TransferGuard Sample Messages

Segment	Usage	Cardinality	Description
MSH		[1..1]	Message Header
PID	Required	[1..1]	Patient Identification
PV1	Required	[1..1]	Patient Visit
[IN1]	Optional	[0..3]	Insurance
[GT1]	Conditional	[0..1]	Guarantor - required when IN1 is included
{	Required	[1..*]	--- Order Begin
ORC	Required	[1..1]	Order Common
OBR	Required	[1..1]	Order
[{NTE}]	Optional	[0..*]	Notes and comments
{DG1}	Required	[1..*]	Diagnosis
[{OBX}]	Optional	[0..*]	Observation - Ask at Order Entry (AOE) Questions
}			--- Order End

MSH - Message Header

MSH.3.1 - Sending Application. PAML Assigned Interface Identifier.

The 4-digit interface identifier assigned by PAML. For orders, you must use the PAML assigned identifier that is included in your client certificate and the SOAP message. For results, this will be the PAML assigned identifier for the laboratory.

MSH.4.1 - Sending Facility

Should be alphanumeric only. For orders, this should be the client or account name. This value will be returned in MSH.6.1 in the result message(s). For results, this will be the laboratory facility.

MSH.5.1 - Receiving Application. PAML Assigned Interface Identifier.

The 4-digit interface identifier assigned by PAML. For orders, you must use the PAML assigned identifier for the laboratory. For results, this will be the PAML assigned identifier that is included in your client certificate and the SOAP message.

MSH.6.1 - Receiving Facility

Should be alphanumeric only. For orders, this should be "PAML". For results, this will be the value provided in MSH4.1 in the order message.

MSH.7.1 - Date/Time of Message

CCYYMMDDHHMMSS (4-digit year, month, day, hour, minute, second)

MSH.8

MSH.9.1 - Message Type

For orders, this should be: "ORM"

MSH.9.2 - Message Type

For orders, this should be: "O01"

MSH.9.3 - Message Type

For orders, this should be: "ORM_O01"

MSH.10 - Message Control Identifier

Unique message identifier.

MSH.11.1 - Processing Identifier

Accepted Values:

Value	Description
D	Debugging
P	Production
T	Training

MSH.12.1.1 - HL7 Message Version

Should be: 2.5

PID - Patient Identification

PID.1 - Set ID

This should be: 1

PID.3.1 - Client Assigned Patient Identifier

PID.5.1 - Patient Last Name

PID.5.2 - Patient First Name

PID.7.1 - Patient Date of Birth (DOB)

CCYYMMDD (4-digit year, month, day)

PID.8 - Patient Gender

Accepted Values:

Value	Description
M	Male
F	Female
U	Unknown

PID.10.1 - Patient Race

Accepted Values:

Value	Description
AF	Black (AF)
ASA	Asian
CAU	Caucasian
HIS	Hispanic
NAT	Native American
OTH	Other

PID.11.1 - Patient Address

PID.11.3 - City

PID.11.4 - State

PID.11.5 - Zip Code

PID.13.1 - Patient Area Code and Phone Number

Example: (509) 555-1212

PID.13.4 - Patient Email Address

PID.13.6 - Patient Area Code

PID.13.7 - Patient Phone Number

PID.18.1 - Laboratory Assigned Patient Identifier

PV1 - Patient Visit

PV1.1.1 - Set ID

This should be: 1

PV1.3.1 -

PV1.3.4 - Patient Location Facility

PV1.3.7 - Patient Location Building

PV1.3.9 - Patient Location Description

PV1.7.1.1 - Attending Provider Identifier

This value will be set equal to OBR.16.1.1 on result messages, if no value is provided on the order.

PV1.7.2.1 - Attending Provider Description

This value will be set equal to OBR.16.2.1 on result messages, if no value is provided on the order.

