Post on 04-Jun-2018
2011 Cortex Medical Management Systems
[HL7 INTERFACE SPECIFICATION]This document describes the Cortex implementation of the HL7 Interface standard applied to sending and receiving ADT, Orders and Result data between our pathology reporting system and the consumers of those reports.
[HL7 INTERFACE SPECIFICATION] July 8, 2011
TableofContentsTable of Contents ........................................................................................................................................................................................................... 2
Requirements ................................................................................................................................................................................................................. 4
Overview ........................................................................................................................................................................................................................ 4
Connectivity ................................................................................................................................................................................................................... 5
TCP / IP ....................................................................................................................................................................................................................... 5
Bi‐Directionality ......................................................................................................................................................................................................... 5
HL7 Minimal Lower Layer Protocol ............................................................................................................................................................................ 5
ACK – Acknowledgment Message .................................................................................................................................................................................. 6
ADT – Admit/Discharge Transfer Message .................................................................................................................................................................... 6
Patient Admission – A01, A04, A05, A06 ................................................................................................................................................................... 6
A01 Event – Patient Admit ..................................................................................................................................................................................... 7
A04 Event – Patient Register.................................................................................................................................................................................. 7
A05 Event – Patient Pre‐Admit .............................................................................................................................................................................. 7
A06 Event – Patient Change Outpatient to Inpatient ............................................................................................................................................ 7
Patient Transfer – A02 ............................................................................................................................................................................................... 7
A02 Event ................................................................................................................................................................................................................... 7
Patient Discharge – A03, A07 ..................................................................................................................................................................................... 8
A03Event ................................................................................................................................................................................................................ 8
A07 Event – Patient Change Inpatient to Outpatient ............................................................................................................................................ 8
Patient Information Update – A08 ............................................................................................................................................................................. 8
ORM / OML Order Entry Message ............................................................................................................................................................................... 10
ORM‐O01 Generic Order Message .......................................................................................................................................................................... 10
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OML‐O21 Laboratory Order Message ...................................................................................................................................................................... 11
ORU – Observation Result Message ............................................................................................................................................................................ 13
R01 Transmission of a result .................................................................................................................................................................................... 13
R01 Event ............................................................................................................................................................................................................. 13
DFT – Financial Transaction Message .......................................................................................................................................................................... 14
P03 Event ............................................................................................................................................................................................................. 14
Appendix A ................................................................................................................................................................................................................... 15
EVN – Event Type ..................................................................................................................................................................................................... 15
FT1 – Financial Transaction Segment ....................................................................................................................................................................... 15
GT1 – Guarantor Segment ....................................................................................................................................................................................... 17
IN1 – Insurance Segment ......................................................................................................................................................................................... 20
IN2 ‐ Insurance Additional Information Segment .................................................................................................................................................... 22
MSH – Message Header Segment ............................................................................................................................................................................ 26
NTE – Notes and Comments Segment ..................................................................................................................................................................... 26
ORC – Common Order Segment .............................................................................................................................................................................. 27
OBR – Observation Request Segment ...................................................................................................................................................................... 28
OBX – Observation / Result Value............................................................................................................................................................................ 31
PID – Patient Identification Segment ....................................................................................................................................................................... 32
PV1 – Patient Visit Information Segment ................................................................................................................................................................ 33
SAC – Specimen Container Detail Segment ............................................................................................................................................................. 35
SPM – Specimen Segment ....................................................................................................................................................................................... 36
[HL7 INTERFACE SPECIFICATION] July 8, 2011
RequirementsDemographics, Billing, and Orders inbound require Gold version 2009 sp1 or Greater
Results and Billing outbound require gold version 2009 or Greater
OverviewThis document facilitates establishing bi‐directional communication between a lab using a Cortex reporting system and the consumer of those reports. The current version of HL7 supported is 2.5.1; however the system is designed to be backward compatible with any 2.xx version of the HL7 interface.
The purposes of the interfaces supported are as follows:
ADT – Process patient demographic information communicated from a hospital or physician’s office in preparation for processing an order.
ORM / OML – ORM and OML messages combine ADT information and lab order request information informing the lab of the tests to perform on the specimens provided. An order interface is typically paired with a results interface.
ORU – The results interface that returns the laboratory observations, typically in response to an ORM previously received.
DFT – DFT messages convey financial information, such as the type and quantity of procedures performed. Typically this data flows from a reporting system to a billing system. Since Cortex has both systems, we have acted as both the sender and receiver for this message type.
Each of these message types will be explained in detail in its own section of this document. Each section will describe the events and segments required by each interface. Because many of message types use the same segments, the segment description tables can be found in Appendix A.
[HL7 INTERFACE SPECIFICATION] July 8, 2011
ConnectivityCortex supports either TCP/IP or ASCII files, sometimes referred to as socket and batch mode. The difference between the two is that TCP/IP messages are typically processed, or at least persisted immediately. Batch mode writes a file to a shared directory and is picked up and processed on a scheduled or periodic basis.
TCP/IPTCP/IP communications are based on the concept of ‘servers’ and ‘clients’. A client requests connection to the server. If the server is not busy, it allows the connection. The client will then transmit its data in the form of an HL7 message and await an acknowledgement message. This continues until the client has no more data to transmit. At that time, the client communicates its intention to disconnect and then does so. By signaling that it is done, the client allows the Server to await further requests from clients. It is important that the client disconnect in a graceful manner, because if it does not and is disconnected, the server will block any attempts to reconnect. Typically the only way to correct this situation is to restart the server software, or at least that connection on the server.
