HL7 Interface Guide

Vision Series RIS 5.0 HL7 Interface Guide


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Use, duplication, or disclosure by licensee is subject to restrictions as set forth in the AMICAS, Inc. contract. Information contained in this document is subject to change without notice and does not represent a commitment on the part of AMICAS, Inc. The software and processes described in this document are furnished under the contract or nondisclosure agreement. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, for any purpose other than the purchaser’s personal use without the written permission of AMICAS, Inc.

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Date Revision Description

3/28/08 A Initial Release for 5.0

8/29/08 B Maintenance Release 1

10/31/08 B.1 Maintenance Release 1, Critical Update 1

11/24/08 C Maintenance Release 2

06/05/09 D Maintenance Release 4

08/18/09 D.1 Maintenance Release 4, Critical Update 1


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Table of Contents Preface ......................................................................................................................................................... v

1. HL7 Overview......................................................................................................................................1 1.1 Messages ...............................................................................................................................1 1.2 Segments ...............................................................................................................................1 1.3 Fields ......................................................................................................................................1

1.3.1 Sequence........................................................................................................................1 1.3.2 Field Name .....................................................................................................................2 1.3.3 Length.............................................................................................................................2 1.3.4 Optionality.......................................................................................................................2

1.4 MSH-9 – Message Types.......................................................................................................2 1.5 Message Delimiters...............................................................................................................2 1.6 Message Details ....................................................................................................................3 1.7 Warning to the Reader ..........................................................................................................4

2. HL7 Support Tables – Definition.......................................................................................................5

3. Inbound Messages .............................................................................................................................6 3.1 ADTÂ01, A02, A03, A04, A05, A06, A07 or ADTÂ08 – Registering / Updating a Patient 6

3.1.1 Message Definition .........................................................................................................6 3.1.2 MSH (Message Header Segment) - ADT Â01 - ADTÂ08 ...........................................6 3.1.3 PID (Patient Identification Definition Segment) - ADT Â01 - ADTÂ08 ........................8 3.1.4 GT1 (Guarantor Segment) - ADT Â01 - ADTÂ08 .....................................................10 3.1.5 IN1 (Insurance Segment) - ADT Â01 - ADTÂ08 .......................................................14 3.1.6 IN2 (Insurance Segment) - ADT Â01 - ADTÂ08 .......................................................17

3.2 ADTÂ34 or ADTÂ40 – HL7 Message Merge Type ........................................................20 3.2.1 Message Definition .......................................................................................................20 3.2.2 MSH (Message Header Segment) – ADTÂ34 or ADTÂ40 .......................................21 3.2.3 EVN (Event Type Segment) - ADTÂ34 or ADTÂ40 ..................................................22 3.2.4 PID (Patient Identification Definition Segment) - ADT Â34 or ADTÂ40 ....................22 3.2.5 MRG (Patient Merge Information Segment) - ADTÂ34 or ADT^40 ............................24

3.3 BAR^P05 – Billing Account Update Message Type.........................................................25 3.3.1 Message Definition .......................................................................................................25 3.3.2 MSH (Message Header Segment) – BAR^P05............................................................25 3.3.3 EVN (Event Type Segment) – BAR^P05......................................................................26 3.3.4 PID (Patient Identification Definition Segment) – BAR^P05.........................................28 3.3.5 PV1 (Patient Visit Segment) – BAR^P05 .....................................................................30

3.4 MFN - Master File Update Message Type..........................................................................33 3.4.1 Message Definition .......................................................................................................33 3.4.2 MSH (Message Header Segment) – MFN....................................................................34 3.4.3 MFI (Message File Identification Segment) – MFN ......................................................35 3.4.4 MFE (Message File Entry Segment) – MFN.................................................................36 3.4.5 ZL7 (Insurance Data to Post Segment) – MFN ............................................................37

3.5 ORMÔ01 – Order Message Type......................................................................................38 3.5.1 Message Definition .......................................................................................................38 3.5.2 MSH (Message Header Segment) – ORMÔ01 ..........................................................38 3.5.3 PID (Patient Identification Definition Segment) - ORMÔ01 ........................................39 3.5.4 PV1 (Patient Visit Segment) – ORMÔ01 ....................................................................42 3.5.5 NTE (Notes and Comments Segment) – ORMÔ01....................................................45 3.5.6 ORC (Common Order Segment) - ORMÔ01..............................................................46 3.5.7 OBR (Observation Request Segment) – ORMÔ01 ....................................................48 3.5.8 OBX (Observation Result Segment) - ORMÔ01 ........................................................52

3.6 ORRÔ02 - General Order Acknowledgment Message Type .........................................53


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3.6.1 Message Definition .......................................................................................................53 3.6.2 MSA (Message Acknowledgment Segment) – ORRÔ02 ...........................................54 3.6.3 MSH (Message Header Segment) - ORRÔ02............................................................54 3.6.4 ORC (Common Order Segment) - ORRÔ02 ..............................................................55 3.6.5 PID (Patient Identification Definition Segment) – ORRÔ02........................................56

3.7 ORU^R01 - Results Message Type....................................................................................56 3.7.1 Message Definition .......................................................................................................56 3.7.2 MSH (Message Header Segment) - ORU^R01............................................................57 3.7.3 PID (Patient Identification Definition Segment) - ORU^R01.........................................58 3.7.4 OBR (Observation Request Segment) - ORU^R01......................................................60 3.7.5 OBX (Observation/Result Segment) - ORU^R01.........................................................63

3.8 ACK – Acknowledgment Message Type ...........................................................................64 3.8.1 Definition.......................................................................................................................64 3.8.2 MSH (Message Header Segment) - ACK.....................................................................64 3.8.3 MSA (Message Acknowledgment Segment) - ACK .....................................................65

4. Outbound Messages ........................................................................................................................66 4.1 Interface Monitor .................................................................................................................66 4.2 Trigger Points and Trigger Events ....................................................................................66

4.2.1 Definition.......................................................................................................................66 4.3 ADTÂ08 – Update Patient Information ............................................................................68

4.3.1 Definition.......................................................................................................................68 4.3.2 MSH (Message Header Segment) - ADTÂ08.............................................................68 4.3.3 PID (Patient Identification Definition Segment) - ADTÂ08..........................................69 4.3.4 PV1 (Patient Visit Segment) - ADTÂ08 ......................................................................71

4.4 ADTÂ34 – Merge Patient Information (Patient ID Only).................................................73 4.4.1 Definition.......................................................................................................................73 4.4.2 MSH (Message Header Segment) - ADTÂ34.............................................................73 4.4.3 EVN (Event Type Segment) - ADTÂ34.......................................................................74 4.4.4 PID (Patient Identification Definition Segment) - ADTÂ34..........................................75 4.4.5 MRG (Patient Merge Information Segment) - ADTÂ34 ..............................................76

4.5 MFN - Master File Update Message Type..........................................................................77 4.5.1 Message Definition .......................................................................................................77 4.5.2 MSH (Message Header Segment) – MFN....................................................................78 4.5.3 MFI (Message File Identification Segment) – MFN ......................................................79 4.5.4 MFE (Message File Entry Segment) – MFN.................................................................80 4.5.5 ZL7 (Insurance Data to Post Segment) – MFN ............................................................81

4.6 ORMÔ01 – Order Message Type......................................................................................81 4.6.1 Definition.......................................................................................................................81 4.6.2 MSH (Message Header Segment) - ORMÔ01 ...........................................................82 4.6.3 PID (Patient Identification Definition Segment) - ORMÔ01 ........................................83 4.6.4 PV1 (Patient Visit Segment) - ORMÔ01.....................................................................84 4.6.5 ORC (Common Order Segment) - ORMÔ01..............................................................87 4.6.6 OBR (Order Detail /Observation Request) - ORMÔ01...............................................88

4.7 ORU^R01 – Results Message Type ...................................................................................91 4.7.1 Definition.......................................................................................................................91 4.7.2 MSH (Message Header Segment) - ORU^R01............................................................92 4.7.3 PID (Patient Identification Definition Segment) - ORU^R01.........................................93 4.7.4 PV1 (Patient Visit Segment) - ORU^R01 .....................................................................94 4.7.5 ORC (Common Order Segment) - ORU^R01 ..............................................................96 4.7.6 OBR (Order Detail /Observation Request) - ORU^R01................................................98 4.7.7 OBX (Observation/Result Segment) - ORU^R01.......................................................101

4.8 ORU^R01 – HL7 HTML Result Message Type ................................................................102 4.8.1 Definition.....................................................................................................................102 4.8.2 MSH (Message Header Segment) - ORU^R01..........................................................103 4.8.3 PID (Patient Identification Definition Segment) - ORU^R01.......................................104


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4.8.4 PV1 (Patient Visit Segment) - ORU^R01 ...................................................................105 4.8.5 ORC (Common Order Segment) - ORU^R01 ............................................................107 4.8.6 OBR (Order Detail /Observation Request) - ORU^R01..............................................109 4.8.7 OBX (Observation/Result Segment) - ORU^R01.......................................................112

4.9 ORMÔ01 – HL7 Batch Charge Out Message Type.......................................................113 4.9.1 Definition.....................................................................................................................113 4.9.2 MSH (Message Header Segment) - ORMÔ01 .........................................................114 4.9.3 PID (Patient Identification Definition Segment) - ORMÔ01 ......................................115 4.9.4 PV1 (Patient Visit Segment) - ORMÔ01...................................................................116 4.9.5 PV2 (Patient Visit Segment) - ORMÔ01...................................................................118 4.9.6 GT1 (Guarantor Segment) - ORMÔ01 .....................................................................120 4.9.7 ACC (Accident Segment) - ORMÔ01 .......................................................................123 4.9.8 DB1 (Disability Segment) - ORMÔ01 .......................................................................123 4.9.9 IN1 (Insurance Segment) - ORMÔ01 .......................................................................124 4.9.10 IN2 (Insurance Segment) - ORMÔ01...................................................................126 4.9.11 PR1 (Procedure Segment) - ORMÔ01.................................................................129

4.10 ACK – Acknowledgment Message Type .........................................................................130 4.10.1 Definition.................................................................................................................130 4.10.2 MSH (Message Header Segment) - ACK ..............................................................130 4.10.3 MSA (Message Acknowledgment Seg.) - ACK......................................................131

Glossary...................................................................................................................................................132

Appendix A: Data Types.........................................................................................................................137


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Preface

The Vision Series RIS 5.0 HL7 Interface Guide contains the procedures for configuring the HL7 component of the Vision Series RIS application.

Purpose and Audience

This document is intended to serve as a procedure manual for the technical staff responsible for setting up the Vision Series RIS application, as well as a guide for third-party systems to interface with Vision Series RIS.

Vision Series RIS 5.0 HL7 Interface Guide HL7 Overview

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1. HL7 Overview

1.1 Messages

Within the HL7 protocol, data is broken up into groups called messages. A message is the atomic unit of data transferred between systems. Each message consists of a group of segments in a defined sequence. Each message has a message type (three-character code) that defines its type. Refer to the Glossary for message type definitions.

The real-world event that initiates an exchange of messages is called a trigger event. These triggers represent actions such as a patient is admitted or an order is placed. The same trigger event code may not be associated with more than one message type; however a message type may be associated with more than one trigger event.

Only the HL7 fields that are used exclusively are listed in this document.

1.2 Segments

A segment is a logical grouping of data fields. Segments of a message may be required or optional. They may occur only once in a message or they may be allowed to repeat. Each segment is given a name. For example, the ADT message may contain the following segments:

Message Header (MSH)

Event Type (EVN)

Patient ID (PID)

Patient Visit (PV1)

Each segment is identified by a unique three-character code known as the Segment ID.

1.3 Fields

A field is a string of characters. When fields are transmitted, they are sent as character strings. Except where noted, HL7 data fields may take on the null value. Sending the null value, which is transmitted as two double quote marks (“”), is different from omitting an optional data field. The difference appears when the contents of a message will be used to update a record in a database rather than create a new one. If no value is sent, (i.e., it is omitted) the old value should remain unchanged.

A null value will be ignored. If you want to remove a value, you need to send a space.

In defining a segment, the following information is specified about each field.

1.3.1 Sequence

The sequence is the position of the data field within the segment.

For Example: MSH-1, MSH-9.



In the segment attribute tables (beginning in Subsection 3.1.2) this information is provided in the column labeled Seq.

1.3.2 Field Name

The field name is the descriptive name for the data item. In the segment attribute tables this information is provided in the column labeled HL7 Field Name.

1.3.3 Length

The length is designated by HL7 or the system, whichever is the smallest. In the segment attribute tables this information is in a column labeled Len (beginning in Subsection 3.1.2).

1.3.4 Optionality

Optionality designates if the field is required, optional, or conditional in a segment. The designations for both Inbound and Outbound Messages are:

R = this designation means required.

O = this designation means optional.

C = this designation means conditional (as described in the Comments column beginning in Subsection 3.1.2).

B = this designation means backward compatibility with previous versions of HL7.

The Vision Series RIS application allows the user to configure optional demographic data to be required in the System Properties. These constraints are imposed specifically upon manual data entry and editing of patient data and will not be enforced upon data received through the inbound interface.

In the segment attribute tables this information is provided in the column labeled Opt (beginning in Subsection 3.1.2).

1.4 MSH-9 – Message Types

Each HL7 message header has a message type (MSH-sequence 9) that defines the purpose of the message. This MSH-9 data field contains two components:

1. A three-character message type code.

2. An alphanumeric trigger event type.

1.5 Message Delimiters

Message delimiters are special characters used in constructing a message. They are the segment initiator, segment terminator, field separator, component separator, subcomponent separator, repetition separator, and escape character.

The escape character is only used in charge out.



The segment terminator is always a carriage return (in ASCII, a hex 0D). The other delimiters are defined in the MSH segment, with the field delimiter in the 4th character position, and the other delimiters occurring as in the field called Encoding Characters, which is the first field after the segment ID. The delimiter values used in the MSH segment are the delimiter values used throughout the entire message.

At any given site, the subset of the possible delimiters may be limited by negotiations between applications. This implies that the receiving applications will use the agreed upon delimiters, as they appear in the Message Header segment (MSH), to parse the message.

In the absence of other considerations, HL7 recommends the following suggested values:

Delimiter Suggested Value Hex

Value Usage

Message Initiator Vertical Tabulation 0B Initiates a message record.

Message Terminator File separator

<CR> carriage return

1C

0D

Terminates a message record. This value cannot be changed by implementers.

Segment Terminator <CR> carriage return 0D Terminates a segment record. The message is wrapped between 0B and 1C 0D.

Field Separator | (pipe) 7C

Separates two adjacent data fields within a segment. It also separates the Segment ID from the first data field in each segment.

Component Separator ^ (carat) 5E Separates adjacent components of data fields where allowed.

Subcomponent Separator & (ampersand) 26

Separates adjacent subcomponents of data fields where allowed. If there are no subcomponents, this character may be omitted.

Repetition Separator ~ (tilde) 7E Separates multiple occurrences of a field where allowed.

Escape Character \ (backslash) 5C

The escape character is for use with any field represented by an ST, TX or FT data type, or for use with the data (fourth) component of the ED data type If no escape characters are used in a message, this character may be omitted. However, it must be present if subcomponents are used in the message.

1.6 Message Details

A message is a unit of data transferred between two systems.

HL7 data will be received via TCP/IP socket or shared folder.

All messages sent or received via Vision Series RIS will be constructed according to the Minimal Lower Layer Protocol (MLLP). Messages are prefixed with a character of <0B> hex. Segments are terminated with a character of <0D> hex. Messages are terminated by an end block character sequence of <1C><0D> hex. All acknowledgment messages from the remote server will need to follow the same format.



An empty string or NULL will be treated as an ignore field. This means that it will not be used to update the database. The old value will remain unchanged. In order to designate a change, it should be represented by pipes || with at least one space in between.

The filler could ignore data fields that are present, but were not expected, rather than treat such a circumstance with an error.

HL7 messages consist of data fields. A data field is a string of characters that are of variable length and separated by delimiters as listed below. Transmitted fields should be sent as character strings.

1.7 Warning to the Reader

Message, segment and field definitions used by this interface are based on the HL7 2.3 standard and where possible match those specifications. However, differences exist and thus the reader is cautioned: where the specifications differ between the HL7 standard and this document, the specifications in this document take precedence.

For general information on HL7 messages, please consult the HL7 Version 2.3 Standard available through www.hl7.org.

http://www.hl7.org/�

Vision Series RIS 5.0 HL7 Interface Guide HL7 Support Tables – Definition


2. HL7 Support Tables – Definition

You must synchronize Vision Series RIS with a receiving system by configuring the PMIS for the following Support Tables:

Support Table Interface

Gender All interfaces

Martial Status All interfaces

Ethnicity All interfaces

Relationship Type Code All interfaces

Location Inbound Order Entry

Referring Physician Inbound Order Entry

Reason Inbound Order Entry

Exam Code Inbound Order Entry

Insurance Inbound ADT and MFN

For more information on Support Tables, see the Vision Series RIS 5.0 Administration Guide.

Vision Series RIS 5.0 HL7 Interface Guide Inbound Messages


3. Inbound Messages

The AMICAS interface will be a one-way (unidirectional) inbound data transfer. Messages received shall conform to the Health Level Seven (HL7) Standard, version 2.3 for electronic data exchange.

The following inbound interfaces are supported:

ADT

BAR

MFN

ORM

ORR

ORU

ACK

See the Glossary for definitions of each interface.

3.1 ADTÂ01, A02, A03, A04, A05, A06, A07 or ADTÂ08 – Registering / Updating a Patient

3.1.1 Message Definition

Vision Series RIS shall receive the patient message event type ADTÂ01 through ADTÂ08 which will create or update patient demographics. All message types will be treated the same.

