V251_IG_SIF_LABRESULTS_R1_N1_2011SEP
HL7 Version 2.5.1 Implementation Guide:
Laboratory Results Interface for US Realm,
Release 1
HL7 Version 2.5.1: ORU^R01
Draft Standard for Trial Use
WIP: 0.13
TBD 2011
Sponsored by:
Orders and Observations in collaboration with the Health and Human Services Standards
and Interoperability Framework Laboratory Result Interface Working Group
LRI Work Group Co-chair:
Hans Buitendijk
Siemens Healthcare
LRI Work Group Co-chair:
Ken McCaslin
Quest Diagnostics
LRI Vocabulary Work Group Cochair:
Cindy Johns
LabCorp
LRI Vocabulary Work Group Cochair:
Riki Merrick
iConnect Consulting
Questions or comments regarding this document should be directed to the Orders and
Observations Workgroup (ord@lists.hl7.org).
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page i
September 2011
Reviewers Notes, Acknowledgements, Copyrights
Reviewers Notes
The review of this draft specification is encouraged to provide feedback that will ensure
broad support and adoption, as well as further the goals of interoperability of information
between exchange mechanisms for structured data (v2.x message, xml, etc.). This guide
therefore directs the reviewer to several areas where the authors seek broader input from
the community in addition to any other items noted about this guide.
1) Pre-adoption - This implementation guide is dependent on both existing V2.x
versions, as well as a new version, V2.7.1, that is going through ballot at the same time.
We encourage the balloter to review both this implementation guide and the V2.7.1 ballot
to ensure your concerns are addressed in the related documents.
2) Component Length Conformance - The introduction of V2.7.1 Conformance Length
(C.LEN) and position on truncation.
3) Minimalism – The content is intended to focus on that which represents unique
constraints to the base standard(s).
Acknowledgments
The authors of this document wish to recognize the following participants who
contributed their time and expertise to the development of this guide.
Austin Kreisler
SAIC
Bill Ormerod
Siemens Healthcare
Bob Yencha
Lantana Consulting Group
Cindy Johns
LabCorp
David Burgess
LabCorp
Erik Pupo
Deloitte Consulting
Ernest Grove
SHAPE HITECH, LLC
Frieda Hall
Quest Diagnostics
Glen Moy
California HealthCare Foundation
Hans Buitendijk
Siemens Healthcare
Jingdong Li
Lantana Consulting Group
Jitin Asnaani
Office of the National Coordinator
John Mooney
BioReference Laboratories, Inc
Jonathan Tadese
Deloitte Consulting
Kate Hamilton
Lantana Consulting Group
Page ii
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Reviewers Notes, Acknowledgments, Copyrights
Ken Gurlach
CDC
Ken McCaslin
American Clinical Laboratory Association (ACLA)
Ken Willett
Ignis Systems Corp
Krishna Murali Brahmandam
Proheamon, Inc.
Lester Keepper
SHAPE HITECH, LLC
Nagesh Bashyam
Harris
Neelima Chennamaraja
Harris
Riki Merrick
iConnect Consulting
Rob Hausam
Hausam Consulting
Robert Dieterle
Cal eConnect
Robert Lutolf
Gensa Corporation
Robert Snelick
National Institute of Standards and Technology
Tom Boal
Lockheed Martin
Virginia Sturmfels
Quest Diagnostics
Ballot #2 Production Change History
Wiki posting date
Posting Date
Ver
Comment
Nov 21, 2011
0.7
Addressed items noted in spreadsheet:
V251_IG_SIF_LABRESULTS_R1_N1_2011SEP_consolidated-22-Nov-2011.xls
Nov 29, 2011,
2:15PM ET
0.8
Addressed items noted in spreadsheet:
V251_IG_SIF_LABRESULTS_R1_N1_2011SEP_consolidated-29-Nov-2011.xls
Nov 30, 2011,
11:00AM ET
0.9
Addressed additional items noted in spreadsheet:
V251_IG_SIF_LABRESULTS_R1_N1_2011SEP_consolidated-30-Nov-2011.xls
Dec 2, 2011
0.10
Addressed additional items noted in spreadsheet (B Yencha)
Added condition predicates and removed condition predicates that were list
below the table as conformance statements (rsnelick)
V251_IG_SIF_LABRESULTS_R1_N1_2011SEP_consolidated-30-Nov-2011.xls
Dec 15, 2011,
12:00PM ET
0.13
Addressed the conformance statements (rsnelick)
V251_IG_SIF_LABRESULTS_R1_N1_2011SEP_consolidated-13-Dec-2011.xls
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page iii
September 2011
Reviewers Notes, Acknowledgements, Copyrights
Copyrights
This document is © 2011 Health Level Seven International, All rights reserved
This material includes SNOMED Clinical Terms ® (SNOMED CT®) which is used by
permission of the International Health Terminology Standards Development Organization
(IHTSDO). All rights reserved. SNOMED CT was originally created by The College of
American Pathologists. "SNOMED ®" and "SNOMED CT ®" are registered trademarks
of the IHTSDO.
This material contains content from LOINC® (http://loinc.org). The LOINC table,
LOINC codes, and LOINC panels and forms file are copyright (c) 1995-2011,
Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes
(LOINC) Committee and available at no cost under the license at http://loinc.org/termsof-use.
Page iv
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE OF CONTENTS
1.
INTRODUCTION .......................................................................................................................................................... 1
1.1
Purpose ............................................................................................................................................ 1
1.2
Audience .......................................................................................................................................... 1
1.2.1
1.3
Scope ............................................................................................................................................... 1
1.4
Use Case And Context Diagrams .................................................................................................... 2
1.4.1
User Story .................................................................................................................................. 3
1.4.2
Use Case Assumptions ............................................................................................................. 4
1.4.3
Pre-Conditions ........................................................................................................................... 4
1.4.4
Post Condition ........................................................................................................................... 5
1.4.5
Functional Requirements........................................................................................................... 5
1.4.6
Sequence Diagram .................................................................................................................... 6
1.5
Key Technical Decisions .................................................................................................................. 6
1.5.1
Use of ISO Object Identifier (OID) ............................................................................................. 7
1.5.2
Use of Vocabulary Standards ................................................................................................... 7
1.5.3
Field Length and Truncation ...................................................................................................... 7
1.5.4
Referenced Profiles ................................................................................................................... 8
1.5.5
Interfaces ................................................................................................................................... 8
1.5.6
Conformance to this Guide ........................................................................................................ 8
1.6
2.
Requisite Knowledge ................................................................................................................. 1
Organization of this Guide................................................................................................................ 9
1.6.1
Conventions ............................................................................................................................... 9
1.6.2
Message Element Attributes .................................................................................................... 10
1.6.3
Keywords ................................................................................................................................. 11
1.6.4
Usage Conformance Testing Recommendations .................................................................... 12
1.6.4.1
Usage................................................................................................................................ 12
1.6.4.1.1
Definition of Conditional Usage ....................................................................................... 13
1.6.4.1.2
Sending and Receiving Application Conformance Requirements................................... 13
DATA TYPES........................................................................................................................................................... 16
2.1
CE – Coded Element ..................................................................................................................... 16
2.2
CWE – Coded with Exceptions – All Fields Except OBX-5............................................................ 17
2.3
CWE – Coded with Exceptions – For OBX-5 Only ........................................................................ 19
2.4
CX – GU – Extended Composite ID with Check Digit (Globally Unique) ....................................... 22
2.5
CX – NG – Extended Composite ID with Check Digit (Non-Globally Unique) ............................... 23
2.6
DR – Date/Time Range .................................................................................................................. 24
2.7
DT – Date ....................................................................................................................................... 24
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page v
September 2011
Table of Contents
2.8
DTM – Date/Time ........................................................................................................................... 25
2.9
ED – Encapsulated Data ................................................................................................................ 25
2.10
EI GU – Entity Identifier (Globally Unique) ................................................................................... 26
2.11
EI NG – Entity Identifier (Non-Globally Unique) ........................................................................... 26
2.12
EIP – GU – Entity Identifier Pair (Globally Unique) ...................................................................... 27
2.13
EIP – NG – Entity Identifier Pair (Non-Globally Unique) .............................................................. 28
2.14
ERL – Error Location .................................................................................................................... 28
2.15
FT – Formatted Text Data ............................................................................................................ 28
2.16
HD GU – Hierarchic Designator (Globally Unique) ...................................................................... 29
2.17
HD NG – Hierarchic Designator (Non-Globally Unique) .............................................................. 30
2.18
ID – Coded Value for HL7-Defined Tables ................................................................................... 30
2.19
IS – Coded Value for User-Defined Tables .................................................................................. 31
2.20
MSG – Message Type .................................................................................................................. 31
2.21
NM – Numeric .............................................................................................................................. 31
2.22
PRL – Parent Result Link ............................................................................................................. 32
2.23
PT – Processing Type .................................................................................................................. 32
2.24
RP – Reference Pointer ............................................................................................................... 33
2.25
SI – Sequence ID ......................................................................................................................... 34
2.26
SN – Structured Numeric ............................................................................................................. 34
2.27
ST – String Data ........................................................................................................................... 35
2.28
TM – Time .................................................................................................................................... 36
2.29
TS – Time Stamp .......................................................................................................................... 36
2.30
TX – Text Data.............................................................................................................................. 37
2.31
VID – Version Identifier ................................................................................................................ 37
2.32
XAD – Extended Address............................................................................................................. 37
2.33
XCN – GU – Extended Composite ID Number and Name for Persons (Globally Unique) .......... 39
2.34
XCN – NG – Extended Composite ID Number and Name for Persons (Non-Globally Unique) .. 41
2.35 XON GU – Extended Composite Name and Identification Number for Organizations Globally
Unique) .................................................................................................................................................... 42
2.36 XON NG – Extended Composite Name and Identification Number for Organizations (NonGlobally Unique) ...................................................................................................................................... 43
2.37
3.
XPN – Extended Person Name ................................................................................................... 44
MESSAGES ............................................................................................................................................................. 46
3.1
ORU^R01^ORU_R01 ..................................................................................................................... 46
3.2
ACK^R01^ACK .............................................................................................................................. 49
3.3
Segment and Field Descriptions .................................................................................................... 49
3.3.1
MSH – Message Header Segment ............................................................................................. 50
3.3.2
SFT – Software Segment –replace with reference to 2.5.1 ........................................................ 54
Page vi
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Table of Contents
3.3.3
MSA – Acknowledgement Segment ............................................................................................ 55
3.3.4
ERR – Error Segment ................................................................................................................. 55
3.3.5
PID – Patient Identification Segment .......................................................................................... 56
3.3.6
NK1 – Next of Kin Segment – make ref ...................................................................................... 59
3.3.7
PV1 – Patient Visit Information ................................................................................................... 60
3.3.8
PV2 – Patient Visit – Additional Information Segment insert ref to base .................................... 62
3.3.9
ORC – Common Order Segment ................................................................................................ 62
3.3.10
OBR – Observation Request Segment ..................................................................................... 65
3.3.11
TQ1 – Timing/Quantity Segment ............................................................................................... 72
3.3.12
OBX – Observation/Result Segment ........................................................................................ 73
3.3.12.1
4.
5.
Observation Identifiers, Observation Values, Interpretations and Comments ....................... 78
3.3.13
SPM – Specimen Segment ....................................................................................................... 81
3.3.14
NTE – Notes and Comments Segment ..................................................................................... 83
CODE SYSTEMS AND VALUE SETS ............................................................................................................................ 84
4.1
Vocabulary Distribution .................................................................................................................. 84
4.2
HL7 TableS ..................................................................................................................................... 84
4.3
LOINC ............................................................................................................................................ 84
4.4
SNOMED CT .................................................................................................................................. 85
4.5
UCUM............................................................................................................................................. 85
4.6
Vocabulary Constraints .................................................................................................................. 86
4.7
HL7 Tables ..................................................................................................................................... 92
4.7.1
HL7 Table 0065 – Specimen Action Code from HL7 V2.7 Message - Constrained .................... 92
4.7.2
HL7 Table 0076 – Message Type 2.5.1 (constrained) ................................................................ 92
4.7.3
HL7 Table 0078 – Interpretation Codes from HL7 V2.7 Message .............................................. 92
4.7.4
HL7 Table 0125 – Value Type (Constrained from the Full HL7 Table) ........................................ 94
4.7.5
HL7 Table 0203 – Identifier Type from HL7 V2.7 ........................................................................ 96
4.7.6
HL7 Table 0291 – Subtype Of Referenced Data ....................................................................... 101
4.7.7
HL7 Table 0301 - Universal ID Type ......................................................................................... 101
4.7.8
HL7 Table 0354 – Message Structurefrom 2.5.1 (constrained) ................................................ 102
4.7.9
HL7 Table 0834 – MIME Type ................................................................................................... 102
4.7.10
HL7 Table new – ??? from 2.7.1 ............................................................................................. 103
MESSAGE PROFILES ............................................................................................................................................. 104
5.1
Profile GU – Global Unique Identifiers ......................................................................................... 104
5.2
Profile NG – Non-Globally Unique Identifiers............................................................................... 106
5.3
Profile RU – Unique Placer/Filler Order Number ......................................................................... 108
5.4
Profile RN – Non-Unique Order Numbers .................................................................................... 108
6.
EXAMPLE LABORATORY RESULT MESSAGES ........................................................................................................... 110
7.
ADDITIONAL IMPLEMENATION GUIDANCE ................................................................................................................. 111
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page vii
September 2011
Table of Contents
7.1
HL7 Reporting of Culture and Susceptibilities ............................................................................. 111
7.1.1
Introduction ............................................................................................................................... 111
7.1.2
Template for Culture Results ..................................................................................................... 111
7.1.3
Examples of Culture Results ..................................................................................................... 112
7.1.4
Template for Culture and Susceptibility Results........................................................................ 115
7.2
Examples of Culture and Susceptibility Results ........................................................................... 117
7.3
Linking Parent and Child Results ................................................................................................. 122
7.4
Clinical Laboratory Improvements Amendment Considerations, US Realm Only ....................... 122
7.4.1
Mandatory Reporting Requirements ......................................................................................... 122
7.5
Regulatory Compliance ................................................................................................................ 124
7.6
Authorized Parties ........................................................................................................................ 124
Page viii
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
INDEX OF TABLES
Table 1-1. Information Interchange Requirements ....................................................................................... 5
Table 1-2. System Requirements ................................................................................................................. 5
Table 1-3. Message Element Attributes ...................................................................................................... 10
Table 1-4. Sending Application Conformance ............................................................................................ 13
Table 1-5. Receiving Application Conformance .......................................................................................... 15
Table 2-1. Coded Element (CE) .................................................................................................................. 16
Table 2-2. Coded with Exceptions − All Fields Except OBX-5 (CWE)........................................................ 17
Table 2-3. Coded with Exceptions – For OBX-5 Only (CWE)..................................................................... 20
Table 2-4. Extended Composite ID with Check Digit (CX GU) ................................................................... 22
Table 2-5. Extended Composite ID with Check Digit (CX NG) ................................................................... 23
Table 2-6. Date/Time Range (DR) .............................................................................................................. 24
Table 2-7. Date (DT) ................................................................................................................................... 24
Table 2-8. Date/Time (DTM) ....................................................................................................................... 25
Table 2-9. Encapsulated Data (ED) ............................................................................................................ 25
Table 2-10. Entity Identifier (EI GU) ............................................................................................................ 26
Table 2-11. Entity Identifier (EI NG) ............................................................................................................ 26
Table 2-12. Entity Identifier Pair (EIP GU) .................................................................................................. 27
Table 2-13. Entity Identifier Pair (EIP NG) .................................................................................................. 28
Table 2-14. Error Location (ERL) ................................................................................................................ 28
Table 2-15. Formatted Text Data (FT) ........................................................................................................ 29
Table 2-16. Hierarchic Designator (HD GU) ............................................................................................... 29
Table 2-17. Hierarchic Designator (HD NG) ............................................................................................... 30
Table 2-18. Coded Value for HL7-Defined Tables (ID) ............................................................................... 31
Table 2-19. Coded Value for User-Defined Tables (IS) .............................................................................. 31
Table 2-20. Message Type (MSG) .............................................................................................................. 31
Table 2-21. Numeric (NM)........................................................................................................................... 31
Table 2-22. Parent Result LInk (PRL) ......................................................................................................... 32
Table 2-23. Processing Type (PT) .............................................................................................................. 32
Table 2-23. Reference Pointer (RP) ........................................................................................................... 33
Table 2-25.SEQuence ID (SI) ..................................................................................................................... 34
Table 2-26. Structured Numeric (SN) ......................................................................................................... 34
Table 2-27. String Data (ST) ....................................................................................................................... 36
Table 2-28. Time (TM) ................................................................................................................................ 36
Table 2-29. Time Stamp (TS)...................................................................................................................... 36
Table 2-30. Text Data (TX) ......................................................................................................................... 37
Table 2-31. Version Identifier (VID) ............................................................................................................ 37
Table 2-32. Extended Address (XAD) ......................................................................................................... 37
Table 2-33. Extended Composite ID Number and Name for Persons (XCN GU) ...................................... 39
Table 2-34. Extended Composite ID Number and Name for Persons (XCN NG) ...................................... 41
Table 2-35. Extended Composite Name and Identification Number for Organizations (XON GU) ............ 42
Table 2-36. Extended Composite Name and Identification Number for Organizations (XON NG) ............ 43
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page ix
September 2011
Index of Tables
Table 2-37. Extended Person Name (XPN) ................................................................................................ 44
Table 3-1. ORU^R01^ORU_R01 Abstract Message Syntax ...................................................................... 46
Table 3-2. ACK^R01^ACK Abstract Message Syntax ................................................................................ 49
Table 3-3. Message Header Segment (MSH) ............................................................................................. 50
Table 3-4. Acknowledgment Segment (MSA) ............................................................................................. 55
Table 3-5. Error Segment (ERR) ................................................................................................................ 55
Table 3-6. Patient Identification Segment (PID) ......................................................................................... 56
Table 3-7. Patient Visit Information (PV1) ................................................................................................... 60
Table 3-8. Common Order Segment (ORC) ............................................................................................... 62
Table 3-9. Observation Request Segment (OBR) ...................................................................................... 65
Table 3-10. TimING/QuaNTity Segment for Order Group .......................................................................... 72
Table 3-11. Observation Result Segment (OBX) ........................................................................................ 73
Table 3-12. Observation Identifiers ............................................................................................................. 79
Table 3-13. Specimen Segment (SPM) ...................................................................................................... 81
Table 3-14. Notes and Comments Segment (NTE) .................................................................................... 83
Table 4-1. Value Set/Code System Summary ............................................................................................ 86
Table 4-2. HL7 Table 0065 Specimen Action Code - constrained ............................................................. 92
Table 4-3. HL7 Table 0078 from 2.7.1 ........................................................................................................ 92
Table 4-4. HL7 Table 0125 – Value Type ................................................................................................... 94
Table 4-5. HL7 Table 0291 – Subtype Of Referenced Data ..................................................................... 101
Table 4-6. HL7 Table 0301 - Universal ID Type ....................................................................................... 101
Table 4-7. HL7 Table 0834 – MIME Type ................................................................................................. 102
Table 7-1. Mandatory Reporting Requirements ........................................................................................ 122
Page x
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
INDEX OF FIGURES
Figure 1-1. Use Case Diagram ..................................................................................................................... 3
Figure 1-2. Context Diagram ......................................................................................................................... 3
Figure 1-3. Sequence Diagram ..................................................................................................................... 6
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page xi
September 2011
1. INTRODUCTION
The HL7 Version 2.5.1 Implementation Guide: Laboratory Results Interface for US Realm,
Release 1 (US Realm) is the result of collaborative efforts between HL7 and the Health and
Human Services Standards and Interoperability Framework Laboratory Results Interface
Initiative. By consensus the HL7 V2.5.1 ORU^R01 Message was selected as the basis to define
the profile constraints expressed in this guide to meet the requirements of the transmission of
laboratory reports, initially focused on the Results for Ambulatory Providers Use Case.
1.1 PURPOSE
The Laboratory Results Interface Initiative focuses on identifying the requirements,
specifications and standards, and on providing the implementation guidance for electronic
reporting of laboratory test results to ambulatory care providers in the US Realm. The scope of
this Use Case includes requirements to enable the incorporation of clinical laboratory test results
into an Electronic Health Record (EHR) as standardized structured data using the defined interorganizational laboratory transaction. The Use Case requirements are directed at laboratory test
results reporting between a laboratory information system and an ambulatory EHR system in
different organizational entities, e.g., different corporate structure, ownership or governance.
Future versions of this Guide may harmonize with existing guides to extend interoperability of
laboratory results across care settings, e.g., acute care and public health.
1.2 AUDIENCE
This guide is designed for use by analysts and developers who require guidance on data elements
and components of the HL7 Version 2.5.1 ORU Unsolicited Observation Message relative to the
Lab Results Interface (LRI) initiative. Users of this guide must be familiar with the details of
HL7 message construction and processing. This guide is not intended to be a tutorial on that
subject.
1.2.1 Requisite Knowledge

HL7 V2.5.1, V2.7, V2.7.1 Messaging (www.HL7.org)

SNOMED (www. http://www.ihtsdo.org/snomed-ct)

LOINC (http://loinc.org)

UCUM (http://unitsofmeasure.org)

OIDS (http://www.hl7.org/oid)
1.3 SCOPE
The scope is the sending of lab results from a laboratory to an ambulatory provider. The
implementation design is as a series of constraining profiles on a base specification, itself a
constraint on the HL7 V2.5.1 Message standard, for future use case expansion.
In Scope

Defining the core data elements required for ambulatory care clinical laboratory test
results.

Reporting of clinical laboratory test results for ambulatory care in the US Realm.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 1 of 151
September 2011

Sending clinical laboratory test results as standardized structured data so they can be
incorporated that way into an EHR.

Supporting Stage 2 certification criteria and Meaningful Use (MU) requirements by
developing requirements for an interface that enables the incorporation of clinical
laboratory test results into EHRs when data is sent as standardized structured data

Reporting test results for an order that was placed either manually or electronically.

Some order specific data has been included to enable the receiving EHR to correlate the
results back to the originating order.

Covering all CLIA reporting requirements, including but not limited to: result report
statuses: preliminary, final, appended, corrected and/or amended.
 Receiving of laboratory results as a non-order placer.
Out of Scope

Specifications and implementation guidance on laboratory ordering transactions.
However, the establishment of requirements in the laboratory result message that will
allow the matching of the reported result to an existing order initiated from the ordering
clinician’s EHR is within the scope of this effort.

Querying for laboratory results.

Querying for historical laboratory results.

Receiving historical laboratory results.

Secondary use of laboratory data (i.e., public health or bio surveillance uses of the
reported laboratory results).

In hospital ordering and reporting of laboratory results.

Advanced error messages related to application transport.

Results not transmitted using a standardized structured format.
1.4 RESULTS FOR AMBULATORY CARE USE CASE AND CONTEXT DIAGRAMS
. The Laboratory provides results based on a request for laboratory services from an authorized
Provider. In this example, it is assumed that the receiving system is an EHR that can receive lab
results even if it is not aware of the request, as there is no assumption that the receiving EHR
provided the request for lab services. It does assume that the EHR can receive lab results even if
it is not aware of the request.
Page 2 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
uc Primary Use Case
Lab Results Exchange Solution
l
Resu
Send
Report Unsolicited
Laboratory Results
ts
R
Ackn eceive an
owle
d
dge R
esult
s
Laboratory
System
EHR System
Figure 1-1. Use Case Diagram
Laboratory
System
EHR
System
Lab Receives Order and Specimen
Send Preliminary Results
Send Final Results
Receives Correction(s) to
Patient Demographic Information
Lab Results
Interface
Provider Sends Order
Receive Preliminary Results
Receive Final Results
Provide Correction(s) to
Patient Demographic Information
Send Corrected, Amended or Appended Results Receive Corrected, Amended or Appended Results
Legend: This diagram reads in the direction of the arrow heads
from to bottom. The grey dashed arrows with italicized font
represent actions that are out of scope.
Figure 1-2. Context Diagram
1.4.1 User Story
A Provider (order placer) may enter a laboratory order into an ambulatory EHR. A laboratory
requisition is generated (paper or electronic) and is communicated to the laboratory. The
information in the laboratory requisition is entered manually or captured electronically into the
Laboratory Information System (LIS). After the specimen(s) has been collected and, if necessary,
shipped or delivered to the laboratory, the laboratory processes the specimen(s). The laboratory
performs or attempts to perform the test(s). If testing is successful, results are obtained and
entered/released in the laboratory information system. An authorized person at the laboratory
reviews and approves the laboratory test results to be sent to the ordering provider.
The laboratory's LIS (results sender) transmits the results to the provider’s EHR (results
receiver). The EHR incorporates the results into the patient’s electronic record. The provider logs
into his/her EHR and views the laboratory results in order to inform patient care decisions.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 3-151
September 2011
1.4.2 Use Case Assumptions

Providers securely access clinical information through an EHR system.

Appropriate security and transport protocols; patient identification methodology;
requisition (order) identification methodology; consent; privacy and security procedures;
coding, vocabulary and normalization standards have been agreed to by all relevant
participants.

This Use Case only addresses the exchange of laboratory results that are associated with
the In Scope laboratory tests.

All relevant parties have agreed on a structured laboratory test results message format.

This Use Case covers all CLIA reporting requirements, including but not limited to: result
reports statuses; preliminary, final, appended, corrected and/or amended.

For the specimen collection process the data included in the dataset considerations table
are assumed to be available and reported in the result.

Legal and governance issues regarding data access authorizations, data ownership, and
data use are in effect.


Established network and policy infrastructure to enable consistent, appropriate,
and accurate information exchange across provider systems, data repositories and
locator services. This includes, but is not limited to:

Methods to identify and authenticate users;

Methods to identify and determine Providers of care;

Methods to enforce data access authorization policies;

Methods to ensure the veracity of data;
Detailed audit trails are kept as necessary by all participating systems.

Security and privacy policies, procedures and practices are commonly implemented to
support acceptable levels of patient privacy and security; i.e. HIPAA, HITECH and EHR
certification criteria.

A LIS will be the sender of laboratory test results while an EHR will be the receiver.

The transport mechanism will provide guaranteed delivery and error handling

This Use Case acknowledges the variations in requirements for reporting across local,
state, tribal, and territorial boundaries as well as voluntary versus mandatory
requirements.

Laboratories meet accreditation criteria according to jurisdiction requirements or agency
criteria.
1.4.3 Pre-Conditions

An order has been generated by an Ordering Provider for one or more laboratory tests
results to be produced.

The Laboratory receives an order (electronic, paper, etc.) or the Laboratory receives a
request to re-run (repeat) a test, or determines a need to re-run a test for possible
correction, or determines that reflex testing (which is based on criteria set by the medical
Page 4 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
review board) is required or determines the need to amend a test result based on
erroneous information.

The Laboratory receives the appropriate clinical information to perform the ordered test.

Laboratory has entered manually or through the interface pertinent (or corrected) data
from an order into the Laboratory Information System.

Laboratory has received and processed properly identified specimen(s) related to the
ordered test(s).

Laboratory entered or received from the ordering EHR environment, pertinent data
from/about the specimen into the Laboratory Information System.

Laboratory performed the ordered tests on received specimens and/or incorporated
calculated and reference data to produce the results referenced.

The laboratory result message contains both the appropriate patient information and the
originating order information to associate the laboratory results to the correct patient and
original order.

Laboratory information system is capable of and ready to send laboratory results
electronically and in standardized structured format.

EHR system is in place and capable of receiving laboratory results electronically and in
standardized structured format.

The laboratory result is verified and ready for release.
1.4.4 Post Condition

Laboratory results are accurately reported and successfully transmitted electronically
from the laboratory LIS system to the Ordering Provider's EHR System, module or other
results receiver (as determined by the laws in each locale).

The provider’s EHR system has electronically received the laboratory results,
incorporated in a standardized structured format, and if available, associated with a
patient and laboratory order.
1.4.5 Functional Requirements
TABLE 1-1. INFORMATION INTERCHANGE REQUIREMENTS
Information
Information Initiating
Interchange
Receiving System
System
Requirement
Name
Laboratory Information System Sends
Laboratory Test Result Receives Electronic Health Record System
System
TABLE 1-2. SYSTEM REQUIREMENTS
System Requirement
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 5-151
September 2011
Laboratory Information System
Form a laboratory message with standardized structured data1 meeting CLIA
and other federal and state regulatory requirements
Electronic Health Record System
Incorporate test data from the laboratory message as standardized structured
data.
1.4.6 Sequence Diagram
sd Interactions with LIS
Provider’s EHR: Lab
Results Receiver
LIS: Lab Results Sender
1.0 ReportResult (ORU_R01, ACK)
1.1 return(ACK, AA)
1.2 ReportResult(ORU_R01, ACK)
1.3 return(ACK, AR)
1.4 retry
1.5 ReportResult(ORU_R01, ACK)
1.6 return(ACK, AA)
1.7 next
Authoritative
Source of Lab
Results
1.8 ReportResult(ORU_R01, ACK)
1.10 log(ERR)
1.9 return(ACK, AE, ERR)
Figure 1-3. Sequence Diagram
1.5 KEY TECHNICAL DECISIONS
One of the primary features of this implementation guide is its focus on key points of broad
interoperability. The HL7 implementation guides in Section 1.5.4-Referenced Profiles informed
the content of this specification as analysis indicated that none of the candidate guides could
satisfy the use case requirements without some adjustment. This guide is the result of combining
the best practices from the current body of work while making further adjustment to meet the
needs of ambulatory reporting and preparing for increased consistency of lab result reporting
across care settings.
1
See the S&I LRI Use Case, Section 2.3 Structured Data Definition
Page 6 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
1.5.1 Use of ISO Object Identifier (OID)
This guide defines multiple profiles, one of which employs the use of an ISO Object Identifier
(ISO/IEC 8824:1990(E)) (OID) for universally unique identifiers. The ISO OID specification is
the globally accepted technology for this purpose and is recommended as the means to satisfy the
requirement for a universally unique identifier. HL7 has developed an implementation guide for
the use of OIDs, “HL7 Implementation Guidance for Unique Object Identifiers (OIDs), Release
12”, which provides guidance on how organizations can use and manage OIDs.
OIDs provide a strong identifier that uniquely identifies the object in question and is global in
scope. Examples of information that OIDs can identify are items about patients, orders, providers
and organizations. This means the identifier includes enough information to remain unique when
taken out of the context within which the identifier was created.
1.5.2 Use of Vocabulary Standards
This guide calls for specific vocabulary standards for the exchange of laboratory information
such as LOINC and SNOMED. Standard vocabularies, particularly coded laboratory results,
enable automated decision support for patient healthcare, as well as for public health surveillance
of populations.
1.5.3 Field Length and Truncation
This guide pre-adopts field length definition conventions and the stated lengths from HL7
Version 2.7.1, Chapter 2 Control; it also provides further constraints to support the use case and
scope defined in this guide.
The Conformance Length parameter (Version 2.7.1, Chapter 2 Control, Section 2.5.5.3,
Conformance Length) has also been adopted in this guide and is defined in this excerpt from the
base standard:
--------- start citation --------If populated, the conformance length column specifies the minimum length that applications
must be able to store. Conformant applications SHALL not truncate a value that is shorter than
the length specified. The conformance length is also the minimum value that maybe assigned to
maximum length in an implementation profile.
In addition, the conformance length may be followed by a “=” or a “#”. The “=” denotes the
value may never be truncated, and the “#” denotes that the truncation behavior defined for the
data type applies.
--------- end citation --------Note that truncation is not allowed in this guide except for the FT primitive datatype, where the
base standard defines truncation behavior.
2
The current version of the HL7 Implementation Guidance for Unique Object Identifiers (OIDs), Release 1 is available from HL7 (www.hl7.org).
Members may obtain a copy without charge in the Members-only area of the site, others may purchase a copy for a nominal fee via the HL7 Store
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 7-151
September 2011
1.5.4 Referenced Profiles
This specification documents a message profile for Laboratory Reporting Results Interface (LRI)
profile for Senders and Recievers based on the HL7 version 2.5.1 3. Other laboratory results
profiles were referenced and used as source materials in the development of this guide,
including:

HL7 Ambulatory Care Laboratory Result Implementation Guide: EHR-Laboratory
Interoperability And Connectivity Specification (ELINCS) - Release 1, July 1, 2008

HL7 Version 2.5.1 Implementation Guide: Orders And Observations; Interoperable
Laboratory Result Reporting To EHR (US Realm), Release 1, November, 2007

HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public
Health, Release 1 (US Realm)
This document should not be considered the source of truth for any statement or assertion in
regards to the referenced profiles. They are provided here as antecedent documentation and are
not required for successful implmentation of this Guide.
1.5.5 Interfaces
Two interfaces are described in this document:
3

Lab Result Sender – A sender of laboratory result messages conforming to the profile will
satisfy the requirements of this profile, and may meet the requirements of future profiles.

