2 Patient Administration for Pathology

2.1 Message Control Segments 

The following segments are necessary to support the functionality described in this chapter.

If a value is the usual default for use in Australia it has been highlighted in blue.

Figure 2-1. HL7 message segments 

2.1.2 BHS - batch header segment

The BHS segment defines the start of a batch.

HL7 Attribute Table - BHS – Batch Header

2.1.2.0 BHS field definitions

2.1.2.1 BHS-1 Batch field separator (ST) 00081

Definition: This field contains the separator between the segment ID and the first real field, BHS-2-batch encoding characters. As such it serves as the separator and defines the character to be used as a separator for the rest of the message. Recommended value is |,(ASCII 124).

2.1.2.2 BHS-2 Batch encoding characters (ST) 00082

Definition: This field contains the four characters in the following order: the component separator, repetition separator, escape characters, and subcomponent separator. Australian values are ^~\& (ASCII 94,126, 92, and 38, respectively). 

2.1.2.3 BHS-3 Batch sending application (ST) 00083

Definition: This field uniquely identifies the sending application among all other applications within the network enterprise. The network enterprise consists of all those applications that participate in the exchange of HL7 messages within the enterprise. Entirely site-defined.

2.1.2.4 BHS-4 Batch sending facility (ST) 00084

Definition: This field contains the address of one of several occurrences of the same application within the sending system. Absent other considerations, the Medicare Provider ID might be used with an appropriate sub-identifier in the second component. Entirely user-defined.

2.1.2.5 BHS-5 Batch receiving application (ST) 00085

Definition: This field uniquely identifies the receiving applications among all other applications within the network enterprise. The network enterprise consists of all those applications that participate in the exchange of HL7 messages within the enterprise. Entirely site-defined.

2.1.2.6 BHS-6 Batch receiving facility (ST) 00086

Definition: This field identifies the receiving application among multiple identical instances of the application running on behalf of different organizations. See comments BHS-4-batch sending facility. Entirely site-defined.

2.1.2.7 BHS-7 Batch creation date/time (TS) 00087

Definition: This field contains the date/time that the sending system created the message. If the time zone is specified, it will be used throughout the message as the default time zone.

2.1.2.8 BHS-8 Batch security (ST) 00088

Definition: In some applications of HL7, this field is used to implement security features. Its use is not yet further specified.

2.1.2.9 BHS-9 Batch name/ID/type (ST) 00089

Definition: This field can be used by the application processing the batch. It can have extra components if needed.

2.1.2.10 BHS-10 Batch comment (ST) 00090

Definition: This field is a comment field that is not further defined in the HL7 protocol.

2.1.2.11 BHS-11 Batch control ID (ST) 00091

Definition: This field is used to uniquely identify a particular batch. It can be echoed back in BHS-12-reference batch control ID if an answering batch is needed.

2.1.2.12 BHS-12 Reference batch control ID (ST) 00092

Definition: This field contains the value of BHS-11-batch control ID when this batch was originally transmitted.

Not present if this batch is being sent for the first time. See definition for BHS-11-batch control ID.

2.1.3 BTS - batch trailer segment

The BTS segment defines the end of a batch.

2.1.3.0 BTS field definitions

HL7 Attribute Table - BTS – Batch Trailer

2.1.3.1 BTS-1 Batch message count (ST) 00093

Definition: This field contains the count of the individual messages contained within the batch.

2.1.3.2 BTS-2 Batch comment (ST) 00090

Definition: This field is a comment field that is not further defined in the HL7 protocol.

2.1.3.3 BTS-3 Batch totals (NM) 00095

Definition: We encourage new users of this field to use the HL7 Version 2.3 data type of NM and to define it as “repeating.” This field contains the batch total. Only a single Batch is allowed in Australia.

This field may be defined as a CM data type for backward compatibility with HL7 Versions 2.2 and 2.1with each total being carried as a separate component. Each component in this case is an NM data type.

2.1.4 DSC - continuation pointer segment

The DSC segment is used in the continuation protocol.

2.1.4.0 DSC field definitions

HL7 Attribute Table - DSC – Continuation Pointer

2.1.4.1 DSC-1 Continuation pointer (ST) 00014

Definition: This field contains the continuation pointer. In an initial query, this field is not present. If the responder returns a value of null or not present, then there is no more data to fulfill any future continuation requests. For use with continuations of unsolicited messages, see HL7 International Standard chapter 5 and section 2.15.2, "Continuation messages and segments.” Note that continuation protocols work with both display- and record-oriented messages.

2.1.4.2 DSC-2 Continuation style (ID) 01354

Definition: Indicates whether this is a fragmented message (see HL7 International Standard Section 2.15.2, "Continuation messages and segments"), or if it is part of an interactive continuation message (see HL7 International Standard Section 5.6.3, "Interactive continuation of response messages").

Refer to HL7 Table 0398 – Continuation style code for valid values.

HL7 Table 0398 - Continuation style code

2.1.5 ERR - error segment

The ERR segment is used to add error comments to acknowledgment messages.

