1. Introduction

This document describes eClaims HL7 file output  for interfacing with information systems.

2. HL7 Messages

A message is the smallest unit of data transferred between systems. It is comprised of a group of segments in a defined sequence. Each message has a message type that defines its purpose.

For example, the ADT Message type is used to transmit portions of a patient’s Patient Administration (ADT) data from one system to another. A 3 character code contained within each message identifies its type.

The real-world event that initiates an exchange of messages is called a trigger event.

These codes represent values such as “A patient is admitted” or “An order event occurred.”

There is a one-to-many relationship between message types and trigger event codes. The same trigger event code may not be associated with more than one message type.

3. 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 3 character code known as the Segment ID.

4. Fields

A field is a string of characters. HL7 does not care how systems actually store data within an application.

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. If the null value is sent, the old value should be changed to null.

5. Position (Sequence Within the Segment)

This is the ordinal position of the data field within the segment. This number is used to refer to the data field in the text comments that follow the segment definition table.

In the segment attribute tables, this information is in a column labelled SEQ.

6. Maximum Length

The maximum length is the maximum number of characters that one occurrence of the data field may occupy. It is calculated to include the component and subcomponent separators. Because the maximum length is that of a single occurrence, the repetition separator is not included in calculating the maximum length.

In the segment attribute tables, this information is in a column labelled LEN.

7. Data Type

The data type restricts the contents of the data field. There are a number of data types defined by HL7.

The data types used in this specification are described in the following table.

Data Type Category or Data Type(Alphanumeric)	Data Type Name	Notes and Format
CE	Coded Element	Identifier ^ text ^ name of coding system ^ alternate identifier ^ alternate text ^ name of alternate coding system
CM	Composite	Combination of components of varying data types
CQ	Composite quantity with units	quantity (NM) ^ units (CE)
CX	Extended composite ID with check digit	ID ^ check digit ^ code identifying the check digit scheme employed^ assigning authority^ identifier type code^ assigning facility
EI	Entity identifier	Entity identifier ^ namespace ID ^ universal ID ^ universal ID type
FT	Formatted text Data	This data type is derived from the string data type by allowing the addition of embedded formatting instructions. These instructions are limited to those that are intrinsic and independent of the circumstances under which the field is being used. See section 2.8.19 “Use of escape sequences in text fields” of the HL7 2.3.1 Standard Specifications for a list of allowed formatting commands.
HD	Hierarchic designator	Namespace ID ^ universal ID ^ universal ID type
ID	Coded value for HL7 defined tables	Valued from a table of HL7 legal values
IS	Coded value for user-defined tables	Valued from a table of site legal values
PT	Processing type	Processing ID ^ processing mode
ST	String	String data is left justified with trailing blanks optional
TQ	Timing quantity	Utilizes the Priority component for order priority
TS	Time Stamp	YYYYMMDDHHMMSS
TX	Text Data	String data meant for user display
XCN	Extended composite id number and name for persons	ID ^ family name ^ given name ^ middle initial or name
XPN	Extended person name	family name ^ given name ^ middle initial or name^Suffix^Prefix^Degree^TypeCode
NM	Numeric	A number represented as a series of ASCII numeric characters consisting of an optional leading sign (+ or -), the digits and an optional decimal point.
XAD	Extended Address	This data type specifies the address of a person, place or organization plus associated information.
XTN	Extended Telecommunication Number	See section 2.8.52 “XTN – extended telecommunication number” of the HL7 v2.3.1 Standard Specifications documentation.
PL	Person Location	This data type is used to specify a patient location within a healthcare institution
DT	Date	Specifies the century and year with optional precision to month and day.
TQ	Timing Quantity	Describes when a service should be performed and how frequently.
ED	Encapsulated Data	This data type transmits encapsulated data from a source system to a destination system. It contains the identity of the source system, the type of data, the encoding method of the data, and the data itself. This data type is similar to the RP (reference pointer) data type of Section 2.8.36, “RP – reference pointer,” except that instead of pointing to the data on another system, it contains the data which is to be sent to that system.

8. Optionality

Optionality indicates whether the field is required, optional, or conditional in a segment. The designations are:

• R—required
• O—optional
• C—conditional on the trigger event or on other field(s)
• X—not used with this trigger event

In the segment attribute tables this information is in a column labelled OPT

9. Repetition

Repetition indicates whether the field may repeat. The designations are:

• N—No repetition
• Y—The field may repeat an indefinite or site-determined number of times.
• (integer)—The field may repeat up to the number of times specified by the integer.

Each occurrence may contain the number of characters specified by the field’s maximum length. In the segment attribute tables, this information is in a column labelled RP/#.