Lab Result Receiver – A message profile for receivers of electronic laboratory result
messages.
The referenced documents are all available from HL7 (www.hl7.org) – Members may obtain a copy without charge in the Members-only area
of the site, others may purchase a copy for a nominal fee via the HL7 Store.
Page 8 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
1.5.6 Conformance to this Guide
Conformance to this guide is through the use of a combination of OIDs in MSH-21 as noted
below:
Common Profile Component– ID: 2.16.840.1.113883.9.16
Indicates that the message adheres to the rules set out in this guide. When this profile is
present in MSH.21, it shall be accompanied by one of Profile GU or Profile NG and one of
Profile RU or Profile RN. Additionally, other profiles may be present that further constrain
the message as agreed to by two or more exchange parties. However, those profiles are
strictly voluntary and shall not conflict with any of the three profiles already listed, nor shall
any additional profile be marked by any exchange party as minimally required to
successfully send or receive Lab Results when Profile LRI is present in MSH.21.
GU Profile Component – ID: 2.16.840.1.113883.9.12
Indicates Globally Unique Identifiers are supported via required use of an ISO OID as noted
in this guide.
NG Profile Component – ID: 2.16.840.1.113883.9.13
Indicates Non-Global Identifiers (Profile NG) were constructed using an alternate method for
providing identifiers noted in this guide; these identifiers are not guaranteed to be globally
unique.
Note: the base profile is constrained to the use of an OID as supplied by this IG for MSH-21,
all other identifiers are not required to be universally unique.
RU Profile Component – ID: 2.16.840.1.113883.9.14
Indicates that the test can be identified by only using either the placer order number, and/or
filler order number.
RN Profile Component – ID: 2.16.840.1.113883.9.15
Indicates that the test can be identified by using the universal service identifier and either the
placer order number or the filler order number.
The Profiles GU and NG are mutually exclusive, as are RU and RN; allowable combinations:




Base + GU + RU
Base + GU + RN
Base + NG + RU
Base + NG + RN
1.6 ORGANIZATION OF THIS GUIDE
1.6.1 Conventions
This guide adheres to the following conventions:

The guide is constructed assuming the implementer has access to the 2.5.1 version of the
HL7 Standard. Although some information from the standard is included in this
implementation guide, much information from the standard has not been repeated here.

The rules outlined in HL7 2.7.1, Chapter 2B, Section 2B5, Conformance Using Message
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 9-151
September 2011
Profiles, were used to document the use case for, and constraints applied to, the messages
described in this guide.

Data types have been described separately from the fields that use the data types.

No conformance information is provided for optional message elements. This includes
length, usage, cardinality, value sets and descriptive information. Implementers who want to
use optional message elements should refer to the HL7 Standard to determine how these
optional message elements will be used. Any information provided in this guide for optional
elements is to be considered suggested best practices; this is particularly true of vocabulary
and value sets associated with optional components.