HL7 Attribute Table - ERR –Error

2.1.5.0 ERR field definition

2.1.5.1 ERR-1 Error code and location (CM) 00024

Components: <segment ID (ST)> ^ <sequence (NM)> ^ <field position (NM)> ^ <code identifying error (CE)>

Definition: This field identifies an erroneous segment in another message. The second component is an index if there is more than one segment of type <segment ID>. For systems that do not use the HL7 Encoding Rules, the data item number may be used for the third component. The fourth component (which references HL7 Table 0357 - Message error condition codes, (as a CE data type) is restricted from having any subcomponents as the subcomponent separator is now the CE’s component separator.

2.1.6 FHS - file header segment

The FHS segment is used to head a file as defined in Overview.

HL7 Attribute Table - FHS - File Header   

2.1.6.0 FHS field definitions

2.1.6.1 FHS-1 File field separator (ST) 00067

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

2.1.6.2 FHS-2 File encoding characters (ST) 00068

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

2.1.6.3 FHS-3 File sending application (ST) 00069

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

2.1.6.4 FHS-4 File sending facility (ST) 00070

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

2.1.6.5 FHS-5 File receiving application (ST) 00071

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

2.1.6.6 FHS-6 File receiving facility (ST) 00072

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

2.1.6.7 FHS-7 File creation date/time (TS) 00073

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

2.1.6.8 FHS-8 File security (ST) 00074

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

2.1.6.9 FHS-9 File name/ID (ST) 00075

Definition: This field can be used by the application processing file. Its use is not further specified.

2.1.6.10 FHS-10 File header comment (ST) 00076

Definition: This field contains the free text field, the use of which is not further specified.

2.1.6.11 FHS-11 File control ID (ST) 00077

Definition: This field is used to identify a particular file uniquely. It can be echoed back in FHS-12-reference file control ID.

2.1.6.12 FHS-12 Reference file control ID (ST) 00078

Definition: This field contains the value of FHS-11-file control ID when this file was originally transmitted.

Not present if this file is being transmitted for the first time.

2.1.7 FTS - file trailer segment

The FTS segment defines the end of a file.

HL7 Attribute Table - FTS - File Trailer

2.1.7.0 FTS field definitions

2.1.7.1 FTS-1 File batch count (NM) 00079

Definition: This field contains the number of batches contained in this file. In Australia there is a maximum of 1 batch in a file.

2.1.7.2 FTS-2 File trailer comment (ST) 00080

Definition: The use of this free text field is not further specified.

2.1.8 MSA - message acknowledgment segment

The MSA segment contains information sent while acknowledging another message.

HL7 Attribute Table - MSA - Message Acknowledgment

The sending system must return the Message Control ID from the received message in the MSA segment. 

2.1.8.0 MSA field definitions

2.1.8.1 MSA-1 Acknowledgment code (ID) 00018

Definition: This field contains an acknowledgment code, see message processing rules. Refer to HL7 Table 0008 - Acknowledgment code for valid values.

HL7 Table 0008 - Acknowledgment code

2.1.8.2 MSA-2 Message control ID (ST) 00010

Definition: This field contains the message control ID of the message sent by the sending system. It allows the sending system to associate this response with the message for which it is intended.

2.1.8.3 MSA-3 Text message (ST) 00020

Definition: This optional field further describes an error condition. This text may be printed in error logs or presented to an end user.

Use of MSA-3-text message and MSA-6-error condition are deprecated in favor of ERR-1-Error code and location. The ERR segment allows for richer descriptions of the erroneous conditions.

2.1.8.4 MSA-4 Expected sequence number (NM) 00021

Definition: This optional numeric field is used in the sequence number protocol.

2.1.8.5 MSA-5 Delayed acknowledgment type (ID) 00022

Definition:  This field has been retained for backward compatibility.   This field is used only as described above, in the HL7 International Standard Section 2.13.2, “Application (level 7) processing rules, deferred processing two phase reply (original acknowledgment mode only).” Otherwise this field is not used.

HL7 Table 0102 - Delayed acknowledgment type

2.1.8.6 MSA-6 Error condition (CE) 00023

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

Definition: This field allows the acknowledging system to use a user-defined error code to further specify AR or AE type acknowledgments. This field is a generalized replacement for MSA-3-text message .

Use of MSA-3-text message  and MSA-6-error condition  are deprecated in favor of ERR-1 -Error code and location. The ERR segment allows for richer descriptions of the erroneous conditions.

The Message Error Condition codes are defined by HL7 Table 0357 - Message error condition codes.

HL7 Table 0357 - Message error condition codes

2.1.9 MSH - message header segment

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

HL7 Attribute Table - MSH - Message Header

† Australian variation to HL7 V2.4 with the length changed from 13 to 15 characters.

†† Australian variation to HL7 V2.4 with the length changed from 20 to 199 characters to accommodate a globally unique identifier. This has been pre-adopted from HL72.6-2.9.

†††Australian variation to HL7 V2.4, field optionality has been changed to required.

