224

Components: <ID Number (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and
Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III)
(ST)> ^ <Prefix (e.g., DR) (ST)> ^ <DEPRECATED-Degree (e.g., MD) (IS)> ^
<Source Table (IS)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^
<Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier
Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code
(ID)> ^ <Name Context (CWE)> ^ <DEPRECATED-Name Validity Range (DR)> ^
<Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date
(DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^
<Assigning Agency or Department (CWE)>
Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own
Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from
Partner/Spouse (ST)>
Subcomponents for Assigning Authority (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>
Subcomponents for Assigning Facility (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>
Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of
Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)>
& <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)>
& <Alternate Coding System Version ID (ST)> & <Original Text (ST)>

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Subcomponents for Name Validity Range (DR): <Range Start Date/Time (DTM)> & <Range
End Date/Time (DTM)>
Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> &
<Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate
Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System
Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original
Text (ST)>
Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text
(ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> &
<Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding
System Version ID (ST)> & <Alternate Coding System Version ID (ST)> &
<Original Text (ST)>

Definition: This field contains the identity of the person who actually keyed the comment into the
application. It provides an audit trail in case the comment is entered incorrectly and the ancillary
department needs to clarify the comment. By local agreement, either the ID number or name component
may be omitted.
2.14.10.6 NTE-6 Entered Date/Time (DTM) 00661
Definition: This field contains the actual date the comment was keyed into the application.
2.14.10.7 NTE-7 Effective Start Date (DTM) 01004
Definition: This field contains the date the comment becomes or became effective.
2.14.10.8 NTE-8 Expiration Date (DTM) 02185
Definition: This field contains the date the comment becomes or became non-effective.

2.14.11 OVR – override segment

Definition: This segment allows a sender to override specific receiving application's business rules to allow
for processing of a message that would normally be rejected or ignored.
In many instances, business rules will be set as guidelines relative to patient care. In some instances it is in
the patient's better interest to circumvent these guidelines. In other cases, business rules may exist to
support normal process flow, but which may be bypassed or ignored under certain special circumstances.
This segment is linked to the proposed ERR segment changes in that the first attempt to process a
transaction that violates a business rule may result in an error that must be overridden. The ERR provides a
mechanism to identify errors that may be overridden, as well as the allowed override codes.
Use case #1: A patient has received a prescription with a duration of 30 days and receives the full amount at
their pharmacy. While at home the patient accidentally spills the container and spoils a significant
proportion of the prescription. The patient returns to their pharmacy and explains the situation to the
pharmacy technician. The technician consults with their supervising pharmacist. Knowing the patient, the
pharmacist decides to override the business rule stating that the dispensed amount for a prescription may
not exceed the prescribed amount. In recording the decision, the pharmacy technician specifies that the
Override Type is a "Compassionate Refill" and that the Override Code, or reason for the override, is
"Spoilage". The technician also provides Override Comments to provide an explanation of the situation
for future reference. While recording the decision, the technician's user ID is automatically stored in an
Override Recorded By field. The pharmacist's ID is stored in the Override Responsible Provider field.
Use case #2:A hospital wishes to submit an invoice to an insurer who is providing secondary coverage. The
invoice is being submitted over a week after the service was performed, which is outside the insurer's
normal accept time window. The insurer would normally reject the invoice. However, the submitter
includes an Override Type of "late submission" as well as an Override Code indicating that the invoice is
late due to delays with the primary payor. The secondary insurer examines the override reason and accepts
the invoice.
Usage Note: The override segment should be included in messages adjacent to the segment(s) containing
the information that would trigger the business rule(s) that needs to be overridden. The segment should be
optional (you shouldn't always need to override business rules), and should be allowed to repeat in
circumstances where there may be more than one business rule overridden at the same time. Committees

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may wish to provide suggested values for override types or codes for use with the OVR segment in
different messages.
The following is an example of how the OVR segment might be used in a dispense message (RDS_O13):
MSH PID PV1 {ORC RXE {RXR} RXD {RXR} <RXC> <NTE> <FT1> <OVR>}

HL7 Attribute Table – OVR – Override Segment

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME
1 705 CWE O 0518 01829 Business Rule Override Type
2 705 CWE O 0521 01830 Business Rule Override Code
3 200 TX O 01831 Override Comments
4 250 XCN O 01832 Override Entered By
5 250 XCN O 01833 Override Authorized By

2.14.11.0 OVR field definitions

2.14.11.1 OVR-1 Business Rule Override Type (CNE) 01829
Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: Identifies what type of business rule override is being performed. Refer to User-defined Table
0518 - Override Type for suggested values. Given that an application provides end users with the ability to
override business rules, there must be a way to communicate what business rule is being overridden.
2.14.11.2 OVR-2 Business Rule Override Code (CWE) 01830
Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: Indicates the reason for the business rule override. Refer to User-Defined Table 0521 – Override
Code for suggested values.
If users are allowed to override business rules in an application, the user will typically need to provide a
reason why the rule is being overridden. The Override Code field in this segment will provide the
mechanism to transmit a coded reason.

User-defined Table 0521 - Override code

Value Description Comment
No suggested values

2.14.11.3 OVR-3 Override Comments (TX) 01831

Definition: Additional descriptive comments detailing the circumstances of the override.
When overriding a business rule there may be special circumstances that require a further explanation of
the override action. The Override Comments field will allow users to provide more specific information in
a free text format.

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2.14.11.4 OVR-4 Override Entered By (XCN) 01832

Components: <ID Number (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and
Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III)
(ST)> ^ <Prefix (e.g., DR) (ST)> ^ <DEPRECATED-Degree (e.g., MD) (IS)> ^
<Source Table (IS)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^
<Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier
Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code
(ID)> ^ <Name Context (CWE)> ^ <DEPRECATED-Name Validity Range (DR)> ^
<Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date
(DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^
<Assigning Agency or Department (CWE)>
Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own
Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from
Partner/Spouse (ST)>
Subcomponents for Assigning Authority (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>
Subcomponents for Assigning Facility (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>
Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of
Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)>
& <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)>
& <Alternate Coding System Version ID (ST)> & <Original Text (ST)>
Subcomponents for Name Validity Range (DR): <Range Start Date/Time (DTM)> & <Range
End Date/Time (DTM)>
Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> &
<Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate
Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System
Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original
Text (ST)>
Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text
(ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> &
<Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding
System Version ID (ST)> & <Alternate Coding System Version ID (ST)> &
<Original Text (ST)>

Definition: Identifies the user entering the override in the system.

When a business rule is overridden, an application must be able to link the override with the user who made
it in order to provide a complete audit history of the transaction, especially when there may be a risk
associated with the override. In situations where the original message was submitted by batch, the
overriding user may be different than the original author of the message.
2.14.11.5 OVR-5 Override Authorized By (XCN) 01833
Components: <ID Number (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and
Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III)
(ST)> ^ <Prefix (e.g., DR) (ST)> ^ <DEPRECATED-Degree (e.g., MD) (IS)> ^
<Source Table (IS)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^
<Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier
Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code
(ID)> ^ <Name Context (CWE)> ^ <DEPRECATED-Name Validity Range (DR)> ^
<Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date
(DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^
<Assigning Agency or Department (CWE)>
Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own
Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from
Partner/Spouse (ST)>
Subcomponents for Assigning Authority (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>
Subcomponents for Assigning Facility (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>

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Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of
Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)>
& <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)>
& <Alternate Coding System Version ID (ST)> & <Original Text (ST)>
Subcomponents for Name Validity Range (DR): <Range Start Date/Time (DTM)> & <Range
End Date/Time (DTM)>
Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> &
<Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate
Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System
Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original
Text (ST)>
Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text
(ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> &
<Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding
System Version ID (ST)> & <Alternate Coding System Version ID (ST)> &
<Original Text (ST)>

Definition: Identifies the health services provider who accepts professional responsibility for overriding the
business rule. This field should be left empty if the recording and responsible health care provider is the
same as who entered the override.
In some cases, a business rule override may be entered by a data entry clerk on behalf of a health service
provider who carries professional responsibility for the decision to override the rule. In order to represent
this scenario, the segment must have a field identifying who is responsible for the override decision, in
addition to the person recording the override.

2.14.12 SFT – software segment

Definition: This segment provides additional information about the software product(s) used as a Sending
Application. The primary purpose of this segment is for diagnostic use. There may be additional uses per
site-specific agreements.
Implementers are encouraged to use message profile identifiers (as found in 2.14.9.21, "MSH-21 Message
Profile Identifier (EI) 01598") to control the behavior of the receiving application rather than relying on
application or version information in the SFT segment.
For example, if software product A has versions 9 and 10 deployed in different Enterprise locations, the fact
that they use different message types, segments, or fields should be reflected via their message profiles (see
section 2B, "Conformance Using Message Profiles"). If there is an upgrade from version 10 to 10.1, this
would be reflected in the SFT segment, but changes to the message contents should be reflected via a
new/different conformance profile.
Use Case: An external application has been customized to communicate with a centralized patient drug
history system. However, due to certain, known characteristics of the external software package, the
centralized system must modify its behavior in order to process transactions correctly. In one example, the
external application may have multiple versions in production. As such, the centralized application will
need to know the name of the Software Vendor Organization, the Software Release Number, the
Software Product Name, and the Software Binary ID so that it can correctly identify the software
submitting the transaction and modify its behavior appropriately.
While preparing a transaction for submission to a centralized system the sending application specifies its
Software Install Date and its configuration settings (Software Product Information). While processing
the transaction, the centralized system encounters an error. Upon examination of the error, install date and
configuration of the software that sent the message, helpdesk staff are able to determine the sending
application has not been updated to reflect recent application changes.
Use Case: In circumstances where a message is manipulated or modified by multiple systems, a repetition
of this segment may be appended by each system.
Example:

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MSH
[{ SFT }]
...

HL7 Attribute Table – SFT – Software Segment

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME
1 567 XON R 01834 Software Vendor Organization
2 15 ST R 01835 Software Certified Version or Release Number
3 20 ST R 01836 Software Product Name
4 20 ST R 01837 Software Binary ID
5 1024 TX O 01838 Software Product Information
6 24 DTM O 01839 Software Install Date

2.14.12.0 SFT field definitions

2.14.12.1 SFT-1 Software Vendor Organization (XON) 01834
Components: <Organization Name (ST)> ^ <Organization Name Type Code (IS)> ^
<DEPRECATED-ID Number (NM)> ^ <Identifier Check Digit (NM)> ^ <Check Digit
Scheme (ID)> ^ <Assigning Authority (HD)> ^ <Identifier Type Code (ID)> ^
<Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^
<Organization Identifier (ST)>
Subcomponents for Assigning Authority (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>
Subcomponents for Assigning Facility (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>

Definition: Organization identification information for the software vendor that created this transaction.
The purpose of this field, along with the remaining fields in this segment, is to provide a more complete
picture of applications that are sending HL7 messages. The Software Vendor Organization field would
allow the identification of the vendor who is responsible for maintaining the application.
2.14.12.2 SFT-2 Software Certified Version or Release Number (ST) 01835
Definition: Latest software version number of the sending system that has been compliance tested and
accepted. Software Certified Version or Release Number helps to provide a complete picture of the
application that is sending/receiving HL7 messages. Versions are important in identifying a specific
'release' of an application. In some situations, the receiving application validates the Software Certified
Version or Release Number against a list of "certified" versions/releases of the particular software to
determine if the sending application adheres to specific business rules required by the receiving application.
Alternatively, the software may perform different processing depending on the version of the sending
software
2.14.12.3 SFT-3 Software Product Name (ST) 01836
Definition: The name of the software product that submitted the transaction. A key component in the
identification of an application is its Software Product Name. This is a key piece of information in
identifying an application.
2.14.12.4 SFT-4 Software Binary ID (ST) 01837
Definition: Issued by a vendor for each unique software version instance to distinguish between like
versions of the same software e.g., a checksum.
Software Binary Ids are issued for each unique software version instance. As such, this information helps to
differentiate between differing versions of the same software. Identical Primary IDs indicate that the
software is identical at the binary level (configuration settings may differ).
2.14.12.5 SFT-5 Software Product Information (TX) 01838
Definition: Software identification information that can be supplied by a software vendor with their
transaction. Might include configuration settings, etc.
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This field would contain any additional information an application provides with the transaction it has
submitted. This information could be used for diagnostic purposes and provides greater flexibility in
identifying a piece of software. Possibilities include setup or configuration parameter information.
This field should not be sent unless performing diagnostics.
2.14.12.6 SFT-6 Software Install Date (DTM) 01839
Definition: Date the submitting software was installed at the sending site.
A Software Install Date on its own can often provide key information about the behavior of the application,
and is necessary to provide a complete picture of the sending application.

