HL7 - REFACTORED

Chapter Chair:	Kathleen Connor Book Zurman Incorporated
Chapter Chair:	Paul Knapp Knapp Consulting, Inc.
Chapter Chair	Mary Kay Mc Daniel Markam Cognosante
Chapter Chair	Benoit Schoeffler almerys
Sponsoring TC:	Financial Management
List Server	fm@lists.hl7.org

PURPOSE

The Finance chapter describes patient accounting transactions. Other financial transactions may be added in the future. Financial transactions can be sent between applications either in batches or online. As defined in Chapter 2 on batch segments, multiple transactions may be grouped and sent through all file transfer media or programs when using the HL7 Encoding Rules.

This chapter defines the transactions that take place at the seventh level, that is, the abstract messages. The examples included in this chapter were constructed using the HL7 Encoding Rules.

PATIENT ACCOUNTING MESSAGE SET

The patient accounting message set provides for the entry and manipulation of information on billing accounts, charges, payments, adjustments, insurance, and other related patient billing and accounts receivable information.

This Standard includes all of the data defined in the National Uniform Billing Field Specifications. We have excluded state-specific coding and suggest that, where required, it be implemented in site-specific "Z" segments. State-specific fields may be included in the Standard at a later time. In addition, no attempt has been made to define data that have traditionally been required for the financial responsibility ("proration") of charges. This requirement is unique to a billing system and not a part of an interface.

We recognize that a wide variety of billing and accounts receivable systems exist today. Therefore, in an effort to accommodate the needs of the most comprehensive systems, we have defined an extensive set of transaction segments.

TRIGGER EVENTS AND MESSAGE DEFINITIONS

The triggering events that follow are served by Detail Financial Transaction (DFT), Add/Change Billing Account (BAR), and General Acknowledgment (ACK) messages.

Each trigger event is documented below, along with the applicable form of the message exchange. The notation used to describe the sequence, optionality, and repetition of segments is described in Chapter 2, "Format for Defining Abstract Messages."

BAR/ACK - Add Patient Account (Event P01)

Data are sent from some application (usually a Registration or an ADT system, for example) to the patient accounting or financial system to establish an account for a patient's billing/accounts receivable record. Many of the segments associated with this event are optional. This optionality allows those systems needing these fields to set up transactions that fulfill their requirements and yet satisfy the HL7 requirements.

When an account's start and end dates span a period greater than any particular visit, the P01 (add account) event should be used to transmit the opening of an account. The A01 (admit/visit notification) event can notify systems of the creation of an account as well as notify them of a patient's arrival in the healthcare facility. In order to create a new account without notifying systems of a patient's arrival, use the P01 trigger event.

From Standard Version 2.3 onward, the P01 event should only be used to add a new account that did not exist before, not to update an existing account. The new P05 (update account) event should be used to update an existing account. The new P06 (end account) event should be used to close an account. With the P01 event, EVN-2 - Recorded Date/Time should contain the account start date.

The error segment will indicate the fields that caused a transaction to be rejected.

BAR^P01^BAR_P01: Add Billing Account

HL7 MessageStructure Table - BAR_P01
Segment	Cardinality	Must Implement	Status
BAR_P01
MSH	1..1	Yes	additional
SFT	0..*		additional
UAC	0..1		additional
EVN	1..1	Yes	additional
PID	1..1	Yes	additional
PD1	0..1		additional
PRT	0..*		additional
ROL	0..*		B
VISIT	1..*	Yes	additional
PV1	1..1	Yes	additional
PV2	0..1		additional
PRT	0..*		additional
ROL	0..*		B
DB1	0..*		additional
OBX	0..*		additional
PRT	0..*		additional
AL1	0..*		additional
DRG	0..1		additional
GT1	0..*		additional
NK1	0..*		additional
ACC	0..1		additional
UB1	0..1		B
UB2	0..1		additional
DIAGNOSIS	0..*		additional
DG1	1..1	Yes	additional
PROCEDURE	0..*		additional
PR1	1..1	Yes	additional
PRT	0..*		additional
ROL	0..*		B
INSURANCE	0..*		additional
IN1	1..1	Yes	additional
IN2	0..1		additional
IN3	0..*		additional
PRT	0..*		additional
ROL	0..*		B

Original Mode Acknowledgement Choreography for BAR^P01^BAR_P01

Send Application Ack: ACK^P01^ACK

Enhanced Mode Acknowledgement Choreography for BAR^P01^BAR_P01

When the MSH-15 value of a BAR^P01^BAR_P01 message is AL or ER or SU, an ACK^P01^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a BAR^P01^BAR_P01 message is NE or AL or ER or SU, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a BAR^P01^BAR_P01 message is AL or ER or SU, an ACK^P01^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a BAR^P01^BAR_P01 message is NE or AL or ER or SU, an application ack SHALL NOT be sent.

Field	Value	Send Response
MSH-15	AL, ER, SU	immediate ack: ACK^P01^ACK
MSH-15	NE, AL, ER, SU	(none)
MSH-16	AL, ER, SU	application ack: ACK^P01^ACK
MSH-16	NE, AL, ER, SU	(none)

<?xml version="1.0"?>
<!--   v2.xml Message Definitions for Version 2.8.2 - here: BAR_P01-->
<!--   Copyright (c) 1999-2019, Health Level Seven. All rights reserved.   -->
<!--   (generated on 09.01.2019 by HL7-Database) D:\Eigene Dateien\HL7\Datenbank\hl7_94.mdb-->
<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema"
xmlns="urn:hl7-org:v2xml" xmlns:hl7="urn:hl7-org:v2xml"
targetNamespace="urn:hl7-org:v2xml" version="1.1">
  <!-- import segment definition for version -->
  <xsd:include schemaLocation="segments.xsd" />
  <!-- MESSAGE BAR_P01 -->
  <!-- .. message definition BAR_P01 -->
  <xsd:complexType name="BAR_P01.CONTENT">
    <xsd:sequence>
      <xsd:element ref="MSH" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="SFT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="UAC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="EVN" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PID" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PD1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="BAR_P01.VISIT" minOccurs="1"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P01" type="BAR_P01.CONTENT" />
  <xsd:complexType name="BAR_P01.VISIT.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PV1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PV2" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DB1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="OBX" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="AL1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DG1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DRG" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="BAR_P01.PROCEDURE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="GT1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="NK1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="BAR_P01.INSURANCE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="ACC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="UB1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="UB2" minOccurs="0" maxOccurs="1" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P01.VISIT" type="BAR_P01.VISIT.CONTENT" />
  <xsd:complexType name="BAR_P01.PROCEDURE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PR1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P01.PROCEDURE"
  type="BAR_P01.PROCEDURE.CONTENT" />
  <xsd:complexType name="BAR_P01.INSURANCE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="IN1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="IN2" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="IN3" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P01.INSURANCE"
  type="BAR_P01.INSURANCE.CONTENT" />
</xsd:schema>

Download

BAR/ACK - Purge Patient Accounts (Event P02)

Generally, the elimination of all billing/accounts receivable records will be an internal function controlled, for example, by the patient accounting or financial system. However, on occasion, there will be a need to correct an account, or a series of accounts, that may require that a notice of account deletion be sent from another sub-system and processed, for example, by the patient accounting or financial system. Although a series of accounts may be purged within this one event, we recommend that only one PID segment be sent per event.

The error segment indicates the fields that caused a transaction to be rejected.

BAR^P02^BAR_P02: Purge Billing Account

HL7 MessageStructure Table - BAR_P02
Segment	Cardinality	Must Implement	Status
BAR_P02
MSH	1..1	Yes	additional
SFT	0..*		additional
UAC	0..1		additional
EVN	1..1	Yes	additional
PATIENT	1..*	Yes	additional
PID	1..1	Yes	additional
PD1	0..1		additional
PRT	0..*		additional
PV1	0..1		additional
DB1	0..*		additional

Original Mode Acknowledgement Choreography for BAR^P02^BAR_P02

Send Application Ack: ACK^P02^ACK

Enhanced Mode Acknowledgement Choreography for BAR^P02^BAR_P02

When the MSH-15 value of a BAR^P02^BAR_P02 message is AL or ER or SU, an ACK^P02^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a BAR^P02^BAR_P02 message is NE or AL or ER or SU, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a BAR^P02^BAR_P02 message is AL or ER or SU, an ACK^P02^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a BAR^P02^BAR_P02 message is NE or AL or ER or SU, an application ack SHALL NOT be sent.

Field	Value	Send Response
MSH-15	AL, ER, SU	immediate ack: ACK^P02^ACK
MSH-15	NE, AL, ER, SU	(none)
MSH-16	AL, ER, SU	application ack: ACK^P02^ACK
MSH-16	NE, AL, ER, SU	(none)

<?xml version="1.0"?>
<!--   v2.xml Message Definitions for Version 2.8.2 - here: BAR_P02-->
<!--   Copyright (c) 1999-2019, Health Level Seven. All rights reserved.   -->
<!--   (generated on 09.01.2019 by HL7-Database) D:\Eigene Dateien\HL7\Datenbank\hl7_94.mdb-->
<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema"
xmlns="urn:hl7-org:v2xml" xmlns:hl7="urn:hl7-org:v2xml"
targetNamespace="urn:hl7-org:v2xml" version="1.1">
  <!-- import segment definition for version -->
  <xsd:include schemaLocation="segments.xsd" />
  <!-- MESSAGE BAR_P02 -->
  <!-- .. message definition BAR_P02 -->
  <xsd:complexType name="BAR_P02.CONTENT">
    <xsd:sequence>
      <xsd:element ref="MSH" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="SFT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="UAC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="EVN" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="BAR_P02.PATIENT" minOccurs="1"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P02" type="BAR_P02.CONTENT" />
  <xsd:complexType name="BAR_P02.PATIENT.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PID" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PD1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PV1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DB1" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P02.PATIENT"
  type="BAR_P02.PATIENT.CONTENT" />
</xsd:schema>

Download

DFT/ACK - Post Detail Financial Transactions (Event P03)

The Detail Financial Transaction (DFT) message is used to describe a financial transaction transmitted between systems, that is, to the billing system for ancillary charges, ADT to billing system for patient deposits, etc.

Use case for Post Detail Financial Transaction with related Order:

This information can originate in many ways. For instance, a detailed financial transaction for an ancillary charge is sent to a billing system that also tracks the transaction(s) in relation to their order via placer order number or wishes to post these transactions with the additional order information. Therefore a service reaches a state where a detailed financial transaction is created and interfaced to other systems along with optional associated order information. If the message contains multiple transactions for the same order, such as a test service and venipuncture charge on the same order, the ordering information is entered in the Order segment construct that precedes the FT1 segments. If a message contains multiple transactions for disparate orders for the same account each FT1 segment construct may contain the order related information specific to that transaction within the message.

If the common order information is sent, the Order Control Code should reflect the current state of the common order and is not intended to initiate any order related triggers on the receiving application. For example if observations are included along with common order information the order control code would indicate 'RE' as observations to follow.

If common order information is sent related to the entire message or a specific financial transaction, the required Order Control Code should reflect the current state of the common order and is not intended to initiate any order related triggers on the receiving application. For example if observations are included along with common order information the order control code would indicate 'RE' as observations to follow.

If order detail information is sent related to the entire message or a specific financial transaction, the required fields for that detail segment must accompany that information.

Note: The ROL segment is optionally included after the PD1 to transmit information for patient level primary care providers, after the PV2 for additional information on the physicians whose information is sent there (i.e., Attending Doctor, Referring Doctor, Consulting Doctor), and within the insurance construct to transmit information for insurance level primary care providers.

Note: There is an information overlap between the FT1, DG1 and PR1 segments. If diagnosis information is sent in an FT1 segment, it should be consistent with the information contained in any DG1 segments present within its hierarchy. Since the procedure code field within the FT1 does not repeat, if procedure information is sent on an FT1 it is recommended that the single occurrence of the code in FT1 equates to the primary procedure (PR1-14 - Procedure Priority code value 1).

Note: The extra set of DG1/DRG/GT1/IN1/IN2/IN3/ROL segments added in V2.4 have been withdrawn as a technical correction

The error segment indicates the fields that caused a transaction to be rejected.

DFT^P03^DFT_P03: Detail Financial Transaction

Message Structure
Acknowlegment Choreography
v2.xml XSD

HL7 MessageStructure Table - DFT_P03
Segment	Cardinality	Must Implement	Status
DFT_P03
MSH	1..1	Yes	additional
SFT	0..*		additional
UAC	0..1		additional
EVN	1..1	Yes	additional
PID	1..1	Yes	additional
PD1	0..1		additional
PRT	0..*		additional
ROL	0..*		B
VISIT	0..1		additional
PV1	0..1		additional
PV2	0..1		additional
PRT	0..*		additional
ROL	0..*		B
DB1	0..*		additional
COMMON_ORDER	0..*		additional
ORC	1..1	Yes	additional
PRT	0..*		additional
TIMING_QUANTITY	0..*		additional
TQ1	1..1	Yes	additional
TQ2	0..*		additional
ORDER	0..1		additional
OBR	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
OBSERVATION	0..*		additional
OBX	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL	1..*	Yes	additional
FT1	1..1	Yes	additional
PRT	0..*		additional
ROL	0..*		B
NTE	0..*		additional
FINANCIAL_PROCEDURE	0..*		additional
PR1	1..1	Yes	additional
PRT	0..*		additional
ROL	0..*		B
FINANCIAL_OBSERVATION_STANDALONE	0..*		additional
OBX	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL_ORDER_STANDALONE	0..*		additional
OBR	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL_OBSERVATION	0..*		additional
OBX	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL_COMMON_ORDER	0..*		additional
ORC	1..1	Yes	additional
PRT	0..*		additional
FINANCIAL_TIMING_QUANTITY	0..*		additional
TQ1	1..1	Yes	additional
TQ2	0..*		additional
FINANCIAL_ORDER	0..1		additional
OBR	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL_OBSERVATION	0..*		additional
OBX	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
DIAGNOSIS	0..*		additional
DG1	1..1	Yes	additional
DRG	0..1		additional
GT1	0..*		additional
INSURANCE	0..*		additional
IN1	1..1	Yes	additional
IN2	0..1		additional
IN3	0..*		additional
PRT	0..*		additional
ROL	0..*		B
ACC	0..1		additional

Original Mode Acknowledgement Choreography for DFT^P03^DFT_P03

Send Application Ack: ACK^P03^ACK

Enhanced Mode Acknowledgement Choreography for DFT^P03^DFT_P03

When the MSH-15 value of a DFT^P03^DFT_P03 message is AL or ER or SU, an ACK^P03^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a DFT^P03^DFT_P03 message is NE or AL or ER or SU, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a DFT^P03^DFT_P03 message is AL or ER or SU, an ACK^P03^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a DFT^P03^DFT_P03 message is NE or AL or ER or SU, an application ack SHALL NOT be sent.