This guide uses “X” as a conformance usage indicator very sparingly. Where the underlying
standard indicates the segments/field/component is present for backwards compatibility
(“B”) or withdrawn ("W") an “X” will be used. For all other fields/components “O” is used
to enable trading partners to explore additional capabilities. Note that without a clearly
agreed to complementary profile between trading partners, a Lab does not have to send any
elements marked as an "O", nor does a receiver of a lab result have to process any elements
marked as an "O". Neither trading partners can mandate the other to accept any such
complementary profiles to enable basic laboratory results interfacing "out-of-the-box".
1.6.2 Message Element Attributes
The following table describes the various attributes used by this guide to document data type
attribute tables, message structure attribute tables and segment attribute tables. Not all attributes
apply to all attribute tables.
TABLE 1-3. MESSAGE ELEMENT ATTRIBUTES
Attribute
Definition
Seq
Sequence of the elements as numbered in the HL7 message element. The SEQ attribute
applies to the data type attribute table and the segment attribute table.
Segment
Three-character code for the segment and the abstract syntax (e.g., the square and curly
braces).
[ XXX ]
Optional
{ XXX } Repeating
XXX Required
[{ XXX }] Optional and Repeating
Note that for segment groups there is no segment code present, but the square and curly
braces will still be present.
The Segment attribute only applies to the Message attribute table.
Page 10 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Attribute
TABLE 1-3. MESSAGE ELEMENT ATTRIBUTES
Definition
Length – (V2.7.1)
For each component in the data type table and field in a segment there is a normative length
column (LEN) and conformance length (C.LEN). This guide follows the length definitions and
conventions from V2.7.1.
LEN – If populated, defines the minimum and maximum length that must be supported. The
minimum or the maximum may be blank, e.g., “..20” or “2..”. indicating there is no minimum or
maximum.
C.LEN – If populated, the conformance length column specifies the minimum length that
applications must be able to store.
Note the following behaviors for the C.LEN:
= - Truncation is not permitted
# - Truncation behavior defined for the data type applies
DT
Data type used by this profile for HL7 element.
The data type attribute applies to data type attribute tables and segment attribute tables.
Usage
Usage of the message element for this profile. Indicates whether the message element
(segment, segment group, field, component, or subcomponent) is R, RE, O, X or C(a/b) in the
corresponding message element. Usage applies to the message attribute table, data type
attribute table and the segment attribute table; see Section XXXX
Cardinality
Value Set
Minimum and maximum number of times the element may appear.
[0..0] Element never present.
[0..1] Element may be omitted and can have, at most, one occurrence.
[1..1] Element must have exactly one occurrence.
[0..n] Element may be omitted or may repeat up to n times.
[1..n] Element must appear at least once, and may repeat up to n times.
[0..*]Element may be omitted or repeat an unlimited number of times.
[1..*] Element must appear at least once, and may repeat unlimited number of times.
[m..n] Element must appear at least m, and at most, n times.
Cardinality applies only to message attribute tables and segment attribute tables.
The set of coded values to be used with the field. The value set attribute applies only to the
data type attribute tables and the segment attribute tables. The value set may equate with an
entire code system part of a code system, or codes drawn from multiple code systems.
Note: Where a table constraint is indicated, or where HL7 Version 2.7.1
standards are pre-adopted, the constrained or specified HL7 table is included
below the data type table.
Name
HL7 descriptor of the message element. Name applies to the message attribute table, data
type attribute table and the segment attribute table.
Description/Comments
Context and usage for the element. Description/Comments applies to the message attribute
table, data type attribute table and the segment attribute table.
1.6.3 Keywords
The following keywords in this document are to be interpreted as follows:
MUST or the terms "REQUIRED" or "SHALL", mean that the definition is an absolute
requirement of the specification.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 11-151
September 2011
MUST NOT or the phrase "SHALL NOT", mean that the definition is an absolute
prohibition of the specification.
SHOULD or the adjective "RECOMMENDED", mean that there may exist valid reasons in
particular circumstances to ignore a particular item, but the full implications must be
understood and carefully weighed before choosing a different course.
SHOULD NOT or the phrase "NOT RECOMMENDED" mean that there may exist valid
reasons in particular circumstances when the particular behavior is acceptable or even useful,
but the full implications should be understood and the case carefully weighed before
implementing any behavior described with this label.
MAY or the adjective "OPTIONAL", mean that an item is truly optional. One software
supplier may choose to include the item to enable certain capabilities while another software
supplier may omit the same item. In either case, the communication partner cannot be
expected to either provide it (sender) or process it (receiver) without clear and voluntary
agreement between the partners.
An implementation which does not include a particular segment/field/component marked as
optional MUST be prepared to interoperate with another implementation which does include the
optional segment/field/component, though perhaps with reduced functionality. In the same vein
an implementation which includes a particular segment/field/component marked as optional
MUST be prepared to interoperate with another implementation which does not include the
optional segment/field/component.
1.6.4 Usage Conformance Testing Recommendations
The following text is pre-adopted from the HL7 V2.7.1 Conformance (Chapter 2B) Draft Version
(Aug 31, 2011) as revised by the S&I Framework Lab Implementation Guide Recommendations
(Sept 2, 2011). Please refer to the base standard documentation for a full explanation of
conformance concepts. Usage is described here as it introduces the revised approach to
conditional element handling; upon successful ballot and publication this material will be
replaced with a reference to the normative documentation.
---------- start citation--------1.6.4.1 Usage
Message content is governed by the cardinality specification associated (explicitly or
implicitly) with each element of an HL7 message. Message content is governed by the
cardinality specification associated (explicitly or implicitly) with each element of an HL7
message. Usage rules govern the expected behavior of the sending application and
place limited restrictions on the receiving application with respect to the element.
These usage codes expand/clarify the optionality codes defined in the HL7 standard. The
usage codes expand/clarify the optionality codes defined in the HL7 standard. Usage
codes are employed in a message profile to constrain the use of elements defined in the
standard. The usage code definitions are given from a sender and receiver perspective and
specify operational and implementation requirements.
The standard allows broad flexibility for the message structures that HL7 applications
must be able to receive without failing. But while the standard allows that messages may
be missing data elements or may contain extra data elements, it should not be inferred
from this requirement that such messages are conformant. In fact, the usage codes
Page 12 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
specified in a message profile place strict conformance requirements on the behavior of
the application.
1.6.4.1.1
Definition of Conditional Usage
The conditional usage is defined as follows:
C(a/b) - “a” and “b” in the expression are placeholders for usage codes representing the
true (“a”) predicate outcome and the false (“b”) predicate outcome of the condition. The
condition is expressed by a conditional predicate associated with the element (“See
section 2.B.7.9, Condition Predicate" in V2.7.1 Chapter 2B). “a” and “b” shall be one of
“R”, “RE”, “O” and/or “X”. In order not to render the condition statement redundant, “a”
and “b” shall be different.
The example C(R/RE) is interpreted as follows. If the condition predicate associated with
the element is true then the usage for the element is R-Required. If the condition
predicate associated with the element is false then the usage for the element is RERequired but may be empty.
1.6.4.1.2
Sending and Receiving Application Conformance Requirements
TABLE 1-4. SENDING APPLICATION CONFORMANCE
Symbol Definition
Implementation
Operational Requirement
Requirement
R
Required
The application SHALL
The application SHALL populate “R” elements with a
implement “R” elements.
non-empty value.
4
RE
Required, but
may be empty
The application SHALL
implement “RE” elements.
C(a/b)
Conditional
An element with a conditional usage code has an associated condition predicate (See
section 2.B.7.9, Condition Predicate in V2.7.1 Chapter 2B") that determines the
operational requirements (usage code) of the element.
If the condition predicate associated with the element is true, follow the rules for a which
shall be one of “R”, “RE”, “O” or X”:
If the condition predicate associated with the element is false, follow the rules for b
which shall be one of “R”, “RE”, “O” or X”.
a and b SHALL be different and defined by the message profile.
X
Not supported in The application SHALL NOT
this guide
implement “X” elements.
The application SHALL populate “RE” elements with a
non-empty value if there is relevant data. The term
“relevant” has a confounding interpretation in this
definition4.
The application SHALL NOT populate “X” elements.
There are multiple interpretations of “RE” when a value is known. One is “the capability must always be supported and a value is sent if
known”, the other is “the capability must always be supported and a value may or may not be sent even when known based on a condition
external to the profile specification. The condition may be noted in the profile but cannot be processed automatically”. This is what can be
interpreted from the “relevant” part of the definition. Regardless of the interpretation the “RE” usage code, a set of test circumstances can
be developed to sufficiently test the “RE” element. See the “Conformity Assessment of Conformance Constructs” section for more details.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 13-151
September 2011
TABLE 1-4. SENDING APPLICATION CONFORMANCE
Symbol Definition
Implementation
Operational Requirement
Requirement
O
Optional
None. The usage indicator for Not Applicable.
this element has not yet been
defined. For an implementation
profile all optional elements
must be profiled to R, RE,
C(a/b), or X.
Page 14 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 1-5. RECEIVING APPLICATION CONFORMANCE
Symbol Definition
Implementation
Operational Requirement
Requirement
R
Required
The application SHALL
implement “R” elements.
The receiving application SHALL process
(save/print/archive/etc.) the information
conveyed by a required element.
A receiving application SHALL raise an exception due
to the absence of a required element. A receiving
application SHALL NOT raise an error due to the
presence of a required element,
RE
Required, but
may be empty
The application SHALL
implement “RE” elements.
C(a/b)
Conditional
The usage code has an associated condition predicate true (See section 2.B.7.9,
Condition Predicate in V2.7.1 Chapter 2B").
If the condition predicate associated with the element is true, follow the rules for a which
may be one of “R”, “RE”, “O” or X”:
If the condition predicate associated with the element is false, follow the rules for b
which may be one of “R”, “RE”, “O” or X”.
a and b SHALL be different and defined by the message profile.
X
Not supported in The application SHALL NOT
this guide
implement “X” elements.
O
Optional
The receiving application SHALL process
(save/print/archive/etc.) the information conveyed by a
required but may be empty element. The receiving
application SHALL process the message if the
element is omitted (that is, an exception SHALL NOT
be raised because the element is missing).
None, if the element is not sent.
If the element is sent the receiving application may
process the message, SHALL ignore the element, and
MAY raise an exception. The receiving application
SHALL NOT process (save/print/archive/etc.) the
information conveyed by a not-supported element.
None. The usage indicator for None.
this element has not yet been
defined. For an implementation
profile all optional elements
must be profiled to R, RE,
C(a/b) or X.
--------- end citation ---------
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 15-151
September 2011
2. DATA TYPES
2.1 CE – CODED ELEMENT
Table 2-1. Coded Element (CE)
SEQ
Component Name
DT
Usage LEN
C.LEN
1
Identifier
ST
RE
=
2
Text
ST
C(R/RE) 1..199
=
3
Name of Coding System
ID
C(R/X)
1..12
=
4
Alternate Identifier
ST
RE
1..20
=
The alternate identifier (from the alternate coding
system) should be the closest match for the identifier
found in component 1.
5
Alternate Text
ST
RE
1..199
=
It is strongly recommended that alternate text be sent
to accompany any alternate identifier.
6
Name of Alternate Coding
System
ID
C(R/X)
1..12
=
1..20
Value Set
Comments
Condition Predicate: If CE.1 (Identifier) is not valued
It is strongly recommended that text be sent to
accompany any identifier. When a coded value is not
known, text can still be sent, in which case no coding
system should be identified.
HL70396
HL70396
Condition Predicate: If CE.1 (Identifier) is valued
Condition Predicate: If CE.4 (Alternate Identifier) is
valued
Usage Note
Senders should always populate the first triplet before populating other triplets; the receiver needs to examine all
triplets to find relevant values.
Conformance Statements: Base Profile
LRI-CE-1: If data is available for only one Coded Element then the triplet of CE.1 (Identifier), CE.2 (Text), and CE.3
(Name of Coding System) SHALL be valued in accordance with the rules given for CE.1, CE.2, and CE.3.
Page 16 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Example
Release Note: Examples will be provided for each datatype defined in this section that are conformant to the statements in
the final version of this Release (R1).
2.2 CWE-CRE – CODED WITH EXCEPTIONS – CODE REQUIRED, BUT MAY BE EMPTY
NOTE: Pre-adoption from V2.7.1 of Components 10-22
TABLE 2-2. CODED WITH EXCEPTIONS − CODE REQUIRED BUT MAY BE EMPTY (CWE-CRE)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
Comments
1
Identifier
ST
RE
1..20
=
2
Text
ST
C(RE/X)
1..199
=
3
Name of Coding System
ID
C(R/X)
1..12
=
4
Alternate Identifier
ST
C(RE/X)
1..20
=
Condition Predicate: If CWE_CRE.1 (Identifier) is valued
The alternate identifier (from the alternate coding system)
should be the closest match for the identifier found in
CWE_CRE.1.
5
Alternate Text
ST
C(RE/X)
1..199
=
Condition Predicate: If CWE_CRE.4 (Alternate Identifier) is
valued It is strongly recommended that alternate text be
sent to accompany any alternate identifier.
6
Name of Alternate Coding
System
ID
C(R/X)
1..12
=
7
Coding System Version ID
ST
O
1..10
=
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Condition Predicate: If CWE_CRE.1 (Identifier) is valued
It is strongly recommended that text be sent to accompany
any identifier. When a coded value is not known, the original
text attribute (CWE_CRE.9) is used to carry the text, not the
text component.
HL70396
HL70396
Condition Predicate: If CWE_CRE.1 (Identifier) is valued
See section 4 for description of the use of coding systems in
this implementation guide.
Condition Predicate: If CWE_CRE.4 (Alternate Identifier) is
valued
See section 4 for description of the use of coding systems in
this implementation guide.
Page 17 of 151
September 2011
TABLE 2-2. CODED WITH EXCEPTIONS − CODE REQUIRED BUT MAY BE EMPTY (CWE-CRE)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
Comments
8
Alternate Coding System
Version ID
ST
O
1..10
=
9
Original Text
ST
C(R/RE)
1..199
=
10
Second Alternate Identifier
ST
O
1..20
=
11
Second Alternate Text
ST
O
1..199
=
12
Second Name of Alternate
Coding System
ID
O
1..12
=
13
Second Alternate Coding
System Version ID
ST
O
1..10
=
14
Coding System OID
ST
O
1..199
=
15
Value Set OID
ST
O
1..199
=
16
Value Set Version ID
DTM
O
1..8
=
17
Alternate Coding System OID ST
O
1..199
=
18
Alternate Value Set OID
O
1..199
=
19
Alternate Value Set Version ID DTM
O
1..8
=
20
Second Alternate Coding
System OID
ST
O
1..199
=
21
Second Alternate Value Set
OID
ST
O
1..199
=
22
Second Alternate Value Set
Version ID
DTM
O
1..8
=
Page 18 of 151
September 2011
ST
Condition Predicate: If CWE_CRE.1 (Identifier) is not valued
Either original Text is used to convey the text that was the
basis for coding, or when there is no code to be sent, only
free text.
If neither the first or second triplet has values, this contains
the text of the field.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Usage Note
The CWE data type is used where it is necessary to communicate a code, text, coding system and the version of coding
system the code was drawn from. It also allows the communication of an alternate code drawn from another coding system.
Many coded fields in this specification identify coding systems or value sets that must be used for the field. When
populating the CWE data types with these values, this guide does not give preference to the triplet in which the
standard code should appear. The receiver is expected to examine the coding system names in components 3 and 6 to
determine if it recognizes the coding system.
The CWE data type allows communication CWE Statuses that indicate whether the value is known or not, not applicable,
or not available (HL7 Table 0353). The full set of allowable values and its use is in Chapter 2A, Section 2.A.13 under Data
Missing. This will be allowed for all uses of CWE, except in OBX.2 and SPM.4.
Conformance Statements: Base Profile
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 19 of 151
September 2011
2.3 CWE-CR– CODED WITH EXCEPTIONS – CODE REQUIRED
NOTE: Pre-adoption from V2.7.1 of Components 10-22
SEQ
TABLE 2-3. CODED WITH EXCEPTIONS – CODE REQUIRED – (CWE-CR)
Component Name
DT
Usage LEN
C.LEN Value Set
Comments
1
Identifier
ST
R
1..20
=
Note: The identifier component is always required.
2
Text
ST
RE
1..199
=
It is strongly recommended that text be sent to
accompany any identifier. When a coded value is not
known, the original text attribute is used to carry the
text, not the text component.
3
Name of Coding System
ID
R
1..12
=
4
Alternate Identifier
ST
RE
1..20
=
The alternate identifier (from the alternate coding
system) should be the closest match for the identifier
found in component 1.
5
Alternate Text
ST
RE
1..199
=
It is strongly recommended that alternate text be sent
to accompany any alternate identifier.
6
Name of Alternate Coding
System
ID
C(R/X)
1..12
=
7
Coding System Version ID
ST
O
1..10
=
8
Alternate Coding System
Version ID
ST
O
1..10
=
9
Original Text
ST
R
1..199
=
10
Second Alternate Identifier
ST
O
1..20
=
11
Second Alternate Text
ST
O
1..199
=
Page 20 of 151
September 2011
HL70396
HL70396
See Section 4 for description of the use of coding
systems in this implementation guide.
Condition Predicate: If CWE_CR.1 (Alternate
Identifier) is valued
See section 4 for description of the use of coding
systems in this implementation guide.
Original Text is used to convey the text that was the
basis for coding.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
SEQ
TABLE 2-3. CODED WITH EXCEPTIONS – CODE REQUIRED – (CWE-CR)
Component Name
DT
Usage LEN
C.LEN Value Set
Comments
12
Second Name of Alternate
Coding System
ID
O
1..12
=
13
Second Alternate Coding
System Version ID
ST
O
1..10
=
14
Coding System OID
ST
O
1..199
=
15
Value Set OID
ST
O
1..199
=
16
Value Set Version ID
DTM
O
1..8
=
17
Alternate Coding System OID
ST
O
1..199
=
18
Alternate Value Set OID
ST
O
1..199
=
19
Alternate Value Set Version ID
DTM
O
1..8
=
20
Second Alternate Coding
System OID
ST
O
1..199
=
21
Second Alternate Value Set OID ST
O
1..199
=
22
Second Alternate Value Set
Version ID
O
1..8
=
DTM
Usage Note
This version of the CWE is used only with OBX-5. The CWE data type is used where it is necessary to communicate a
code, text, coding system and the version of coding system the code was drawn from. It also allows the communication of
an alternate code drawn from another coding system. Many coded fields in this specification identify coding systems or
value sets that must be used for the field. When populating the CWE data types with these values, this guide does not
give preference to the triplet in which the standard code should appear. The receiver is expected to examine the coding
system names in components 3 and 6 to determine if it recognizes the coding system. CWE.9 is always expected to be sent
in this CWE to comply with CLIA regulation of matching result statements between reports of record at both sender and
receiver system.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 21 of 151
September 2011
The CWE data type allows communication of "null flavors", referred to as CWE Status(es), where the values are drawn
from HL7 Table 0353. The CWE Statuses are not supported in this guide.
Conformance Statements: Base Profile
2.4 CX-GU – EXTENDED COMPOSITE ID WITH CHECK DIGIT (GLOBALLY UNIQUE)
SEQ
TABLE 2-4. EXTENDED COMPOSITE ID WITH CHECK DIGIT (CX GU)
Component Name
DT
Usage LEN
C.LEN Value Set Comments
1
ID Number
ST
R
1..15
=
2
Check Digit
ST
O
1..4
=
3
Check Digit Scheme
ID
C(O/X)
3..3
=
Refer to base standard
4
Assigning Authority
HD-GU R
#
The Assigning Authority component is used to identify the
system, application, organization, etc. that assigned the ID
Number in component 1.
5
Identifier Type Code
ID
R
6
Assigning Facility
HD
O
#
7
Effective Date
DT
O
=
8
Expiration Date
DT
O
=
9
Assigning Jurisdiction
CWE
O
#
10
Assigning Agency or
Department
CWE
O
#
Page 22 of 151
September 2011
2..5
=
The ID Number component combined with the Assigning
Authority component must uniquely identify the associated
object, i.e., any object with which the field is associated. Note despite the component being named “ID Number” this
component is an ST string data type, not numeric, so the
component is not limited to just numbers.
HL70203
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Usage Note
The CX data type is used to carry identifiers. The GU profile requires that all identifiers be accompanied by assigning
authorities, and that all identifiers carry an identifier type. This method allows the exchange of universally unique
identifiers for the associated object across organizational and enterprise boundaries, enabling broad interoperability.
Although the Identifier Type Code component is required, it is not a part of the actual identifier. Rather, it is metadata about
the identifier. The ID Number and Assigning Authority component, together, constitute the actual identifier. The reason for
this requirement is to promote forward compatibility with HL7 Version 3 identifiers, where there is no concept of identifier
type codes.
Conformance Statement: LRI-GU Profile
2.5 CX-NG – EXTENDED COMPOSITE ID WITH CHECK DIGIT (NON-GLOBALLY UNIQUE)
TABLE 2-5. EXTENDED COMPOSITE ID WITH CHECK DIGIT (CX NG)
SEQ Component Name
DT
Usage LEN C.LEN Value Set Comments
1
ID Number
ST
R
1..15
=
2
Check Digit
ST
O
1..4
=
3
Check Digit Scheme
ID
C(O/X)
3..3
=
Condition Predicate:
4
Assigning Authority
HD-NG RE
#
The Assigning Authority component is used to identify the system,
application, organization, etc. that assigned the ID Number in
component 1.
5
Identifier Type Code
ID
R
6
Assigning Facility
HD
O
#
7
Effective Date
DT
O
=
8
Expiration Date
DT
O
=
2..5
=
The ID Number component combined with the Assigning Authority
component must uniquely identify the associated object, i.e., any
object with which the field is associated. Note - despite the
component being named “ID Number” this component is an ST
string data type, not numeric, so the component is not limited to
just numbers.
HL70203
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 23 of 151
September 2011
TABLE 2-5. EXTENDED COMPOSITE ID WITH CHECK DIGIT (CX NG)
SEQ Component Name
DT
Usage LEN C.LEN Value Set Comments
9
Assigning Jurisdiction
CWE
O
#
10
Assigning Agency or
Department
CWE
O
#
Usage Note
The CX data type is used to carry identifiers. This guide requires that assigning authorities accompany all identifiers, and
that all identifiers carry an identifier type. This method allows the exchange of unique identifiers for the associated object
across organizational and enterprise boundaries, enabling broad interoperability.
Although the Identifier Type Code component is required, it is not a part of the actual identifier. Rather, it is metadata about
the identifier. The ID Number and Assigning Authority component, together, constitute the actual identifier. The reason for
this requirement is to promote forward compatibility with HL7 Version 3 identifiers, where there is no concept of identifier
type codes.
Conformance Statement: LRI-NG Profile
2.6 DR – DATE/TIME RANGE
SEQ Component Name
DT
TABLE 2-6. DATE/TIME RANGE (DR)
Usage LEN C.LEN Value Set
Comments
1
Range Start Date/Time
TS
RE
#
2
Range End Date/Time
TS
RE
#
To be addressed per field (in SPM)
2.7 DT – DATE
SEQ Component Name
DT
Usage
TABLE 2-7. DATE (DT)
LEN C.LEN Value Set
Comments
1
-
R
4..8
Date
Page 24 of 151
September 2011
=
Format: YYYY[MM[DD]]
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
2.8 DTM – DATE/TIME
TABLE 2-8. DATE/TIME (DTM)
SEQ Component Name
DT
Usage
LEN
C.LEN Value Set
Comments
1
-
R
4..24
=
Format: YYYY[MM[DD[HH[MM[SS[.S[S[S[S]]]]]]]]][+/-ZZZZ]
Date/Time
Usage Note
It is strongly recommended that the time zone offset always be included in the DTM particularly if the granularity includes
hours, minutes, seconds, etc. Specific fields in this implementation guide may require Date/Time to a specific level of
granularity, which may require the time zone offset. The granularity of the DTM as well as whether the time zone offset is
required or recommended is set for each field separately in the comments section.
2.9 ED – ENCAPSULATED DATA
SEQ Component Name
DT
TABLE 2-9. ENCAPSULATED DATA (ED)
Usage LEN C.LEN
Value Set
Comments
1
Source Application
HD
RE
#
2
Type of Data
ID
R
4..11
=
HL70834 (from
HL7 2.7.1)
Identifier of the type of data found in component 5.
See section 0 for details of HL70834.
3
Data Subtype
ID
RE
1..32
=
HL70291 (from
HL7 2.7.1)
Identifier of the subtype of data found in component 5.
4
Encoding
ID
R
1..6
=
HL70299
Identifier of the type of encoding to be performed in
the data component
5
Data
TX
R
=
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Identifier of the application that is the source of the
encapsulated data.
The data in this component must be properly escaped
after encoding. Receivers will need to un-escape the
text prior to decoding.
Be aware that this can be very big, e.g., large
documents, images, etc. Trading partners must agree
whether they can support this, thus the field using this
(OBX.2 and OBX.5) mark this data type as optional.
Page 25 of 151
September 2011
Usage Note
Specific MIME type/MIME subtypes to be supported will be worked out for specific implementations.
2.10 EI GU – ENTITY IDENTIFIER (GLOBALLY UNIQUE)
SEQ
Component Name
DT
TABLE 2-10. ENTITY IDENTIFIER (EI GU)
Usage LEN
C.LEN Value Set
Comments
1
Entity Identifier
ST
R
1..199
=
2
Namespace ID
IS
RE
1..20
=
3
Universal ID
ST
R
1..199
=
4
Universal ID Type
ID
R
1..6
=
Local
See profile for stronger requirements. The coding
system for this component is locally managed.
HL70301
Constrained to the value "ISO"
Usage Note
The EI data type is used to carry identifiers. This guide requires that all entity identifiers be accompanied by assigning
authorities. This allows the exchange of unique identifiers for the associated object across organizational and enterprise
boundaries, enabling broad interoperability.
In the EI data type, the Namespace ID, Universal ID and Universal ID type correspond to the HD data type identified
elsewhere. These types, together, are commonly considered the assigning authority for the identifier.
Conformance Statement: LRI-GU Profile
LRI-EI-1: EI.4 (Universal ID Type) SHALL contain the value “ISO”.
LRI-EI-2: EI.3 (Universal ID) SHALL be valued with an ISO-compliant OID.
2.11 EI NG – ENTITY IDENTIFIER (NON-GLOBALLY UNIQUE)
SEQ
Component Name
DT
TABLE 2-11. ENTITY IDENTIFIER (EI NG)
Usage LEN
C.LEN Value Set
Comments
1
Entity Identifier
ST
R
Page 26 of 151
September 2011
1..199
=
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
SEQ
Component Name
DT
TABLE 2-11. ENTITY IDENTIFIER (EI NG)
Usage LEN
C.LEN Value Set
Comments
2
Namespace ID
IS
O
3
Universal ID
ST
C(R/RE) 1..199
=
4
Universal ID Type
ID
C(R/X)
=
1..20
1..6
=
Condition Predicate: If EI_NG.1 (Namespace ID) is not
valued
HL70301
Condition Predicate: If EI_NG.2 (Universal ID) is valued
Usage Note
The EI data type is used to carry identifiers. This guide requires that all entity identifiers be accompanied by assigning
authorities. This allows the exchange of unique identifiers for the associated object across organizational and enterprise
boundaries, enabling broad interoperability.
In the EI data type, the Namespace ID, Universal ID and Universal ID type correspond to the HD data type identified
elsewhere. These types, together, are commonly considered the assigning authority for the identifier.
Conformance Statement LRI-NG Profile
LRI-EI-1: EI.3 (Universal ID) SHALL be valued with an ISO-compliant OID.
LRI-EI-2: EI.4 (Universal ID Type) SHALL contain the value “ISO”.
2.12 EIP – GU – ENTITY IDENTIFIER PAIR (GLOBALLY UNIQUE)
SEQ Component Name
TABLE 2-12. ENTITY IDENTIFIER PAIR (EIP GU)
DT
Usage LEN
C.LEN Value Set
Comments
1
Placer Assigned Identifier
EI GU
RE
#
2
Filler Assigned Identifier
EI GU
C(R/RE)
#
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Condition Predicate: If EIP_GU.1 is not valued
Page 27 of 151
September 2011
Conformance Statement: LRI-GU Profile
2.13 EIP – NG – ENTITY IDENTIFIER PAIR (NON-GLOBALLY UNIQUE)
SEQ Component Name
TABLE 2-13. ENTITY IDENTIFIER PAIR (EIP NG)
DT
Usage LEN
C.LEN Value Set
Comments
1
Placer Assigned Identifier
EI_NG
RE
#
2
Filler Assigned Identifier
EI_NG
C(R/RE)
#
Condition Predicate: if EIP_NG.1 is not valued
Conformance Statement: LRI-NG Profile
2.14 ERL – ERROR LOCATION
TABLE 2-14. ERROR LOCATION (ERL)
SEQ Component Name
DT
Usage
LEN
C.LEN
1
Segment ID
ST
R
3..3
=
2
Segment Sequence
NM
R
1..2
=
3
Field Position
NM
O
1..2
=
4
Field Repetition
NM
O
1..2
=
5
Component Number
NM
O
1..2
=
6
Sub-component Number
NM
O
1..2
=
Value Set
Comments
The 3-character name for the segment (i.e., PID).
2.15 FN – FAMILY NAME
TABLE 2-14. FAMILY NAME (FN)
SEQ Component Name
DT
Usage
LEN
C.LEN
1
Surname
ST
R
50
50#
2
Own Surname Prefix
ST
O
20
20#
3
Own Surname
ST
O
50
50#
Page 28 of 151
September 2011
Value Set
Comments
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 2-14. FAMILY NAME (FN)
SEQ Component Name
DT
Usage
LEN
C.LEN
4
Surname Prefix From
Partner/Spouse
ST
O
20
20#
5
Surname From
Partner/Spouse
ST
O
50
50#
Value Set
Comments
2.16 FT – FORMATTED TEXT DATA
TABLE 2-15. FORMATTED TEXT DATA (FT)
SEQ Component Name
Formatted Text Data
DT
Usage
LEN
C.LEN
-
R
1..65536
64,000
Value Set
Comments
Usage Note
The FT data type allows use of the formatting escape sequences documented in HL7 Version 2.5.1, Chapter 2, Section 2.7.1
- Use of Escape Sequences in Text Fields. In this Profile, the only allowed escape sequences are those allowed in HL7
Version 2.5.1, Chapter 2, Section 2.7.4 - Special Characters. These are the escape sequences for the message delimiters
(i.e., |^&~\).
2.17 HD-GU – HIERARCHIC DESIGNATOR (GLOBALLY UNIQUE)
TABLE 2-16. HIERARCHIC DESIGNATOR (HD-GU)
SEQ
Component Name
DT
Usage LEN
C.LEN
Value Set
Comments
1
Namespace ID
IS
RE
1..20
=
Local
The coding system for this component is locally managed.
2
Universal ID
ST
R
1..199
=
3
Universal ID Type
ID
R
1..6
=
HL70301
Constrained to the value ‘ISO’ except for Lab Result
Receiver for MSH-4 where the value ‘CLIA’ is allowed.
Usage Note
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 29 of 151
September 2011
The HD data type is used directly to identify objects such as applications or facilities. It is used also as a component of
other data types, where it is typically an assigning authority for an identifier. Where this capability is used in this
specification, the usage is described separately. Note that the HD datatype has been constrained to carry an OID identifying
an application, a facility, or an assigning authority. The only exception to the use of OID’s for the HD is for the Lab Result
Receiver profile for MSH-4 (Sending Facility)
Conformance Statement: LRI-GU Profile
LRI-HD-1: HD.2 (Universal ID) SHALL be valued with an ISO-compliant OID.
LRI-HD-2: HD.3 (Universal ID Type) SHALL contain the value “ISO”.
2.18 HD-NG – HIERARCHIC DESIGNATOR (NON-GLOBALLY UNIQUE)
TABLE 2-17. HIERARCHIC DESIGNATOR (HD-NG)
SEQ
Component Name
DT
Usage
LEN
C.LEN
Value Set
1
Namespace ID
IS
O
1..20
=
Local
2
Universal ID
ST
C(R/RE)
1..199
=
3
Universal ID Type
ID
C(R/X)
1..6
=
Comments
Condition Predicate: If HD_NG.1 (Namespace ID) is not
valued
HL70301
Condition Predicate: If HD_NG.2 (Universal ID) is valued
Note: Conditions need to be negotiated by the trading
partners
Usage Note
The HD-NG data type is used directly to identify objects such as applications or facilities. It is used also as a component of
other data types, where it is typically an assigning authority for an identifier. Where this capability is used in this
specification, the usage is described separately.
Page 30 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
2.19 ID – CODED VALUE FOR HL7-DEFINED TABLES
TABLE 2-18. CODED VALUE FOR HL7-DEFINED TABLES (ID)
SEQ
Component Name
DT
Usage LEN
C.LEN
1
Coded Value for HL7-Defined
Tables
-
R
=
1..15
Value Set
Comments
2.20 IS – CODED VALUE FOR USER-DEFINED TABLES
SEQ Component Name
1
Coded Value for User-Defined
Tables
TABLE 2-19. CODED VALUE FOR USER-DEFINED TABLES (IS)
DT
Usage LEN
C.LEN Value Set
Comments
-
R
1..20
=
2.21 MSG – MESSAGE TYPE
SEQ
Component Name
DT
TABLE 2-20. MESSAGE TYPE (MSG)
Usage LEN
C.LEN Value Set
Comments
1
Message Code
ID
R
3..3
=
HL70076
2
Trigger Event
ID
R
3..3
=
HL70003
3
Message Structure
ID
R
3..7
=
HL70354
2.22 NM – NUMERIC
TABLE 2-21. NUMERIC (NM)
SEQ
Component Name
DT
Usage
LEN
C.LEN
1
Numeric
-
R
1..16
=
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Value Set
Comments
HL7 allows only ASCII numeric characters as well as
an optional leading plus or minus sign and an option
decimal point. Note that use of scientific notation for
numbers is not supported by this data type.
Page 31 of 151
September 2011
2.23 PRL – PARENT RESULT LINK
TABLE 2-22. PARENT RESULT LINK (PRL)
SEQ
Component Name
DT
Usage
1
Parent Observation Identifier
CWE R
2
Parent Observation SubIdentifier
ST
RE
3
Parent Observation Value
Descriptor
TX
O
LEN
1..20
C.LEN
Value Set
Comments
#
Laboratory
Identifier of the OBX-3 Observation ID of the parent
Observation Value result. Typically, this is used in microbiology results
Set
where the sensitivities are linked to the specific culture
OBX where the organism was identified.
=
Identifier of the OBX-4 Observation Sub-ID associated
with the OBX-3 Observation ID of the parent result.
Typically, this is used in microbiology results where the
sensitivities are linked to the specific culture OBX
where the organism was identified. The combination of
OBX-3 and OBX-4 must be unique within a particular
OBR.
=
Usage Note
See Section 7.1 of this document for details on how this data type and the EIP data type are used in parent/child result
linking. Use of data type CWE for sequence 1 reflects a pre-adoption of HL7 Version 2.7.1 standards.
2.24 PT – PROCESSING TYPE
SEQ
Component Name
DT
TABLE 2-23. PROCESSING TYPE (PT)
Usage LEN
C.LEN Value Set
Comments
1
Processing ID
ID
R
1..1
=
2
Processing Mode
ID
O
1..1
=
Page 32 of 151
September 2011
HL70103
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
2.25 RP – REFERENCE POINTER
SEQ
Component Name
DT
TABLE 2-23. REFERENCE POINTER (RP)
Usage
LEN
C.LEN Value Set
Comments
1
Pointer
ST
R
2
Application ID
HD
R
2.1
Namespace ID
ID
O
1..20
=
2.2
Universal ID
ID
R
1..199
=
2.3
Universal ID Type
ID
R
1..6
=
HL70301
This component is constrained to support only
universal Resource Identifier. Literal value: ‘URI’
3
Type of Data
ID
RE
4..11
=
HL70834 (2.7.1)
Identifier of the type of data pointed to. For the URI
example referenced above, this is '"application."
4
Subtype
ID
RE
1..32
=
HL70291 (2.7.1)
Identifier of the subtype of data pointed to. For the URI
example above, this is "pdf," indicating portable
document format.
1..999
=
Pointer to the object. For URIs, it contains the path and
query parts. Example:
/phin/library/documents/pdf/DRAFT_PHIN_ORU_ELR
_v2.5.1_20061221.pdf
#
Unique identifier of the application that holds the object
being pointed to. For URIs, it contains the scheme and
authority parts.
Note that the HD data type used for this component is
specialized for use in the RP data type, and is different
than what is defined in section 2.18 (HD).
This component is restricted to a universal resource
identifier (URI). For URIs, contains the scheme and
authority parts. Example: http://www.cdc.gov
Usage Note
The field uses the RP data type to allow communication of pointers to images, sound clips, XML documents, HTML
markup, etc. The RP data type is used when the object being pointed to is too large to transmit directly.
This specification defines the mechanism for exchanging pointers to objects, but does not address the details of
applications actually accessing and retrieving the objects over a network.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 33 of 151
September 2011
This guide constrains this data type to support only Universal Resource Identifiers (URI). See http://ietf.org/rfc/rfc2396.txt for
a detailed definition. The general format of a URI is in the form <scheme>://<authority><path>?<query>. The scheme and
authority portions appear in the Application ID component, Universal ID subcomponent. The path and query portion of the
URI appear in the Pointer component of the RP data type.
2.26 SAD – STREET ADDRESS
TABLE 2-24.STREET ADDRESS (SAD)
SEQ
Component Name
DT
Usage
LEN
C.LEN
1
Street or Mailing Address
ST
R
120
120#
2
Street Name
ST
O
50
50#
3
Dwlling Number
ST
O
12
12#
Value Set
Comments
2.27 SI – SEQUENCE ID
TABLE 2-24.SEQUENCE ID (SI)
SEQ
Component Name
DT
Usage
LEN
C.LEN
1
Sequence ID
-
R
1..4
=
Value Set
Comments
Non-negative integer up to 9999. May be further
constrained to limit the number of times a segment
may repeat.
2.28 SN – STRUCTURED NUMERIC
TABLE 2-25. STRUCTURED NUMERIC (SN)
SEQ Component Name
DT
Usage LEN
C.LEN
1
Comparator
ST
RE
=
2
Num1
NM
RE
3
Separator/Suffix
ST
RE
Page 34 of 151
September 2011
1..2
Value Set
Comments
Component that must be one of ">" or "<" or ">=" or "<="
or "=" or "<>". This component defaults to "=" if empty.
=
1..1
=
Component that must be one of "-" or "+" or "/" or "." or ":".
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 2-25. STRUCTURED NUMERIC (SN)
SEQ Component Name
DT
Usage LEN
C.LEN
4
NM
RE
=
Num2
Value Set
Comments
Usage Note
The SN data type carries a structured numeric result value. Structured numeric values include intervals (^0^-^1), ratios
(^1^/^2 or ^1^:^2), inequalities (<^10), or categorical results (2^+)
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 35 of 151
September 2011
2.29 ST – STRING DATA
TABLE 2-26. STRING DATA (ST)
SEQ Component Name
DT
Usage LEN
1
-
R
String Data
C.LEN Value Set
Comments
Usage Note
The ST data type is normally used for short text strings. No leading blanks (space characters) are permitted. Trailing blanks
are permitted. In this Profile, the only allowed escape sequences are those allowed in HL7 Version 2.5.1, Chapter 2, Section
2.7.4 - Special Characters. These are the escape sequences for the message delimiters (i.e., |^&~\).
2.30 TM – TIME
SEQ Component Name
DT
TABLE 2-27. TIME (TM)
Usage LEN
C.LEN Value Set
1
-
R
Time
2..16
Comments
Format: HH[MM[SS[.S[S[S[S]]]]]][+/-ZZZZ]
Usage Note
It is strongly recommended that the time zone offset always be included in the TM. Specific fields in this implementation
guide may require time to a specific level of granularity, which may require the time zone offset.
2.31 TS – TIME STAMP
SEQ Component Name
DT
TABLE 2-28. TIME STAMP (TS)
Usage LEN
C.LEN Value Set
1
Time
DTM
R
2
Degree of Precision
ID
X
Page 36 of 151
September 2011
Comments
Deprecated as of HL7 Version 2.3. See component 1
(DTM) for the current method of designating degree of
precision.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
2.32 TX – TEXT DATA
SEQ Component Name
DT
Usage
1
-
R
Text Data
TABLE 2-29. TEXT DATA (TX)
LEN
C.LEN Value Set
Comments
Usage Note
The TX data type is used to carry string data intended for display purposes. It can contain leading blanks (space
characters). In this Profile, the only allowed escape sequences are those allowed in HL7 Version 2.5.1, Chapter 2, Section
2.7.4 - Special Characters. These are the escape sequences for the message delimiters (i.e., |^&~\).
2.33 VID – VERSION IDENTIFIER
TABLE 2-30. VERSION IDENTIFIER (VID)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
Comments
1
Version ID
ID
R
=
See MSH.12 for conformance statement.
2
Internationalization Code
CWE O
#
3
International Version ID
CWE O
#
3..5
HL70104
2.34 XAD – EXTENDED ADDRESS
TABLE 2-31. EXTENDED ADDRESS (XAD)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
1
Street Address
SAD
RE
#
2
Other Designation
ST
RE
1..120
=
3
City
ST
RE
1..50
=
4
State or Province
ST
RE
1..50
=
State Value Set
5
Zip or Postal Code
ST
RE
1..12
=
Postal Code Value In the US, the zip code takes the form 99999[-9999],
Set
while the Canadian postal code takes the form A9A9A9.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Comments
Example: Suite 555
The 2 letter (alpha) codes should be used here.
Page 37 of 151
September 2011
TABLE 2-31. EXTENDED ADDRESS (XAD)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
6
Country
ID
RE
3..3
=
Country Value Set
7
Address Type
ID
RE
1..3
=
HL70190
8
Other Geographic Designation ST
O
1..50
=
9
County/Parish Code
IS
RE
1..20
=
10
Census Tract
IS
O
1..20
=
11
Address Representation Code
ID
O
1..1
=
12
Address Validity Range
DR
X
13
Effective Date
TS
O
1..8
=
14
Expiration Date
TS
O
1..8
=
Page 38 of 151
September 2011
Comments
PHVS_County_FIP
S_6-4
Deprecated as of HL7 Version 2.5. See XAD-13
Effective Date and XAD-14 Expiration Date
components.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
2.35 XCN – GU – EXTENDED COMPOSITE ID NUMBER AND NAME FOR PERSONS (GLOBALLY UNIQUE)
TABLE 2-32. EXTENDED COMPOSITE ID NUMBER AND NAME FOR PERSONS (XCN GU)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
Comments
1
ID Number
ST
RE
=
The ID Number component combined with the Assigning
Authority component (component 9) must uniquely identify
the associated person. Note - despite the component being
named “ID Number” this component is an ST string data
type, not numeric, so the component is not limited to just
numbers.
2
Family Name
FN
RE
3
Given Name
ST
RE
1..30
=
4
Second and Further Given
Names or Initials Thereof
ST
RE
1..30
=
5
Suffix (e.g., JR or III)
ST
RE
1..20
=
6
Prefix (e.g., DR)
ST
RE
1..20
=
7
Degree (e.g., MD)
IS
X
1..20
=
8
Source Table
IS
O
1..20
=
9
Assigning Authority
HD-GU C(R/X)
10
Name Type Code
ID
RE
1..5
=
11
Identifier Check Digit
ST
O
1..4
=
12
Check Digit Scheme
ID
C(O/X)
3..3
=
13
Identifier Type Code
ID
C(R/X)
2..5
=
14
Assigning Facility
HD
O
1..15
#
I.e., first name.
#
Condition Predicate: If XCN_GU.1 (ID Number) is valued
The Assigning Authority component is used to identify the
system, application, organization, etc. that assigned the ID
Number in component 1.
HL70200
Condition Predicate:
HL70203
Condition Predicate: If XCN_GU.1 (ID Number) is valued
#
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 39 of 151
September 2011
TABLE 2-32. EXTENDED COMPOSITE ID NUMBER AND NAME FOR PERSONS (XCN GU)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
15
Name Representation Code
ID
O
=
16
Name Context
CE
O
17
Name Validity Range
DR
X
18
Name Assembly Order
ID
O
1..1
=
19
Effective Date
TS
O
1..8
=
20
Expiration Date
TS
O
1..8
=
21
Professional Suffix
ST
O
1..199
=
22
Assigning Jurisdiction
CWE
O
#
23
Assigning Agency or
Department
CWE
O
#
1..1
Comments
#
Deprecated as of HL7 Version 2.5. See XCN-19 Effective
Date and XCN-20 Expiration Date components.
Suggest using values from HL7 table 360.
Conformance Statement: LRI-GU
Page 40 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
2.36 XCN – NG – EXTENDED COMPOSITE ID NUMBER AND NAME FOR PERSONS (NON-GLOBALLY
UNIQUE)
TABLE 2-33. EXTENDED COMPOSITE ID NUMBER AND NAME FOR PERSONS (XCN NG)
SEQ Component Name
DT
Usage
LEN
C.LEN Value Set
Comments
1
ID Number
ST
RE
1..15
=
The ID Number component combined with the Assigning
Authority component (component 9) must uniquely
identify the associated person. Note - despite the
component being named “ID Number” this component is
an ST string data type, not numeric, so the component is
not limited to just numbers.
2
Family Name
FN
RE
3
Given Name
ST
RE
1..30
=
4
Second and Further Given
Names or Initials Thereof
ST
RE
1..30
=
5
Suffix (e.g., JR or III)
ST
RE
1..20
=
6
Prefix (e.g., DR)
ST
RE
1..20
=
7
Degree (e.g., MD)
IS
X
1..20
8
Source Table
IS
O
1..20
9
Assigning Authority
HD-NG C(RE/X)
10
Name Type Code
ID
RE
1..5
=
11
Identifier Check Digit
ST
O
1..4
=
12
Check Digit Scheme
ID
C(O/X)
3..3
=
13
Identifier Type Code
ID
RE
2..5
=
14
Assigning Facility
HD
O
#
I.e., first name.
=
#
Condition Predicate: If XCN_NG.1 (ID Number) is valued
The Assigning Authority component is used to identify the
system, application, organization, etc. that assigned the
ID Number in component 1.
HL70200
Condition Predicate:
HL70203
#
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 41 of 151
September 2011
TABLE 2-33. EXTENDED COMPOSITE ID NUMBER AND NAME FOR PERSONS (XCN NG)
SEQ Component Name
DT
Usage
LEN
C.LEN Value Set
15
Name Representation Code
ID
O
1..1
=
16
Name Context
CE
O
17
Name Validity Range
DR
X
18
Name Assembly Order
ID
O
1..1
=
19
Effective Date
TS
O
1..8
=
20
Expiration Date
TS
O
1..8
=
21
Professional Suffix
ST
O
1..199
=
22
Assigning Jurisdiction
CWE
O
#
23
Assigning Agency or
Department
CWE
O
#
Comments
#
Deprecated as of HL7 Version 2.5. See XCN-19 Effective
Date and XCN-20 Expiration Date components.
Conformance Statement: LRI-NG Profile
2.37 XON GU – EXTENDED COMPOSITE NAME AND IDENTIFICATION NUMBER FOR ORGANIZATIONS
GLOBALLY UNIQUE)
TABLE 2-34. EXTENDED COMPOSITE NAME AND IDENTIFICATION NUMBER FOR ORGANIZATIONS (XON GU)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
1
Organization Name
ST
RE
1..50
=
2
Organization Name Type Code IS
O
1..20
=
3
ID Number
NM
X
4
Check Digit
NM
O
1..4
=
5
Check Digit Scheme
ID
C(O/X)
3..3
=
Page 42 of 151
September 2011
Comments
Deprecated as of HL7 Version 2.5. Use XON-10
Organization Identifier.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 2-34. EXTENDED COMPOSITE NAME AND IDENTIFICATION NUMBER FOR ORGANIZATIONS (XON GU)
SEQ Component Name
DT
Usage LEN
6
Assigning Authority
HD GU C(R/X)
7
Identifier Type Code
ID
C(R/X)
2..5
C.LEN Value Set
Comments
#
Condition Predicate: If XON_GU.10 (Organization
Identifier) is valued
The Assigning Authority component is used to identify
the system, application, organization, etc. that assigned
the ID in component 10.
=
HL70203
Condition Predicate: If XON_GU.10 (Organization
Identifier) is valued
8
Assigning Facility
HD
O
#
9
Name Representation Code
ID
O
10
Organization Identifier
ST
C(R/RE) 1..20
1..1
=
=
Condition Predicate: If XON_GU.1 (Organization
Name) is not valued
Conformance Statement: Base Profile
LRI-XON-1:
Note: both XON.1 and XON.10 may be populated, but at least one of them must be valued.
Conformance Statement: LRI-GU Profile
2.38 XON NG – EXTENDED COMPOSITE NAME AND IDENTIFICATION NUMBER FOR ORGANIZATIONS
(NON-GLOBALLY UNIQUE)
TABLE 2-35. EXTENDED COMPOSITE NAME AND IDENTIFICATION NUMBER FOR ORGANIZATIONS (XON NG)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
1
Organization Name
ST
RE
1..50
=
2
Organization Name Type Code IS
O
1..20
=
3
ID Number
X
NM
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Comments
(Deprecated as of HL7 Version 2.5.) Use XON-10
Organization Identifier.
Page 43 of 151
September 2011
TABLE 2-35. EXTENDED COMPOSITE NAME AND IDENTIFICATION NUMBER FOR ORGANIZATIONS (XON NG)
SEQ Component Name
DT
Usage LEN
C.LEN Value Set
4
Check Digit
NM
O
1..4
=
5
Check Digit Scheme
ID
C(O/X)
3..3
=
6
Assigning Authority
HD NG C(RE/X)
7
Identifier Type Code
ID
C(R/X)
8
Assigning Facility
HD
O
9
Name Representation Code
ID
O
10
Organization Identifier
ST
C(R/RE) 1..20
#
2..5
=
Comments
Condition Predicate: If XON_NG.10 (Organization
Identifier) is valued
The Assigning Authority component is used to identify
the system, application, organization, etc. that assigned
the ID in component 10.
HL70203
Condition Predicate: If XON_NG.10 (Organization
Identifier) is valued
#
1..1
=
=
Condition Predicate: If XON_NG.1 (Organization
Name) is not valued
Conformance Statement: Base Profile
Note: both XON.1 and XON.10 may be populated, but at least one of them must be valued.
2.39 XPN – EXTENDED PERSON NAME
TABLE 2-36. EXTENDED PERSON NAME (XPN)
SEQ Component Name
DT
Usage
1
Family Name
FN
RE
2
Given Name
ST
RE
1..30
=
3
Second and Further Given
Names or Initials Thereof
ST
RE
1..30
=
4
Suffix (e.g., JR or III)
ST
RE
1..20
=
Page 44 of 151
September 2011
LEN
C.LEN Value Set
Comments
#
I.e., first name.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 2-36. EXTENDED PERSON NAME (XPN)
SEQ Component Name
DT
Usage
LEN
C.LEN Value Set
5
Prefix (e.g., DR)
ST
RE
1..20
=
6
Degree (e.g., MD)
IS
X
1..20
7
Name Type Code
ID
RE
1..5
=
8
Name Representation Code
ID
O
1..1
=
9
Name Context
CWE O
10
Name Validity Range
DR
X
11
Name Assembly Order
ID
O
12
Effective Date
TS
O
=
13
Expiration Date
TS
O
=
14
Professional Suffix
ST
RE
Comments
HL70360
HL70200
#
Deprecated as of HL7 Version 2.5. See XPN-12
Effective Date and XPN-13 Expiration Date
components.
1..1
1..199
=
=
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Suggest using values from HL7 table 360.
Page 45 of 151
September 2011
3. MESSAGES
The following sections detail the structure of each message, including segment name, usage, cardinality and description. See Section 1.6.2 for
a description of the columns in the Abstract Message Syntax Tables.
3.1 ORU^R01^ORU_R01
The ORU^R01 message is constrained for transmitting laboratory results from the testing source to the Receiver as defined in each Use Case.
Segment in Name
Standard
MSH
Message Header
[{SFT}]
{
[
TABLE 3-1. ORU^R01^ORU_R01 ABSTRACT MESSAGE SYNTAX
Usage Cardinality Description
R
[1..1]
O
[0..*]
PATIENT_RESULT Begin
R
[1..1]
PATIENT Begin
R
[1..1]
Software Segment
PID
Patient Identification
R
[1..1]
[PD1]
Additional Demographics
O
[0..1]
[{NTE}]
Notes and Comments for PID
O
[0..1]
[{NK1}]
Next of Kin/Associated Parties
O
[0..*]
O
[0..1]
[
VISIT Begin
PV1
Patient Visit
R
[1..1]
[PV2]
Patient Visit – Additional
Information
O
[0..1]
]
VISIT End
]
PATIENT End
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
The message header (MSH) segment contains information describing how to parse and process
the message. This includes identification of message delimiters, sender, receiver, message type,
timestamp, etc.
The patient identification (PID) segment is used to provide basic demographics regarding the
subject of the testing. The subject shall be a person.
HL7 requires that the patient visit (PV1) segment be present if the VISIT group is present.
Page 46 of 151
September 2011
TABLE 3-1. ORU^R01^ORU_R01 ABSTRACT MESSAGE SYNTAX
Segment in Name
Usage Cardinality Description
Standard
{
ORDER_OBSERVATION Begin R
[1..*]
The ORDER_OBSERVATION is required and can repeat.
Snapshot processing of the result message involves processing as a snapshot all the repeats of
the ORDER_OBSERVATION group together as a group. This is especially important when dealing
with parent/child results (such as cultures and sensitivities) that will span multiple
ORDER_OBSERVATION groups. All these must be processed from both a message sender and
message receiver perspective as a single snapshot.
[ORC]
Order Common
R
[1..1]
The common order (ORC) segment identifies basic information about the order for testing of the
specimen. This segment includes identifiers of the order, who placed the order, when it was
placed, what action to take regarding the order, etc.
OBR
Observations Request
R
[1..1]
The observation request (OBR) segment is used to capture information about one test being
performed on the specimen. Most importantly, the OBR identifies the type of testing to be
performed on the specimen, and ties that information to the order for the testing.
Notes and Comments for OBR
RE
[0..*]
RE
[0..1]
[{NTE}]
[{
TIMING_QTY Begin
TQ1
Timing/Quantity
R
[1..1]
[{TQ2}]
Timing/Quantity Order Sequence O
[0..*]
}]
[CTD]
[{
Although Timing/Quantity may be necessary for orders, it’s not necessary for result reporting.
TIMING_QTY End
Contact Data
OBSERVATION Begin
O
[0..1]
C(R/X)
[0..*]
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Condition Predicate: If OBR.25 (Result Status) is valued A, C, F, P, or R
Multiple Observation groups, each containing a single OBX and an optional repeating NTE, may
be associated with a single order.
Snapshot processing: Since the OBX segment in 2.5.1 does not contain a unique instance
identifier; it is assumed that the repeating observation group will contain a complete set of
observations (OBXs) associated with the OBR. Where a single OBX is being updated, all the
OBXs related to the OBR must accompany the updated OBX, i.e., a full snapshot is sent.
Page 47 of 151
September 2011
Segment in Name
Standard
OBX
Observation related to OBR
[{NTE}]
}]
TABLE 3-1. ORU^R01^ORU_R01 ABSTRACT MESSAGE SYNTAX
Usage Cardinality Description
Notes and Comments
R
[1..1]
The observation/result (OBX) segment contains information regarding a single observation
(analyte) result. This includes identification of the specific type of observation, the result for the
observation, when the observation was made, etc.
For laboratory testing, the OBX is normally reporting the results of a test performed on a
specimen, Because the ORU^R01^ORU_R01 message structure allows multiple specimens to be
associated with a single OBR, there is no direct way to tell which specimen this OBX is associated
with. There are other HL7 messages for laboratory results where this ambiguity does not exist, but
were not chosen for this implementation guide.
RE
[0..*]
The notes and comment (NTE) segment may carry comments related to the result being reported
in the OBX segment.
OBSERVATION End
[{FTI}]
Financial Transaction
O
[0..*]
{[CTI]}
Clinical Trial Identification
O
[0..*]
RE
[0..*]
The specimen group is required if known in the ORU and is used to carry specimen information
that is no longer contained in the OBR segment. It also provides a place for the specimen number.
Each specimen group documents a single sample.
The specimen information (SPM) segment describes the characteristics of a single sample. The
SPM segment carries information regarding the type of specimen, where and how it was collected,
who collected it, and some basic characteristics of the specimen.
-
[{
SPECIMEN Begin
SPM
Specimen Information related to
OBR
R
[1..1]
[{OBX}]
Observation related to Specimen O
[0..*]
}]
}
}
[DSC]
Page 48 of 151
September 2011
SPECIMEN End
ORDER_ OBSERVATION End
PATIENT_RESULT End
Continuation Pointer
X
[0..0]
Not supported.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
3.2 ACK^R01^ACK
Segment Name
in
Standard
MSH
Message Header
Usage
TABLE 3-2. ACK^R01^ACK ABSTRACT MESSAGE SYNTAX
Cardinality C.LEN
Description
R
[1..1]
[{SFT}]
Software Segment
O
[0..*]
MSA
Message
Acknowledgment
R
[1..1]
[{ ERR }]
Error
C(R/O)
[0..*]
The message header (MSH) segment contains information describing how to parse and
process the message. This includes identification of message delimiters, sender, receiver,
message type, timestamp, etc.
Condition predicate: If MSA.1 (Message Acknowledgement) is not valued AA or CA
3.3 SEGMENT AND FIELD DESCRIPTIONS
This messaging guide provides notes for required (non-optional) fields. The following format is used in this document for listing and defining
message segments and fields. First, the message segment use is defined and then a segment attribute table listing all fields defined in the
segment is shown. See Section Error! Reference source not found. for a description of the columns in the Segment Attribute Tables.
Note that any optional segments that are brought forward from the base will have to be used within the constraints set forth in this guide, e.g.,
constraint statements will be required to use the GU or NG profiles, or to use the correct CWE datatype.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 49 of 151
September 2011
3.3.1 MSH – MESSAGE HEADER SEGMENT
SEQ Element Name
DT
TABLE 3-3. MESSAGE HEADER SEGMENT (MSH)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
1
Field Separator
ST
R
[1..1]
1..1
Character to be used as the field separator for the rest of the
message.
Constrained to the literal value: ‘|’ [ASCII (124)].
2
Encoding Characters
ST
R
[1..1]
4..5
Constrained to the literal values ‘^~\&’ or ‘^~\&#’, always
appearing in the same order.
3
Sending Application
Varies R
[1..1]
Datatype Usage: HD_GU for GU Profile
Datatype Usage: HD_NG for NG Profile
Field that may be used to identify the sending application
uniquely for messaging purposes.
For this field only, if all three components of the HD are valued,
the first component defines a member in the set defined by the
second and third components.
4
Sending Facility
Varies R
[1..1]
Datatype Usage: HD_GU for GU Profile
Datatype Usage: HD_NG for NG Profile
Field that uniquely identifies the facility associated with the
application that plays the Laboratory Result Sender Actor (see
section 3.1 Use Case Model) that sends the message. If
acknowledgments are in use, this facility will receive any
related acknowledgment message.
5
Receiving Application
HD
O
[0..1]
6
Receiving Facility
Varies R
[1..1]
Page 50 of 151
September 2011
Datatype Usage: HD_GU for GU Profile
Datatype Usage: HD_NG for NG Profile
Field that uniquely identifies the facility for the application that
plays the Laboratory Result Receiver Actor (see section 3.1
Use Case Model) and receives the message. If
acknowledgments are in use, this facility originates any related
acknowledgment message.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
SEQ Element Name
DT
TABLE 3-3. MESSAGE HEADER SEGMENT (MSH)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
7
Date/Time Of Message
TS
R
[1..1]
8
Security
ST
O
[0..1]
9
Message Type
MSG
R
[1..1]
10
Message Control ID
ST
R
[1..1]
11
Processing ID
PT
R
[1..1]
Field that may be used to indicate the intent for processing the
message, such as "T" (training,) "D" (debug,) or "P"
(production.)
12
Version ID
VID
R
[1..1]
HL7 version number used to interpret format and content of the
message. Constrained to the literal value ‘2.5.1’.
Note that receivers must examine MHS-21 (Message Profile
Identifier) to understand which message profile the message
instance conforms with.
13
Sequence Number
NM
O
[0..1]
14
Continuation Pointer
ST
O
[0..1]
1..180=
15
Accept Acknowledgment Type ID
R
[1..1]
2..2
HL70155
16
Application Acknowledgment
Type
ID
R
[1..1]
2..2
HL70155
Field containing the date/time the message was created by the
sending system. Format:
YYYYMMDDHHMMSS[.S[S[S[S]]]]+/-ZZZZ. Note that the time
zone offset is required, and the minimum granularity is to the
second, although more precise time stamps are allowed.
1..40=
Constrained to the literal value ‘ORU^R01^ORU_R01’ for the
result message.
Constrained to the literal value for the acknowledgement
message.
1..199=
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
199=
String that uniquely identifies the message instance from the
sending application. Example formats for message control IDs
include GUID, timestamp plus sequence number, OID plus
sequence number or sequence number. The important point is
that care must be taken to insure that the message control id is
unique. The sending application (MSH-3) plus MSH-10
(message control id) needs to be globally unique.
Page 51 of 151
September 2011
SEQ Element Name
DT
TABLE 3-3. MESSAGE HEADER SEGMENT (MSH)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
17
Country Code
ID
O
[0..1]
3..3
18
Character Set
ID
O
[0..*]
5..15
19
Principal Language Of
Message
CWE
O
[0..1]
20
Alternate Character Set
Handling Scheme
ID
O
[0..1]
21
Message Profile Identifier
EI GU R
[1..*]
3..13
Field used to reference or assert adherence to a message
profile.
The sender asserts that the message conforms to all the
profiles included. It must include one of the sender profiles
defined in this implementation guide ("base profile"), while the
combination of profiles cannot create conflicts, and the
additional profiles must be properly constrained against the
base profile.
The indication whether to uniquely identify a result based on
placer/filler order number + universal service identifier or just
placer/filler order number is done through declaring a profile in
this field.
If Profile GU is declared to be in effect, all profiles shall use
OIDs as defined by HD-GU, including the profiles not defined
in this IG.
If Profile NG, only the HL7 Profile identifier is required to be an
OID (assigned and managed by HL7); all other local profiles
can use locally agreed to identification.
Usage Note
The Message Header Segment (MSH) contains information describing how to parse and process the message. This includes identification
of message delimiters, sender, receiver, message type, timestamp, etc.
Note: When there is no performing lab is specified in the OBX, use the combination of MSH-3 and MSH-4 to define a local coding
system. It is assumed that:
Page 52 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.