††††Australian variation to HL7 V2.4 with the length changed from 60 to 250 characters.

††††† Australian variation to HL7 V2.4, field is pre-adopted from HL7 International v2.9. Length of 250 has been set consistent with the CWE length specified in section 3.6 CWE – coded with exceptions.

†††††† Australian variation to HL7 V2.4, field repeat is disallowed.

2.1.9.0 MSH field definitions

2.1.9.1 MSH-1 Field separator (ST) 00001

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

2.1.9.2 MSH-2 Encoding characters (ST) 00002

Definition: This field contains the four characters in the following order: the component separator, repetition separator, escape character, and subcomponent separator. Recommended values are ^~\& (ASCII 94,126, 92, and 38, respectively). In the Australian context the separators are fixed to these values.

2.1.9.3 MSH-3 Sending application (HD) 00003

Components: <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>

Definition: This field uniquely identifies the sending application among all other applications within the network enterprise. The network enterprise consists of all those applications that participate in the exchange of HL7 messages within the enterprise. Entirely site-defined.

User-defined Table 0361-Sending/receiving application is used as the user-defined table of values for the first component.

User-defined Table 0361 – Sending/receiving application

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

2.1.9.4 MSH-4 Sending facility (HD) 00004

Components: <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>

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

User-defined Table 0362 - Sending/receiving facility is used as the HL7 identifier for the user-defined table of values for the first component.

User-defined Table 0362 – Sending/receiving facility

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

2.1.9.5 MSH-5 Receiving application (HD) 00005

Components: <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>

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

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

2.1.9.6 MSH-6 Receiving facility (HD) 00006

Components: <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>

Definition: This field identifies the receiving application among multiple identical instances of the application running on behalf of different organizations. 

User-defined Table 0362 - Sending/receiving facility is used as the HL7 identifier for the user-defined table of values for the first component. Entirely site-defined.

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

2.1.9.7 MSH-7 Date/time of message (TS) 00007

Definition: This field contains the date/time that the sending system created the message. If the time zone is specified, it will be used throughout the message as the default time zone.

Note: This field was made required in version 2.4. Messages with versions prior to 2.4 are not required to value this field. This usage supports backward compatibility.

2.1.9.8 MSH-8 Security (ST) 00008

Definition: In some applications of HL7, this field is used to implement security features. Its use is not yet further specified.

2.1.9.9 MSH-9 Message type (CM) 00009

Components: <message type (ID)> ^ <trigger event (ID)> ^ <message structure (ID)>

Definition: This field contains the message type, trigger event, and the message structure ID for the message.

The first component is the message type code defined by HL7 Table 0076 - Message type. This table contains values such as ACK, ADT, ORM, ORU etc. See HL7 International Standard section 2.17.1 for complete listing.

The second component is the trigger event code defined by HL7 Table 0003 - Event type. This table contains values like A01, O01, R01 etc. See HL7 International Standard section 2.17.2 for a complete listing

The third component is the abstract message structure code defined by HL7 Table 0354 - Message structure.

This table has two columns. The first column contains the value of this code, which describes a particular HL7 “abstract message structure definition” in terms of segments, as defined in HL7 International Standard sections 2.12, “CHAPTER FORMATS FOR DEFINING HL7 MESSAGES” and 2.12.1, “HL7 abstract message syntax example”. The second column of table 0354 lists the various HL7 trigger events that use the particular abstract message definition. For example, the message structure code ADT_A01 describes the single abstract message structure used by the trigger events A01, A04, A05, A08, A13, A14, A28 and A31. See HL7 International Standard section 2.17.3 for a complete listing.

Note: Australian variation to HL7 V2.4 with the length changed from 13 to 15 characters.

2.1.9.10 MSH-10 Message control ID (ST) 00010

Definition: This field contains a number or other identifier that uniquely identifies the message. The receiving system echoes this ID back to the sending system in the Message acknowledgment segment (MSA).
The Message Control ID is not an order number for the request nor is it a specimen identifier used by the pathology provider. It is a unique internal identifier for one specific message originating from a particular site. This internal field in the message will not conflict when messages from different placers/fillers with the same Message Control ID are received.  All systems should ensure that their data tables are not keyed uniquely using the value from Message Control ID.

If a patient has one MSH with multiple OBR segments and if there is an error in one result then all results in the message are rejected, not just the OBR with the error. However, when one MSH is sent for each OBR then only the result with the error is rejected.

The recommended format for Message Control ID is a combination of two or three components, including:
1) The first component is to identify the sending facility. 
2) The second (optional) component is a date in YYYYMMDD format.
3) The third component is an incremental counter starting at number 1. 
The generalised format is:

 <sending facility>_<date>.n{nnnnnnn..}

Example:

dhm_20160505.2178

qml_20160915.789

Note: It is not intended for the full AUSNATA form to be used, only the first component of the AUSNATA code. 

For placers, they could use their <site code> or <site code>_<date> e.g. px_45678912.25 

Note: Australian variation to HL7 V2.4 with the length changed from 20 to 36 characters to accommodate a globally unique identifier (GUID).   