Field	Value	Send Response
MSH-15	AL, ER, SU	immediate ack: ACK^P03^ACK
MSH-15	NE, AL, ER, SU	(none)
MSH-16	AL, ER, SU	application ack: ACK^P03^ACK
MSH-16	NE, AL, ER, SU	(none)

<?xml version="1.0"?>
<!--   v2.xml Message Definitions for Version 2.8.2 - here: DFT_P03-->
<!--   Copyright (c) 1999-2019, Health Level Seven. All rights reserved.   -->
<!--   (generated on 09.01.2019 by HL7-Database) D:\Eigene Dateien\HL7\Datenbank\hl7_94.mdb-->
<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema"
xmlns="urn:hl7-org:v2xml" xmlns:hl7="urn:hl7-org:v2xml"
targetNamespace="urn:hl7-org:v2xml" version="1.1">
  <!-- import segment definition for version -->
  <xsd:include schemaLocation="segments.xsd" />
  <!-- MESSAGE DFT_P03 -->
  <!-- .. message definition DFT_P03 -->
  <xsd:complexType name="DFT_P03.CONTENT">
    <xsd:sequence>
      <xsd:element ref="MSH" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="SFT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="UAC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="EVN" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PID" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PD1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="PV1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DFT_P03.VISIT" minOccurs="0"
      maxOccurs="1" />
      <xsd:element ref="DB1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DFT_P03.COMMON_ORDER" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="DFT_P03.FINANCIAL" minOccurs="1"
      maxOccurs="unbounded" />
      <xsd:element ref="DG1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DRG" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="GT1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DFT_P03.INSURANCE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="ACC" minOccurs="0" maxOccurs="1" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03" type="DFT_P03.CONTENT" />
  <xsd:complexType name="DFT_P03.VISIT.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PV2" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.VISIT" type="DFT_P03.VISIT.CONTENT" />
  <xsd:complexType name="DFT_P03.COMMON_ORDER.CONTENT">
    <xsd:sequence>
      <xsd:element ref="ORC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DFT_P03.TIMING_QUANTITY" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="DFT_P03.ORDER" minOccurs="0"
      maxOccurs="1" />
      <xsd:element ref="DFT_P03.OBSERVATION" minOccurs="0"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.COMMON_ORDER"
  type="DFT_P03.COMMON_ORDER.CONTENT" />
  <xsd:complexType name="DFT_P03.TIMING_QUANTITY.CONTENT">
    <xsd:sequence>
      <xsd:element ref="TQ1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="TQ2" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.TIMING_QUANTITY"
  type="DFT_P03.TIMING_QUANTITY.CONTENT" />
  <xsd:complexType name="DFT_P03.ORDER.CONTENT">
    <xsd:sequence>
      <xsd:element ref="OBR" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.ORDER" type="DFT_P03.ORDER.CONTENT" />
  <xsd:complexType name="DFT_P03.OBSERVATION.CONTENT">
    <xsd:sequence>
      <xsd:element ref="OBX" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.OBSERVATION"
  type="DFT_P03.OBSERVATION.CONTENT" />
  <xsd:complexType name="DFT_P03.FINANCIAL.CONTENT">
    <xsd:sequence>
      <xsd:element ref="FT1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DFT_P03.FINANCIAL_PROCEDURE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="DFT_P03.FINANCIAL_COMMON_ORDER"
      minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.FINANCIAL"
  type="DFT_P03.FINANCIAL.CONTENT" />
  <xsd:complexType name="DFT_P03.FINANCIAL_PROCEDURE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PR1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.FINANCIAL_PROCEDURE"
  type="DFT_P03.FINANCIAL_PROCEDURE.CONTENT" />
  <xsd:complexType name="DFT_P03.FINANCIAL_COMMON_ORDER.CONTENT">
    <xsd:sequence>
      <xsd:element ref="ORC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DFT_P03.FINANCIAL_TIMING_QUANTITY"
      minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DFT_P03.FINANCIAL_ORDER" minOccurs="0"
      maxOccurs="1" />
      <xsd:element ref="DFT_P03.FINANCIAL_OBSERVATION"
      minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.FINANCIAL_COMMON_ORDER"
  type="DFT_P03.FINANCIAL_COMMON_ORDER.CONTENT" />
  <xsd:complexType name="DFT_P03.FINANCIAL_TIMING_QUANTITY.CONTENT">

    <xsd:sequence>
      <xsd:element ref="TQ1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="TQ2" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.FINANCIAL_TIMING_QUANTITY"
  type="DFT_P03.FINANCIAL_TIMING_QUANTITY.CONTENT" />
  <xsd:complexType name="DFT_P03.FINANCIAL_ORDER.CONTENT">
    <xsd:sequence>
      <xsd:element ref="OBR" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.FINANCIAL_ORDER"
  type="DFT_P03.FINANCIAL_ORDER.CONTENT" />
  <xsd:complexType name="DFT_P03.FINANCIAL_OBSERVATION.CONTENT">
    <xsd:sequence>
      <xsd:element ref="OBX" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.FINANCIAL_OBSERVATION"
  type="DFT_P03.FINANCIAL_OBSERVATION.CONTENT" />
  <xsd:complexType name="DFT_P03.INSURANCE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="IN1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="IN2" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="IN3" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P03.INSURANCE"
  type="DFT_P03.INSURANCE.CONTENT" />
</xsd:schema>

Download

QRY/DSR - Generate Bills And Accounts Receivable Statements (Event P04)

Retained for backwards compatibility only in version 2.4 and later; refer to Chapter 5, "Queries", section 5.4. The original mode query and the QRD/QRF segments have been replaced.

BAR/ACK - Update Account (Event P05)

The P05 event is sent when an existing account is being updated. From version 2.3 onward, the P01 (add account) event should no longer be used for updating an existing account, but only for creating a new account. With the addition of P10 (transmit ambulatory payment classification [APC] groups) in version 2.4, it is expected that the P05 (update account) will be used to send inpatient coding information and the P10 (transmit ambulatory payment classification [APC] groups) will be used to send outpatient coding information.

The error segment indicates the fields that caused a transaction to be rejected.

BAR^P05^BAR_P05: Update Billing Account

HL7 MessageStructure Table - BAR_P05
Segment	Cardinality	Must Implement	Status
BAR_P05
MSH	1..1	Yes	additional
SFT	0..*		additional
UAC	0..1		additional
EVN	1..1	Yes	additional
PID	1..1	Yes	additional
PD1	0..1		additional
PRT	0..*		additional
ROL	0..*		B
VISIT	1..*	Yes	additional
PV1	1..1	Yes	additional
PV2	0..1		additional
PRT	0..*		additional
ROL	0..*		B
DB1	0..*		additional
OBX	0..*		additional
PRT	0..*		additional
AL1	0..*		additional
DRG	0..1		additional
GT1	0..*		additional
NK1	0..*		additional
ACC	0..1		additional
UB1	0..1		B
UB2	0..1		additional
ABS	0..1		additional
BLC	0..*		additional
RMI	0..1		additional
DIAGNOSIS	0..*		additional
DG1	1..1	Yes	additional
PROCEDURE	0..*		additional
PR1	1..1	Yes	additional
PRT	0..*		additional
ROL	0..*		B
INSURANCE	0..*		additional
IN1	1..1	Yes	additional
IN2	0..1		additional
IN3	0..*		additional
PRT	0..*		additional
ROL	0..*		B

Original Mode Acknowledgement Choreography for BAR^P05^BAR_P05

Send Application Ack: ACK^P05^ACK

Enhanced Mode Acknowledgement Choreography for BAR^P05^BAR_P05

When the MSH-15 value of a BAR^P05^BAR_P05 message is AL or ER or SU, an ACK^P05^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a BAR^P05^BAR_P05 message is NE or AL or ER or SU, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a BAR^P05^BAR_P05 message is AL or ER or SU, an ACK^P05^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a BAR^P05^BAR_P05 message is NE or AL or ER or SU, an application ack SHALL NOT be sent.

Field	Value	Send Response
MSH-15	AL, ER, SU	immediate ack: ACK^P05^ACK
MSH-15	NE, AL, ER, SU	(none)
MSH-16	AL, ER, SU	application ack: ACK^P05^ACK
MSH-16	NE, AL, ER, SU	(none)

<?xml version="1.0"?>
<!--   v2.xml Message Definitions for Version 2.8.2 - here: BAR_P05-->
<!--   Copyright (c) 1999-2019, Health Level Seven. All rights reserved.   -->
<!--   (generated on 09.01.2019 by HL7-Database) D:\Eigene Dateien\HL7\Datenbank\hl7_94.mdb-->
<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema"
xmlns="urn:hl7-org:v2xml" xmlns:hl7="urn:hl7-org:v2xml"
targetNamespace="urn:hl7-org:v2xml" version="1.1">
  <!-- import segment definition for version -->
  <xsd:include schemaLocation="segments.xsd" />
  <!-- MESSAGE BAR_P05 -->
  <!-- .. message definition BAR_P05 -->
  <xsd:complexType name="BAR_P05.CONTENT">
    <xsd:sequence>
      <xsd:element ref="MSH" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="SFT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="UAC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="EVN" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PID" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PD1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="BAR_P05.VISIT" minOccurs="1"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P05" type="BAR_P05.CONTENT" />
  <xsd:complexType name="BAR_P05.VISIT.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PV1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PV2" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DB1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="OBX" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="AL1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DG1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DRG" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="BAR_P05.PROCEDURE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="GT1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="NK1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="BAR_P05.INSURANCE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="ACC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="UB1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="UB2" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="ABS" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="BLC" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="RMI" minOccurs="0" maxOccurs="1" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P05.VISIT" type="BAR_P05.VISIT.CONTENT" />
  <xsd:complexType name="BAR_P05.PROCEDURE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PR1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P05.PROCEDURE"
  type="BAR_P05.PROCEDURE.CONTENT" />
  <xsd:complexType name="BAR_P05.INSURANCE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="IN1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="IN2" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="IN3" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P05.INSURANCE"
  type="BAR_P05.INSURANCE.CONTENT" />
</xsd:schema>

Download

BAR/ACK - End Account (event P06)

The P06 event is a notification that the account is no longer open, that is, no new charges can accrue to this account. This notification is not related to whether or not the account is paid in full. EVN-2 - Recorded Date/Time must contain the account end date.

The error segment indicates the fields that caused a transaction to be rejected.

Note: P07-P09 have been defined by the Orders/Observations Technical Committee as product experience messages. Refer to Chapter 7.

BAR^P06^BAR_P06: End Billing Account

HL7 MessageStructure Table - BAR_P06
Segment	Cardinality	Must Implement	Status
BAR_P06
MSH	1..1	Yes	additional
SFT	0..*		additional
UAC	0..1		additional
EVN	1..1	Yes	additional
PATIENT	1..*	Yes	additional
PID	1..1	Yes	additional
PRT	0..*		additional
PV1	0..1		additional

Original Mode Acknowledgement Choreography for BAR^P06^BAR_P06

Send Application Ack: ACK^P06^ACK

Enhanced Mode Acknowledgement Choreography for BAR^P06^BAR_P06

When the MSH-15 value of a BAR^P06^BAR_P06 message is AL or ER or SU, an ACK^P06^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a BAR^P06^BAR_P06 message is NE or AL or ER or SU, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a BAR^P06^BAR_P06 message is AL or ER or SU, an ACK^P06^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a BAR^P06^BAR_P06 message is NE or AL or ER or SU, an application ack SHALL NOT be sent.

Field	Value	Send Response
MSH-15	AL, ER, SU	immediate ack: ACK^P06^ACK
MSH-15	NE, AL, ER, SU	(none)
MSH-16	AL, ER, SU	application ack: ACK^P06^ACK
MSH-16	NE, AL, ER, SU	(none)

<?xml version="1.0"?>
<!--   v2.xml Message Definitions for Version 2.8.2 - here: BAR_P06-->
<!--   Copyright (c) 1999-2019, Health Level Seven. All rights reserved.   -->
<!--   (generated on 09.01.2019 by HL7-Database) D:\Eigene Dateien\HL7\Datenbank\hl7_94.mdb-->
<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema"
xmlns="urn:hl7-org:v2xml" xmlns:hl7="urn:hl7-org:v2xml"
targetNamespace="urn:hl7-org:v2xml" version="1.1">
  <!-- import segment definition for version -->
  <xsd:include schemaLocation="segments.xsd" />
  <!-- MESSAGE BAR_P06 -->
  <!-- .. message definition BAR_P06 -->
  <xsd:complexType name="BAR_P06.CONTENT">
    <xsd:sequence>
      <xsd:element ref="MSH" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="SFT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="UAC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="EVN" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="BAR_P06.PATIENT" minOccurs="1"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P06" type="BAR_P06.CONTENT" />
  <xsd:complexType name="BAR_P06.PATIENT.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PID" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PV1" minOccurs="0" maxOccurs="1" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P06.PATIENT"
  type="BAR_P06.PATIENT.CONTENT" />
</xsd:schema>

Download

BAR/ACK - Transmit Ambulatory Payment Classification (APC) Groups (Event P10)

The P10 event is used to communicate Ambulatory Payment Classification (APC) grouping. The grouping can be estimated or actual, based on the APC status indictor in GP1-1. This information is mandated in the USA by the Centers for Medicare and Medicaid Services (CMS) for reimbursement of outpatient services. The PID and PV1 segments are included for identification purposes only. When other patient or visit related fields change, use the A08 (update patient information) event.

The error segment indicates the fields that caused a transaction to be rejected.

BAR^P10^BAR_P10: Transmit Ambulatory Payment Classification (APC) groups

HL7 MessageStructure Table - BAR_P10
Segment	Cardinality	Must Implement	Status
BAR_P10
MSH	1..1	Yes	additional
SFT	0..*		additional
UAC	0..1		additional
EVN	1..1	Yes	additional
PID	1..1	Yes	additional
PRT	0..*		additional
PV1	1..1	Yes	additional
DIAGNOSIS	0..*		additional
DG1	1..1	Yes	additional
GP1	1..1	Yes	additional
PROCEDURE	0..*		additional
PR1	1..1	Yes	additional
GP2	0..1		additional

Original Mode Acknowledgement Choreography for BAR^P10^BAR_P10

Send Application Ack: ACK^P10^ACK

Enhanced Mode Acknowledgement Choreography for BAR^P10^BAR_P10

When the MSH-15 value of a BAR^P10^BAR_P10 message is AL or ER or SU, an ACK^P10^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a BAR^P10^BAR_P10 message is NE or AL or ER or SU, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a BAR^P10^BAR_P10 message is AL or ER or SU, an ACK^P10^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a BAR^P10^BAR_P10 message is NE or AL or ER or SU, an application ack SHALL NOT be sent.

Field	Value	Send Response
MSH-15	AL, ER, SU	immediate ack: ACK^P10^ACK
MSH-15	NE, AL, ER, SU	(none)
MSH-16	AL, ER, SU	application ack: ACK^P10^ACK
MSH-16	NE, AL, ER, SU	(none)

<?xml version="1.0"?>
<!--   v2.xml Message Definitions for Version 2.8.2 - here: BAR_P10-->
<!--   Copyright (c) 1999-2019, Health Level Seven. All rights reserved.   -->
<!--   (generated on 09.01.2019 by HL7-Database) D:\Eigene Dateien\HL7\Datenbank\hl7_94.mdb-->
<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema"
xmlns="urn:hl7-org:v2xml" xmlns:hl7="urn:hl7-org:v2xml"
targetNamespace="urn:hl7-org:v2xml" version="1.1">
  <!-- import segment definition for version -->
  <xsd:include schemaLocation="segments.xsd" />
  <!-- MESSAGE BAR_P10 -->
  <!-- .. message definition BAR_P10 -->
  <xsd:complexType name="BAR_P10.CONTENT">
    <xsd:sequence>
      <xsd:element ref="MSH" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="SFT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="UAC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="EVN" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PID" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PV1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="DG1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="GP1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="BAR_P10.PROCEDURE" minOccurs="0"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P10" type="BAR_P10.CONTENT" />
  <xsd:complexType name="BAR_P10.PROCEDURE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PR1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="GP2" minOccurs="0" maxOccurs="1" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P10.PROCEDURE"
  type="BAR_P10.PROCEDURE.CONTENT" />
</xsd:schema>

Download

DFT/ACK - Post Detail Financial Transactions - Expanded (Event P11)

The Detail Financial Transaction (DFT) - Expanded message is used to describe a financial transaction transmitted between systems, that is, to the billing system for ancillary charges, ADT to billing system for patient deposits, etc. It serves the same function as the Post Detail Financial Transactions (event P03) message, but also supports the use cases described below.