Bi‐DirectionalityIn terms of connectivity, all the interfaces are bi‐directional. Messages are sent by the client and acknowledgements are received from the server. In terms of message exchange between a lab and its client, bi‐directional typically means order and result. While typically they are paired, they need not be and Cortex treats each order and result connection as a separate interface. It is important to note that each interface will listen for messages on a specified server and a particular port on that server. Each client will need to know the IP Address and port number in order to transmit to that server.
HL7MinimalLowerLayerProtocolCortex follows the HL7 protocol recommendation for transferring data over TCP/IP as follows:
Each transmission begins with ASCII 11 Each message is separated with ASCII 13 Each transmission ends with ASCII 28 and ASCII 13
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ACK–AcknowledgmentMessageThe receiving system responds with an ACK message upon successful receipt of a data message.
Segment SegmentName Required/Optional
Comments
MSH Message Header R MSA Message Identification R
ADT–Admit/DischargeTransferMessageADT messages exchange patient demographics between the lab system and our interface partner. Different events indicate how the message should be handled. Cortex supports events A01, A02, A03, A04, A05, A06, A07, A08, A18, A34, A40, A41 and A42. All other events will be ignored.
PatientAdmission–A01,A04,A05,A06Where a facility treating patients may be concerned with the type of visit (in‐patient, out‐patient, emergency) and where the patient falls within the admission process (registered, pre‐admitted, admitted), the lab typically is not concerned. It is important that the patient’s status is now such that care is being provided and tests may be ordered on the facilities behalf. Note, Cortex can record patient visit type, admit and discharge dates, typically for billing purposes.
Segment SegmentName Required/Optional
Comment
MSH Message Header R EVN Event Type R PID Patient Identification R Patient demographics PV1 Patient Visit Information O Used for tracking admission information GT1 Guarantor O Typically a parent, spouse, or legal
guardian ‐‐‐ Insurance Info Group O Group may repeat 3 times. If no COB
Priority information is provided in the IN1
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segment, it is assumed they are in order of priority
IN1 Insurance Information O Required if any insurance info is sent IN2 Additional Insurance Info O Not required even if IN1 is given
A01Event–PatientAdmitAn A01 event is used to indicate a patient has been admitted to a facility, or a new account created in the sending system. Use PV1‐44 for the Admit Date/Time and PV1‐3 will contain the location assigned to the patient.
A04Event–PatientRegisterThe A04 event is used to indicate a patient has arrived, but not assigned a bed typically this indicates an outpatient status. Use PV1‐44 to indicate the time the patient has arrived for the visit.
A05Event–PatientPre‐AdmitThe A05 event is used to indicate a patient has not been admitted yet, but is considered within the system in preparation for admission. Cortex treats this exactly as an A04 event except it will not expect PV1‐44 to be filled in.
A06Event–PatientChangeOutpatienttoInpatientCortex treats A06 exactly the same as A01.
PatientTransfer–A02
A02EventThe A02 event is used to indicate a patient has moved to a new location, typically the room and bed information changes.
Segment SegmentName Required/Optional
Comment
MSH Message Header R EVN Event Type R PID Patient Identification R PV1 Patient Visit Information R PV1‐3 will contain current location info
and PV1‐6 will contain previous location.
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PatientDischarge–A03,A07When a patient is discharged, it is an indication that treatment has been completed and further tests for the patient will not be at the request of the facility, at least for this visit.
A03EventThe A03 event is used to indicate a patient has been discharged from a facility. If the patient has been discharged, update PV1‐45 with the discharged date. PV1‐3 will contain location info prior to discharge. If the patient has expired, fill in PID‐29 and PID‐30.
A07Event–PatientChangeInpatienttoOutpatientCortex treats A07 exactly the same as A03.
Segment SegmentName Required/Optional
Comment
MSH Message Header R EVN Event Type R PID Patient Identification R Patient demographics PV1 Patient Visit Information O Used for tracking admission information GT1 Guarantor O Typically a parent, spouse, or legal
guardian ‐‐‐ Insurance Info Group O Group may repeat 3 times. If no COB
Priority information is provided in the IN1 segment, it is assumed they are in order of priority
IN1 Insurance Information O Required if any insurance info is sent IN2 Additional Insurance Info O Not required even if IN1 is given
PatientInformationUpdate–A08The A08 event is used to update any patient information. By default, Cortex only updates patients already within our system, but it is a common request to insert new accounts based on this event. If that is the case, it is treated as an A01 event.
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Segment SegmentName Required/Optional
Comment
MSH Message Header R EVN Event Type R PID Patient Identification R Patient demographics PV1 Patient Visit Information O Used for tracking admission information GT1 Guarantor O Typically a parent, spouse, or legal
guardian ‐‐‐ Insurance Info Group O Group may repeat 3 times. If no COB
Priority information is provided in the IN1 segment, it is assumed they are in order of priority
IN1 Insurance Information O Required if any insurance info is sent IN2 Additional Insurance Info O Not required even if IN1 is given
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ORM/OMLOrderEntryMessageEach orders interface can use one of two message types; ORM‐O01 and OML‐O21. The main difference between the two is that OML‐O21 has specific segments dedicated to contain the characteristics of specimens and specimen containers.
The orders system in Cortex has a major deviation from the standard in that we only allow one OBR segment per order message. Since each order creates a case in Cortex, it presents difficulty in ordering multiple procedures.