2.1.9.11 MSH-11 Processing ID (PT) 00011

Components: <processing ID (ID)> ^ <processing mode (ID)>

Definition: This field is used to decide whether to process the message as defined in HL7 Application (level 7) Processing rules. The first component defines whether the message is part of a production, training, or debugging system (refer to HL7 Table 0103 - Processing ID for valid values). The second component defines whether the message is part of an archival process or an initial load (refer to HL7 Table 0207 - Processing mode for valid values). This allows different priorities to be given to different processing modes. The value used in normal usage is highlighted in blue.

HL7 Table 0103 - Processing ID

HL7 Table 0207 - Processing mode

2.1.9.12 MSH-12 Version ID (VID) 00012

Components: <version ID (ID)> ^ <internationalization code (CE)> ^ <internal version ID (CE)>

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

HL7 Table 0104 —Version ID

To indicate compliance with this localisation the <internationalization code (CE)> must be "AUS&Australia&ISO3166_1".

The <internal version ID (CE)> component must be valued as follows to indicate the profile that is being adhered by the sender.

When the profile is referenced in AU FHIR Provider Directory Endpoint resource payloadType attribute, append the internal version ID identifier component to the following base URL http://ns.hl7.org.au/hl7v2/profiles/. The allowed values in the following table should be maintained into the Australian Endpoint Payload Types value set FHIR resource.

The year and serial number component YYYYXX (where YYYY is a 4 digit year, and XX is a 2 digit serial number) of the internal version ID may change on publication of this specification to align with the version numbering. e.g. "HL7AUSD-STD-OO-ADRM-2018.1" an ID becomes: HL7AU-OO-REF-SIMPLIFIED-201801 where there is a substantive change to the profile otherwise it will remain unchanged and reflect the time of the last substantial change. (A serial number XX is used instead of a date as often the date of publication is unknown, this allows for advance drafting prior to release) 

These are identifiers and they are not intended to be parsed.

HL7 Table 01043—Internal Version ID

*Note that the internal version ID value is shared between multiple message types e.g. REF / RRI.

To indicate compliance with Simplified Referral profile see Appendix 8 Simplified REF profile A8.3 Sender Conformance.

To indicate compliance with other profiles, refer to the profile specification.

2.1.9.13 MSH-13 Sequence number (NM) 00013

Definition: A non-null value in this field implies that the sequence number protocol is in use. This numeric field is incremented by one for each subsequent value.

2.1.9.14 MSH-14 Continuation pointer (ST) 00014

Definition: This field is used to define continuations in application-specific ways.

Only the sender of a fragmented message values this field.

2.1.9.15 MSH-15 Accept acknowledgment type (ID) 00015

Definition: This field identifies the conditions under which accept acknowledgments are required to be returned in response to this message. Required for enhanced acknowledgment mode. Refer to HL7 Table 0155 - Accept/application acknowledgment conditions for valid values.

Note: In the Australian context acknowledgements must always be used and the value must be "AL".

2.1.9.16 MSH-16 Application acknowledgment type (ID) 00016

Definition: This field contains the conditions under which application acknowledgments are required to be returned in response to this message. Required for enhanced acknowledgment mode.

The following table contains the possible values for MSH-15-accept acknowledgment type and MSH-16- application acknowledgment type:

HL7 Table 0155 - Accept/application acknowledgment conditions

Note: In the Australian context application acknowledgements should be used and the value must be "AL".

2.1.9.17 MSH-17 Country code (ID) 00017

Definition: This field contains the country of origin for the message. It will be used primarily to specify default elements, such as currency denominations. The values to be used are those of ISO 3166, which are reprinted here upon written approval from ANSI.². The ISO 3166 table has three separate forms of the country code: HL7 specifies that the 3-character (alphabetic) form be used for the country code.

^{2 Available from ISO 1 Rue de Varembe, Case Postale 56, CH 1211, Geneve, Switzerland}

Refer to HL7 Table 0399 - Country code for the 3-character codes as defined by ISO 3166 table.

HL7 Table 0399 – Country code 

2.1.9.18 MSH-18 Character set (ID) 00692

Definition: This field contains the character set for the entire message. Refer to HL7 Table 0211 - Alternate character sets for valid values.

In Australian usage only "ASCII" must be used (unvalued implies "ASCII").  "UNICODE UTF-8" and "8859/1" messages should only be used by specific agreement.

The International standard allows repeats of this field, but this standard has constrained it to a single character set for the entire message.

HL7 Table 0211 - Alternate character sets

^{† "UNICODE UTF-8" was introduced in HL7v2.6 and has been back ported into this HL7v2.4 localisation to allow use of UTF-8 character encoding.}

Note: The field separator character must still be chosen from the printable 7-bit ASCII character set.

The repetitions of this field to specify different character sets apply only to fields of the, FT, ST, and TX data types.

The field MSH-18-character set is an optional, repeating field of data type ID, using IDs outlined in HL7 Table 0211 - Alternate character sets (or equivalents from "ISO 2375").