2.14.13 UAC - User Authentication Credential Segment

Definition: This optional segment provides user authentication credentials, a Kerberos Service Ticket or
SAML assertion, to be used by the receiving system to obtain user identification data. Refer to HL7 Table
0615 - User Authentication Credential Type Code. It is to be used in when the receiving application system
requires the sending system to provide end-user identification for accountability or access control in
interactive applications. Since user authentication implementations often limit the time period for validity
of the session authentication credentials, this segment is not intended for use in non-interactive
applications.
It is possible that various user authentication credential standards' data may be communicated. Kerberos
and SAML are two such standards. A user authentication credential is an encapsulated data (ED type)
element, as defined by standards, with no HL7-relevant structure.
Note: The UAC segment is defined for use within simple protocols, such as MLLP, that do not have user
authentication semantics. Implementations that use WSDL/SOAP, or similar protocols, to envelope HL7 should
employ the user authentication semantics and data structures available within the scope of those protocols rather
than the UAC segment.
If the receiving system accepts the user credentials in the UAC segment, no specific acknowledgement is
required. However, if the receiving system detects an error while processing the UAC segment, its
acknowledgment message shall report it to the sender via an MSA and ERR segment pair:
• The ERR-3 (error code) field value is 207 to signify an application error
• The ERR-7 (diagnostic information) field reports the specific error. Examples of possible errors are:
• User credentials expected but not provided
• User credentials invalid
• User credentials expired
• User credentials from an unknown or untrusted source
• User unknown
• User not allowed to create or access data on the receiving system.
• User not allowed to initiate a processing function on the receiving system.

When an MSA and ERR segment pair is reported to the sender, an application data response shall not occur.
In such cases it is correct to assume that the sending application's user is not authorized to get the data.
The processing rules for the ERR segment are outside of HL7's scope.

HL7 Attribute Table – UAC - User Authentication Credential Segment

SEQ LEN DT OPT RP/# TBL# ITEM# ELEMENT NAME
1 7 05 CWE R 0615 02267 User Authentication Credential Type Code
2 65536 ED R 02268 User Authentication Credential

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2.14.13.0 UAC Field Definitions

2.14.13.1 UAC-1 User Authentication Credential Type Code (CWE) 02267
Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^
<Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate
Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding
System Version ID (ST)> ^ <Original Text (ST)>

Definition: This an identifier code for the type of user authentication credential.

HL7 Table 0615 - User Authentication Credential Type Code

Value Description Comment
KERB Kerberos Service Ticket Structure defined by RFC 1510
SAML Authenticated User Identity Assertion XML structure defined by the OASIS Security Assertion Markup Language
(SAML) specification

2.14.13.2 UAC-2 User Authentication Credential (ED) 02268

Components: <Source Application (HD)> ^ <Type of Data (ID)> ^ <Data Subtype (ID)> ^
<Encoding (ID)> ^ <Data (TX)>
Subcomponents for Source Application (HD): <Namespace ID (IS)> & <Universal ID (ST)>
& <Universal ID Type (ID)>

Definition: This is user credential data as supplied by the sender's operating platform. The content and
structure of this is defined by other standards and contain no HL7-relevant data.

2.15 DATA TYPES

HL7 Table 0440 – Data types
Data Data Type Name LEN Category Comment
type
AD Address 415 Demographics Replaced by XAD as of v 2.3
AUI Authorization information 239 Replaces the CM data type used in
sections 6.5.6.14 IN1-14, as of v 2.5.
CCD Charge code and date 28 Replaces the CM data type used in
section 4.5.2.1 BLG-1, as of v 2.5.
CCP Channel calibration parameters 20 Replaces the CM data type used in
7.14.1.5 OBX-5.3 where OBX-
5Observation value (*) is data type CD as
of v 2.5.
CD Channel definition 581 Specialty/Chapter For waveform data only;.
Specific:
waveform
CE Coded element 483 Code Values Replaced by CNE and CWE as of v 2.3.1.
Retained for backward compatibility only
as of v 2.5.
CF Coded element with formatted 65536 Code Values
values
CK Composite ID with check digit Code Values Withdrawn
CM Composite Generic Withdrawn Replaced by numerous new
unambiguous data types in v 2.5
CN Composite ID number and name Code Values Withdrawn. Replaced by XCN as of v 2.3
CNE Coded with no exceptions 705 Code Values
CNS Composite ID number and name 406 Restores the original data type CN as
simplified was initially implementable in the CM
used in sections 4.5.3.32 and 7.4.1.32-(
OBR-32) , 4.5.3.33 and 7.4.1.33 - ( OBR-
33) 4.5.3.34 and 7.4.1.34 - ( OBR-34)
4.5.3.35 and 7.4.1.35 - ( OBR-35).
Components 7 and 8, however, have
been promoted to data type IS to be
consistent with current practice without

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Data Data Type Name LEN Category Comment

type
violating backward compatibility.
CP Composite price 543 Price Data .
CQ Composite quantity with units 500 Numerical CQ cannot be legally expressed when
embedded within another data type. Its
use is constrained to a segment field.
CSU Channel sensitivity 490 Replaces the CM data type used in
7.14.1.5 OBX-5.3 where OBX-
5Observation value (*) is data type CD as
of v 2.5.
CWE Coded with exceptions 705 Code Values
CX Extended composite ID with 1913 Code Values
check digit
DDI Daily deductible information 25 Replaces the CM data type used in
section 6.5.7.30 IN2-30, as of v 2.5.
DIN Date and institution name 510 Replaces the CM data type used in
sections 15.4.6.12 STF-12 and 15.4.6.14
STF-13, as of v 2.5.
DLD Discharge to location and date 47 Replaces the CM data type used in
section 8.8.4.9 – OM2-9, as of v 2.5
DLN Driver's license number 66 Extended Queries
DLT Delta 45
DR Date/time range 53 Time Series
DT Date 8 Date/Time
DTM Date/time 24
DTN Day type and number 6 Replaces the CM data type used in
section 6.5.8.11 IN3-11, as of v 2.5.
ED Encapsulated data 65536 Specialty/Chapter Supports ASCII MIME-encoding of binary
Specific data.
EI Entity identifier 427 Identifier
EIP Entity identifier pair 855 Replaces the CM data type used in
sections 4.5.1.8 - ORC-8, 4.5.3.29 –
OBR-29, 7.3.1.29 – OBR-29, as of v 2.5.
LD Error location and description 493 Replaces the CM data type used in
2.16.5.1 ERR-1 as of v 2.5. Retained for
backward compatibility only as of v 2.5.
Refer to ERR segment.
ERL Error location 18
FC Financial class 47 Patient
Administration
/Financial
Information
FN Family name 194 Demographics Appears ONLY in the PPN, XCN, and
XPN.
FT Formatted text 65536 Alphanumeric
GTS General timing specification 199
HD Hierarchic designator 227 Identifier
ICD Insurance certification definition 40 Replaces the CM data type used in
section 6.5.8.20 IN3-20, as of v 2.5.
ID Coded values for HL7 tables Variable Identifier
IS Coded value for user-defined 20 Identifier
tables
JCC Job code/class 292 Extended Queries
LA1 Location with address variation 1 415 Replaces the CM data type used in
4.14.1.8 RXO-8 and 4.14.4.8 RXE-8 as of
v 2.5. Retained for backward compatibility
only as of v 2.5
LA2 Location with address variation 2 790 Replaces the CM data type used in
4.14.5.13 RXD-13, 4.14.6.11 RXG-11
and 4.14.7.11 RXA-11 as of v 2.5.
Retained for backward compatibility only
as of v 2.5,

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Data Data Type Name LEN Category Comment

type
MA Multiplexed array 65536 Specialty/Chapter For waveform data only
Specific:
waveform
MO Money 20 Numerical
MOC Money and charge code 504 Replaces the CM data type used in
sections 4.5.3.23 OBR-23 and 7.4.1.23-
OBR-23 as of v 2.5.
MOP Money or percentage 23 Replaces the CM data type used in
section 6.5.8.5 IN3-5, as of v 2.5. This
data type is restricted to this field.
MSG Message type 15 Replaces the CM data type used in
2.16.9.9 MSH-9 as of v 2.5.
NA Numeric array 65536 Specialty/Chapter For waveform data only
Specific:
waveform
NDL Name with location and date 835 Replaces the CM data type used in
sections 4.5.3.32 and 7.4.1.32-( OBR-32)
, 4.5.3.33 and 7.4.1.33 - ( OBR-33)
4.5.3.34 and 7.4.1.34 - ( OBR-34)
4.5.3.35 and 7.4.1.35 - ( OBR-35) as of v
2.5.
NM Numeric 16 Numerical
NR Numeric range 33 Replaces the CM data type used in
sections 8.8.4.6.1– OM2-6.1, 8.8.4.6.3–
OM2-6.3and 8.8.4.6.4– OM2-6.4, as of v
2.5.
OCD Occurrence code and date 714 Replaces the CM data type used in
sections 6.5.10.10 UB1-16 and 6.5.11.7
UB2-7, as of v 2.5.
OSD Order sequence definition 110 Replaces the CM data type used in the
TQ data type, component 10, as of v 2.5.
OSP Occurrence span code and date 723 Replaces the CM data type used in
section 6.5.11.8 UB2-8, as of v 2.5.
PIP Practitioner institutional privileges 1413 Replaces the CM data type used in
15.4.5.7 PRA-7 as of v 2.5.
PL Person location 1230 Identifier
PLN Practitioner license or other ID 101 Replaces the CM data type used in
number 15.4.5.6 PRA-6, 11.6.3.7 PRD-7 and
11.6.4.7 CTD-7 as of v 2.5.
PN Person name Demographics Withdrawn
PPN Performing person time stamp 2993 Medical equivalent of an XCN joined with a TS
Records/Informati
on Management
PRL Parent result link 755 Replaces the CM data type used in
sections 4.5.3.26 - OBR-26 and 7.4.1.26 -
OBR-26 as of v 2.5.
PT Processing type 3 Identifier
PTA Policy type and amount 56 Replaces the CM data type used in
section 6.5.7.29 IN2-29, as of v 2.5.
QIP Query input parameter list 212 Extended Queries
QSC Query selection criteria 219 Extended Queries
RCD Row column definition 19 Extended Queries
RFR Reference range 352 Replaces the CM data type used in
sections 8.8.4.6 – OM2-6, 8.8.4.7 – OM2-
7 and8.8.4.8 – OM2-8 as of v 2.5.
RI Repeat interval 206 Time Series
RMC Room coverage 82 Replaces the CM data type used in
section 6.5.7.28 IN2-28, as of v 2.5.
RP Reference pointer 273 Identifier
RPT Repeat pattern 984
SAD Street Address 184 Demographics Appears ONLY in the XAD data type.
SCV Scheduling class value pair 41 Time Series For scheduling data only. See Chapter 10
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Data Data Type Name LEN Category Comment