Use case for adding the INx and GT1 segments inside the FT1 repetition:

If the insurance and/or the guarantor information is specific to a certain financial transaction of a patient and differs from the patient's regular insurance and/or guarantor, you may use the INx and GT1 segments related to the FT1 segment. If being used, the information supersedes the information on the patient level.

Example: Before being employed by a company, a pre-employment physical is required. The cost of the examinations is paid by the company, and not by the person's private health insurance. One of the physicians examining the person is an eye doctor. For efficiency reasons, the person made an appointment for these examinations on the same day as he already had an appointment with his eye doctor in the same hospital. The costs for this eye doctor appointment are being paid by the patient's private health insurance. Both financial transactions for the same patient/person could be sent in the same message. To bill the examination for the future-employer to that organization, you need to use the GT1 segment that is related to the FT1.

The error segment indicates the fields that caused a transaction to be rejected.

DFT^P11^DFT_P11: Detail Financial Transaction - Expanded

Message Structure
Acknowlegment Choreography
v2.xml XSD

HL7 MessageStructure Table - DFT_P11
Segment	Cardinality	Must Implement	Status
DFT_P11
MSH	1..1	Yes	additional
SFT	0..*		additional
UAC	0..1		additional
EVN	1..1	Yes	additional
PID	1..1	Yes	additional
PRT	0..*		additional
PD1	0..1		additional
PRT	0..*		additional
ROL	0..*		B
VISIT	0..1		additional
PV1	0..1		additional
PV2	0..1		additional
PRT	0..*		additional
ROL	0..*		B
DB1	0..*		additional
COMMON_ORDER	0..*		additional
ORC	1..1	Yes	additional
PRT	0..*		additional
TIMING_QUANTITY	0..*		additional
TQ1	1..1	Yes	additional
TQ2	0..*		additional
ORDER	0..1		additional
OBR	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
OBSERVATION	0..*		additional
OBX	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
DIAGNOSIS	0..*		additional
DG1	1..1	Yes	additional
DRG	0..1		additional
GT1	0..*		additional
INSURANCE	0..*		additional
IN1	1..1	Yes	additional
IN2	0..1		additional
IN3	0..*		additional
PRT	0..*		additional
ROL	0..*		B
ACC	0..1		additional
FINANCIAL	1..*	Yes	additional
FT1	1..1	Yes	additional
NTE	0..*		additional
PRT	0..*		additional
DRG	0..1		additional
GT1	0..*		additional
FINANCIAL_PROCEDURE	0..*		additional
PR1	1..1	Yes	additional
PRT	0..*		additional
ROL	0..*		B
FINANCIAL_OBSERVATION_STANDALONE	0..*		additional
OBX	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL_ORDER_STANDALONE	0..*		additional
OBR	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL_OBSERVATION	0..*		additional
OBX	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL_COMMON_ORDER	0..*		additional
ORC	1..1	Yes	additional
PRT	0..*		additional
FINANCIAL_TIMING_QUANTITY	0..*		additional
TQ1	1..1	Yes	additional
TQ2	0..*		additional
FINANCIAL_ORDER	0..1		additional
OBR	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
FINANCIAL_OBSERVATION	0..*		additional
OBX	1..1	Yes	additional
PRT	0..*		additional
NTE	0..*		additional
DIAGNOSIS_FT1	0..*		additional
DG1	1..1	Yes	additional
FINANCIAL_INSURANCE	0..*		additional
IN1	1..1	Yes	additional
IN2	0..1		additional
IN3	0..*		additional
PRT	0..*		additional
ROL	0..*		B

Original Mode Acknowledgement Choreography for DFT^P11^DFT_P11

Send Application Ack: ACK^P11^ACK

Enhanced Mode Acknowledgement Choreography for DFT^P11^DFT_P11

When the MSH-15 value of a DFT^P11^DFT_P11 message is AL or ER or SU, an ACK^P11^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a DFT^P11^DFT_P11 message is NE or AL or ER or SU, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a DFT^P11^DFT_P11 message is AL or ER or SU, an ACK^P11^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a DFT^P11^DFT_P11 message is NE or AL or ER or SU, an application ack SHALL NOT be sent.

Field	Value	Send Response
MSH-15	AL, ER, SU	immediate ack: ACK^P11^ACK
MSH-15	NE, AL, ER, SU	(none)
MSH-16	AL, ER, SU	application ack: ACK^P11^ACK
MSH-16	NE, AL, ER, SU	(none)

<?xml version="1.0"?>
<!--   v2.xml Message Definitions for Version 2.8.2 - here: DFT_P11-->
<!--   Copyright (c) 1999-2019, Health Level Seven. All rights reserved.   -->
<!--   (generated on 09.01.2019 by HL7-Database) D:\Eigene Dateien\HL7\Datenbank\hl7_94.mdb-->
<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema"
xmlns="urn:hl7-org:v2xml" xmlns:hl7="urn:hl7-org:v2xml"
targetNamespace="urn:hl7-org:v2xml" version="1.1">
  <!-- import segment definition for version -->
  <xsd:include schemaLocation="segments.xsd" />
  <!-- MESSAGE DFT_P11 -->
  <!-- .. message definition DFT_P11 -->
  <xsd:complexType name="DFT_P11.CONTENT">
    <xsd:sequence>
      <xsd:element ref="MSH" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="SFT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="UAC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="EVN" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PID" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PD1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="PV1" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DFT_P11.VISIT" minOccurs="0"
      maxOccurs="1" />
      <xsd:element ref="DB1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DFT_P11.COMMON_ORDER" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="DG1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DRG" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="GT1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DFT_P11.INSURANCE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="ACC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DFT_P11.FINANCIAL" minOccurs="1"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11" type="DFT_P11.CONTENT" />
  <xsd:complexType name="DFT_P11.VISIT.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PV2" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.VISIT" type="DFT_P11.VISIT.CONTENT" />
  <xsd:complexType name="DFT_P11.COMMON_ORDER.CONTENT">
    <xsd:sequence>
      <xsd:element ref="ORC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DFT_P11.TIMING_QUANTITY" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="DFT_P11.ORDER" minOccurs="0"
      maxOccurs="1" />
      <xsd:element ref="DFT_P11.OBSERVATION" minOccurs="0"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.COMMON_ORDER"
  type="DFT_P11.COMMON_ORDER.CONTENT" />
  <xsd:complexType name="DFT_P11.TIMING_QUANTITY.CONTENT">
    <xsd:sequence>
      <xsd:element ref="TQ1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="TQ2" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.TIMING_QUANTITY"
  type="DFT_P11.TIMING_QUANTITY.CONTENT" />
  <xsd:complexType name="DFT_P11.ORDER.CONTENT">
    <xsd:sequence>
      <xsd:element ref="OBR" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.ORDER" type="DFT_P11.ORDER.CONTENT" />
  <xsd:complexType name="DFT_P11.OBSERVATION.CONTENT">
    <xsd:sequence>
      <xsd:element ref="OBX" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.OBSERVATION"
  type="DFT_P11.OBSERVATION.CONTENT" />
  <xsd:complexType name="DFT_P11.INSURANCE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="IN1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="IN2" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="IN3" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.INSURANCE"
  type="DFT_P11.INSURANCE.CONTENT" />
  <xsd:complexType name="DFT_P11.FINANCIAL.CONTENT">
    <xsd:sequence>
      <xsd:element ref="FT1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="DFT_P11.FINANCIAL_PROCEDURE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="DFT_P11.FINANCIAL_COMMON_ORDER"
      minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DG1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DRG" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="GT1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DFT_P11.FINANCIAL_INSURANCE" minOccurs="0"
      maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.FINANCIAL"
  type="DFT_P11.FINANCIAL.CONTENT" />
  <xsd:complexType name="DFT_P11.FINANCIAL_PROCEDURE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PR1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.FINANCIAL_PROCEDURE"
  type="DFT_P11.FINANCIAL_PROCEDURE.CONTENT" />
  <xsd:complexType name="DFT_P11.FINANCIAL_COMMON_ORDER.CONTENT">
    <xsd:sequence>
      <xsd:element ref="ORC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="DFT_P11.FINANCIAL_TIMING_QUANTITY"
      minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DFT_P11.FINANCIAL_ORDER" minOccurs="0"
      maxOccurs="1" />
      <xsd:element ref="DFT_P11.FINANCIAL_OBSERVATION"
      minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.FINANCIAL_COMMON_ORDER"
  type="DFT_P11.FINANCIAL_COMMON_ORDER.CONTENT" />
  <xsd:complexType name="DFT_P11.FINANCIAL_TIMING_QUANTITY.CONTENT">

    <xsd:sequence>
      <xsd:element ref="TQ1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="TQ2" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.FINANCIAL_TIMING_QUANTITY"
  type="DFT_P11.FINANCIAL_TIMING_QUANTITY.CONTENT" />
  <xsd:complexType name="DFT_P11.FINANCIAL_ORDER.CONTENT">
    <xsd:sequence>
      <xsd:element ref="OBR" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.FINANCIAL_ORDER"
  type="DFT_P11.FINANCIAL_ORDER.CONTENT" />
  <xsd:complexType name="DFT_P11.FINANCIAL_OBSERVATION.CONTENT">
    <xsd:sequence>
      <xsd:element ref="OBX" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="NTE" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.FINANCIAL_OBSERVATION"
  type="DFT_P11.FINANCIAL_OBSERVATION.CONTENT" />
  <xsd:complexType name="DFT_P11.FINANCIAL_INSURANCE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="IN1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="IN2" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="IN3" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="DFT_P11.FINANCIAL_INSURANCE"
  type="DFT_P11.FINANCIAL_INSURANCE.CONTENT" />
</xsd:schema>

Download

BAR/ACK - Update Diagnosis/Procedure (Event P12)

The P12 event is used to communicate diagnosis and/or procedures in update mode. The newly created fields in DG1 and PR1, i.e., identifiers and action codes, must be populated to indicate which change should be applied. When other patient or visit related fields change, use the A08 (update patient information) event.

The error segment indicates the fields that caused a transaction to be rejected.

BAR^P12^BAR_P12: Update Diagnosis/Procedures

HL7 MessageStructure Table - BAR_P12
Segment	Cardinality	Must Implement	Status
BAR_P12
MSH	1..1	Yes	additional
SFT	0..*		additional
UAC	0..1		additional
EVN	1..1	Yes	additional
PID	1..1	Yes	additional
PRT	0..*		additional
PV1	1..1	Yes	additional
DIAGNOSIS	0..*		additional
DG1	1..1	Yes	additional
DRG	0..1		additional
PROCEDURE	0..*		additional
PR1	1..1	Yes	additional
PRT	0..*		additional
ROL	0..*		B
OBX	0..1		additional
PRT	0..*		additional

Original Mode Acknowledgement Choreography for BAR^P12^BAR_P12

Send Application Ack: ACK^P12^ACK

Enhanced Mode Acknowledgement Choreography for BAR^P12^BAR_P12

When the MSH-15 value of a BAR^P12^BAR_P12 message is AL or ER or SU, an ACK^P12^ACK message SHALL be sent as an immediate ack.

When the MSH-15 value of a BAR^P12^BAR_P12 message is NE or AL or ER or SU, an immediate ack SHALL NOT be sent.

When the MSH-16 value of a BAR^P12^BAR_P12 message is AL or ER or SU, an ACK^P12^ACK message SHALL be sent as an application ack.

When the MSH-16 value of a BAR^P12^BAR_P12 message is NE or AL or ER or SU, an application ack SHALL NOT be sent.

Field	Value	Send Response
MSH-15	AL, ER, SU	immediate ack: ACK^P12^ACK
MSH-15	NE, AL, ER, SU	(none)
MSH-16	AL, ER, SU	application ack: ACK^P12^ACK
MSH-16	NE, AL, ER, SU	(none)

<?xml version="1.0"?>
<!--   v2.xml Message Definitions for Version 2.8.2 - here: BAR_P12-->
<!--   Copyright (c) 1999-2019, Health Level Seven. All rights reserved.   -->
<!--   (generated on 09.01.2019 by HL7-Database) D:\Eigene Dateien\HL7\Datenbank\hl7_94.mdb-->
<xsd:schema xmlns:xsd="http://www.w3.org/2001/XMLSchema"
xmlns="urn:hl7-org:v2xml" xmlns:hl7="urn:hl7-org:v2xml"
targetNamespace="urn:hl7-org:v2xml" version="1.1">
  <!-- import segment definition for version -->
  <xsd:include schemaLocation="segments.xsd" />
  <!-- MESSAGE BAR_P12 -->
  <!-- .. message definition BAR_P12 -->
  <xsd:complexType name="BAR_P12.CONTENT">
    <xsd:sequence>
      <xsd:element ref="MSH" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="SFT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="UAC" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="EVN" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PID" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PV1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="DG1" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="DRG" minOccurs="0" maxOccurs="1" />
      <xsd:element ref="BAR_P12.PROCEDURE" minOccurs="0"
      maxOccurs="unbounded" />
      <xsd:element ref="OBX" minOccurs="0" maxOccurs="1" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P12" type="BAR_P12.CONTENT" />
  <xsd:complexType name="BAR_P12.PROCEDURE.CONTENT">
    <xsd:sequence>
      <xsd:element ref="PR1" minOccurs="1" maxOccurs="1" />
      <xsd:element ref="PRT" minOccurs="0" maxOccurs="unbounded" />
      <xsd:element ref="ROL" minOccurs="0" maxOccurs="unbounded" />
    </xsd:sequence>
  </xsd:complexType>
  <xsd:element name="BAR_P12.PROCEDURE"
  type="BAR_P12.PROCEDURE.CONTENT" />
</xsd:schema>

Download

MESSAGE SEGMENTS

FT1 - Financial Transaction Segment

The FT1 segment contains the detail data necessary to post charges, payments, adjustments, etc., to patient accounting records.