Different applications within an organization with a single CLIA number may have different local coding systems (e.g., a clinical
pathology application vs. an anatomic pathology application).

A single application within an organization with a single CLIA number has a single local coding system. That coding system may
contain multiple value sets, for example, it may contain local value sets for observation identifier, observation value, interpretation
code, race, ethnicity, reason for study, and others.
Conformance Statement: Base Profile
LRI-XXX-X MSH.1 (Field Separator) SHALL contain the constant value ‘|’.
LRI-XXX-X MSH.2 (Encoding Characters) SHALL contain the constant value ‘^~\&’ or the constant value ‘^~\&#’.
LRI-XXX-X MSH.9 (Message Type) SHALL contain the constant value ‘ORU^R01^ORU_R01’.
LRI-XXX-X MSH.12.1 (Version ID) SHALL contain the constant value ‘2.5.1’.
LRI-XXX-X MSH.15 (Accept Acknowledgement Type) SHALL contain the constant value ‘AL’.
LRI-XXX-X MSH.16 (Application Acknowledgement Type) SHALL contain the constant value ‘NE’.
Conformance Statement: Acknowledgement Message Profile
LRI-XXX-X MSH.1 (Field Separator) SHALL contain the constant value ‘|’.
LRI-XXX-X MSH.2 (Encoding Characters) SHALL contain the constant value ‘^~\&’ or the constant value ‘^~\&#’.
LRI-XXX-X MSH.9 (Message Type) SHALL contain the constant value ‘ACK^R01^ACK’.
LRI-XXX-X MSH.12.1 (Version ID) SHALL contain the constant value ‘2.5.1’.
LRI-XXX-X MSH.15 (Accept Acknowledgement Type) SHALL contain the constant value ‘NE’.
LRI-XXX-X MSH.16 (Application Acknowledgement Type) SHALL contain the constant value ‘??’.
Conformance Statement: LRI-GU Profile
LRI-MSH-3: MSH.21 (Message Profile Identifier) SHALL be valued with 2.16.840.1.113883.9.16 (LRI Common Profile Component)
and with 2.16.840.1.113883.9.12 (GU – Globally Unique) and SHALL also be valued with either the OID 2.16.840.1.113883.9.14 (RU –
Unique Placer/Filler Order Number) or 2.16.840.1.113883.9.15 (RN – Non-Unique Order Numbers) but not both
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 53 of 151
September 2011
Conformance Statement: LRI-NG Profile
LRI-MSH-5: MSH.21 (Message Profile Identifier) SHALL be valued with 2.16.840.1.113883.9.16 (LRI Common Profile Component)
and with 2.16.840.1.113883.9.13 (NG – Non-Globally Unique) and SHALL also be valued with either the OID 2.16.840.1.113883.9.14
(RU– Unique Placer/Filler Order Number ) or 2.16.840.1.113883.9.15 (RN – Non-Unique Order Numbers) but not both.
3.3.2 SFT – SOFTWARE SEGMENT
The software segment provides information about the sending application or other applications that manipulate the message before the
receiving application processes the message. This guide imposes no additional constraints on the base specification HL7 V2.5.1, Chapter 2.
Page 54 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
MSA – Acknowledgement Segment
The Message Response Segment (MSA) contains the information sent as acknowledgment to the order message received by a Laboratory
Information System.
SEQ
Element
Name
TABLE 3-4. ACKNOWLEDGMENT SEGMENT (MSA)
Value
DT Usage Cardinality LEN C.LEN
Description/Comments
Set
1
Acknowledgment ID
Code
R
[1..1]
2..2
HL70008 Acknowledgment code indicating receipt of message. (Refer to HL7 Table 0008 Acknowledgment Code for valid values.)
2
Message Control ST
ID
R
[1..1]
1..199
3
Text Message
ST
X
[0..0]
4
NM
Expected
Sequence Number
O
[0..1]
5
ID
Delayed
Acknowledgment
Type
X
[0..0]
Deprecated as of HL7 Version 2.2 and the detail was withdrawn and removed from the
standard as of HL7 Version 2.5.
6
Error Condition
CWE X
[0..0]
Deprecated as of HL7 Version 2.4. See ERR segment.
Identifier that enables the sending system to associate this response with the message for
which it is intended. This value will be the MSH.10 message control ID from the message
being acknowledged.
Deprecated as of HL7 Version 2.4. See ERR segment.
3.3.3 ERR – ERROR SEGMENT
The ERR segment is used to add error comments to acknowledgment messages.
TABLE 3-5. ERROR SEGMENT (ERR)
SEQ
Element Name
DT
Usage Cardinality LEN
1
Error Code and Location
ELD
X
[0..0]
2
Error Location
ERL
O
[0..1]
3
HL7 Error Code
CWE
R
[1..1]
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
C.LEN
Value Set
Description/Comments
Deprecated as of HL7 Version 2.5. See ERR-2 Error Location
and ERR-3 HL7 Error Code fields.
HL70357
Identifies the HL7 (communications) error code.
Page 55 of 151
September 2011
TABLE 3-5. ERROR SEGMENT (ERR)
SEQ
Element Name
DT
Usage Cardinality LEN
4
Severity
ID
R
[1..*]
5
Application Error Code
CWE
O
[0..1]
6
Application Error Parameter ST
O
[0..10]
1..80
7
Diagnostic Information
TX
RE
[0..1]
1..2048
8
User Message
TX
O
[0..1]
1..250
9
Inform Person Indicator
IS
O
[0..*]
1..20
10
Override Type
CWE
O
[0..0]
11
Override Reason Code
CWE
O
[0..*]
12
Help Desk Contact Point
XTN
RE
[0..*]
C.LEN
1..1
Value Set
Description/Comments
HL70516
Identifies the severity of an application error. Knowing if
something is Error, Warning, or Information is intrinsic to how
an application handles the content.
Information that may be used by help desk or other support
personnel to diagnose a problem.
Conformance Statement: Base Profile
3.3.4 PID – PATIENT IDENTIFICATION SEGMENT
The Patient Identification Segment (PID) is used to provide basic demographics regarding the subject of the testing. The subject may be a
person or animal.
TABLE 3-6. PATIENT IDENTIFICATION SEGMENT (PID)
SEQ Element Name
DT
Usage Cardinality LEN
1
Set ID – PID
SI
R
[1..1]
2
Patient ID
CX
X
[0..0]
Page 56 of 151
September 2011
1..4
C.LEN
Value Set
Description/Comments
Constrained to the literal value ‘1’.
Deprecated as of HL7 Version 2.3.1. See PID-3 Patient
Identifier List.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 3-6. PATIENT IDENTIFICATION SEGMENT (PID)
SEQ Element Name
DT
Usage Cardinality LEN
3
Patient Identifier List
Varies
R
[1..*]
Datatype Usage: CX_GU for the GU Profile
Datatype Usage: CX_NG for the NG Profile
Field used to convey all types of patient/person identifiers. This
includes social security numbers, driver’s license numbers,
medical record numbers, etc.
4
Alternate Patient ID – PID
CX
X
[0..0]
Deprecated as of HL7 Version 2.3.1. See PID-3.
5
Patient Name
XPN
R
[1..*]
Patient name or aliases. When the name of the patient is not
known, a value must still be placed in this field since the field is
required. In that case, HL7 recommends the following:
|~^^^^^^U|. The "U" for the name type code in the second name
indicates that it is unspecified. Since there may be no name
components populated, this means there is no legal name, nor
is there an alias. This guide will interpret this sequence to mean
there is no patient name.
Stay with base V2.5.1 interpretation using ~ and U in
component 7 of the second repeat when the name is unknown.
6
Mother’s Maiden Name
XPN
RE
[0..1]
May be included for identification purposes. Name type code is
constrained to the value "M."
7
Date/Time of Birth
TS
RE
[0..1]
4..24
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
C.LEN
=
Value Set
Description/Comments
Patient’s date of birth. The time zone component is optional.
Note that the granularity of the birth date may be important. For
a newborn, birth date may be known down to the minute, while
for adults it may be known only to the date. Birth date may be
used by the lab to calculate an age for the patient, which may
affect what normal ranges apply to particular test results.
Format: YYYY[MM[DD[HH[MM[SS[.S[S[S[S]]]]]]]]][+/-ZZZZ]
Timezone offset is optional.
Be as precise as appropriate and available. Particularly
important for newborns. Precision at least YYYY
Note: If a birth date is not provided in the PID, then the patient
age at specimen collection must be reported as an observation
associated with the specimen.
Page 57 of 151
September 2011
TABLE 3-6. PATIENT IDENTIFICATION SEGMENT (PID)
SEQ Element Name
DT
Usage Cardinality LEN
8
Administrative Sex
IS
RE
[0..1]
9
Patient Alias
XPN
X
[0..0]
10
Race
CE
RE
[0..*]
11
Patient Address
XAD
O
[0..*]
12
County Code
IS
X
[0..0]
13
Phone Number – Home
XTN
O
[0..*]
14
Phone Number – Business XTN
O
[0..*]
15
Primary Language
CWE
O
[0..*]
16
Marital Status
CWE
O
[0..1]
17
Religion
CWE
O
[0..1]
18
Patient Account Number
CX
O
[0..1]
19
SSN Number – Patient
ST
X
[0..0]
Deprecated as of HL7 Version 2.3.1. See PID-3 Patient
Identifier List.
20
Driver’s License Number – DLN
Patient
X
[0..0]
Deprecated as of HL7 Version 2.5. See PID-3 Patient Identifier
List.
21
Mother’s Identifier
CX
O
[0..*]
22
Ethnic Group
CWE
O
[0..*]
23
Birth Place
ST
O
[0..1]
1..250
24
Multiple Birth Indicator
ID
O
[0..1]
1..1
25
Birth Order
NM
O
[0..1]
1..2
26
Citizenship
CWE
O
[0..*]
27
Veterans Military Status
CWE
O
[0..1]
Page 58 of 151
September 2011
1..20
C.LEN
Value Set
Description/Comments
HL70001
Patient’s gender.
Deprecated as of HL7 Version 2.4. See PID-5 Patient Name.
HL70005
1..20
One or more codes that broadly refer to the patient’s race(s).
Note that state regulations may dictate other behaviors.
Deprecated as of HL7 Version 2.3. See PID-11 - Patient
Address, component 9 County/Parish Code.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 3-6. PATIENT IDENTIFICATION SEGMENT (PID)
SEQ Element Name
DT
Usage Cardinality LEN
28
Nationality
CWE
X
[0..0]
29
Patient Death Date and
Time
TS
O
[0..1]
30
Patient Death Indicator
ID
O
[0..1]
1..1
31
Identity Unknown Indicator ID
X
[0..1]
1..1
32
Identity Reliability Code
IS
O
[0..*]
1..20
33
Last Update Date/Time
TS
O
[0..1]
34
Last Update Facility
HD
O
[0..1]
35
Species Code
CWE
X
[0..1]
36
Breed Code
CWE
X
[0..1]
37
Strain
ST
X
[0..1]
38
Production Class Code
CWE
X
[0..2]
39
Tribal Citizenship
CWE
X
[0..*]
C.LEN
Value Set
Description/Comments
Deprecated as of HL7 Version 2.4. See PID-10 Race, PID-22
Ethnic Group, and PID-26 Citizenship.
Conformance Statement: Base Profile
LRI-XXX-X PID.1 (Set ID - PID) SHALL be valued with the constant value ‘1’.
LRI-PID-1: PID.7 (Date/Time of Birth) and PID.29 (Patient Death Date and Time) SHALL be valued with precision to the Year (YYYY)
and SHOULD be precise to the hour.
LRI-XXX-X PID.6.1 (Name Type Code) SHALL be valued with the constant value ‘M’.
Conformance Statement: LRI-GU Profile
Conformance Statement: LRI-NG Profile
3.3.5 NK1 – NEXT OF KIN SEGMENT – MAKE REF
The Next of Kin Segment is optional in this Guide,;refer to base standard
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 59 of 151
September 2011
3.3.6 PV1 – PATIENT VISIT INFORMATION
This segment contains basic inpatient or outpatient encounter information.
SEQ Element Name
DT
TABLE 3-7. PATIENT VISIT INFORMATION (PV1)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
1
Set ID - PV1
SI
R
[1..1]
1..4
2
Patient Class
IS
R
[1..1]
1..20
3
Assigned Patient Location
PL
O
[0..1]
4
Admission Type
IS
O
[0..1]
5
Preadmit Number
CX
O
[0..1]
6
Prior Patient Location
PL
O
[0..1]
7
Attending Doctor
XCN
O
[0..*]
8
Referring Doctor
XCN
O
[0..*]
9
Consulting Doctor
XCN
O
[0..*]
10
Hospital Service
IS
O
[0..1]
11
Temporary Location
PL
O
[0..1]
12
Preadmit Test Indicator
IS
O
[0.1]
1..20
13
Re-admission Indicator
IS
O
[0..0]
1..20
14
Admit Source
IS
O
[0..1]
1..20
15
Ambulatory Status
IS
O
[0..*]
1..20
16
VIP Indicator
IS
O
[0..0]
1..20
17
Admitting Doctor
XCN
O
[0..*]
18
Patient Type
IS
O
[0..1]
19
Visit Number
CX
O
[0..1]
20
Financial Class
FC
O
[0..*]
21
Charge Price Indicator
IS
O
[0..0]
1..20
22
Courtesy Code
IS
O
[0..0]
1..20
Page 60 of 151
September 2011
Constrained to the literal value ‘1’.
=
HL70004
A gross identification of the classification of patient’s visit
1..20
1..20
1..20
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
SEQ Element Name
DT
TABLE 3-7. PATIENT VISIT INFORMATION (PV1)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
23
Credit Rating
IS
O
[0..0]
1..20
24
Contract Code
IS
O
[0..*]
1..20
25
Contract Effective Date
DT
O
[0..*]
26
Contract Amount
NM
O
[0..*]
1..12
27
Contract Period
NM
O
[0..*]
1..3
28
Interest Code
IS
O
[0..0]
1..20
29
Transfer to Bad Debt Code IS
O
[0..0]
1..20
30
Transfer to Bad Debt Date DT
O
[0..1]
31
Bad Debt Agency Code
O
[0..1]
1..20
32
Bad Debt Transfer Amount NM
O
[0..1]
1..12
33
Bad Debt Recovery Amount NM
O
[0..1]
1..12
34
Delete Account Indicator
IS
O
[0..1]
1..20
35
Delete Account Date
DT
O
[0..1]
36
Discharge Disposition
IS
O
[0..1]
37
Discharged to Location
DLD
O
[0..1]
38
Diet Type
CWE
O
[0..1]
39
Servicing Facility
IS
O
[0..1]
1..20
40
Bed Status
IS
X
[0..0]
1..20
41
Account Status
IS
O
[0..1]
1..20
42
Pending Location
PL
O
[0..1]
43
Prior Temporary Location
PL
O
[0..1]
44
Admit Date/Time
TS
RE
[0..1]
Date and time patient arrived for services
45
Discharge Date/Time
TS
RE
[0..*]
Date and time patient services ended
46
Current Patient Balance
NM
O
[0..1]
IS
1..20
1..12
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 61 of 151
September 2011
SEQ Element Name
DT
TABLE 3-7. PATIENT VISIT INFORMATION (PV1)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
47
Total Charges
NM
O
[0..1]
1..12
48
Total Adjustments
NM
O
[0..1]
1..12
49
Total Payments
NM
O
[0..1]
1..12
50
Alternate Visit ID
CX
O
[0..1]
51
Visit Indicator
IS
O
[0..1]
52
Other Healthcare Provider XCN
O
[0..*]
1..20
1
Conformance Statement: LRI-GU Profile
LRI-XXX-X PID.1 (Set ID - PID) SHALL be valued with the constant value ‘1’.
Conformance Statement: LRI-GU Profile
Conformance Statement: LRI-NG Profile
3.3.7 PV2 – PATIENT VISIT – ADDITIONAL INFORMATION SEGMENT INSERT REF TO BASE
The PV2 segment is an optional segment that is a continuation of information contained in the PV1 segment.
3.3.8 ORC – COMMON ORDER SEGMENT
The Common Order Segment (ORC) identifies basic information about the order for testing of the specimen. This segment includes
identifiers for the order, who placed the order, when it was placed, what action to take regarding the order, etc.
SEQ Element Name
DT
TABLE 3-8. COMMON ORDER SEGMENT (ORC)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
1
Order Control
ID
R
[1..1]
2
Placer Order Number
Varies
RE
[0..1]
Page 62 of 151
September 2011
2..2
HL70119
Determiner of the function of the order segment. In the
ORU^R01 this should be the literal value: "RE."
Datatype Usage: EI_GU for Profile GU
Datatype Usage: EI_NG for Profile NG
Conformance: Echo as received from the order.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
SEQ Element Name
DT
TABLE 3-8. COMMON ORDER SEGMENT (ORC)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
3
Filler Order Number
Varies
R
[1..1]
Datatype Usage: EI_GU for Profile GU
Datatype Usage: EI_NG for Profile NG
Note: In the circumstance where some of the lab results are
generated by the lab, but others are performed by a reference
lab, the sending lab can choose what filler order number to
use. Regardless of what is used, the sending lab is expected
to be able to trace all the observations in the lab result back to
the appropriate source lab based on the filler order number
provided in ORC-3.
4
Placer Group Number
Varies
RE
[0..1]
Datatype Usage: EI_GU for Profile GU
Datatype Usage: EI_NG for Profile NG
Conformance: Echo as received from the order.
The placer group number is used to identify a group of orders.
In the laboratory setting this is commonly referred to as a
"requisition number."
5
Order Status
ID
O
[0..1]
2..2
6
Response Flag
ID
O
[0..1]
1..1
7
Quantity/Timing
TQ
X
[0..0]
8
Parent
EIP
O
[0..1]
9
Date/Time of Transaction
TS
O
[0..1]
10
Entered By
XCN
O
[0..*]
11
Verified By
XCN
O
[0..*]
12
Ordering Provider
Varies
R
[1..1]
13
Enterer's Location
PL
O
[0..1]
14
Call Back Phone Number
XTN
O
[0..*]
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Deprecated as of HL7 Version 2.5. See TQ1 and TQ2
segments.
Datatype Usage: XCN_GU for Profile GU
Datatype Usage: XCN_NG for Profile NG
Page 63 of 151
September 2011
SEQ Element Name
DT
TABLE 3-8. COMMON ORDER SEGMENT (ORC)
Usage Cardinality LEN
C.LEN Value Set
Description/Comments
15
Order Effective Date/Time
TS
O
[0..1]
16
Order Control Code Reason CWE
O
[0..1]
17
Entering Organization
CWE
O
[0..1]
18
Entering Device
CWE
O
[0..1]
19
Action By
XCN
O
[0..*]
20
Advanced Beneficiary Notice CWE
Code
X
[0..0]
21
Ordering Facility Name
XON
O
[0..*]
22
Ordering Facility Address
XAD
O
[0.*]
23
Ordering Facility Phone
Number
XTN
O
[0..*]
24
Ordering Provider Address
XAD
O
[0..*]
25
Order Status Modifier
CWE
O
[0..1]
26
Advanced Beneficiary Notice CWE
Override Reason
X
[0..0]
27
Filler's Expected Availability
Date/Time
TS
O
[0..1]
28
Confidentiality Code
CWE
O
[0..1]
29
Order Type
CWE
O
[0..1]
30
Enterer Authorization Mode
CNE
O
[0..1]
31
Parent Universal Service
Identifier
CWE_CR C(R/X)
[0..1]
Condition Predicate: If OBR.50 (Parent Universal Service
Identifier) is valued
Conformance Statement: Base Profile
LRI-ORC-1: The value of ORC.2 (Placer Order Number) SHALL be identical to the value of OBR.2 (Placer Order Number).
LRI-ORC-2: The value of ORC.3 (Filler Order Number) SHALL be identical to the value of OBR.3 (Filler Order Number).
Page 64 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
LRI-ORC-3: The value of ORC.12 (Ordering Provider) SHALL be identical to the value of OBR.16 (Ordering Provider).
LRI-ORC-6: The value of ORC.31 (Parent Universal Service Identifier) SHALL be identical to the value of OBR.50 (Parent Universal
Service Identifier).
Conformance Statement: LRI-GU Profile
Conformance Statement: LRI-NG Profile
3.3.9 OBR – OBSERVATION REQUEST SEGMENT
The Observation Request Segment (OBR) is used to capture information about one test being performed on the specimen. Most importantly,
the OBR identifies the type of testing to be performed on the specimen and ties that information to the order for the testing.
TABLE 3-9. OBSERVATION REQUEST SEGMENT (OBR)
SEQ
Element Name
DT
Usage Cardinality LEN
1
Set ID - OBR
SI
R
[1..1]
2
Placer Order Number
Varies
RE
[0..1]
1..4
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
C.LEN
Value Set
Description/Comments
For the first occurrence of the OBR segment, the Sequence
number shall be one (1), for the second occurrence, the
Sequence number shall be two (2), etc.
Datatype Usage: EI_GU for Profile GU
Datatype Usage: EI_NG for Profile NG
Conformance: Echo as received from the order.
This identifier is assigned by the placer of the order being
fulfilled by this result message. This identifier distinguishes the
placer’s order from all other orders created by the placer
where an order is interpreted to be the testing identified in a
single OBR segment. Normally, it is a type of system identifier
assigned by the placer software application.
The Placer Order Number and the Filler Order Number are
essentially foreign keys exchanged between applications for
uniquely identifying orders and the associated results across
applications.
Page 65 of 151
September 2011
TABLE 3-9. OBSERVATION REQUEST SEGMENT (OBR)
SEQ
Element Name
DT
Usage Cardinality LEN
3
Filler Order Number
Varies
R
[1..1]
Datatype Usage: EI_GU for Profile GU
Datatype Usage: EI_NG for Profile NG
Order number associated with the Filling Application. This
number is assigned to the test by the organization performing
the test. This field should not contain the accession number or
specimen identifier for a specimen unless these identifiers
meet the criteria for a filler order number. The specimen or
accession identifier should be placed in SPM-2. The Filler
Order Number identifies this order as distinct from all other
orders being processed by this filler where an order is
interpreted to be the testing identified in a single OBR
segment. Normally, this is a type of system identifier assigned
by the filler software application.
The Filler Order Number, along with the Placer Order Number,
is essentially foreign keys exchanged between applications for
uniquely identifying orders and the associated results across
applications.
In messages containing multiple OBRs, each OBR must be
identified by a unique Filler Order Number. This is critical for
making parent/child results relationships work properly.
Microbiology cultures and sensitivities are linked in this
fashion in this profile. See Appendix A, Section 7.2. Linking
Parent and Child Results, of this document for more
information on linking parent/child results.
4
Universal Service Identifier CWE_C R
R
[1..1]
Identifier code for the requested observation/test/ battery.
5
Priority – OBR
ID
X
[0..0]
Deprecated as of HL7 Version 2.3. See TQ1-9 Priority Field.
6
Requested Date/Time
TS
X
[0..0]
Deprecated as of HL7 Version 2.3. See TQ1-8 Start
Date/Time.
Page 66 of 151
September 2011
C.LEN
Value Set
Description/Comments
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 3-9. OBSERVATION REQUEST SEGMENT (OBR)
SEQ
Element Name
DT
Usage Cardinality LEN
C.LEN
7
Observation Date/Time
TS
RE
[1..1]
8..24
=
For specimen-based observations, the date/time the
specimen was collected. Since a test may also involve
drawing specimens at different times, e.g., tolerance tests,
this date/time only covers the draw of the first specimen. All
other specimen collection date/times, including the first one,
are communicated in the SPM segment
For unknown collection date/time use "0000".
Format: YYYYMMDD[HH[MM[SS[.S[S[S[S]]]]]]]]+/-ZZZZ]
except when reporting an unknown date of ‘0000”
Timezone offset is optional, but encouraged.
Be as precise as possible; particularly important for newborns.
At least YYYYMMDD, and prefers HH and MM for newborns
as well.
8
Observation End Date/Time TS
RE
[0..1]
8..24
=
For specimen-based observations where the specimen was
collected over a period of time, this represents the end point in
time when the specimen was collected.
Timezone offset is optional but encouraged.
Be as precise as appropriate and available. Particularly
important for newborns. At least YYYYMMDD, and prefers
HH for newborns as welll.
9
Collection Volume
CQ
O
[0..0]
10
Collector Identifier
XCN
O
[0..*]
11
Specimen Action Code
ID
RE
[0..1]
12
Danger Code
CWE
O
[0..1]
13
Relevant Clinical
Information
CWE_C RE
RE
[0..*]
14
Specimen Received
Date/Time
TS
X
[0..0]
Deprecated as of HL7 Version 2.5. See SPM-18 Specimen
Received Date/Time.
15
Specimen Source
SPS
X
[0..0]
Deprecated as of HL7 Version 2.5. See SPM-4 Specimen
Type.
1..1
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Value Set
Description/Comments
HL70065
Page 67 of 151
September 2011
TABLE 3-9. OBSERVATION REQUEST SEGMENT (OBR)
SEQ
Element Name
DT
Usage Cardinality LEN
16
Ordering Provider
XCN
R
[1..1]
17
Order Call-back Phone
Number
XTN
O
[0..*]
18
Placer Field 1
ST
O
[0..1]
1..199
Conformance: Echo as received from the order.
19
Placer Field 2
ST
O
[0..1]
1..199
Conformance: Echo as received from the order.
20
Filler Field 1
ST
O
[0..1]
1..199
21
Filler Field 2
ST
O
[0..1]
1..199
22
Results Rpt/Status Chng Date/Time
TS
R
[1..1]
8..24
23
Charge to Practice
MOC
O
[0..1]
24
Diagnostic Serv Sect ID
ID
O
[0..1]
2..3
25
Result Status
ID
R
[1..1]
1..1
26
Parent Result
PRL
C(R/RE) [0..1]
Page 68 of 151
September 2011
C.LEN
Value Set
Description/Comments
Identifier of the provider who ordered the testing being
performed. The National Provider Identifier (NPI) may be used
as the identifier.
Note that ORC.12 Ordering Provider is constrained to contain
the same value as this field.
=
Required field in this message. Applies to the entire report.
Receipt of a subsequent message with the same Filler
Number and a different status in this field implies that
processing may need to occur at the receiving application
level to update a previous report. Format:
YYYYMMDDHHMMSS.SS[…]+/-ZZZZ
Timezone offset is optional and encouraged.
V2 Result Status
Value Set
Condition Predicate: If OBR.11 (Specimen Action Code) is
valued G
Field that, together with OBR-29 Parent, allows this result to
be linked to a specific OBX segment associated with another
OBR segment. See Section 7.2. Linking Parent and Child
Results, of this document for more information on linking
parent/child results.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 3-9. OBSERVATION REQUEST SEGMENT (OBR)
SEQ
Element Name
DT
Usage Cardinality LEN
27
Quantity/Timing
TQ
X
[0..0]
Deprecated as of HL7 Version 2.5. See TQ1 and TQ2
segments.
28
Result Copies To
XCN
C(R/X)
[0..*]
Condition Predicate:
Rationale to use * instead of 5 is that the number of copies
that is supported is most likely negotiated during the order
transactions.
Condition Predicate: If OBR.nnn is valued
Conformance Statement: If OBR.nnn is "E" then OBR.28
must be valued with only one recipient's name.
Conformance Statement: If OBR.nnn is "R" then OBR.28 must
contain at least one recipient's name.
29
Parent
EIP
C(R/RE) [0..1]
Condition Predicate: If OBR.11 (Specimen Action Code) is
valued G
Used to link this OBR with a parent OBR. Commonly used
with microbiology messages to link a susceptibility result with
the parent culture that identified the organism. For this linkage
to work properly, the Placer Order Number and the Filler
Order Number must uniquely identify the specific parent OBR.
This means that the same Filler Number cannot be used to
identify multiple OBRs. See Appendix A, Section 7.2. Linking
Parent and Child Results, of this document for more
information on linking parent/child results.
30
Transportation Mode
ID
X
[0..0]
31
Reason for Study
CWE
O
[0..*]
32
Principal Result Interpreter NDL
O
[0..1]
33
Assistant Result Interpreter NDL
O
[0..*]
34
Technician
NDL
O
[0..*]
35
Transcriptionist
NDL
O
[0..*]
36
Scheduled Date/Time
TS
O
[0..1]
4..4
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
C.LEN
Value Set
Description/Comments
Not supported.
Page 69 of 151
September 2011
TABLE 3-9. OBSERVATION REQUEST SEGMENT (OBR)
SEQ
Element Name
DT
Usage Cardinality LEN
37
Number of Sample
Containers
NM
X
[0..0]
38
Transport Logistics of
Collected Sample
CWE
X
[0..0]
39
Collector's Comment
CWE
O
[0..*]
40
Transport Arrangement
Responsibility
CWE
X
[0..0]
41
Transport Arranged
ID
X
[0..0]
1..1
42
Escort Required
ID
X
[0..0]
1..1
43
Planned Patient Transport
Comment
CWE
X
[0..0]
44
Procedure Code
CWE
O
[0..1]
45
Procedure Code Modifier
CWE
O
[0..*]
46
Placer Supplemental
Service Information
CWE
O
[0..*]
47
Filler Supplemental Service CWE
Information
O
[0..*]
48
Medically Necessary
Duplicate Procedure
Reason
CWE
O
[0..1]
49
Result Handling
IS
O
[0..1]
50
Parent Universal Service
Identifier
CWE
C(R/X)
[0..1]
C.LEN
Value Set
Description/Comments
1..16
Condition Predicate: If OBR.29 (Parent) is valued
OBR.50 contains the universal service identifier of the parent
order.
Usage Note
Page 70 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
In the circumstance where some of the lab results are generated by the lab, but others are performed by a reference lab, the sending lab
can choose what filler order number to use. Whichever filler order number is used, the sending lab is expected to be able to trace all the
observations in the lab result back to the appropriate source lab based on the filler order number provided in OBR-3.
Conformance Statement: Base Profile
LRI-XXX-X: For each occurrence of the OBR segment, OBR.1 (Set ID – OBR) SHALL be valued with successive values starting with
‘1’.
Note: For the first occurrence of the OBR segment, OBR.1 (Set ID – OBR) SHALL be valued with the constant ‘1’, for the second
occurrence of the OBR segment, OBR.1 (Set ID – OBR) SHALL be valued with the constant ‘2’, etc.
LRI-OBR-1: The value of OBR.2 (Placer Order Number) SHALL be identical to the value of ORC.2 (Placer Order Number).
LRI-OBR-2: The value of OBR.3 (Filler Order Number) SHALL be identical to the value of ORC.3 (Filler Order Number).
LRI-OBR-3: The value of OBR.7 (Observation Date/Time) and OBR.8 (Observation End Date/Time) SHALL be precise to the DAY
(YYYYMMDD) and SHOULD be precise to the minute (YYMMDDHHMM)
LRI-OBR-4: The value of OBR.22 (Results Rpt/Status Chng - Date/Time) SHALL be precise to the DAY (YYYYMMDD) and
SHOULD be precise to the second (YYYYMMDDHHMMSS).
LRI-OBR-5: If SPM segment is present, the value of OBR.7 (Observation Date/Time) SHALL be identical to SPM.17 (Specimen
Collection Date/Time).
LRI-OBX-6: If an OBX segment is related to this OBR, the value of OBX.14 (Date/Time of the Observation) SHALL be identical to
OBR.7 (Observation Date/Time).
LRI-OBR-7: OBR.11 (Specimen Action Code) SHALL be a value of A, G, L, or O or empty (blank).
LRI-OBR-8: The value of OBR.12 (Ordering Provider) SHALL be identical to the value of ORC.3 (Ordering Provider).
LRI-OBR-11: If OBR.29 (Parent) is valued, OBR.50 (Parent Universal Service Identifier) SHALL be valued and SHALL be identical to
the value of ORC.31 (Parent Universal Service Identifier).
Conformance Statement: LRI-GU Profile
LRI-OBR-14: OBR.29 (Parent) SHALL be valued using the EIP – GU – Entity Identifier Pair (Globally Unique) datatype definition and
constraints.
LRI-OBR-15: OBR.10 (Collector Identifier), OBR.16 (Ordering Provider), and OBR.28 (Result Copies To) SHALL be valued using the
XCN – GU – Extended Composite ID Number and Name for Persons (Globally Unique) datatype definition and constraints.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 71 of 151
September 2011
Conformance Statement: LRI-NG Profile
LRI-OBR-16: OBR.2 (Placer Order Number) and OBR.3 (Filler Order Number) SHALL be valued using the SHALL be valued using the
EI NG – Entity Identifier (Non-Globally Unique) datatype definition and constraints.
LRI-OBR-17: OBR.29 (Parent) SHALL be valued using the EIP – NG – Entity Identifier Pair (Non-Globally Unique) datatype definition
and constraints.
LRI-OBR-18: OBR.10 (Collector Identifier), OBR.16 (Ordering Provider), and OBR.28 (Result Copies To) SHALL be valued using the
XCN – NG – Extended Composite ID Number and Name for Persons (Non-Globally Unique) datatype definition and constraints.
3.3.10 TQ1 – TIMING/QUANTITY SEGMENT
The TQ1 segment is used to specify the timing of events and actions such as those that occur in order management and scheduling systems.
TABLE 3-10. TIMING/QUANTITY SEGMENT FOR ORDER GROUP
SEQ
Element Name
DT
Usage
Cardinality LEN
1
Set ID - TQ1
SI
R
[1..1]
2
Quantity
CQ
O
[0..1]
3
Repeat Pattern
RPT
O
[0..*]
4
Explicit Time
TM
O
[0..*]
5
Relative Time and Units
CQ
O
[0..*]
6
Service Duration
CQ
O
[0..1]
7
Start date/time
TS
C(R/RE)
[0..1]
4..24
=
Condition Predicate: If TQ1.8 (End date/time) is not valued
Conformance: Echo as received from the order.
8
End date/time
TS
C(R/RE)
[0..1]
4..24
=
Condition Predicate: If TQ1.7 (Start date/time) is not valued
Conformance: Echo as received from the order.
9
Priority
CWE
O
[0..*]
10
Condition text
TX
O
[0..1]
1..250
11
Text instruction
TX
O
[0..1]
1..250
Page 72 of 151
September 2011
C.LEN
1..4
Value Set
Description/Comments
Sequence number of the timing specification, the first of which
shall be 1; the second of which shall be 2; and so on.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 3-10. TIMING/QUANTITY SEGMENT FOR ORDER GROUP
SEQ
Element Name
DT
Usage
Cardinality LEN
12
Conjunction
ID
O
[0..1]
13
Occurrence duration
CQ
O
[0..1]
14
Total occurrence's
NM
O
[0..1]
C.LEN
Value Set
Description/Comments
1..1
1..10
Usage Note
In the circumstance where some of the lab results are generated by the lab, but others are performed by a reference lab, the sending lab
can choose what filler order number to use., Which ever filler order number is used, the sending lab is expected to be able to trace all the
observations in the lab result back to the appropriate source lab based on the filler order number provided in OBR-3.
Conformance Statement: Base Profile
LRI-TQ1-1: The value of TQ1.1 (Set ID – T Q1) SHALL be valued sequentially.
LRI-TQ1-2: The value of TQ1.7 (Start Date/Time) and TQ1.8 (End Date/Time) SHALL be echoed from the order.
LRI-TQ1-3: OBR.9 (Priority) SHALL be valued using the CWE – Coded with Exceptions – All Fields Except OBX-5 datatype definition
and constraints.
3.3.11 OBX – OBSERVATION/RESULT SEGMENT
The Observation/Result Segment (OBX) contains information regarding a single observation related to a single test (OBR) or specimen
(SPM). This includes identification of the specific type of observation, the result for the observation, when the observation was made, etc.
TABLE 3-11. OBSERVATION RESULT SEGMENT (OBX)
SEQ
Element Name
DT
Usage
Cardinality LEN
1
Set ID – OBX
SI
R
[1..1]
1..4
2
Value Type
ID
C(R/X)
[0..1]
2..3
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
C.LEN
Value Set
Description/Comments
For the first repeat of the OBX segment, the sequence number
shall be one (1), for the second repeat, the sequence number
shall be two (2), etc.
HL70125
Condition Predicate: If OBX.5 (Observation Value) is valued
This field identifies the data type used for OBX-5.
Page 73 of 151
September 2011
TABLE 3-11. OBSERVATION RESULT SEGMENT (OBX)
SEQ
Element Name
DT
Usage
Cardinality LEN
3
Observation Identifier
CWE
R
[1..1]
4
Observation Sub-ID
ST
C(R/RE)
[0..1]
5
Observation Value
Var
RE
[0..1]
For coded
observation
values, use
Laboratory Coded
Observation
Value Set.
6
Units
CWE
C(R/RE)
[0..1]
Unified Code for Condition Predicate: If OBX.2 (Value Type) is valued as NM or
Units of Measure SN and OBX.11 is not X
(UCUM)
UCUM® is an HL7-approved code system.
For dimensionless units the UCUM representation would be
{string}, e.g., for titer this would be {titer}.
7
References Range
ST
RE
[0..1]
Page 74 of 151
September 2011
C.LEN
Value Set
Description/Comments
Laboratory
Observation
Identifier Value
Set
Unique identifier for the type of observation. This field provides
a code for the type of observation. OBX-3 in conjunction with
OBX-4 Observation Sub-ID should uniquely identify this OBX
from all other OBXs associated with this OBR.
LOINC is used as the coding system for this field. Local codes
may also be used in conjunction with LOINC codes
When populating this field with values, this guide does not give
preference to the triplet in which the standard (LOINC) code
should appear.
1..20
1..60
Condition Predicate:
=
Interpretation range that applies to the value reported in OBX5. It should provide enough information to understand the
abnormal flags reported in OBX-8.
Note-It is not appropriate to send the reference range for a
result in an associated NTE segment. It would be appropriate
to send information amplifying the reference range provided in
this field in an NTE associated with this OBX.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 3-11. OBSERVATION RESULT SEGMENT (OBX)
SEQ
Element Name
DT
Usage
Cardinality LEN
C.LEN
Value Set
8
Abnormal Flags
CWE
RE
[0..*]
1..20
#
HL70078 (2.7.1) Indicator of the normalcy of the result found in OBX-5.
Cardinality indicates the possible need for multiple abnormal
flags, as in the following example:
Example: Hemoglobin has a normal range of 12-16
Initial result (reported in a separate ORU message based on
testing an earlier specimen): HGB = 15.9 (results normal)
Current result (in this OBX based on current specimen): HGB
= 11.9 abnormality: (L) below low normal and a (D) significant
change down (delta > 3).
In this example, OBX-8 would be set to |L~D|.
Microbiology example:
Ceftazidime susceptibility (LOINC 133-9) value = |<=^1|, units
= ug/ml, Abnormal flag = S
Note that this IG is adopting HL70078 from 2.7.1.
9
Probability
NM
O
[0..1]
1..5
10
Nature of Abnormal Test
ID
O
[0..1]
1..2
11
Observation Result Status ID
R
[1..1]
1..1
12
Effective Date of Reference TS
Range
O
[0..1]
13
User-Defined Access
Checks
ST
O
[0..1]
HL70085
Description/Comments
Status of the observation result.
20
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 75 of 151
September 2011
TABLE 3-11. OBSERVATION RESULT SEGMENT (OBX)
SEQ
Element Name
DT
Usage
Cardinality LEN
C.LEN
14
Date/Time of the
Observation
TS
RE
[0..1]
=
15
Producer’s Reference
CWE
O
[0..1]
16
Responsible Observer
XCN
RE
[0..*]
17
Observation Method
CWE
RE
[0..*]
18
Equipment Instance
Identifier
EI
O
[0..*]
19
Date/Time of the Analysis
TS
RE
[0..1]
Time at which the testing was performed.
Timezone offset is required, format:
YYYYMMDDHHMMSS.SS[…]+/-ZZZZ)
Be as precise as appropriate and available. At least
YYYYMMDDHH.
20
Reserved for harmonization (TBD)
with Version 2.6.
X
[0..0]
Not supported.
21
Reserved for harmonization (TBD)
with Version 2.6.
X
[0..0]
Not supported.
22
Reserved for harmonization (TBD)
with Version 2.6.
[0..0]
Not supported.
Page 76 of 151
September 2011
8..24
Value Set
Description/Comments
Emphasize that it reflects the clinically relevant date/time, not
when it is run on the machine or interpreted.
For specimen based test, if it is valued it must be the same as
SPM.17
If SPM.17 is present and relates to the same observation, then
OBX.14 must be within the DR range.
Timezone offset is optional, but strongly encourage, format:
YYYYMMDDHHMMSS.SS[…]+/-ZZZZ)
Be as precise as appropriate and available. Shall support at
least YYYYMMDDHHMM. For newborn needs to be down to
YYYYMMDDHH, possibly minutes, while other YYYYMMDD
could be appropriate.
HL7 V3
Observation
Method
Method of testing by the laboratory. If the LOINC code in OBX3 is methodless, this field shall be populated. Sometimes the
method may be extrapolated from the local test codes.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 3-11. OBSERVATION RESULT SEGMENT (OBX)
SEQ
Element Name
DT
Usage
Cardinality LEN
C.LEN
Value Set
Description/Comments
23
Performing Organization
Name
XON
R
[1..1]
The information for producer ID is recorded as an XON data
type.
For laboratories, this field specifies the laboratory that
produced the test result described in this OBX segment. This
information supports CLIA regulations in the US. For producing
laboratories that are CLIA-certified, the CLIA identifier should
be used for the organization identifier (component 10).
24
Performing Organization
Address
XAD
R
[1..1]
Address of the laboratory that actually performed the test when
used as a reference laboratory.
25
Performing Organization
Medical Director
XCN
RE
[0..1]
Name of the Medical Director of the reference laboratory.
Required when OBX-24 indicates the performing lab is in a
jurisdiction that requires this information.
Conformance Statement: Base Profile
LRI-OBX-1: The value of OBX.1 (Set ID – OBX) SHALL be valued sequentially.
LRI-OBX-2: If there are multiple OBX segments with the same OBX-3 values under the same OBR, a combination of OBX-3 and OBX-4
SHALL create a unique identification under a single OBR.
LRI-OBX-3: If OBX.5 (Observation Value) is valued, then OBX.2 (Value Type) SHALL support datatypes CE, DT, NM, SN, ST, TM,
TS, TX, FT and CWE.
LRI-OBX-4: If OBX.5 (Observation Value) is valued, then OBX.2 (Value Type) MAY support datatypes CX, ED, and RP.
LRI-OBX-5: If OBX.5 (Observation Value) is valued, then OBX.2 (Value Type) SHALL NOT support remaining datatypes in Table
HL70125.
LRI-OBX-6: If OBX.5 (Observation Value) is CWE, then it SHALL be valued using the CWE – Coded with Exceptions – For OBX-5
Only datatype definition and constraints.
LRI-OBX-7: If OBX.5 (Observation Value) is CE, then CE.1 (Identifier) and CE.3 (Name of Coding System) or CE. 4 (Alternate
Identifier) and CE.6 (Name of Alternate Coding System) SHALL be valued.
LRI-OBX-8: If OBX.2 (Value Type) is valued as NM or SN and OBX.11 is not X, then OBX.6 (Units) SHALL be required/mandatory.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 77 of 151
September 2011
LRI-OBX-9: If OBX.5 (Value Type) is not valued and OBX.11 is not X, then OBX.6 (Abnormal Flags) SHALL be required/mandatory.
LRI-OBX-10: OBX.14 (Date/Time of the Observation) SHALL be precise to the hour (YYYYMMDDHH) and MAY include the
timezone offset.
LRI-OBX-11: OBX19 (Date/Time of the Analysis) SHALL be precise to the hour (YYYYMMDDHH) and SHALL include the timezone
offset.
Conformance Statement: LRI-GU Profile
LRI-OBX-12: The value of OBX.16 (Responsible Observer) and OBX.25 (Performing Organization Medical Director) SHALL be valued
using the XCN – GU – Extended Composite ID Number and Name for Persons (Globally Unique) datatype definition and constraints.
LRI-OBX-13: The value of OBX.23 (Performing Organization Name) SHALL be valued using the XON GU – Extended Composite
Name and Identification Number for Organizations Globally Unique) datatype definition and constraints.
Conformance Statement: LRI-NG Profile
LRI-OBX-14: The value of OBX.16 (Responsible Observer) OBX.25 (Performing Organization Medical Director) SHALL be valued
using the XCN – NG – Extended Composite ID Number and Name for Persons (Non-Globally Unique) datatype definition and constraints.
LRI-OBX-15: The value of OBX.23 (Performing Organization Name) SHALL be valued using the XON NG – Extended Composite
Name and Identification Number for Organizations (Non-Globally Unique) datatype definition and constraints.
3.3.11.1 OBSERVATION IDENTIFIERS, OBSERVATION VALUES, INTERPRETATIONS AND COMMENTS
Laboratory results fall into several broad categories or types of results. The first type of result is a quantitative measure of some property of a
specimen and is typically numerical in nature. Often these numeric results are also associated with some sort of interpretation, typically in
terms of the normality or abnormality of the measured quantity in relationship to a reference range or normal range. Another type of result is a
qualitative result related to the testing of a specimen. This is typically coded or textual in nature. Qualitative results may actually be
interpretations of more detailed quantitative measurement. Finally, both quantitative and qualitative results may have comments associated
with them. These comments may provide additional clarification, information regarding how the result was obtained, etc.
How a particular result should be reported using the OBX segment above depends upon what is being used as an observation identifier for
OBX-3. This guide assumes that LOINC is normally being used for the identification of observations. LOINC identifiers can easily be
classified as quantitative or qualitative. The LOINC scale property QN (quantitative) indicates that the LOINC identifier is quantitative. All
other LOINC identifiers can be treated as qualitative for the purpose of this discussion. Those OBX’s associated with quantitative LOINC
identifiers should be using OBX-5 with either the NM (numeric), SN (structured numeric), TS (timestamp), DT (date) or TM (time) data
types. These quantitative results can be accompanied by an interpretation. Coded interpretations should be reported using OBX-8 (abnormal
Page 78 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
flags) when the values have been drawn from HL7 table 0078. When a coded interpretation is sent, or when a textual interpretation is sent, a
second OBX using a non-quantitative LOINC identifier should be used.
The above discussion has focused on actual clinical findings, whether they are quantitative or qualitative. Often, additional clarifying
documentation is sent along with the clinical findings. These should be handled as comments, conveyed in an NTE segment(s) following the
OBX in question. Comments typically fall into the following categories:

Comments about how a clinical finding was reached

Clarification regarding the meaning of a clinical finding

Additional information not directly related to the clinical finding such as contact information for the lab, disclaimers, etc.
 Most canned, or boiler plate text associated with a result falls into the comment category
The following table gives examples of how the different fields in the OBX segment interact to create the complete observation.
TABLE 3-12. OBSERVATION IDENTIFIERS
Testing
Situation
Discussion
Numeric result
along with
interpretation
Numerical
intervals, ratios,
inequalities
Time like
quantitative result
with interpretation
OBX.3
OBX.2
Observation
Observation
Identifier: LOINC
Type
part = scale
NM
SN
TS, TM, DT
OBX.7
OBX.8
Reference
Abnormal Flags
Range
NTE Segment
number
May be populated
with UCUM Units
May be populated
with codes from HL7
table 0078
May be populated
May be populated
with comments, not
clinical findings.
QN
structured numeric
May be populated
with UCUM Units
May be populated
with codes from HL7
table 0078
May be populated
May be populated
with comments, not
clinical findings.
QN
timestamp, time or
date
[empty]
May be populated
with codes from HL7
table 0078
May be populated
May be populated
with comments, not
clinical findings.
QN
OBX.5
Observation
value
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
OBX.6
Units
Page 79 of 151
September 2011
Testing
Situation
Discussion
Conveys ordinal
value and
interpretation
Conveys ordinal
value and
interpretation
Conveys
observation and
interpretation
Conveys
observation and
interpretation
Conveys
observation and
interpretation
TABLE 3-12. OBSERVATION IDENTIFIERS
OBX.3
OBX.2
OBX.5
Observation
OBX.6
OBX.8
Observation
Observation
Identifier: LOINC
Units
Abnormal Flags
Type
value
part = scale
Ordinal as a code.
SNOMED CT shall
be used when code
exists; otherwise a
local code. Sending
ordinals as codes is
May be populated
the preferred ELR
with codes from HL7
CWE
ORD
[empty]
approach.
table 0078
SN
CWE
FT, TX or ST
FT, TX or ST
Conveys imbedded
object (ED) or
pointer to object
ED, RP
(RP)
Page 80 of 151
September 2011
OBX.7
Reference
Range
May be populated
NTE Segment
May be populated
with comments, not
clinical findings.
ORD
Ordinal as structured
[empty]
numeric
May be populated
with codes from HL7
Required
table 0078
May be populated
with comments, not
clinical findings.
NOM
Coded observation.
SNOMED CT shall
be used when code
exists; otherwise it’s
[empty]
a local code.
May be populated
with codes from HL7
May be populated
table 0078
May be populated
with comments, not
clinical findings.
text
[empty]
May be populated
with codes from HL7
May be populated
table 0078
May be populated
with comments, not
clinical findings.
[empty]
May be populated
with codes from HL7
May be populated
table 0078
May be populated
with comments, not
clinical findings.
[empty]
May be populated
with comments, not
clinical findings.
NAR
MULTI
text
Varies
Object pointer or
imbedded object
[empty]
[empty]
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
3.3.12 SPM – SPECIMEN SEGMENT
The Specimen Information Segment (SPM) describes the characteristics of a single sample. The SPM segment carries information regarding
the type of specimen, where and how it was collected, who collected it and some basic characteristics of the specimen.
TABLE 3-13. SPECIMEN SEGMENT (SPM)
SEQ Element Name
DT
Usage Cardinality LEN
1
Set ID – SPM
SI
R
[1..1]
2
Specimen ID
EIP
O
[0..1]
3
Specimen Parent IDs
EIP
O
[0..*]
4
Specimen Type
CWE R
_CRE
[1..1]
5
Specimen Type Modifier CWE O
[0..*]
6
Specimen Additives
CWE O
[0..*]
7
Specimen Collection
Method
CWE O
[0..1]
8
Specimen Source Site
CWE O
[0..1]
9
Specimen Source Site
Modifier
CWE O
[0..*]
10
Specimen Collection
Site
CWE O
[0..1]
11
Specimen Role
CWE O
[0..*]
12
Specimen Collection
Amount
CQ
O
[0..1]
13
Grouped Specimen
Count
NM
O
[0..1]
14
Specimen Description
ST
O
[0..1]
15
Specimen Handling
Code
CWE O
[0..*]
C.LEN Value Set
1..4
Description/Comments
For the first repeat of the SPM segment, the sequence number shall be
one (1), for the second repeat, the sequence number shall be two (2), etc.
Specimen Type Description of the precise nature of the entity that is the source material for
Value Set
the observation.
1..6
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 81 of 151
September 2011
TABLE 3-13. SPECIMEN SEGMENT (SPM)
SEQ Element Name
DT
16
Specimen Risk Code
CWE O
[0..*]
17
Specimen Collection
Date/Time
DR
R
[1..1]
18
Specimen Received
Date/Time
TS
O
[0..1]
19
Specimen Expiration
Date/Time
TS
O
[0..1]
20
Specimen Availability
ID
O
[0..1]
21
Specimen Reject
Reason
CWE O
[0..*]
22
Specimen Quality
CWE O
[0..1]
23
Specimen
Appropriateness
CWE O
[0..1]
24
Specimen Condition
CWE O
[0..*]
25
Specimen Current
Quantity
CQ
[0..1]
Page 82 of 151
September 2011
Usage Cardinality LEN
O
8..24
C.LEN Value Set
Description/Comments
=
Time range over which the sample was collected, as opposed to the time
the sample collection device was recovered. This value should be the
same as OBR.7, unless a new specimen was drawn at the testing
laboratory.
The first component of the date range must match OBR-7 Observation
Date/Time. The second component must match OBR-8 Observation End
Date/Time. For OBXs reporting observations based on this specimen,
OBX-14 should contain the same value as component 1 of this field.
A minimum of year, month and day must be provided when the actual
date/time is known. For unknown collection date/time use "0000".
Format: |YYYYMMDD[HH[MM[SS[.S[S[S[S]]]]]]][+/ZZZZ]^YYYYMMDD[HH[MM[SS[.S[S[S[S]]]]]]][+/-ZZZZ]|
Timezone offset is required.
Be as precise as appropriate and available. At least YYYYMMDD. For
newborn needs to be down to the hours, possibly minutes.
1..1
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 3-13. SPECIMEN SEGMENT (SPM)
SEQ Element Name
DT
Usage Cardinality LEN
26
Number of Specimen
Containers
NM
O
[0..1]
27
Container Type
CWE O
[0..1]
28
Container Condition
CWE O
[0..1]
29
Specimen Child Role
CWE O
[0..1]
C.LEN Value Set
Description/Comments
1..4
3.3.13 NTE – NOTES AND COMMENTS SEGMENT
The Notes and Comments Segment (NTE) is used to convey additional comments regarding the associated segment. The NTE segment is not
intended for automatic processing. The contents of the NTE segment are primarily intended for human use. Automated process should not be
based upon the contents of NTE-3 (Comment); rather the content of that field should be displayed to humans.
TABLE 3-14. NOTES AND COMMENTS SEGMENT (NTE)
SEQ Element Name
DT
Usage Cardinality LEN
1
Set ID – NTE
SI
R
[1..1]
2
Source of Comment
ID
RE
[0..1]
3
Comment
FT
R
[1..*]
4
Comment Type
CWE
RE
[0..1]
C.LEN Value Set
Description/Comments
For the first repeat of the NTE segment, the sequence number shall be
one (1), for the second repeat, the seqence number shall be two (2), etc.
1..1
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
HL70105
Comment contained in the segment.
HL70364
Page 83 of 151
September 2011
4. CODE SYSTEMS AND VALUE SETS
Successful message implementation requires that transmitted messages (message instances)
contain valid values for coded fields. It is important to note that code sets are relatively dynamic
and subject to change between publications of these implementation guides.
Every code value passed in a message instance is drawn from a code system that either may have
a globally unique identifier, such as an OID, an HL7 identifier (Table 0396), or a locally defined
identifier. In general, the coded values allowed in a field (a) may be drawn from more than one
code system, and (b) may be a subset of the codes from a given coding system. Combining (a)
and (b) makes it possible for the allowed code value to be a combination of multiple subsets
drawn from multiple coding systems. In most cases, only subsets of the codes defined in a code
system are legal for use in a particular message.
The subsets of the codes that are allowed for a particular field is identified by an HL7 construct
known as a "value set." A value set is a collection of coded values drawn from code systems.
Value sets serve to identify the specific set of coded values for the message from the universe of
coded values across all coding systems.
The segment tables in previous sections identify the value set or coding system used for each
supported field containing a coded value. Some of these pre-coordinated value sets must be
updated, or new ones created, as new needs are identified.
Value sets are identified by a unique identifier, but is not transmitted in the message. The
identifier or code for the coding system from which the value is derived is sent in the message.
However, the value set identifier is useful and important when vocabulary items are modified or
replaced.
4.1 HL7 TABLES
Tables in this guide are as specified in the HL7 Version 2.5.1 Standard, except as noted below.

HL7 Table 0065-Specimen Action Code is pre-adopted from HL7 Version 2.7.1

HL7 Table 0078-Interpretation Codes is pre-adopted from HL7 Version 2.7.1

HL7 Table 0203-Identifier Type is pre-adopted from HL7 Version 2.7.1

HL7 Table 0291-Subtype of referenced data is pre-adopted from HL7 Version 2.7.1

HL7 Table 0301-Universal ID Type is pre-adopted from HL7 Version 2.7.1

HL7 Table 0834-MIME Types is pre-adopted from HL7 Version 2.7.1
4.2 LOINC
The use of the Logical Observation Identifiers Names and Codes (LOINC) vocabulary is
required. The LOINC terms transmitted by the sender in OBX.3 must be valid but it is not the
intent of this guide to specify LOINC terms for a given test.
Further information on LOINC and access to tools, please visit http://loinc.org/
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 84 of 151
September 2011
4.3 SNOMED CT
SNOMED CT is a required vocabulary for communicating coded results when reported as Coded
With Exception (CWE) data types in OBX.5 for specific result categories as defined below.
It is also recommended for specimen source terms in SPM.4.
Further information on SNOMED can be found at the National Library of Medicine.
4.4 UCUM
UCUM (Unified Code for Units of Measure) appears to be a viable option for reporting units of
measure but must be pilot tested in order to understand the impact of key issues identified by
various stakeholders. This guide does not preclude the use of UCUM coding where senders and
receivers have localized this guide by mutual agreement.
Further information on UCUM can be found at http://unitsofmeasure.org/
HL7 Version 2.5.1 IG: Ambulatory Laboratory Results Reporting for LRI, R1 (US Realm)
© 2011 Health Level Seven International. All rights reserved.
Page 85-151
August 2011
4.5 VOCABULARY CONSTRAINTS
Table 4-1. Value Set/Code System Summary shows the various value sets/code systems used in this IG. It also provides information about the
source of the vocabulary and an identifier for the vocabulary. The name found in the Value Set/Code System Name column corresponds with the
value set identified in the Value Set column of the data type and segment attribute tables found above.
Name
TABLE 4-1. VALUE SET/CODE SYSTEM SUMMARY
Source
Unique Identifier
Comments
Country Value Set
Source ID/
Reference
HL70399
Administrative Sex
HL70001
HL7 Version 2.5.1
2.16.840.1.113883.12.1
Marital Status
HL70002
HL7 Version 2.5.1
2.16.840.1.113883.12.2
Event Type
HL70003
HL7 Version 2.5.1
2.16.840.1.113883.12.3
Patient Class
HL70004
HL7 Version 2.5.1
2.16.840.1.113883.12.4
Race Category
HL70005
HL7 Version 2.5.1
2.16.840.1.113883.6.238
Acknowledgment Code
HL70008
HL7 Version 2.5.1
2.16.840.1.113883.12.8
Check Digit Scheme
HL70061
HL7 Version 2.5.1
2.16.840.1.113883.12.61
Specimen Action Code
HL70065
HL7 Version 2.7.1
2.16.840.1.113883.12.65
Constrained to A, G, L, O
Message Type
HL70076
HL7 Version 2.5.1
2.16.840.1.113883.12.76
Constrained to ORU, ACK
Observation Interpretation
HL70078
HL7 Version 2.7.1
2.16.840.1.113883.12.78
Observation Result Status
HL70085
HL7 Version 2.5.1
2.16.840.1.113883.12.85
Processing ID
HL70103
HL7 Version 2.5.1
2.16.840.1.113883.12.103
Version ID
HL70104
HL7 Version 2.5.1
2.16.840.1.113883.12.104
Page 86 of 151
September 2011
HL7 Version 2.5.1
Refer to HL7 V2.5.1 Message, Chapter 2, Section 2.15.9.1
This identifies the codes for the representation of names of countries,
territories and areas of geographical interest. The complete set of
3166-1 codes. http://www.iso.org/iso/iso-3166-1_decoding_table
Constrained to ‘R01’
Constrained to ‘v2.5.1’
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Name
Order Control
Source ID/
Reference
HL701119
Observation Result Status
TABLE 4-1. VALUE SET/CODE SYSTEM SUMMARY
Source
Unique Identifier
Comments
HL7 Version 2.5.1
2.16.840.1.113883.12.119
HL70123
HL7 Version 2.5.1
2.16.840.1.113883.12.123
Value Type
HL70125
HL7 Version 2.5.1
2.16.840.1.113883.12.125
Accept/Application
Acknowledgment Condition
HL70155
HL7 Version 2.5.1
2.16.840.1.113883.12.155
Ethnic Group
HL70189
HL7 Version 2.5.1
2.16.840.1.113883.6.238
Address Type
HL70190
HL7 Version 2.5.1
2.16.840.1.113883.12.190
Type of Referenced Data
HL70191
HL7 Version 2.5.1
2.16.840.1.113883.12.191
Name type
HL70200
HL7 Version 2.5.1
2.16.840.1.113883.12.200
Identifier type
HL70203
HL7 Version 2.7.1
2.16.840.1.113883.12.203
Subtype of referenced data
HL70291
HL7 Version 2.7.1
2.16.840.1.113883.12.291
Encoding
HL70299
HL7 Version 2.5.1
2.16.840.1.113883.12.299
Universal ID type
HL70301
HL7 Version 2.7.1
2.16.840.1.113883.12.301
Message structure
HL70354
HL7 Version 2.5.1
2.16.840.1.113883.12.354
Message Error Condition
Codes
HL70357
HL7 Version 2.5.1
2.16.840.1.113883.12.357
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Constrained as follows:
R for CE, DT, NM, SN, ST, TM, TS, TX, FT, CWE
RE for CX, ED, RP (requires agreement between trading partners)
.
Constrained to ORU_R01, ACK
Page 87 of 151
September 2011
Name
Coding Systems
Source ID/
Reference
HL70396
TABLE 4-1. VALUE SET/CODE SYSTEM SUMMARY
Source
Unique Identifier
Comments
HL7
2.16.840.1.113883.12.396
http://www.hl7.org/sp
ecial/committees/voca
b/table_0396/index.cf
m
Specimen Type
HL70487
HL7 Version 2.5.1
2.16.840.1.113883.12.487
Sequence Condition Code
HL70504
HL7 Version 2.5.1
2.16.840.1.113883.12.504
Cyclic Entry/Exit Indicator
HL70505
HL7 Version 2.5.1
2.16.840.1.113883.12.505
Service Request Relationship
HL70506
HL7 Version 2.5.1
2.16.840.1.113883.12.506
Page 88 of 151
September 2011
HL7 Table 0396 defines the standard coding systems recognized by
HL7. The table defines a mechanism by which locally defined codes
can be transmitted. Any code/coding system not defined in HL7 Table
0396 is considered a “local” coding system from the HL7 perspective.
Coding systems that are identified in this implementation guide will be
identified according to the recommended HL7 nomenclature from table
0396 as “99ELR-zzz” where “zzz” represents a string identifying the
specific non-standard coding system. To maintain backwards
compatibility with the 2.3.1 ELR implementation Guide, coding systems
defined locally (i.e., not identified in this guide) and not defined in HL7
Table 0396 can continue to identify the coding system as “L”. It is
strongly suggested that implementers instead adopt the use of “99zzz”
approach to identifying local coding systems since HL7 has indicated
that use of the “L” for local coding systems is retained only for
backwards compatibility, and its use may be withdrawn in a
subsequent 2.x version. Note that the local use of “99zzz” should not
collide with any of the “locally” defined coding systems identified in this
implementation guide.
HL7 now maintains HL7 table 0396 “real time”. This means that values
may be added to the table at any time so that implementers can have
an up-to-date source of truth for the codes to be used to identify coding
systems in any 2.x message. Users of this IG should acquire the latest
version of HL7 table 0396. The latest version of HL7 table 0396
(independent of HL7 version) is available for download from HL7 at:
http://www.hl7.org/special/committees/vocab/table_0396/index.cfm.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Name
Error severity
Source ID/
Reference
HL70516
MIME Types
HL70834
TABLE 4-1. VALUE SET/CODE SYSTEM SUMMARY
Source
Unique Identifier
Comments
HL7 Version 2.5.1
2.16.840.1.113883.12.516
HL7 Version 2.7.1
2.16.840.1.113883.12.834
Imported Table 0834
Note that the HITSP Lab to EHR IG uses HL70191, which can be
directly mapped to the 2.7.1 values imported from IANA.
Laboratory Coded Observation
Value Set
TBD
TBD
Drawn from SNOMED CT. See Usage Notes.
Laboratory Observation
Identifier Value Set
TBD
TBD
Unique identifiers for the type of observations. Values must be drawn
from LOINC and is required for use with any test on the in-scope test
list.
LOINC
LOINC
2.16.840.1.113883.6.1
(code system)
Logical Observation Identifiers Names and Codes
http://www.loinc.org
New codesystem for new OBR
Field
TBD
TBD
Values are:
R-Results Copy Requested
E - Result Copy Enclosed per Order Provider's request
2.16.840.1.114222.4.11.829
Codes representing county of origin, address county, reporting county
Also referred to as HL70289
2.16.840.1.114222.4.11.831
Primary spoken language
Note that HITSP identifies a language value set as follows:
“The value set is defined by Internet RFC 4646 (replacing RFC 3066).
Please see ISO 639 language code set maintained by Library of
Congress for enumeration of language codes and Frequently Asked
Questions.”
RFC4646 seems to point to ISO 639 as the source of the actual
language codes, so this value set is consistent with the HITSP value
set.
County ()
FIPS 6-4
Language ()
ISO_6392_Alpha3
ISO
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 89 of 151
September 2011
Name
Source ID/
Reference
TABLE 4-1. VALUE SET/CODE SYSTEM SUMMARY
Source
Unique Identifier
Comments
Postal Code Value Set
US Postal Service via 2.16.840.1.113883.3.88.12.80.2 This identifies the postal (ZIP) Code of an address in the United States
HITSP C-80, 20090708
http://zip4.usps.com/zip4/welcome.jsp
V1.1
SNOMED CT
SNOMED CT
2.16.840.1.113883.6.96
SNOMED CT
http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html
Specimen Type Value Set
TBD
TBD
Specimen Type
Union of HL70487 and SNOMED CT Specimen hierarchy
State Value Set
FIPS 5-2
Unified Code for Units of
Measure (UCUM)
HITSP C-80,20090708 2.16.840.1.113883.3.88.12.80.1 Identifies addresses within the United States are recorded using the
V1.1
FIPS 5-2 two-letter alphabetic codes for the State, District of Columbia,
or an outlying area of the United States or associated area.
http://www.itl.nist.gov/fipspubs/fip5-2.htm
Regenstrief Institute, 2.16.840.1.113883.3.88.12.80.29 Units of measure concepts that includes atomic UCUM units as well as
Inc.
UCUM expression. Commonly used UCUM units of measure concepts
http://www.regenstrief.o
can be obtained from UCUM Web Site
rg/medinformatics/ucu
http://www.regenstrief.org/medinformatics/ucum
m
A tool for converting non-UCUM units of measure to the equivalent
UCUM units is available at:
http://www.regenstrief.org/medinformatics/ucum/unit-conversion-tool
A pre-coordinated value set of common units is also available from
PHIN VADS as: PHVS_UnitsOfMeasure_UCUM
Usage Notes
Laboratory Coded Observation Value Set
For specific result categories:
Organisms