The following table lists each supported message segment and their description:

Message Segment

Segment Description

MSH Message Header

PID Patient Identification

GT1 Guarantor

IN1 Insurance

IN2 Insurance

Refer to the Glossary for the complete message segment definitions.

3.1.2 MSH (Message Header Segment) - ADT Â01 - ADTÂ08

The following table lists each Message Header segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

Any field name that has a blank cell in the Rejection Rules column does not have any rejections. The RIS Req column designates which fields are required by Vision Series RIS.



MSHSeq

HL7 Field Name Opt RIS Req

Length Data Type

Rejection Rules

Vision Series Data Mapping/

Comments

1 Field Separator R 1 ST "|"

2 Encoding Characters R 4 ST "^~\&”

3 Sending Application O 180 HD <name of the originating application>

4 Sending Facility O 180 HD <name of the originating facility>

5 Receiving Application O 180 HD <name of the receiving application>

6 Receiving Facility O 180 HD <name of the receiving facility>

7 Date/time of Message O 26 TS Current date/time. <yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R R 7 CM Rejected if field is empty.

“ADT^A04” or “ADT^A08” Register or update a patient.

10 Message Control ID R R 20 ST Rejected if field is empty.

Message unique identifier for the ADT message which will be echoed back in the MSA_2 of the acknowledgment message.

11 Processing ID R

3 PT “P” Production Environment

12 Version ID R

8 ID “2.3” HL7 version number

13 Sequence Number O 15 NM

14 Continuation Pointer O 180 ST

15 Accept Acknowledgement Type

O

2 ID

16 Application Acknowledgement Type

O

2 ID

17 Country Code O 2 ID

18 Character Set O 16 ID

19 Principal Language Of Message

O

60 CE

20 Alternate Character Set Handling Scheme

O

20 ID



3.1.3 PID (Patient Identification Definition Segment) - ADT ^A01 - ADT^A08

The following table lists each Patient Identification Definition segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:


PID Seq


Length Data Type

Rejection Rules


Comments

1 Set ID - Patient ID O

4 SI One PID segment per message. “1”

2 Patient ID (External ID) B C 20 CX

If the unique ID is not PMIS, this is rejected if the PID 2 and 3 fields are empty.

Patient Unique Identifier <Internal Patient ID Number>

3 Patient ID (Internal ID) R C 20 CX

If the unique ID is not PMIS and this field is empty, the data must be in the PID 2 field.

Patient Jacket Number <Jacket Number> This field is required if the interface is using the jacket number as the unique identifier.

4 Alternate Patient ID B

20 CX Patient SS Number <#########>

5

Patient Name last name first name middle initial

R R

90 total 30 30 30

XPN Rejected if field is empty.

Patient Name <last name^ first name^ middle name> Excess length will be truncated.

6 Mother’s Maiden Name O 48 XPN

7 Date of Birth O R 26 TS Rejected if field is empty and if not at least <yyyymmdd>.

Patient DOB <yyyymmdd>

8 Sex O 1 ST Will not be set if PMIS code does not match

Patient Gender <PMIS code only> (reference the RIS Gender support table)

9 Patient Alias O 48 XPN

10 Race O

1 IS

Patient Ethnicity <PMIS code only> (reference the RIS Ethnicity support table)



PID Seq


Length Data Type

Rejection Rules


Comments

11 Patient Address O

151 total60 40 40 2 9

XAD

Patient Address <address 1^ address 2^ city^ state (standard abbreviation only)^ zip (alphanumeric with no validation) Excess length will be truncated. Country does not update.

12 County Code B 4 IS

13 Phone Number - Home O

12 XTN

Patient Home Phone – numeric only <area code and phone number>

14 Phone Number - Business O

12 XTN

Patient Work Phone –numeric only <area code and phone number>

15 Language - Patient O 60 CE

16 Marital Status O 1 IS

Patient Marital Status<PMIS code only> (reference the RIS Marital Status support table)

17 Religion O 3 IS

18 Patient Account Number O C 20 CX

If the PMIS is used as the unique ID, reject if blank and PID 3 must be NULL if you do not wish to modify the jacket.

Patient Unique Identifier <Patient File PMIS> This field is required if the interface is configured to use the patient PMIS number as the unique identifier. If the PMIS is used as the unique ID, then PID_3 Jacket Number must be NULL on the inbound message if the patient jacket should not be changed. The patient PMIS must be unique to all patients, guarantors and insureds. Alphanumeric.



PID Seq


Length Data Type

Rejection Rules


Comments

19 SSN Number - Patient B

16 ST Rejected if not 9 sequential numbers.

Patient Social Security Number <#########> Numeric with no special characters. No validation is performed for length or duplicates.

20 Drivers License Number- Patient

O

25 CM

21 Mother’s Identifier O 20 CX

22 Ethnic Group O 3 IS

23 Birth Place O 60 ST

24 Multiple Birth Indicator O 2 ID

25 Birth Order O 2 NM

26 Citizenship O 4 IS

27 Veterans Military Status O 60 CE

28 Nationality O 80 CE

29 Patient Death Date/Time O

26 TS Reject if not at least <yyyymmdd>.

Patient Date of Death<yyyymmdd>

30 Patient Death Indicator O 1 ID

3.1.4 GT1 (Guarantor Segment) - ADT ^A01 - ADT^A08

The following table lists each Guarantor segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:


GT1 Seq


Length Data Type

Rejection Rules


Comments

1 Set ID - GT1 R

4 SI One GT1 segment per message. "1"



GT1 Seq


Length Data Type

Rejection Rules


Comments

2 Guarantor Number O C 59 CX

If this field is the guarantor’s ID then rejected if field is empty or if the PMIS code does not match.

Guarantor Unique Identifier <Guarantor PMIS> This field is required if the interface is configured to accept guarantors. The guarantor PMIS number must be unique to all patients, guarantors and insureds. Alphanumeric.

3 Guarantor Name R R

90 total 30 30 30

XPN If this field is blank, it will associate the patient as the guarantor..

Guarantor Name <last name^ first name^ middle name>Excess length will be truncated. Suffix does not update.

4 Guarantor Spouse Name O

48 XPN Guarantor Spouse Name

5 Guarantor Address O

151 total60 40 40 2 9

XAD

Guarantor Address <address 1^ address 2^ city^ state (standard abbreviation only)^ zip (alphanumeric with no validation)> Excess length will be truncated. Country does not update.

6 Guarantor Ph Num - Home O

12 XTN

Guarantor Home Phone – numeric only<area code and phone number>

7 Guarantor Ph Num - Business

O C 12 XTN If not found in GT1-7.7 then it will be read from GT1-7.1

Guarantor Work Phone – numeric only GT1-7.7 <^^^^^^area code and phone number>

8 Guarantor Date/Time Of Birth

O R 26 TS

If this field is configured to identify the guarantor or if GT1-3 is other than the patient, reject if blank. Rejected if format is not at least <yyyymmdd>.

Guarantor DOB <yyyymmdd>

9 Guarantor Administrative Sex

O O 1 ST Will be ignored if code does not match

Guarantor Gender <PMIS code only> (reference the RIS Gender support table)



GT1 Seq


Length Data Type

Rejection Rules


Comments

10 Guarantor Type O 2 IS

Guarantor Qualifier “1” if person and “2” if non-person. “1” is the default.

11 Guarantor Relationship O C 80 CE

Required if GT1-3 is other than the patient. Rejected if the field is empty or if the relationship code does not match.

Guarantor Relationship – Patient relation to Guarantor<PMIS code only> (reference the RIS Relationship support table)

12 Guarantor SSN O C 11 ST If this field is configured to identify the guarantor, reject if blank.

Guarantor SS Number <#########> Numeric with no special characters. No validation is performed for length or duplicates.

13 Guarantor Date – Begin O 8 DT

14 Guarantor Date – End O 8 DT

15 Guarantor Priority O 2 NM

16 Guarantor Employer Name O

130 XPN Guarantor Employer Name <Employer Name>

17 Guarantor Employer Address

O

106 XAD

Guarantor Employer Address <Address 1^^City^State^Zip>

18 Guarantor Employer Phone Number

O

40 XTN

Employer Phone, Fax, Email <(Area Code)Phone Number^Fax Number^Email Address>

19 Guarantor Employee ID Number

O

20 CX

20 Guarantor Employment Status

O

2 IS

21 Guarantor Organization Name

O

130 XON

22 Guarantor Billing Hold Flag O 1 ID

23 Guarantor Credit Rating Code

O

80 CE

24 Guarantor Death Date And Time

O

26 TS

25 Guarantor Death Flag O 1 ID

26 Guarantor Charge Adjustment Code

O

80 CE



GT1 Seq


Length Data Type

Rejection Rules


Comments

27 Guarantor Household Annual Income

O

10 CP

28 Guarantor Household Size O 3 NM

29 Guarantor Employer ID Number

O

20 CX

Guarantor Employer ID <PMIS code only> (Reference the RIS Employer support table.)

30 Guarantor Marital Status Code

O

80 CE

31 Guarantor Hire Effective Date

O

8 DT

32 Employment Stop Date O 8 DT

33 Living Dependency O 2 IS

34 Ambulatory Status O 2 IS

35 Citizenship O 80 CE

36 Primary Language O 60 CE

37 Living Arrangement O 2 IS

38 Publicity Code O 80 CE

39 Protection Indicator O 1 ID

40 Student Indicator O 2 IS

41 Religion O 80 CE



44 Ethnic Group O 80 CE

45 Contact Person’s Name O 48 XPN

46 Contact Person’s Telephone Number

O

40 XTN

47 Contact Reason O 80 CE

48 Contact Relationship O 2 IS

49 Job Title O 20 ST

50 Job Code/Class O 20 JCC

51 Guarantor Employer’s Organization Name

O

130 XON

52 Handicap O 2 IS

53 Job Status O 2 IS

54 Guarantor Financial Class O 50 FC

55 Guarantor Race O

1 IS Will be ignored if code does not match.

Guarantor Ethnicity <PMIS code only> (reference the RIS Ethnicity support table)



3.1.5 IN1 (Insurance Segment) - ADT ^A01 - ADT^A08

The following table lists each Insurance segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

Information provided will not update the insurance support tables.


IN1 Seq


Length Data Type

Rejection Rules


Comments

1 Set ID - IN1 R R 4 SI Rejected if field is empty.

Insurance Patient Plan Rank

<sequence identifier>

1 = primary

2 = secondary, etc.

No limit. This field will determine insurance ranking for the patient. Segments can be sent non-sequential. May send 2 and not 1.

2 Insurance Plan ID R C 60 CE Refer to IN1-3 if blank

Insurance Coverage Plan Code

<Plan Code>

3 Insurance Company ID R R 59 CX If IN1-2 is blank and IN1-3 does not match, then reject.

Insurance Company ID <Insurance Coverage Plan PMIS code>

(reference the RIS Insurance Coverage support table.)

The ADT will fail if this PMIS code is invalid. If using Self-Pay, a Self-Pay Insurance Coverage and PMIS is required in the support table.

4 Insurance Company Name O 130 XON

5 Insurance Company Address

O 106 XAD



IN1 Seq


Length Data Type

Rejection Rules


Comments

6 Insurance Co Contact Person

O 48 XPN

7 Insurance Co Phone Number

O 40 XTN

8 Group Number O 12 ST

9 Group Name O 130 XON

10 Insured’s Group Emp ID O 12 CX Member Number

<Member Number>

11 Insured’s Group Emp Name O 130 XON

12 Plan Effective Date O 8 DT Plan Effective Start Date <yyyymmdd>

13 Plan Expiration Date O 8 DT Plan Expiration Date<yyyymmdd>

14 Authorization Information O 55 CM

15 Plan Type O 3 IS

Insurance Coverage Type

<Coverage Type Name>

16 Name Of Insured O 0

90 total 30 30 30

XPN If this field is blank, it will associate the patient as the insured.

Insured Name

<last name^first name^ middle name>

Suffix does not update.

Excess length will be truncated.

Though RIS only displays First and Last, the First, Middle and Last are sent through standard charge out.

Patient name is used if this field is left blank.

17 Insured’s Relationship To Patient

O C 80 CE

Required if IN1-16 is other than the patient. Rejected if the field is empty or if the relationship code does not match

Patient Relation to Insured <PMIS code only>

(reference the RIS Relationship support table)



IN1 Seq


Length Data Type

Rejection Rules


Comments

18 Insured’s Date Of Birth O C 26 TS

Required if IN1-16 is provided or If this field is configured to identify the insured, reject if blank.

Insured DOB <yyyymmdd>

19 Insured’s Address O

151 total60 40 40 2 9

XAD

Insured Address

<address 1^address 2^city^

state (standard abbreviation only)^zip (alphanumeric with no validation)>

Excess length will be truncated. Country does not update.

20 Assignment Of Benefits O 2 IS

21 Coordination Of Benefits O 2 IS

22 Coord Of Ben. Priority O 2 ST

23 Notice Of Admission Flag O 1 ID

24 Notice Of Admission Date O 8 DT

25 Report Of Eligibility Flag O 1 ID

26 Report Of Eligibility Date O 8 DT

27 Release Information Code O 2 IS

28 Pre-Admit Cert (PAC) O 15 ST

29 Verification Date/Time O 26 TS

30 Verification By O 60 XCN

31 Type Of Agreement Code O 2 IS

32 Billing Status O 2 IS

33 Lifetime Reserve Days O 4 NM

34 Delay Before L.R. Day O 4 NM

35 Company Plan Code O 8 IS

36 Policy Number O 15 ST

Policy Number

<Policy Number>

Alphanumeric

37 Policy Deductible O 12 CP

38 Policy Limit – Amount B 12 CP

39 Policy Limit – Days O 4 NM



IN1 Seq


Length Data Type

Rejection Rules


Comments

40 Room Rate - Semi-Private B 12 CP

41 Room Rate – Private B 12 CP

42 Insured’s Employment Status

O 60 CE

43 Insured’s Administrative Sex

O O 1 IS Will be ignored if code does not match

Insured Gender

<PMIS code only>

(reference the RIS Gender support table)

44 Insured’s Employer’s Address

O 151 XAD

Insured’s Employer Address

<Address 1^^City^ State^Zip>

45 Verification Status O 2 ST

46 Prior Insurance Plan ID O 8 IS

47 Coverage Type O 3 IS

48 Handicap O 2 IS

49 Insured’s ID Number O C 12 CX If this field is configured to identify the insured, reject if blank.

Insured Unique Identifier

<Insured PMIS code only>

This field is required if the interface is configured to accept the Insured. The insured PMIS number must be unique to all patients, guarantors and insureds.

Alphanumeric.

3.1.6 IN2 (Insurance Segment) - ADT ^A01 - ADT^A08



IN2 Seq


Length Data Type

Rejection Rules


Comments

1 Insured's Employee ID O 59 CX



IN2 Seq


Length Data Type

Rejection Rules


Comments

2 Insured's Social Security Number

O C 11 ST If this field is configured to identify the insured, reject if blank.

Insured's SS Number<SS Number format #########>

3 Insured's Employer Name and ID

O 130 XCN

Insured's Employer Name and ID <Employer Name^PMIS or Unique Identification Number>

4 Employer Information Data O 1 IS

5 Mail Claim Party O 1 IS

6 Medicare Health Ins Card Number

O

15 ST

7 Medicaid Case Name O 48 XPN

8 Medicaid Case Number O 15 ST

9 Military Sponsor Name O 48 XPN

10 Military ID Number O 20 ST

11 Dependent Of Military Recipient

O

80 CE

12 Military Organization O 25 ST

13 Military Station O 25 ST

14 Military Service O 14 IS

15 Military Rank/Grade O 2 IS

16 Military Status O 3 IS

17 Military Retire Date O 8 DT

18 Military Non-Avail Cert On File

O

1 ID

19 Baby Coverage O 1 ID

20 Combine Baby Bill O 1 ID

21 Blood Deductible O 1 ST

22 Special Coverage Approval Name

O

48 XPN

23 Special Coverage Approval Title

O

30 ST

24 Non-Covered Insurance Code

O

8 IS

25 Payor ID O 59 CX

26 Payor Subscriber ID O 59 CX

27 Eligibility Source O 1 IS



IN2 Seq


Length Data Type

Rejection Rules


Comments

28 Room Coverage Type/Amount

O

25 CM

29 Policy Type/Coverage O 25 CM

30 Daily Deductible O 25 CM









39 Religion O 80 CE

40 Mother's Maiden Name O 48 XPN



43 Marital Status O 80 CE

44 Insured's Employment Start Date

O

8 DT




48 Job Status O

2 IS

Insured's Employment Status <PMIS Code or Employment Status Code>

49 Employer Contact Person Name

O

48 XPN

50 Employer Contact Person Phone Number

O

40 XTN

51 Employer Contact Reason O 2 IS

52 Insured Contact Person Name

O

48 XPN

53 Insured Contact Person's Phone Number

O

40 XTN

54 Employer Contact Person Reason

O

2 IS



IN2 Seq


Length Data Type

Rejection Rules


Comments

55 Relationship To The Patient Start Date

O

8 DT

56 Relationship To The Patient Stop Date

O

8 DT

57 Insurance Co. Contact Reason

O

2 IS

58 Insurance Co. Contact Phone Number

O

40 XTN

59 Policy Scope O 2 IS

60 Policy Source O 2 IS

61 Patient Member Number O 60 CX

62 Guarantor's Relationship To Insured

O

80 CE

63 Insured's Phone Number - Home

O

40 XTN

Insured Phone Number <(Area Code)Phone Number>

64 Insured's Employer Phone Number

O

40 XTN

65 Military Handicapped Program

O

60 CE

66 Suspend Flag O 1 ID

67 Copay Limit Flag O 1 ID

68 Stoploss Limit Flag O 1 ID

69 Insured Organization Name and ID

O

130 XON

70 Insured Employer Organization Name and ID

O

130 XON

71 Race O 80 CE

72 HCFA Patient's Relationship to Insured

O

60 CE

3.2 ADT^A34 or ADT^A40 – HL7 Message Merge Type


These messages will allow the RIS to merge two patients. Patients will be identified by using either the PMIS code or the Patient Jacket number. Patient Demographics will not be modified using a merge message.