HL7 Attribute Table - FT1 - Financial Transaction Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
FT1
1	Set ID - FT1	SI	O		[0..1]	00355	[1..4]
2	Transaction ID	CX	O		[0..1]	00356	[1..12]
3	Transaction Batch ID	ST	O		[0..1]	00357	[1..10]
4	Transaction Date	DR	R		[1..1]	00358
5	Transaction Posting Date	DTM	O		[0..1]	00359
6	Transaction Type	CWE	R	0017 Transaction Type	[1..1]	00360
7	Transaction Code	CWE	R	0132 Transaction Code	[1..1]	00361
8	Transaction Description		W		[0..1]	00362
9	Transaction Description - Alt		W		[0..1]	00363
10	Transaction Quantity	NM	O		[0..1]	00364		6	#
11	Transaction Amount - Extended	CP	O		[0..1]	00365
12	Transaction Amount - Unit	CP	O		[0..1]	00366
13	Department Code	CWE	O	0049 Department Code	[0..1]	00367
14	Health Plan ID	CWE	O	0072 Insurance Plan ID	[0..1]	00368
15	Insurance Amount	CP	O		[0..1]	00369
16	Assigned Patient Location	PL	O		[0..1]	00133
17	Fee Schedule	CWE	O	0024 Fee Schedule	[0..1]	00370
18	Patient Type	CWE	O	0018 Patient Type	[0..1]	00148
19	Diagnosis Code - FT1	CWE	O	0051 Diagnosis Code	[0..*]	00371
20	Performed By Code	XCN	O	0084 Performed by	[0..*]	00372
21	Ordered By Code	XCN	O		[0..*]	00373
22	Unit Cost	CP	O		[0..1]	00374
23	Filler Order Number	EI	O		[0..1]	00217
24	Entered By Code	XCN	O		[0..*]	00765
25	Procedure Code	CNE	O		[0..1]	00393
26	Procedure Code Modifier	CNE	O		[0..*]	01316
27	Advanced Beneficiary Notice Code	CWE	O	0339(S) Advanced Beneficiary Notice Code(Suggested)	[0..1]	01310
28	Medically Necessary Duplicate Procedure Reason	CWE	O	0476 Medically Necessary Duplicate Procedure Reason	[0..1]	01646
29	NDC Code	CWE	O	0549 NDC Codes	[0..1]	01845
30	Payment Reference ID	CX	O		[0..1]	01846
31	Transaction Reference Key	SI	O		[0..*]	01847	[1..4]
32	Performing Facility	XON	O		[0..*]	02361
33	Ordering Facility	XON	O		[0..1]	02362
34	Item Number	CWE	O		[0..1]	02363
35	Model Number	ST	O		[0..1]	02364		20	#
36	Special Processing Code	CWE	O		[0..*]	02365
37	Clinic Code	CWE	O		[0..1]	02366
38	Referral Number	CX	O		[0..1]	02367
39	Authorization Number	CX	O		[0..1]	02368
40	Service Provider Taxonomy Code	CWE	O		[0..1]	02369
41	Revenue Code	CWE	O	0456(S) Revenue code(Suggested)	[0..1]	01600
42	Prescription Number	ST	O		[0..1]	00325		20	#
43	NDC Qty and UOM	CQ	O		[0..1]	02370
44	DME Certificate of Medical Necessity Transmission Code	CWE	O		[0..1]	03496
45	DME Certification Type Code	CWE	O		[0..1]	03497
46	DME Duration Value	NM	O		[0..1]	03498
47	DME Certification Revision Date	DT	O		[0..1]	03499
48	DME Initial Certification Date	DT	O		[0..1]	03500
49	DME Last Certification Date	DT	O		[0..1]	03501
50	DME Length of Medical Necessity Days	NM	O		[0..1]	03502
51	DME Rental Price	MO	O		[0..1]	03503
52	DME Purchase Price	MO	O		[0..1]	03504
53	DME Frequency Code	CWE	O		[0..1]	03505
54	DME Certification Condition Indicator	ID	O		[0..1]	03506
55	DME Condition Indicator Code	CWE	O		[0..2]	03507
56	Service Reason Code	CWE	O	0964(R) Service Reason(Required)	[0..1]	03508

FT1-1: Set ID - FT1 (SI) 00355

FIXME

FT1-2: Transaction ID (CX) 00356

FIXME

FT1-3: Transaction Batch ID (ST) 00357

FIXME

FT1-4: Transaction Date (DR) 00358

FIXME

FT1-5: Transaction Posting Date (DTM) 00359

FIXME

FT1-6: Transaction Type (CWE) 00360

FIXME

FT1-7: Transaction Code (CWE) 00361

FIXME

FT1-8: Transaction Description () 00362

FIXME

FT1-9: Transaction Description - Alt () 00363

FIXME

FT1-10: Transaction Quantity (NM) 00364

FIXME

FT1-11: Transaction Amount - Extended (CP) 00365

FIXME

FT1-12: Transaction Amount - Unit (CP) 00366

FIXME

FT1-13: Department Code (CWE) 00367

FIXME

FT1-14: Health Plan ID (CWE) 00368

FIXME

FT1-15: Insurance Amount (CP) 00369

FIXME

FT1-16: Assigned Patient Location (PL) 00133

FIXME

FT1-17: Fee Schedule (CWE) 00370

FIXME

FT1-18: Patient Type (CWE) 00148

FIXME

FT1-19: Diagnosis Code - FT1 (CWE) 00371

FIXME

FT1-20: Performed By Code (XCN) 00372

FIXME

FT1-21: Ordered By Code (XCN) 00373

FIXME

FT1-22: Unit Cost (CP) 00374

FIXME

FT1-23: Filler Order Number (EI) 00217

FIXME

FT1-24: Entered By Code (XCN) 00765

FIXME

FT1-25: Procedure Code (CNE) 00393

FIXME

FT1-26: Procedure Code Modifier (CNE) 01316

FIXME

FT1-27: Advanced Beneficiary Notice Code (CWE) 01310

FIXME

FT1-28: Medically Necessary Duplicate Procedure Reason (CWE) 01646

FIXME

FT1-29: NDC Code (CWE) 01845

FIXME

FT1-30: Payment Reference ID (CX) 01846

FIXME

FT1-31: Transaction Reference Key (SI) 01847

FIXME

FT1-32: Performing Facility (XON) 02361

FIXME

FT1-33: Ordering Facility (XON) 02362

FIXME

FT1-34: Item Number (CWE) 02363

FIXME

FT1-35: Model Number (ST) 02364

FIXME

FT1-36: Special Processing Code (CWE) 02365

FIXME

FT1-37: Clinic Code (CWE) 02366

FIXME

FT1-38: Referral Number (CX) 02367

FIXME

FT1-39: Authorization Number (CX) 02368

FIXME

FT1-40: Service Provider Taxonomy Code (CWE) 02369

FIXME

FT1-41: Revenue Code (CWE) 01600

FIXME

FT1-42: Prescription Number (ST) 00325

FIXME

FT1-43: NDC Qty and UOM (CQ) 02370

FIXME

FT1-44: DME Certificate of Medical Necessity Transmission Code (CWE) 03496

FIXME

FT1-45: DME Certification Type Code (CWE) 03497

FIXME

FT1-46: DME Duration Value (NM) 03498

FIXME

FT1-47: DME Certification Revision Date (DT) 03499

FIXME

FT1-48: DME Initial Certification Date (DT) 03500

FIXME

FT1-49: DME Last Certification Date (DT) 03501

FIXME

FT1-50: DME Length of Medical Necessity Days (NM) 03502

FIXME

FT1-51: DME Rental Price (MO) 03503

FIXME

FT1-52: DME Purchase Price (MO) 03504

FIXME

FT1-53: DME Frequency Code (CWE) 03505

FIXME

FT1-54: DME Certification Condition Indicator (ID) 03506

FIXME

FT1-55: DME Condition Indicator Code (CWE) 03507

FIXME

FT1-56: Service Reason Code (CWE) 03508

FIXME

DG1 - Diagnosis Segment

The DG1 segment contains patient diagnosis information of various types, for example, admitting, primary, etc. The DG1 segment is used to send multiple diagnoses (for example, for medical records encoding). It is also used when the FT1-19 - Diagnosis Code - FT1 does not provide sufficient information for a billing system. This diagnosis coding should be distinguished from the clinical problem segment used by caregivers to manage the patient (see Chapter 12, Patient Care). Coding methodologies are also defined.

HL7 Attribute Table - DG1 - Diagnosis Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
DG1
1	Set ID - DG1	SI	R		[1..1]	00375	[1..4]
2	Diagnosis Coding Method		W		[0..1]	00376
3	Diagnosis Code - DG1	CWE	R	0051 Diagnosis Code	[1..1]	00377
4	Diagnosis Description		W		[0..1]	00378
5	Diagnosis Date/Time	DTM	O		[0..1]	00379
6	Diagnosis Type	CWE	R	0052(S) Diagnosis Type(Suggested)	[1..1]	00380
7	Major Diagnostic Category	CNE	W	0118 Major Diagnostic Category	[0..1]	00381
8	Diagnostic Related Group	CNE	W	0055 Diagnosis Related Group	[0..1]	00382
9	DRG Approval Indicator	ID	W	0136(R) Yes/no Indicator(Required)	[0..1]	00383
10	DRG Grouper Review Code	CWE	W	0056 DRG Grouper Review Code	[0..1]	00384
11	Outlier Type	CWE	W	0083(S) Outlier Type(Suggested)	[0..1]	00385
12	Outlier Days	NM	W		[0..1]	00386
13	Outlier Cost	CP	W		[0..1]	00387
14	Grouper Version And Type		W		[0..1]	00388
15	Diagnosis Priority	NM	O	0359 Diagnosis Priority	[0..1]	00389		2	#
16	Diagnosing Clinician	XCN	O		[0..*]	00390
17	Diagnosis Classification	CWE	O	0228 Diagnosis Classification	[0..1]	00766
18	Confidential Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00767	[1..1]
19	Attestation Date/Time	DTM	O		[0..1]	00768
20	Diagnosis Identifier	EI	C		[0..1]	01850
21	Diagnosis Action Code	ID	C	0206(R) Segment Action Code(Required)	[0..1]	01894	[1..1]
22	Parent Diagnosis	EI	C		[0..1]	02152
23	DRG CCL Value Code	CWE	O	0728(R) CCL Value(Required)	[0..1]	02153
24	DRG Grouping Usage	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	02154	[1..1]
25	DRG Diagnosis Determination Status	CWE	O	0731(R) DRG Diagnosis Determination Status(Required)	[0..1]	02155
26	Present On Admission	CWE	O	0895(S) Present On Admission (POA) Indicator(Suggested)	[0..1]	02288

DG1-1: Set ID - DG1 (SI) 00375

FIXME

DG1-2: Diagnosis Coding Method () 00376

FIXME

DG1-3: Diagnosis Code - DG1 (CWE) 00377

FIXME

DG1-4: Diagnosis Description () 00378

FIXME

DG1-5: Diagnosis Date/Time (DTM) 00379

FIXME

DG1-6: Diagnosis Type (CWE) 00380

FIXME

DG1-7: Major Diagnostic Category (CNE) 00381

FIXME

DG1-8: Diagnostic Related Group (CNE) 00382

FIXME

DG1-9: DRG Approval Indicator (ID) 00383

FIXME

DG1-10: DRG Grouper Review Code (CWE) 00384

FIXME

DG1-11: Outlier Type (CWE) 00385

FIXME

DG1-12: Outlier Days (NM) 00386

FIXME

DG1-13: Outlier Cost (CP) 00387

FIXME

DG1-14: Grouper Version And Type () 00388

FIXME

DG1-15: Diagnosis Priority (NM) 00389

FIXME

DG1-16: Diagnosing Clinician (XCN) 00390

FIXME

DG1-17: Diagnosis Classification (CWE) 00766

FIXME

DG1-18: Confidential Indicator (ID) 00767

FIXME

DG1-19: Attestation Date/Time (DTM) 00768

FIXME

DG1-20: Diagnosis Identifier (EI) 01850

FIXME

DG1-21: Diagnosis Action Code (ID) 01894

FIXME

DG1-22: Parent Diagnosis (EI) 02152

FIXME

DG1-23: DRG CCL Value Code (CWE) 02153

FIXME

DG1-24: DRG Grouping Usage (ID) 02154

FIXME

DG1-25: DRG Diagnosis Determination Status (CWE) 02155

FIXME

DG1-26: Present On Admission (CWE) 02288

FIXME

DRG - Diagnosis Related Group Segment

The DRG segment contains diagnoses-related grouping information of various types. The DRG segment is used to send the DRG information, for example, for billing and medical records encoding.

HL7 Attribute Table - DRG - Diagnosis Related Group Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
DRG
1	Diagnostic Related Group	CNE	O	0055 Diagnosis Related Group	[0..1]	00382
2	DRG Assigned Date/Time	DTM	O		[0..1]	00769
3	DRG Approval Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00383
4	DRG Grouper Review Code	CWE	O	0056 DRG Grouper Review Code	[0..1]	00384
5	Outlier Type	CWE	O	0083(S) Outlier Type(Suggested)	[0..1]	00385
6	Outlier Days	NM	O		[0..1]	00386
7	Outlier Cost	CP	O		[0..1]	00387
8	DRG Payor	CWE	O	0229 DRG Payor	[0..1]	00770
9	Outlier Reimbursement	CP	O		[0..1]	00771
10	Confidential Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00767	[1..1]
11	DRG Transfer Type	CWE	O	0415(R) Transfer Type(Required)	[0..1]	01500
12	Name of Coder	XPN	O		[0..1]	02156
13	Grouper Status	CWE	O	0734 Grouper Status	[0..1]	02157
14	PCCL Value Code	CWE	O	0728(R) CCL Value(Required)	[0..1]	02158
15	Effective Weight	NM	O		[0..1]	02159		5	#
16	Monetary Amount	MO	O		[0..1]	02160
17	Status Patient	CWE	O	0739 DRG Status Patient	[0..1]	02161
18	Grouper Software Name	ST	O		[0..1]	02162		100	#
19	Grouper Software Version	ST	O		[0..1]	02282		100	#
20	Status Financial Calculation	CWE	O	0742(S) DRG Status Financial Calculation(Suggested)	[0..1]	02163
21	Relative Discount/Surcharge	MO	O		[0..1]	02164
22	Basic Charge	MO	O		[0..1]	02165
23	Total Charge	MO	O		[0..1]	02166
24	Discount/Surcharge	MO	O		[0..1]	02167
25	Calculated Days	NM	O		[0..1]	02168		5	#
26	Status Gender	CWE	O	0749(S) DRG Grouping Status(Suggested)	[0..1]	02169
27	Status Age	CWE	O	0749(S) DRG Grouping Status(Suggested)	[0..1]	02170
28	Status Length of Stay	CWE	O	0749(S) DRG Grouping Status(Suggested)	[0..1]	02171
29	Status Same Day Flag	CWE	O	0749(S) DRG Grouping Status(Suggested)	[0..1]	02172
30	Status Separation Mode	CWE	O	0749(S) DRG Grouping Status(Suggested)	[0..1]	02173
31	Status Weight at Birth	CWE	O	0755 Status Weight At Birth	[0..1]	02174
32	Status Respiration Minutes	CWE	O	0757 DRG Status Respiration Minutes	[0..1]	02175
33	Status Admission	CWE	O	0759(S) Status Admission(Suggested)	[0..1]	02176

DRG-1: Diagnostic Related Group (CNE) 00382

FIXME

DRG-2: DRG Assigned Date/Time (DTM) 00769

FIXME

DRG-3: DRG Approval Indicator (ID) 00383

FIXME

DRG-4: DRG Grouper Review Code (CWE) 00384

FIXME

DRG-5: Outlier Type (CWE) 00385

FIXME

DRG-6: Outlier Days (NM) 00386

FIXME

DRG-7: Outlier Cost (CP) 00387

FIXME

DRG-8: DRG Payor (CWE) 00770

FIXME

DRG-9: Outlier Reimbursement (CP) 00771

FIXME

DRG-10: Confidential Indicator (ID) 00767

FIXME

DRG-11: DRG Transfer Type (CWE) 01500

FIXME

DRG-12: Name of Coder (XPN) 02156

FIXME

DRG-13: Grouper Status (CWE) 02157

FIXME

DRG-14: PCCL Value Code (CWE) 02158

FIXME

DRG-15: Effective Weight (NM) 02159

FIXME

DRG-16: Monetary Amount (MO) 02160

FIXME

DRG-17: Status Patient (CWE) 02161

FIXME

DRG-18: Grouper Software Name (ST) 02162

FIXME

DRG-19: Grouper Software Version (ST) 02282

FIXME

DRG-20: Status Financial Calculation (CWE) 02163

FIXME

DRG-21: Relative Discount/Surcharge (MO) 02164

FIXME

DRG-22: Basic Charge (MO) 02165

FIXME

DRG-23: Total Charge (MO) 02166

FIXME

DRG-24: Discount/Surcharge (MO) 02167

FIXME

DRG-25: Calculated Days (NM) 02168

FIXME

DRG-26: Status Gender (CWE) 02169

FIXME

DRG-27: Status Age (CWE) 02170

FIXME

DRG-28: Status Length of Stay (CWE) 02171

FIXME

DRG-29: Status Same Day Flag (CWE) 02172

FIXME

DRG-30: Status Separation Mode (CWE) 02173

FIXME

DRG-31: Status Weight at Birth (CWE) 02174

FIXME

DRG-32: Status Respiration Minutes (CWE) 02175

FIXME

DRG-33: Status Admission (CWE) 02176

FIXME

PR1 - Procedures Segment

The PR1 segment contains information relative to various types of procedures that can be performed on a patient. The PR1 segment can be used to send procedure information, for example: Surgical, Nuclear Medicine, X-ray with contrast, etc. The PR1 segment is used to send multiple procedures, for example, for medical records encoding or for billing systems.