Identify using codes from the SNOMED CT “organism” hierarchy
Page 90 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
o This will normally exclude the use of codes from the “clinical finding” hierarchy representing the presence of a specific organism
(e.g., "312210001^methicillin resistant staphylococcus aureus positive^SCT”, "431256002^culture positive for vancomycin
resistant enterococcus^SCT”, "441070005^Human enterovirus present^SCT”). However, in some cases a specific absence finding
may be appropriate (e.g., "404520004^no Chlamydia trachomatis found^SCT”).
Organism-related substances (e.g. toxin, DNA, RNA, antigen, antibody, etc.)

Identify using codes from the SNOMED CT “substance” hierarchy (e.g., "12671002^Clostridium difficile toxin^SCT”,
"121181000^Chlamydia trachomatis DNA^SCT”, "121006005^influenza virus A antigen^SCT”)
o This will normally exclude the use of codes from the “clinical finding” hierarchy representing the presence of a specific
organism-related substance (e.g., "310541005^Clostridium difficile toxin A detected^SCT”). Currently (as of the January 2011
release) we are not aware of any SNOMED CT codes representing the absence of an organism-related substance.
Presence and absence findings

Identify using codes from the SNOMED CT “qualifier value" hierarchy (e.g., "52101004^present^SCT”, "10828004^positive^SCT”,
"2667000^absent^SCT”, "260385009^negative^SCT”)
Anatomic Pathology

Use of SNOMED CT codes is recommended, but further evaluation is needed to determine which hierarchies are appropriate for use
o The NAACCR examples list "abnormal morphology" codes
Clinical genomics and additional clinical areas

Consider whether other vocabularies in addition to, or in place of, SNOMED CT might apply
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 91 of 151
September 2011
4.6 HL7 TABLES
This section provides values for HL7 tables that have had constraints applied to them in this IG.
4.6.1 HL7 TABLE 0065 – SPECIMEN ACTION CODE FROM HL7 V2.7.1 MESSAGE - CONSTRAINED
TABLE 4-2. HL7 TABLE 0065 SPECIMEN ACTION CODE - CONSTRAINED
Value
Description
Comment
A
Add ordered tests to the existing specimen
G
Generated order; reflex order
L
Lab to obtain specimen from patient
O
Specimen obtained by service other than Lab
4.6.2 HL7 TABLE 0076 – MESSAGE TYPE 2.5.1 (CONSTRAINED)
TABLE 4-3. HL7 TABLE 0076 FROM 2.5.1 - CONSTRAINED
Comment
Value
Description
ORU
Unsolicited transmission of an observation message
ACK
General acknowledgment message
4.6.3 HL7 TABLE 0078 – INTERPRETATION CODES FROM HL7 V2.7.1 MESSAGE
TABLE 4-3. HL7 TABLE 0078 FROM 2.7.1
Value
Description
L
Below low normal
H
Above high normal
LL
Below lower panic limits
HH
Above upper panic limits
Page 92 of 151
September 2011
Comment
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 4-3. HL7 TABLE 0078 FROM 2.7.1
Value
Description
<
Below absolute low-off instrument scale
>
Above absolute high-off instrument scale
N
Normal (applies to non-numeric results)
A
Abnormal (applies to non-numeric results)
AA
Very abnormal (applies to non-numeric units, analogous to panic limits for numeric units)
null
No range defined, or normal ranges don't apply
U
Significant change up
D
Significant change down
B
Better—use when direction not relevant
W
Worse—use when direction not relevant
S
Susceptible. Indicates for microbiology susceptibilities only.
R
Resistant. Indicates for microbiology susceptibilities only.
I
Intermediate. Indicates for microbiology susceptibilities only.
MS
Moderately susceptible. Indicates for microbiology susceptibilities only.
VS
Very susceptible. Indicates for microbiology susceptibilities only.
POS
Positive
Added in HL7 Version 2.7.1
NEG
Negative
Added in HL7 Version 2.7.1
IND
Indeterminate
Added in HL7 Version 2.7.1
DET
Detected
Added in HL7 Version 2.7.1
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Comment
Page 93 of 151
September 2011
TABLE 4-3. HL7 TABLE 0078 FROM 2.7.1
Value
Description
Comment
ND
Not Detected
Added in HL7 Version 2.7.1
AC
Anti-complementary substances present
Added in HL7 Version 2.7.1
TOX
Cytotoxic substance present
Added in HL7 Version 2.7.1
QCF
Quality Control Failure
Added in HL7 Version 2.7.1
RR
Reactive
Added in HL7 Version 2.7.1
WR
Weakly reactive
Added in HL7 Version 2.7.1
NR
Non-reactive
Added in HL7 Version 2.7.1
4.6.4 HL7 TABLE 0125 – VALUE TYPE (CONSTRAINED FROM THE FULL HL7 TABLE)
TABLE 4-4. HL7 TABLE 0125 – VALUE TYPE
Value
Description
Use
CE
Coded Entry
R
CWE
Coded with Exceptions
R
CX
Extended Composite ID With Check
Digit
O
DT
Date
R
Page 94 of 151
September 2011
C.LEN
Comment
This Implementation Guide has a specially constrained version of the CWE data
type in section 2.3 above which is used for OBX-5. The version of the CWE
documented in section Error! Reference source not found. shall not be used for
OBX-5. The version of the CWE constrained for use with OBX-5 requires sending
coded data. If the lab is trying to send only string data, the ST, TX or FT data types
should be used.
Data type to be used where it is important to communicate the coding system and
coding system version with the coded result being reported. Pre-adopted from
Version 2.6.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 4-4. HL7 TABLE 0125 – VALUE TYPE
Value
Description
Use
ED
Encapsulated Data
O
Field using the ED data type to allow communication of images, sound clips, XML
documents, html markup, etc.
Requires agreement between trading partners
FT
Formatted Text (Display)
R
Field using the FT data type to carry a text result value. This is intended for
display. The text may contain formatting escape sequences as described in the
data types section. Numeric results and numeric results with units of measure
should not be reported as text. These should be reported as NM or SN numeric
results, with the units of measure in OBX-6.
NM
Numeric
R
Field using the NM data type to carry a numeric result value. The only nonnumeric characters allowed in this field are a leading plus (+) or minus (-) sign.
The structured numeric (SN) data type should be used for conveying inequalities,
ranges, ratios, etc. The units for the numeric value should be reported in OBX-6.
RP
Reference Pointer
O
Field using the RP data type to allow communication of pointers to images, sound
clips, XML documents, html markup, etc. The RP data type is used when the
object being pointed to is too large to transmit directly.
This specification defines the mechanism for exchanging pointers to objects, but it
does not address the details of applications actually accessing and retrieving the
objects over a network.
The most common scheme for passing a pointer is to use a Universal Resource
Identifier (URI). See http://ietf.org/rfc/rfc2396.txt for detailed definition. The
general format of a URI is in the form:
<scheme>://<authority><path>?<query>. The scheme and authority portions
appear in the Application ID component, Universal ID subcomponent. The path
and query portion of the URI appear in the Pointer component of the RP data type.
SN
Structured Numeric
R
Field using the SN data type to carry a structured numeric result value. Structured
numeric include intervals (^0^-^1), ratios (^1^/^2 or ^1^:^2), inequalities (<^10), or
categorical results (2^+). The units for the structured numeric value should be
reported in OBX-6.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
C.LEN
Comment
Page 95 of 151
September 2011
TABLE 4-4. HL7 TABLE 0125 – VALUE TYPE
Value
Description
Use
ST
String Data
R
TM
Time
R
TS
Time Stamp (Date & Time)
R
TX
Text Data (Display)
R
C.LEN
Comment
Field using the ST data type to carry a short text result value. Numeric results and
numeric results with units of measure should not be reported as text. These shall
be reported as NM or SN numeric results, with the units of measure in OBX-6.
Field using the TX data type to carry a text result value this is intended for display.
Numeric results and numeric results with units of measure should not be reported
as text. These should be reported as NM or SN numeric results, with the units of
measure in OBX-6.
4.6.5 HL7 TABLE 0203 – IDENTIFIER TYPE FROM HL7 V2.7.1
TABLE 4-6. HL7 TABLE 0203 – FROM 2.7.1
Value
Description
AM
American Express
AN
Account number
ANC
Account number Creditor
AND
Account number debitor
ANON
Anonymous identifier
ANT
Temporary Account Number
APRN
Advanced Practice Registered Nurse number
BA
Bank Account Number
BC
Bank Card Number
Page 96 of 151
September 2011
Comment
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 4-6. HL7 TABLE 0203 – FROM 2.7.1
Value
Description
BR
Birth registry number
BRN
Breed Registry Number
CC
Cost Center number
CY
County number
DDS
Dentist license number
DEA
Drug Enforcement Administration registration number
DFN
Drug Furnishing or prescriptive authority Number
DI
Diner_s Club card
DL
Driver_s license number
DN
Doctor number
DO
Osteopathic License number
DPM
Podiatrist license number
DR
Donor Registration Number
DS
Discover Card
EI
Employee number
EN
Employer number
FI
Facility ID
GI
Guarantor internal identifier
GL
General ledger number
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Comment
Page 97 of 151
September 2011
TABLE 4-6. HL7 TABLE 0203 – FROM 2.7.1
Value
Description
GN
Guarantor external identifier
HC
Health Card Number
IND
Indigenous/Aboriginal
JHN
Jurisdictional health number (Canada)
LI
Labor and industries number
LN
License number
LR
Local Registry ID
MA
Patient Medicaid number
MB
Member Number
MC
Patient's Medicare number
MCD
Practitioner Medicaid number
MCN
Microchip Number
MCR
Practitioner Medicare number
MD
Medical License number
MI
Military ID number
MR
Medical record number
MRT
Temporary Medical Record Number
MS
MasterCard
NE
National employer identifier
Page 98 of 151
September 2011
Comment
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 4-6. HL7 TABLE 0203 – FROM 2.7.1
Value
Description
NH
National Health Plan Identifier
NI
National unique individual identifier
NII
National Insurance Organization Identifier
NIIP
National Insurance Payor Identifier (Payor)
NNxxx
National Person Identifier where the xxx is the ISO table 3166 3-character (alphabetic) country code
NP
Nurse practitioner number
NPI
National provider identifier
OD
Optometrist license number
PA
Physician Assistant number
PCN
Penitentiary/correctional institution Number
PE
Living Subject Enterprise Number
PEN
Pension Number
PI
Patient internal identifier
PN
Person number
PNT
Temporary Living Subject Number
PPN
Passport number
PRC
Permanent Resident Card Number
PRN
Provider number
PT
Patient external identifier
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Comment
Page 99 of 151
September 2011
TABLE 4-6. HL7 TABLE 0203 – FROM 2.7.1
Value
Description
QA
QA number
RI
Resource identifier
RN
Registered Nurse Number
RPH
Pharmacist license number
RR
Railroad Retirement number
RRI
Regional registry ID
SID
Specimen identifier
SL
State license
SN
Subscriber Number
SR
State registry ID
SS
Social Security number
TAX
Tax ID number
TN
Treaty Number/ (Canada)
U
Unspecified identifier
UPIN
Medicare/CMS (formerly HCFA)_s Universal Physician Identification numbers
VN
Visit number
VS
VISA
WC
WIC identifier
WCN
Workers_ Comp Number
Page 100 of 151
September 2011
Comment
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
TABLE 4-6. HL7 TABLE 0203 – FROM 2.7.1
Value
Description
XX
Organization identifier
Comment
4.6.6 HL7 TABLE 0291 – SUBTYPE OF REFERENCED DATA
TABLE 4-5. HL7 TABLE 0291 – SUBTYPE OF REFERENCED DATA
Description
Comment
Source RFC 2046
MIME media subtypes established in accordance with RFC
2046 (http://ietf.org/rfc/rfc2046.txt) and registered with the
Internet Assigned Numbers Authority
(http://www.iana.org/numbers.html). Note that the MIME
media subtype values are case-insensitive, in accordance
with RFC 2045.
Value
x-hl7-cda-level-one
HL7 Clinical Document Architecture Level One document
Not supported.
4.6.7 HL7 TABLE 0301 - UNIVERSAL ID TYPE
TABLE 4-6. HL7 TABLE 0301 - UNIVERSAL ID TYPE
Value
Description
Use
Comments
CLIA
Clinical Laboratory Improvement Amendments. Allows for the ability to designate organization identifier
as a "CLIA" assigned number (for labs)
RE
Use in MSH.4 allowed
DNS
An Internet dotted name. Either in ASCII or as integers
?
?
GUID
Same as UUID.
?
?
CEN
The CEN Healthcare Coding Scheme Designator. (Identifiers used in DICOM follow this
assignment scheme.)
?
?
HL7
Reserved for future HL7 registration schemes
?
?
ISO
An International Standards Organization Object Identifier
R
Used as the Universal ID Type in the CNN, EI and
HD data types.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 101 of 151
September 2011
TABLE 4-6. HL7 TABLE 0301 - UNIVERSAL ID TYPE
Value
Description
Use
Comments
L,M,N
These are reserved for locally defined coding schemes.
?
?
Random
Usually a base64 encoded string of random bits.
The uniqueness depends on the length of the bits. Mail systems often generate ASCII string
_unique names," from a combination of random bits and system names. Obviously, such identifiers
will not be constrained to the base64 character set.
?
?
URI
Uniform Resource Identifier
R
Used as the Universal ID Type in the RP data type
UUID
The DCE Universal Unique Identifier
?
?
x400
An X.400 MSH format identifier
?
?
x500
An X.500 directory name
?
?
4.6.8 HL7 TABLE 0354 – MESSAGE STRUCTUREFROM 2.5.1 (CONSTRAINED)
Value
ORU_R01
TABLE 4-8. HL7 TABLE 0354 – FROM 2.5.1 (CONSTRAINED)
Description
Use
Comments
Unsolicited transmission of an observation message
R
ACK_R01
General Acknowledgment Message for unsolicited transmission of an observation message
R
4.6.9 HL7 TABLE 0834 – MIME TYPE
TABLE 4-7. HL7 TABLE 0834 – MIME TYPE
Use
?
Value
application
Description
Application data
audio
Audio data
R
image
Image data
R
model
Model data
?
text
Text data
R
Page 102 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Comments
Value
video
Description
Video data
Use
R
multipart
MIME multipart package
?
Comments
4.6.10 HL7 TABLE NEW – ??? FROM 2.7.1
TABLE 4-10. HL7 TABLE 0??? – FROM 2.7.1
Usage
Value
Description
E
Result Copy Enclosed per Order Provider's request
R
R
Results Copy Requested
R
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 103 of 151
September 2011
Comments
5. MESSAGE PROFILES
This implementation guide uses 5 profiles to enable communication of the conformance
statements that are applicable to the message. The basic purpose of these profiles is defined in
section 1.6 Conformance to this Guide {get hyperlink}. This chapter summarizes for four of
those profiles the data types and segments which conformance statements change depending on
the profile used. Note that the base profile is not summarized here as it indicates that all
conformance statements in this implementation guide apply.
5.1 PROFILE GU – GLOBAL UNIQUE IDENTIFIERS
This profile (2.16.840.1.113883.9.12) is used when all identifiers in the message use ISO OIDs to
identify the respective objects.
The following data types have specific conformance statement to conform to this profile:



CX – Extended Composite ID with Check Digit
Description: CX.4 - Assigning Authority is required
o See section 1.14.5 CX – GU {get hyperlink} for the full data type definition
o See section 1.14.17 HD - GU {get hyperlink} for the data type definition used in
CX.4 -Assigning Authority.
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 PID.3 – Patient Identifier List
 PID.18 – Patient Account Number
 PID.21 – Mother’s Identifier
 NK1.12 - Next of Kin / Associated Parties Employee Number
 NK1.33 - Next of Kin/Associated Party’s Identifiers
 PV1.5 – Preadmit Number
 PV1.19 – Visit Number
 PV1.50 – Alternate Visit ID
EI – Entity Identifier
Description: EI.2 - NameSpace ID is required, but can be empty if not available, while
EI.3 – Universal ID must be valued with OID and EI.4 – Universal ID Type must be
valued to “ISO”
o See section 1.14.11 EI – GU {get hyperlink} for the full data type definition
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 MSH.21 – Message Profile Identifier
 ORC.2 – Placer Order Number
 ORC.3 – Filler Order Number
 ORC.4 – Placer Group Number
 OBR.2 – Placer Order Number
 OBR.3 – Filler Order Number
 OBX.18 – Equipment Instance Identifier
EIP – Entity Identifier Pair
Description: The EI - GU datatype definition is used for both EIP.1 and EIP.2
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 104 of 151
September 2011


o See section 1.14.13 EIP – GU {get hyperlink} for the full data type definition
o See section 1.14.11 EI – GU {get hyperlink} for the data type definition to be
used for both EIP.1 and EIP.2
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 ORC.8 – Parent
 OBR.29 – Parent
 SPM.2 – Specimen Identifier
 SPM.3 – Specimen Parent IDs
HD – Hierarchy Identifier
Description: HD.1 - NameSpace ID is required, but can be empty if not available, while
HD.2 – Universal ID must be valued with OID and HD.3 – Universal ID Type must be
valued to “ISO”
o See section 1.14.17 HD – GU {get hyperlink} for the full data type definition
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 MSH.3 – Sending Application
 MSH.4 – Sending Facility
 MSH.5 – Receiving Application
 MSH.6 – Receiving Facility
 MSH.34 – Last Update Facility
 FSH.3 – File Sending Application
 FSH.4 – File Sending Facility
 FSH.5 – File Receiving Application
 FSH.6 – File Receiving Facility
 BHS.3 – Batch Sending Application
 BHS.4 – Batch Sending Facility
 BHS.5 – Batch Receiving Application
 BHS.6 – Batch Receiving Facility
XCN – Extended Composite ID Number and Name for Persons
Description: XCN.9 – Assigning Authority and XCN.14 – Assigning Facility use the HD
– GU data type definition
o See section 1.14.34 XCN – GU {get hyperlink} for the full data type definition
o See section 1.14.17 HD – GU {get hyperlink} for the data type definition to be
used
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 PV1.7 – Attending Doctor
 PV1.8 – Referring Doctor
 PV1.9 – Consulting Doctor
 PV1.17 – Admitting Doctor
 PV1.52 – Other Healthcare Provider
 PV2.13 – Referral Source Code
 ORC.10 – Entered By
 ORC.11 – Verified By
 ORC.12 – Ordering Provider
 ORC.19 – Action By
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 105 of 151
September 2011

 OBR.10 – Collector Identifier
 OBR.16 – Ordering Provider
 OBR.28 – Result Copies To
 OBX.16 – Responsible Observer
 OBX.25 – Performing Organization Medical Director
XON – Extended Composite ID Number and Name for Organizations
Description: XON.6 – Assigning Authority and XON.9 – Assigning Facility use the HD –
GU data type definition
o See section 1.14.?? XON – GU {get hyperlink} for the full data type definition
o See section 1.14.17 HD – GU {get hyperlink} for the data type definition to be
used
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 SFT.1 – Software Vendor Organization
 NK1.13 – Organization Name
 PV2.23 – Clinic Organization Name
 ORC.21 - Ordering Facility Name
 OBX.23 – Performing Organization Name
5.2 PROFILE NG – NON-GLOBALLY UNIQUE IDENTIFIERS
This profile (2.16.840.1.113883.9.13) indicates that at least one of the identifiers used in this
message is constructed using an alternate method to ISO OIDs for providing strong
identification. As a result, identifiers are not guaranteed to be globally unique and require review
between the trading partners to ensure appropriate identification can occur.
The following data types have specific conformance statement to conform to this profile:


CX – Extended Composite ID with Check Digit
Description: CX.4 - Assigning Authority is required but can be empty
o See section 1.14.6 CX – NG {get hyperlink} for the full data type definition
o See section 1.14.18 HD - NG {get hyperlink} for the data type definition used in
CX.4 -Assigning Authority.
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 PID.3 – Patient Identifier List
 PID.18 – Patient Account Number
 PID.21 – Mother’s Identifier
 NK1.12 - Next of Kin / Associated Parties Employee Number
 NK1.33 - Next of Kin/Associated Party’s Identifiers
 PV1.5 – Preadmit Number
 PV1.19 – Visit Number
 PV1.50 – Alternate Visit ID
EI – Entity Identifier
Description: EI.2 - NameSpace ID is optional
o See section 1.14.12 EI – NG {get hyperlink} for the full data type definition
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
Page 106 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.



 MSH.21 – Message Profile Identifier
 ORC.2 – Placer Order Number
 ORC.3 – Filler Order Number
 ORC.4 – Placer Group Number
 OBR.2 – Placer Order Number
 OBR.3 – Filler Order Number
 OBX.18 – Equipment Instance Identifier
EIP – Entity Identifier Pair
Description: The EI - NG datatype definition is used for both EIP.1 and EIP.2
o See section 1.14.12 EI – NG {get hyperlink} for the full data type definition to be
used for both EIP.1 and EIP.2
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 ORC.8 – Parent
 OBR.29 – Parent
 SPM.2 – Specimen Identifier
 SPM.3 – Specimen Parent IDs
HD – Hierarchy Identifier
Description: HD.1 – Namespace ID is optional, while HD.2 – Universal ID and HD.3 –
Universal ID Type have conditions depending on HD.1 and HD.2
o See section 1.14.18 HD – NG {get hyperlink} for the full data type definition
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 MSH.3 – Sending Application
 MSH.4 – Sending Facility
 MSH.5 – Receiving Application
 MSH.6 – Receiving Facility
 MSH.34 – Last Update Facility
 FSH.3 – File Sending Application
 FSH.4 – File Sending Facility
 FSH.5 – File Receiving Application
 FSH.6 – File Receiving Facility
 BHS.3 – Batch Sending Application
 BHS.4 – Batch Sending Facility
 BHS.5 – Batch Receiving Application
 BHS.6 – Batch Receiving Facility
XCN – Extended Composite ID Number and Name for Persons
Description: XCN.9 – Assigning Authority and XCN.14 – Assigning Facility use the HD
– NG data type definition
o See section 1.14.35 XCN – NG {get hyperlink} for the full data type definition
o See section 1.14.18 HD – NG {get hyperlink} for the data type definition to be
used
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 PV1.7 – Attending Doctor
 PV1.8 – Referring Doctor
 PV1.9 – Consulting Doctor
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 107 of 151
September 2011