Message Segment

Segment Description

MSH Message Header



Message Segment

Segment Description

EVN Event Type Segment


MRG Patient Merge Information


3.2.2 MSH (Message Header Segment) – ADTÂ34 or ADTÂ40



MSH Seq


Length Data Type

Rejection Rules


Comments


2 Encoding Characters R 4 ST "^~\&"

3 Sending Application O R 180 HD Rejected if field is empty. <Sending Application>

4 Sending Facility O 180 HD <Sending Facility>

5 Receiving Application O R 180 HD Rejected if field is empty. <Receiving Application>

6 Receiving Facility O 180 HD

7 Date/time of Message O R 26 TS Rejected if field is empty. Current date/time <yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R R 7 CM Rejected if field is empty. “ADTÂ34” or “ADTÂ40”

10 Message Control ID R R 20 ST Rejected if field is empty. System date/time. <yyyymmddhhmmss>

11 Processing ID R 3 PT “P”

12 Version ID R 60 ID “2.3” HL7 version number




O

2 ID “AL”


O

2 ID “NE”




O

60 CE




O

20 ID

3.2.3 EVN (Event Type Segment) - ADTÂ34 or ADTÂ40

The following table lists each Event Type segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:


EVNSeq HL7 Field Name Opt RIS Req

Length Data Type

Rejection Rules


Comments

1 Event Type Code O 3 ID “A34” or “A40”

2 Recorded Date/Time O

26 TS Current Date/Time

<yyyymmddhhmmss>

3 Date/Time Planned Event O 26 TS

4 Event Reason Code O 3 IS

5 Operator ID O 60 XCN

Operator ID & Name

<User IDÛser Name (FML)>

6 Event Occurred O 26 TS Current Date/Time

<yyyymmddhhmmss>

3.2.4 PID (Patient Identification Definition Segment) - ADT Â34 or ADTÂ40



PID Seq


Length Data Type

Rejection Rules


Comments



2 Patient ID (External ID) O 20 CX



PID Seq


Length Data Type

Rejection Rules


Comments

3 Patient ID (Internal ID) R R 20 CX Rejected if field is empty.

Patient Unique Identifier <Defined Unique ID> PMIS, SSN, Jacket, RIS Internal ID

4 Alternate Patient ID O

20 CX Patient Unique Identifier <Defined Unique ID>

5


R R 48 XPN Rejected if field is empty or if suffix code does not match this field.

Patient Name <last name^ first name^ middle name^suffix>




8 Sex O R 1 ST

Rejected if the field is empty or if the gender code does not match this field.

Patient Gender (F, M, O, U) <PMIS code or gender code?

9 Patient Alias O

48 XPN Patient Alias <Alias field>

10 Race O

80 IS Rejected if the race code does not match this field.

Patient Ethnicity <PMIS code or ethnicity code>


106 XAD

Patient Address <address 1âddress 2^city^ state^zip^country>

12 County Code B

4 IS Country Code <Country field>


40 XTN

Patient Home Phone, Fax, Email <(Area Code)Phone NumberÂdditional text in phone number field^Fax NumberÊmail Address>


12 XTN

Patient Work Phone <(Area Code)Phone NumberÂdditional text in phone number field>


16 Marital Status O

80 IS Rejected if the martial status code does not match this field.

Patient Marital Status<PMIS code for Marital Status Code>

17 Religion O 80 IS



PID Seq


Length Data Type

Rejection Rules


Comments

18 Patient Account Number O C 20 CX If the PMIS is used as the unique ID, reject if blank and PID 3 must be NULL.

Patient PMIS <Patient File PMIS>



Patient Social Security Number <#########>


O

25 CM













3.2.5 MRG (Patient Merge Information Segment) - ADT^A34 or ADT^40

The following table lists each Patient Merge Information segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

MRG Seq


Length Data Type

Rejection Rules


Comments

1 Prior Patient ID - Internal R

20 CX Patient Unique Identifier

<Defined Unique ID>

2 Prior Alternate Patient ID O 20 CX Patient Unique Identifier

<Defined Unique ID>

3 Prior Patient Account Number

O 20 CX Prior Patient PMIS

<Patient File PMIS>

4 Prior Patient ID - External O

20 CX

Prior Patient Unique Identifier

<Internal Patient ID Number>

5 Prior Visit Number O 20

6 Prior Alternate Visit ID O 20

7 Prior Patient Name O 48



3.3 BAR^P05 – Billing Account Update Message Type


The financial system sends the patient’s billing/accounts information to the Vision Series RIS

The P05 event is sent when an existing account is being updated with financial information. From Standard Version 2.3 onward, the P01 (add account) event should not longer be used for updating an existing account with financial information, but only for creating a new financial account.

Update of the Patient Demographics will not be done from this message type. An ADT message must be used to update the Patient Demographics.


Message Segment

Segment Description

MSH Message Header

EVN Event Type


PV1 Patient Visit


3.3.2 MSH (Message Header Segment) – BAR^P05



MSH Seq

HL7 Field Name Opt Req by RIS

Length Data Type

Rejection Rules


Comments

1 Field Separator R R 1 ST Must always be pipe "|". "|"

2 Encoding Characters R R 4 ST Must always be "^~\&". "^~\&"

3 Sending Application O R 180 HD Rejected if not acceptable sending application.

<Sending Application>


5 Receiving Application O 180 HD <Receiving Application>


<Interface Engine Name for new customers> or <AMICAS RIS for existing customers>



MSH Seq


Length Data Type

Rejection Rules


Comments

7 Date/time of Message O R 26 TS Rejected if field is empty or date/time is in the incorrect format.

Current date/time <yyyymmddhhmmss>or <yymmddhhmmssss>or <yyymmddhhmmssss> or <yymmddhhmmss>

8 Security O 40 ST

9 Message Type R R 7 CM

Rejected if the value is not a defined message type (ORM^O01). If it is a define message type, then the appropriate specification and logic will be applied to the message.

“BAR^P05”

10 Message Control ID O R 20 ST Rejected if field is empty.

Unique Message Identifier

11 Processing ID R R 3 PT Rejected if not “P”. “P”

12 Version ID R R 60 ID Rejected if not “2.0”, “2.1”, “2.2” or 2.3”.

“2.3” HL7 version number




O

2 ID “AL”


O

2 ID




O

60 CE


O

20 ID

3.3.3 EVN (Event Type Segment) – BAR^P05




Length Data Type

Rejection Rules


Comments

1 Event Type Code O 3 ID




Length Data Type

Rejection Rules


Comments

2 Recorded Date/Time O


<yyyymmddhhmmss>



5 Operator ID O 250 XCN

Operator ID & Name



<yyyymmddhhmmss>

7 Event Facility O 241 HD



3.3.4 PID (Patient Identification Definition Segment) – BAR^P05



PID Seq


Length Data Type

Rejection Rules


Comments

1 Set ID - Patient ID R


2 Patient ID (External ID) X C 20 CX

If the unique ID is not PMIS, this is rejected if the PID 2 and 3 fields are empty.

Patient Unique Identifier <Internal Patient ID Number>

3 Patient ID (Internal ID) R C 20 CX

If the unique ID is not PMIS and this field is empty, the data must be in the PID 2 field.

Patient Internal ID from RIS. PID 3.1.

4 Alternate Patient ID X

20 CX Patient Jacket Number

5


R R

90 total 30 30 30

XPN Rejected if field is empty or if suffix code does not match this field.

Patient Name <last name^ first name^ middle name> Excess length will be truncated.

6 Mother’s Maiden Name X 48 XPN



8 Sex O R 1 ST



9 Patient Alias X


10 Race O





PID Seq


Length Data Type

Rejection Rules


Comments


151 total60 40 40 2 9

XAD


12 County Code X



12 XTN



12 XTN


15 Language - Patient X 60 CE

16 Marital Status O


Patient Marital Status<PMIS code only> (reference the RIS Marital Status support table)

17 Religion X 3 IS

18 Patient Account Number O C 20 CX If the PMIS is used as the unique ID, reject if blank and PID 3 must be NULL.

Patient Unique Identifier <Patient File PMIS>

19 SSN Number - Patient O




X

25 CM

21 Mother’s Identifier X 20 CX

22 Ethnic Group X 3 IS

23 Birth Place X 60 ST

24 Multiple Birth Indicator X 2 ID

25 Birth Order X 2 NM

26 Citizenship X 4 IS



PID Seq


Length Data Type

Rejection Rules


Comments

27 Veterans Military Status X 60 CE

28 Nationality X 80 CE





3.3.5 PV1 (Patient Visit Segment) – BAR^P05

The following table lists each Patient Visit segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:


PV1 Seq


Length Data Type

Rejection Rules


Comments

1 Set ID – PV1 O

4 SI One PV1 Segment per message. “1”

2 Patient Class O R 1 IS Reject if empty or the PMIS code does not match.

Appointment Code, for example: O = Outpatient I = Inpatient <PMIS Code or Service Type>

3 Assigned Patient Location O

80 PL

Patient location <point of care or nursing station>^<room>^<bed> All other PV1-3 sub components will be ignored. Displayed in RIS separated by a space colon (“ :”).

4 Admission Type O 2 IS

5 Pre-admit Number O 20 CX

6 Prior Patient Location O 80 PL



PV1 Seq


Length Data Type

Rejection Rules


Comments

7 Attending Doctor O R 60 XCN Reject if empty or PMIS code does not match.

Attending (referring) Provider. A tilde (~) separates referring from any/all cc physicians. <Physician Location PMIS Code or Physician Location Unique Identifier^Last Name^First^Middle Name^Suffix^~PMIS^Last Name^First Name^Middle Name^Suffix>

8 Referring Doctor O R 60 XCN

Referring (cc) Provider <Physician Location PMIS Code or Physician Location Unique Identifier ^Last Name^First^Middle Name^Suffix^~PMIS^Last Name^First Name^Middle Name^Suffix>

9 Consulting Doctor O R 60 XCN

Consulting (cc) Provider <Physician Location PMIS Code or Physician Location Unique Identifier ^Last Name^First^ Middle Name^Suffix^ ~PMIS^Last Name^ First Name^Middle Name^Suffix>

10 Hospital Service O 3 IS

11 Temporary Location O 80 PL

12 Preadmit Test Indicator O 2 IS

13 Readmission Indicator O 2 IS

14 Admit Source O 3 IS

15 Ambulatory Status O

2 IS Pregnancy Indicator <B6 if flag Y else other>

16 VIP Indicator O 2 IS

17 Admitting doctor O 60 XCN

18 Patient Type O

2 IS Service Type <PMIS Code for Service Type Code>

19 Visit Number O

20 CX Visit Number will populate the Order Number field.

20 Financial Class O 50 CM

21 Charge Price Indicator O 2 IS

22 Courtesy Code O 2 IS



PV1 Seq


Length Data Type

Rejection Rules


Comments

23 Credit Rating O 2 IS

24 Contract Code O 2 IS

25 Contract Effective Date O 8 DT

26 Contract Amount O 12 NM

27 Contract Period O 3 NM

28 Interest Code O 2 IS

29 Transfer to Bad Debt Code

R

1 IS Collection Indicator <Y> or <N>

30 Transfer to Bad Debt Date O 8 DT

31 Bad Debt Agency Code O 10 IS

32 Bad Debt Transfer Amount

R

12 NM Collection Balance

33 Bad Debt Recovery Amount

O

12 NM

34 Delete Account Indicator O 1 IS

35 Delete Account Date O 8 DT

36 Discharge Disposition O 3 IS

37 Discharged to Location O 25 CM

38 Diet Type O 80 IS

39 Servicing Facility O 2 IS

40 Bed Status B 1 IS

41 Account Status O 2 IS

42 Pending Location O 80 PL

43 Prior Temporary Location O 80 PL

44 Admit Date/Time O

26 TS Admit Date <yyyymmdd>

45 Discharge Date/Time O

26 TS Discharge Date <yyyymmdd>

46 Current Patient Balance O 12 NM Patient Account Balance

47 Total Charges O 12 NM

48 Total Adjustments O 12 NM

49 Total Payments O 12 NM

50 Alternate Visit ID O 20 CX

51 Visit Indicator O 1 IS

52 Other Healthcare Provider O

60 XCN Patient Weight <Patient Weight>



3.4 MFN - Master File Update Message Type


In an open-architecture healthcare environment there is often a set of common reference files used by one or more application systems. These files are called master files. Some common examples of master files in the healthcare environment include:

staff and health practitioner master file

system user (and password) master file

location (census and clinic) master file

device type and location (e.g., workstations, terminals, printers, etc.)

lab test definition file

exam code (radiology) definition file

charge master file

patient status master

patient type master

service item master file

These common reference files need to be synchronized across the various applications at a given site. The Master Files Notification (MFN) message provides a way of maintaining this synchronization by specifying a standard for the transmission of this data between applications.

In many implementations, one application system will "own" a particular master file such as the staff and practitioner master file. The changes (e.g., adds, deletes, updates) to this file are made available to various other applications on a routine basis. The MFN message supports this common case, but also supports the situation where an application not "owning" a particular master file, transmits update information to other systems (usually to the "owning" system), for review and possible inclusion.

The MFN message supports the distribution of changes to various master files between systems in either online or batch modes, and allows the use of either original or enhanced acknowledgment modes, as well as providing for a delayed application acknowledgment mode. These messages use the MSH segment to pass the basic event code (master files notification or acknowledgment). The Master File Identification (MFI) segment identifies the master file being updated as well as the initial and requested dates for file-level events (such as replace file). For each record being changed, the Master File Entry (MFE) segment carries the record-level event code (such as add, update, etc.), the initial and requested dates for the event, and the record-level key identifying the entry in the master file. The Master File Acknowledgment (MFA) segment returns record-specific acknowledgment information.


Message Segment

Segment Description

MSH Message Header

MFI Master File Identification

MFE Master File Entry

ZL7 Insurance Data to Post




3.4.2 MSH (Message Header Segment) – MFN



MSH Seq


Length Data Type

Rejection Rules


Comments










Current date/time <yyyymmddhhmmss>or<yymmddhhmmssss>or<yyymmddhhmmssss> or <yymmddhhmmss>

8 Security O 40 ST

9 Message Type R R 7 CM


“MFN”

10 Message Control ID O R 20 ST Rejected if field is empty. Unique Message Identifier

11 Processing ID R R 3 PT Rejected if not “P” or “T”. “P” or “T”






O

2 ID


O

2 ID



MSH Seq


Length Data Type

Rejection Rules


Comments




O

60 CE


O

20 ID

3.4.3 MFI (Message File Identification Segment) – MFN



MFI Seq


Length Data Type

Rejection Rules


Comments

1 Message File Identifier R

250 CE

INS <INS^Insurance Master File> Note: See HL7 Table: Master File Identifier Codes.

2 Master File Application Identifier

O

180 HD

3 File-Level Event Code R 3 ID UPD

4 Entered Date/Time O 26 TS <yyyymmddhhmmss>

5 Effective Date/Time O 26 TS <yyyymmddhhmmss>

6 Response Level Code R

2 ID AL Always sends an ACK.

a. HL7 Table: Master File Identifier Codes

Value Description Comment

CDM Charge Description Master File

CLN Clinic Master File

CMA Clinical Study with Phases and Scheduled Master File

CMB Clinical Study without Phases but with Scheduled Master File

CPT Procedure Master File




DEP Procedure Category Code Master File

DXC Diagnosis Code Master Record

INS Insurance Master File AMICAS currently updates this file.

INV Inventory Master File

LOC Location Master file

MOD CPT Code Modifier Master File

OMA Numerical Observation Master File

OMB Categorical Observation Master File

OMC Observation Batteries Master File

OMD Calculated Observations Master File

OME Other Observation/Service Item Master File

PHY Physician Master File

PRA Practitioner Master File

STF Staff Master File

ZIP Zip Code Master File

3.4.4 MFE (Message File Entry Segment) – MFN



MFE Seq


Length Data Type

Rejection Rules


Comments

1 Record-Level Event Code R

3 ID

MAD, MDL, MUP, MDC,MAC Note: See HL7 Table: Actions Performed on Master Files.

2 MFN Control ID C 20 ST <yyyymmddhhmmss>




MFE Seq


Length Data Type

Rejection Rules


Comments

4 Primary Key Value – MFE R

200 Varies

<Identifier -Location PMIS>

This is the search key for the PMIS Code depending upon the support table.

DX and ZIP use Code all others use the PMIS Code.

a. HL7 Table: Actions Performed on Master Files

Value Description

MAD Add the record to the master file.

MDL Delete the record from the master file.

MUP Update the record for the master file.

MDC Deactivate. Discontinue using the record in the master file, but do not delete it from the database.

MAC Reactivate the deactivated record.