10. Message Delimiters

In constructing a message, the following special characters are used.

Segment terminator—The segment terminator is always a carriage return (in ASCII, a hex 0D).

• Field separator
• Component separator
• Subcomponent separator
• Repetition separator
• Escape character

The other delimiters are defined in the MSH segment with the field delimiter in the fourth character position. Other delimiters occurring as in the field called Encoding Characters are indicated in the first field after the segment ID.

The delimiter values used in the MSH segment are the delimiter values used throughout the entire message. Each delimiter character can be escaped when required to be used as a field value as opposed to a delimiter.

Delimiter	Suggested Value	Encoding Character Position	Escaping Character	Usage
Segment Terminator	<cr> hex 0D	–	\n	Terminates a segment record. This value cannot be changed by implementers.
Field Separator	|	–	\F\	Separates two adjacent data fields within a segment. It also separates the segment ID from the first data field in each segment.
Component Separator	^	1	\S\	Separates adjacent components of data fields where allowed.
Subcomponent Separator	&	4	\T\	Separates adjacent subcomponents of data fields where allowed. If there are no subcomponents, this character may be omitted.
Repetition Separator	~	2	\R\	Separates multiple occurrences of a field where allowed.
Escape Character	\	3	Not supported	Escape character for use with any field represented by an ST, TX or FT data type, or for use with the data (fourth) component of the ED data type. If no escape characters are used in a message, this character may be omitted. However, it must be present if subcomponents are used in the message.

11. Messages

This section describes the HL7 messages eClaims produces. The segments listed for every message type are required, segments in square brackets are optional, and segments that do not appear are ignored.

11.1 ADT A04 – Register a Patient

• MSH
• PID
• PV1

11.2 ADT A08 – Update Patient Information

• MSH
• PID
• PV1

11.3 ADT A18 – Merge Patient Information – Patient ID Only

• MSH
• PID
• MRG 

11.4 ORM O01 – General Order Message

This message may contain multiple OBR segments but each repetition must follow a PID segment.

• MSH
• PID
• PV1
• ORC
• OBR

11.5 ORU R01 – Observational Results

• MSH
• PID
• PV1
• ORC
• OBR
• OBX

Many report headers (OBR) may be sent beneath each patient segment, with many separate observation segments (OBX) beneath each OBR. Note segments (NTE) may be inserted after any of the segments.

The note segment applies to the entity that immediately precedes it, i.e., the patient, if it follows the PID segment, the observation, if it follows the OBR segment, and the individual result, if it follows the OBX segment.

12. Segments

Note: In the Optional/Required column, R indicates that the field is required in the segment.

12.1 MSH – Message Header

#	Field Name	HL7 Type	Optional/Required	Repeated	Comment
1	Field Separator	ST	R
2	Encoding Characters	ST	R
3	Sending Application	HD			eClaims
4	Sending Facility	HD			eClaims Client Name / ACSS
5	Receiving Application	HD
6	Receiving Facility	HD
7	Message Date/Time	TS			Date and time the HL7 file was generated                                      EG: 20160101113022
8	Security	ST			N/A
9	Message Type	CM	R
10	Message Control ID	ST			N/A
11	Processing ID	PT			N/A
12	Version ID	ID			N/A
13	Sequential Number	NM
14	Continuation Pointer	ST
15	Accept Acknowledgement type	ID
16	Application Acknowledgement type	ID
17	Country Code	ID			AU
18	Character Set	ID		R	ASCII
19	Language of Message	CE			ENG
20	Alternate Character Set Handling Scheme	ID

12.2 PID – Patient Identification and Details

#	Field Name	HL7 Type	Optional/Required	Repeated	Comments
1	Set ID	NM
2	Patient External ID	CX		R
3	Patient Internal ID	CX	R	R	eClaims Patient Number and Medicare card number and/or DVA number if present. EG: 102.1^^^ACSS^PIEC~21111111115^^^AUSHIC^MC
4	Patient Alternate ID	CX		R
5	Patient Name	XPN	R		eClaims Patient Last Name^First^Mi^^Title
6	Mother’s Maiden name	XPN
7	Patient Date of Birth	TS	R		eClaims DOB/Age
8	Patient Sex	ID	R		eClaims Sex
9	Patient Alias	XPN		R	N/A
10	Patient Race	ID			Re-Used as the Date and Time the exam pick up
11	Patient Address	XAD		R	eClaims Address^City^State^P/Code
12	Country Code	ID
13	Home Phone	XTN		R	eClaims Home Phone
14	Business Phone	XTN		R	eClaims Work Phone
15	Language	CE
16	Marital Status	ID
17	Religion	ID
18	Account Number	CX			N/A
19	Social Security Number	ST			See PID-3 – Patient Internal ID for Medicare Card Number
20	Driver License Number	CM
21	Mothers ID	CX		R
22	Ethnic Group	ID
23	Birth Place	ST
24	Multiple Birth Indicator	ID
25	Birth Order	NM
26	Citizenship	ID		R
27	Veterans Military Status	CE			See PID-3 – Patient Internal ID for DVA Card Number
28	Nationality	CE
29	Death Date/Time	TS			N/A
30	Death Indicator	ID			N/A