 PV1.17 – Admitting Doctor
 PV1.52 – Other Healthcare Provider
 PV2.13 – Referral Source Code
 ORC.10 – Entered By
 ORC.11 – Verified By
 ORC.12 – Ordering Provider
 ORC.19 – Action By
 OBR.10 – Collector Identifier
 OBR.16 – Ordering Provider
 OBR.28 – Result Copies To
 OBX.16 – Responsible Observer
 OBX.25 – Performing Organization Medical Director
XON – Extended Composite ID Number and Name for Organizations
Description: XON.6 – Assigning Authority and XON.9 – Assigning Facility use the HD –
NG data type definition
o See section 1.14.?? XON – NG {get hyperlink} for the full data type definition
o See section 1.14.18 HD – NG {get hyperlink} for the data type definition to be
used
o All fields using these data types must use the data types per the definitions
referenced above. That includes:
 SFT.1 – Software Vendor Organization
 NK1.13 – Organization Name
 PV2.23 – Clinic Organization Name
 ORC.21 - Ordering Facility Name
 OBX.23 – Performing Organization Name
5.3 PROFILE RU – UNIQUE PLACER/FILLER ORDER NUMBER
This profile (2.16.840.1.113883.9.14) indicates that the test can be identified by only using either
the placer order number, and/or filler order number.
The following fields are subject to this profile:
 ORC.2 – Order Place Number
 ORC.3 – Filler Order Number
 ORC.8 – Parent
 OBR.2 – Placer Order Number
 OBR.3 – Filler Order Number
 OBR.29 – Parent
When used, each of these fields must be able to uniquely identify the test being reported on
within the ordering application without needing the universal service identifier.
5.4 PROFILE RN – NON-UNIQUE ORDER NUMBERS
This profile (2.16.840.1.113883.9.15) indicates that the test can be identified by using the
universal service identifier and either the placer order number or the filler order number as the
placer or filler order number alone would not uniquely identify a test.
To get to a unique order instance :
Page 108 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
ORC.2 – Placer Order Number + OBR.4 – Universal Service Identifier
or:
OBR.2 Placer Order Number + OBR.4 – Universal Service Identifier
ORC.3 – Filler Order Number + OBR.4 – Universal Service Identifier
or:
OBR.3 – Filler Order Number + OBR.4 – Universal Service Identifier
To get to a unique parent instance :
ORC.8 – Parent + OBR.50 – Parent Universal Service Identifier
or :
OBR.29 – Parent + OBR.50 – Parent Universal Service Identifier
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 109 of 151
September 2011
6. EXAMPLE LABORATORY RESULT MESSAGES
Examples should not be used as the basis for implementing the messages in the
implementation guide. Examples are handcrafted and as such are subject to human error.
The information in this section is informative and not normative.
Release Note: Examples will be provided for this section that are conformant to the statements in
the final version of this Release (R1).
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 110 of 151
September 2011
7. ADDITIONAL IMPLEMENATION GUIDANCE
7.1 CULTURE AND SUSCEPTIBILITIES REPORTING
7.1.1 INTRODUCTION
Parent-child relationships, such as culture and sensitivities, can be reported using the HL7
electronic messaging standard. However, this is an area where many vendors and large
laboratories have augmented the standard to account for variations in the systems with which
they work. This usually does not present a problem until these messages must be shared between
systems (for instance, between laboratories and sub-contracted laboratories, or between
laboratories and public health agencies).
Parent-child information such as culture and susceptibilities (e.g., reporting of multi-resistant
tuberculosis or drug-resistant gonococcus or pneumococcus) is a critical component of electronic,
laboratory-based public health reporting.
The approach described here is required for use in reporting microbiology results for this
message profile.
7.1.2 TEMPLATE FOR CULTURE RESULTS
A template report for the initial identification of three organisms from a single stool culture is
presented below. For each field (i.e., the space between the pipes, "|"), a description of what
should appear in that particular field is given, along with the segment-field number in
parentheses (e.g., OBR-3) for some of the fields. Note that these examples use the ORU^R01
message type.
Release Note: Revised examples will be provided for this section that are conformant to the
statements in the final version of this Release (R1). The examples in the shaded below are all
subject to change.
MSH|…
PID|…
OBR|1| Placer number | Filler number | Identifier code for the
requested test or panel of tests(OBR-4) |…
OBX|1|CE| Specific organism identifier (OBX-3) | Sub-id for the
first organism (OBX-4) | Description of organism (OBX-5) |…
OBX|2|SN| Other identifier (OBX-3) | Sub-id for the first organism
(OBX-4) | Observation on the organism (OBX-5) |…
OBX|3|CE| Specific organism identifier (OBX-3) | Sub-id for the
second organism (OBX-4) | Description of organism (OBX-5) |…
OBX|4|SN| Other identifier (OBX-3) | Sub-id for the second
organism (OBX-4) | Observation on the Organism (OBX-5) |…
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 111 of 151
September 2011
OBX|5|CE| Specific organism identifier (OBX-3) | Sub-id for the
third organism (OBX-4) | Description of organism (OBX-5) |…
OBX|6|SN| Other identifier (OBX-3) | Sub-id for the third organism
(OBX-4) | Observation on the organism (OBX-5) |…
SPM|1| Specimen identifier for the specimen being tested|_
This report has the MSH (Message Header), the PID (Patient Identification Segment), a single
OBR (Observation Request Segment), and six OBX (Observation/Results) segments, and a single
SPM (Specimen Segment). Note that the Set ID in the first field of each OBX isSEQuential,
while the Sub-ID in the fourth field of each OBX is notSEQuential, but acts as a link for all of
the OBX segments that are reporting information for a related observation. The Sub-ID field in
the template above has the words "first," "second" and "third" in bold and highlighted in green.
This is done to show that the identification of the first organism is the relating observation for the
first two OBX segments (e.g., Set-ID numbers 1 and 2). The identification of the second
organism is the relating observation for the second two segments (e.g., Set-ID numbers 3 and 4),
and so on. An example using the template above is presented below.
7.1.3 EXAMPLES OF CULTURE RESULTS
In this example, Reliable Labs, Inc. is sending preliminary results of a stool culture to state
public health authorities. Three pathogens have been identified: Campylobacter jejuni,
Salmonella and Shigella.
This example shows the use of the Sub-ID in OBX-4 to connect related observations. The Sub-ID
is shown in bolded letters and highlighted in green, as presented in the previous template. In this
example, numbers are used for the Sub-ID. However, a text identifier such as "isolate1" could be
used. The HL7 standard has defined the Sub-ID (e.g., OBX-4) as a "string" data type. Thus, it can
be either a number or text.
In this example, the information about colony counts in OBX segments with Set IDs 2, 4, and 6
is provided to show how the Sub-ID is used to relate the associated OBX segments to each other
(e.g., 1 and 2, 3 and 4, 5 and 6). Some laboratories may not have this additional information and
would therefore transmit only the identification of the organisms (e.g., OBX segments 1, 3 and
5).
Identified organisms must be reported as coded data instead of text data. Coded data enables
machine processing of results. String data can normally be interpreted only by humans.
MSH|^~\&|Lab1^1234^CLIA|Reliable^1234^CLIA|ELR^2.16.840.1.113
883.19.3.2.3^ISO|SPH^2.16.840.1.113883.19.3.2^ISO|2007070
11325540400||ORU^R01^ORU_R01|20070701132554000008|P^T|2.5.1|||NE
|NE|USA||||USELR1.0^^2.16.840.1.113883.19.9.7^ISO
SFT|1|Level
Page 112 of 151
September 2011
Seven
Healthcare
Software,
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Inc.^L^^^^&2.16.840.1.113883.19.4.6^ISO^XX^^^1234|1.2|An
Lab System|56734||20080817
PID|1||36363636^^^MPI&2.16.840.1.113883.19.3.2.1&ISO^MR^A&2.1
6.840.1.113883.19.3.2.1&ISO~444333333^^^&2.16.840.1.11388
3.4.1^ISO^SS||Everyman^Adam^A^^^^L^^^^^^^BS|Mum^Martha^M^
^^^M|19750602|M||2106-3^White^CDCREC^^^^04/24/2007|2222
Home
Street^^Ann
Arbor^MI^99999^USA^H||^PRN^PH^^1^555^5552004|^WPN^PH^^1^9
55^5551009|eng^English^ISO6392^^^^3/29/2007|M^Married^HL7
0002^^^^2.5.1||||||N^Not
Hispanic
or
Latino^HL70189^^^^2.5.1||||||||N|||2008081510000700|Reliable^2.16.840.1.113883.19.3.1^ISO
ORC|RE|23456^EHR^2.16.840.1.113883.19.3.2.3^ISO|9700123^Lab^2
.16.840.1.113883.19.3.1.6^ISO|||||||||1234^Admit^Alan^A^I
II^Dr^^^&2.16.840.1.113883.19.4.6^ISO^L^^^EI^&2.16.840.1.
113883.19.4.6^ISO^^^^^^^^MD||^WPN^PH^^1^555^5551005||||||
|Level
Seven
Healthcare,
Inc.^L^^^^&2.16.840.1.113883.19.4.6^ISO^XX^^^1234|1005
Healthcare
Drive^^Ann
Arbor^MI^99999^USA^B|^WPN^PH^^1^555^5553001|4444
Healthcare Drive^Suite 123^Ann Arbor^MI^99999^USA^B
OBR|1|23456^EHR^2.16.840.1.113883.19.3.2.3^ISO|9700123^Lab^2.
16.840.1.113883.19.3.1.6^ISO|625-4^Bacteria
identified^LN^3456543^
CULTURE,
STOOL^99USI^2.26|||2008081510300700||||||diarrhea|||1234^Admit^Alan^A^III^Dr^^^&2.16.840
.1.113883.19.4.6^ISO^L^^^EI^&2.16.840.1.113883.19.4.6^ISO
^^^^^^^^MD|^WPN^PH^^1^555^5551005|||||20080818300700|||P||||||787.91^DIARRHEA^I9CDX^^^^07/09/2008|1235&Sl
ide&Stan&S&&Dr&MD&&DOC&2.16.840.1.113883.19.4.6&ISO
OBX|1|CWE|625-4^Bacteria
identified:Prid:Pt:Stool:Nom:Culture^LN^^^^2.26|1|6654300
0^Campylobacter
jejuni^SCT^^^^January
2007||||||P|||200808151030-0700|||0086^Bacterial
identification^OBSMETHOD^^^^501-20080815||2008081610300700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|2|SN|564-5^COLONY
COUNT:NUM:PT:XXX:QN:VC^LN^^^^2.26|1|^10000^^90000|1^^UCUM^^^^1.6|||||P|||2008081510300700|||||200808161030-0700||||Reliable
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Labs,
Page 113 of 151
September 2011
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|3|CWE|625-4^Bacteria
identified:Prid:Pt:Stool:Nom:Culture^LN^^^^2.26|2|3026200
05^Salmonella
group
B
phase
1
a-e^SCT^^^^January
2007||||||P|||200808151030-0700|||0086^Bacterial
identification^OBSMETHOD^^^^501-20080815||2008081610300700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|4|SN|564-5^COLONY
COUNT:NUM:PT:XXX:QN:VC^LN^^^^2.26|2|>^100000|1^^UCUM^^^^1
.6|||||P|||200808151030-0700|||||2008081610300700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|5|CWE|625-4^Bacteria
identified:Prid:Pt:Stool:Nom:Culture^LN^^^^2.26|3|7735200
2^Shigella^SCT^^^^January
2007||||||P|||2008081510300700|||0086^Bacterial
identification^OBSMETHOD^^^^50120080815||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|6|SN|564-5^COLONY
COUNT:NUM:PT:XXX:QN:VC^LN^^^^2.26|3|<^1000|1^^UCUM^^^^1.6
|||||P|||200808151030-0700|||||2008081610300700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
SPM|1|23456&EHR&2.16.840.1.113883.19.3.2.3&ISO^9700122&Lab&2.
16.840.1.113883.19.3.1.6&ISO||119339001^Stool
specimen^SCT^^^^20080131|||||||P^Patient^HL60369^^^^2.5.1
|10^g&gram&UCUM&&&&1.6|||||2008081510300700|200808151100-0700
Page 114 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
7.1.4 TEMPLATE FOR CULTURE AND SUSCEPTIBILITY RESULTS
The template and example in the Template for Culture Results section of this appendix describe a
report for a culture. The following template shows how antimicrobial susceptibility results are
reported for the culture described in that section. The connection of the culture to the
susceptibilities is a "parent-child" relationship, where the culture is the parent result and the
susceptibilities are the child results. This means that there can be many child results for a single
parent result. In other words, there can be multiple OBR child segments for the single OBR
parent segment presented in the Template for Culture Results section of this appendix. The
template for the report containing the culture and susceptibilities appears below. The titles in
Italics are given to highlight the individual parent and child segments and are not found in an
actual HL7 message transmission. It is important to note that in each of the OBR child segments
there is a pointer back to the parent result. This pointer is found in OBR-26 (Parent Result) and in
OBR-29 (Parent Number).
Message Header and Patient Identification Segment for the
Parent-Child Message
MSH|…
PID|…
Parent OBR Segment
OBR|1| Placer number (OBR-2) | Filler order number (OBR-3) |
Identifier code for the requested test or panel of tests
(OBR-4) |…
Parent OBX Segments for First Organism Identified
OBX|1|CE| Specific organism identifier (OBX-3) | Sub-id for
the first organism (OBX-4) | Description of organism
(OBX-5) |…
OBX|2|SN| Other identifier (OBX-3) | Sub-id for the first
organism (OBX-4) | Observation on the organism (OBX-5) |…
Parent OBX Segments for Second Organism Identified
OBX|3|CE| Specific organism identifier (OBX-3) | Sub-id for
the second organism (OBX-4) | Description of organism
(OBX-5) |…
OBX|4|SN| Other identifier (OBX-3) | Sub-id for the second
organism (OBX-4) | Observation on the Organism (OBX-5) |…
Parent OBX Segments for Third Organism Identified
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 115 of 151
September 2011
OBX|5|CE| Specific organism identifier (OBX-3) | Sub-id for
the third organism (OBX-4) | Description of organism
(OBX-5) |…
OBX|6|SN| Other identifier (OBX-3) | Sub-id for the third
organism (OBX-4) | Observation on the organism (OBX-5) |…
Child OBR for First Organism identified
OBR|2| Placer number (OBR-2)| Filler order number (OBR-3) |
Identifier code for the requested test or panel of tests
(OBR-4) |||||||||||||||||||||| A pointer back to the parent
OBX segment that contained the identification of the first
organism, see below for description of "Pointers" (OBR-26)
||| Parent Filler order number (OBR-29) |...
Child OBX Segments for Susceptibilities of First Organism
Identified
OBX|1|CE|Specific
susceptibility
identifier
for
first
antimicrobial (OBX-3) || Susceptibility finding (OBX-5)
||| Susceptibility interpretation (OBX-8) |…
OBX|2|CE|Specific
susceptibility
identifier
for
second
antimicrobial (OBX-3) || Susceptibility finding (OBX-5)
||| Susceptibility interpretation (OBX-8) |…
OBX|3|CE|Specific
susceptibility
identifier
for
third
antimicrobial (OBX-3) || Susceptibility finding (OBX-5)
||| Susceptibility interpretation (OBX-8) |…
Child OBR Segment for Susceptibilities of Second Organism
Identified
OBR|3| Placer number (OBR-2)| Filler order number (OBR-3) |
Identifier code for the requested test or panel of tests
(OBR-4) |||||||||||||||||||||| A pointer back to the parent
OBX segment that contained the identification of the second
organism, see below for description of "Pointers" (OBR-26)
||| Parent Filler order number (OBR-29) |...
Child OBX Segments for Susceptibilities of Second Organism
Identified
OBX|1|CE|Specific
susceptibility
identifier
for
first
antimicrobial (OBX-3) || Susceptibility finding (OBX-5) |||
Susceptibility interpretation (OBX-8) |…
Page 116 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
OBX|2|CE|Specific
susceptibility
identifier
for
second
antimicrobial (OBX-3) || Susceptibility finding (OBX-5) |||
Susceptibility interpretation (OBX-8) |…
OBX|3|CE|Specific
susceptibility
identifier
for
third
antimicrobial (OBX-3) || Susceptibility finding (OBX-5) |||
Susceptibility interpretation (OBX-8) |…
Child OBR Segment
Identified
for
Susceptibilities
of
Third
Organism
OBR|3| Placer number (OBR-2)| Filler order number (OBR-3) |
Identifier code for the requested test or panel of tests
(OBR-4) |||||||||||||||||||||| A pointer back to the parent
OBX segment that contained the identification of the third
organism, see below for description of "Pointers" (OBR-26)
||| Parent Filler order number (OBR-29) |...
Child OBX Segments for Susceptibilities of Third Organism
Identified
OBX|1|CE|Specific
susceptibility
identifier
for
first
antimicrobial (OBX-3) || Susceptibility finding (OBX-5) |||
Susceptibility interpretation (OBX-8) |…
OBX|2|CE|Specific
susceptibility
identifier
for
second
antimicrobial (OBX-3) || Susceptibility finding (OBX-5) |||
Susceptibility interpretation (OBX-8) |…
OBX|3|CE|Specific
susceptibility
identifier
for
third
antimicrobial (OBX-3) || Susceptibility finding (OBX-5) |||
Susceptibility interpretation (OBX-8) |…
SPM Segment
SPM|1| Specimen identifier for the specimen being tested|…
7.1.5 EXAMPLES OF CULTURE AND SUSCEPTIBILITY RESULTS
Using the template above, this example shows a report of three pathogens identified from a stool
specimen with their respective antimicrobial susceptibility tests.
MSH|^~\&|
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 117 of 151
September 2011
Lab1^1234^CLIA|Reliable^1234^CLIA|ELR^2.16.840.1.113883.1
9.3.2.3^ISO|SPH^2.16.840.1.113883.19.3.2^ISO|200707011325
540400||ORU^R01^ORU_R01|20070701132554000008|P^T|2.5.1|||NE
|NE|USA||||USELR1.0^^2.16.840.1.113883.19.9.7^ISO
SFT|1|Level
Seven
Healthcare
Software,
Inc.^L^^^^&2.16.840.1.113883.19.4.6^ISO^XX^^^1234|1.2|An
Lab System|56734||20080817
PID|1||36363636^^^MPI&2.16.840.1.113883.19.3.2.1&ISO^MR^A&2.1
6.840.1.113883.19.3.2.1&ISO~444333333^^^&2.16.840.1.11388
3.4.1^ISO^SS||Everyman^Adam^A^^^^L^^^^^^^BS|Mum^Martha^M^
^^^M|19750602|M||2106-3^White^CDCREC^^^^04/24/2007|2222
Home
Street^^Ann
Arbor^MI^99999^USA^H||^PRN^PH^^1^555^5552004|^WPN^PH^^1^9
55^5551009|eng^English^ISO6392^^^^3/29/2007|M^Married^HL7
0002^^^^2.5.1||||||N^Not
Hispanic
or
Latino^HL70189^^^^2.5.1||||||||N|||2008081510000700|Reliable^2.16.840.1.113883.19.3.1^ISO
ORC|RE|23456^EHR^2.16.840.1.113883.19.3.2.3^ISO|9700123^Lab^2
.16.840.1.113883.19.3.1.6^ISO|||||||||1234^Admit^Alan^A^I
II^Dr^^^&2.16.840.1.113883.19.4.6^ISO^L^^^EI^&2.16.840.1.
113883.19.4.6^ISO^^^^^^^^MD||^WPN^PH^^1^555^5551005||||||
|Level
Seven
Healthcare,
Inc.^L^^^^&2.16.840.1.113883.19.4.6^ISO^XX^^^1234|1005
Healthcare
Drive^^Ann
Arbor^MI^99999^USA^B|^WPN^PH^^1^555^5553001|4444
Healthcare Drive^Suite 123^Ann Arbor^MI^99999^USA^B
OBR|1|23456^EHR^2.16.840.1.113883.19.3.2.3^ISO|9700123^Lab^2.
16.840.1.113883.19.3.1.6^ISO|625-4^Bacteria
identified^LN^3456543^
CULTURE,
STOOL^99USI^2.26|||2008081510300700||||||diarrhea|||1234^Admit^Alan^A^III^Dr^^^&2.16.840
.1.113883.19.4.6^ISO^L^^^EI^&2.16.840.1.113883.19.4.6^ISO
^^^^^^^^MD|^WPN^PH^^1^555^5551005|||||20080818300700|||F||||||787.91^DIARRHEA^I9CDX^^^^07/09/2008|1235&Sl
ide&Stan&S&&Dr&MD&&DOC&2.16.840.1.113883.19.4.6&ISO
OBX|1|CWE|625-4^Bacteria
identified:Prid:Pt:Stool:Nom:Culture^LN^^^^2.26|1|6654300
0^Campylobacter
jejuni^SCT^^^^January
2007||||||F|||200808151030-0700|||0086^Bacterial
identification^OBSMETHOD^^^^501-20080815||2008081610300700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Page 118 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|2|SN|564-5^COLONY
COUNT:NUM:PT:XXX:QN:VC^LN^^^^2.26|1|^10000^^90000|1^^UCUM^^^^1.6|||||F|||2008081510300700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|3|CWE|625-4^Bacteria
identified:Prid:Pt:Stool:Nom:Culture^LN^^^^2.26|2|3026200
05^Salmonella
group
B
phase
1
a-e^SCT^^^^January
2007||||||F|||200808151030-0700|||0086^Bacterial
identification^OBSMETHOD^^^^501-20080815||2008081610300700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|4|SN|564-5^COLONY
COUNT:NUM:PT:XXX:QN:VC^LN^^^^2.26|2|>^100000|1^^UCUM^^^^1
.6|||||F|||200808151030-0700|||||2008081610300700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|5|CWE|625-4^Bacteria
identified:Prid:Pt:Stool:Nom:Culture^LN^^^^2.26|3|7735200
2^Shigella^SCT^^^^January
2007||||||F|||2008081510300700|||0086^Bacterial
identification^OBSMETHOD^^^^50120080815||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|6|SN|564-5^COLONY
COUNT:NUM:PT:XXX:QN:VC^LN^^^^2.26|3|<^1000|1^^UCUM^^^^1.6
|||||F|||200808151030-0700|||||2008081610300700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 119 of 151
September 2011
SPM|1|23456&EHR&2.16.840.1.113883.19.3.2.3&ISO^9700122&Lab&2.
16.840.1.113883.19.3.1.6&ISO||119339001^Stool
specimen^SCT^^^^20080131|||||||P^Patient^HL60369^^^^2.5.1
|10^g&gram&UCUM&&&&1.6|||||2008081510300700|200808151100-0700
OBR|2||9700124^Lab^2.16.840.1.113883.19.3.1.6^ISO|505453^Bacterial
susceptibility
panel::Pt:Isolate:OrdQn:MIC^LN^^^^2.26|||2008081510300700|||||||||1234^Admit^Alan^A^III^Dr^^^&2.16.840.1.11388
3.19.4.6^ISO^L^^^EI^&2.16.840.1.113883.19.4.6^ISO^^^^^^^^
MD|^WPN^PH^^1^555^5551005|||||2008081830-0700|||F|6254&Bacteria
identified:Prid:Pt:Stool:Nom:Culture&LN^1^Campylobacter
jejuni|||23456&EHR&2.16.840.1.113883.19.3.2.3&ISO^9700123
&Lab&2.16.840.1.113883.19.3.1.6&ISO||787.91^DIARRHEA^I9CD
X^^^^07/09/2008|1235&Slide&Stan&S&&Dr&MD&&DOC&2.16.840.1.
113883.19.4.6&ISO
OBX|1|SN|6979-9^AMPICILLIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|<^0.06|ug/mL^^UCUM^^^^1.6||S|||F|||200
808151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|2|SN|7016-9^GENTAMICIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|^0.05|ug/mL^^UCUM^^^^1.6||S|||F|||2008
08151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|3|SN|7002-9^CIPROFLOXACIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|^0.05|ug/mL^^UCUM^^^^1.6||S|||F|||2008
08151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBR|3||9700125^Lab^2.16.840.1.113883.19.3.1.6^ISO|505453^Bacterial
susceptibility
panel::Pt:Isolate:OrdQn:MIC^LN^^^^2.26|||2008081510300700|||||||||1234^Admit^Alan^A^III^Dr^^^&2.16.840.1.11388
3.19.4.6^ISO^L^^^EI^&2.16.840.1.113883.19.4.6^ISO^^^^^^^^
MD|^WPN^PH^^1^555^5551005|||||2008081830-0700|||F|625Page 120 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
4&Bacteria
identified:Prid:Pt:Stool:Nom:Culture&LN^2^Salmonella
group
B
phase
1
ae|||23456&EHR&2.16.840.1.113883.19.3.2.3&ISO^9700123&Lab&
2.16.840.1.113883.19.3.1.6&ISO||787.91^DIARRHEA^I9CDX^^^^
07/09/2008|1235&Slide&Stan&S&&Dr&MD&&DOC&2.16.840.1.11388
3.19.4.6&ISO
OBX|1|SN|6979-9^AMPICILLIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|<^0.06|ug/mL^^UCUM^^^^1.6||S|||F|||200
808151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|2|SN|7016-9^GENTAMICIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|^0.05|ug/mL^^UCUM^^^^1.6||S|||F|||2008
08151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|3|SN|7002-9^CIPROFLOXACIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|^0.05|ug/mL^^UCUM^^^^1.6||S|||F|||2008
08151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBR|4||9700126^Lab^2.16.840.1.113883.19.3.1.6^ISO|505453^Bacterial
susceptibility
panel::Pt:Isolate:OrdQn:MIC^LN^^^^2.26|||2008081510300700|||||||||1234^Admit^Alan^A^III^Dr^^^&2.16.840.1.11388
3.19.4.6^ISO^L^^^EI^&2.16.840.1.113883.19.4.6^ISO^^^^^^^^
MD|^WPN^PH^^1^555^5551005|||||2008081830-0700|||F|6254&Bacteria
identified:Prid:Pt:Stool:Nom:Culture&LN^2^Shigella|||2345
6&EHR&2.16.840.1.113883.19.3.2.3&ISO^9700123&Lab&2.16.840
.1.113883.19.3.1.6&ISO||787.91^DIARRHEA^I9CDX^^^^07/09/20
08|1235&Slide&Stan&S&&Dr&MD&&DOC&2.16.840.1.113883.19.4.6
&ISO
OBX|1|SN|6979-9^AMPICILLIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|<^0.06|µg/mL^^UCUM^^^^1.6||S|||F|||200
808151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 121 of 151
September 2011
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|2|SN|7016-9^GENTAMICIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|^0.05|µg/mL^^UCUM^^^^1.6||S|||F|||2008
08151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
OBX|3|SN|7002-9^CIPROFLOXACIN:SUSC:PT:ISLT:ORDQN:GRADIENT
STRIP^LN^^^^2.26|1|^0.05|µg/mL^^UCUM^^^^1.6||S|||F|||2008
08151030-0700|||||200808161030-0700||||Reliable
Labs,
Inc^L^^^^CLIA&2.16.840.1.113883.19.4.6&ISO^XX^^^1236|3434
Industrial
Loop^^Ann
Arbor^MI^99999^USA^B|9876543^Slide^Stan^S^^^^^NPPES&2.16.
840.1.113883.19.4.6&ISO^L^^^NPI
7.2 LINKING PARENT AND CHILD RESULTS
The previous example uses the information in OBR-26 as a pointer to the parent OBX where the
culture result is reported. OBR-26 has three components. The three components of OBR-26 are
the OBX-3, OBX-4 and part of the OBX-5 from the parent OBX segment. The pointer to the
parent (using PRL data type) requires only the first two components.
7.3 CLINICAL LABORATORY IMPROVEMENTS AMENDMENT CONSIDERATIONS
In the United States, Clinical Laboratory testing of human specimens is regulated by the Clinical
Laboratory Improvements Amendments of 1988 (CLIA). Several sections of the regulations
implementing CLIA impact how electronic laboratory is formatted for the US Realm and these
changes are outlined in this appendix. Impacted areas include mandatory reporting requirements,
report retention and display, and those authorized to receive a report. Specifics on the CLIA
Regulation are found at http://wwwn.cdc.gov/clia/regs/toc.aspx.
7.3.1 MANDATORY REPORTING REQUIREMENTS
Section 493.1291 of the CLIA Regulations defines items that must appear on a clinical laboratory
report in the US (http://wwwn.cdc.gov/clia/regs/subpart_k.aspx493.1291). Interpretative Guidelines
on the elements required in a report may be found at
http://www.cms.hhs.gov/CLIA/downloads/apcsubk2.pdf . Specific report fields impacted include the
following:
Segment
PID-3
Page 122 of 151
September 2011
TABLE 7-1. MANDATORY REPORTING REQUIREMENTS
Field
CLIA Impact
Patient Identifier List
A unique patient identification number is required
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Segment
5
Field
CLIA Impact
PID-5
Patient Name
Positive patient identification required. If the patient’s name is
known, this must be that name. If it is not known, a unique patient
identifier must be assigned.
OBX-3
Observation Identifier5
Unique identification of the test performed is required. LOINC® is
an HL7-approved code system and shall be used for the
Observation Identifier as described in the appropriate HITSP
Interoperability Specification. Use of LOINC codes for additional
tests is strongly encouraged. See Section 6 for more details.
Addition of a local laboratory code is allowed.
For certain tests CLIA requires additional information:
Laboratories using manufacturer's instruments, kits or test systems
labeled for "investigational use only" or "research use only" must
clearly state that the test results are not to be used for treatment or
diagnostic purposes. If results of such tests are being reported
without a disclaimer statement, or are being used by the provider
for patient care, they are in the same category as in-house
developed tests and the laboratory must establish performance
specifications in accordance with §493.1253.
The disclaimer for Analyte Specific Reagents (ASR) should state,
"This test was developed and its performance characteristics
determined by (Laboratory Name). It has not been cleared or
approved by the U.S. Food and Drug Administration." The ASR
disclaimer on the test report is required by the FDA under 21 CFR,
Part 809.30, "Restrictions on the sale, distribution and use of
analyte -specific reagents."
OBX-5
Observation Value
The laboratory result is required. No regulatory requirements are
specified, outside of readability, regarding result appearance.
OBX-6
Units
Units, if required, or an interpretation must be given. For tests such
as genetic screens the interpretation may actually be the test result.
OBX-7
Reference Range
Required.
OBX-8
Abnormal flag.
Use is not required, but a laboratory may use this field as part of its
interpretation guidance. If reported, it should be displayed by an
EHR.
OBX-11
Observation Result Status
Used to reflect CLIA required conditions such as specimen
acceptability, result corrections, cancellations as well as report
status (§493.1291 (c)(7) and (k)(1,2). See SPM-21 and -22 below.
OBX-19
Date/Time of Analysis
Use this field to meet the requirement for test report time.
OBX-23, 24,
25
Laboratory Identification
Fields
The identification of the performing laboratory is required.
Populating with the CLIA ID Number in OBX-23 meets the
requirement if this receiving EHR has access to a look-up table that
will convert the CLIA ID number to full demographics comprising
OBX-23,Performing Organization Name; OBX-24, Performing
Organization Address; and OBX-25, Performing Organization
While CLIA requires a laboratory to maintain positive identification of a specimen reporting, that information as part of the result is not
required.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 123 of 151
September 2011
Segment
Field
CLIA Impact
Medical Director. If the CLIA ID number is not used, all
demographic fields (OBX-23, OBX-24 and OBX-25) must be
populated with appropriate information.
SPM-4
Specimen Type
Reporting requirements call for the specimen source, which
equates to the Specimen Type in the SPM segment.
SPM-21
Specimen Reject Reason
Use this field in connection with OBX-11 if a test is cancelled for
specimen related reason.
SPM-22
Specimen Quality
Use this field to provide a coded version for Specimen Description.
For Electronic Health Records, it is preferred that this field be used
in place of, or in connection with, SPM-14.
7.4 REGULATORY COMPLIANCE
There may be local, state or federal regulations where the electronic message from a performing
laboratory is presumed to be the legal report of the tests performed. Hence, the receiver may be
required to save the format or content of the message for the same time period as required for any
other legal document.
7.5 AUTHORIZED PARTIES
Local laws, generally at the State level, govern who is authorized to receive laboratory reports.
CLIA restricts the availability of those authorized to receive laboratory reports to just those
approved at the local level and sets no national standards. Testing laboratories may not report
results to unauthorized parties under CLIA.
Testing laboratories either have a trusted relationship with the ordering party or presume that the
ordering party is authorized to receive results. However, testing laboratories need not have
knowledge of the appropriateness of others requested to receive results, such as "Copy to"
recipients. To maintain CLIA compliance, a US testing laboratory may choose to restrict its
reports to only those recipients authorized and verified to receive them. Hence, a testing
laboratory need not send copies of a result. Note that CLIA places no restrictions on the receiver
of a laboratory report regarding its retransmission of the report to others.
Page 124 of 151
September 2011
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
8. EXAMPLE UCUM CODES
The following list of examples is presented by the kind permission of the National Library of
Medicine.
1.7 PREFACE TO TABLE OF EXAMPLE UCUM CODES FOR ELECTRONIC
MESSAGING
Attached is a first draft of an enumeration of The Unified Code for Units of Measure (UCUM),
designed to make it clear what the UCUM syntax would produce for specific unit patterns in
electronic communication. This early version, composed in a relatively short time frame, is
based on content provided by Intermountain Healthcare, from a National Library of
Medicine/Regenstrief Institute project that is analyzing raw units from more than 23 laboratory
sources and their translation to UCUM (http://unitsofmeasure.org/) and from the HL7 table of units.
In this version we have not included all of the content from all of these sources. Specifically for
this version, we excluded units for which we could not quickly find definitions or clear patterns
of usage, units of measure that we believed would only be used in pharmacy dispensing, and
units used for purely clinical reporting (e.g. cigarette pack-years). We have included most of the
pure metric units that were in the source table whether they apply directly to the laboratory or not
because they will be generally useful and because we could not always be sure what should be
excluded.
We have included a row number in the first column of the table. Please use this number when