type
SI Sequence ID 4 Numerical
SN Structured numeric 36 Numerical
SPD Specialty description 112 Replaces the CM data type used in
15.4.5.5 PRA-5 as of v 2.5.
SPS Specimen source 4436 Replaces the CM data type used in
4.5.3.15 OBR-15, 7.4.1.15 OBR-15,
13.4.3.6 SAC-6 and 13.4.9.3 TCC-3 as of
v 2.5. This data type is retained for
backward compatibility only as on v 2.5,
SRT Sort order 15 Alphanumeric
ST String 199 Alphanumeric
TM Time 16 Date/Time
TN Telephone number 199 Demographics Withdrawn
TQ Timing/quantity 1209 Time Series Retained for backward compatibility only
as of v 2.5.
TS Time stamp 26 Date/Time
TX Text data 65536 Alphanumeric
UVC UB value code and amount 41 Replaces the CM data type used in
sections 6.5.10.10 UB1-10 and 6.5.11.6
UB2-6, as of v 2.5.
VH Visiting hours 41 Extended Queries
VID Version identifier 973 Identifier
VR Value range 13 Replaces the CM data type used in
5.10.5.3.11 QRD-11 as of v 2.5.
WVI Channel Identifier 22 Replaces the CM data type used in
7.14.1.3.1 OBX-5.1 where OBX-5
Observation value (*) is data type CD as
of v 2.5.
WVS Waveform source 17 Replaces the CM data type used in
7.14.1.4 OBX-5.2 where OBX-5
Observation value (*) is data type CD as
of v 2.5.
XAD Extended address 631 Demographics Replaces AD as of v 2.3
XCN Extended composite ID number 3002 Code Values Replaces CN as of v 2.3
and name
XON Extended composite name and ID 567 Demographics
number for organizations
XPN Extended person name 1103 Demographics Replaces PN as of v 2.3.
XTN Extended telecommunications 850 Demographics Replaces TN as of v 2.3
number

2.16 MISCELLANEOUS HL7 TABLES USED ACROSS ALL

CHAPTERS
2.16.1 Message type table (0076)
HL7 Table 0076 - Message type
Message Description Chapter
ACK General acknowledgment message 2
ADR ADT response 3
ADT ADT message 3
BAR Add/change billing account 6
CRM Clinical study registration message 7
BPS Blood product dispense status message 4
BRP Blood product dispense status acknowledgement message 4
BRT Blood product transfusion/disposition acknowledgement message 4
BTS Blood product transfusion/disposition message 4

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Message Description Chapter

CSU Unsolicited study data message 7
DFT Detail financial transactions 6
DOC Document response 9
DSR Display response 5
EAC Automated equipment command message 13
EAN Automated equipment notification message 13
EAR Automated equipment response message 13
EHC Health Care Invoice 16
ESR Automated equipment status update acknowledgment message 13
ESU Automated equipment status update message 13
INR Automated equipment inventory request message 13
INU Automated equipment inventory update message 13
LSR Automated equipment log/service request message 13
LSU Automated equipment log/service update message 13
MDM Medical document management 9
MFD Master files delayed application acknowledgment 8
MFK Master files application acknowledgment 8
MFN Master files notification 8
MFQ Master files query 8
MFR Master files response 8
NMD Application management data message 14
NMQ Application management query message 14
NMR Application management response message 14
OMB Blood product order message 4
OMD Dietary order 4
OMG General clinical order message 4
OMI Imaging order 4
OML Laboratory order message 4
OMN Non-stock requisition order message 4
OMP Pharmacy/treatment order message 4
OMS Stock requisition order message 4
OMS Stock requisition order message 4
OPL Population/Location-Based Laboratory Order Message 4
OPR Population/Location-Based Laboratory Order Acknowledgment 4
Message
OPU Unsolicited Population/Location-Based Laboratory Observation 7
Message
ORB Blood product order acknowledgement message 4
ORD Dietary order acknowledgment message 4
ORF Query for results of observation 7
ORG General clinical order acknowledgment message 4
ORI Imaging order acknowledgement message 4
ORL Laboratory acknowledgment message (unsolicited) 7
ORM Pharmacy/treatment order message 4
ORN Non-stock requisition - General order acknowledgment message 4
ORP Pharmacy/treatment order acknowledgment message 4
ORR General order response message response to any ORM 4
ORS Stock requisition - Order acknowledgment message 4
ORU Unsolicited transmission of an observation message 7
OSQ Query response for order status 4
OSR Query response for order status 4
OUL Unsolicited laboratory observation message 7
PEX Product experience message 7
PGL Patient goal message 12
PIN Patient insurance information 11
PMU Add personnel record 15
PPG Patient pathway message (goal-oriented) 12

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Message Description Chapter

PPP Patient pathway message (problem-oriented) 12
PPR Patient problem message 12
PPT Patient pathway goal-oriented response 12
PPV Patient goal response 12
PRR Patient problem response 12
PTR Patient pathway problem-oriented response 12
QBP Query by parameter 5
QCK Deferred query 5
QCN Cancel query 5
QRY Query, original mode 3
QSB Create subscription 5
QSX Cancel subscription/acknowledge message 5
QVR Query for previous events 5
RAR Pharmacy/treatment administration information 4
RAS Pharmacy/treatment administration message 4
RCI Return clinical information 11
RCL Return clinical list 11
RDE Pharmacy/treatment encoded order message 4
RDR Pharmacy/treatment dispense information 4
RDS Pharmacy/treatment dispense message 4
RDY Display based response 5
REF Patient referral 11
RER Pharmacy/treatment encoded order information 4
RGR Pharmacy/treatment dose information 4
RGV Pharmacy/treatment give message 4
ROR Pharmacy/treatment order response 4
RPA Return patient authorization 11
RPI Return patient information 11
RPL Return patient display list 11
RPR Return patient list 11
RQA Request patient authorization 11
RQC Request clinical information 11
RQI Request patient information 11
RQP Request patient demographics 11
RRA Pharmacy/treatment administration acknowledgment message 4
RRD Pharmacy/treatment dispense acknowledgment message 4
RRE Pharmacy/treatment encoded order acknowledgment message 4
RRG Pharmacy/treatment give acknowledgment message 4
RRI Return referral information 11
RSP Segment pattern response 5
RTB Tabular response 5
SCN Notification of Anti-Microbial Device Cycle Data 17
SDN Notification of Anti-Microbial Device Data 17
SDR Sterilization anti-microbial device data request 17
SIU Schedule information unsolicited 10
SLN Notification of New Sterilization Lot 17
SLR Sterilization lot request 17
SMD Sterilization anti-microbial device cycle data request 17
SQM Schedule query message 10
SQR Schedule query response 10
SRM Schedule request message 10
SRR Scheduled request response 10
SSR Specimen status request message 13
SSU Specimen status update message 13
STC Notification of Sterilization Configuration 17
STI Sterilization item request 17
SUR Summary product experience report 7
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Message Description Chapter

TBR Tabular data response 5
TCR Automated equipment test code settings request message 13
TCU Automated equipment test code settings update message 13
UDM Unsolicited display update message 5
VXQ Query for vaccination record 4
VXR Vaccination record response 4
VXU Unsolicited vaccination record update 4
VXX Response for vaccination query with multiple PID matches 4

2.16.2 Event type table (0003)

HL7 Table 0003 - Event type
Value Description Comment
A01 ADT/ACK - Admit/visit notification
A02 ADT/ACK - Transfer a patient
A03 ADT/ACK - Discharge/end visit
A04 ADT/ACK - Register a patient
A05 ADT/ACK - Pre-admit a patient
A06 ADT/ACK - Change an outpatient to an inpatient
A07 ADT/ACK - Change an inpatient to an outpatient
A08 ADT/ACK - Update patient information
A09 ADT/ACK - Patient departing - tracking
A10 ADT/ACK - Patient arriving - tracking
A11 ADT/ACK - Cancel admit/visit notification
A12 ADT/ACK - Cancel transfer
A13 ADT/ACK - Cancel discharge/end visit
A14 ADT/ACK - Pending admit
A15 ADT/ACK - Pending transfer
A16 ADT/ACK - Pending discharge
A17 ADT/ACK - Swap patients
A18 ADT/ACK - Merge patient information (for backward compatibility only)
A19 QRY/ADR - Patient query
A20 ADT/ACK - Bed status update
A21 ADT/ACK - Patient goes on a "leave of absence"
A22 ADT/ACK - Patient returns from a "leave of absence"
A23 ADT/ACK - Delete a patient record
A24 ADT/ACK - Link patient information
A25 ADT/ACK - Cancel pending discharge
A26 ADT/ACK - Cancel pending transfer
A27 ADT/ACK - Cancel pending admit
A28 ADT/ACK - Add person information
A29 ADT/ACK - Delete person information
A30 ADT/ACK - Merge person information (for backward compatibility only)
A31 ADT/ACK - Update person information
A32 ADT/ACK - Cancel patient arriving - tracking
A33 ADT/ACK - Cancel patient departing - tracking
A34 ADT/ACK - Merge patient information - patient ID only (for backward
compatibility only)
A35 ADT/ACK - Merge patient information - account number only (for backward
compatibility only)
A36 ADT/ACK - Merge patient information - patient ID and account number (for
backward compatibility only)
A37 ADT/ACK - Unlink patient information
A38 ADT/ACK - Cancel pre-admit
A39 ADT/ACK - Merge person – patient ID (for backward compatibility only)
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Value Description Comment

A40 ADT/ACK - Merge patient – patient identifier list
A41 ADT/ACK - Merge account - patient account number
A42 ADT/ACK - Merge visit - visit number
A43 ADT/ACK - Move patient information – patient identifier list
A44 ADT/ACK - Move account information - patient account number
A45 ADT/ACK - Move visit information - visit number
A46 ADT/ACK - Change patient ID (for backward compatibility only)
A47 ADT/ACK - Change patient identifier list
A48 ADT/ACK - Change alternate patient ID (for backward compatibility
only)
A49 ADT/ACK - Change patient account number
A50 ADT/ACK - Change visit number
A51 ADT/ACK - Change alternate visit ID
A52 ADT/ACK – Cancel leave of absence for a patient
A53 ADT/ACK – Cancel patient returns from a leave of absence
A54 ADT/ACK - Change attending doctor
A55 ADT/ACK – Cancel change attending doctor
A60 ADT/ACK – Update allergy information
A61 ADT/ACK – Change consulting doctor
A62 ADT/ACK – Cancel change consulting doctor
B01 PMU/ACK – Add personnel record
B02 PMU/ACK – Update personnel record
B03 PMU/ACK – Delete personnel re cord
B04 PMU/ACK – Active practicing person
B05 PMU/ACK – Deactivate practicing person
B06 PMU/ACK – Terminate practicing person
B07 PMU/ACK – Grant Certificate/Permission
B08 PMU/ACK – Revoke Certificate/Permission
C01 CRM - Register a patient on a clinical trial
C02 CRM - Cancel a patient registration on clinical trial (for clerical mistakes only)
C03 CRM - Correct/update registration information
C04 CRM - Patient has gone off a clinical trial
C05 CRM - Patient enters phase of clinical trial
C06 CRM - Cancel patient entering a phase (clerical mistake)
C07 CRM - Correct/update phase information
C08 CRM - Patient has gone off phase of clinical trial
C09 CSU - Automated time intervals for reporting, like monthly
C10 CSU - Patient completes the clinical trial
C11 CSU - Patient completes a phase of the clinical trial
C12 CSU - Update/correction of patient order/result information
E01 Submit HealthCare Services Invoice
E02 Cancel HealthCare Services Invoice
E03 HealthCare Services Invoice Status
E04 Re-Assess HealthCare Services Invoice Request
E10 Edit/Adjudication Results
E12 Request Additional Information
E13 Additional Information Response
E15 Payment/Remittance Advice
E20 Submit Authorization Request
E21 Cancel Authorization Request
E22 Authorization Request Status
E24 Authorization Response
E30 Submit Health Document related to Authorization Request reserved for future/not yet
defined
E31 Cancel Health Document related to Authorization Request reserved for future/not yet
defined
I01 RQI/RPI - Request for insurance information
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Value Description Comment