3.4.5 ZL7 (Insurance Data to Post Segment) – MFN



MFN Seq


LengthData Type

Rejection Rules

Vision Series Data Mapping/ Comments

1 Location R

400 CE

Location <PMIS^Name^ Address1& Address2&City& State& ZipCode^Phone&&&Email&&&fax^Contact^^Plan Insurance Type Code^^^>



3.5 ORM^O01 – Order Message Type


Per HL7, the function of this message is to initiate the transmission of information about an order. This includes placing new orders, canceling existing orders, discontinuing orders, holding orders, etc. The trigger event for this message is any change to an order. Such changes include submission of new orders, cancellations, updates, patient and non-patient specific orders, etc.


Message Segment

Segment Description

MSH Message Header


PVI Patient Visit

NTE Notes

ORC Common Order

OBR Observation Request

OBX Observation Result


3.5.2 MSH (Message Header Segment) – ORM^O01



MSH Seq


Length Data Type

Rejection Rules


Comments











MSH Seq


Length Data Type

Rejection Rules


Comments



8 Security O 40 ST

9 Message Type O R 13 CM


“ORM^O01”



11 Processing ID R R 3 PT Rejected if not “P” or “T”.

“P” or “T”






O

2 ID


O

2 ID




O

60 CE


O

20 ID

3.5.3 PID (Patient Identification Definition Segment) - ORM^O01





PID Seq


Length Data Type

Rejection Rules


Comments

1 Set ID - Patient ID O R 4 SI

Rejected if not empty or “1”. MSA1 = [ACK Code], MSA6 = [Field] [Field Name] [error]

One PID segment per message. “1”

2 Patient ID (External ID) B 20 CX

3 Patient Identifier List R R 250 CX

Reject if empty. MSA1 = [ACK Code], MSA6 = [Field] [Field Name] [error]

Patient Identifier Number <Patient Identifier Number>

4 Alternate Patient ID - PID C 20 CX

Reject if not formatted correctly. MSA1 = [ACK Code], MSA6 = [Field] [Field Name] [error]

5

Patient Name last name first name middle name suffix prefix

R R 250 XPN

Reject if empty, not formatted correctly or the suffix code does not match. MSA1 = [ACK Code], MSA6 = [Field] [Field Name] [error]

<last name^first name^ middle name^suffix^prefix>


7 Date/Time of Birth O R 26 TS Rejected if field is empty and if not formatted correctly.

Patient DOB <yyyy^mm^dd> or <yyyymmdd>

8 Administrative Sex O O 1 ST Rejected if the gender code does not match.

Patient Gender <PMIS code only> (reference the Gender support table)

9 Patient Alias O


10 Race O

250 IS Rejected if the ethnicity code does not match this field.



250 XAD




PID Seq


Length Data Type

Rejection Rules


Comments

12 County Code B



250 XTN

<home phone number^fax number^^email address>


250 XTN



16 Marital Status O

250 IS Rejected if the marital status code does not match this field.

Patient Marital Status<PMIS code> or <Jacket Number> or <SSN> (reference the RIS Marital Status support table)

17 Religion O 3 IS


Rejected if not formatted correctly. MSA1 = [ACK Code], MSA6 = [Field] [Field Name] [error]

Patient Unique Identifier <Patient File PMIS> or <Jacket Number> or <SSN> This field is required if the interface is configured to use the patient PMIS number as the unique identifier. If the PMIS is used as the unique ID, then PID_3 Jacket Number must be NULL on the inbound message. The patient PMIS must be unique to all patients, guarantors and insureds. Alphanumeric.

19 SSN Number - Patient B C 16 ST

Rejected if formatted correctly. MSA1 = [ACK Code], MSA6 = [Field] [Field Name] [error]

Patient Social Security Number <nnnnnnnnn> or <nnn-nnn-nnn> Numeric with no special characters. No validation is performed for length or duplicates.



PID Seq


Length Data Type

Rejection Rules


Comments


O

25 CM










26 TS

Patient Death Date and Time <yyyy^mm^dd> or <yyyymmdd>


3.5.4 PV1 (Patient Visit Segment) – ORM^O01



If the PV1 segment is missing, the value in OBR.16 will be used for the referring physician.

PV1 Seq


Length Data Type

Rejection Rules


Comments

1 Set ID – PV1 O


2 Patient Class R R 1 IS Reject if empty or the PMIS code does not match.

Patient type, for example: E = Emergency Room O = Outpatient I = Inpatient If PV1 is not included, then Global Service Type will be selected by default.



PV1 Seq


Length Data Type

Rejection Rules


Comments

3 Assigned Patient Location O

80 PL

Patient location <point of care or nursing station>^<room>^<bed>All other PV1-3 sub components will be ignored. Displayed in RIS separated by a space colon (“ :”).


5 Pre-admit Number O 20 CX


7 Attending Doctor O R 60 XCN

Reject if the PMIS or Last Name empty. The first name is also required if RIS creates the physician record from the message. Physician matching will occur only on PMIS. If the PV1 segment has a value for PV1.7 and PV1.8, PV1.7 will be used as the referring physician and PV1.8 will be used as the CC physician. If the PV1 segment is not found then the value in OBR-16 will be used as the referring physician.

Attending (referring) Provider. A Tilde (~) separates reffering from any/all cc physicians. <Physician Location PMIS Code or Physician Location Unique Identifier ^Last Name^First^ Middle Name^Suffix^ ~PMIS^Last Name^ First Name^Middle Name^Suffix>

8 Referring Doctor O R 60 XCN


Referring (cc) Provider <Physician Location PMIS Code or Physician Location Unique Identifier ^Last Name^First^ Middle Name^Suffix^ ~PMIS^Last Name^ First Name^Middle Name^Suffix>



PV1 Seq


Length Data Type

Rejection Rules


Comments

9 Consulting Doctor O R 60 XCN

Reject if the PMIS or Last Name is empty. The first name is also required if RIS creates the physician record from the message. Physician matching will occur only on PMIS. PV1-9 will be used as the CC physician.

Consulting (cc) Provider<Physician Location PMIS Code or Physician Location Unique Identifier ^Last Name^First^ Middle Name^Suffix^ ~PMIS^Last Name^ First Name^Middle Name^Suffix>






15 Ambulatory Status O

2 IS Pregnancy Indicator <B6 if flag Y else other>

16 VIP Indicator O

2 IS Reject if empty or PMIS code does not match last name.


18 Patient Type O

2 IS Service Type <PMIS Code for Service Type Code>

19 Visit Number O

20 CX Visit Number will populate the Order Number field.










29 Transfer to Bad Debt Code

O

1 IS



32 Bad Debt Transfer Amount O 12 NM

33 Bad Debt Recovery Amount

O

12 NM




PV1 Seq


Length Data Type

Rejection Rules


Comments




38 Diet Type O 2 IS




42 Pending Location O

80 PL

Rejected if empty and schedule directly is selected and always schedule to is empty.

Location to schedule the exam. <^^^code ^^^^^ description>


44 Admit Date/Time O

26 TS Admit Date <yyyymmdd>

45 Discharge Date/Time O

26 TS Discharge Date <yyyymmdd>

46 Current Patient Balance O 12 NM






52 Other Healthcare Provider O

60 XCN Patient Weight <Patient Weight>

3.5.5 NTE (Notes and Comments Segment) – ORM^O01



NTE Seq


Length Data Type

Rejection Rules


Comments

1 Set ID – OBR O


3 Comment 64k FT

<comment text> NTE following the PID will be a Patient comment.



3.5.6 ORC (Common Order Segment) - ORM^O01

The following table lists each Common Order segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

ORCSeq


Length Data Type

Rejection Rules


Comments

1 Order Control R

2 ID Rejected if not a valid code.

NW = New Order

CA = Cancel Order

XO = Change/ Update Order

DC = Canceled Order (discontinued)

HD = Hold Order

IP = In Process Order

SC = Scheduled Order

RL = Release Hold Order

RP = Order Replace

2 Placer Order Number C

16 EI Accession Number

<Accession Number>

3 Filler Order Number C

16 EI Accession Number

<Accession Number>

4 Placer Group Number O 22 EI

5 Order Status O

2 ID

Blank if New Order

“CM” if Order sent at Tech End

“CA” if Cancel Order

“XO” if Change Order

6 Response Flag O 1 ID

7

Quantity/Timing quantity interval duration start date/time end date/time Priority condition text conjunction order sequencing

O

200 TQ

Scheduled Exam Date/Time

<^^^yyyymmddhhmm^^s> if urgent or <R> if not urgent

8 Parent O 200 CM

9 Date/Time of Transaction O


<yyyymmddhhmmss>



ORCSeq


Length Data Type

Rejection Rules


Comments

10 Entered By O

250 XCN

User ID & Name

<User ID^Last Name^First Name^^>

Do not store in our database. This is for information purposes only.

The following table lists the valid ORC-1 / 5 pairs and what happens to the message:

ORC-1 / ORC-5 RIS Visit Status

RIS Exam Status Comments

ORM^001 Messages: NW / blank Order

or Scheduled if schedule directly is selected

Order or Scheduled if schedule directly is selected

NW / SC Scheduled Scheduled Schedules in the first available resource, if no openings, it will force the appointment to a resource.

NW / IP Check in Check in Schedules in the first available resource, if no openings, it will force the appointment to a resource.

NW / CM Check out Ended Always force the appointment - this will not show in the appointment book since the procedure was not performed at the location.

SC / blank Order

or Scheduled if schedule directly is selected

Order or Scheduled if schedule directly is selected

SC / SC Scheduled Scheduled Schedules in the first available resource, if no openings, it will force the appointment to a resource.

SC / IP Check in Check in Schedules in the first available resource, if no openings, it will force the appointment to a resource.

SC / CM Check out Ended Always force the appointment – this will not show in the appointment book since the procedure was not performed at the location

If no NW or SC is received to create the order, all message types below are rejected CA / CA Cancel Whatever the

status is Can cancel all orders and appointments unless there is a report attached

CA / DC Cancel Whatever the status is

Can cancel all orders and appointments unless there is a report attached

DC / DC Cancel Whatever the


DC / CA Cancel Whatever the status is


OC / CA Cancel Whatever the


OC / DC Cancel Whatever the status is


OD / CA Cancel Whatever the


OD / DC Cancel Whatever the status is


XO / XO See comments See comments This will only update orders that are configured to automatically



ORC-1 / ORC-5 RIS Visit Status

RIS Exam Status Comments

schedule, if order is at the status of schedule, then sending an XO/XO will take it to the next step which will be checkin, then if we continue sending this status, the order will move through the RIS workflow, Inprocess, checkout

XO / IP Check in Check in This will only update orders that are configured to automatically schedule, order must be at a schedule status, sending this will move it to checkin

XO / CM Check out Ended This will only update orders that are configured to automatically schedule, order must be at either schedule, checkin or inProcess, this will take the order to a checkout status

XX / XO See comments See comments See XO/XO XX / IP Check in Check in See XO/IP XX / CM Check out Ended See XO/CM OH / HD Order hold Order only supported for orders that have not been scheduled; otherwise

NACK with error message order must be canceled, this message will be seen in the monitor, since we do not process HL7 messages in advanced mode

HD / HD Order hold Order only supported for orders that have not been scheduled; otherwise

NACK with error message order must be canceled this message will be seen in the monitor, since we do not process HL7 messages in advanced mode

RL / ORC-5 ignored

Order Hold Order Release an order on hold in the work queue

OE / ORC-5 ignored

Order Hold Order Release an order on hold in the work queue

ORR^002 Message: NA / ORC-5 ignored

Any status Any status The only reason for this message is to add the Order Number. And patient account number Logic: An order created in RIS will send an ORM^001 with ORC-1 = SN, OBR-2 is blank, and OBR-3 = accession #. HIS will return an ORR^O02 with ORC-1 = NA, OBR-2 has order number and OBR.3 will have the RIS accession number

3.5.7 OBR (Observation Request Segment) – ORM^O01

The following table lists each Observation Request segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:


OBR Seq


Length Data Type

Rejection Rules


Comments

1 Set ID - Observation Request

O

4 SI Sequence number for one or more OBR Segments per message.



OBR Seq


Length Data Type

Rejection Rules


Comments

2 Placer Order Number C R 22 EI Rejected if field is empty or code does not match.

<order number from the external system> A value that uniquely identifies the procedure to the host system for this patient.

3 Filler Order Number C 22 EI

4 Universal Service ID identifier text

R R 250 CE Rejected if field is empty or code does not match.

<exam being ordered or canceled> Optionally, this can be followed by two carets (^^) to include a modifier. 4.1 = Code 4.2 = Description 4.3 = Modifier

5 Priority B 2 ID

6 Requested Date/Time B 26 TS

7 Observation Date/Time C

O

26 TS Rejected if not formatted correctly.

Date/time the order was started. <yyyymmddhhmmss> or <yyyy^mm^dd^hh^mm^ss>

8 Obs End Date/Time O 26 TS

9 Collection Volume O 20 CQ

10 Collector Identifier O 60 XCN

11 Specimen Action Code O 1 ID

12 Danger Code O 60 CE

13 Relevant Clinical Info. O 300 ST

14 Specimen Rec'd Date/Time

C

26 TS

15

Specimen Source Source Code Additives Source Description Body Site

O

300 CM



OBR Seq


Length Data Type

Rejection Rules


Comments

16 Ordering Provider O O 250 XCN


Ordering (referring) provider. Tilde (~) separates referring from any or all CC physicians.

<Physician Location PMIS Code or Physician Location Unique Identifier

^ Last Name ^ First Name ^ Middle Name ^ Suffix ^ - PMIS ^ Last Name ^ First Name ^ Middle Name ^ Suffix ^>

17 Order Callback Phone No.

O

40 XTN

18 Placer Field 1 O

60 ST A definable field that the placing (ordering) system can use.

19 Placer Field 2 O 60 ST

20 Filler Field 1 O

60 ST A definable field that the filling (RIS) system can use.

21 Filler Field 2 O 60 ST

22 Result Rpt/Status Change - Date/Time

C O 26 TS Rejected if not formatted correctly.

Date/time of order or status change. <yyyymmddhhmmss> or <yyyy^mm^dd^hh^mm^ss>

23 Charge To Practice O 40 CM



OBR Seq


Length Data Type

Rejection Rules


Comments

24 Diagnostic Serv Sect ID O

10 ID

Schedule Resource

<Resource Category Code>

Note: If OBR-24 does not match an active resource for the provided exam, the exam will be scheduled in the first available resource during the given appt time or it will be forced into the timeslot on the appointment book if the given time is not available.

25 Result Status C R 1 ID Rejected if not P, F or A.

“P” for Preliminary “F” for Final “A” for Addendum

26 Parent Result O 400 CM

27 Quantity/Timing

O

200 TQ

Can identify quantity of this exam to be ordered, start and end date/time and priority. <quantity ^ ^ ^ start_date/time ^ end_date/time ^ priority> Priority = S (STAT) or A (ASAP) will se the urgent flag otherwise normal priority. R (Routine).

28 Result Copies To O 150 XCN

29 Parent Number O 200 CM

30 Transportation Mode O 20 ID

31 Reason For Study O

C

250 CE

Reject if empty or if schedule directly is selected and always schedule to is empty.

<reason code ^ reason text> If code, then try to match. If not match, use the reason text in the Other Reason field. Note that, in a multiple OBR segment, only one appointment reason is allowed per order.

32 Principal Result Interpreter

O R 200 CM Reject if empty or if PMIS codes does not match.

Reading Radiologist <PMIS Code or Unique ID^Last Name^First Name^Middle^Suffix>

33 Assistant Result Interpreter

O R 200 CM Dictated Date and Time <^^yyyymmddhhmmss>



OBR Seq


Length Data Type

Rejection Rules


Comments

34 Technician O 200 CM

35 Transcriptionist O 200 CM

Transcriptionist ID <PMIS Code or Unique ID^Last Name^First name^Middle^Suffix>

36 Scheduled Date/Time O R 26 TS Reject if not formatted correctly.

Schedule date/time of the exam. <yyyymmddhhmmss> or <yyyy^mm^dd^hh^mm^ss>

37 Number of Sample Containers

O 4 NM

38 Transport Logistics of Collected Samples

O 60 CE

39 Collector’s Comment O 200 CE

40 Transport Arrangement Responsibility

O 60 CE

41 Transport Arranged O 30 ID

42 Escort Required O 1 ID

43 Planned Patient Transport Comment

O 200 CE

44 Procedure Code O 80 CE

45 Procedure Code Modifier O 80 CE

3.5.8 OBX (Observation Result Segment) - ORM^O01

The following table lists each Observation/Result segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:


OBX Seq


Length Data Type

Rejection Rules


Comments

1 Set ID – OBR O

4 SI

Sequence number for one or more OBX segments per message.

2 Value Type C 3 ID

3 Observation Identifier R

80 CE

Treated as a lead in to an order comment. Likely to be combined with OBX – 5.

4 Observation Sub-ID C 20 ST



OBX Seq


Length Data Type

Rejection Rules


Comments

5 Observation Value C

4k *

Treated as an order comment. If OBX-3 is sent, will concatenate with OBX-3.

6 Units O 60 CE

7 References Range O 60 ST

8 Abnormal Flags O 5 ID

9 Probability O 5 NM

10 Nature of Abnormal Test O 2 ID

11 Observation Result Status R R 1 ID

12 Date Of Last Obs Normal Values

O

26 TS

13 User Defined Access Checks

O

20 ST

14 Date-Time of the Observation

O

26 TS

15 Producer’s ID O 60 CE

16 Responsible Observer O C 80 XCN

17 Observation Method O 60 CE

3.6 ORR^O02 - General Order Acknowledgment Message Type


The function of this message is to respond to an ORM message. An ORR message is the application acknowledgment to an ORM message.