12.3 PVI – Patient Visit Details

#	Field Name	HL7 Type	Optional/Required	Repeated	Comments
1	Set ID	NM
2	Patient Class	ID	R
3	Patient Location	PL	R		eClaims Practice Data screen. City
4	Admission Type	ID	R
5	Pre-admit Number	CX
6	Prior Location	PL
7	Attending Doctor	XCN	R	R	eClaims Servicing Provider Doctor Number^Last Name^Name^Title
8	Referring Doctor	XCN	R	R	eClaims Referring provider Number Referring Doctor provider number^Last Name^First Name^^^Title^^^^External ID
9	Consulting Doctor	XCN	R	R
10	Hospital Service	ID	R
11	Temporary Location	PL
12	Pre-admit test indicator	ID
13	Re-admission Indicator	ID
14	Admit Source	ID
15	Ambulatory Status	ID		R
16	VIP Indicator	ID
17	Admitting doctor	XCN	R	R
18	Patient Type	ID	R		eClaims ExamNo
19	Visit ID	CX	R		Uniquely identifies an encounter/visit.
20	Financial Class	CM		R	N/A
21	Charge Price Indicator	ID			N/A
22	Courtesy Code	ID			N/A
23	Credit Rating	ID			N/A
24	Contract Code	ID		R	N/A
25	Contract Effective Date	DT		R	N/A
26	Contract Amount	NM		R	N/A
27	Contract Period	NM		R	N/A
28	Interest Code	ID			N/A
29	Transfer to Bad Debt Code	ID			N/A
30	Transfer to Bad Debt Date	DT			N/A
31	Bad Debt Agency Code	ID			N/A
32	Bad Debt Date Transfer Amount	NM			N/A
33	Bad Debt Date recovery Amount	NM			N/A
34	Delete Account Indication	ID			N/A
35	Delete Account Date	DT			N/A
36	Discharge Disposition	ID			N/A
37	Discharge Location	CM			N/A
38	Diet Type	ID			N/A
39	Servicing Facility	ID			N/A
40	Bed Status	ID			N/A
41	Account Status	ID			N/A
42	Pending Location	PL			N/A
43	Prior Temporary Location	PL			N/A
44	Admit Date/Time	TS			N/A
45	Discharge Date/Time	TS			N/A. Required in a message ending an encounter/visit.
46	Current Balance	NM			N/A
47	Total Charge	NM			N/A
48	Total Adjustments	NM			N/A
49	Total Payments	NM			N/A
50	Alternative Visit ID	CX			N/A
51	Visit indicator	ID			N/A
52	Other Healthcare Provider	XCN		R	N/A

12.4 ORC – Order Control Segment

This segment conveys the order control information.

#	Field Name	HL7 Type	Optional/Required	Comments
1	Order Control	ID	R	NW—Add new order SC—Update order CA—Cancel order RE—Observations to follow
2	Placer Order Number	EI		eClaims ExamNo. If presented should be identical to OBR-2.
3	Filler Order Number	EI	R	eClaims position index of item number. Uniquely identifies the order. If presented should be identical to OBR-3.
4	Placer Group Number	EI
5	Order Status	ID	R	SC—Order scheduled CA—Order cancelled CM—Order is complete
6	Response Flag	ID
7	Quantity Timing	TQ	R	N/A. The time the order was scheduled to(the scan/test should) take place, inthe fourth component. The priority information of the orderin the sixth component. If presented, it should be identical to OBR-27.
8	Parent	CM		N/A
9	Transaction Date/Time	TS		N/A
10	Entered By	XCN		N/A
11	Verified By	XCN		N/A
12	Ordering Provider	XCN		N/A. Ordering referring physician. If presented should be identical to OBR-16
13	Enterer Location	PL		N/A
14	Callback Phone Number	XTN		N/A. If presented should be identical to OBR-17.
15	Order Date/Time	TS		N/A
16	Order Control Code Reason	CE		N/A
17	Entering Oranization	CE		N/A
18	Entering Device	CE		N/A
19	Action By	XCN		N/A

12.5 OBR – Order Segment

This segment conveys the order information.