I02 RQI/RPL - Request/receipt of patient selection display list
I03 RQI/RPR - Request/receipt of patient selection list
I04 RQD/RPI - Request for patient demographic data
I05 RQC/RCI - Request for patient clinical information
I06 RQC/RCL - Request/receipt of clinical data listing
I07 PIN/ACK - Unsolicited insurance information
I08 RQA/RPA - Request for treatment authorization information
I09 RQA/RPA - Request for modification to an authorization
I10 RQA/RPA - Request for resubmission of an authorization
I11 RQA/RPA - Request for cancellation of an authorization
I12 REF/RRI - Patient referral
I13 REF/RRI - Modify patient referral
I14 REF/RRI - Cancel patient referral
I15 REF/RRI - Request patient referral status
J01 QCN/ACK – Cancel query/acknowledge message
J02 QSX/ACK – Cancel subscription/acknowledge message
K11 RSP - Segment pattern response in response to QBP^Q11
K13 RTB - Tabular response in response to QBP^Q13
K15 RDY - Display response in response to QBP^Q15
K21 RSP – Get person demographics response
K22 RSP – Find candidates response
K23 RSP – Get corresponding identifiers response
K24 RSP – Allocate identifiers response
K25 RSP - Personnel Information by Segment Response
K31 RSP –Dispense History Response
M01 MFN/MFK - Master file not otherwise specified (for backward compatibility
only)
M02 MFN/MFK - Master file – staff practitioner
M03 MFN/MFK - Master file - test/observation (for backward compatibility only)
M04 MFN/MFK - Master files charge description
M05 MFN/MFK - Patient location master file
M06 MFN/MFK - Clinical study with phases and schedules master file
M07 MFN/MFK - Clinical study without phases but with schedules master file
M08 MFN/MFK - Test/observation (numeric) master file
M09 MFN/MFK - Test/observation (categorical) master file
M10 MFN/MFK - Test /observation batteries master file
M11 MFN/MFK - Test/calculated observations master file
M12 MFN/MFK – Master file notification message
M13 MFN/MFK - Master file notification - general
M14 MFN/MFK - Master file notification – site defined
M15 MFN/MFK – Inventory item master file notification
M16 MFN/MFK - Master File Notification Inventory Item Enhanced
M17 DRG Master File Message
N01 NMQ/NMR - Application management query message
N02 NMD/ACK - Application management data message (unsolicited)
O01 ORM - Order message (also RDE, RDS, RGV, RAS)
O02 ORR - Order response (also RRE, RRD, RRG, RRA)
O03 OMD – Diet order
O04 ORD – Diet order acknowledgment
O05 OMS – Stock requisition order
O06 ORS – Stock requisition acknowledgment
O07 OMN – Non-stock requisition order
O08 ORN – Non-stock requisition acknowledgment
O09 OMP – Pharmacy/treatment order
O10 ORP – Pharmacy/treatment order acknowledgment
O11 RDE – Pharmacy/treatment encoded order

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Value Description Comment

O12 RRE – Pharmacy/treatment encoded order acknowledgment
O13 RDS – Pharmacy/treatment dispense
O14 RRD – Pharmacy/treatment dispense acknowledgment
O15 RGV – Pharmacy/treatment give
O16 RRG – Pharmacy/treatment give acknowledgment
O17 RAS – Pharmacy/treatment administration
O18 RRA – Pharmacy/treatment administration acknowledgment
O19 OMG – General clinical order
O20 ORG/ORL – General clinical order response
O21 OML - Laboratory order
O22 ORL - General laboratory order response message to any OML
O23 OMI – Imaging order
O24 ORI – Imaging order response message to any OMI
O25 RDE - Pharmacy/treatment refill authorization request
O26 RRE - Pharmacy/Treatment Refill Authorization Acknowledgement
O27 OMB – Blood product order
O28 ORB – Blood product order acknowledgment
O29 BPS – Blood product dispense status
O30 BRP – Blood product dispense status acknowledgment
O31 BTS – Blood product transfusion/disposition
O32 BRT – Blood product transfusion/disposition acknowledgment
O33 OML – Laboratory order for multiple orders related to a single specimen
O34 ORL – Laboratory order response message to a multiple order related to single
specimen OML
O35 OML – Laboratory order for multiple orders related to a single container of a
specimen
O36 ORL - Laboratory order response message to a single container of a specimen
OML
O37 OPL – Population/Location-Based Laboratory Order Message
O38 OPR – Population/Location-Based Laboratory Order Acknowledgment Message
P01 BAR/ACK - Add patient accounts
P02 BAR/ACK - Purge patient accounts
P03 DFT/ACK - Post detail financial transaction
P04 QRY/DSP – Generate bill and A/R statements
P05 BAR/ACK – Update account
P06 BAR/ACK - End account
P07 PEX - Unsolicited initial individual product experience report
P08 PEX - Unsolicited update individual product experience report
P09 SUR - Summary product experience report
P10 BAR/ACK –Transmit Ambulatory Payment Classification(APC)
P11 DFT/ACK - Post Detail Financial Transactions - New
P12 BAR/ACK - Update Diagnosis/Procedure
PC1 PPR - PC/ problem add
PC2 PPR - PC/ problem update
PC3 PPR - PC/ problem delete
PC4 QRY - PC/ problem query
PC5 PRR - PC/ problem response
PC6 PGL - PC/ goal add
PC7 PGL - PC/ goal update
PC8 PGL - PC/ goal delete
PC9 QRY - PC/ goal query
PCA PPV - PC/ goal response
PCB PPP - PC/ pathway (problem-oriented) add
PCC PPP - PC/ pathway (problem-oriented) update
PCD PPP - PC/ pathway (problem-oriented) delete
PCE QRY - PC/ pathway (problem-oriented) query
PCF PTR - PC/ pathway (problem-oriented) query response

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Value Description Comment

PCG PPG - PC/ pathway (goal-oriented) add
PCH PPG - PC/ pathway (goal-oriented) update
PCJ PPG - PC/ pathway (goal-oriented) delete
PCK QRY - PC/ pathway (goal-oriented) query
PCL PPT - PC/ pathway (goal-oriented) query response
Q01 QRY/DSR - Query sent for immediate response
Q02 QRY/QCK - Query sent for deferred response
Q03 DSR/ACK - Deferred response to a query
Q05 UDM/ACK - Unsolicited display update message
Q06 OSQ/OSR - Query for order status
Q11 QBP - Query by parameter requesting an RSP segment pattern response
Q13 QBP - Query by parameter requesting an RTB - tabular response
Q15 QBP - Query by parameter requesting an RDY display response
Q16 QSB – Create subscription
Q17 QVR – Query for previous events
Q21 QBP – Get person demographics
Q22 QBP – Find candidates
Q23 QBP – Get corresponding identifiers
Q24 QBP – Allocate identifiers
Q25 QBP - Personnel Information by Segment Query
Q26 ROR - Pharmacy/treatment order response
Q27 RAR - Pharmacy/treatment administration information
Q28 RDR - Pharmacy/treatment dispense information
Q29 RER - Pharmacy/treatment encoded order information
Q30 RGR - Pharmacy/treatment dose information
Q31 QBP Query Dispense history
R01 ORU/ACK - Unsolicited transmission of an observation message
R02 QRY - Query for results of observation
R04 ORF - Response to query; transmission of requested observation
ROR ROR - Pharmacy prescription order query response
R21 OUL – Unsolicited laboratory observation
R22 OUL – Unsolicited Specimen Oriented Observation Message
R23 OUL – Unsolicited Specimen Container Oriented Observation Message
R24 OUL – Unsolicited Order Oriented Observation Message
R25 OPU - Unsolicited Population/Location-Based Laboratory Observation Message
R30 ORU – Unsolicited Point-Of-Care Observation Message Without Existing Order
– Place An Order
R31 ORU – Unsolicited New Point-Of-Care Observation Message – Search For An
Order
R32 ORU – Unsolicited Pre-Ordered Point-Of-Care Observation
S01 SRM/SRR - Request new appointment booking
S02 SRM/SRR - Request appointment rescheduling
S03 SRM/SRR - Request appointment modification
S04 SRM/SRR - Request appointment cancellation
S05 SRM/SRR - Request appointment discontinuation
S06 SRM/SRR - Request appointment deletion
S07 SRM/SRR - Request addition of service/resource on appointment
S08 SRM/SRR - Request modification of service/resource on appointment
S09 SRM/SRR - Request cancellation of service/resource on appointment
S10 SRM/SRR - Request discontinuation of service/resource on appointment
S11 SRM/SRR - Request deletion of service/resource on appointment
S12 SIU/ACK - Notification of new appointment booking
S13 SIU/ACK - Notification of appointment rescheduling
S14 SIU/ACK - Notification of appointment modification
S15 SIU/ACK - Notification of appointment cancellation
S16 SIU/ACK - Notification of appointment discontinuation
S17 SIU/ACK - Notification of appointment deletion

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Value Description Comment

S18 SIU/ACK - Notification of addition of service/resource on appointment
S19 SIU/ACK - Notification of modification of service/resource on appointment
S20 SIU/ACK - Notification of cancellation of service/resource on appointment
S21 SIU/ACK - Notification of discontinuation of service/resource on appointment
S22 SIU/ACK - Notification of deletion of service/resource on appointment
S23 SIU/ACK - Notification of blocked schedule time slot(s)
S24 SIU/ACK - Notification of opened ("unblocked") schedule time slot(s)
S25 SQM/SQR - Schedule query message and response
S26 SIU/ACK Notification that patient did not show up for schedule appointment
S28 SLR/SLS – Request new sterilization lot
S29 SLR/SLS - Request Sterilization lot deletion
S30 STI/STS - Request item
S31 SDR/SDS - Request anti-microbial device data
S32 SMD/SMS - Request anti-microbial device cycle data
S33 STC/ACK - Notification of sterilization configuration
S34 SLN/ACK - Notification of sterilization lot
S35 SLN/ACK - Notification of sterilization lot deletion
S36 SDN/ACK - Notification of anti-microbial device data
S37 SCN/ACK - Notification of anti-microbial device cycle data
T01 MDM/ACK - Original document notification
T02 MDM/ACK - Original document notification and content
T03 MDM/ACK - Document status change notification
T04 MDM/ACK - Document status change notification and content
T05 MDM/ACK - Document addendum notification
T06 MDM/ACK - Document addendum notification and content
T07 MDM/ACK - Document edit notification
T08 MDM/ACK - Document edit notification and content
T09 MDM/ACK - Document replacement notification
T10 MDM/ACK - Document replacement notification and content
T11 MDM/ACK - Document cancel notification
T12 QRY/DOC - Document query
U01 ESU/ACK – Automated equipment status update
U02 ESR/ACK – Automated equipment status request
U03 SSU/ACK - Specimen status update
U04 SSR/ACK - specimen status request
U05 INU/ACK - Automated equipment inventory update
U06 INR/ACK – Automated equipment inventory request
U07 EAC/ACK – Automated equipment command
U08 EAR/ACK – Automated equipment response
U09 EAN/ACK – Automated equipment notification
U10 TCU/ACK – Automated equipment test code settings update
U11 TCR/ACK – Automated equipment test code settings request
U12 LSU/ACK – Automated equipment log/service update
U13 LSR/ACK – Automated equipment log/service request
V01 VXQ - Query for vaccination record
V02 VXX - Response to vaccination query returning multiple PID matches
V03 VXR - Vaccination record response
V04 VXU - Unsolicited vaccination record update
Varies MFQ/MFR - Master files query (use event same as asking for e.g., M05 -
location)
W01 ORU - Waveform result, unsolicited transmission of requested information
W02 QRF - Waveform result, response to query