In ORR the PID and ORC segments are optional, particularly in case of an error response. However, ORC segments are always required in ORR when an order detail segment is present. For example, a response ORR might include only the MSH and MSA.


Message Segment

Segment Description

MSA Message Acknowledgment

MSH Message Header

ORC Common Order





3.6.2 MSA (Message Acknowledgment Segment) – ORR^O02



MSA Seq

HL7 Field Name OptRIS Req

LengthData Type

Rejection Rules


Comments

1 Acknowledgment Code R R 2 ID If the code is not AA then no updates will occur.

“AA” if Accepted “AE” if Error “AR” if Rejected

3 Text Message O

80 ST

If the code is equal to AE or AR then the reason for its failure will be in this field

3.6.3 MSH (Message Header Segment) - ORR^O02



MSH Seq

HL7 Field Name OptReq by RIS

LengthData Type

Rejection Rules


Comments

1 Field Separator R R

1 ST Must always be pipe "|".

"|"

2 Encoding Characters R R

4 ST Must always be "^~\&".

"^~\&"









MSH Seq

HL7 Field Name OptReq by RIS

LengthData Type

Rejection Rules


Comments

7 Date/time of Message O R 26 TS

Rejected if field is empty or date/time is in the incorrect format.

Current date/time <yyyymmddhhmmss>or<yymmddhhmmssss>or<yyymmddhhmmssss> or <yymmddhhmmss>

8 Security O 40 ST

9 Message Type O R 13 CM


“ORM^O01”



11 Processing ID R R 3 PT Rejected if not “P” or “T”.

“P” or “T”






O

2 ID


O

2 ID




O

60 CE


O

20 ID

3.6.4 ORC (Common Order Segment) - ORR^O02


ORCSeq


Length Data Type

Rejection Rules


Comments

1 Order Control R R 2 ID Rejected if not a valid code. NA is the only valid code.

Trigger event identifier for orders.

NA =Number Assigned



ORCSeq


Length Data Type

Rejection Rules


Comments

2 Placer Order Number C R 22 EI Rejected if empty. Order number from placer.

3 Filler Order Number C R 16 EI Rejected if empty. Accession number.

3.6.5 PID (Patient Identification Definition Segment) – ORR^O02



PID Seq


LengthData Type

Rejection Rules


Comments

3 Patient ID (Internal ID) R 22 CX Patient Internal ID. The Patient MRN, Jacket, etc

5 Patient Name R 90 XPN Patient Name.

18 Patient Account Number O R 22 CX Rejected if empty. Patient Account Number.

3.7 ORU^R01 - Results Message Type


Vision Series RIS will receive the patient message event type ORU^R01 which will create or update patient reports. The AMICAS interface will be a one-way (unidirectional) data transfer. Message received shall conform to the Health Level Seven (HL7) Standard, version 2.3 for electronic data exchange.


Message Segment

Segment Description

MSH Message Header


OBR Observation Request

OBX Observation/Result




3.7.2 MSH (Message Header Segment) - ORU^R01



MSH Seq


LengthData Type

Rejection Rules


Comments



3 Sending Application O R 180 HD Rejected if field is empty.



5 Receiving Application O R 180 HD Rejected if field is empty.

<Receiving Application>


7 Date/time of Message O R 26 TS Rejected if field is empty.

Current date/time <yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R R 7 CM Rejected if field is empty.

“ORU^R01”








O

2 ID


O

2 ID




O

60 CE


O

20 ID



3.7.3 PID (Patient Identification Definition Segment) - ORU^R01



PID Seq


LengthData Type

Rejection Rules


Comments



2 Patient ID (External ID) B 20 CX

3 Patient ID (Internal ID) R R 20 CX

Rejected if PID 3 does not match this field. If this field is empty then refer to PID 2. If PID 2 is empty or does not match, then reject.

Patient Identifier Number <Patient Identifier Number>

4 Alternate Patient ID B 20 CX

5


R

48 XPN

<last name^first name^ middle name>




8 Sex O R 1 ST



9 Patient Alias O


10 Race O




151 60 40 40 2 9

XAD

Patient Address <address 1^ address 2^ city^ state (standard abbreviation only)^ zip (alphanumeric with no validation)>



PID Seq


LengthData Type

Rejection Rules


Comments

Excess length will be truncated. Country does not update.

12 County Code B



12 XTN


14 Phone Number - Business

O

12 XTN

Patient Work Phone – numeric only <area code and phone number>


16 Marital Status O


Patient Marital Status <PMIS code only> (reference the RIS Marital Status support table)

17 Religion O 3 IS


If the PMIS is used as the unique ID, reject if blank and PID 3 must be NULL.

Patient Unique Identifier <Patient File PMIS>This field is required if the interface is configured to use the patient PMIS number as the unique identifier. If the PMIS is used as the unique ID, then PID_3 Jacket Number must be NULL on the inbound message. The patient PMIS must be unique to all patients, guarantors and insureds. Alphanumeric.






PID Seq


LengthData Type

Rejection Rules


Comments


O

25 CM











Patient Date of Death <yyyymmdd>


3.7.4 OBR (Observation Request Segment) - ORU^R01

The following table lists each Observation Request segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:


OBR Seq


LengthData Type

Rejection Rules


Comments


O

4 SI Sequence number for one or more OBR Segments per Message

2 Placer Order Number C R 16 EI Rejected if field is empty or does not match.

Accession Number <Accession Number>

3 Filler Order Number C 22 EI


R

200 CE

5 Priority B 2 ID

6 Requested Date/Time B 26 TS

7 Observation Date/Time C 26 TS







OBR Seq


LengthData Type

Rejection Rules


Comments


13 Relevant Clinical Info. O

300 ST

If 13.1 has a value then 13.3 is required and the message will be rejected. If 13.2 is not populated it will default to N.

Updates information for mammography procedures. The assessment, biopsy and recall flags are set for the patient's mammography procedure(s) associated with the report. Bi-rad PMIS^ N (New) C (Compare Film) F (Need Film)^ Recall PMIS code

14 Specimen Rec'd Date/Time

C

26 TS

If an invalid date is applied, the current date will serve as the approval date.

Approval Date <yyyymmdd>

15


O

300 CM

16

Ordering Provider physician ID family name given name middle initial or name

O

80 XCN

Ordering (referring) provider. Tilde (~) separates referring from any or all CC physicians. <Physician Location PMIS Code or Physician Location Unique Identifier ^ Last Name ^ First Name ^ Middle Name ^ Suffix ^ - PMIS ^ Last Name ^ First Name ^ Middle Name ^ Suffix ^>

17 Order Callback Phone No.

O

40 XTN






C

26 TS




OBR Seq


LengthData Type

Rejection Rules


Comments

24 Diagnostic Serv Sect ID O

10 ID Schedule Resource

<Resource Category Title>

25 Result Status C R 1 ID

Rejected if not P, F or A. If it is an A or a P and OBX 11 is an S, the report will be placed on hold.

“P” for Preliminary “F” for Final “A” for Addendum


27 Quantity/Timing

O

200 TQ




31 Reason For Study O 300 CE

32 Principal Result Interpreter

O R 200 CM Reject if empty or if PMIS codes does not match.

Reading Radiologist <PMIS Code or Unique ID^Last Name^First Name^Middle^Suffix>

33 Assistant Result Interpreter

O R 200 CM Dictated Date and Time<^^yyyymmddhhmmss>



Transcriptionist ID <PMIS Code or Unique ID^Last Name^First name^Middle^Suffix>

36 Scheduled Date/Time O 26 TS


O 4 NM

38 Transport Logistics of Collected Samples

O 60 CE



O 60 CE




O 200 CE





3.7.5 OBX (Observation/Result Segment) - ORU^R01



OBX Seq


LengthData Type

Rejection Rules


Comments

1 Set ID - Observation Simple

O

4 SI

Sequence number for one or more OBX segments per message.

2 Value Type C 3 ID

3 Observation Identifier R 80 CE

4 Observation Sub-ID C 20 ST

5 Observation Value C

65536 *

Line(s) of text from report. Tildes (~) and carats (^) are recognized as carriage returns.

6 Units O 60 CE





11 Observation Result Status

R R 1 ID

Rejected if not “P” or “F”. Also reject if this field does not coincide with OBR 25. If OBX 11 is an S, OBR 25 must be a P or an A.

“P” Preliminary “F” Final “S” Partial Results


O

26 TS


O

20 ST


O

26 TS


16 Responsible Observer O C 80 XCN Reject if the field is empty and if OBX 11 is “F”.

Approving Radiologist <PMIS Code or Unique ID^Last Name^First Name^Middle^Suffix>




3.8 ACK – Acknowledgment Message Type

3.8.1 Definition

The HL7 Acknowledgment Message Type, ACK is sent from Vision Series RIS with a success or error message via the interface.

When Vision Series RIS receives an HL7 message, it will validate the message syntactically. If validation fails, a reject message is constructed and returned to the placer. If validation does not fail, the message will be sent to a process which will update the database and Vision Series RIS will generate a functional response message. If an error occurs during processing, Vision Series RIS will send an error response. If it processes correctly, Vision Series RIS will send a successful response.


Message Segment

Segment Description

MSH Message Header

MSA Message Acknowledgment


3.8.2 MSH (Message Header Segment) - ACK



MSHSeq HL7 Field Name OptRIS Req

LengthData Type

Rejection Rules


Comments



3 Sending Application O 180 HD ”Vision Series RIS”

4 Sending Facility O 180 HD

5 Receiving Application O 180 HD


7 Date/time of Message O

26 TS Current date/time <yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R 13 CM “ACK”

10 Message Control ID R

20 ST System Date/Time <yyyymmddhhmmss>


12 Version ID R

60 ID “2.3” HL7 version number




MSHSeq HL7 Field Name OptRIS Req

LengthData Type

Rejection Rules


Comments


15 Accept Acknowledgment Type

O

2 ID "AL"

16 Application Acknowledgment Type

O

2 ID




O

60 CE


O

20 ID

3.8.3 MSA (Message Acknowledgment Segment) - ACK



MSA Seq


LengthData Type

Rejection Rules


Comments

1 Acknowledgment Code R

2 ID “AA” if Accepted “AE” if Error “AR” if Rejected

2 Message Control ID R

20 ST

Unique identifier echoed back from the received HL7 message, MSH_10.

3 Text Message O

80 ST

If MSA_1 is AA this field will be empty, otherwise this will contain text.

4 Expected Sequence Number

O

15 NM

5 Delayed Acknowledgment Type

B

1 ID

6 Error Condition O 100 CE

Vision Series RIS 5.0 HL7 Interface Guide Outbound Messages


4. Outbound Messages

The AMICAS interface will be a one-way (unidirectional) outbound data transfer. Patient demographic and appointment information will be sent from Vision Series RIS at several points within the application workflow. The results report (Transcription Report) will be sent for each preliminary and/or approved report. Messages sent shall conform to the Health Level Seven (HL7) Standard, version 2.3 for electronic data exchange.

All outbound messages will fail if the jacket number is empty.

The following outbound interfaces are supported:

ADT

MFN

ORM

ORU

ORM (Charge Out)

ACK


4.1 Interface Monitor

A distribution entry is created for each message and is monitored through the HL7 Interface Monitor page. The HL7 Message Type is appended in parentheses to the transmission mode (Online-socket (ORM^O01)) in the Patient Files: Audit Trail window, as shown below. The monitor page displays each of the messages sent and the status of each message. This page also provides the ability to resend a message.

4.2 Trigger Points and Trigger Events

4.2.1 Definition

A trigger point is a location in the workflow in which a trigger event will occur. A trigger event is an event which initiates the flow of information among application systems. The trigger event is only sent if the corresponding trigger event is sent.



The following table lists each workflow item and their associated trigger events:

Workflow/ Workflow Event

Trigger Event

Schedule New orders (O01) sent at time of scheduling visits if schedule trigger set.

Cancel orders (O01) sent at time of canceling visits.

Reschedule orders (O01) will send cancel message followed by new order message.

Patient Information Update (A08) sent for demographic registration data change.

Check-In/Out New orders (O01) sent at the time patient checks-in if schedule trigger is not set, otherwise a change order is sent when the patient is checked-in.

New orders (O01) sent for added procedures/exams.

Change orders (O01) sent for changed procedures/exams.

Completed orders (O01) sent for procedures in a Check Out status.

Cancel orders (O01) sent on canceled procedures/exams.

Patient Information Update (A08) sent for demographic registration data change.

Tech Entry Change orders (O01) sent when all procedures are started on the same exam.

New orders (O01) sent for added procedures.

Cancel orders (O01) sent on deleted procedures.

Completed orders (O01) sent for procedures in an Ended status.

Patient File and/or Patient History

New orders (O01) sent for added procedures or visits.

Change orders (O01) sent for changed procedures.

Cancel orders (O01) sent on canceled procedures.

Patient Information Update (O01) sent for changes to demographic registration data.

Merge patient (A34) sent when merge occurs.

Transcription Results (R01) sent for preliminary reports or addendums.

Completed orders (O01) added for outside reads.

Report Review Results sent for approved reports or addendums.

Film Completed orders (O01) added check-in films.

Canceling/ Deleting an Exam or Procedure

If the interface is configured for Multi-OBR, cancel orders (O01) are sent for each cancelled or deleted exam.

If the interface is not configured for Multi-OBR, cancel orders (O01) are sent for each cancelled or deleted procedure.

Adding an Exam or Procedure

If the interface is configured for Multi-OBR, new orders (O01) are sent for each for each added exam.

If the interface is not configured for Multi-OBR, new orders (O01) are sent for each added procedure.

Replacing an Exam

Cancel orders (O01) are sent followed by New Orders (O01) when replacing an exam.

Canceling a Visit If the interface is configured for Multi-OBR set for the Exam level, cancel orders



Workflow/ Workflow Event

Trigger Event

(O01) are sent for each cancelled exam.

If the interface is configured for Multi-OBR set to the Visit level, cancel orders (O01) are sent for each cancelled procedure.

4.3 ADTÂ08 – Update Patient Information

4.3.1 Definition

Vision Series RIS shall send the patient message event type ADTÂ08 which will update patient information. This trigger event is used when any patient information has changed when no other trigger event has occurred. The A08 event can include information specific to an episode of care, but it can also be used for demographic information only.

Do not send any guarantor or insured updates.


Message Segment

Segment Description

MSH Message Header


PV1 Patient Class


4.3.2 MSH (Message Header Segment) - ADTÂ08


MSHSeq

HL7 Field Name Opt Length Data Type




3 Sending Application O 180 HD ”Vision SeriesRIS”

4 Sending Facility O 180 HD <Corporation Name>

5 Receiving Application O 180 HD “PACS”


7 Date/time of Message O 26 TS Current date/time

<yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R 7 CM “ADTÂ08”



MSHSeq



10 Message Control ID O 20 ST System date/time

<yyyymmddhhmmss>


12 Version ID R 60 ID “2.3”

HL7 version number



15 Accept

Acknowledgment Type O 2 ID "AL"


O 2 ID "NE"



19 Principal Language of Message

O 60 CE


O 20 ID

4.3.3 PID (Patient Identification Definition Segment) - ADT^A08


PID Seq



1 Set ID - Patient ID O 4 SI One PID segment per message.

“1”

2 Patient ID (External ID) O 20 CX Patient Unique Identifier


3 Patient ID (Internal ID) R 20 CX

Patient Unique Identifier

<Internal Generated Patient ID, Jacket, PMIS or Social Security>

4 Alternate Patient ID O 20 CX Patient Unique Identifier

<Jacket, PMIS or Social Security >

5

Patient Name

last name

first name

middle initial

R 48 XPN Patient Name

<last name^first^middle^suffix>



PID Seq




7 Date of Birth O 26 TS Patient DOB - Date portion only

<yyyymmdd>

8 Sex O 1 ST Patient Gender (F, M, O, U)

<PMIS Code or Gender Code>

9 Patient Alias O 48 XPN Patient Alias

<Alias field>

10 Race O 80 IS Patient Ethnicity

<PMIS code or Ethnicity Code>

11 Patient Address O 106 XAD

Patient Address

<Address 1Âddress 2^

City^State^Zip^Country>

12 County Code B 4 IS County Code

<County Field>

13 Phone Number - Home O 40 XTN

Patient Home Phone, Fax, Email

<(Area Code)Phone NumberÂdditional text in phone number field^Fax NumberÊmail Address>

14 Phone Number - Business O 40 XTN

Work Phone

<(Area Code)Phone NumberÂdditional text in phone number field>


16 Marital Status O 80 IS Patient Marital Status

<PMIS Code for Marital Status Code>

17 Religion O 80 IS

18 Patient Account Number O 20 CX Patient Unique Identifier

<PMIS>

19 SSN Number - Patient O 16 ST Patient SS Number

<SS Number>

20 Driver’s Lic Num - Patient O 25 CM








PID Seq






29 Patient Death Date/Time O 26 TS Patient Date of Death

<yyyymmdd>


4.3.4 PV1 (Patient Visit Segment) - ADT^A08


PV1 Seq



1 Set ID – PV1 O 4 SI One PV1 Segment per message.

“1”

2 Patient Class R 1 IS Service Type

<PMIS Code for Service Type Code>

3 Assigned Patient Location O 80 PL

Patient Location

<Location Name^^^PMIS Code^^^^^Location Name>


5 Preadmit Number O 20 CX


7 Attending Doctor O 60 XCN

8 Referring Doctor O 60 XCN

Rank 1 Physician

<Physician Identifier (configurable to Location PMIS Code or RIS Unique Identifier and/or NPI)^LastName^First^Middle Name^Suffix>

9 Consulting Doctor O 60 XCN

Additional Physicians

<Physician Identifier (configurable to Location PMIS Code or RIS Unique Identifier and/or NPI)^LastName^First^Middle Name^Suffix^~ Physician Identifier (configurable to Location PMIS Code or RIS Unique Identifier and/or NPI)^LastName^First^Middle Name^Suffix>







PV1 Seq




15 Ambulatory Status O 2 IS Pregnancy Indicator

<B6 if flag Y else other>



18 Patient Type O 2 IS Service Type


19 Visit Number O 20 CX Unique Visit Number

<System Generated Number>










29 Transfer to Bad Debt Code O 1 IS




33 Bad Debt Recovery Amount O 12 NM












PV1 Seq




44 Admit Date/Time O 26 TS Admit Date

<yyyymmdd>

45 Discharge Date/Time O 26 TS Discharge Date

<yyyymmdd>





50 Alternate Visit ID O 20 CX <Order Number>


52 Other Healthcare Provider O 60 XCN Patient Weight

<Patient Weight>

4.4 ADTÂ34 – Merge Patient Information (Patient ID Only)

4.4.1 Definition

Vision Series RIS shall send the patient message event type ADTÂ34 which will merge patient information. An A34 event is used to signal a merge of records for a patient that was incorrectly created under two different identifiers. This merge is done to change patient identifiers on all of the patient’s incorrect accounts.