• • if the field is not valued, the default single-byte character set (ASCII ("ISO IR6")) should be assumed. No other character sets are allowed in the message.
  • if the field repeats, but the first element is NULL (i.e., present but unvalued), the single-byte ASCII ("ISO IR6") is assumed as the default character set.
  • if the sequence is present and the first element is specified, this character set is regarded as the default character set for the message. This must be a single-byte character set (i.e., "ISO IR6", "ISO IR13", "ISO IR14", "ISO IR100", etc.).
  • elements in the remainder of the sequence (i.e., elements 2..n) are alternate character sets that may be used. These may include multi-byte character sets (i.e., JIS X 0208).
  • the default character set should always be a single-byte character set. It should always have "ISO IR6" (ISO 646) or "ISO IR14" (JIS X 0201-1976) in the G0 area. 

2.1.9.19 MSH-19 Principal language of message (CE) 00693

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

Definition: This field contains the principal language of the message. Codes come from ISO 639.

Note: In the Australian context use "en" for English. 

2.1.9.20 MSH-20 Alternate character set handling scheme (ID) 01317

        Alternative Character Sets are not used in Australia and this field is null. The information below is what appears in the international standard.

Definition: When any alternative character sets are used (as specified in the second or later components of MSH-18 character sets), and if any special handling scheme is needed, this component is to specify the scheme used, according to HL7 Table 0356- Alternate character set handling scheme as defined below:

HL7 Table 0356 - Alternate character set handling scheme

2.1.9.21 MSH-21 Conformance statement ID (ID) 01598

Definition: Sites may use this field to assert adherence to a Conformance Statement published by HL7 or by a site. Conformance Statements contain detailed explanations of grammar, syntax, and usage for a particular message or set of messages. Examples of the use of Conformance Statements appear in HL7 International Standard Chapter 5, "Query."

Repetition of this field allows more flexibility in creating and naming conformance statements. For example, the first repetition could reference a standard conformance statement, and the second, just some changes to it.

Values for HL7-standard conformance statements appear in HL7 Table 0449 - Conformance statements as defined below.

HL7 Table 0449 - Conformance statements

Note: As HL7 technical committees ballot conformance statements, table 449 will be populated with their identifiers. No identifiers have been issued as of v 2.4. As with any HL7 table, this table may be extended with site-defined identifiers.

The sender should specify in this field the appropriate version of this specification that the message is compliant with. This field may become a requirement in future versions.

2.1.9.27 MSH-27 Security Handling Instructions (CWE) 2430

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)> ^ <coding system version ID (ST)> ^ alternate coding system version ID (ST)> ^ <original text (ST)>

Definition: This field is repeatable and conveys instructions to users and receivers for secure distribution, transmission, and storage; dictate obligations or mandated actions; specify any action prohibited by refrain policy such as dissemination controls; and stipulate the permissible purpose of use of an IT resource.

This field is pre-adopted from HL7 International v2.9.

In addition to the above definition, in the context of messages that will be submitted to a repository where they will be accessed subsequently by an unknown party using a retrieval token such as printed on a barcode, then that retrieval token can be stored in the Identifier <ST> component while the Name of Coding System <IS> must indicate the scheme for the retrieval repository.

2.2 Other segments used in pathology messaging 

This section covers the following segments that are often included in pathology messaging. Important order and observation segments are not included here, but are covered in detail in Chapters 4 and 5 of this guide.

 Quick links:

2.2.1 PID - patient identification segment

The PID segment is used by all applications as the primary means of communicating patient identification information.  This segment contains permanent patient identifying and demographic information that, for the most part, is not likely to change frequently.

It should be noted that from V2.4 onwards the demographics of animals can also be sent in the PID segment (see PID-35 to PID-38).

The assigning authority, the fourth component of the patient identifiers, is a HD data type that is uniquely associated with the assigning authority that originally assigned the number.  A given institution, or group of intercommunicating institutions, should establish a list of assigning authorities that may be potential assignors of patient identification (and other important identification) numbers.  The list will be one of the institution’s master dictionary lists.  Since third parties (other than the assignors of patient identification numbers) may send or receive HL7 messages containing patient identification numbers, the assigning authority in the patient identification numbers may not be the same as the sending and receiving systems identified in the MSH.  The assigning authority must be unique across applications at a given site.  This field is required in HL7 implementations that have more than a single Patient Administration application assigning such numbers.  The assigning authority and identifier type codes are strongly recommended for all CX data types.

With HL7 V2.3, the nomenclature for the fourth component of the patient identifiers was changed from "assigning facility ID" to "assigning authority".  While the identifier may be unique to a given healthcare facility (for example, a medical record assigned by facility A in Hospital XYZ), the identifier might also be assigned at a system level (for example a corporate person index or enterprise number spanning multiple facilities) or by a government entity, for example a nationally assigned unique individual identifier.  While a facility is usually an assigning authority, not all assigning authorities are facilities.  Therefore, the fourth component is referred to as an assigning authority, but retains backward compatibility using the construct of the HD data type (see the note in section 2.8.18).  Additionally, CX data types support the use of assigning facility (HD) as the sixth component.