HL7 Attribute Table - PR1 - Procedures Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
PR1
1	Set ID - PR1	SI	R		[1..1]	00391	[1..4]
2	Procedure Coding Method		W		[0..1]	00392
3	Procedure Code	CNE	R		[1..1]	00393
4	Procedure Description		W		[0..1]	00394
5	Procedure Date/Time	DTM	R		[1..1]	00395
6	Procedure Functional Type	CWE	O	0230 Procedure Functional Type	[0..1]	00396
7	Procedure Minutes	NM	O		[0..1]	00397		4	#
8	Anesthesiologist		W		[0..1]	00398
9	Anesthesia Code	CWE	O	0019 Anesthesia Code	[0..1]	00399
10	Anesthesia Minutes	NM	O		[0..1]	00400		4	#
11	Surgeon		W		[0..1]	00401
12	Procedure Practitioner		W		[0..1]	00402
13	Consent Code	CWE	O	0059 Consent Code	[0..1]	00403
14	Procedure Priority	NM	O	0418(S) Procedure Priority(Suggested)	[0..1]	00404	[1..2]
15	Associated Diagnosis Code	CWE	O	0051 Diagnosis Code	[0..1]	00772
16	Procedure Code Modifier	CNE	O		[0..*]	01316
17	Procedure DRG Type	CWE	O	0416(S) Procedure DRG Type(Suggested)	[0..1]	01501
18	Tissue Type Code	CWE	O	0417 Tissue Type Code	[0..*]	01502
19	Procedure Identifier	EI	C		[0..1]	01848
20	Procedure Action Code	ID	C	0206(R) Segment Action Code(Required)	[0..1]	01849	[1..1]
21	DRG Procedure Determination Status	CWE	O	0761 DRG Procedure Determination Status	[0..1]	02177
22	DRG Procedure Relevance	CWE	O	0763(S) DRG Procedure Relevance(Suggested)	[0..1]	02178
23	Treating Organizational Unit	PL	O		[0..*]	02371
24	Respiratory Within Surgery	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	02372	[1..1]
25	Parent Procedure ID	EI	O		[0..1]	02373

PR1-1: Set ID - PR1 (SI) 00391

FIXME

PR1-2: Procedure Coding Method () 00392

FIXME

PR1-3: Procedure Code (CNE) 00393

FIXME

PR1-4: Procedure Description () 00394

FIXME

PR1-5: Procedure Date/Time (DTM) 00395

FIXME

PR1-6: Procedure Functional Type (CWE) 00396

FIXME

PR1-7: Procedure Minutes (NM) 00397

FIXME

PR1-8: Anesthesiologist () 00398

FIXME

PR1-9: Anesthesia Code (CWE) 00399

FIXME

PR1-10: Anesthesia Minutes (NM) 00400

FIXME

PR1-11: Surgeon () 00401

FIXME

PR1-12: Procedure Practitioner () 00402

FIXME

PR1-13: Consent Code (CWE) 00403

FIXME

PR1-14: Procedure Priority (NM) 00404

FIXME

PR1-15: Associated Diagnosis Code (CWE) 00772

FIXME

PR1-16: Procedure Code Modifier (CNE) 01316

FIXME

PR1-17: Procedure DRG Type (CWE) 01501

FIXME

PR1-18: Tissue Type Code (CWE) 01502

FIXME

PR1-19: Procedure Identifier (EI) 01848

FIXME

PR1-20: Procedure Action Code (ID) 01849

FIXME

PR1-21: DRG Procedure Determination Status (CWE) 02177

FIXME

PR1-22: DRG Procedure Relevance (CWE) 02178

FIXME

PR1-23: Treating Organizational Unit (PL) 02371

FIXME

PR1-24: Respiratory Within Surgery (ID) 02372

FIXME

PR1-25: Parent Procedure ID (EI) 02373

FIXME

GT1 - Guarantor Segment

The GT1 segment contains guarantor (e.g., the person or the organization with financial responsibility for payment of a patient account) data for patient and insurance billing applications.

HL7 Attribute Table - GT1 - Guarantor Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
GT1
1	Set ID - GT1	SI	R		[1..1]	00405	[1..4]
2	Guarantor Number	CX	O		[0..*]	00406
3	Guarantor Name	XPN	R		[1..*]	00407
4	Guarantor Spouse Name	XPN	O		[0..*]	00408
5	Guarantor Address	XAD	O		[0..*]	00409
6	Guarantor Ph Num – Home	XTN	O		[0..*]	00410
7	Guarantor Ph Num – Business	XTN	O		[0..*]	00411
8	Guarantor Date/Time Of Birth	DTM	O		[0..1]	00412
9	Guarantor Administrative Sex	CWE	O	0001(S) Administrative Sex(Suggested)	[0..1]	00413
10	Guarantor Type	CWE	O	0068 Guarantor Type	[0..1]	00414
11	Guarantor Relationship	CWE	O	0063 Relationship	[0..1]	00415
12	Guarantor SSN	ST	O		[0..1]	00416		11	#
13	Guarantor Date - Begin	DT	O		[0..1]	00417
14	Guarantor Date - End	DT	O		[0..1]	00418
15	Guarantor Priority	NM	O		[0..1]	00419	[1..2]
16	Guarantor Employer Name	XPN	O		[0..*]	00420
17	Guarantor Employer Address	XAD	O		[0..*]	00421
18	Guarantor Employer Phone Number	XTN	O		[0..*]	00422
19	Guarantor Employee ID Number	CX	O		[0..*]	00423
20	Guarantor Employment Status	CWE	O	0066(S) Employment Status(Suggested)	[0..1]	00424
21	Guarantor Organization Name	XON	O		[0..*]	00425
22	Guarantor Billing Hold Flag	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00773	[1..1]
23	Guarantor Credit Rating Code	CWE	O	0341 Guarantor Credit Rating Code	[0..1]	00774
24	Guarantor Death Date And Time	DTM	O		[0..1]	00775
25	Guarantor Death Flag	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00776	[1..1]
26	Guarantor Charge Adjustment Code	CWE	O	0218 Patient Charge Adjustment	[0..1]	00777
27	Guarantor Household Annual Income	CP	O		[0..1]	00778
28	Guarantor Household Size	NM	O		[0..1]	00779		3	#
29	Guarantor Employer ID Number	CX	O		[0..*]	00780
30	Guarantor Marital Status Code	CWE	O	0002(S) Marital Status(Suggested)	[0..1]	00781
31	Guarantor Hire Effective Date	DT	O		[0..1]	00782
32	Employment Stop Date	DT	O		[0..1]	00783
33	Living Dependency	CWE	O	0223 Living Dependency	[0..1]	00755
34	Ambulatory Status	CWE	O	0009(S) Ambulatory Status(Suggested)	[0..*]	00145
35	Citizenship	CWE	O	0171 Citizenship	[0..*]	00129
36	Primary Language	CWE	O	0296 Primary Language	[0..1]	00118
37	Living Arrangement	CWE	O	0220 Living Arrangement	[0..1]	00742
38	Publicity Code	CWE	O	0215 Publicity Code	[0..1]	00743
39	Protection Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00744	[1..1]
40	Student Indicator	CWE	O	0231(S) Student Status(Suggested)	[0..1]	00745
41	Religion	CWE	O	0006(S) Religion(Suggested)	[0..1]	00120
42	Mother's Maiden Name	XPN	O		[0..*]	00109
43	Nationality	CWE	O	0212 Nationality	[0..1]	00739
44	Ethnic Group	CWE	O	0189 Ethnic Group	[0..*]	00125
45	Contact Person's Name	XPN	O	0200(R) Name Type(Required)	[0..*]	00748
46	Contact Person's Telephone Number	XTN	O		[0..*]	00749
47	Contact Reason	CWE	O	0222 Contact Reason	[0..1]	00747
48	Contact Relationship	CWE	O	0063 Relationship	[0..1]	00784
49	Job Title	ST	O		[0..1]	00785		20	#
50	Job Code/Class	JCC	O	0327 Job Code	[0..1]	00786
51	Guarantor Employer's Organization Name	XON	O		[0..*]	01299
52	Handicap	CWE	O	0295 Handicap	[0..1]	00753
53	Job Status	CWE	O	0311 Job Status	[0..1]	00752
54	Guarantor Financial Class	FC	O		[0..1]	01231
55	Guarantor Race	CWE	O	0005(S) Race(Suggested)	[0..*]	01291
56	Guarantor Birth Place	ST	O		[0..1]	01851		100	#
57	VIP Indicator	CWE	O	0099 VIP Indicator	[0..1]	00146

GT1-1: Set ID - GT1 (SI) 00405

FIXME

GT1-2: Guarantor Number (CX) 00406

FIXME

GT1-3: Guarantor Name (XPN) 00407

FIXME

GT1-4: Guarantor Spouse Name (XPN) 00408

FIXME

GT1-5: Guarantor Address (XAD) 00409

FIXME

GT1-6: Guarantor Ph Num – Home (XTN) 00410

FIXME

GT1-7: Guarantor Ph Num – Business (XTN) 00411

FIXME

GT1-8: Guarantor Date/Time Of Birth (DTM) 00412

FIXME

GT1-9: Guarantor Administrative Sex (CWE) 00413

FIXME

GT1-10: Guarantor Type (CWE) 00414

FIXME

GT1-11: Guarantor Relationship (CWE) 00415

FIXME

GT1-12: Guarantor SSN (ST) 00416

FIXME

GT1-13: Guarantor Date - Begin (DT) 00417

FIXME

GT1-14: Guarantor Date - End (DT) 00418

FIXME

GT1-15: Guarantor Priority (NM) 00419

FIXME

GT1-16: Guarantor Employer Name (XPN) 00420

FIXME

GT1-17: Guarantor Employer Address (XAD) 00421

FIXME

GT1-18: Guarantor Employer Phone Number (XTN) 00422

FIXME

GT1-19: Guarantor Employee ID Number (CX) 00423

FIXME

GT1-20: Guarantor Employment Status (CWE) 00424

FIXME

GT1-21: Guarantor Organization Name (XON) 00425

FIXME

GT1-22: Guarantor Billing Hold Flag (ID) 00773

FIXME

GT1-23: Guarantor Credit Rating Code (CWE) 00774

FIXME

GT1-24: Guarantor Death Date And Time (DTM) 00775

FIXME

GT1-25: Guarantor Death Flag (ID) 00776

FIXME

GT1-26: Guarantor Charge Adjustment Code (CWE) 00777

FIXME

GT1-27: Guarantor Household Annual Income (CP) 00778

FIXME

GT1-28: Guarantor Household Size (NM) 00779

FIXME

GT1-29: Guarantor Employer ID Number (CX) 00780

FIXME

GT1-30: Guarantor Marital Status Code (CWE) 00781

FIXME

GT1-31: Guarantor Hire Effective Date (DT) 00782

FIXME

GT1-32: Employment Stop Date (DT) 00783

FIXME

GT1-33: Living Dependency (CWE) 00755

FIXME

GT1-34: Ambulatory Status (CWE) 00145

FIXME

GT1-35: Citizenship (CWE) 00129

FIXME

GT1-36: Primary Language (CWE) 00118

FIXME

GT1-37: Living Arrangement (CWE) 00742

FIXME

GT1-38: Publicity Code (CWE) 00743

FIXME

GT1-39: Protection Indicator (ID) 00744

FIXME

GT1-40: Student Indicator (CWE) 00745

FIXME

GT1-41: Religion (CWE) 00120

FIXME

GT1-42: Mother's Maiden Name (XPN) 00109

FIXME

GT1-43: Nationality (CWE) 00739

FIXME

GT1-44: Ethnic Group (CWE) 00125

FIXME

GT1-45: Contact Person's Name (XPN) 00748

FIXME

GT1-46: Contact Person's Telephone Number (XTN) 00749

FIXME

GT1-47: Contact Reason (CWE) 00747

FIXME

GT1-48: Contact Relationship (CWE) 00784

FIXME

GT1-49: Job Title (ST) 00785

FIXME

GT1-50: Job Code/Class (JCC) 00786

FIXME

GT1-51: Guarantor Employer's Organization Name (XON) 01299

FIXME

GT1-52: Handicap (CWE) 00753

FIXME

GT1-53: Job Status (CWE) 00752

FIXME

GT1-54: Guarantor Financial Class (FC) 01231

FIXME

GT1-55: Guarantor Race (CWE) 01291

FIXME

GT1-56: Guarantor Birth Place (ST) 01851

FIXME

GT1-57: VIP Indicator (CWE) 00146

FIXME

IN1 - Insurance Segment

The IN1 segment contains insurance policy coverage information necessary to produce properly pro-rated and patient and insurance bills.