2.16.3 Message structure table (0354)

The first column of this table contains the message structure code, which describes a particular HL7
"abstract message structure definition" in terms of segments, as defined in section.2.12, "Chapter Formats
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For Defining HL7 Messages". The second column lists the various HL7 trigger events that use the
particular abstract message definition. For example, the message structure code ADT_A01 describes the
single abstract message structure used by the trigger events A01, A04, A08 and A13.

HL7 Table 0354 - Message structure

Value Events Comment
ACK Varies
ADR_A19 A19
ADT_A01 A01, A04, A08, A13
ADT_A02 A02
ADT_A03 A03
ADT_A05 A05, A14, A28, A31
ADT_A06 A06, A07
ADT_A09 A09, A10, A11
ADT_A12 A12
ADT_A15 A15
ADT_A16 A16
ADT_A17 A17
ADT_A18 A18
ADT_A20 A20
ADT_A21 A21, A22, A23, A25, A26, A27, A29, A32, A33
ADT_A24 A24
ADT_A30 A30, A34, A35, A36, A46, A47, A48, A49
ADT_A37 A37
ADT_A38 A38
ADT_A39 A39, A40, A41, A42
ADT_A43 A43, A44
ADT_A45 A45
ADT_A50 A50, A51
ADT_A52 A52, A53
ADT_A54 A54, A55
ADT_A60 A60
ADT_A61 A61, A62
BAR_P01 P01
BAR_P02 P02
BAR_P05 P05
BAR_P06 P06
BAR_P10 P10
BAR_P12 P12
BPS_O29 O29
BRP_O30 O30
BRT_O32 O32
BTS_O31 O31
CRM_C01 C01, C02, C03, C04, C05, C06, C07, C08
CSU_C09 C09, C10, C11, C12
DFT_P03 P03
DFT_P11 P11
DOC_T12 T12
DSR_Q01 Q01
DSR_Q03 Q03
EAC_U07 U07
EAN_U09 U09
EAR_U08 U08
EHC_E01 E01
EHC_E02 E02
EHC_E04 E04
EHC_E10 E10

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Value Events Comment

EHC_E12 E12
EHC_E13 E13
EHC_E15 E15
EHC_E20 E20
EHC_E21 E21
EHC_E24 E24
ESR_U02 U02
ESU_U01 U01
INR_U06 U06
INU_U05 U05
LSU_U12 U12, U13
MDM_T01 T01, T03, T05, T07, T09, T11
MDM_T02 T02, T04, T06, T08, T10
MFK_M01 M01, M02, M03, M04, M05, M06, M07, M08, M09, M10, M11
MFN_M01 M01
MFN_M02 M02
MFN_M03 M03
MFN_M04 M04
MFN_M05 M05
MFN_M06 M06
MFN_M07 M07
MFN_M08 M08
MFN_M09 M09
MFN_M10 M10
MFN_M11 M11
MFN_M12 M12
MFN_M13 M13
MFN_M15 M15
MFN_M16 M16
MFN_M17 M17
MFQ_M01 M01, M02, M03, M04, M05, M06
MFR_M01 M01, M02, M03,
MFR_M04 M04
MFR_M05 M05
MFR_M06 M06
MFR_M07 M07
NMD_N02 N02
NMQ_N01 N01
NMR_N01 N01
OMB_O27 O27
OMD_O03 O03
OMG_O19 O19
OMI_O23 O23
OML_O21 O21
OML_O33 O33
OML_O35 O35
OMN_O07 O07
OMP_O09 O09
OMS_O05 O05
OPL_O37 O37
OPR_O38 O38
OPU_R25 R25
ORB_O28 O28
ORD_O04 O04
ORF_R04 R04
ORG_O20 O20
ORI_O24 O24
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Value Events Comment

ORL_O22 O22
ORL_O34 O34
ORL_O36 O36
ORM_O01 O01
ORN_O08 O08
ORP_O10 O10
ORR_O02 O02
ORS_O06 O06
ORU_R01 R01
ORU_R30 R30
OSQ_Q06 Q06
OSR_Q06 Q06
OUL_R21 R21
OUL_R22 R22
OUL_R23 R23
OUL_R24 R24
PEX_P07 P07, P08
PGL_PC6 PC6, PC7, PC8
PMU_B01 B01, B02
PMU_B03 B03
PMU_B04 B04, B05, B06
PMU_B07 B07
PMU_B08 B08
PPG_PCG PCC, PCG, PCH, PCJ
PPP_PCB PCB, PCD
PPR_PC1 PC1, PC2, PC3
PPT_PCL PCL
PPV_PCA PCA
PRR_PC5 PC5
PTR_PCF PCF
QBP_E03 E03
QBP_E22 E22
QBP_Q11 Q11
QBP_Q13 Q13
QBP_Q15 Q15
QBP_Q21 Q21, Q22, Q23,Q24, Q25
QCK_Q02 Q02
QCN_J01 J01, J02
QRY_A19 A19
QRY_PC4 PC4, PC9, PCE, PCK
QRY_Q01 Q01, Q26, Q27, Q28, Q29, Q30
QRY_Q02 Q02
QRY_R02 R02
QRY_T12 T12
QSB_Q16 Q16
QVR_Q17 Q17
RAR_RAR RAR
RAS_O17 O17
RCI_I05 I05
RCL_I06 I06
RDE_O11 O11, O25
RDR_RDR RDR
RDS_O13 O13
RDY_K15 K15
REF_I12 I12, I13, I14, I15
RER_RER RER
RGR_RGR RGR
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Value Events Comment

RGV_O15 O15
ROR_ROR ROR
RPA_I08 I08, I09. I10, I11
RPI_I01 I01, I04
RPI_I04 I04
RPL_I02 I02
RPR_I03 I03
RQA_I08 I08, I09, I10, I11
RQC_I05 I05, I06
RQI_I01 I01, I02, I03, I07
RQP_I04 I04
RRA_O18 O18
RRD_O14 O14
RRE_O12 O12, O26
RRG_O16 O16
RRI_I12 I12, I13, I14, I15
RSP_E03 E03
RSP_E22 E22
RSP_K11 K11
RSP_K21 K21
RSP_K23 K23, K24
RSP_K25 K25
RSP_K31 K31
RSP_Q11 Q11
RTB_K13 K13
SDR_S31 S31, S36
SDR_S32 S32, S37
SIU_S12 S12, S13, S14, S15, S16, S17, S18, S19, S20, S21, S22, S23, S24, S26
SLR_S28 S28, S29, S30, S34, S35
SQM_S25 S25
SQR_S25 S25
SRM_S01 S01, S02, S03, S04, S05, S06, S07, S08, S09, S10, S11
SRR_S01 S01, S02, S03, S04, S05, S06, S07, S08, S09, S10, S11
SSR_U04 U04
SSU_U03 U03
STC_S33 S33
SUR_P09 P09
TCU_U10 U10, U11
UDM_Q05 Q05
VXQ_V01 V01
VXR_V03 V03
VXU_V04 V04
VXX_V02 V02
ORU_W01 W01
QRF_W02 W02

2.16.4 Coding system table (0396)

Note: The Vocabulary T.C. is the steward of HL7 Table 0396. As of v2.6, no special characters, except for underscore
if absolutely necessary, are allowed for the Value in this table.

HL7 Table 0396 - Coding system

Value Description Comment / Source Category Status
99zzz or L Local general code Locally defined codes for purpose of sender or receiver. General code Active
(where z is an Local codes can be identified by L (for backward
alphanumeric character) compatibility) or 99zzz (where z is an alphanumeric

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character).

rd
ACR American College of Index for Radiological Diagnosis Revised, 3 Edition Specific Non-Drug Active
Radiology finding codes 1986, American College of Radiology, Reston, VA. Code
ALPHAID20 German Alpha-ID v2006 ID of the alphabetical Index ICD-10-GM-2006. Alpha-ID. New
06
ALPHAID20 German Alpha-ID v2007 ID of the alphabetical Index ICD-10-GM-2007. Alpha-ID. New
07
ALPHAID20 German Alpha-ID v2008 ID of the alphabetical Index ICD-10-GM-2008. Alpha-ID. New
08
ART WHO Adverse Reaction WHO Collaborating Centre for International Drug Drug code Active
Terms Monitoring, Box 26, S-751 03, Uppsala, Sweden.
ANS+ HL7 set of units of HL7 set of units of measure based upon ANSI X3.50 - Active
measure 1986, ISO 2988-83, and US customary units / see chapter
7, section 7.4.2.6.
AS4 ASTM E1238/ E1467 American Society for Testing & Materials and CPT4 (see Specific Non-Drug Active
Universal Appendix X1 of Specification E1238 and Appendix X2 of Code
Specification E1467).
AS4E AS4 Neurophysiology ASTM’s diagnostic codes and test result coding/grading Specific Non-Drug Active
Codes systems for clinical neurophysiology. See ASTM Code
Specification E1467, Appendix 2.
ATC American Type Culture Reference cultures (microorganisms, tissue cultures, Specific Non-Drug Active
Collection etc.), related biological materials and associated data. Code
American Type Culture Collection, 12301 Parklawn Dr,
Rockville MD, 20852. (301) 881-2600. http://www.atcc.org
C4 CPT-4 American Medical Association, P.O. Box 10946, Chicago Specific Non-Drug Active
IL 60610. Code
C5 CPT-5 (under development – same contact as above) Specific Non-Drug Active
Code
CAS Chemical abstract codes These include unique codes for each unique chemical, Drug code Active
including all generic drugs. The codes do not distinguish
among different dosing forms. When multiple equivalent
CAS numbers exist, use the first one listed in USAN.
USAN 1990 and the USP dictionary of drug names,
William M. Heller, Ph.D., Executive Editor, United States
Pharmacopeial Convention, Inc., 12601 Twinbrook
Parkway, Rockville, MD 20852.
CCC Clinical Care Clinical Care Classification System (formerly Home Active
Classification system Health Care Classification system) codes.
The Clinical Care Classification (CCC) consists of two
terminologies: CCC of Nursing Diagnose
and CCC of Nursing Interventions both of which are
classified by 21 Care Components.
Virginia Saba, EdD, RN; Georgetown University School of
Nursing; Washington, DC.
CD2 CDT-2 Codes American Dental Association’s Current Dental Specific Non-Drug Active
Terminology (CDT-2) code. American Dental Association, Code
211 E. Chicago Avenue,. Chicago, Illinois 60611.
CDCA CDC Analyte Codes As above, for CDCM Active
CDCM CDC Public Health Practice Program Office, Centers for Drug code Active
Methods/Instruments Disease Control and Prevention, 4770 Buford Highway,
Codes Atlanta, GA, 30421. Also available via FTP:
ftp.cdc.gov/pub/laboratory _info/CLIA and
Gopher:
gopher.cdc.gov:70/11/laboratory_info/CLIA
CDS CDC Surveillance CDC Surveillance Codes. For data unique to specific Specific Non-Drug Active
public health surveillance requirements. Epidemiology Code
Program Office, Centers for Disease Control and
Prevention, 1600 Clifton Rd, Atlanta, GA, 30333. (404)
639-3661.
CE CEN ECG diagnostic CEN ECG diagnostic codes – (Obsolete, retained for Specific Non-Drug Active
(obsolete) codes backwards compatibility only. See the entry for the MDC Code
coding system.)
CLP CLIP Simon Leeming, Beth Israel Hospital, Boston MA. Codes Specific Non-Drug Active