ORM‐O01GenericOrderMessageThis is the traditional method used for submitting orders to the lab. In the future, it is likely that ORM messages will be replaced by OML messages.
Segment SegmentName Required/Optional
Comment
MSH Message Header R PID Patient Identification R Patient demographics PV1 Patient Visit Information O Used for tracking admission information ‐‐‐ Insurance Info Group O Group may repeat 3 times. If no COB
Priority information is provided in the IN1 segment, it is assumed they are in order of priority
IN1 Insurance Information O Required if any insurance info is sent IN2 Additional Insurance Info O Not required even if IN1 is given GT1 Guarantor O Typically a parent, spouse, or legal
guardian ORC Common Order O Used to provide order encounter details.
Only one ORC is expected. ‐‐‐ Order Details R Only one allowed OBR Observation Request R Used to provide order specific details,
such as request a lab procedure. NTE Notes and Comments O Default to Clinical History. Use of the
SourceOfComment field can be
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negotiated to add text to data fields such as Gross and Micro
‐‐‐ Observations O Repeatable OBX Observation/Result O Not typically used in orders NTE Notes and Comments O Specific to OBX.
OML‐O21LaboratoryOrderMessageAnother message structure used for submitting orders to the lab, OML messages are often used to send data to automated laboratory equipment.
Segment SegmentName Required/Optional
Comment
MSH Message Header R PID Patient Identification R Patient demographics PV1 Patient Visit Information O Used for tracking admission information ‐‐‐ Insurance Info Group O Group may repeat 3 times. If no COB
Priority information is provided in the IN1 segment, it is assumed they are in order of priority
IN1 Insurance Information O Required if any insurance info is sent IN2 Additional Insurance Info O Not required even if IN1 is given GT1 Guarantor O Typically a parent, spouse, or legal
guardian ORC Common Order O Used to provide order encounter details.
Only one ORC is expected. ‐‐‐ Order Details R Only one allowed OBR Observation Request R Used to provide order specific details,
such as request a lab procedure. NTE Notes and Comments O Default to Clinical History. Use of the
SourceOfComment field can be negotiated to add text to data fields such
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as Gross and Micro
‐‐‐ Observations O Repeatable OBX Observation/Result O Not typically used in orders NTE Notes and Comments O Specific to OBX. ‐‐‐ Specimens O Repeatable SPM Specimen O Characteristics of specimen OBX Observations related to
Specimen O Repeatable
SAC Specimen Container O Characteristics of specimen container. Only one container expected per specimen
OBX Observations related to Specimen Container
O Repeatable
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ORU–ObservationResultMessageORU messages provide cases based results to our interface partner. Cortex will only generate R01 Events.
R01TransmissionofaresultThese events exist to transfer results to a host system.
R01Event
Segment SegmentName Required/Optional
Comment
MSH Message Header R EVN Event Type R PID Patient Identification R Patient demographics ORC Common Order O Used to provide order encounter details OBR Observation Request R Used to provide order specific details OBX Observation/Results R Used to provide results on an order NTE Notes and Comments O Used to provide additional notes
The result message may be sent 2 ways the first is the result message is contained in a series of OBX level results, many systems post each OBX as separate results and do not retain specific formatting. The second method is be including the report as a series of NTE segments follow an initial OBX that results as “See Note”. Not all systems accept this second method.
Also once a client is upgraded to version 9 and their print server is installed with Office 2007 the client has the option of including an encoded PDF message with their results.
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DFT–FinancialTransactionMessageThe Detail Financial Transaction message is used to describe financial transactions between systems. At Cortex, we only allow the P03 event over an interface to an external system. Regardless of whether the information is inbound or outbound, the layout is the same.
P03Event
Segment SegmentName Required/Optional
Comment
MSH Message Header R EVN Event Type R PID Patient Identification R Patient demographics PV1 Patient Visit Information O Used for tracking admission information FT1 Financial Transaction O This is where the FT1 segment falls in the
sequence described by the HL7 specification, however, we have legacy interfaces that send the FT1 segment following the other segments. Either way is acceptable as long as it is consistent within the interface. Repeats
GT1 Guarantor O Typically a parent, spouse, or legal guardian
‐‐‐ Insurance Info Group O Group may repeat 3 times. If no COB Priority information is provided in the IN1 segment, it is assumed they are in order of priority
IN1 Insurance Information O Required if any insurance info is sent IN2 Additional Insurance Info O Not required even if IN1 is given FT1 Financial Transaction O Alternate sequence order. If this segment
is sent, do not send the one above Patient demographic information sent will be treated the same as an ADT‐A01 event. If the data is inbound and the patient can be matched, the data from the interface will not update the existing information unless specifically defined in the specification.
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AppendixA
EVN–EventType
SEQ Len DT OPT ElementName CortexLocation Comment1 3 ID B Event Type Code Not used 2 26 TS R Recorded Date/Time Time transaction entered. Used if Event
Occurred not provided. 3 26 TS O Date/Time Planned Event Not used 4 3 IS O Event Reason Code Not used 5 250 XCN O Operator ID Not used 6 26 TS O Event Occurred Actual Time of event occurred 7 241 HD O Event Facility Not used
FT1–FinancialTransactionSegment
SEQ Len DT OPT ElementName CortexLocation Comment1 4 SI O Set ID ‐ FT1 2 12 ST O Transaction ID 3 10 ST O Transaction Batch ID Service.BatchNumber 4 53 DR R Transaction Date Service.FromDate Date sample collected. Default to
current date if not provided. 5 26 TS O Transaction Posting Date Service.EnteredDate Current date 6 8 IS R Transaction Type If charge, then a service record is created. Credit / Charge field, typically only accept
charges 7 250 CE R Transaction Code Service.ServiceItem Billed Item, often CPT code. May need to
create translation table. 8 40 ST B Transaction Description Used only if Service Item does not
contain a billing description 9 40 ST B Transaction Description ‐
Alt
10 6 NM O Transaction Quantity Service.Units 11 12 CP O Transaction Amount ‐
Extended
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12 12 CP O Transaction Amount ‐ Unit 13 250 CE O Department Code 14 250 CE O Insurance Plan ID Service.PayorNumber Primary insurance plan ID. Translation
may be required. IN1 data will probably contain reference to the same plan.