Message Segment

Segment Description

MSH Message Header

EVN Event Type


MRG Merge Information


4.4.2 MSH (Message Header Segment) - ADTÂ34


MSHSeq







MSHSeq








<yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R 7 CM “ADT^A34”

10 Message Control ID R 20 ST System date/time

<yyyymmddhhmmss>



HL7 version number



15 Accept

Acknowledgment Type O 2 ID

"AL"


O 2 ID "NE"




O 60 CE


O 20 ID

4.4.3 EVN (Event Type Segment) - ADT^A34


EVNSeq



1 Event Type Code B 3 ID “A34”

2 Recorded Date/Time R 26 TS Current Date/Time

<yyyymmddhhmmss>




EVNSeq




5 Operator ID O 60 XCN Operator ID & Name



<yyyymmddhhmmss>

4.4.4 PID (Patient Identification Definition Segment) - ADT^A34


PID Seq




“1”

2 Patient ID (External ID) B 20 CX Patient Unique Identifier




Destination Patient Identifier

<Defined Unique ID>

4 Alternate Patient ID B 20 CX Patient Unique Identifier


5

Patient Name

last name

first name

middle initial




7 Date of Birth O 26 TS Patient DOB - Date portion only

<yyyymmdd>

8 Sex O 1 ST Patient Gender (F, M, O,U)

<PMIS code or Gender Code>


<Alias field>





PID Seq




Patient Address




<County Field>





Work Phone





17 Religion O 80 IS


<PMIS>

19 SSN Number - Patient B 16 ST Patient SS Number

<SS Number>











<yyyymmdd>


4.4.5 MRG (Patient Merge Information Segment) - ADT^A34

The following table lists each Patient Merge Information segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:



MRG Seq



1 Prior Patient ID - Internal R 20 CX


Source Patient Identifier

<Defined Unique ID>

2 Prior Alternate Patient ID O 20 CX Patient Unique Identifier

<Defined Unique ID>

3 Prior Patient Account Number

O 20 CX Prior Patient PMIS

<Patient File PMIS>

4 Prior Patient ID - External O 20 CX Prior Patient Unique Identifier


5 Prior Visit Number O 20

6 Prior Alternate Visit ID O 20

7 Prior Patient Name O 48

4.5 MFN - Master File Update Message Type


In an open-architecture healthcare environment there is often a set of common reference files used by one or more application systems. These files are called master files. Some common examples of master files in the healthcare environment include:

staff and health practitioner master file

system user (and password) master file

location (census and clinic) master file

device type and location (e.g., workstations, terminals, printers, etc.)

lab test definition file

exam code (radiology) definition file

charge master file

patient status master

patient type master

service item master file

These common reference files need to be synchronized across the various applications at a given site. The Master Files Notification (MFN) message provides a way of maintaining this synchronization by specifying a standard for the transmission of this data between applications.

In many implementations, one application system will "own" a particular master file such as the staff and practitioner master file. The changes (e.g., adds, deletes, updates) to this file are made available to various other applications on a routine basis. The MFN message supports this common case, but also supports the situation where an application not "owning" a particular master file, transmits update information to other systems (usually to the "owning" system), for review and possible inclusion.



The MFN message supports the distribution of changes to various master files between systems in either online or batch modes, and allows the use of either original or enhanced acknowledgment modes, as well as providing for a delayed application acknowledgment mode. These messages use the MSH segment to pass the basic event code (master files notification or acknowledgment). The Master File Identification (MFI) segment identifies the master file being updated as well as the initial and requested dates for file-level events (such as replace file). For each record being changed, the Master File Entry (MFE) segment carries the record-level event code (such as add, update, etc.), the initial and requested dates for the event, and the record-level key identifying the entry in the master file. The Master File Acknowledgment (MFA) segment returns record-specific acknowledgment information.


Message Segment

Segment Description

MSH Message Header

MFI Master File Identification

MFE Master File Entry

ZL7 Insurance Data to Post


4.5.2 MSH (Message Header Segment) – MFN



MSH Seq





3 Sending Application O 180 HD <Sending Application>



6 Receiving Facility O 180 HD <Interface Engine Name for new customers> or <AMICAS RIS for existing customers>

7 Date/time of Message O 26 TS


8 Security O 40 ST

9 Message Type R 7 CM “ORM^O01”

10 Message Control ID O 20 ST Unique Message Identifier

11 Processing ID R 3 PT “P” or “T”



MSH Seq







O 2 ID


O 2 ID




O 60 CE


O 20 ID

4.5.3 MFI (Message File Identification Segment) – MFN



MFI Seq



1 Message File Identifier R 250 CE

INS <INS^Insurance Master File> Note: See HL7 Table: Master File Identifier Codes.

2 Master File Application Identifier

O 180 HD

3 File-Level Event Code R 3 ID UPD

4 Entered Date/Time O 26 TS <yyyymmddhhmmss>


6 Response Level Code R 2 ID AL Always sends an ACK.

a. HL7 Table: Master File Identifier Codes


CDM Charge Description Master File

CLN Clinic Master File

CMA Clinical Study with Phases and Scheduled Master File




CMB Clinical Study without Phases but with Scheduled Master File

CPT Procedure Master File

DEP Procedure Category Code Master File

DXC Diagnosis Code Master Record

INS Insurance Master File AMICAS currently updates this file.

INV Inventory Master File

LOC Location Master file

MOD CPT Code Modifier Master File

OMA Numerical Observation Master File

OMB Categorical Observation Master File

OMC Observation Batteries Master File

OMD Calculated Observations Master File

OME Other Observation/Service Item Master File

PHY Physician Master File

PRA Practitioner Master File

STF Staff Master File

ZIP Zip Code Master File

4.5.4 MFE (Message File Entry Segment) – MFN



MFE Seq



1 Record-Level Event Code

R 3 ID MAD, MDL, MUP, MDC, MAC Note: See HL7 Table: Actions Performed on Master Files.

2 MFN Control ID C 20 ST <yyyymmddhhmmss>




MFE Seq



4 Primary Key Value – MFE

R 200 Varies

<Identifier -Location PMIS>

This is the search key for the PMIS Code depending upon the support table.

DX and ZIP use Code all others use the PMIS Code.

a. HL7 Table: Actions Performed on Master Files

Value Description

MAD Add the record to the master file.

MDL Delete the record from the master file.

MUP Update the record for the master file.

MDC Deactivate. Discontinue using the record in the master file, but do not delete it from the database.

MAC Reactivate the deactivated record.

4.5.5 ZL7 (Insurance Data to Post Segment) – MFN



MFE Seq

HL7 Field Name

Opt Length Data Typ

e


1 Location R 400 CE

Location <PMIS^NameÂddress1& Address2&City&State&ZipCode^Phone&&&Email&&&fax^Contact^^Plan Insurance Type Code^^^>

4.6 ORMÔ01 – Order Message Type

4.6.1 Definition

Vision Series RIS sends the order message event type ORMÔ01 which contains patient orders. The function of this message is to initiate the transmission of information about an order. Orders are associated with a particular patient and usually contain a set of one or more procedures to be performed on a patient. Supported order messages include the Common Order Segment (ORC) and the Observation Request Segment (OBR).




Message Segment

Segment Description

MSH Message Header


PV1 Patient Visit (optional)

ORC Common Order

OBR Order Detail /Observation Request


4.6.2 MSH (Message Header Segment) - ORM^O01


MSH Seq










<yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R 7 CM “ORM^O01”

10 Message Control ID R 20 ST System date/time

<yyyymmddhhmmss>



HL7 version number



15 Accept

Acknowledgment Type O 2 ID "AL"


O 2 ID "NE"



MSH Seq






O 60 CE


O 20 ID



PID Seq




“1”








5

Patient Name

last name first name middle initial




7 Date of Birth O 26 TS Patient DOB - Date portion only (YYYYMMDD)




<Alias field>




Patient Address

<Address 1^Address 2^City^State^Zip^Country>


<County Field>



PID Seq







Work Phone





17 Religion O 80 IS


<PMIS>


<SS Number>











<yyyymmdd>


4.6.4 PV1 (Patient Visit Segment) - ORM^O01


PV1 Seq



1 Set ID – PV1 O 4 SI One PV1 segment per message.

“1”



PV1 Seq






Patient Location

< Location Name ^^^PMIS Code^^^^^Location Name>






Rank 1 Physician











<B6 if flag Y else other>













PV1 Seq
























<yyyymmdd>


<yyyymmdd>





50 Alternate Visit ID O 20 CX <Order Number>



<Patient Weight>



4.6.5 ORC (Common Order Segment) - ORM^O01


ORCSeq



1 Order Control R 2 ID

“NW” if New Order



2 Placer Order Number C 16 EI Accession Number

<Accession Number>

3 Filler Order Number C 16 EI Accession Number

<Accession Number>


Group Number for grouping procedures

Blank if no grouping, or Unique Group Number for Exam level or Unique Group Number for Visit level

<Group Order Number>

5 Order Status O 2 ID

Blank if New Order

“CM” if Order sent at Tech End




7


O 200 TQ


<^^^yyyymmddhhmm^^s> if urgent or <R> if not urgent

8 Parent O 200 CM

9 Date/Time of Transaction O 26 TS Current Date/Time

<yyyymmddhhmmss>

10 Entered By O 120 XCN

User ID & Name

<User ID^Last Name^First Name^Middle^Suffix>

11 Verified By O 120 XCN



ORCSeq



12

Ordering Provider physician id family name given name middle initial or name

O 120 XCN

Rank 1 Physician


13 Enterer’s Location O 80 PL Location ID & Name

^^^<PMIS^^^^^Location Name>

14 Call Back Phone Number O 40 XTN Rank 1 Physician Phone # & Fax #

<Phone Number^Fax Number>

15 Order Effective Date/Time O 26 TS

16 Order Control Reason O 200 CE Reason

<Reason or Free Text if Other Reason>

17 Entering Organization O 60 CE Rank 1 Physician Location

<PMIS or Unique ID^Phy Location Name>

18 Entering Device O 60 CE

19 Action By O 120 XCN

20 Advanced Beneficiary Notice Code

O 40 CE

21 Ordering Facility Name O 60 XON

22 Ordering Facility Address O 106 XAD

23 Ordering Facility Phone Number

O 48 XTN

24 Ordering Provider Address O 106 XAD

4.6.6 OBR (Order Detail /Observation Request) - ORM^O01

The following table lists each Order Detail/Observation Request segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

OBRSeq




O 4 SI One OBR Segment per Message

“1”


<Accession Number>


<Accession Number>



OBRSeq




R 200 CE

Procedure Code

Procedure Description

Exam Code

Exam Description

<Procedure Code^Procedure DescriptionÊxam CodeÊxam Description>

5 Priority B 2 ID

6 Requested Date/Time B 26 TS Scheduled Date/Time

^^^<yyyymmddhhmmss^^s>

7 Observation Date/Time C 26 TS Scheduled Date/Time








Comments

<Visit Comment~Visit Comment^Patient Comments~Patient CommentsÊxam Comments~Exam Comments^Schedule Comments>

14 Specimen Rec'd Date/Time C 26 TS

15


O 300 CM

16


O 80 XCN



17 Order Callback Phone No. O 40 XTN

Rank 1 Physician Phone number and Fax number




OBRSeq








Procedure Category & Resource

<Procedure Category Description^Resource Category Title>


21 Filler Field 2 O 60 ST Application Entity Title

<Modality Name>


C 26 TS


24 Diagnostic Serv Sect Id O 10 ID Schedule Resource


25 Result Status C 1 ID


27

Quantity/Timing quantity interval duration start date/time end date/time priority condition text conjunction order sequencing

O 200 TQ

Scheduled Date/Time


if urgent else <R>








Reason for Visit

<Reason or Free form if Other Reason^ Reason or Free form if Other Reason>

32 Principal Result Interpreter O 200 CM



OBRSeq



33 Assistant Result Interpreter O 200 CM



36 Scheduled Date/Time O 26 TS Scheduled Date/Time



O 4 NM

38 Transport Logistics of Collected Sample

O 60 CE



O 60 CE




O 200 CE



4.7 ORU^R01 – Results Message Type

4.7.1 Definition

Vision Series RIS sends the order message event type ORU^R01 which is the Observational Report Unsolicited. The ORU will send preliminary, final or addendum reports based upon a trigger define in Vision Series RIS. The HL7 message will consist of the following message segments.


Message Segment

Segment Description

MSH Message Header


PV1 Patient Visit

ORC Common Order (optional)


OBX Observation Results (may have repetitions)






MSH Seq










<yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R 7 CM “ORU^R01”


<yyyymmddhhmmss>



HL7 version number




O 2 ID "AL"


O 2 ID "NE"




O 60 CE


O 20 ID





PID Seq



1 Set ID - Patient ID O 4 SI One PID segment per message

“1”








5



<lastname^first^middle^suffix>






<Alias field>




Patient Address




<County Field>





Work Phone





PID Seq





17 Religion O 80 IS


<PMIS>


<SS Number>











<yyyymmdd>


4.7.4 PV1 (Patient Visit Segment) - ORU^R01


PV1 Seq



1 Set ID – PV1 O 4 SI One PV1 Segment per Message

“1”




Patient Location






PV1 Seq






Rank 1 Physician











<B6> if flag <Y> else other



















PV1 Seq


















<yyyymmdd>


<yyyymmdd>








<Patient Weight>

4.7.5 ORC (Common Order Segment) - ORU^R01


ORCSeq



1 Order Control R 2 ID “RE”



ORCSeq




<Accession Number>


<Accession Number>


5 Order Status O 2 ID “CM” Complete order


7


O 200 TQ


<yyyymmddhhmm^s> if urgent or <R> if not urgent

8 Parent O 200 CM


<yyyymmddhhmmss>


User ID & Name

<User ID^Last Name^First Name^Middle^ Suffix>


12


O 120 XCN

Rank 1 Physician



<^^^PMIS Code^^^^^Location Name>




16 Order Control Reason O 200 CE

Reason

<Reason> or <Free Text if Other Reason^Reason>


<PMIS> or <Unique ID^Phy Location Name>




ORCSeq





O 40 CE




O 48 XTN


4.7.6 OBR (Order Detail /Observation Request) - ORU^R01


OBRSeq





“1”


<Accession Number>


<Accession Number>


R 200 CE

Procedure Code


Exam Code

Exam Description


5 Priority B 2 ID

6 Requested Date/Time B 26 TS Scheduled date/time

<yyyymmddhhmm>

7 Observation Date/Time C 26 TS Scheduled date/time

<yyyymmddhhmm>








OBRSeq




Comments

<Patient Comments^Visit Comments^Exam Comments^Schedule Comments>


15


O 300 CM

16


O 80 XCN



17 Order Callback Phone No. O 40 XTN Rank 1 Physician Phone # & Fax #











<Modality Name>


C 26 TS






OBRSeq




“F” for Final

“A” for Addendum

“P” for Preliminary

Final is not appended to the addendum.

If Report Deleted HL7 trigger point has been selected:

“A” if Addendum

“C” for Correction


27

Quantity/Timing quantity interval duration start date/time end date/time priority condition text conjunction order sequencing priority condition text conjunction order sequencing

O 200 TQ

Scheduled Date/Time

^^^<yyyymmddhhmmss^^s> if urgent else <R>




29 Parent Number O 200 CM <Parent Report Id>^<Child Report Id>



Reason for Visit

<Reason or Free form if Other Reason^Reason or Free form if Other Reason>


Dictating Radiologist

<PMIS Code or Unique ID^Last Name^First Name^Middle^Suffix>


Approving Radiologist




OBRSeq




Technologist

<PMIS Code or Unique ID^Last Name^First name^Middle^Suffix>


Transcriptionist



<yyyymmddhhmmss>


O 4 NM


O 60 CE



O 60 CE




O 200 CE





OBXSeq



1 Set ID - Observation Simple O 4 SI Sequence number

2 Value Type C 3 ID 'TX'

3 Observation Identifier R 80 CE Accession Number

<Accession Number>

4 Observation Sub-ID C 20 ST '1'

5 Observation Value C 65536 * Line of text from report.

6 Units O 60 CE







OBXSeq



11 Observe Result Status R 1 ID

“P” if Preliminary Report

“F” if Approved/Final



“D” for Delete

“W” for Wrong


O 26 TS


O 20 ST


O 26 TS Transcribed Date/Time

<yyyymmddhhmm>


16 Responsible Observer O 80 XCN


4.8 ORU^R01 – HL7 HTML Result Message Type

4.8.1 Definition

This is an HTML version of the order results message type. It allows the same report in Vision Series RIS to be viewed in other AMICAS products.