HL7 Attribute Table - IN1 - Insurance Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
IN1
1	Set ID - IN1	SI	R		[1..1]	00426	[1..4]
2	Health Plan ID	CWE	R	0072 Insurance Plan ID	[1..1]	00368
3	Insurance Company ID	CX	R		[1..*]	00428
4	Insurance Company Name	XON	O		[0..*]	00429
5	Insurance Company Address	XAD	O		[0..*]	00430
6	Insurance Co Contact Person	XPN	O		[0..*]	00431
7	Insurance Co Phone Number	XTN	O		[0..*]	00432
8	Group Number	ST	O		[0..1]	00433		12	#
9	Group Name	XON	O		[0..*]	00434
10	Insured's Group Emp ID	CX	O		[0..*]	00435
11	Insured's Group Emp Name	XON	O		[0..*]	00436
12	Plan Effective Date	DT	O		[0..1]	00437
13	Plan Expiration Date	DT	O		[0..1]	00438
14	Authorization Information	AUI	O		[0..1]	00439
15	Plan Type	CWE	O	0086 Plan ID	[0..1]	00440
16	Name Of Insured	XPN	O		[0..*]	00441
17	Insured's Relationship To Patient	CWE	O	0063 Relationship	[0..1]	00442
18	Insured's Date Of Birth	DTM	O		[0..1]	00443
19	Insured's Address	XAD	O		[0..*]	00444
20	Assignment Of Benefits	CWE	O	0135(S) Assignment of Benefits(Suggested)	[0..1]	00445
21	Coordination Of Benefits	CWE	O	0173(S) Coordination of Benefits(Suggested)	[0..1]	00446
22	Coord Of Ben. Priority	ST	O		[0..1]	00447		2	#
23	Notice Of Admission Flag	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00448	[1..1]
24	Notice Of Admission Date	DT	O		[0..1]	00449
25	Report Of Eligibility Flag	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00450	[1..1]
26	Report Of Eligibility Date	DT	O		[0..1]	00451
27	Release Information Code	CWE	O	0093 Release Information	[0..1]	00452
28	Pre-Admit Cert	ST	O		[0..1]	00453		15	#
29	Verification Date/Time	DTM	O		[0..1]	00454
30	Verification By	XCN	O		[0..*]	00455
31	Type Of Agreement Code	CWE	O	0098 Type of Agreement	[0..1]	00456
32	Billing Status	CWE	O	0022 Billing Status	[0..1]	00457
33	Lifetime Reserve Days	NM	O		[0..1]	00458		4	#
34	Delay Before L.R. Day	NM	O		[0..1]	00459		4	#
35	Company Plan Code	CWE	O	0042 Company Plan Code	[0..1]	00460
36	Policy Number	ST	O		[0..1]	00461		15	#
37	Policy Deductible	CP	O		[0..1]	00462
38	Policy Limit - Amount		W		[0..1]	00463
39	Policy Limit - Days	NM	O		[0..1]	00464		4	#
40	Room Rate - Semi-Private		W		[0..1]	00465
41	Room Rate - Private		W		[0..1]	00466
42	Insured's Employment Status	CWE	O	0066(S) Employment Status(Suggested)	[0..1]	00467
43	Insured's Administrative Sex	CWE	O	0001(S) Administrative Sex(Suggested)	[0..1]	00468
44	Insured's Employer's Address	XAD	O		[0..*]	00469
45	Verification Status	ST	O		[0..1]	00470		2	#
46	Prior Insurance Plan ID	CWE	O	0072 Insurance Plan ID	[0..1]	00471
47	Coverage Type	CWE	O	0309 Coverage Type	[0..1]	01227
48	Handicap	CWE	O	0295 Handicap	[0..1]	00753
49	Insured's ID Number	CX	O		[0..*]	01230
50	Signature Code	CWE	O	0535 Signature Code	[0..1]	01854
51	Signature Code Date	DT	O		[0..1]	01855
52	Insured's Birth Place	ST	O		[0..1]	01899
53	VIP Indicator	CWE	O	0099 VIP Indicator	[0..1]	01852
54	External Health Plan Identifiers	CX	O		[0..*]	03292
55	Insurance Action Code	ID	O	0206(R) Segment Action Code(Required)	[0..1]	03335	[1..*]

IN1-1: Set ID - IN1 (SI) 00426

FIXME

IN1-2: Health Plan ID (CWE) 00368

FIXME

IN1-3: Insurance Company ID (CX) 00428

FIXME

IN1-4: Insurance Company Name (XON) 00429

FIXME

IN1-5: Insurance Company Address (XAD) 00430

FIXME

IN1-6: Insurance Co Contact Person (XPN) 00431

FIXME

IN1-7: Insurance Co Phone Number (XTN) 00432

FIXME

IN1-8: Group Number (ST) 00433

FIXME

IN1-9: Group Name (XON) 00434

FIXME

IN1-10: Insured's Group Emp ID (CX) 00435

FIXME

IN1-11: Insured's Group Emp Name (XON) 00436

FIXME

IN1-12: Plan Effective Date (DT) 00437

FIXME

IN1-13: Plan Expiration Date (DT) 00438

FIXME

IN1-14: Authorization Information (AUI) 00439

FIXME

IN1-15: Plan Type (CWE) 00440

FIXME

IN1-16: Name Of Insured (XPN) 00441

FIXME

IN1-17: Insured's Relationship To Patient (CWE) 00442

FIXME

IN1-18: Insured's Date Of Birth (DTM) 00443

FIXME

IN1-19: Insured's Address (XAD) 00444

FIXME

IN1-20: Assignment Of Benefits (CWE) 00445

FIXME

IN1-21: Coordination Of Benefits (CWE) 00446

FIXME

IN1-22: Coord Of Ben. Priority (ST) 00447

FIXME

IN1-23: Notice Of Admission Flag (ID) 00448

FIXME

IN1-24: Notice Of Admission Date (DT) 00449

FIXME

IN1-25: Report Of Eligibility Flag (ID) 00450

FIXME

IN1-26: Report Of Eligibility Date (DT) 00451

FIXME

IN1-27: Release Information Code (CWE) 00452

FIXME

IN1-28: Pre-Admit Cert (ST) 00453

FIXME

IN1-29: Verification Date/Time (DTM) 00454

FIXME

IN1-30: Verification By (XCN) 00455

FIXME

IN1-31: Type Of Agreement Code (CWE) 00456

FIXME

IN1-32: Billing Status (CWE) 00457

FIXME

IN1-33: Lifetime Reserve Days (NM) 00458

FIXME

IN1-34: Delay Before L.R. Day (NM) 00459

FIXME

IN1-35: Company Plan Code (CWE) 00460

FIXME

IN1-36: Policy Number (ST) 00461

FIXME

IN1-37: Policy Deductible (CP) 00462

FIXME

IN1-38: Policy Limit - Amount () 00463

FIXME

IN1-39: Policy Limit - Days (NM) 00464

FIXME

IN1-40: Room Rate - Semi-Private () 00465

FIXME

IN1-41: Room Rate - Private () 00466

FIXME

IN1-42: Insured's Employment Status (CWE) 00467

FIXME

IN1-43: Insured's Administrative Sex (CWE) 00468

FIXME

IN1-44: Insured's Employer's Address (XAD) 00469

FIXME

IN1-45: Verification Status (ST) 00470

FIXME

IN1-46: Prior Insurance Plan ID (CWE) 00471

FIXME

IN1-47: Coverage Type (CWE) 01227

FIXME

IN1-48: Handicap (CWE) 00753

FIXME

IN1-49: Insured's ID Number (CX) 01230

FIXME

IN1-50: Signature Code (CWE) 01854

FIXME

IN1-51: Signature Code Date (DT) 01855

FIXME

IN1-52: Insured's Birth Place (ST) 01899

FIXME

IN1-53: VIP Indicator (CWE) 01852

FIXME

IN1-54: External Health Plan Identifiers (CX) 03292

FIXME

IN1-55: Insurance Action Code (ID) 03335

FIXME

IN2 - Insurance Additional Information Segment

The IN2 segment contains additional insurance policy coverage and benefit information necessary for proper billing and reimbursement. Fields used by this segment are defined by CMS or other regulatory agencies.

HL7 Attribute Table - IN2 - Insurance Additional Information Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
IN2
1	Insured's Employee ID	CX	O		[0..*]	00472
2	Insured's Social Security Number	ST	O		[0..1]	00473		11	#
3	Insured's Employer's Name and ID	XCN	O		[0..*]	00474
4	Employer Information Data	CWE	O	0139 Employer Information Data	[0..1]	00475
5	Mail Claim Party	CWE	O	0137 Mail Claim Party	[0..*]	00476
6	Medicare Health Ins Card Number	ST	O		[0..1]	00477		15	#
7	Medicaid Case Name	XPN	O		[0..*]	00478
8	Medicaid Case Number	ST	O		[0..1]	00479		15	#
9	Military Sponsor Name	XPN	O		[0..*]	00480
10	Military ID Number	ST	O		[0..1]	00481		20	#
11	Dependent Of Military Recipient	CWE	O	0342 Military Recipient	[0..1]	00482
12	Military Organization	ST	O		[0..1]	00483		25	#
13	Military Station	ST	O		[0..1]	00484		25	#
14	Military Service	CWE	O	0140 Military Service	[0..1]	00485
15	Military Rank/Grade	CWE	O	0141 Military Rank/Grade	[0..1]	00486
16	Military Status	CWE	O	0142 Military Status	[0..1]	00487
17	Military Retire Date	DT	O		[0..1]	00488
18	Military Non-Avail Cert On File	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00489	[1..1]
19	Baby Coverage	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00490	[1..1]
20	Combine Baby Bill	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00491	[1..1]
21	Blood Deductible	ST	O		[0..1]	00492		1	#
22	Special Coverage Approval Name	XPN	O		[0..*]	00493
23	Special Coverage Approval Title	ST	O		[0..1]	00494		30	#
24	Non-Covered Insurance Code	CWE	O	0143 Non-covered Insurance Code	[0..*]	00495
25	Payor ID	CX	O		[0..*]	00496
26	Payor Subscriber ID	CX	O		[0..*]	00497
27	Eligibility Source	CWE	O	0144 Eligibility Source	[0..1]	00498
28	Room Coverage Type/Amount	RMC	O		[0..*]	00499
29	Policy Type/Amount	PTA	O		[0..*]	00500
30	Daily Deductible	DDI	O		[0..1]	00501
31	Living Dependency	CWE	O	0223 Living Dependency	[0..1]	00755
32	Ambulatory Status	CWE	O	0009(S) Ambulatory Status(Suggested)	[0..*]	00145
33	Citizenship	CWE	O	0171 Citizenship	[0..*]	00129
34	Primary Language	CWE	O	0296 Primary Language	[0..1]	00118
35	Living Arrangement	CWE	O	0220 Living Arrangement	[0..1]	00742
36	Publicity Code	CWE	O	0215 Publicity Code	[0..1]	00743
37	Protection Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00744	[1..1]
38	Student Indicator	CWE	O	0231(S) Student Status(Suggested)	[0..1]	00745
39	Religion	CWE	O	0006(S) Religion(Suggested)	[0..1]	00120
40	Mother's Maiden Name	XPN	O		[0..*]	00109
41	Nationality	CWE	O	0212 Nationality	[0..1]	00739
42	Ethnic Group	CWE	O	0189 Ethnic Group	[0..*]	00125
43	Marital Status	CWE	O	0002(S) Marital Status(Suggested)	[0..*]	00119
44	Insured's Employment Start Date	DT	O		[0..1]	00787
45	Employment Stop Date	DT	O		[0..1]	00783
46	Job Title	ST	O		[0..1]	00785		20	#
47	Job Code/Class	JCC	O	0327 Job Code	[0..1]	00786
48	Job Status	CWE	O	0311 Job Status	[0..1]	00752
49	Employer Contact Person Name	XPN	O		[0..*]	00789
50	Employer Contact Person Phone Number	XTN	O		[0..*]	00790
51	Employer Contact Reason	CWE	O	0222 Contact Reason	[0..1]	00791
52	Insured's Contact Person's Name	XPN	O		[0..*]	00792
53	Insured's Contact Person Phone Number	XTN	O		[0..*]	00793
54	Insured's Contact Person Reason	CWE	O	0222 Contact Reason	[0..*]	00794
55	Relationship to the Patient Start Date	DT	O		[0..1]	00795
56	Relationship to the Patient Stop Date	DT	O		[0..*]	00796
57	Insurance Co Contact Reason	CWE	O	0232 - Insurance Company Contact Reason	[0..1]	00797
58	Insurance Co Contact Phone Number	XTN	O		[0..*]	00798
59	Policy Scope	CWE	O	0312 Policy Scope	[0..1]	00799
60	Policy Source	CWE	O	0313 Policy Source	[0..1]	00800
61	Patient Member Number	CX	O		[0..1]	00801
62	Guarantor's Relationship to Insured	CWE	O	0063 Relationship	[0..1]	00802
63	Insured's Phone Number - Home	XTN	O		[0..*]	00803
64	Insured's Employer Phone Number	XTN	O		[0..*]	00804
65	Military Handicapped Program	CWE	O	0343 Military Handicapped Program Code	[0..1]	00805
66	Suspend Flag	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00806	[1..1]
67	Copay Limit Flag	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00807	[1..1]
68	Stoploss Limit Flag	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00808	[1..1]
69	Insured Organization Name and ID	XON	O		[0..*]	00809
70	Insured Employer Organization Name and ID	XON	O		[0..*]	00810
71	Race	CWE	O	0005(S) Race(Suggested)	[0..*]	00113
72	Patient's Relationship to Insured	CWE	O	0344(S) Patient's Relationship to Insured(Suggested)	[0..1]	00811
73	Co-Pay Amount	CP	O		[0..1]	01620

IN2-1: Insured's Employee ID (CX) 00472

FIXME

IN2-2: Insured's Social Security Number (ST) 00473

FIXME

IN2-3: Insured's Employer's Name and ID (XCN) 00474

FIXME

IN2-4: Employer Information Data (CWE) 00475

FIXME

IN2-5: Mail Claim Party (CWE) 00476

FIXME

IN2-6: Medicare Health Ins Card Number (ST) 00477

FIXME

IN2-7: Medicaid Case Name (XPN) 00478

FIXME

IN2-8: Medicaid Case Number (ST) 00479

FIXME

IN2-9: Military Sponsor Name (XPN) 00480

FIXME

IN2-10: Military ID Number (ST) 00481

FIXME

IN2-11: Dependent Of Military Recipient (CWE) 00482

FIXME

IN2-12: Military Organization (ST) 00483

FIXME

IN2-13: Military Station (ST) 00484

FIXME

IN2-14: Military Service (CWE) 00485

FIXME

IN2-15: Military Rank/Grade (CWE) 00486

FIXME

IN2-16: Military Status (CWE) 00487

FIXME

IN2-17: Military Retire Date (DT) 00488

FIXME

IN2-18: Military Non-Avail Cert On File (ID) 00489

FIXME

IN2-19: Baby Coverage (ID) 00490

FIXME

IN2-20: Combine Baby Bill (ID) 00491

FIXME

IN2-21: Blood Deductible (ST) 00492

FIXME

IN2-22: Special Coverage Approval Name (XPN) 00493

FIXME

IN2-23: Special Coverage Approval Title (ST) 00494

FIXME

IN2-24: Non-Covered Insurance Code (CWE) 00495

FIXME

IN2-25: Payor ID (CX) 00496

FIXME

IN2-26: Payor Subscriber ID (CX) 00497

FIXME

IN2-27: Eligibility Source (CWE) 00498

FIXME

IN2-28: Room Coverage Type/Amount (RMC) 00499

FIXME

IN2-29: Policy Type/Amount (PTA) 00500

FIXME

IN2-30: Daily Deductible (DDI) 00501

FIXME

IN2-31: Living Dependency (CWE) 00755

FIXME

IN2-32: Ambulatory Status (CWE) 00145

FIXME

IN2-33: Citizenship (CWE) 00129

FIXME

IN2-34: Primary Language (CWE) 00118

FIXME

IN2-35: Living Arrangement (CWE) 00742

FIXME

IN2-36: Publicity Code (CWE) 00743

FIXME

IN2-37: Protection Indicator (ID) 00744

FIXME

IN2-38: Student Indicator (CWE) 00745

FIXME

IN2-39: Religion (CWE) 00120

FIXME

IN2-40: Mother's Maiden Name (XPN) 00109

FIXME

IN2-41: Nationality (CWE) 00739

FIXME

IN2-42: Ethnic Group (CWE) 00125

FIXME

IN2-43: Marital Status (CWE) 00119

FIXME

IN2-44: Insured's Employment Start Date (DT) 00787

FIXME

IN2-45: Employment Stop Date (DT) 00783

FIXME

IN2-46: Job Title (ST) 00785

FIXME

IN2-47: Job Code/Class (JCC) 00786

FIXME

IN2-48: Job Status (CWE) 00752

FIXME

IN2-49: Employer Contact Person Name (XPN) 00789

FIXME

IN2-50: Employer Contact Person Phone Number (XTN) 00790

FIXME

IN2-51: Employer Contact Reason (CWE) 00791

FIXME

IN2-52: Insured's Contact Person's Name (XPN) 00792

FIXME

IN2-53: Insured's Contact Person Phone Number (XTN) 00793

FIXME

IN2-54: Insured's Contact Person Reason (CWE) 00794

FIXME

IN2-55: Relationship to the Patient Start Date (DT) 00795

FIXME

IN2-56: Relationship to the Patient Stop Date (DT) 00796

FIXME

IN2-57: Insurance Co Contact Reason (CWE) 00797

FIXME

IN2-58: Insurance Co Contact Phone Number (XTN) 00798

FIXME

IN2-59: Policy Scope (CWE) 00799

FIXME

IN2-60: Policy Source (CWE) 00800

FIXME

IN2-61: Patient Member Number (CX) 00801

FIXME

IN2-62: Guarantor's Relationship to Insured (CWE) 00802

FIXME

IN2-63: Insured's Phone Number - Home (XTN) 00803

FIXME

IN2-64: Insured's Employer Phone Number (XTN) 00804

FIXME

IN2-65: Military Handicapped Program (CWE) 00805

FIXME

IN2-66: Suspend Flag (ID) 00806

FIXME

IN2-67: Copay Limit Flag (ID) 00807

FIXME

IN2-68: Stoploss Limit Flag (ID) 00808

FIXME

IN2-69: Insured Organization Name and ID (XON) 00809

FIXME

IN2-70: Insured Employer Organization Name and ID (XON) 00810

FIXME

IN2-71: Race (CWE) 00113

FIXME

IN2-72: Patient's Relationship to Insured (CWE) 00811

FIXME

IN2-73: Co-Pay Amount (CP) 01620

FIXME

IN3 - Insurance Additional Information, Certification Segment

The IN3 segment contains additional insurance information for certifying the need for patient care. Fields used by this segment are defined by CMS, or other regulatory agencies.