15 12 CP O Insurance Amount 16 80 PL O Assigned Patient Location Service.LocationNumber Location where the service was ordered. 17 1 IS O Fee Schedule 18 2 IS O Patient Type 19 250 CE O Diagnosis Code ‐ FT1 Service.ICDCodes (1‐4) Repeating multi‐value field separated by
repetition delimiter (usually ~) 20 250 XCN O Performed By Code Service.PerformedByID Pathologist or Tech that performed the
lab procedure. May need translation table.
21 250 XCN O Ordered By Code Service.ReferredByID Doctor that ordered the lab test. May need translation table.
22 12 CP O Unit Cost Typically not used Looked up on Service Item table. 23 427 EI O Filler Order Number Service.CaseNumber Typically Accession Number from lab
system. 24 250 XCN O Entered By Code 25 250 CE O Procedure Code CPTCode typically comes from Service
Item record. 26 250 CE O Procedure Code Modifier Service.Modifier1 27 250 CE O Advanced Beneficiary
Notice Code
28 250 CWE O Medically Necessary Duplicate Procedure Reason.
29 250 CNE O NDC Code 30 250 CX O Payment Reference ID 31 4 SI O Transaction Reference Key
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GT1–GuarantorSegment
SEQ Len DT OPT ElementName CortexLocation Comment1 4 SI R Set ID ‐ GT1 2 250 CX O Guarantor Number 3 250 XPN R Guarantor Name PatientPayor ‐ SubscriberName 4 250 XPN O Guarantor Spouse Name 5 250 XAD O Guarantor Address PatientPayor ‐SubscriberAddressLine1,
SubscriberAddressLine2, City, State, ZipCode
6 250 XTN O Guarantor Ph Num ‐ Home PatientPayor – PhoneNo 7 250 XTN O Guarantor Ph Num ‐
Business
8 26 TS O Guarantor Date/Time Of Birth
PatientPayor –SubscriberBirthdate
9 1 IS O Guarantor Administrative Sex
PatientPayor –SubscriberSex
10 2 IS O Guarantor Type 11 250 CE O Guarantor Relationship PatientPayor ‐SubscriberRelation 12 11 ST O Guarantor SSN PatientPayor –SubscriberSocSecNo 13 8 DT O Guarantor Date ‐ Begin 14 8 DT O Guarantor Date ‐ End 15 2 NM O Guarantor Priority 16 250 XPN O Guarantor Employer Name PatientPayor –EmployerName 17 250 XAD O Guarantor Employer
Address
18 250 XTN O Guarantor Employer Phone Number
19 250 CX O Guarantor Employee ID Number
20 2 IS O Guarantor Employment Status
21 250 XON O Guarantor Organization
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Name
22 1 ID O Guarantor Billing Hold Flag 23 250 CE O Guarantor Credit Rating
Code
24 26 TS O Guarantor Death Date And Time
25 1 ID O Guarantor Death Flag 26 250 CE O Guarantor Charge
Adjustment Code
27 10 CP O Guarantor Household Annual Income
28 3 NM O Guarantor Household Size 29 250 CX O Guarantor Employer ID
Number
30 250 CE O Guarantor Marital Status Code
31 8 DT O Guarantor Hire Effective Date
32 8 DT O Employment Stop Date 33 2 IS O Living Dependency 34 2 IS O Ambulatory Status 35 250 CE O Citizenship 36 250 CE O Primary Language 37 2 IS O Living Arrangement 38 250 CE O Publicity Code 39 1 ID O Protection Indicator 40 2 IS O Student Indicator 41 250 CE O Religion 42 250 XPN O Mother’s Maiden Name 43 250 CE O Nationality 44 250 CE O Ethnic Group 45 250 XPN O Contact Person’s Name 46 250 XTN O Contact Person’s Telephone
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Number
47 250 CE O Contact Reason 48 3 IS O Contact Relationship 49 20 ST O Job Title 50 20 JCC O Job Code/Class 51 250 XON O Guarantor Employer’s
Organization Name
52 2 IS O Handicap 53 2 IS O Job Status 54 50 FC O Guarantor Financial Class 55 250 CE O Guarantor Race
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IN1–InsuranceSegmentTypically, insurance information is used in filling out a specific patients insurance information. However, it can also be used to create payors in the Cortex system if they do not already exist.