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October 2007. Final Standard.
 Chapter 2: Control

for radiology reports. Code

CPTM CPT Modifier Code Available for the AMA at the address listed for CPT Specific Non-Drug Active
above. These codes are found in Appendix A of CPT Code
2000 Standard Edition. (CPT 2000 Standard Edition,
American Medical Association, Chicago, IL).
CST COSTART International coding system for adverse drug reactions. In Drug code Active
the USA, maintained by the FDA, Rockville, MD.
CVX CDC Vaccine Codes National Immunization Program, Centers for Disease Drug code Active
Control and Prevention, 1660 Clifton Road, Atlanta, GA,
30333
DCM DICOM Controlled Codes defined in DICOM Content Mapping Resource. Specific Non-Drug Active
Terminology Digital Imaging and Communications in Medicine Code
(DICOM). NEMA Publication PS-3.16 National Electrical
Manufacturers Association (NEMA). Rosslyn, VA, 22209.
Available at: http://medical.nema.org
E EUCLIDES Available from Euclides Foundation International nv, Specific Non-Drug Active
Excelsiorlaan 4A, B-1930 Zaventem, Belgium; Phone: 32 Code
2 720 90 60.
E5 Euclides quantity codes Available from Euclides Foundation International nv (see Specific Non-Drug Active
above) Code
E6 Euclides Lab method Available from Euclides Foundation International nv, Specific Non-Drug Active
codes Excelsiorlaan 4A, B-1930 Zaventem, Belgium; Phone: 32 Code
2 720 90 60.
E7 Euclides Lab equipment Available from Euclides Foundation International nv (see Specific Non-Drug Active
codes above) Code
ENZC Enzyme Codes Enzyme Committee of the International Union of Specific Non-Drug Active
Biochemistry and Molecular Biology. Enzyme Code
Nomenclature: Recommendations on the Nomenclature
and Classification of Enzyme-Catalysed Reactions.
London: Academic Press, 1992.
FDDC First DataBank Drug National Drug Data File. Proprietary product of First Drug code Active
Codes DataBank, Inc. (800) 633-3453, or
http://www.firstdatabank.com.
FDDX First DataBank Used for drug-diagnosis interaction checking. Proprietary Drug code Active
Diagnostic Codes product of First DataBank, Inc. As above for FDDC.
FDK FDA K10 Dept. of Health & Human Services, Food & Drug Specific Non-Drug Active
Administration, Rockville, MD 20857. (device & analyte Code
process codes).
GDRG2004 G-DRG German DRG German Handbook for DRGs 2004. Deprecated
Codes v2004
GDRG2005 G-DRG German DRG German Handbook for DRGs 2005. Deprecated
Codes v2005
GDRG2006 G-DRG German DRG German Handbook for DRGs 2006. Active
Codes v2006
GDRG2007 G-DRG German DRG German Handbook for DRGs 2007. New
Codes v2007
GDRG2008 G-DRG German DRG German Handbook for DRGs 2008. New
Codes v2008
GMDC2004 German Major German Major Diagnostic Codes version 2004. Deprecated
Diagnostic Codes v2004
GMDC2005 German Major German Major Diagnostic Codes version 2005. Deprecated
Diagnostic Codes v2005
GMDC2006 German Major German Major Diagnostic Codes version 2006. Active
Diagnostic Codes v2006
GMDC2007 German Major German Major Diagnostic Codes version 2007. New
Diagnostic Codes v2007
GMDC2008 German Major German Major Diagnostic Codes version 2008. New
Diagnostic Codes v2008
HB HIBCC Health Industry Business Communications Council, 5110 Specific Non-Drug Active
th
N. 40 St., Ste 120, Phoenix, AZ 85018. Code
HCPCS CMS (formerly HCFA) HCPCS: contains codes for medical equipment, injectable Specific Non-Drug Active
Common Procedure drugs, transportation services, and other services not Code

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Final Standard. October 2007.
Chapter 2: Control

Coding System found in CPT4.

http://www.cms.hhs.gov/MedHCPCSGenInfo/
HCPT Health Care Provider The Blue Cross and Blue Shield Association will act as Specific Non-Drug Active
Taxonomy the administrator of the Provider Taxonomy so that the Code
code structure is classified as external to X12. Ongoing
maintenance is solely the responsibility of Workgroup 15
(Provider Information) within ANSI ASC X12N, or the
work group’s successor. Blue Cross and Blue Shield
Association, 225 North Michigan Avenue, Chicago, IL
60601, Attention: ITS Department, ECNS Unit.
http://www.wpc-edi.com/taxonomy/

Primary distribution is the responsibility of Washington

Publishing Company, through its World Wide Web Site, at
the same web site.
HHC Home Health Care Home Health Care Classification System; Virginia Saba, Specific Non-Drug Active
EdD, RN; Georgetown University School of Nursing; Code
Washington, DC.
Superceded by 'CCC' (see above); this entry is retained
for backward-compatibility.
HI Health Outcomes Health Outcomes Institute codes for outcome variables Specific Non-Drug Active
available (with responses) from Stratis Health (formerly Code
Foundation for Health Care Evaluation and Health
Outcomes Institute), 2901 Metro Drive, Suite 400,
Bloomington, MN, 55425-1525; (612) 854-3306 (voice);
(612) 853-8503 (fax); [email protected]. See
examples in the Implementation Guide.
HL7nnnn HL7 Defined Codes Health Level Seven where nnnn is the HL7 table number General code Active
where nnnn is the HL7
table number
HOT Japanese Nationwide Active
Medicine Code
HPC CMS (formerly HCFA Health Care Financing Administration (HCFA) Common Specific Non-Drug Active
)Procedure Codes Procedure Coding System (HCPCS) including Code
7
(HCPCS) modifiers.[1]
I10 ICD-10 World Health Publications, Albany, NY. Specific Non-Drug Active
Code
I10P ICD-10 Procedure Procedure Coding System (ICD-10-PCS.) See Specific Non-Drug Active
Codes http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/0 Code
8_ICD10.asp for more information.
I9 ICD9 World Health Publications, Albany, NY. Specific Non-Drug Active
Code
I9C ICD-9CM International Classification Of Diseases-9-CM, (1979) Specific Non-Drug Active
Commission on Professional and Hospital Activities, 1968 Code
Green Road, Ann Arbor, MI 48105 (includes all
procedures and diagnostic tests).
I9CDX ICD-9CM Diagnosis Indicates codes from ICD-9-CM drawn from Volumes 1 Active
codes and 2, which cover diagnosis codes only.
I9CP ICD-9CM Procedure Indicates codes from ICD-9-CM drawn from Volume 3, Active
codes which covers procedure codes only.
IBT ISBT Retained for backward compatibility only as of v 2.5. This Specific Non-Drug Active
code value has been superceded by IBTnnnn. Code

International Society of Blood Transfusion. Blood Group

7 The HCPCS code is divided into three "levels." Level I includes the entire CPT-4 code by reference. Level II includes the American Dental
Association’s Current Dental Terminology (CDT-2) code by reference. Level II also includes the genuine HCPCS codes, approved and
maintained jointly by the Alpha-Numeric Editorial Panel, consisting of CMS, the Health Insurance Association of America, and the Blue
Cross and Blue Shield Association. Level III are codes developed locally by Medicare carriers. The HCPCS modifiers are divided into the
same three levels, I being CPT-4 modifiers, II CDT-2 and genuine HCPCS modifiers, and III being locally agreed modifiers.

The genuine HCPCS codes and modifiers of level II can be found at http://www.cms.hhs.gov/MedHCPCSGenInfo/. CMS distributes the
HCPCS codes via the National Technical Information Service (NTIS, www.ntis.gov) and NTIS distribution includes the CDT-2 part of
HCPCS Level II, but does not include the CPT-4 part (Level I). CMS may distribute the CPT-4 part to its contractors.
Page 90 Health Level Seven, Version 2.6 © 2007. All rights reserved.
October 2007. Final Standard.
 Chapter 2: Control

Terminology 1990. VOX Sanquines 1990 58(2):152-169.

IBTnnnn ISBT 128 codes where International Society of Blood Transfusion. (specific Specific Non-Drug Active
nnnn specifies a contact information will be supplied to editor.) Code
specific table within
ISBT 128. The variable suffix (nnnn) identifies a specific table within
ISBT 128.
I10G2004 ICD 10 Germany v2004 ICD German modification for 2004. Deprecated
I10G2005 ICD 10 Germany v2005 ICD German modification for 2005. Deprecated
I10G2006 ICD 10 Germany v2006 ICD German modification for 2006. Active
ICD10GM2 ICD 10 Germany v2007 ICD German modification for 2007. New
007
ICD10GM2 ICD 10 Germany v2008 ICD German modification for 2008. New
008
ICD10AM ICD-10 Australian Active
modification
ICD10CA ICD-10 Canada Active
ICDO International International Classification of Diseases for Oncology, 2nd Specific Non-Drug Active
Classification of Edition. World Health Organization: Geneva, Switzerland, Code
Diseases for Oncology 1990. Order from: College of American Pathologists, 325
Waukegan Road, Northfield, IL, 60093-2750. (847) 446-
8800.
ICS ICCS Commission on Professional and Hospital Activities, 1968 Specific Non-Drug Active
Green Road, Ann Arbor, MI 48105. Code
ICSD International International Classification of Sleep Disorders Diagnostic Specific Non-Drug Active
Classification of Sleep and Coding Manual, 1990, available from American Sleep Code
Disorders Disorders Association, 604 Second Street SW,
Rochester, MN 55902
ISOnnnn ISO Defined Codes International Standards Organization where nnnn is the General code Active
where nnnn is the ISO ISO table number
table number
ISO+ ISO 2955.83 (units of See chapter 7, section 7.4.2.6 Active
measure) with HL7
extensions
ITIS Integrated Taxonomic Source= www.itis.usda.gov. This is a taxonomic hierarchy Active
Information System for living organisms.
IUPP IUPAC/IFCC Property International Union of Pure and Applied Specific Non-Drug Active
Codes Chemistry/International Federation of Clinical Chemistry. Code
The Silver Book: Compendium of terminology and
nomenclature of properties in clinical laboratory sciences.
Oxford: Blackwell Scientific Publishers, 1995. Henrik
Olesen, M.D., D.M.Sc., Chairperson, Department of
Clinical Chemistry, KK76.4.2, Rigshospitalet, University
Hospital of Copenhagen, DK-2200, Copenhagen.
http://inet.uni-c.dk/~qukb7642/
IUPC IUPAC/IFCC Codes used by IUPAC/IFF to identify the component Specific Non-Drug Active
Component Codes (analyte) measured. Contact Henrik Olesen, as above for Code
IUPP.
JC8 Japanese Chemistry Clinical examination classification code. Japan withdrawn Active
Association of Clinical Pathology. Version 8, 1990. A
multiaxial code including a subject code (e.g., Rubella =
5f395, identification code (e.g., virus ab IGG), a specimen
code (e.g., serum =023) and a method code (e.g., ELISA
= 022)
JC10 JLAC/JSLM, nationwide Source: Classification &Coding for Clinical Laboratory. Active
laboratory code Japanese Society of Laboratory Medicine(JSLM,
Old:Japan Society of Clinical Pathology). Version 10,
1997. A multiaxial code including a analyte code (e.g.,
Rubella = 5f395), identification code (e.g., virus ab
IGG=1431), a specimen code (e.g., serum =023) and a
method code (e.g., ELISA = 022)
JJ1017 Japanese Image Active