HL7 Attribute Table - IN3 - Insurance Additional Information, Certification Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
IN3
1	Set ID - IN3	SI	R		[1..1]	00502	[1..4]
2	Certification Number	CX	O		[0..1]	00503
3	Certified By	XCN	O		[0..*]	00504
4	Certification Required	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00505	[1..1]
5	Penalty	MOP	O		[0..1]	00506
6	Certification Date/Time	DTM	O		[0..1]	00507
7	Certification Modify Date/Time	DTM	O		[0..1]	00508
8	Operator	XCN	O		[0..*]	00509
9	Certification Begin Date	DT	O		[0..1]	00510
10	Certification End Date	DT	O		[0..1]	00511
11	Days	DTN	O		[0..1]	00512
12	Non-Concur Code/Description	CWE	O	0233 Non-Concur Code/Description	[0..1]	00513
13	Non-Concur Effective Date/Time	DTM	O		[0..1]	00514
14	Physician Reviewer	XCN	O	0010 Physician ID	[0..*]	00515
15	Certification Contact	ST	O		[0..1]	00516		48	#
16	Certification Contact Phone Number	XTN	O		[0..*]	00517
17	Appeal Reason	CWE	O	0345 Appeal Reason	[0..1]	00518
18	Certification Agency	CWE	O	0346 Certification Agency	[0..1]	00519
19	Certification Agency Phone Number	XTN	O		[0..*]	00520
20	Pre-Certification Requirement	ICD	O	0136(R) Yes/no Indicator(Required)	[0..*]	00521
21	Case Manager	ST	O		[0..1]	00522		48	#
22	Second Opinion Date	DT	O		[0..1]	00523
23	Second Opinion Status	CWE	O	0151 Second Opinion Status	[0..1]	00524
24	Second Opinion Documentation Received	CWE	O	0152 Second Opinion Documentation Received	[0..*]	00525
25	Second Opinion Physician	XCN	O	0010 Physician ID	[0..*]	00526
26	Certification Type	CWE	O	0921 Certification Type Code	[0..1]	03336
27	Certification Category	CWE	O	0922 Certification Category Code	[0..1]	03337
28	Online Verification Date/Time	DTM	O		[0..1]	02483
29	Online Verification Result	CWE	C	0970(S) Online Verification Result(Suggested)		02484
30	Online Verification Result Error Code	CWE	C	0971(S) Online Verification Result Error Code(Suggested)		02485
31	Online Verification Result Check Digit	ST	C			02486

IN3-1: Set ID - IN3 (SI) 00502

FIXME

IN3-2: Certification Number (CX) 00503

FIXME

IN3-3: Certified By (XCN) 00504

FIXME

IN3-4: Certification Required (ID) 00505

FIXME

IN3-5: Penalty (MOP) 00506

FIXME

IN3-6: Certification Date/Time (DTM) 00507

FIXME

IN3-7: Certification Modify Date/Time (DTM) 00508

FIXME

IN3-8: Operator (XCN) 00509

FIXME

IN3-9: Certification Begin Date (DT) 00510

FIXME

IN3-10: Certification End Date (DT) 00511

FIXME

IN3-11: Days (DTN) 00512

FIXME

IN3-12: Non-Concur Code/Description (CWE) 00513

FIXME

IN3-13: Non-Concur Effective Date/Time (DTM) 00514

FIXME

IN3-14: Physician Reviewer (XCN) 00515

FIXME

IN3-15: Certification Contact (ST) 00516

FIXME

IN3-16: Certification Contact Phone Number (XTN) 00517

FIXME

IN3-17: Appeal Reason (CWE) 00518

FIXME

IN3-18: Certification Agency (CWE) 00519

FIXME

IN3-19: Certification Agency Phone Number (XTN) 00520

FIXME

IN3-20: Pre-Certification Requirement (ICD) 00521

FIXME

IN3-21: Case Manager (ST) 00522

FIXME

IN3-22: Second Opinion Date (DT) 00523

FIXME

IN3-23: Second Opinion Status (CWE) 00524

FIXME

IN3-24: Second Opinion Documentation Received (CWE) 00525

FIXME

IN3-25: Second Opinion Physician (XCN) 00526

FIXME

IN3-26: Certification Type (CWE) 03336

FIXME

IN3-27: Certification Category (CWE) 03337

FIXME

IN3-28: Online Verification Date/Time (DTM) 02483

FIXME

IN3-29: Online Verification Result (CWE) 02484

FIXME

IN3-30: Online Verification Result Error Code (CWE) 02485

FIXME

IN3-31: Online Verification Result Check Digit (ST) 02486

FIXME

ACC - Accident Segment

The ACC segment contains patient information relative to an accident in which the patient has been involved.

HL7 Attribute Table - ACC - Accident Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
ACC
1	Accident Date/Time	DTM	O		[0..1]	00527
2	Accident Code	CWE	O	0050 Accident Code	[0..1]	00528
3	Accident Location	ST	O		[0..1]	00529		25	#
4	Auto Accident State	CWE	B	0347 State/Province	[0..1]	00812
5	Accident Job Related Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00813	[1..1]
6	Accident Death Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	00814	[1..1]
7	Entered By	XCN	O		[0..1]	00224
8	Accident Description	ST	O		[0..1]	01503		1000	#
9	Brought In By	ST	O		[0..1]	01504		80	#
10	Police Notified Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	01505	[1..1]
11	Accident Address	XAD	O		[0..1]	01853
12	Degree of patient liability	NM	O		[0..1]	02374		3	#
13	Accident Identifier	EI	O		[0..*]	03338

ACC-1: Accident Date/Time (DTM) 00527

FIXME

ACC-2: Accident Code (CWE) 00528

FIXME

ACC-3: Accident Location (ST) 00529

FIXME

ACC-4: Auto Accident State (CWE) 00812

FIXME

ACC-5: Accident Job Related Indicator (ID) 00813

FIXME

ACC-6: Accident Death Indicator (ID) 00814

FIXME

ACC-7: Entered By (XCN) 00224

FIXME

ACC-8: Accident Description (ST) 01503

FIXME

ACC-9: Brought In By (ST) 01504

FIXME

ACC-10: Police Notified Indicator (ID) 01505

FIXME

ACC-11: Accident Address (XAD) 01853

FIXME

ACC-12: Degree of patient liability (NM) 02374

FIXME

ACC-13: Accident Identifier (EI) 03338

FIXME

UB1 - Uniform Billing 1 Segment

The UB1 segment contains data specific to the United States. Only billing/claims fields that do not exist in other HL7 defined segments appear in this segment. The codes listed as examples are not an exhaustive or current list.

Attention: the UB1 segment was deprecated as of v 2.3 and the detail was withdrawn and removed from the standard as of v 2.6.

HL7 Attribute Table - UB1 - Uniform Billing 1 Segment
Seq#	Data Element Name	DataType	Usage	Cardinality	Item #
UB1
1	Set ID - UB1	SI	W	[0..1]	00530
2	Blood Deductible		W	[0..1]	00531
3	Blood Furnished-Pints		W	[0..1]	00532
4	Blood Replaced-Pints		W	[0..1]	00533
5	Blood Not Replaced-Pints		W	[0..1]	00534
6	Co-Insurance Days		W	[0..1]	00535
7	Condition Code		W	[0..5]	00536
8	Covered Days		W	[0..1]	00537
9	Non Covered Days		W	[0..1]	00538
10	Value Amount & Code		W	[0..8]	00539
11	Number Of Grace Days		W	[0..1]	00540
12	Special Program Indicator		W	[0..1]	00541
13	PSRO/UR Approval Indicator		W	[0..1]	00542
14	PSRO/UR Approved Stay-Fm		W	[0..1]	00543
15	PSRO/UR Approved Stay-To		W	[0..1]	00544
16	Occurrence		W	[0..5]	00545
17	Occurrence Span		W	[0..1]	00546
18	Occur Span Start Date		W	[0..1]	00547
19	Occur Span End Date		W	[0..1]	00548
20	UB-82 Locator 2		W	[0..1]	00549
21	UB-82 Locator 9		W	[0..1]	00550
22	UB-82 Locator 27		W	[0..1]	00551
23	UB-82 Locator 45		W	[0..1]	00552

UB1-1: Set ID - UB1 (SI) 00530

FIXME

UB1-2: Blood Deductible () 00531

FIXME

UB1-3: Blood Furnished-Pints () 00532

FIXME

UB1-4: Blood Replaced-Pints () 00533

FIXME

UB1-5: Blood Not Replaced-Pints () 00534

FIXME

UB1-6: Co-Insurance Days () 00535

FIXME

UB1-7: Condition Code () 00536

FIXME

UB1-8: Covered Days () 00537

FIXME

UB1-9: Non Covered Days () 00538

FIXME

UB1-10: Value Amount & Code () 00539

FIXME

UB1-11: Number Of Grace Days () 00540

FIXME

UB1-12: Special Program Indicator () 00541

FIXME

UB1-13: PSRO/UR Approval Indicator () 00542

FIXME

UB1-14: PSRO/UR Approved Stay-Fm () 00543

FIXME

UB1-15: PSRO/UR Approved Stay-To () 00544

FIXME

UB1-16: Occurrence () 00545

FIXME

UB1-17: Occurrence Span () 00546

FIXME

UB1-18: Occur Span Start Date () 00547

FIXME

UB1-19: Occur Span End Date () 00548

FIXME

UB1-20: UB-82 Locator 2 () 00549

FIXME

UB1-21: UB-82 Locator 9 () 00550

FIXME

UB1-22: UB-82 Locator 27 () 00551

FIXME

UB1-23: UB-82 Locator 45 () 00552

FIXME

UB2 - Ub92 Data Segment

The UB2 segment contains data necessary to complete UB92 bills specific to the United States. Realms outside the US are referred to chapter 16. Only Uniform Billing fields that do not exist in other HL7 defined segments appear in this segment. For example, Patient Name and Date of Birth are required; they are included in the PID segment and therefore do not appear here. Uniform Billing field locators are provided in parentheses ( ). The UB codes listed as examples are not an exhaustive or current list; refer to a UB specification for additional information.

HL7 Attribute Table - UB2 - UB92 Data Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length
UB2
1	Set ID - UB2	SI	O		[0..1]	00553	[1..4]
2	Co-Insurance Days	ST	O		[0..1]	00554	[1..3]
3	Condition Code	CWE	O	0043 Condition Code	[0..7]	00555
4	Covered Days	ST	O		[0..1]	00556	[1..3]
5	Non-Covered Days	ST	O		[0..1]	00557	[1..4]
6	Value Amount & Code	UVC	O		[0..12]	00558
7	Occurrence Code & Date	OCD	O		[0..8]	00559
8	Occurrence Span Code/Dates	OSP	O		[0..2]	00560
9	Uniform Billing Locator 2	ST	O		[0..2]	00561	[1..29]
10	Uniform Billing Locator 11	ST	O		[0..2]	00562	[1..12]
11	Uniform Billing Locator 31	ST	O		[0..1]	00563	[1..5]
12	Document Control Number	ST	O		[0..3]	00564	[1..23]
13	Uniform Billing Locator 49	ST	O		[0..23]	00565	[1..4]
14	Uniform Billing Locator 56	ST	O		[0..5]	00566	[1..14]
15	Uniform Billing Locator 57	ST	O		[0..1]	00567	[1..27]
16	Uniform Billing Locator 78	ST	O		[0..2]	00568	[1..2]
17	Special Visit Count	NM	O		[0..1]	00815	[1..3]

UB2-1: Set ID - UB2 (SI) 00553

FIXME

UB2-2: Co-Insurance Days (ST) 00554

FIXME

UB2-3: Condition Code (CWE) 00555

FIXME

UB2-4: Covered Days (ST) 00556

FIXME

UB2-5: Non-Covered Days (ST) 00557

FIXME

UB2-6: Value Amount & Code (UVC) 00558

FIXME

UB2-7: Occurrence Code & Date (OCD) 00559

FIXME

UB2-8: Occurrence Span Code/Dates (OSP) 00560

FIXME

UB2-9: Uniform Billing Locator 2 (ST) 00561

FIXME

UB2-10: Uniform Billing Locator 11 (ST) 00562

FIXME

UB2-11: Uniform Billing Locator 31 (ST) 00563

FIXME

UB2-12: Document Control Number (ST) 00564

FIXME

UB2-13: Uniform Billing Locator 49 (ST) 00565

FIXME

UB2-14: Uniform Billing Locator 56 (ST) 00566

FIXME

UB2-15: Uniform Billing Locator 57 (ST) 00567

FIXME

UB2-16: Uniform Billing Locator 78 (ST) 00568

FIXME

UB2-17: Special Visit Count (NM) 00815

FIXME

ABS - Abstract Segment

This segment was created to communicate patient abstract information used for billing and reimbursement purposes. "Abstract" is a condensed form of medical history created for analysis, care planning, etc.