SEQ Len DT OPT ElementName CortexLocation Comment1 4 SI R Set ID ‐ IN1 2 250 CE R Insurance Plan ID 3 250 CX R Insurance Company ID PatientPayor –PayorNumber, Payor‐
Number
4 250 XON O Insurance Company Name Payor – Name 5 250 XAD O Insurance Company
Address Payor – AddressLine1, AddressLine2, City, State, ZipCode
6 250 XPN O Insurance Co Contact Person
Payor – ContactPerson Name
7 250 XTN O Insurance Co Phone Number
Payor – TelephoneNumber
8 12 ST O Group Number PatientPayor – GroupNumber 9 250 XON O Group Name 10 250 CX O Insured’s Group Emp ID 11 250 XON O Insured’s Group Emp
Name Can house EmployerName if IN2 not sent
12 8 DT O Plan Effective Date PatientPayor – DateCoverageBegins 13 8 DT O Plan Expiration Date PatientPayor – DateCoverageEnds 14 239 AUI O Authorization Information PatientPayor – AuthorizationNumber 15 3 IS O Plan Type PatientPayor – InsuranceType; Payor –
TypeCode
16 250 XPN O Name Of Insured PatientPayor – SubscriberName 17 250 CE O Insured’s Relationship To
Patient PatientPayor –SubscriberRelation
18 26 TS O Insured’s Date Of Birth PatientPayor –SubscriberBirthdate 19 250 XAD O Insured’s Address PatientPayor ‐SubscriberAddressLine1,
SubscriberAddressLine2, City, State,
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ZipCode
20 2 IS O Assignment Of Benefits PatientPayor – AcceptAssignment 21 2 IS O Coordination Of Benefits 22 2 ST O Coordination Of Ben.
Priority PatientPayor – Type P,S, T ‐ Primary, Secondary, Tertiary
23 1 ID O Notice Of Admission Flag 24 8 DT O Notice Of Admission Date 25 1 ID O Report Of Eligibility Flag 26 8 DT O Report Of Eligibility Date 27 2 IS O Release Information Code 28 15 ST O Pre‐Admit Cert (PAC) 29 26 TS O Verification Date/Time 30 250 XCN O Verification By 31 2 IS O Type Of Agreement Code 32 2 IS O Billing Status 33 4 NM O Lifetime Reserve Days 34 4 NM O Delay Before L.R. Day 35 8 IS O Company Plan Code 36 15 ST O Policy Number PatientPayor – PolicyNumber 37 12 CP O Policy Deductible 38 12 CP B Policy Limit ‐ Amount 39 4 NM O Policy Limit ‐ Days 40 12 CP B Room Rate ‐ Semi‐Private 41 12 CP B Room Rate ‐ Private 42 250 CE O Insured’s Employment
Status
43 1 IS O Insured’s Administrative Sex
PatientPayor –SubscriberSex
44 250 XAD O Insured’s Employer’s Address
45 2 ST O Verification Status 46 8 IS O Prior Insurance Plan ID 47 3 IS O Coverage Type
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48 2 IS O Handicap 49 250 CX O Insured’s ID Number 50 1 IS O Signature Code PatientPayor ‐ SignatureSourceCode C, S, M, P 51 8 DT O Signature Code Date 52 250 ST O Insured’s Birth Place 53 2 IS O VIP Indicator
IN2‐InsuranceAdditionalInformationSegment
SEQ Len DT OPT ElementName CortexLocation Comment1 250 CX O Insured’s Employee ID 2 11 ST O Insured’s Social Security
Number PatientPayor –SubscriberSocSecNo
3 250 XCN O Insured’s Employer’s Name and ID
PatientPayor –EmployerName
4 1 IS O Employer Information Data 5 1 IS O Mail Claim Party 6 15 ST O Medicare Health Ins Card
Number
7 250 XPN O Medicaid Case Name 8 15 ST O Medicaid Case Number 9 250 XPN O Military Sponsor Name 10 20 ST O Military ID Number 11 250 CE O Dependent Of Military
Recipient
12 25 ST O Military Organization 13 25 ST O Military Station 14 14 IS O Military Service 15 2 IS O Military Rank/Grade 16 3 IS O Military Status 17 8 DT O Military Retire Date 18 1 ID O Military Non‐Avail Cert On
File
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19 1 ID O Baby Coverage 20 1 ID O Combine Baby Bill 21 1 ST O Blood Deductible 22 250 XPN O Special Coverage Approval
Name
23 30 ST O Special Coverage Approval Title
24 8 IS O Non‐Covered Insurance Code
25 250 CX O Payor ID 26 250 CX O Payor Subscriber ID 22 250 XPN O Special Coverage Approval
Name
23 30 ST O Special Coverage Approval Title
24 8 IS O Non‐Covered Insurance Code
25 250 CX O Payor ID 26 250 CX O Payor Subscriber ID 27 1 IS O Eligibility Source 28 82 RMC O Room Coverage
Type/Amount
29 56 PTA O Policy Type/Amount 30 25 DDI O Daily Deductible 31 2 IS O Living Dependency 32 2 IS O Ambulatory Status 33 250 CE O Citizenship 34 250 CE O Primary Language 35 2 IS O Living Arrangement 36 250 CE O Publicity Code 37 1 ID O Protection Indicator 38 2 IS O Student Indicator 39 250 CE O Religion
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40 250 XPN O Mother’s Maiden Name 41 250 CE O Nationality 42 250 CE O Ethnic Group 43 250 CE O Marital Status 44 8 DT O Insured’s Employment Start
Date
45 8 DT O Employment Stop Date 46 20 ST O Job Title 47 20 JCC O Job Code/Class 48 2 IS O Job Status 49 250 XPN O Employer Contact Person
Name
50 250 XTN O Employer Contact Person Phone Number
51 2 IS O Employer Contact Reason 52 250 XPN O Insured’s Contact Person’s
Name
53 250 XTN O Insured’s Contact Person Phone Number
54 2 IS O Insured’s Contact Person Reason
55 8 DT O Relationship to the Patient Start Date
56 8 DT O Relationship to the Patient Stop Date
57 2 IS O Insurance Co. Contact Reason
58 250 XTN O Insurance Co Contact Phone Number