HL7 Attribute Table – PID – Patient identification

† PID-6 and PID-10: component repeatability has been removed in the Australian context.  Variance to HL7 International.

†† PID-22: Not to be used for indigenous status or country of birth in Australia.  Variance to HL7 International.

‡ PID-24: HL7 table 0136 has options of 'Yes/No', whereas METeOR 668881 is the number of live births arising from a single pregnancy. Use HL7 Table 0136.

φ PID-27: DVA file number is sent in PID-3.1. The DVA card colour is no longer sent in this field (refer to PID-3.5). Variance to HL7 International.

††† PID-1 is mandatory in the Australian context. Variance to HL7 International.

2.2.1.0 PID field definition

2.2.1.1 PID-1 Set ID PID (SI) 00104

Definition:  This field contains the number that identifies this transaction.  For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

2.2.1.2 PID-2 Patient ID  (CX) 00105

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (ID)> ^ < assigning facility (HD) ^ <effective date (DT)> ^ <expiration date (DT)>

Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Definition:  This field has been retained for backward compatibility only. The arbitrary term of "external ID" has been removed from the name of this field.  The repetition, assigning authority, healthcare facility, and identifier type code attributes of PID-3 - patient identifier list allow for distinctive identifier representation.  This field remains for systems with a negotiated understanding of "external."  It is recommended to use PID-3 - patient identifier list for all patient identifiers.

When used for backward compatibility, this field is valued when the patient is from another institution, outside office, etc., and the identifier used by that institution can be shown in this field.  This may be a number that multiple disparate corporations or facilities share.  Refer to HL7 Table 0061 - Check digit scheme.

2.2.1.3 PID-3 Patient identifier list  (CX) 00106

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (ID)> ^ < assigning facility (HD) ^ <effective date (DT)> ^ <expiration date (DT)>

Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Definition:  This field contains the list of identifiers (one or more) used by the healthcare facility to uniquely identify a patient (e.g., medical record number, billing number, birth registry, national unique individual identifier, etc.).  The Australian individual healthcare identifier (IHI) should be sent in this field.  Refer to HL7 Table 0061 - Check digit scheme for valid values. The arbitrary term of  "internal ID" has been removed from the name of this field for clarity.  Refer also to HL7 Table 0203 - Identifier Type and User-defined Table 0363 - Assigning authority for valid values.

Only the sender's identifier(s) and the receiver's identifier(s) should be transmitted to avoid inappropriate use and disclosure of patient information. Other organizations' identifiers should not be used by organisations or providers as their own identifiers. The Privacy Act 1998 (commonwealth) has the relevant state and territory legislation regarding person identifiers. 

Patient identifiers are not always unique.

2.2.1.4 PID-4 Alternate patient ID - PID  (CX) 00107

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (ID)> ^ < assigning facility (HD) ^ <effective date (DT)> ^ <expiration date (DT)>

Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Definition: This field has been retained for backward compatibility only. It is recommended to use PID-3 - patient identifier list for all patient identifiers. When used for backward compatibility, this field contains the alternate, temporary, or pending optional patient identifier to be used if needed  - or additional numbers that may be required to identify a patient.  This field may be used to convey multiple patient IDs when more than one exist for a patient. Possible contents might include a visit number, a visit date, or a Social Security Number.

2.2.1.5 PID-5 Patient name (XPN) 00108

Components: In Version 2.3, replaces the PN data type.  <family name (FN)> ^ <given name (ST)> ^ <second and further given names or initials thereof (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <name type code (ID) > ^ <name representation code (ID)> ^ <name context (CE)> ^ <name validity range (DR)> ^ <name assembly order (ID)>

Subcomponents of family name: <family name (ST)> & <own family name prefix (ST)> & <own family name (ST)> & <family name prefix from partner/spouse (ST)> & <family name from partner/spouse (ST)>

Definition:  This field contains the names of the patient, the primary or legal name of the patient is reported first. Therefore, the name type code in this field should be "L - Legal". Refer to HL7 Table 0200 - Name type for valid values.  Repetition of this field is allowed for representing the same name in different character sets.  Note that "last name prefix" is synonymous to "own family name prefix" of previous versions of HL7, as is "second and further given names or initials thereof" to "middle initial or name". Multiple given names and/or initials are separated by spaces.

HL7 Table 0200 - Name type

For animals, if a Name Type of "R" is used, use "Name Context" to identify the authority with which the animal’s name is registered.

2.2.1.6 PID-6 Mother's maiden name  (XPN) 00109

Components: In Version 2.3, replaces the PN data type.  <family name (FN)> ^ <given name (ST)> ^ <second and further given names or initials thereof (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <name type code (ID) > ^ <name representation code (ID)> ^ <name context (CE)> ^ <name validity range (DR)> ^ <name assembly order (ID)>

Subcomponents of family name: <family name (ST)> & <own family name prefix (ST)> & <own family name (ST)> & <family name prefix from partner/spouse (ST)> & <family name from partner/spouse (ST)>

Definition:  This field contains the family name under which the mother was born (i.e., before marriage). It is used to distinguish between patients with the same last name.