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Examination Cache
LB Local billing code Local billing codes/names (with extensions if needed). General code Active
th
LN Logical Observation Regenstrief Institute, c/o LOINC, 1050 Wishard Blvd., 5 Specific Non-Drug Active
Identifier Names and floor, Indianapolis, IN 46202. 317/630-7433. Available Code
Codes (LOINC®) from the Regenstrief Institute server at
http://www.Regenstrief.org/loinc/loinc.htm.
Also available via HL7 file server: FTP/Gopher
(www.mcis.duke.edu/standards/termcode/loinc
lab and
www.mcis.duke.edu/standards/termcode/loinc
lin) and World Wide Web
(http://www.mcis.duke.edu/standards/termcod
e/loincl.htm). January 2000 version has identifiers,
synonyms and cross-reference codes for reporting over
26,000 laboratory and related observations and 1,500
clinical measures.
MCD Medicaid Medicaid billing codes/names. Specific Non-Drug Active
Code
MCR Medicare Medicare billing codes/names. Specific Non-Drug Active
Code
MDC Medical Device EN ISO/IEEE 11073-10101 Health informatics – Point-of- Specific Non-Drug Active
Communication care medical device communication - Nomenclature Code
MDDX Medispan Diagnostic Codes Used for drug-diagnosis interaction checking. Drug code Active
Codes Proprietary product. Hierarchical drug codes for
identifying drugs down to manufacturer and pill size.
MediSpan, Inc., 8425 Woodfield Crossing Boulevard,
Indianapolis, IN 46240. Tel: (800) 428-4495. URL:
http://www.medispan.com/Products/index.aspx?cat=1. As
above for MGPI.
MEDC Medical Economics Drug Proprietary Codes for identifying drugs. Proprietary Drug code Active
Codes product of Medical Economics Data, Inc. (800) 223-0581.
MEDR Medical Dictionary for Patrick Revelle, Director MSSO Drug code Active
Drug Regulatory Affairs 12011 Sunset Hills Road, VAR1/7B52
(MEDDRA) Reston, VA 20190
[email protected]
http://www.meddramsso.com/MSSOWeb/index.htm

MEDX Medical Economics Used for drug-diagnosis interaction checking. Proprietary Drug code Active
Diagnostic Codes product of Medical Economics Data, Inc. (800) 223-0581.
MGPI Medispan GPI Medispan hierarchical drug codes for identifying drugs Drug code Active
down to manufacturer and pill size. Proprietary product of
MediSpan, Inc., 8425 Woodfield Crossing Boulevard,
Indianapolis, IN 46240. Tel: (800) 428-4495.
MVX CDC Vaccine As above, for CVX Drug code Active
Manufacturer Codes
NCPDPnnn NCPDP code list for NCPDP maintain code list associated with the specified Active
nsss data element nnnn [as Data Element (nnnn) and Segment (sss). The Segment
used in segment sss] portion is optional if there is no specialization of the Data
Element codes between segments.
Examples:
NCPDP1131RES = code set defined for NCPDP data
element 1131 as used in the RES segment (Code List
Qualifier – Response Code)
NCPDP1131STS = code set defined for NCPDP data
element 1131 as used in the STS segment (Code List
Qualifier – Reject Code)
NCPDP9701 = code set defined for NCPDP data
element 9701 (Individual Relationship, Coded). No
specialization to a segment exists for this data element.

National Council for Prescription Drug Programs, 924Ø

ast Raintree Drive, Scottsdale, AZ 8526Ø.

Phone: (48Ø) 477-1ØØØ

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October 2007. Final Standard.
 Chapter 2: Control

Fax: (48Ø) 767-1Ø42

e-mail: [email protected]
www.ncpdp.org

NDA NANDA North American Nursing Diagnosis Association, Specific Non-Drug Active
Philadelphia, PA. Code
NDC National drug codes These provide unique codes for each distinct drug, dosing Drug code Active
form, manufacturer, and packaging. (Available from the
National Drug Code Directory, FDA, Rockville, MD, and
other sources.)
NIC Nursing Interventions Iowa Intervention Project, College of Nursing, University Specific Non-Drug Active
Classification of Iowa, Iowa City, Iowa Code
NPI National Provider Health Care Finance Administration, US Dept. of Health Specific Non-Drug Active
Identifier and Human Services, 7500 Security Blvd., Baltimore, MD Code
21244.
NUBC National Uniform Billing Active
Committee Code
OHA Omaha System Omaha Visiting Nurse Association, Omaha, NB. Specific Non-Drug Active
Code
OHA Omaha Omaha Visiting Nurse Association, Omaha, NB. Specific Non-Drug Active
Code
O301 German Procedure Source: OPS Operationen- und Prozedurenschluessel. Deprecated
Codes
O3012004 OPS Germany v2004 Source: OPS Operationen- und Prozedurenschluessel Deprecated
2004.
O3012005 OPS Germany v2005 Source: OPS Operationen- und Prozedurenschluessel Deprecated
2005.
O3012006 OPS Germany v2006 Source: OPS Operationen- und Prozedurenschluessel Active
2006.
OPS2007 OPS Germany v2007 Source: OPS Operationen- und Prozedurenschluessel New
2007.
OPS2008 OPS Germany v2008 Source: OPS Operationen- und Prozedurenschluessel New
2008.
POS POS Codes HCFA Place of Service Codes for Professional Claims Specific Non-Drug Active
(see http://www.cms.hhs.gov/PlaceofServiceCodes/). Code

RC Read Classification The Read Clinical Classification of Medicine, Park View Specific Non-Drug Active
Surgery, 26 Leicester Rd., Loughborough LE11 2AG Code
(includes drug procedure and other codes, as well as
diagnostic codes).
SCT SNOMED Clinical Terms SNOMED-CT concept identifier codes. Specific Non-Drug Active
SNOMED International, I325 Waukegan Rd, Northfield, Code
IL, 60093, +1 800-323-4040, mailto:[email protected]
http://www.snomed.org
SCT2 SNOMED Clinical Terms Used to indicate that the code value is the legacy-style Active
alphanumeric codes SNOMED alphanumeric codes, rather than the concept
identifier codes.
SNOMED International, I325 Waukegan Rd, Northfield,
IL, 60093, +1 800-323-4040, mailto:[email protected]
http://www.snomed.org
SDM SNOMED- DICOM College of American Pathologists, Skokie, IL, 60077- Specific Non-Drug Active
Microglossary 1034. (formerly designated as 99SDM). Code
nd
SNM Systemized Systemized Nomenclature of Medicine, 2 Edition 1984 Specific Non-Drug Active

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Chapter 2: Control

Nomenclature of Vols 1, 2, College of American Pathologists, Skokie, IL. Code

Medicine (SNOMED)
SNM3 SNOMED International SNOMED International, 1993 Vols 1-4, College of Specific Non-Drug Active
American Pathologists, Skokie, IL, 60077-1034. Code
SNT SNOMED topology College of American Pathologists, 5202 Old Orchard Specific Non-Drug Active
codes (anatomic sites) Road, Skokie, IL 60077-1034. Code
UB04FL14 Priority (Type) of Visit Source: Official UB-04 Data Specification Manual, Active
published July 2007, by the National Uniform Billing
Committee (NUBC), and can be found at
http://www.nubc.org. This coding system supersedes
UB92 and is effective immediately (July, 2007).
UB04FL15 Point of Origin Source: Official UB-04 Data Specification Manual, Active
published July 2007, by the National Uniform Billing
Committee (NUBC), and can be found at
http://www.nubc.org. This coding system supersedes
UB92 and is effective immediately (July, 2007).
UB04FL17 Patient Discharge Status Source: Official UB-04 Data Specification Manual, Active
published July 2007, by the National Uniform Billing
Committee (NUBC), and can be found at
http://www.nubc.org. This coding system supersedes
UB92 and is effective immediately (July, 2007).
UC UCDS Uniform Clinical Data Systems. Ms. Michael McMullan, Specific Non-Drug Active
Office of Peer Review Health Care Finance Code
Administration, The Meadows East Bldg., 6325 Security
Blvd., Baltimore, MD 21207; (301) 966 6851.
UCUM UCUM code set for units Added by motion of VOCABULARY T.C. 20060308 14-0- Active
of measure(from 3
Regenstrief)
UMD MDNS Universal Medical Device Nomenclature System. ECRI, Device code Active
5200 Butler Pike, Plymouth Meeting, PA 19462 USA.
Phone: 215-825-6000, Fax: 215-834-1275.
UML Unified Medical National Library of Medicine, 8600 Rockville Pike, Specific Non-Drug Active
Language Bethesda, MD 20894. Code
UPC Universal Product Code The Uniform Code Council. 8163 Old Yankee Road, Suite Specific Non-Drug Active
J, Dayton, OH 45458; (513) 435 3070 Code
UPIN UPIN Medicare/CMS 's (formerly HCFA) universal physician Specific Non-Drug Active
identification numbers, available from Health Care Code
Financing Administration, U.S. Dept. of Health and
Human Services, Bureau of Program Operations, 6325
Security Blvd., Meadows East Bldg., Room 300,
Baltimore, MD 21207
USPS United States Postal Two Letter State and Possession Abbreviations are listed Specific Non-Drug Active
Service in Publication 28, Postal Addressing Standards which Code
can be obtained from Address Information Products,
National Address Information Center, 6060 Primacy
Parkway, Suite 101, Memphis, Tennessee 38188-0001

Questions of comments regarding the publication should

be addressed to the Office of Address and Customer
Information Systems, Customer and Automation Service
Department, US Postal Service, 475 Lenfant Plaza SW
Rm 7801, Washington, DC 20260-5902
W1 WHO record # drug World Health organization record number code. A unique Drug code Active
codes (6 digit) sequential number is assigned to each unique single
component drug and to each multi-component drug. Eight
digits are allotted to each such code, six to identify the
active agent, and 2 to identify the salt, of single content
drugs. Six digits are assigned to each unique combination
of drugs in a dispensing unit. The six digit code is
identified by W1, the 8 digit code by W2.
W2 WHO record # drug World Health organization record number code. A unique Drug code Active
codes (8 digit) sequential number is assigned to each unique single
component drug and to each multi-component drug. Eight
digits are allotted to each such code, six to identify the
active agent, and 2 to identify the salt, of single content
drugs. Six digits are assigned to each unique combination

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 Chapter 2: Control

of drugs in a dispensing unit. The six digit code is

identified by W1, the 8 digit code by W2.