59 2 IS O Policy Scope 60 2 IS O Policy Source 61 250 CX O Patient Member Number 62 250 CE O Guarantor’s Relationship to
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Insured
63 250 XTN O Insured’s Phone Number ‐ Home
64 250 XTN O Insured’s Employer Phone Number
65 250 CE O Military Handicapped Program
66 1 ID O Suspend Flag 67 1 ID O Copay Limit Flag 68 1 ID O Stoploss Limit Flag 69 250 XON O Insured Organization Name
and ID
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MSH–MessageHeaderSegment
SEQ Len DT OPT ElementName CortexLocation Comment1 1 ST R Field Separator 2 4 ST R Encoding Characters 3 227 HD O Sending Application 4 227 HD R Sending Facility 5 227 HD O Receiving Application 6 227 HD R Receiving Facility 7 26 TS R Date/Time of Message 8 40 ST O Security Not used 9 15 MSG R Message Type 10 20 ST R Message Control ID Unique message ID 11 3 PT R Processing ID P = Production, T = Test 12 60 VID R Version ID Default = 2.5.1 13 15 NM O Sequence Number 14 180 ST O Continuation Pointer 15 2 ID O Accept Acknowledgement
Type
16 2 ID O Application Acknowledgment Type
17 3 ID O Country Code 18 16 ID O Character Set 19 250 CE O Principal Language of
Message
20 20 ID O Alternate Character Set 21 427 EI O Message Profile Identifier
NTE–NotesandCommentsSegmentNotes are often used to transmit data that doesn’t fit elsewhere. This segment could be used to populate specific fields on the case, such as gross description by using the source of comment field to instruct the system on how to handle the text. The Comment Type field could then be used to pass information such as transcriber ID and name.
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SEQ Len DT OPT ElementName CortexLocation Comment1 4 SI O Set ID ‐ NTE
2 8 ID O Source of Comment Negotiated handling code, such as
GROSS 3 65000 FT O Comment Text to process 4 250 CE O Comment Type Transcribed by
ORC–CommonOrderSegmentThe common order segment contains data that on a level roughly equivalent to a cortex case. The data is common to all the procedures on the case.
SEQ Len DT OPT ElementName CortexLocation Comment1 2 ID R Order Control 2 22 EI C Placer Order Number Orders.Usertext2 Stored and returned in result 3 22 EI C Filler Order Number Orders.Usertext3 Result usually returns accession number 4 22 EI O Placer Group Number 5 2 ID O Order Status (P)reliminary, (C)hanged, (F)inal 6 1 ID O Response Flag 7 200 TQ B Quantity/Timing 8 200 EIP O Parent
9 26 TS O Date/Time of Transaction
Patient_List.EnteredDate; Patient_RiskFactor.EnteredDate; Orders.CollectedDate
Result returns ResultsInterfaceDate
10 250 XCN O Entered By 11 250 XCN O Verified By 12 250 XCN O Ordering Provider Orders.CortexClinicianNumber Will become the clinician on the case 13 80 PL O Enterer's Location 14 250 XTN O Call Back Phone Number 15 26 TS O Order Effective Date/Time
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16 250 CE O Order Control Code Reason 17 250 CE O Entering Organization 18 250 CE O Entering Device 19 250 XCN O Action By
20 250 CE O Advanced Beneficiary Notice Code
21 250 XON O Ordering Facility Name Orders.CortexHospitalID Will become the hospital Id on the case 22 250 XAD O Ordering Facility Address
23 250 XTN O Ordering Facility Phone Number
24 250 XAD O Ordering Provider Address 25 250 CWE O Order Status Modifier
26 60 CWE C Advanced Beneficiary Notice Override Reason
27 26 TS O Filler's Expected Availability Date/Time
28 250 CWE O Confidentiality Code 29 250 CWE O Order Type 30 250 CNE O Enterer Authorization Mode
31 250 CWE O Parent Universal Service Identifier
OBR–ObservationRequestSegmentThe observation request is roughly equivalent to a case procedure. While the case is capable of containing multiple procedures, the order process can only import one.
SEQ Len DT OPT ElementName CortexLocation Comment1 4 SI O Set ID ‐ OBR 2 22 EI C Placer Order Number Orders.Usertext2 Alternative to using ORC field 3 22 EI C Filler Order Number Orders.Usertext2 Alternative to using ORC field 4 250 CE R Universal Service Identifier Orders.Usertext4; Often returned in result; Identifier is
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Orders.ProcedureShortName copied to procedureShortName
5 2 ID B Priority – OBR 6 26 TS B Requested Date/Time
7 26 TS C Observation Date/Time # Orders.CollectedDate Will become the case collected date
Alternate to using ORC field 8 26 TS O Observation End Date/Time # 9 20 CQ O Collection Volume * 10 250 XCN O Collector Identifier * 11 1 ID O Specimen Action Code * 12 250 CE O Danger Code Used to fill out Patient_RiskFactor Depends on data received 13 300 ST O Relevant Clinical Information Orders.RequisitionComments
14 26 TS B Specimen Received Date/Time *
15 300 SPS B Specimen Source
Orders_Specimen.CortexSpecimenCode; Orders_Specimen.Location; Orders.CortexPapCollectionMethod
NameOrCode; Free text used to describe specimen location; optional code that can be translated into a cortex code
16 250 XCN O Ordering Provider Orders.CortexClinicianNumber Will become the clinician on the case.