2.2.1.7 PID-7 Date/time of birth (TS) 00110

Definition:  This field contains the patient’s date and time of birth.

This field allows for variable precision of the date/time of birth. Refer to 3.26 TS - time stamp for details how to encode date/time in this field.

Refer to METeOR 287007, ‘Date of birth’ and AS 4846-2014 Clause 5.2.3 'Date of Birth Accuracy Indicator', Clause 5.2.2 'Date of Birth'.

2.2.1.8 PID-8 Administrative sex (IS) 00111

Definition:  This field contains the patient’s sex. 

HL7 code values (User-defined Table 0001 - Administrative sex) need to be used for messages whereas METeOR values are required for data collection and statistics. The following mapping should be used:

Also refer to AS 4846-2014 Clause 5.5 'Sex'.

2.2.1.9 PID-9 Patient alias (XPN) 00112

 Components: In Version 2.3, replaces the PN data type.  <family name (FN)> ^ <given name (ST)> ^ <second and further given names or initials thereof (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <name type code (ID) > ^ <name representation code (ID)> ^ <name context (CE)> ^ <name validity range (DR)> ^ <name assembly order (ID)>

Subcomponents of family name: <family name (ST)> & <own family name prefix (ST)> & <own family name (ST)> & <family name prefix from partner/spouse (ST)> & <family name from partner/spouse (ST)>

Definition:  This field has been retained for backward compatibility only. It is recommended to use PID-5 - patient name for all patient names. This field contained the name(s) by which the patient has been known at some time.  Refer to HL7 Table 0200 - Name type for valid values.

2.2.1.10 PID-10 Race (CE) 00113

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

Definition:  This element is used for Indigenous status - refer to METeOR 602543 'Indigenous status'.  The second triplet of the CE data type for race (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes.

Note: In the Australian context the component repeatability has been removed. A variance to HL7 International.

2.2.1.11 PID-11 Patient address (XAD) 00114

Components: In Version 2.3 and later, replaces the AD data type.  <street address (ST)> ^ <other designation (ST)> ^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code (ST)> ^ <country (ID)> ^ < address type (ID)> ^ <other geographic designation (ST)> ^ <county/parish code (IS)> ^ <census tract (IS)> ^ <address representation code (ID)> ^ <address validity range (DR)>

Subcomponents of street address: <street address (ST)> & <street name (ST)> & <dwelling number (ST)>

Definition:  This field contains the mailing address of the patient.  Address type codes are defined by HL7 Table 0190 - Address type.  Multiple addresses for the same person may be sent in the following sequence: The primary mailing address must be sent first in the sequence (for backward compatibility); if the mailing address is not sent, then a repeat delimiter must be sent in the first sequence.

HL7 Table 0190 - Address Type 

Example field: PID-11 Patient address

Refer to AS 4846-2014 Clause 6.

2.2.1.12 PID-12 County code (IS) 00115

Definition:  This field has been retained for backward compatibility.  This field contains the patient’s county code.  The county can now be supported in the county/parish code component of the XAD data type (PID-11 - Patient Address).  Refer to User-defined Table 0289 - County/parish for suggested values

2.2.1.13 PID-13 Phone number - home (XTN) 00116

Components: [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <e-mail address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)>

Definition:  This field contains the patient’s personal phone numbers.  All personal phone numbers for the patient are sent in the following sequence.  The first sequence is considered the primary number (for backward compatibility).  If the primary number is not sent, then a repeat delimiter is sent in the first sequence.  Refer to HL7 Table 0201 - Telecommunication use code and HL7 Table 0202 - Telecommunication equipment type for valid values.

Refer to AS 4846-2014 Clause 7 Electronic Address Group.

2.2.1.14 PID-14 Phone number - business (XTN) 00117

Components: [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <e-mail address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)>

Definition:  This field contains the patient’s business telephone numbers.  All business numbers for the patient are sent in the following sequence.  The first sequence is considered the patient’s primary business phone number (for backward compatibility).  If the primary business phone number is not sent, then a repeat delimiter must be sent in the first sequence.  Refer to HL7 Table 0201 - Telecommunication use code and HL7 Table 0202 - Telecommunication equipment type for valid values.

Refer to AS 4846-2014 Clause 7 Electronic Address Group.

2.2.1.15 PID-15 Primary language (CE) 00118

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

Definition:  This field contains the patient’s primary language.  HL7 recommends using ISO table 639 as the suggested values in User-defined Table 0296 - Primary Language.

User-defined Table 0296 - Primary language

Refer to METeOR 659407, ‘Preferred language’.

2.2.1.16 PID-16 Marital status (CE) 00119

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

Definition:  This field contains the patient’s marital (civil) status. 

Refer to User-defined Table 0002 - Marital status for the HL7 values that are to be used in this data field.