#	Field Name	DT	OPT	Notes
1	Set ID	NM
2	Placer Order Number	EI		eClaims ExamNo. Should be identical to ORC-2, if present.
3	Filler Order Number	EI	R	eClaims position index of item number. This is the unique order identification number. It may be the same as the accession number (see field 18). Should be identical to ORC-3, if present.
4	Universal Service ID	CE	R	The first component of this field contains the MBS item code that indicates the procedure. The second component contains a description of the procedure. eClaims MBS Item code^description^MBS
5	Priority	ID
6	Requested Date/Time	TS		eClaims Ref Date
7	Observation Date/Time	TS		eClaims Job Date
8	Observation End Date/Time	TS		eClaims Job Date
9	Collection Volume	CQ
10	Collector ID	XCN
11	Specimen Action Code	ID
12	Danger Code	CE
13	Relevant Clinical Information	ST
14	Specimen Received Date/Time	TS
15	Specimen Source	CM	R	Contains the body part in the fourth component and laterality in the fifth component: |^^^KNEE^LEFT|
16	Ordering Provider	XCN	R	eClaims Referring provider Number Referring Doctor provider number^Last Name^First Name^^^Title^^^^AUSHICPR^ExternalID
17	Order Call Back Phone Number	XTN		Should be identical to ORC-14, if presented.
18	Placer Field 1	ST	R	eClaims position index of item number
19	Placer Field2	ST		eClaims ExamNo
20	Filler Field 1	ST		eClaims Item code-00
21	Filler Field 2	ST
22	Results Date/Time	TS		Same as OBX-14-Observation Date/Time if presented in an ORU message
23	Charge To Practice	CM
24	Diagnostic Service Section ID	ID	R	Scanner ID.
25	Result Status	ID	R	Same as OBX-11-Observation Result Status if presented in an ORU message.
26	Parent Result	CM
27	Quantity Timing	TQ	R	eClaims Job Date
28	Result Copies To	XCN
29	Parent Order	CM		N/A
30	Transportation Mode	ID		N/A
31	Reason For Study	CE		N/A. This information may help radiologists in future diagnostics (or in current analysis if the order information will be transmitted as soon as it is ordered using the ORM message).
32	Principal Result Interpreter	CM		N/A. This field conveys the name of the radiologist who read the study in the following format: |8798&Jordan&Michael|
33	Assistant Result Interpreter	CM		N/A. This field conveys the name of the assistant radiologist in the following format: |98548&Pippen&Scottie|
34	Technician	CM		N/A
35	Transcriptionist	CM		N/A
36	Scheduled Date/Time	TS		N/A
37	Number of Sample Containers	NM		N/A
38	Transport Logistics of Collected Sample	CE		N/A
39	Collectors Comment	CE		N/A
40	Transport Arrangement Responsibility	CE		N/A
41	Transport Arranged	ID		N/A
42	Escort Required	ID		N/A
43	Planned Patient Transport Comment	CE		N/A

12.6 OBX – Observation/Report Segment

#	Field Name	DT	OPT	Comments
1	Set ID	NM	R	Sequential number of the OBX segment within the message.
2	Value type	ID	R	FT – Formatted Text (Display) or ED – Encapsulated Data. See Table 0125 – Value Type
3	Observation Identifier	CE	R	Identifies the section of the report. REPORT^^LN
4	Observation Sub-ID	ST		A numeric value that may be used to sort the report lines (the OBX segments)
5	Observation Value	ST	R	This section contain the text that typed in the report (FT) or Encapsulated Data (ED) segment can be used to transmit images or documents.
6	Units	CE
7	Reference Range	ST
8	Abnormal Flags	ID
9	Probability	NM
10	Nature Of Abnormal Test	ID
11	Observation Result Status	ID	R	The status of the report. For example, ‘P’ (Preliminary results), ‘F’ (Final results). Should be identical for all OBX segments of the same report. If OBR-25-Result Status exists, it should be identical. See table 0085 – Observation result status codes interpretation.
12	Normal Values Date/Time	TS
13	Access Checks	ST
14	Observation Date/Time	TS	R	The report date and time are both required. Should be identical for all OBX segments of the same report. If OBR-22-Results Date/Time exists it should be identical.
15	Producer ID	CE
16	Responsible Observer	XCN	R	This field conveys the ID, name and other details of the radiologist who verified the report in the following format: |8765^Tom^JERRY|
17	Observation Method	CE
18	Equipment Instance Identifier	EI