HL7 Attribute Table - ABS - Abstract Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
ABS
1	Discharge Care Provider	XCN	O	0010 Physician ID	[0..1]	01514
2	Transfer Medical Service Code	CWE	O	0069 Hospital Service	[0..1]	01515
3	Severity of Illness Code	CWE	O	0421(S) Severity of Illness Code(Suggested)	[0..1]	01516
4	Date/Time of Attestation	DTM	O		[0..1]	01517
5	Attested By	XCN	O		[0..1]	01518
6	Triage Code	CWE	O	0422 Triage Code	[0..1]	01519
7	Abstract Completion Date/Time	DTM	O		[0..1]	01520
8	Abstracted By	XCN	O		[0..1]	01521
9	Case Category Code	CWE	O	0423 Case Category Code	[0..1]	01522
10	Caesarian Section Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	01523	[1..1]
11	Gestation Category Code	CWE	O	0424(S) Gestation Category Code(Suggested)	[0..1]	01524
12	Gestation Period - Weeks	NM	O		[0..1]	01525		3	#
13	Newborn Code	CWE	O	0425 Newborn Code	[0..1]	01526
14	Stillborn Indicator	ID	O	0136(R) Yes/no Indicator(Required)	[0..1]	01527	[1..1]

ABS-1: Discharge Care Provider (XCN) 01514

FIXME

ABS-2: Transfer Medical Service Code (CWE) 01515

FIXME

ABS-3: Severity of Illness Code (CWE) 01516

FIXME

ABS-4: Date/Time of Attestation (DTM) 01517

FIXME

ABS-5: Attested By (XCN) 01518

FIXME

ABS-6: Triage Code (CWE) 01519

FIXME

ABS-7: Abstract Completion Date/Time (DTM) 01520

FIXME

ABS-8: Abstracted By (XCN) 01521

FIXME

ABS-9: Case Category Code (CWE) 01522

FIXME

ABS-10: Caesarian Section Indicator (ID) 01523

FIXME

ABS-11: Gestation Category Code (CWE) 01524

FIXME

ABS-12: Gestation Period - Weeks (NM) 01525

FIXME

ABS-13: Newborn Code (CWE) 01526

FIXME

ABS-14: Stillborn Indicator (ID) 01527

FIXME

BLC - Blood Code Segment

The BLC segment contains data necessary to communicate patient abstract blood information used for billing and reimbursement purposes. This segment is repeating to report blood product codes and the associated blood units.

HL7 Attribute Table - BLC - Blood Code Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #
BLC
1	Blood Product Code	CWE	O	0426 Blood Product Code	[0..1]	01528
2	Blood Amount	CQ	O		[0..1]	01529

BLC-1: Blood Product Code (CWE) 01528

FIXME

BLC-2: Blood Amount (CQ) 01529

FIXME

RMI - Risk Management Incident Segment

The RMI segment is used to report an occurrence of an incident event pertaining or attaching to a patient encounter.

HL7 Attribute Table - RMI - Risk Management Incident Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #
RMI
1	Risk Management Incident Code	CWE	O	0427 Risk Management Incident Code	[0..1]	01530
2	Date/Time Incident	DTM	O		[0..1]	01531
3	Incident Type Code	CWE	O	0428 Incident Type Code	[0..1]	01533

RMI-1: Risk Management Incident Code (CWE) 01530

FIXME

RMI-2: Date/Time Incident (DTM) 01531

FIXME

RMI-3: Incident Type Code (CWE) 01533

FIXME

GP1 - Grouping/Reimbursement - Visit Segment

These fields are used in grouping and reimbursement for CMS APCs. Please refer to the "Outpatient Prospective Payment System Final Rule" ("OPPS Final Rule") issued by CMS.

The GP1 segment is specific to the US and may not be implemented in non-US systems.

HL7 Attribute Table - GP1 - Grouping/Reimbursement - Visit Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #
GP1
1	Type of Bill Code	CWE	R	0455 Type of Bill Code	[1..1]	01599
2	Revenue Code	CWE	O	0456(S) Revenue code(Suggested)	[0..*]	01600
3	Overall Claim Disposition Code	CWE	O	0457 Overall Claim Disposition Code	[0..1]	01601
4	OCE Edits per Visit Code	CWE	O	0458 OCE Edit Code	[0..*]	01602
5	Outlier Cost	CP	O		[0..1]	00387

GP1-1: Type of Bill Code (CWE) 01599

FIXME

GP1-2: Revenue Code (CWE) 01600

FIXME

GP1-3: Overall Claim Disposition Code (CWE) 01601

FIXME

GP1-4: OCE Edits per Visit Code (CWE) 01602

FIXME

GP1-5: Outlier Cost (CP) 00387

FIXME

GP2 - Grouping/Reimbursement - Procedure Line Item Segment

This segment is used for items that pertain to each HCPC/CPT line item.

The GP2 segment is specific to the US and may not be implemented in non-US systems.

HL7 Attribute Table - GP2 - Grouping/Reimbursement - Procedure Line Item Segment
Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	C.LEN	Flags
GP2
1	Revenue Code	CWE	O	0456(S) Revenue code(Suggested)	[0..1]	01600
2	Number of Service Units	NM	O		[0..1]	01604	7	#
3	Charge	CP	O		[0..1]	01605
4	Reimbursement Action Code	CWE	O	0459 Reimbursement Action Code	[0..1]	01606
5	Denial or Rejection Code	CWE	O	0460 Denial or Rejection Code	[0..1]	01607
6	OCE Edit Code	CWE	O	0458 OCE Edit Code	[0..*]	01608
7	Ambulatory Payment Classification Code	CWE	O	0466 Ambulatory Payment Classification Code	[0..1]	01609
8	Modifier Edit Code	CWE	O	0467 Modifier Edit Code	[0..*]	01610
9	Payment Adjustment Code	CWE	O	0468 Payment Adjustment Code	[0..1]	01611
10	Packaging Status Code	CWE	O	0469 Packaging Status Code	[0..1]	01617
11	Expected CMS Payment Amount	CP	O		[0..1]	01618
12	Reimbursement Type Code	CWE	O	0470 Reimbursement Type Code	[0..1]	01619
13	Co-Pay Amount	CP	O		[0..1]	01620
14	Pay Rate per Service Unit	NM	O		[0..1]	01621	4	#

GP2-1: Revenue Code (CWE) 01600

FIXME

GP2-2: Number of Service Units (NM) 01604

FIXME

GP2-3: Charge (CP) 01605

FIXME

GP2-4: Reimbursement Action Code (CWE) 01606

FIXME

GP2-5: Denial or Rejection Code (CWE) 01607

FIXME

GP2-6: OCE Edit Code (CWE) 01608

FIXME

GP2-7: Ambulatory Payment Classification Code (CWE) 01609

FIXME

GP2-8: Modifier Edit Code (CWE) 01610

FIXME

GP2-9: Payment Adjustment Code (CWE) 01611

FIXME

GP2-10: Packaging Status Code (CWE) 01617

FIXME

GP2-11: Expected CMS Payment Amount (CP) 01618

FIXME

GP2-12: Reimbursement Type Code (CWE) 01619

FIXME

GP2-13: Co-Pay Amount (CP) 01620

FIXME

GP2-14: Pay Rate per Service Unit (NM) 01621

FIXME

EXAMPLE TRANSACTIONS

Create a patient billing/accounts receivable record

MSH|^~VALUEamp;|PATA|01|PATB|01|19930908135031||BAR^P01^BAR_P01|641|P|2.8|000000000000001|

EVN|P01|19930908135030||

PID|1||8064993^^^PATA1^MR^A~6045681^^^PATA1^BN^A~123456789ABC^^^US^NI~123456789^^^USSSA^SS||EVERYWOMAN^EVE^J^^^||19471007|F||1|22220018 HOMESTREET^^HOUSTON^TX^77030^USA|HAR||||S||6045681

GT1|001||JOHNSON^SAM^J||1111 HEALTHCARE DRIVE^^BALTIMORE^MD^

21234^USA|||||||193-22-1876

NK1|001|BETTERHALF^BORIS|F|2222 HOME STREET^^CUMBERLAND^MD

^28765^US|(301)555-2134

IN1|001|A357|1234|BCMD||||| 132987

A patient has been registered by the ADT system (PATA) and notification is sent to the Patient Billing system (PATB). The patient's name is Eve J. Everywoman, a female Caucasian, born on October 7, 1947. Living at 1234 Homestreet, Houston, TX.

Ms. Everywoman's medical record number is 8064993 and her billing number is 6045681. Her national identifier is 123456789ABC. Her social security number, assigned by the U.S. Social Security Administration, is 123456789. Ms. Everywoman has provided her father's name and address for next of kin. Ms. Smith is insured under plan ID A357 with an insurance company known to both systems as BCMD, with a company ID of 1234.

Post a charge to a patient's account

MSH|^~VALUEamp;|PATA|01|PATB|01|19930908135031||DFT^P03^DFT_P03|641|P|2.8|000000000000001|

EVN|P03|19930908135030||

PID||0008064993^^^ENT^PE|0008064993^^^PAT^MR||0006045681^^^PATA^AN|EVERYWOMEN^EVE^J^^^|19471007|F||1|2222 HOMESTREET^^HOUSTON^TX^77030^USA|HAR||||S||6045681^^^PATA^AN

FT1|1|||19950715|19950716|CG|B1238^BIOPSY-SKIN^SYSTEMA|||1|||ONC|A357||||||P8765^KILDARE^BEN

Ms. Everywoman's patient number is 8064993 and her billing number is 6045681. This transaction is posting a charge for a skin biopsy to her account.

Update patient accounts - update UB1 information

MSH|^~VALUEamp;|UREV||PATB||19930906135030||BAR^P05^BAR_P05|MSG0018|P|2.8

EVN|P05|19930908135030

PID|||125976||EVERYMAN^ADAM^J|||||||||||||125976011

UB1|1|1|5|3|1||39|||01^500.00|||1|19880501|19880507|10^19880501

Utilization review sends data for Patient Billing to the Patient Accounting system. The patient's insurance program has a 1-pint deductible for blood; the patient received five pints of blood, and three pints were replaced, with one pint not yet replaced.

The patient has been assigned to a medically necessary private room (UB condition code 39). The hospital's most common semi-private rate is $500.00 (UB value code 01.)

The services provided for the period 05/01/88 through 05/07/88 are fully approved (PSRO/UR Approval Code 1). The patient's hospitalization is the result of an auto accident (UB occurrence code 01.)

Update patient accounts - update diagnosis and DRG information

MSH|^~VALUEamp;|UREV||PATB||19930908135030||BAR^P05^BAR_P05|MSG0018|P|2.8

EVN|P05|19930908135030

PID|||125976||EVERYMAN^ADAM^J|||||||||||||125976011

DG1|001|I9|1550|MAL NEO LIVER, PRIMARY|19880501103005|F

DRG|203|19880501103010|Y||D|5

The DG1 segment contains the information that the patient was diagnosed on May 1 as having a malignancy of the hepatobiliary system or pancreas (ICD9 code 1550). In the DRG segment, the patient has been assigned a Diagnostic Related Group (DRG) of 203 (corresponding to the ICD9 code of 1550). Also, the patient has been approved for an additional five days (five-day outlier).

Draft Website - For Review Purposes Only

Financial Management

PURPOSE

PATIENT ACCOUNTING MESSAGE SET

TRIGGER EVENTS AND MESSAGE DEFINITIONS

BAR/ACK - Add Patient Account (Event P01)

Original Mode Acknowledgement Choreography for BAR^P01^BAR_P01

Enhanced Mode Acknowledgement Choreography for BAR^P01^BAR_P01

BAR/ACK - Purge Patient Accounts (Event P02)

Original Mode Acknowledgement Choreography for BAR^P02^BAR_P02

Enhanced Mode Acknowledgement Choreography for BAR^P02^BAR_P02

DFT/ACK - Post Detail Financial Transactions (Event P03)

Original Mode Acknowledgement Choreography for DFT^P03^DFT_P03

Enhanced Mode Acknowledgement Choreography for DFT^P03^DFT_P03

QRY/DSR - Generate Bills And Accounts Receivable Statements (Event P04)

BAR/ACK - Update Account (Event P05)

Original Mode Acknowledgement Choreography for BAR^P05^BAR_P05

Enhanced Mode Acknowledgement Choreography for BAR^P05^BAR_P05

BAR/ACK - End Account (event P06)

Original Mode Acknowledgement Choreography for BAR^P06^BAR_P06

Enhanced Mode Acknowledgement Choreography for BAR^P06^BAR_P06

BAR/ACK - Transmit Ambulatory Payment Classification (APC) Groups (Event P10)

Original Mode Acknowledgement Choreography for BAR^P10^BAR_P10

Enhanced Mode Acknowledgement Choreography for BAR^P10^BAR_P10

DFT/ACK - Post Detail Financial Transactions - Expanded (Event P11)

Original Mode Acknowledgement Choreography for DFT^P11^DFT_P11

Enhanced Mode Acknowledgement Choreography for DFT^P11^DFT_P11

BAR/ACK - Update Diagnosis/Procedure (Event P12)

Original Mode Acknowledgement Choreography for BAR^P12^BAR_P12

Enhanced Mode Acknowledgement Choreography for BAR^P12^BAR_P12

MESSAGE SEGMENTS

FT1 - Financial Transaction Segment

FT1-1: Set ID - FT1 (SI) 00355

FT1-2: Transaction ID (CX) 00356

FT1-3: Transaction Batch ID (ST) 00357

FT1-4: Transaction Date (DR) 00358

FT1-5: Transaction Posting Date (DTM) 00359

FT1-6: Transaction Type (CWE) 00360

FT1-7: Transaction Code (CWE) 00361

FT1-8: Transaction Description () 00362

FT1-9: Transaction Description - Alt () 00363

FT1-10: Transaction Quantity (NM) 00364

FT1-11: Transaction Amount - Extended (CP) 00365

FT1-12: Transaction Amount - Unit (CP) 00366

FT1-13: Department Code (CWE) 00367

FT1-14: Health Plan ID (CWE) 00368

FT1-15: Insurance Amount (CP) 00369

FT1-16: Assigned Patient Location (PL) 00133

FT1-17: Fee Schedule (CWE) 00370

FT1-18: Patient Type (CWE) 00148

FT1-19: Diagnosis Code - FT1 (CWE) 00371

FT1-20: Performed By Code (XCN) 00372

FT1-21: Ordered By Code (XCN) 00373

FT1-22: Unit Cost (CP) 00374

FT1-23: Filler Order Number (EI) 00217

FT1-24: Entered By Code (XCN) 00765

FT1-25: Procedure Code (CNE) 00393

FT1-26: Procedure Code Modifier (CNE) 01316

FT1-27: Advanced Beneficiary Notice Code (CWE) 01310

FT1-28: Medically Necessary Duplicate Procedure Reason (CWE) 01646

FT1-29: NDC Code (CWE) 01845

FT1-30: Payment Reference ID (CX) 01846

FT1-31: Transaction Reference Key (SI) 01847

FT1-32: Performing Facility (XON) 02361

FT1-33: Ordering Facility (XON) 02362

FT1-34: Item Number (CWE) 02363

FT1-35: Model Number (ST) 02364

FT1-36: Special Processing Code (CWE) 02365

FT1-37: Clinic Code (CWE) 02366

FT1-38: Referral Number (CX) 02367

FT1-39: Authorization Number (CX) 02368

FT1-40: Service Provider Taxonomy Code (CWE) 02369

FT1-41: Revenue Code (CWE) 01600

FT1-42: Prescription Number (ST) 00325

FT1-43: NDC Qty and UOM (CQ) 02370

FT1-44: DME Certificate of Medical Necessity Transmission Code (CWE) 03496

FT1-45: DME Certification Type Code (CWE) 03497

FT1-46: DME Duration Value (NM) 03498

FT1-47: DME Certification Revision Date (DT) 03499

FT1-48: DME Initial Certification Date (DT) 03500