suggesting changes or identifying problems with a given term. This number has no significance
beyond identifying a unique row in this table. In particular, it does not officially denote a UCUM
code. The table is ordered alphabetically by the content of the column Description of the Unit.
Some details of the UCUM syntax follow, but for a more complete explanation than this please
refer to the full UCUM specification at http://unitsofmeasure.org/.
The UCUM codes that you see in the table are mixed-case ASCII text. The standard metric units
all have their usual mixed-case representation, so milligram per deciliter is portrayed in UCUM
as mg/dL. US, British, and other special units are usually enclosed in square brackets, e.g. inches
is [in_i] (inches international) — the “i” is needed because the British inch and the US inch were
slightly different until about 1980 when all parties agreed the international inch. In UCUM a dot
(.) means multiply, a number to the right of a string means a power, and the divisor sign (/) means
divide. So m2 means meter squared.
Strings that are often included in units of measure but are adornments for human reading and that
are not formally units of measure are enclosed in curlicue brackets {}. For example,
mg/mol{creat} means milligram per mole of creatinine.
UCUM does not formally specify what to put inside of the curlicue brackets except to insist there
be no spaces, because spaces will break the parser and the UCUM units converter. In principle,
users could adjust the contents of any such curlicue brackets because they aren’t a formal part of
UCUM. In this table, we encourage the use of the same string consistently within curlicue
brackets, e.g. {creat} for creatinine and {Hb} for hemoglobin. However, this is not an absolute
constraint of UCUM, and, when needed, users may adjust the content within the curlicue
brackets.
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 125 of 151
September 2011
1.8 TABLE OF EXAMPLE UCUM CODES FOR ELECTRONIC
MESSAGING
As of March 22, 2016 (Table sorted by "Description of the Unit" column)
Row # (not a
code)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
UCUM_CODE
10.L/min
10.L/(min.m2)
10.uN.s/(cm5.m2)
10*4/uL
10*8
24.h
{absorbance}
{activity}
[AU]
{AHF’U}
A
A/m
[arb'U]
[arb'U]/mL
{ARU}
atm
ag/{cell}
bar
Bq
[beth’U]
10*9/L
10*9/uL
10*9/mL
{binding_index}
[bdsk'U]
{CAG_repeats}
cal
{cells}
{cells}/[HPF]
{cells}/uL
cg
cL
cm
cm[Hg]
cm[H2O]
cm[H2O]/L/s
cm[H2O]/s/m
cP
cSt
{delta_OD}
{clock_time}
[CFU]
[CFU]/L
[CFU]/mL
{CAE'U}
{CH100'U}
{copies}
{copies}/ug
{copies}/mL
{count}
{CPM}
{CPM}/10*3{cell}
[cin_i]
Page 126 of 151
September 2011
Description of the Unit
(using UCUM descriptions where they exist)
10 liter per minute
10 liter per minute per square meter
10 micronewton second per centimeter to the fifth power per square meter
10 thousand per microliter
100 million
24 hour
absorbance
activity
allergy unit
American Hospital Formulary unit
ampere
ampere per meter
arbitrary unit
arbitrary unit per milliliter
aspirin response unit
atmosphere
attogram per cell
bar
Becquerel
Bethesda unit
billion per liter
billion per microliter
billion per milliliter
binding index
Bodansky unit
CAG trinucleotide repeats
calorie
cells
cells per high power field
cells per microliter
centigram
centiliter
centimeter
centimeter of mercury
centimeter of water
centimeter of water per liter per second
centimeter of water per second per meter
centipoise
centistoke
change in (delta) optical density
clock time e.g 12:30PM
colony forming unit
colony forming unit per liter
colony forming unit per milliliter
complement activity enzyme unit
complement CH100 unit
copies
copies per microgram
copies per milliliter
count
counts per minute
counts per minute per thousand cells
cubic inch (international)
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Row # (not a
code)
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
UCUM_CODE
m3/s
d
dB
dg
dL
dm
deg
Cel
[degF]
K
K/W
deg/s
daL/min
daL/min/m2
{dilution}
[dr_av]
[drp]
dyn.s/cm
dyn.s/(cm.m2)
{Ehrlich’U}
{Ehrlich’U}/100g
{Ehrlich’U}/(2.h)
{Ehrlich’U}/d
{Ehrlich'U}/dL
{EIA_index}
{EIA_titer}
{EIA'U}
{EIA'U}/U
{EV}
eV
{ELISA'U}
U
U/10
U/10*10
U/10*10{cells}
U/(10.g){feces}
U/(12.h)
U/(2.h)
U/(24.h)
U/10*9
U/d
U/dL
U/g
U/g{creat}
U/g{Hb}
U/g{protein}
U/h
U/kg{Hb}
U/L
U{25Cel}/L
U{37Cel}/L
U/mL
U/mL{RBCs}
U/mmol{creat}
U/10*6
U/min
U/s
U/10*12
U/10*12{RBCs}
eq
eq/L
Description of the Unit
(using UCUM descriptions where they exist)
cubic meter per second
day
decibel
decigram
deciliter
decimeter
degree (plane angle)
degree Celsius
degree Fahrenheit
degree Kelvin
degree Kelvin per Watt
degree per second
dekaliter per minute
dekaliter per minute per square meter
dilution
dram (US and British)
drop (1/12 milliliter)
dyne second per centimeter
dyne second per centimeter per square meter
Ehrlich unit
Ehrlich unit per 100 gram
Ehrlich unit per 2 hour
Ehrlich unit per day
Ehrlich unit per deciliter
EIA index
EIA titer
EIA unit
EIA unit per enzyme unit
EIA value
electron Volt
ELISA unit
enzyme unit
enzyme unit per 10
enzyme unit per 10 billion
enzyme unit per 10 billion cells
enzyme unit per 10 gram of feces
enzyme unit per 12 hour
enzyme unit per 2 hour
enzyme unit per 24 hour
enzyme unit per billion
enzyme unit per day
enzyme unit per deciliter
enzyme unit per gram
enzyme unit per gram of creatinine
enzyme unit per gram of hemoglobin
enzyme unit per gram of protein
enzyme unit per hour
enzyme unit per kilogram of hemoglobin
enzyme unit per liter
enzyme unit per liter at 25 deg Celsius
enzyme unit per liter at 37 deg Celsius
enzyme unit per milliliter
enzyme unit per milliliter of red blood cells
enzyme unit per millimole of creatinine
enzyme unit per million
enzyme unit per minute
enzyme unit per second
enzyme unit per trillion
enzyme unit per trillion red blood cells
equivalent
equivalent per liter
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 127 of 151
September 2011
Row # (not a
code)
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
UCUM_CODE
eq/umol
eq/mL
eq/mmol
erg
F
fg
fL
fm
fmol
fmol/g
fmol/L
fmol/mg
fmol/mg{cytosol_protein}
fmol/mg{protein}
fmol/mL
[foz_us]
{FIU}
[ft_i]
{fraction}
[Ch]
{GAA_repeats}
[gal_us]
{genomes}/mL
{Globules}/[HPF]
g
g.m
g.m/{beat}
g{creat}
g{Hb}
g{total_nit}
g{total_prot}
g{wet_tissue}
g/kg/8.h
g/100g
g/(12.h)
g/(24.h)
g/(3.d)
g/(4.h)
g/(48.h)
g/(5.h)
g/(6.h)
g/(72.h)
g/(8.h){shift}
g/cm3
g/d
g/dL
g/g
g/g{creat}
g/g{globulin}
g/g{tissue}
g/h
g/h/m2
g/kg
g/kg/(8.h){shift}
g/kg/d
g/kg/h
g/kg/min
g/L
g/mg
g/mL
Page 128 of 151
September 2011
Description of the Unit
(using UCUM descriptions where they exist)
equivalent per micromole
equivalent per milliliter
equivalent per millimole
erg
Farad
femtogram
femtoliter
femtometer
femtomole
femtomole per gram
femtomole per liter
femtomole per milligram
femtomole per milligram of cytosol protein
femtomole per milligram of protein
femtomole per milliliter
fluid ounce (US)
fluorescent intensity unit
foot (international)
fraction
French (catheter gauge)
GAA trinucleotide repeats
gallon (US)
genomes per milliliter
globules (drops) per high power field
gram
gram meter
gram meter per heart beat
gram of creatinine
gram of hemoglobin
gram of total nitrogen
gram of total protein
gram of wet tissue
gram per kilogram per 8 hour
gram per 100 gram
gram per 12 hour
gram per 24 hour
gram per 3 days
gram per 4 hour
gram per 48 hour
gram per 5 hour
gram per 6 hour
gram per 72 hour
gram per 8 hour shift
gram per cubic centimeter
gram per day
gram per deciliter
gram per gram
gram per gram of creatinine
gram per gram of globulin
gram per gram of tissue
gram per hour
gram per hour per square meter
gram per kilogram
gram per kilogram per 8 hour shift
gram per kilogram per day
gram per kilogram per hour
gram per kilogram per minute
gram per liter
gram per milligram
gram per milliliter
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Row # (not a
code)
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
UCUM_CODE
g/mmol
g/min
g/mol{creat}
g/{specimen}
g/m2
g/{total_output}
g/{total_weight}
Gy
{beats}/min
H
Hz
[HPF]
h
[APL'U]/mL
[APL'U]
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
{APS'U}
[GPL'U]/mL
[GPL'U]
{GPS'U}
[MPL'U]/mL
[MPL'U]
{MPS'U}
{MPS'U}/mL
{ImmuneComplex’U}
{ISR}
{IFA_index}
{IFA_titer}
[in_i]
[in_i'H2O]
{index_val}
{HA_titer}
{INR}
[IU]
[IU]/(2.h)
[IU]/(24.h)
[IU]/10*9{RBCs}
[IU]/d
[IU]/dL
[IU]/g
[IU]/g{Hb}
[IU]/h
[IU]/kg
[IU]/kg/d
[IU]/L
[IU]/L{37Cel}
[IU]/mg{creat}
[IU]/mL
[IU]/min
J
J/L
{JDF'U}
{JDF'U}/L
{KCT'U}
kat
kat/kg
kat/L
k[AU]
k[AU]/L
kU
Description of the Unit
(using UCUM descriptions where they exist)
gram per millimole
gram per minute
gram per mole of creatinine
gram per specimen
gram per square meter
gram per total output
gram per total weight
Gray
heart beats per minute
Henry
Hertz
high power field
hour
IgA anticardiolipin unit per milliliter**
IgA anticardiolipin unit**
(**anticardiolipin can also be called "biologic activity of anticardiolipin" or
"antiphospholipid")
IgA antiphosphatidylserine unit
IgG anticardiolipin unit per milliliter**
IgG anticardiolipin unit**
IgG antiphosphatidylserine unit
IgM anticardiolipin unit per milliliter**
IgM anticardiolipin unit**
IgM antiphosphatidylserine unit
IgM antiphosphatidylserine unit per milliliter
immune complex unit
immune status ratio
immunofluorescence assay index
Immunofluorescence assay titer
inch (international)
inch (international) of water
index value
influenza hemagglutination titer
international normalized ratio
international unit
international unit per 2 hour
international unit per 24 hour
international unit per billion red blood cells
international unit per day
international unit per deciliter
international unit per gram
international unit per gram of hemoglobin
international unit per hour
international unit per kilogram
international unit per kilogram per day
international unit per liter
international unit per liter at 37 degrees Celsius
international unit per milligram of creatinine
international unit per milliliter
international unit per minute
joule
joule per liter
Juvenile Diabetes Foundation unit
Juvenile Diabetes Foundation unit per liter
kaolin clotting time
katal
katal per kilogram
katal per liter
kilo allergy unit
kilo allergy unit per liter
kilo enzyme unit
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 129 of 151
September 2011
Row # (not a
code)
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
UCUM_CODE
kU/g
kU/L
kU/L{class}
kU/mL
k[IU]/L
k[IU]/mL
kcal
kcal/d
kcal/h
kcal/kg/(24.h)
kcal/[oz_av]
kg
kg.m/s
kg/m3
kg/h
kg/L
kg/min
kg/mol
kg/s
kg/(s.m2)
kg/m2
kL
km
kPa
ks
[KA'U]
{KRONU'U}/mL
[KNK'U]
L
L/(24.h)
L/(8.h)
L/d
L/h
L/kg
L/L
L/min
L/(min.m2)
L/s
L/s/s2
{Log_copies}/mL
{Log_IU}
{Log_IU}/mL
{Log}
[LPF]
lm
lm.m2
{Lyme_index_value}
[MCLG'U]
Ms
m
m/s
m/s2
t
uU/g
uU/L
uU/mL
u[IU]
u[IU]/mL
ueq
ueq/L
Page 130 of 151
September 2011
Description of the Unit
(using UCUM descriptions where they exist)
kilo enzyme unit per gram
kilo enzyme unit per liter
kilo enzyme unit per liter class
kilo enzyme unit per milliliter
kilo international unit per liter
kilo international unit per milliliter
kilocalorie
kilocalorie per day
kilocalorie per hour
kilocalorie per kilogram per 24 hour
kilocalorie per ounce (US & British)
kilogram
kilogram meter per second
kilogram per cubic meter
kilogram per hour
kilogram per liter
kilogram per minute
kilogram per mole
kilogram per second
kilogram per second per square meter
kilogram per square meter
kiloliter
kilometer
kilopascal
kilosecond
King Armstrong unit
Kronus unit per milliliter
Kunkel unit
liter
liter per 24 hour
liter per 8 hour
liter per day
liter per hour
liter per kilogram
liter per liter
liter per minute
liter per minute per square meter
liter per second
liter per second per square second
log (base 10) copies per milliliter
log (base 10) international unit
log (base 10) international unit per milliliter
log base 10
low power field
lumen
lumen square meter
Lyme index value
Maclagan unit
megasecond
meter
meter per second
meter per square second
metric ton
micro enzyme unit per gram
micro enzyme unit per liter
micro enzyme unit per milliliter
micro international unit
micro international unit per milliliter
microequivalent
microequivalent per liter
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Row # (not a
code)
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
UCUM_CODE
ueq/mL
ug
ug/g{feces}
ug{FEU}/mL
ug/100g
ug/(24.h)
ug/(8.h)
ug/m3
ug/d
ug/dL
ug/dL{RBCs}
ug/g
ug/g{creat}
ug/g{dry_tissue}
ug/g{dry_wt}
ug/g{hair}
ug/g{Hb}
ug/g{tissue}
ug/h
ug/kg
ug/kg/(8.h)
ug/kg/d
ug/kg/h
ug/kg/min
ug/L
ug/L{RBCs}
ug/L/(24.h)
ug/mg
ug/mg{creat}
ug/mL
ug/mL{class}
ug/mL{eqv}
ug/mmol
ug/mmol{creat}
ug/min
ug/ng
ug/{specimen}
ug/[sft_i]
ug/m2
u[IU]/L
ukat
uL
uL/(2.h)
uL/h
um
umol
umol{BCE}/mol
umol/(2.h)
umol/(24.h)
umol/(8.h)
umol/d
umol/dL
umol/dL{GF}
umol/g
umol/g{creat}
umol/g{Hb}
umol/h
umol/kg
umol/kg{feces}
umol/L
umol/L{RBCs}
Description of the Unit
(using UCUM descriptions where they exist)
microequivalent per milliliter
microgram
microgram per gram of feces
microgram fibrinogen equivalent unit per milliliter
microgram per 100 gram
microgram per 24 hour
microgram per 8 hour
microgram per cubic meter
microgram per day
microgram per deciliter
microgram per deciliter of red blood cells
microgram per gram
microgram per gram of creatinine
microgram per gram of dry tissue
microgram per gram of dry weight
microgram per gram of hair
microgram per gram of hemoglobin
microgram per gram of tissue
microgram per hour
microgram per kilogram
microgram per kilogram per 8 hour
microgram per kilogram per day
microgram per kilogram per hour
microgram per kilogram per minute
microgram per liter
microgram per liter of red blood cells
microgram per liter per 24 hour
microgram per milligram
microgram per milligram of creatinine
microgram per milliliter
microgram per milliliter class
microgram per milliliter equivalent
microgram per millimole
microgram per millimole of creatinine
microgram per minute
microgram per nanogram
microgram per specimen
microgram per square foot (international)
microgram per square meter
microinternational unit per liter
microkatal
microliter
microliter per 2 hour
microliter per hour
micrometer
micromole
micromole bone collagen equivalent per mole
micromole per 2 hour
micromole per 24 hour
micromole per 8 hour
micromole per day
micromole per deciliter
micromole per deciliter of glomerular filtrate
micromole per gram
micromole per gram of creatinine
micromole per gram of hemoglobin
micromole per hour
micromole per kilogram
micromole per kilogram of feces
micromole per liter
micromole per liter of red blood cells
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 131 of 151
September 2011
Row # (not a
code)
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
UCUM_CODE
umol/L/h
umol/umol
umol/umol{creat}
umol/mg
umol/mg{creat}
umol/mL
umol/mL/min
umol/mmol
umol/mmol{creat}
umol/min
umol/min/g
umol/min/g{mucosa}
umol/min/g{protein}
umol/min/L
umol/mol
umol/mol{creat}
umol/mol{Hb}
um/s
uOhm
us
uV
[mi_i]
mU/g
mU/mL
mU/mL/min
mU/mmol{creat}
mU/mmol{RBCs}
m[IU]/mL
mU/g{Hb}
mU/g{protein}
mU/L
mU/mg
mU/mg{creat}
m[IU]/L
mA
mbar
mbar/L/s
mbar.s/L
meq
meq/(2.h)
meq/(24.h)
meq/(8.h)
meq/d
meq/dL
meq/g
meq/g{creat}
meq/h
meq/kg
meq/kg/h
meq/L
meq/mL
meq/min
meq/{specimen}
meq/m2
meq/{total_volume}
mg
mg{FEU}/L
mg/(10.h)
mg/(12.h)
mg/(2.h)
Page 132 of 151
September 2011
Description of the Unit
(using UCUM descriptions where they exist)
micromole per liter per hour
micromole per micromole
micromole per micromole of creatinine
micromole per milligram
micromole per milligram of creatinine
micromole per milliliter
micromole per milliliter per minute
micromole per millimole
micromole per millimole of creatinine
micromole per minute
micromole per minute per gram
micromole per minute per gram of mucosa
micromole per minute per gram of protein
micromole per minute per liter
micromole per mole
micromole per mole of creatinine
micromole per mole of hemoglobin
microns per second
microOhm
microsecond
microvolt
mile (international)
milli enzyme unit per gram
milli enzyme unit per milliliter
milli enzyme unit per milliliter per minute
milli enzyme unit per millimole of creatinine
milli enzyme unit per millimole of red blood cells
milli international unit per milliliter
milli enzyme unit per gram of hemoglobin
milli enzyme unit per gram of protein
milli enzyme unit per liter
milli enzyme unit per milligram
milli enzyme unit per milligram of creatinine
milli international unit per liter
milliampere
millibar
millibar per liter per second
millibar second per liter
milliequivalent
milliequivalent per 2 hour
milliequivalent per 24 hour
milliequivalent per 8 hour
milliequivalent per day
milliequivalent per deciliter
milliequivalent per gram
milliequivalent per gram of creatinine
milliequivalent per hour
milliequivalent per kilogram
milliequivalent per kilogram per hour
milliequivalent per liter
milliequivalent per milliliter
milliequivalent per minute
milliequivalent per specimen
milliequivalent per square meter
milliequivalent per total volume
milligram
milligram fibrinogen equivalent unit per liter
milligram per 10 hour
milligram per 12 hour
milligram per 2 hour
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Row # (not a
code)
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
UCUM_CODE
mg/(24.h)
mg/(6.h)
mg/(72.h)
mg/(8.h)
mg/{collection}
mg/m3
mg/d
mg/d/(1.73_m2)
mg/dL
mg/dL{RBCs}
mg/g
mg/g{creat}
mg/g{dry_tissue}
mg/g{feces}
mg/g{tissue}
mg/g{wet_tissue}
mg/h
mg/kg
mg/kg/(8.h)
mg/kg/d
mg/kg/h
mg/kg/min
mg/L
mg/L{RBCs}
mg/mg
mg/mg{creat}
mg/mL
mg/mmol
mg/mmol{creat}
mg/min
mg/{specimen}
mg/m2
mg/{total_output}
mg/{total_volume}
mg/wk
mL
mL{fetal_RBCs}
mL/(10.h)
mL/(12.h)
mL/(2.h)
mL/(24.h)
mL/(4.h)
mL/(5.h)
mL/(6.h)
mL/(72.h)
mL/(8.h)
mL(8.h.kg)
mL/cm[H2O]
mL/d
mL/dL
mL/{beat}
mL/{beat}/m2
mL/h
mL/kg
mL/kg/(8.h)
mL/kg/d
mL/kg/h
mL/kg/min
mL/mbar
mL/mm
mL/min
Description of the Unit
(using UCUM descriptions where they exist)
milligram per 24 hour
milligram per 6 hour
milligram per 72 hour
milligram per 8 hour
milligram per collection
milligram per cubic meter
milligram per day
milligram per day per 1.73 square meter
milligram per deciliter
milligram per deciliter of red blood cells
milligram per gram
milligram per gram of creatinine
milligram per gram of dry tissue
milligram per gram of feces
milligram per gram of tissue
milligram per gram of wet tissue
milligram per hour
milligram per kilogram
milligram per kilogram per 8 hour
milligram per kilogram per day
milligram per kilogram per hour
milligram per kilogram per minute
milligram per liter
milligram per liter of red blood cells
milligram per milligram
milligram per milligram of creatinine
milligram per milliliter
milligram per millimole
milligram per millimole of creatinine
milligram per minute
milligram per specimen
milligram per square meter
milligram per total output
milligram per total volume
milligram per week
milliliter
milliliter of fetal red blood cells
milliliter per 10 hour
milliliter per 12 hour
milliliter per 2 hour
milliliter per 24 hour
milliliter per 4 hour
milliliter per 5 hour
milliliter per 6 hour
milliliter per 72 hour
milliliter per 8 hour
milliliter per 8 hour per kilogram
milliliter per centimeter of water
milliliter per day
milliliter per deciliter
milliliter per heart beat
milliliter per heart beat per square meter
milliliter per hour
milliliter per kilogram
milliliter per kilogram per 8 hour
milliliter per kilogram per day
milliliter per kilogram per hour
milliliter per kilogram per minute
milliliter per millibar
milliliter per millimeter
milliliter per minute
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 133 of 151
September 2011
Row # (not a
code)
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
535
UCUM_CODE
mL/min/{1.73_m2}
mL/min/m2
mL/s
mL/[sin_i]
mL/m2
mm
mm[Hg]
mm[H2O]
mm/h
mm/min
mmol
mmol/(12.h)
mmol/(2.h)
mmol/(24.h)
mmol/(5.h)
mmol/(6.h)
mmol/(8.h)
mmol/d
mmol/dL
mmol/{ejaculate}
mmol/g
mmol/g{creat}
mmol/h
mmol/h/mg{Hb}
mmol/h/mg{protein}
mmol/kg
mmol/kg/(8.h)
mmol/kg/d
mmol/kg/h
mmol/kg/min
mmol/L
mmol/L{RBCs}
mmol/mmol
mmol/mmol{urea}
mmol/mmol{creat}
mmol/min
mmol/mol
mmol/mol{creat}
mmol/s/L
mmol/{specimen}
mmol/m2
mmol/{total_vol}
10*6
10*6.[CFU]/L
10*6.[IU]
10*6/(24.h)
10*6/kg
10*6/L
10*6/uL
10*6/mL
mosm
mosm/kg
mosm/L
mPa
mPa.s
ms
mV
{minidrop}/min
{minidrop}/s
min
Page 134 of 151
September 2011
Description of the Unit
(using UCUM descriptions where they exist)
milliliter per minute per 1.73 square meter
milliliter per minute per square meter
milliliter per second
milliliter per square inch (international)
milliliter per square meter
millimeter
millimeter of mercury
millimeter of water
millimeter per hour
millimeter per minute
millimole
millimole per 12 hour
millimole per 2 hour
millimole per 24 hour
millimole per 5 hour
millimole per 6 hour
millimole per 8 hour
millimole per day
millimole per deciliter
millimole per ejaculate
millimole per gram
millimole per gram of creatinine
millimole per hour
millimole per hour per milligram of hemoglobin
millimole per hour per milligram of protein
millimole per kilogram
millimole per kilogram per 8 hour
millimole per kilogram per day
millimole per kilogram per hour
millimole per kilogram per minute
millimole per liter
millimole per liter of red blood cells
millimole per millimole
millimole per millimole of urea
millimole per millmole of creatinine
millimole per minute
millimole per mole
millimole per mole of creatinine
millimole per second per liter
millimole per specimen
millimole per square meter
millimole per total volume
million
million colony forming unit per liter
million international unit
million per 24 hour
million per kilogram
million per liter
million per microliter
million per milliliter
milliosmole
milliosmole per kilogram
milliosmole per liter
millipascal
millipascal second
millisecond
millivolt
minidrop per minute
minidrop per second
minute
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Row # (not a
code)
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
UCUM_CODE
mol
mol/
mol/m3
mol/kg
mol/kg/s
mol/L
mol/mL
mol/mol
mol/s
{molecule}/{platelet}
mo
{mm/dd/yyyy}
{M.o.M}
{mutation}
nU/mL
nU/{RBC}
ng
ng{FEU}/mL
ng/(24.h)
ng/(8.h)
ng/d
ng/dL
ng/U
ng/g
ng/g{creat}
ng/h
ng/kg
ng/kg/(8.h)
ng/kg/h
ng/kg/min
ng/L
ng/mg
ng/mg{creat}
ng/mg{protein}
ng/mg/h
ng/mL{RBCs}
ng/mL/h
ng/10*6
ng/10*6{RBCs}
ng/mL
ng/min
ng/s
ng/m2
nkat
nL
nm
nm/s/L
nmol
nmol{BCE}
nmol{BCE}/L
nmol{BCE}/mmol{creat}
nmol{1/2cys}/mg{protein}
nmol{ATP}
nmol/(24.h)
nmol/d
nmol/dL
nmol/dL{GF}
nmol/g
nmol/g{creat}
nmol/g{dry_wt}
nmol/h/L
Description of the Unit
(using UCUM descriptions where they exist)
mole
mole per
mole per cubic meter
mole per kilogram
mole per kilogram per second
mole per liter
mole per milliliter
mole per mole
mole per second
molecule per platelet
month
month-day-year
multiple of the median
mutation
nanoenzyme unit per milliliter
nanoenzyme unit per red blood cell
nanogram
nanogram fibrinogen equivalent unit per milliliter
nanogram per 24 hour
nanogram per 8 hour
nanogram per day
nanogram per deciliter
nanogram per enzyme unit
nanogram per gram
nanogram per gram of creatinine
nanogram per hour
nanogram per kilogram
nanogram per kilogram per 8 hour
nanogram per kilogram per hour
nanogram per kilogram per minute
nanogram per liter
nanogram per milligram
nanogram per milligram of creatinine
nanogram per milligram of protein
nanogram per milligram per hour
nanogram per milliliter of red blood cells
nanogram per milliliter per hour
nanogram per million
nanogram per million red blood cells
nanogram per millliiter
nanogram per minute
nanogram per second
nanogram per square meter
nanokatal
nanoliter
nanometer
nanometer per second per liter
nanomole
nanomole bone collagen equivalent
nanomole bone collagen equivalent per liter
nanomole bone collagen equivalent per millimole of creatinine
nanomole of 1/2 cystine per milligram of protein
nanomole of ATP
nanomole per 24 hour
nanomole per day
nanomole per deciliter
nanomole per deciliter of glomerular filtrate
nanomole per gram
nanomole per gram of creatinine
nanomole per gram of dry weight
nanomole per hour per liter
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 135 of 151
September 2011
Row # (not a
code)
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
UCUM_CODE
nmol/h/mg{protein}
nmol/L
nmol/L{RBCs}
nmol/L/mmol{creat}
nmol/m/mg{protein}
nmol/umol{creat}
nmol/mg
nmol/mg{creat}
nmol/mg{protein}
nmol/mg{protein}/h
nmol/mg/h
nmol/mL
nmol/mL/h
nmol/mL/min
nmol/mmol
nmol/mmol{creat}
nmol/min
nmol/min/mg{Hb}
nmol/min/mg{protein}
nmol/min/mL
nmol/min/10*6{cells}
nmol/mol
nmol/nmol
nmol/s
nmol/s/L
ns
N
N.cm
N.s
{#}
{#}/[HPF]
{#}/L
{#}/[LPF]
{#}/uL
{#}/mL
{#}/min
Ohm
Ohm.m
10*5
{OD_unit}
osm
osm/kg
osm/L
[oz_av]
{Pan_Bio'U}
[ppb]
[ppm]
[ppm]{v/v}
[ppth]
[ppt]
Pa
/10*10
/10*4{RBCs}
/100
/100{cells}
/100{neutrophils}
/100{spermatozoa}
/100{WBCs}
/[arb'U]
/10*9
Page 136 of 151
September 2011
Description of the Unit
(using UCUM descriptions where they exist)
nanomole per hour per milligram of protein
nanomole per liter
nanomole per liter of red blood cells
nanomole per liter per millimole of creatinine
nanomole per meter per milligram of protein
nanomole per micromole of creatinine
nanomole per milligram
nanomole per milligram of creatinine
nanomole per milligram of protein
nanomole per milligram of protein per hour
nanomole per milligram per hour
nanomole per milliliter
nanomole per milliliter per hour
nanomole per milliliter per minute
nanomole per millimole
nanomole per millimole of creatinine
nanomole per minute
nanomole per minute per milligram of hemoglobin
nanomole per minute per milligram of protein
nanomole per minute per milliliter
nanomole per minute per million cells
nanomole per mole
nanomole per nanomole
nanomole per second
nanomole per second per liter
nanosecond
Newton
Newton centimeter
Newton second
number
number per high power field
number per liter
number per low power field
number per microliter
number per milliliter
number per minute
Ohm
Ohm meter
one hundred thousand
optical density unit
osmole
osmole per kilogram
osmole per liter
ounce (US and British)
panbio unit
part per billion
part per million
part per million in volume per volume
part per thousand
part per trillion
Pascal
per 10 billion
per 10 thousand red blood cells
per 100
per 100 cells
per 100 neutrophils
per 100 spermatozoa
per 100 white blood cells
per arbitrary unit
per billion
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Row # (not a
code)
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
694
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
UCUM_CODE
/cm[H2O]
/m3
/d
/dL
/{entity}
/U
/g
/g{creat}
/g{Hb}
/g{tot_nit}
/g{tot_prot}
/g{wet_tis}
/[HPF]
/h
/[IU]
/kg
/kg{body_wt}
/L
/[LPF]
/uL
/mg
/mL
/mm
/mmol{creat}
/10*6
/min
/mo
/{OIF}
/s
/m2
/10*3
/10*3.{RBCs}
/10*12
/10*12{RBCs}
/(12.h)
/wk
/a
%
%{loss_AChR}
%{penetration}
%{abnormal}
%{activity}
%{aggregation}
%{at_60_min}
%{basal_activity}
%{binding}
%{blockade}
%{blocked}
%{bound}
%{breakdown}
%{vol}
%{deficient}
%{dose}
%{excretion}
%{Hb}
%{hemolysis}
%{index}
%{inhibition}
%{loss}
%{lysis}
%{normal}
Description of the Unit
(using UCUM descriptions where they exist)
per centimeter of water
per cubic meter
per day
per deciliter
per entity
per enzyme unit
per gram
per gram of creatinine
per gram of hemoglobin
per gram of total nitrogen
per gram of total protein
per gram of wet tissue
per high power field
per hour
per international unit
per kilogram
per kilogram of body weight
per liter
per low power field
per microliter
per milligram
per milliliter
per millimeter
per millimole of creatinine
per million
per minute
per month
per oil immersion field
per second
per square meter
per thousand
per thousand red blood cells
per trillion
per trillion red blood cells
per twelve hour
per week
per year
percent
percent loss of acetylcholine receptor
percent penetration
percent abnormal
percent activity
percent aggregation
percent at 60 minute
percent basal activity
percent binding
percent blockade
percent blocked
percent bound
percent breakdown
percent by volume
percent deficient
percent dose
percent excretion
percent hemoglobin
percent hemolysis
percent index
percent inhibition
percent loss
percent lysis
percent normal
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 137 of 151
September 2011
Row # (not a
code)
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
UCUM_CODE
%{normal_pooled_plasma}
%{bacteria}
%{baseline}
%{cells}
%{RBCs}
%{WBCs}
%{positive}
%{reactive}
%{recovery}
%{reference}
%{residual}
%{saturation}
%{total}
%{uptake}
%{viable}
{percentile}
[pH]
{phenotype}
pA
pg
pg/{cell}
pg/dL
pg/L
pg/mg
pg/mg{creat}
pg/mL
pg/mm
pg/{RBC}
pkat
pL
pm
pmol
pmol/(24.h)
pmol/d
pmol/dL
pmol/g
pmol/h/mg{protein}
pmol/h/mL
pmol/L
pmol/umol
pmol/umol{creat}
pmol/mg{protein}
pmol/mL
pmol/mmol{creat}
pmol/min
pmol/min/mg{protein}
pmol/{RBC}
ps
pT
[pt_us]
[lb_av]
[psi]
[qt_us]
{ratio}
{RBC}/uL
%{relative}
{relative_saturation}
{Rubella_virus}
{saturation}
s
Page 138 of 151
September 2011
Description of the Unit
(using UCUM descriptions where they exist)
percent normal pooled plasma
percent of bacteria
percent of baseline
percent of cells
percent of red blood cells
percent of white blood cells
percent positive
percent reactive
percent recovery
percent reference
percent residual
percent saturation
percent total
percent uptake
percent viable
percentile
pH
phenotype
picoampere
picogram
picogram per cell
picogram per deciliter
picogram per liter
picogram per milligram
picogram per milligram of creatinine
picogram per milliliter
picogram per millimeter
picogram per red blood cell
picokatal
picoliter
picometer
picomole
picomole per 24 hour
picomole per day
picomole per deciliter
picomole per gram
picomole per hour per milligram of protein
picomole per hour per milliliter
picomole per liter
picomole per micromole
picomole per micromole of creatinine
picomole per milligram of protein
picomole per milliliter
picomole per millimole of creatinine
picomole per minute
picomole per minute per milligram of protein
picomole per red blood cell
picosecond
picotesla
pint (US)
pound (US and British)
pound per square inch
quart (US)
ratio
red blood cell per microliter
relative percent
relative saturation
rubella virus
saturation
second
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Row # (not a
code)
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
796
797
798
799
800
801
802
803
804
805
806
807
808
809
810
811
812
813
814
815
UCUM_CODE
s/{control}
{shift}
S
Sv
{s_co_ratio}
{spermatozoa}/mL
cm2
cm2/s
dm2/s2
[sft_i]
[sin_i]
m2
m2/s
mm2
[syd_i]
{STDV}
[tbs_us]
[tsp_us]
T
10*3
10*3{copies}/mL
10*3/L
10*3/uL
10*3/mL
10*3{RBCs}
{TSI_index}
{titer}
[Todd’U]
Torr
10*12/L
[oz_tr]
[tb'U]
V
Wb
wk
{WBCs}
[yd_i]
a
Description of the Unit
(using UCUM descriptions where they exist)
second per control
shift
Siemens
Sievert
signal to cutoff ratio
spermatozoa per milliliter
square centimeter
square centimeter per second
square decimeter per square second
square foot (international)
square inch (international)
square meter
square meter per second
square millimeter
square yard (international)
standard deviation
tablespoon (US)
teaspoon (US)
Tesla
thousand
thousand copies per milliliter
thousand per liter
thousand per microliter
thousand per milliliter
thousand red blood cells
thyroid-stimulating immunoglobulin index
titer
Todd unit
Torr
trillion per liter
Troy ounce
tuberculin unit
volt
Weber
week
white blood cells
yard (international)
year
HL7 Version 2.5.1 IG: Laboratory Results Interface for US Realm, Release 1
© 2011 Health Level Seven International. All rights reserved.
Page 139 of 151
September 2011