Alternate to using ORC‐12
17 250 XTN O Order Callback Phone Number
18 60 ST O Placer Field 1 19 60 ST O Placer Field 2 20 60 ST O Filler Field 1 + 21 60 ST O Filler Field 2 +
22 26 TS C Results Rpt/Status Chng ‐ Date/Time +
23 40 MOC O Charge to Practice + 24 10 ID O Diagnostic Serv Sect ID 25 1 ID C Result Status + 26 400 PRL O Parent Result +
[HL7 INTERFACE SPECIFICATION] July 8, 2011
27 200 TQ B Quantity/Timing 28 250 XCN O Result Copies To 29 200 EIP O Parent 30 20 ID O Transportation Mode 31 250 CE O Reason for Study Used to fill out Patient_List Depends on data received 32 200 NDL O Principal Result Interpreter + 33 200 NDL O Assistant Result Interpreter + 34 200 NDL O Technician + 35 200 NDL O Transcriptionist + 36 26 TS O Scheduled Date/Time +
37 4 NM O Number of Sample Containers *
38 250 CE O Transport Logistics of Collected Sample *
39 250 CE O Collector's Comment * Orders.RequistionComments
40 250 CE O Transport Arrangement Responsibility
41 30 ID O Transport Arranged 42 1 ID O Escort Required
43 250 CE O Planned Patient Transport Comment
44 250 CE O Procedure Code 45 250 CE O Procedure Code Modifier
46 250 CE O Placer Supplemental Service Information
47 250 CE O Filler Supplemental Service Information
48 250 CWE C Medically Necessary Duplicate Procedure Reason.
49 2 IS O Result Handling
50 250 CWE O Parent Universal Service Identifier
[HL7 INTERFACE SPECIFICATION] July 8, 2011
OBX–Observation/ResultValueDepending on the interface, the OBX may be sent one or more times. If multiple OBX segments are employed, they may contain data in a?here?
SEQ Len DT OPT ElementName CortexLocation Comment1 4 SI O Set ID – OBX 2 2 ID C Value Type Typically FT, ST 3 250 CE R Observation Identifier Procedure code or USI from order 4 20 ST C Observation Sub‐ID Sometimes used a s a ‘Field’ name 5 65000 varies C Observation Value Text containing findings 6 250 CE O Units 7 60 ST O References Range 8 5 IS O Abnormal Flags 9 5 NM O Probability 10 2 ID O Nature of Abnormal Test 11 1 ID R Observation Result Status Typically P, C, F 12 26 TS O Effective Date of Reference
Range Values
13 20 ST O User Defined Access Checks
14 26 TS O Date/Time of the Observation
15 250 CE O Producer's Reference 16 250 XCN O Responsible Observer 17 250 CE O Observation Method 18 22 EI O Equipment Instance
Identifier
19 26 TS O Date/Time of the Analysis 23 567 XON O Performing Organization
Name
24 631 XAD O Performing Organization Address
25 3002 XCN O Performing Organization
[HL7 INTERFACE SPECIFICATION] July 8, 2011
Medical Director
PID–PatientIdentificationSegment
SEQ Len DT OPT ElementName CortexLocation Comment
1 4 SI O Set ID Cortex will always assume only one PID segment per message
2 20 CX B Patient ID Patient.UserText1‐2
3 250 CX R Patient ID List PartnerID will be used in InterfaceKeyTranslation
Typical entry will be like: <PartnerID>&&&<PartnerName> ^1234567890&&&MRN ^555‐55‐5555&&&SSN
4 20 CX B Alternate Patient ID Patient.UserText1‐2 5 250 XPN R Patient Name Patient.Name Only 1 name expected
6 250 XPN O Mother’s Maiden Name
7 26 TS O Date of Birth Patient.Birthdate
8 1 IS O Gender Patient.Sex M,F, and U are typical accepted values, conversion is possible
9 250 XPN B Patient Alias Patient.AliasName Only 1 name expected
10 250 CE O Race Patient.Race Code must be translated to Cortex System Code
11 250 XAD O Patient Address Patient.AddressLine1, Patient.AddressLine2, Patient.City, Patient.State, Patient.ZipCode Only 1 address expected
12 4 IS B County Code 13 250 XTN O Home Phone Number Patient.PhoneNo1 Only 1 number expected 14 250 XTN O Work Phone Number Patient.PhoneNo2 Only 1 number expected 15 250 CE O Primary Language 16 250 CE O Marital Status Patient.MaritalStatus 17 250 CE O Religion
18 250 CX O Patient Account Number Patient.UserText1‐2 Account and Patient are the same entity in Cortex
[HL7 INTERFACE SPECIFICATION] July 8, 2011
19 16 ST B Social Security Number Patient.SocialSecurityNo 20 25 DLN B Driver’s License Number 21 250 CX O Mother’s Identifier 22 250 CE O Ethnic Group 23 250 ST O Birth place 24 1 ID O Multiple birth indicator 25 2 NM O Birth order 26 250 CE O Citizenship 27 250 CE O Veteran military status 28 250 CE B Nationality
29 26 TS O Patient Death Date and Time Patient.ExpiredDate, Patient.ExpiredTime