Vision Series RIS sends the order message event type ORU^R01 which is the Observational Report Unsolicited. The ORU will send preliminary, final or addendum reports based upon a trigger define in Vision Series RIS. The HL7 message will consist of the following message segments.

OBX 2 Formatted Text

OBX 5 is an Html report representation


Message Segment

Segment Description

MSH Message Header


PV1 Patient Visit

ORC Common Order (optional)


OBX Observation Results (may have repetitions)






MSH Seq










<yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R 7 CM “ORU^R01”


<yyyymmddhhmmss>



HL7 version number




O 2 ID "AL"


O 2 ID "NE"




O 60 CE


O 20 ID





PID Seq



1 Set ID - Patient ID O 4 SI One PID segment per message

“1”








5



<lastname^first^middle^suffix>






<Alias field>




Patient Address




<County Field>





Work Phone





PID Seq





17 Religion O 80 IS


<PMIS>


<SS Number>











<yyyymmdd>


4.8.4 PV1 (Patient Visit Segment) - ORU^R01


PV1 Seq



1 Set ID – PV1 O 4 SI One PV1 Segment per Message

“1”




Patient Location






PV1 Seq






Rank 1 Physician











<B6> if flag <Y> else other



















PV1 Seq


















<yyyymmdd>


<yyyymmdd>








<Patient Weight>

4.8.5 ORC (Common Order Segment) - ORU^R01


ORCSeq



1 Order Control R 2 ID “RE”



ORCSeq




<Accession Number>


<Accession Number>


5 Order Status O 2 ID “CM” Complete order


7


O 200 TQ


<yyyymmddhhmm^s> if urgent or <R> if not urgent

8 Parent O 200 CM


<yyyymmddhhmmss>


User ID & Name

<User ID^Last Name^First Name^Middle^ Suffix>


12


O 120 XCN

Rank 1 Physician



<^^^PMIS Code^^^^^Location Name>




16 Order Control Reason O 200 CE

Reason

<Reason> or <Free Text if Other Reason^Reason>


<PMIS> or <Unique ID^Phy Location Name>




ORCSeq





O 40 CE




O 48 XTN


4.8.6 OBR (Order Detail /Observation Request) - ORU^R01


OBRSeq





“1”


<Accession Number>


<Accession Number>


R 200 CE

Procedure Code


Exam Code

Exam Description


5 Priority B 2 ID

6 Requested Date/Time B 26 TS Scheduled date/time

<yyyymmddhhmm>

7 Observation Date/Time C 26 TS Scheduled date/time

<yyyymmddhhmm>








OBRSeq




Comments

<Patient Comments^Visit Comments^Exam Comments^Schedule Comments>


15


O 300 CM

16


O 80 XCN



17 Order Callback Phone No. O 40 XTN Rank 1 Physician Phone # & Fax #











<Modality Name>


C 26 TS






OBRSeq




“F” for Final

“A” for Addendum

“P” for Preliminary

Final is not appended to the addendum.


“A” if Addendum



27

Quantity/Timing quantity interval duration start date/time end date/time priority condition text conjunction order sequencing priority condition text conjunction order sequencing

O 200 TQ

Scheduled Date/Time

^^^<yyyymmddhhmmss^^s> if urgent else <R>




29 Parent Number O 200 CM <Parent Report Id>^<Child Report Id>



Reason for Visit

<Reason or Free form if Other Reason^Reason or Free form if Other Reason>


Dictating Radiologist



Approving Radiologist




OBRSeq




Technologist



Transcriptionist



<yyyymmddhhmmss>


O 4 NM


O 60 CE



O 60 CE




O 200 CE





OBXSeq



1 Set ID - Observation Simple O 4 SI Sequence number

2 Formatted Text C 2 ID 'FT'

3 Observation Identifier R 80 CE Accession Number

<Accession Number>

4 Observation Sub-ID C 20 ST '1'

5 HTML Report Representation

C 65536 * An HTML representation of the report in Vision Series RIS. The report will keep the same formatting as displayed in RIS.

6 Units O 60 CE





OBXSeq





11 Observe Result Status R 1 ID

“P” if Preliminary Report

“F” if Approved/Final



“D” for Delete

“W” for Wrong


O 26 TS


O 20 ST


O 26 TS Transcribed Date/Time

<yyyymmddhhmm>


16 Responsible Observer O 80 XCN


4.9 ORM^O01 – HL7 Batch Charge Out Message Type

4.9.1 Definition

Vision Series RIS uses the order message event type ORM^O01 to send the Charge Out information to the billing system. The function of this message is to initiate the transmission of information about procedures qualifying for charges. The message is triggered to be sent once a charge out is done. The receiving billing system can pick up the message and continue with the charge out process.


Message Segment

Segment Description

MSH Message Header


PV1 Patient Visit

PV2 Patient Visit

GT1 Guarantor

ACC Accident

DB1 Disability

IN1 Insurance



Message Segment

Segment Description

IN2 Insurance

PR1 Procedure


4.9.2 MSH (Message Header Segment) - ORM^O01


MSHSeq



1 Field Separator R 4 ST "MSH"


3 Sending Application O 180 HD "Vision Series RIS"

4 Sending Facility O 180 HD Corporation Name <Corporation Name>

5 Receiving Application O 180 HD "Billing System"


7 Date/Time of Message O 26 TS Date and Time of File Creation <yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R 7 CM Order Message Type "ORM^O01"

10 Message Control ID R 20 ST Message Unique Identifier <System Generated Number>

11 Processing ID R 3 PT

12 Version ID R 60 VID HL7 Version <Version Number - Currently "2.3">




O 2 ID


O 2 ID

17 Country Code ID O 2 ID



O 60 CE


O 20 ID





PID Seq



1 Set ID - PID O 4 SI One PID Segment per Message "1"

2 Patient ID External B 20 CX Patient Unique Identifier

<Jacket>

3 Patient ID Internal R 20 CX Patient Unique Identifier

<Jacket>


<Social Security >

5 Patient Name R 48 XPN Patient Name <Last Name^First^Middle^Suffix>

6 Mother Maiden Name O 48 XPN

7 Date Of Birth O 26 TS Patient DOB <yyyymmdd>

8 Sex O 1 ST Patient Gender <PMIS code or Gender Code>

9 Patient Alias O 48 XPN Patient Alias <Alias field>

10 Race O 80 IS Patient Ethnicity <PMIS code or Ethnicity Code>

11 Patient Address O 106 XAD Patient Address <Address 1^Address 2^City^State^Zip^ Country>

12 County Code B 4 IS County Code <County Field>

13 Home Phone O 40 XTN Patient Home Phone, Fax, Email <(Area Code)Phone Number^(Fax Area Code) Fax Number^Email Address>

14 Business Phone O 40 XTN Work Phone <(Area Code)Phone Number>

15 Patient Language O 60 CE

16 Marital Status O 80 IS Patient Marital Status <PMIS code for Martial Status Code>

17 Religion O 80 IS


<PMIS>



PID Seq



19 Patient SSN B 16 ST Patient SS Number <SS Number format ###-##-####>

20 Drivers License Number O 25 CM Patient PMIS Number

21 Mother ID O 20 CX






27 Veteran’s Military Status O 60 CE


29 Patient Death Date and Time

O 26 TS Patient Date of Death <yyyymmdd>




PV1 Seq



1 Set - PV1 O 4 SI One PV1 Segment per Message "1"



3 Assigned Patient Location O 80 PL Patient Location <Location PMIS or Unique Identification Number^Location Name>





Attending (referring) Provider. A Tilde (~) separates referring from any/all cc physicians.

<Physician Location PMIS Code or Physician Location Unique Identifier^Last Name^First^Middle Name^Suffix^~PMIS^ Last Name^First Name^Middle Name^ Suffix>



PV1 Seq




Rank 1 Physician <Physician Location PMIS Code or Physician Location Unique Identifier ^Last Name^First^Middle^Suffix ^^^^^^^^^^^^National Provider Identification>


Additional Physicians <Physician Location PMIS Code or Physician Location Unique Identifier ^Last Name^First^Middle^Suffix~PMIS Code or Unique Identification Number^Last Name^First^Middle^Suffix~(additional physicians)>




13 Re-admission Indicator O 2 IS




17 Admitting Doctor O 60 XCN

18 Patient Type O 2 IS Service Type <PMIS code for Service Type Code>

19 Visit Number O 20 CX Unique Visit Number <System Generated Number>

20 Financial Class O 50 CM <Room Number>















PV1 Seq














44 Admit Date/Time O 26 TS Admit Date <yyyymmdd>

45 Discharge Date/Time O 26 TS Discharge Date <yyyymmdd>





50 Alternate Visit ID O 20 CX <Order Number> (specific to a visit)


52 Other Healthcare Provider O 60 XCN <Patient Weight>



PV2 Seq



1 Prior Pending Location C 80 PL

2 Accommodation Code O 250 CE

3 Admit Reason O 250 CE Comments (Patient, Schedule & Visit) <(comment type)^(comment free text)>

4 Transfer Reason O 250 CE

5 Patient Valuables O 25 ST



PV2 Seq



6 Patient Valuables Location O 25 ST

7 Visit User Code O 2 IS

8 Expected Admit Date/Time O 26 TS

9 Expected Discharge Date/Time

O 26 TS

10 Estimated Length of Inpatient Stay

O 3 NM

11 Actual Length of Inpatient Stay

O 3 NM

12 Visit Description O 50 ST Visit Reason <Visit Reason>

13 Referral Source Code O 250 XCN

14 Previous Service Date O 8 DT Onset Date Questionnaire Response Date

<yyyymmdd>

15 Employment Illness Related Indicator

O 1 ID

16 Purge Status Code O 1 IS

17 Purge Status Date O 8 DT

18 Special Program Code O 2 IS Special Program Code <Special Program Code>

19 Retention Indicator O 1 ID

20 Expected Number of Insurance Plans

O 1 NM

21 Visit Publicity Code O 1 IS

22 Visit Protection Indicator O 1 ID

23 Clinic Organization Name O 250 XON

24 Patient Status Code O 2 IS Pregnancy Indicator

<Y>

25 Visit Priority Code O 1 IS

26 Previous Treatment Date O 8 ST

27 Expected Discharge Disposition

O 2 IS

28 Signature on File Date O 8 DT

29 First Similar Illness Date O 8 DT

Similar Onset Date Questionnaire Response Date

<yyyymmdd>

30 Patient Charge Adjustment Code

O 250 CE

31 Recurring Service Code O 2 IS



PV2 Seq



32 Billing Media Code O 1 ID

33 Expected Surgery Date and Time

O 26 TS

34 Military Partnership Code O 1 ID

35 Military Non-Availability Code

O 1 ID

36 Newborn Baby Indicator O 1 ID

37 Baby Detained Indicator O 1 ID

38 Mode of Arrival Code 250

39 Recreational Drug Use Code

250

40 Admission Level of Care Code

250

41 Precaution Code 250

42 Patient Condition Code 250

43 Living Will Code 2

44 Organ Donor Code 2

45 Advance Directive Code 250

46 Patient Status Effective Date

8 LMP Questionnaire Response

47 Expected LOA Return Date/Time

26

4.9.6 GT1 (Guarantor Segment) - ORM^O01

The following table lists each Guarantor segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

GT1Seq



1 Set ID - GT1 R 4 SI One GT1 Segment per Message "1"

2 Guarantor Number O 59 CX Guarantor PMIS

<PMIS Code>

3 Guarantor Name R 48 XPN Guarantor Name <Last Name^First^Middle^Suffix>

4 Guarantor Spouse Name O 48 XPN

5 Guarantor Address O 106 XAD Guarantor Address <Address 1^^City^State^Zip^Country>

6 Guarantor Ph Num - Home O 40 XTN Guarantor Home Phone <(Area Code)Phone Number^^>



GT1Seq



7 Guarantor Ph Num - Business

O 40 XTN Guarantor Work Phone <(Area Code)Phone Number>

8 Guarantor Date/Time Of Birth

O 26 TS Guarantor DOB <yyyymmdd>

9 Guarantor Administrative Sex

O 1 ST Guarantor Gender <PMIS code or Gender Code>

10 Guarantor Type O 2 IS Guarantor Qualifier <"1" if person>

11 Guarantor Relationship O 120 CE Guarantor Relationship to Patient <PMIS code or Relationship Code>

12 Guarantor SSN O 11 ST Guarantor SS Number <SS Number format ###-##-####>

13 Guarantor Date - Begin O 8 DT

14 Guarantor Date - End O 8 DT

15 Guarantor Priority O 2 NM

16 Guarantor Employer Name O 130 XPN Guarantor Employer Name <Employer Name>

17 Guarantor Employer Address

O 106 XAD Guarantor Employer Address <Address 1^^City^State^Zip>

18 Guarantor Employer Phone Number

O 40 XTN Employer Phone, Fax, Email <(Area Code)Phone Number^Fax Number^Email Address>

19 Guarantor Employee ID Number

O 20 CX

20 Guarantor Employment Status

O 2 IS

21 Guarantor Organization Name

O 130 XON

22 Guarantor Billing Hold Flag O 1 ID

23 Guarantor Credit Rating Code

O 80 CE

24 Guarantor Death Date And Time

O 26 TS

25 Guarantor Death Flag O 1 ID

26 Guarantor Charge Adjustment Code

O 80 CE

27 Guarantor Household Annual Income

O 10 CP

28 Guarantor Household Size O 3 NM

29 Guarantor Employer ID Number

O 20 CX Guarantor Employer ID <PMIS or Unique Identification Number>

30 Guarantor Marital Status Code

O 80 CE



GT1Seq



31 Guarantor Hire Effective Date

O 8 DT










41 Religion O 80 CE




45 Contact Person’s Name O 48 XPN

46 Contact Person’s Telephone Number

O 40 XTN

47 Contact Reason O 80 CE

48 Contact Relationship O 2 IS



51 Guarantor Employer’s Organization Name

O 130 XON

52 Handicap O 2 IS

53 Job Status O 2 IS

54 Guarantor Financial Class O 50 FC

55 Guarantor Race O 80 IS Guarantor Ethnicity <PMIS Code or Ethnicity Code>



4.9.7 ACC (Accident Segment) - ORM^O01

The following table lists each Accident segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

ACCSeq



1 Accident Date/Time O 26 TS Accident Date <yyyymmdd>

2 Accident Code O 60 CE Accident Code

<PMIS Code>

3 Accident Location O 25 ST

4 Auto Accident State O 60 CE Accident State <State>

5 Accident Job Related Indicator

O 1 ID

6 Accident Death Indicator O 12 ID

7 Entered By 250

8 Accident Description 25 Accident Type <Accident Type>

9 Brought In By 80

10 Police Notified Indicator 1

4.9.8 DB1 (Disability Segment) - ORM^O01

The following table lists each Disability segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

DB1Seq



1 Set ID - DB1 R 4 SI One Disability Segment per Message "1"

2 Disabled Person Code O 2 IS

3 Disabled Person Identifier O 32 CX

4 Disability Indicator O 1 ID

5 Disability Start Date O 8 DT

Disability Start Date Questionnaire Response

<yyyymmdd>

6 Disability End Date O 8 DT

Disability End Date Questionnaire Response

<yyyymmdd>

7 Disability Return to Work Date

O 8 DT

Disability Work Return Date Questionnaire Response

<yyyymmdd>



DB1Seq



8 Disability Unable to Work Date

O 8 DT Last Worked Date Questionnaire Response

<yyyymmdd>

4.9.9 IN1 (Insurance Segment) - ORM^O01


IN1 Seq



1 Set ID - IN1 R 4 SI Number sequentially increased for each insurance segment provided <sequence identifier>

2 Insurance Plan ID R 60 CE Insurance Carrier Code <Insurance Carrier Code>

3 Insurance Company ID R 59 CX Insurance Coverage Plan Code <Coverage Plan Code>

4 Insurance Company Name O 130 XON Insurance Name <Insurance Carrier Name>

5 Insurance Company Address

O 106 XAD Insurance Address <Address 1^Address 2^City^State^Zip>

6 Insurance Co Contact Person

O 48 XPN Insurance Contact Name <Contact Name>

7 Insurance Co Phone Number

O 40 XTN Insurance Phone Number <(Area Code)Phone Number>

8 Group Number O 12 ST Group Number <Group Number>

9 Group Name O 130 XON Group or Plan Name <Coverage Plan Name>

10 Insured’s Group Emp ID O 12 CX Member Number <Member Number>

11 Insured’s Group Emp Name O 130 XON

12 Plan Effective Date O 8 DT Effective Plan Start Date <yyyymmdd>

13 Plan Expiration Date O 8 DT Effective Plan End Date <yyyymmdd>

14 Authorization Information O 55 CM Authorization, Date, Identifier <Authorization^^G1>

15 Plan Type O 3 IS Insurance Plan Type <Plan Type Name>

16 Name Of Insured O 48 XPN Insured Name <Last Name^First^Middle^Suffix>



IN1 Seq



17 Insured’s Relationship To Patient

O 80 CE Insured Relationship & Qualifier <PMIS Code for Relationship^ "1"=person>