If METeOR values are required for data collection or statistical purposes, the values should be mapped using the following mapping:

2.2.1.17 PID-17 Religion (CE) 00120

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

Definition:  This field contains the patient’s religion, for example, Baptist, Catholic, Methodist, etc.  Refer to User-defined Table 0006 - Religion for suggested values.

2.2.1.18 PID-18 Patient account number (CX) 00121

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (ID)> ^ < assigning facility (HD) ^ <effective date (DT)> ^ <expiration date (DT)>

Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Definition:  This field contains the patient account number assigned by accounting to which all charges, payments, etc., are recorded.  It is used to identify the patient’s account.  Refer to HL7 Table 0061 - Check digit scheme for valid values.

Note: If an account number is used for patient identification, report in PID-3 with a patient identifier type code of 'AN'.

2.2.1.19 PID-19 SSN number patient (ST) 00122

Definition: This field has been retained for backward compatibility only.  It is recommended to use PID-3 - Patient Identifier List for all patient identifiers. However, in order to maintain backward compatibility, this field should also be populated. When used for backward compatibility, this field contains the patient’s social security number.  This number may also be a RR retirement number.

2.2.1.20 PID-20 Driver's license number - Patient (DLN) 00123

Components: <license number (ST)> ^ <issuing state, province, country (IS)> ^ <expiration date (DT)>

Definition: This field contains the patient’s driver’s license number.  Some sites may use this number as a unique identifier of the patient.  The default of the second component is the state in which the patient’s license is registered.

Note: In the Australian context this field has been superseded; hence use PID-3 Patient Identifier List.

2.2.1.21 PID-21 Mother's identifier (CX) 00124

Components: <ID (ST)> ^ <check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ < assigning authority (HD)> ^ <identifier type code (ID)> ^ < assigning facility (HD) ^ <effective date (DT)> ^ <expiration date (DT)>

Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)>

Definition: This field is used, for example, as a link field for newborns. Typically a patient ID or account number may be used. This field can contain multiple identifiers for the same mother. Refer to HL7 Table 0061 - Check digit scheme for valid values.

2.2.1.22 PID-22 Ethnic group (CE) 00125

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

Definition: This field further defines the patient’s ancestry.

Note: In the Australian context, this field is retained for backwards compatibility and hence is a variance to HL7 International. In the Australian context this field is not to be used for indigenous status or country of birth - refer to PID-10.

2.2.1.23 PID-23 Birth place (ST) 00126

Definition: This field indicates the location of the patient’s birth, for example "St. Francis Community Hospital of Lower South Side". The actual address is reported in PID-11 with an identifier of "N".

Note: In the Australian context this field is used for the patient's country of birth. Refer to METeOR 659454 'Country of birth' and AS 4846-2014 Clause 5.8.4 'Country of birth'.

2.2.1.24 PID-24 Multiple birth indicator (ID) 00127

Definition: This field indicates whether the patient was part of a multiple birth. Refer to HL7 Table 0136 - Yes/No Indicator for valid values.

In the Australian context METeOR 482409 Birth plurality indicates the total number of births from a single pregnancy.

Note: Note that HL7 table 0136 is a 'Yes/No' valued table, where as METeOR 668881 'Birth Plurality' is the number of live births resulting from a single pregnancy. Use HL7 table 0136.

2.2.1.25 PID-25 Birth order (NM) 00128

Definition: When a patient was part of a multiple birth, a value (number) indicating the patient’s birth order is entered in this field.

Refer to METeOR 669962 'Birth order' and AS 4846-2014 Clause 5.3.2.

2.2.1.31 PID-31 Identity unknown indicator (ID) 01535

Definition: This field indicates whether or not the patient’s/person’s identity is known. Suggested valid values:

Y the patient’s/person’s identity is unknown

N the patient’s/person’s identity is known

2.2.1.32 PID-32 Identity reliability code (IS) 01536

Definition: This field contains a coded value used to communicate information regarding the reliability of patient/person identifying data transmitted via a transaction. Values could indicate that certain fields on a PID segment for a given patient/person are known to be false (e.g., use of default or system-generated values for Date of Birth or Social Security Number. Refer to User-defined Table 0445 - Identity reliability code for suggested values.

User-defined Table 0445 - Identity Reliability Code 

2.2.1.34 PID-34 Last update facility (HD) 01538

Definition: This field identifies the facility of the last update to a patient’s/person’s identifying and demographic data, as defined in the PID segment. Receiving systems or users will use this field to determine how to apply the transaction to their systems. If the receiving system (such as a hospital’s patient management system) already has a record for the patient/person, then it may decide to only update its data if the source is a "trusted" source. A hospital might consider other hospitals trusted sources, but not "trust" updates from non-acute care facilities. For example:

...|Metro Hospital|...

2.2.1.35 PID-35 Species code (CE) 01539

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

Definition: The species of living organism. This may include the common or scientific name, based on the coding system(s) used. SNOMED is the recommended coding system. If this field is not valued, a human is assumed. Refer to User-defined Table 0446 - Species Code for suggested values.

User-defined Table 0446 - Species Code