30 1 ID O Patient Death Indicator 31 1 ID O Identity Unknown 32 20 IS O Identity Reliability Code 33 26 TS O Last Updated Date/Time 34 241 HD O Last Update Facility 35 250 CE C Species Code 36 250 CE C Breed Code 37 80 ST O Strain 38 250 CE O Production Class Code 39 250 CWE O Tribal Citizenship
PV1–PatientVisitInformationSegmentSEQ Len DT OPT Element Name Cortex Location Comment
1 4 SI O Set ID Cortex will always assume only one PV1 segment per message
2 1 IS R Patient Class As part of Admission.RoomAndBed, or Admission.UserText(1‐4)
E, I, O for emergency, in‐patient, and out‐patient
3 80 PL O Assigned Patient Location Admission.RoomAndBed 4 2 IS O Admission Type Can be used to set auto accident / work
[HL7 INTERFACE SPECIFICATION] July 8, 2011
injury flags
5 250 CX O Pre‐Admit Number 6 80 PL O Prior Patient Location 7 250 XCN O Attending Doctor Admisson.AttendingClinicianID 8 250 XCN O Referring Doctor 9 250 XCN O Consulting Doctor 10 3 IS O Hospital Service 11 80 PL O Temporary Location 12 2 IS O Pre‐Admit Test Indicator 13 2 IS O Re‐Admit Indicator 14 6 IS O Admit Source 15 2 IS O Ambultory Status 16 2 IS O VIP Indicator 17 250 XCN O Admitting Doctor 18 2 IS O Patient Type 19 250 CX R Visit Number Admission.Number Deviation from standard
20 50 FC O Financial Class Has been used to indicate patient vs. client responsibility
21 2 IS O Charge Price Indicator Fee schedule to use 22 2 IS O Courtesy Code 23 2 IS O Credit Rating 24 2 IS O Contract Code 25 8 DT O Contract Effective Date 26 12 NM O Contract Amount 27 3 NM O Contract Period 28 2 IS O Interest Code 29 4 IS O Transfer to Bad Debt Code 30 8 DT O Transfer to Bad Debt Date 31 10 IS O Bad Debt Agency Code
[HL7 INTERFACE SPECIFICATION] July 8, 2011
SAC–SpecimenContainerDetailSegment
SEQ Len DT OPT ElementName CortexLocation Comment1 80 EI O External Accession Identifier 2 80 EI O Accession Identifier 3 80 EI C Container Identifier 4 80 EI C Primary (parent) Container
Identifier
5 80 EI O Equipment Container Identifier
6 300 SPS C Specimen Source 7 26 TS O Registration Date/Time 8 250 CE O Container Status 9 250 CE O Carrier Type 10 80 EI O Carrier Identifier 11 80 NA O Position in Carrier 12 250 CE O Tray Type ‐ SAC 13 80 EI O Tray Identifier 14 80 NA O Position in Tray 15 250 CE O Location 16 20 NM O Container Height 17 20 NM O Container Diameter 18 20 NM O Barrier Delta 19 20 NM O Bottom Delta 20 250 CE O Container
Height/Diameter/Delta Units
21 20 NM O Container Volume 22 20 NM O Available Specimen Volume 23 20 NM O Initial Specimen Volume 24 250 CE O Volume Units 25 250 CE O Separator Type 26 250 CE O Cap Type 27 250 CWE O Additive
[HL7 INTERFACE SPECIFICATION] July 8, 2011
28 250 CE O Specimen Component 29 20 SN O Dilution Factor 30 250 CE O Treatment 31 20 SN O Temperature 32 20 NM O Hemolysis Index 33 250 CE O Hemolysis Index Units 34 20 NM O Lipemia Index 35 250 CE O Lipemia Index Units 36 20 NM O Icterus Index 37 250 CE O Icterus Index Units 38 20 NM O Fibrin Index 39 250 CE O Fibrin Index Units 40 250 CE O System Induced
Contaminants
41 250 CE O Drug Interference 42 250 CE O Artificial Blood 43 250 CWE O Special Handling Code 44 250 CE O Other Environmental Factors
SPM–SpecimenSegment
SEQ Len DT OPT ElementName CortexLocation Comment1 4 SI O Set ID – SPM 2 80 EIP O Specimen ID 3 80 EIP O Specimen Parent IDs 4 250 CWE R Specimen Type 5 250 CWE O Specimen Type Modifier 6 250 CWE O Specimen Additives 7 250 CWE O Specimen Collection
Method
8 250 CWE O Specimen Source Site 9 250 CWE O Specimen Source Site
[HL7 INTERFACE SPECIFICATION] July 8, 2011
Modifier
10 250 CWE O Specimen Collection Site 11 250 CWE O Specimen Role 12 20 CQ O Specimen Collection
Amount
13 6 NM C Grouped Specimen Count 14 250 ST O Specimen Description 15 250 CWE O Specimen Handling Code 16 250 CWE O Specimen Risk Code 17 26 DR O Specimen Collection
Date/Time
18 26 TS O Specimen Received Date/Time
19 26 TS O Specimen Expiration Date/Time
20 1 ID O Specimen Availability 21 250 CWE O Specimen Reject Reason 22 250 CWE O Specimen Quality 23 250 CWE O Specimen Appropriateness 24 250 CWE O Specimen Condition 25 20 CQ O Specimen Current Quantity 26 4 NM O Number of Specimen
Containers
27 250 CWE O Container Type 28 250 CWE O Container Condition 29 250 CWE O Specimen Child Role