18 Insured’s Date Of Birth O 26 TS Insured DOB <yyyymmdd>

19 Insured’s Address O 106 XAD Insured Address <Address 1^^City^State^Zip^Country>

20 Assignment Of Benefits O 2 IS

21 Coordination Of Benefits O 2 IS

22 Coord Of Ben. Priority O 2 ST

23 Notice Of Admission Flag O 1 ID

24 Notice Of Admission Date O 8 DT

25 Report Of Eligibility Flag O 1 ID

26 Report Of Eligibility Date O 8 DT

27 Release Information Code O 2 IS Release Information

<Y, N, or empty>

28 Pre-Admit Cert (PAC) O 15 ST

29 Verification Date/Time O 26 TS

30 Verification By O 60 XCN

31 Type Of Agreement Code O 2 IS

32 Billing Status O 2 IS

33 Lifetime Reserve Days O 4 NM

34 Delay Before L.R. Day O 4 NM

35 Company Plan Code O 8 IS

36 Policy Number O 15 ST Policy Number <Policy Number>

37 Policy Deductible O 12 CP

38 Policy Limit - Amount B 12 CP

39 Policy Limit - Days O 4 NM

40 Room Rate - Semi-Private B 12 CP

41 Room Rate - Private B 12 CP

42 Insured’s Employment Status

O 60 CE Insured's Employment Status <PMIS Code or Employment Status Code>

43 Insured’s Administrative Sex

O 1 IS Insured's Gender <PMIS Code or Gender Code>



IN1 Seq



44 Insured’s Employer’s Address

O 106 XAD Insured's Employer Address <Address 1^^City^State^Zip>

45 Verification Status O 2 ST

46 Prior Insurance Plan ID O 8 IS

47 Coverage Type O 3 IS

48 Handicap O 2 IS

49 Insured’s ID Number O 12 CX Insured's SS Number <SS Number format ###-##-####>

4.9.10 IN2 (Insurance Segment) - ORM^O01


IN2 Seq



1 Insured's Employee ID O 59 CX

2 Insured's Social Security Number

O 11 ST Insured's SS Number <SS Number format ###-##-####>

3 Insured's Employer Name and ID

O 130 XCN Insured's Employer Name and ID <Employer Name^PMIS or Unique Identification Number>

4 Employer Information Data O 1 IS

5 Mail Claim Party O 1 IS

6 Medicare Health Ins Card Number

O 15 ST

7 Medicaid Case Name O 48 XPN

8 Medicaid Case Number O 15 ST

9 Military Sponsor Name O 48 XPN

10 Military ID Number O 20 ST

11 Dependent Of Military Recipient

O 80 CE

12 Military Organization O 25 ST

13 Military Station O 25 ST

14 Military Service O 14 IS

15 Military Rank/Grade O 2 IS

16 Military Status O 3 IS

17 Military Retire Date O 8 DT

18 Military Non-Avail Cert On File

O 1 ID



IN2 Seq



19 Baby Coverage O 1 ID

20 Combine Baby Bill O 1 ID

21 Blood Deductible O 1 ST

22 Special Coverage Approval Name

O 48 XPN

23 Special Coverage Approval Title

O 30 ST

24 Non-Covered Insurance Code

O 8 IS

25 Payor ID O 59 CX

26 Payor Subscriber ID O 59 CX

27 Eligibility Source O 1 IS

28 Room Coverage Type/Amount

O 25 CM

29 Policy Type/Coverage O 25 CM

30 Daily Deductible O 25 CM









39 Religion O 80 CE

40 Mother's Maiden Name O 48 XPN



43 Marital Status O 80 CE Insured's Marital Status <PMIS Code or Marital Status Code>

44 Insured's Employment Start Date

O 8 DT






IN2 Seq



48 Job Status O 2 IS Insured's Employment Status <PMIS Code or Employment Status Code>

49 Employer Contact Person Name

O 48 XPN

50 Employer Contact Person Phone Number

O 40 XTN

51 Employer Contact Reason O 2 IS

52 Insured Contact Person Name

O 48 XPN

53 Insured Contact Person's Phone Number

O 40 XTN

54 Employer Contact Person Reason

O 2 IS

55 Relationship To The Patient Start Date

O 8 DT

56 Relationship To The Patient Stop Date

O 8 DT

57 Insurance Co. Contact Reason

O 2 IS

58 Insurance Co. Contact Phone Number

O 40 XTN

59 Policy Scope O 2 IS

60 Policy Source O 2 IS

61 Patient Member Number O 60 CX

62 Guarantor's Relationship To Insured

O 80 CE

63 Insured's Phone Number - Home

O 40 XTN Insured Phone Number <(Area Code)Phone Number>

64 Insured's Employer Phone Number

O 40 XTN

65 Military Handicapped Program

O 60 CE

66 Suspend Flag O 1 ID

67 Copay Limit Flag O 1 ID

68 Stoploss Limit Flag O 1 ID

69 Insured Organization Name and ID

O 130 XON

70 Insured Employer Organization Name and ID

O 130 XON

71 Race O 80 CE

72 HCFA Patient's Relationship to Insured

O 60 CE



4.9.11 PR1 (Procedure Segment) - ORMÔ01

The following table lists each Procedure segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

PR1Seq



1 Set - PR1 R 4 SI Number sequentially increased for each procedure segment provided <sequence identifier>

2 Procedure Coding Method (B) R

2 IS

3 Procedure Code R 80 CE

Procedure Code, Unit Value and Accession Number <Procedure CodeÛnitÂccession Number>

4 Procedure Description B 40 ST

Procedure Code Description and Resource Category <Procedure Code Description^Resource Category>

5 Procedure Date/Time R 26 TS Procedure Schedule Date and Time <yyyymmddhhmm>

6 Procedure Functional Type R 2 IS

7 Procedure Minutes O 4 NM

8 Anesthesiologist B 120 XCN

9 Anesthesia Code O 2 IS

10 Anesthesia Minutes O 4 NM

11 Surgeon B 120 XCN Technologist PMIS

<PMIS Code>

12 Procedure Practitioner B 230 XCN Dictating Radiologist <PMIS code or Unique Identification Number^Last Name^First^Middle^Suffix>

13 Consent Code O 60 CE

14 Procedure Priority O 2 NM

15 Associated Diagnosis Code O 80 CE Diagnosis Codes <Diagnosis Code 1~Diagnosis Code 2~(all diagnoses)>

16 Procedure Code Modifier O 80 CE Procedure Modifier Rank 1 <Procedure Modifier 1~Modifier 2~Modifier 3~Modifier 4>



4.10 ACK – Acknowledgment Message Type

4.10.1 Definition

The HL7 Acknowledgment Message Type, ACK will be sent by the filler to Vision Series RIS with a success or error message. Once a message is sent from Vision Series RIS (VSRIS) the filler should validate the message. If validation fails, a reject message should be constructed and returned to VSRIS. If validation does not fail, a success message should be returned to VSRIS.

The following tables list each Message Type, Trigger Event Type and their descriptions:

Message Type Trigger Event Type Description

MSH A08, A34, R01 Message Header

MSA A08, A34, R01 Message Acknowledgment


4.10.2 MSH (Message Header Segment) - ACK


MSH Seq





3 Sending Application O 180 HD ”Vision Series RIS”





<yyyymmddhhmmss>

8 Security O 40 ST

9 Message Type R 7 CM “ACK”

10 Message Control ID O 20 ST

System date/time

<yyyymmddhhmmss>

This ID is echoed back to the placer in the MSA segment.


12 Version ID R 60 VID “2.3”

HL7 version number





MSH Seq




O 2 ID "AL"


O 2 ID




O 60 CE


O 20 ID

4.10.3 MSA (Message Acknowledgment Seg.) - ACK

The following table lists each Message Acknowledgement segment and their Seq, HL7 Field Name, Opt, Length, Data Type, Rejection Rules, and Mapping/Comments:

MSASeq



1 Acknowledgment Code R 2 ID

“AA” if Accepted (Original Mode)

“AE” if Error (Original Mode)

“AR” if Rejected (Original Mode)

“CA” if Accepted (Enhanced Mode)

“CE” if Error (Enhanced Mode)

“CR” if Rejected (Enhanced Mode)

2 Message Control ID R 20 ST The MSH_10 Message Control Number is echoed back to the placer

3 Text Message O 80 ST Message Text

4 Expected Sequence Number

O 15 NM

5 Delayed Acknowledgment Type

B 1 ID

6 Error Condition O 100 CE

Vision Series RIS 5.0 HL7 Interface Guide Glossary


Glossary

Term Definition

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

ACK General Acknowledgment. The ACK message is used to respond to a message indicating receipt and status (either success or failure) by the receiving system.

ADT Admission, Discharge and Transfer messages contain information relating to patient demographics.

AE Application Entity.

AIL The appointment information location resource segment contains information about location resources (meeting rooms, operating rooms, examination rooms, or other locations) that can be scheduled. Resources included in a transaction using this segment are assumed to be controlled by a schedule on a schedule filler application. Resources not controlled by a schedule are not identified on a schedule request using this segment. Location resources are identified with this specific segment because of the specific encoding of locations used by the HL7 specification.

AIP The appointment information personnel resource segment contains information about the personnel types that can be scheduled. Personnel included in a transaction using this segment are assumed to be controlled by a schedule on a schedule filler application. Personnel not controlled by a schedule are not identified on a schedule request using this segment. The kinds of personnel described on this segment include any healthcare provider in the institution controlled by a schedule (for example: technicians, physicians, nurses, surgeons, anesthesiologists, or CRNAs).

AIS The appointment information service segment contains information about various kinds of services that can be scheduled. Services included in a transaction using this segment are assumed to be controlled by a schedule on a schedule filler application. Services not controlled by a schedule are not identified on a schedule request using this segment.

ASCII American Standard Code for Information Interchange.

BAR Patient Account Balance Information message type. This message type sends data from some application (usually a Registration or an ADT system) to the patient accounting or financial system to establish an account for a patient’s billing/accounts receivable record.

Broker An interface engine.

DB1 The disability segment contains information related to the disability of a person. This segment was created instead of adding disability attributes to each segment that contains a person (to which disability may apply).



Term Definition

EVN Event Type segment. This segment is used to communicate necessary trigger event information to receiving applications.

Filler The application receiving and processing an HL7 message, i.e., entering the report in received in an ORU^R01into their application or creating a record or an order based on receipt of an ORM^O01.

GT1 The guarantor segment contains information on the person or the organization with financial responsibility for payment of a patient account.

HL7 Health Level Seven (HL7) is an application protocol for electronic data exchange in health care environments. The HL7 protocol is a collection of standard formats which specify the implementation of interfaces between different computer applications from vendors. This communication protocol allows healthcare institutions to exchange key sets of data amount different application systems. Flexibility is built into the protocol to allow compatibility for specialized data sets that have facility-specific needs.

IN1 The insurance segment contains insurance policy coverage information relating to the patient and visit.

IN2 The insurance segment contains additional insurance policy coverage and benefit information necessary for proper billing and reimbursement.

IS Information System.

LLP Lower Layer Protocol.

Message Type Each message has a message type that defines its purpose. For example, the ADT Message Type is used to transmit portions of a patient’s demographic data from one system to another. A 3-character code contained within each message identifies its type.

MFA Master File Acknowledgment segment. This segment returns record-specific acknowledgement information.

MFE Master File Entry segment. This segment carries the record-level event code (such as Add, Update, etc.), the initial and requested dates for the event and the record-level key identifying the entry in the master file.

MFI Master File Identification segment. This segment identifies the master file being updated, as well as the initial and requested dates for file-level events such as Replace File.

MFN Master Files Notification message type. This message type provides a way of maintaining the synchronization of data across various applications at a given site.

MRG Patient Merge Information segment. This segment sends patient demographics to the receiving system to initiate the merging of one patient’s data into another patient’s data.



Term Definition

MSA Message Acknowledgement segment. The filler will use this segment to send an acknowledgment of success or error to placer.

If the message is processed successfully, the filler generates a functional response message with an MSA-1 Acknowledgment Code of AA.

If an error occurs during processing, the filler will send an error response providing a MSA-1 Acknowledgement Code of AE and an error message in MSA-3 Text Message.

If the filler rejects the message for any reason, it creates an ACK message with a MSA-1 Acknowledgement Code of AR.

MSH Message Header segment. A message control segment that defines the intent, source, destination and some specifics of the syntax of a message. All HL7 messages start with a MSH segment.

NTE Notes and comments segment.

OBR Observation Request segment. In the reporting of clinical data, this segment serves as the report header. It is used to transmit information specific to an order for a diagnostic study or observation. When a set of observations is ordered, the order message contains an OBR message. When observations are reported, the report message includes one OBR segment. Some fields only apply to the ordering message and some only apply to the reporting message.

OBX Observation/result message. OBX is intended to cover all types of patient specific observation reports except pharmacy. This segment is used to transmit a single observation or part of an observation. It is the smallest inseparable unit of a report. It is used to carry information about observations in report messages and can also be part of an observation order. Multiple OBXs may be sent in an observation report.

ORC Common Order segment. This segment is required in the ORM message. The ORC is a common segment for all orders. It is used to transmit fields that are common to all orders.

ORM General Order Message. The function of this message is to initiate the transmission of information about an order. This includes placing new orders, cancellation of existing orders, discontinuation, holding, etc.

ORR General Order Acknowledgment. The function of this message is to respond to an ORM message. An ORR message is the application acknowledgment to an ORM message.

ORU Unsolicited Transmission of an Observation. For each patient order results may be transmitted depending upon the number of observations generated by the order.



Term Definition

PID Patient Identification segment. This segment is used by all applications as the primary means of communicating patient identification information. It contains permanent patient identifying and demographic information.

Placer The application originating the HL7 message, i.e. if a patient’s report is signed, an ORU^R01 message is triggered to be sent to the defined filler(s).

PR1 The procedures 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: Abdominal Ultrasound, X-ray with contrast, etc. The PR1 segment is used to send the procedures for medical records encoding or for billing systems.

PV1 Patient Visit segment. This segment is used to communicate information on an account or visit-specific basis.

PV2 The PV2 segment is a continuation of visit-specific information contained on the PV1 segment.

RGS The resource group segment is used to identify relationships between resources identified for a scheduled event. This segment can be used, on a site specified basis, to identify groups of resources that are used together within a scheduled event, or to describe some other relationship between resources. To specify related groups of resources within a message, begin each group with an RGS segment, and then follow that RGS with one or more of the Appointment Information segments (AIG, AIL, AIS, or AIP).

RIS Radiology Information System.

SCH The schedule segment contains general information about the scheduled appointment.

Segment An HL7 segment is a logical grouping of data fields. Segments of a message may be required or optional. They may occur only once in a message or they may be allowed to repeat. Each segment is identified by a unique three character code known as the Segment ID.

SIU Schedule Information Unsolicited messages are used to send and receive schedule information regarding patient appointments.

TCP/IP Transmission Control Protocol/Internet Protocol.



Term Definition

Trigger Event The event that initiates an exchange of messages is called a trigger event. The HL7 Standard is written from the assumption that an event in the real world of healthcare creates the need for data to flow among systems. The real-world event is called the trigger event. For example, the trigger event “a patient is scheduled” may cause the need for data about that patient to be sent to a number of other systems. There is a one-to-many relationship between message types and trigger event codes. The same trigger event code may not be associated with more than one message type.

UID Unique Identifier.

Vision Series RIS 5.0 HL7 Interface Guide Appendix A: Data Types


Appendix A: Data Types

Data Type Category

Data Type Name Length Notes/Format

Alphanumeric

ST String 199

TX Text data 65536

FT Formatting text 65536

Numerical

CQ Composite quantity with units

<quantity (NM)> ^ <units (CE)>

NM Numeric

SI Sequence ID

Identifier

ID Coded values for HL7 tables

IS Coded value for user-defined tables

HD Hierarchic designator <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>

EI Entity identifier <entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>

PL Person location <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ < location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>

PT Processing type <processing ID (ID)> ^ <processing mode (ID)>

Date/Time

DT Date YYYY[MM[DD]]

TS Time stamp YYYY[MM[DD[HHMM[SS[.S[S[S[S]]]]]]]][+/-ZZZZ] ^ <degree of precision>

Code Values

CE Coded element 250 <identifier (ST)> ^ <text (ST)> ^ <name of coding system (IS)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (IS)>

CX Extended composite ID with check digit

250

<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)>

Vision Series RIS 5.0 HL7 Interface Guide Appendix A: Data Types


Data Type Category

Data Type Name Length Notes/Format

XCN Extended Composite ID Number and Name

250

<ID number (ST)> ^ <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code (ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID)> ^ <identifier type code (IS)> ^ <assigning facility (HD)>

Generic

CM Composite No new CMs are allowed after HL7 Version 2.2. The CM data type is maintained strictly for backward compatibility and may not be used for the definition of new fields.

Demographics

XAD Extended address 250

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)>

XPN Extended person name 250

In Version 2.3, replaces the PN data type. <family name (FN)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (IS)> ^ <name type code (ID) >

XON Extended composite name and ID number for organizations

250

<organization name (ST)> ^ <organization name type code (IS)> ^ <ID number (NM)> ^ <check digit (NM)> ^ <code identifying the check digit scheme employed (ID)> ^ <assigning authority (HD)> ^ <identifier type code (IS)> ^ <assigning facility ID (HD)>

XTN Extended telecommunications number

250

In Version 2.3 and later, replaces the TN data type. [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)>

Time Series

TQ Timing/quantity

<quantity (CQ)> ^ <interval (*)> ^ <duration (*)> ^ <start date/time (TS)> ^ <end date/time (TS)> ^ <priority (ID)> ^ <condition (ST)> ^ <text (TX)> ^ <conjunction (ID)> ^ <order sequencing (*)>

HL7 Interface Guide

Documents

Transcript of HL7 Interface Guide