W4 WHO record # code with With ASTM extensions (see Implementation Guide), the Drug code Active
ASTM extension WHO codes can be used to report serum (and other)
levels, patient compliance with drug usage instructions,
average daily doses and more (see Appendix X1 the
Implementation Guide).
WC WHO ATC WHO’s ATC codes provide a hierarchical classification of Drug code Active
drugs by therapeutic class. They are linked to the record
number codes listed above.
X12DEnnnn ASC X12 Code List Code list associated with X12 Data Element nnnn. General Codes Active
nnnn Example::
X12DE738 – code set defined for X12 data element 738
(Measurement Qualifier)

The Accredited Standards Committee (ASC) X12

http://www.x12.org

2.16.5 Yes/no indicator table (0136)

The actual interpretation of Yes/No is context sensitive. Individual chapters will further refine the meaning
of Yes/No in their specific context.

HL7 Table 0136 - Yes/no indicator

Value Description Comment
Y Yes
N No

2.16.6 Expanded yes/no indicator table (0532)

This table expands on the original Yes/no indicator table by including "flavors of null". It is intended to be
applied to fields where the response is not limited to "yes" or "no".
Use Case: A reporting facility/person has little or no information on a particular event or outcome and these
are reported as unknown for public health reporting purposes.

HL7 Table 0532 – Expanded yes/no indicator

Value Description Comment
Y Yes
N No
NI No Information No information whatsoever can be inferred from this exceptional value. This is
the most general exceptional value. It is also the default exceptional value
NA not applicable No proper value is applicable in this context (e.g., last menstrual period for a
male)
UNK unknown A proper value is applicable, but not known
NASK not asked This information has not been sought (e.g., patient was not asked
ASKU asked but unknown Information was sought but not found (e.g., patient was asked but didn't know
NAV temporarily unavailable Information is not available at this time but it is expected that it will be available
later
NP not present Value is not present in a message. This is only defined in messages, never in
application data! All values not present in the message must be replaced by
the applicable default, or no-information (NI) as the default of all defaults

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Chapter 2: Control

2.17 SAMPLE CONTROL MESSAGES

2.17.1 General acknowledgment
LAB acknowledges the message that ADT sent identified as ZZ9380. (LAB and ADT, the sending and
receiving system IDs, are site-defined.) Both systems are associated with the same FACILITY, 767543. The
AA code in the MSA segment indicates that the message was accepted by the application.
MSH|^~\&|LAB|767543|ADT|767543|19900314130405||ACK^A08^ACK |XX3657|P|2.5<cr>
MSA|AA|ZZ9380<cr>

2.17.2 General acknowledgement, error return

The AR code in MSA indicates that the application rejected the message for functional reasons. The
optional ERR segment includes here that the 16th field of the PID segment with the SET ID value of 1 had
an error which was defined by the locally-established code X3L. The optional text message UNKNOWN
COUNTY CODE in the link is designed to help programmers and support personnel while reviewing
message logs.
MSH|^~\&|LAB|767543|ADT|767543|199003141304-0500||ACK^A08^ACK |XX3657|P|2.5<cr>
MSA|AR|ZZ9380| <cr>
ERR| |PID^1^11^^9|103|E<cr>

2.17.3 Message using sequence number: protocol

The sender initiates the link with a message that has no functional content. The sequence number is 0. The
message type and event code are not used.
MSH|^~\&|ADT|767543|LAB|767543|199003141304-
0500||ADT^A08^ADT_A01|XX3657|P|2.5|0<cr>
The responder uses a general acknowledgment. The expected sequence number is 1.
MSH|^~\&|LAB|767543|ADT|767543|199003141304-0500||ACK^A08^ACK |ZZ9380|P|2.5<cr>
MSA|AA|XX3657||1<cr>
See section 2.10.1, "Sequence number protocol" for further detail.

2.17.4 Message fragmentation

This summarizes the methodology for splitting a single logical HL7 message among two or more actual
HL7 messages. The actual specifications for this, the segment definitions of the ADD and DSC segments,
and examples are in Section 2.10.2, "Continuation messages and segments".
Continuing of messages is a generic methodology that can be used for all HL7 message types. It can be
used to split based on segment boundaries, on field boundaries, and to split a single field among several
messages. It utilizes two specific segments, ADD and DSC, as well as a field in the message header, MSH-
14-Continuation pointer.
When a message is continued, a unique continuation value is used. This same value will appear in MSH-14
and DSC-1 as appropriate for a single pair of messages. This allows messages to be "chained together".
Here are two examples of ways to create continuation pointers for fragmented messages. The only absolute
requirement is that when the sending application values the continuation pointer, the receiving application
can appropriately reconstruct the message.
Sitecode-interfaceapplicationcode-date-sequentialcounterwithindate
This will guarantee uniqueness of this field.
e.g., BWH-LDS-19990331-27 for the 27th large message to be created on March 31, within the Discharge
Summary interfaces at BWH
An alternative method of valuing the continuation pointer:
Sitecode-interfaceapplicationcode-medicalrecordnumber-datetime

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 Chapter 2: Control

e.g.. MGH-PCIS-1234567-19980331121314 for a message created on March 31, at 12:13:14pm for

patient medical record number 1234567, within the PCIS interfaces at MGH
Sending Application Note: In the ADD segment, a trailing field delimiter, i.e., the vertical bar character,
after the final field, has explicit meaning. The sending application should not include a trailing field
delimiter for the last field in the ADD segment unless it has completely valued the entire field from the
message being continued.
Receiving Application Note: The receiving application will need to be concerned with a single segment and
a single field being continued.
Receiving a message with an empty ADD segment followed by a DSC segment is the notification that the
segment preceding the ADD is being continued in a subsequent message. Note that the continuing message
may not be the next one received! The receiver must match up the continuation pointer value from MSH-
14 of subsequent messages to the DSC-1 continuation pointer value of the prior message. Also if the
continuing message contains an ADD segment, the receiver should continue appending to the fields from
the segment being continued with values from the ADD segment. For example, if OBX-5 is being
continued, the continuation will appear in ADD-1 of the continuing message. If there were a value for
OBX-13 of the original message, that would appear in ADD-9 of the continuing message, assuming that the
remainder of the OBX segment fit into the single ADD segment.
Question: if continuing a message after the completion of a complete segment, should the continuing
message have an empty ADD segment or not? Answer: No. This means that a continuing message need not
have an ADD segment, if the continued message was split on a segment boundary.
Notation conventions: items within angle brackets are comments and not intended to represent a portion of
an actual message. For example, <this is a comment>.
Note the multiple continuation pointer values, one for each pair of physical messages.
Message 1
MSH|...|<field-13>||...
PID|...
ORC|...
OBR|...
OBX|1|FT|^Discharge Summary|1|This is the first sentence of a long
message. This is the second sentence of a long message.
<snip>
This is the 967th sentence of "
ADD|
DSC|BWH-LDS-19990405-6|
Message 2
MSH|...|<field-13>|BWH-LDS-19990405-6|
ADD|a long message. This is the 968th sentence of a long message.
<snip>
This is the 1001st line of
<there should be no trailing field delimiter after the last field in this ADD
segment>
DSC|BWH-LDS-19990405-7|
Message 3
MSH|...|<field-13>|BWH-LDS-19990405-7|
ADD|a long message. This is the 1002nd sentence of a long message. <snip> This is
the final sentence of this long message!|||||F||199707211325|
DG1|...
<end of message>
The following examples discuss an unsolicited transmission of an observation message, ORU^R01.
The expected result values in OBX-5, Observation Value, for reports (e.g., autopsy, pathology) may exceed
the message length restrictions of one or more interfaces.
Thus the OBX-5, Observation Value data element will be split into more than one message.
Here's an example intended to illustrate the interpretation of Chapter 2 and 7. It reflects a single logical
message broken up into three distinct messages.

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Example 1, a single field being split across three messages

Message #1: ---------------------------------------------------------------
Note: MSH-14, continuation pointer, is empty.
MSH|...|<field-13>||...
PID|...
ORC|...
OBR|...
OBX|1|FT|^Discharge Summary|1|This is the first sentence of a long
message. This is the second sentence of a long message.
<snip>
This is the 967th sentence of "
ADD|
DSC|<continuation-pointer-value-1>|F

Message #2: --------------------------------------------------------------

Note: MSH-14, continuation pointer, is valued with the same value as in DSC-1,
continuation pointer from the message this is continuing, in this case
Message #1.

MSH|...|<field-13>|<continuation-pointer-value-1>|
ADD|a long message. This is the 968th sentence of a long message.
<snip>
This is the 1001st line of
<there should be no trailing field delimiter after the last field in this ADD
segment>
DSC|<continuation-pointer-value-2>|F

Message #3: ---------------------------------------------------------------

Note: MSH-14, continuation pointer, is valued with the same value as in DSC-1,
continuation pointer from the message this is continuing, in this case
Message #1.

MSH|...|<field-13>|<continuation-pointer-value-2>|
ADD|a long message. This is the 1002nd sentence of a long message. <snip> This is
the final sentence of this long message!|||||F||199707211325|

<remaining segments after the big OBX from the original message go here, after
the ADD segment>

PR1|...
DG1|...

Example 2, a single message being split across two messages, but on segment boundaries
Message #1: ---------------------------------------------------------------
Note: MSH-14, continuation pointer, is empty.

MSH|...|<field-13>||...
PID|...
ORC|...
OBR|...
OBX|1|FT|^Discharge Summary|1|This is the first sentence of a long
message. This is the final sentence of this long discharge
summary!|||||F||199707211325|
DSC|<continuation-pointer-value-3>|F

Message #2: --------------------------------------------------------------

Note: MSH-14, continuation pointer, is valued with the same value as in DSC-1, continuation pointer from the
message this is continuing, in this case Message #1.
Note that no ADD segment is necessary, since a segment is not being split across two messages.

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 Chapter 2: Control

MSH|...|<field-13>|<continuation-pointer-value-3>|
PR1|...
DG1|...

2.17.5 Acknowledgement message using original mode processing

This example shows the lab system using the Master Files specification to send two update test dictionary
entries to an ICU system.
Initiating Message:
MSH|^~\&|LABxxx|ClinLAB|ICU||19910918060544||MFN^M03^MFN_M03|MSGID002|P|2.5
MFI|LABxxx^Lab Test Dictionary^L|UPD|||AL
MFE|MUP|199109051000|199110010000|12345^WBC^L
OM1|...
MFE|MUP|199109051015|199110010000|6789^RBC^L
OM1|...
Response Message: Original mode acknowledgment of the HL7 message according to MFI Response Level
Code of AL.
MSH|^~\&|ICU||LABxxx|ClinLAB|19910918060545||MFK^M03^MFK_M01|MSGID99002|P|2.5
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

2.17.6 Acknowledgement message using enhanced mode processing

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

2.18 OUTSTANDING ISSUES

The following items are being discussed in the Control/Query technical committee for addition
to future versions of HL7:
1) Rationalization and clarification of event structures.
2) Creation of a network server for HL7 tables so that updates to them can be made public
immediately, rather than waiting until the publication of the next version of the Standard.
3) Reviewing network application management messages for possible upgrade requirements.
4) Conformance Based Queries use of the Message Profiles. Current status of this can be found
on the Conformance SIG web site (http://www.hl7.org).
U U

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