PV1.39 - Laboratory Assigned Patient Visit Facility Identifier

IN1 - Insurance

The IN1 segment contains insurance policy coverage information necessary to produce properly prorated and patient insurance bills. The IN1 segment is "C" (conditional) and is required OBR.19 is "T" (third-party bill). If OBR.19 is not equal to "T", the IN1 segment should not be sent. When lab services are to be billed to a third party, information for a primary, secondary, and tertiary insurance may be provided (i.e., up to 3 IN1 segments may be sent). The information for the primary insurance plan must be reported in the first IN1 segment.

IN1.1 - Set ID

Up to 3 occurrences of the IN1 segment cans be sent to accommodate a patient's primary, secondary and tertiary insurance information. The information for the primary insurance plan must be reported in the first IN1 segment and the IN1.1 Set ID field must be populated with the value "1". If information for a secondary or tertiary insurance is transmitted in the order, the IN1 Set ID field must be populated with a value of "2" and "3", respectively. Accepted Values:

Value	Description
1	1st IN1 segment providing patient's primary insurance information
2	2nd IN1 segment providing patient's secondary insurance information
3	3rd IN1 segment providing patient's tertiary insurance information

IN1.2.1 - Insurance Plan ID

The ordering system must use the Insurance Plan ID field to send an indicator of the specific type of policy that the ensured holds (e.g. PPO, HMO, etc.). There is a great deal of variety in how insurance companies define the format for their plan IDs.

Note: See IN1.36 Policy Number for information on sending the patient's unique subscriber ID. See IN1.3 Insurance Company ID and IN1.4 Insurance Company Name for information on sending the identifier and name of the patient's insurance carrier.

IN1.3.1 - Insurance Company ID

The ordering EHR system must provide the identifier of the patient’s insurance company. This identifier may be the lab’s proprietary identifier, the ordering systems proprietary identifier, or an insurance company identifier from a third party intermediary (e.g., a clearinghouse). Despite the name of this component, the actual insurance company identifier may be an alphanumeric text string, not just a numeric identifier. See http://billingcodes.paml.com/ for a list of valid Insurance Company Identifiers.

IN1.4.1 - Insurance Company Name

The ordering system must include the name of the third-party payer/insurance company when the lab test is billed to a third-party. Only the Organization Name component (IN1.4.1) must be populated to indicate the name of the insurance company.

IN1.5.1 - Insurance Company Address

The ordering system must include the address of the patient's insurance carrier when the lab test is billed to a third-party. Only a single insurance company address may be sent.

IN1.5.3 - Insurance Company City

Insurance Company city.

IN1.5.4 - Insurance Company State

Insurance Company state.

IN1.5.5 - Insurance Company Zip Code

Insurance Company zip code.

IN1.8 - Insurance Group Number

If a lab test is billed to a third-party payer, and the patient's insurance carrier has assigned a group number for the patient's coverage, and the ordering system has a record of the group number, the ordering system must send this group number in this field.

IN1.11.1 - Insured's Group Employer Name

When an insurance claim is related to a workman’s compensation claim, the lab may need to provide the name of the employer providing the coverage for the workman’s compensation claim. Only the Organization Name component (IN1.8.1) must be populated when indicating the employer name.

Condition: The IN1.8 Insured’s Group Employer Name is required when the IN1.31 Type of Agreement Code field is populated with the value "W", indicating that the insurer is providing coverage as part of a workman’s compensation claim. Otherwise, this field must be empty.

IN1.13 - Insurance Plan Expiration Date

This field is optional. If provided, it must confirm to the DT data type.

IN1.16.1 - Last Name of Insured

The ordering system must include the name of the policy holder (subscriber) for the insurance policy when the lab test is billed to a third-party payer. Both a first (IN1.16.2) and last name (IN1.16.1) must be provided at a minimum.

IN1.16.2 - First Name of Insured

IN1.17.1 - Insured's Relationship to Patient Identifier

Accepted Values:

Value	Description
SEL	Self
SPO	Spouse
DEP	Dependent

IN1.17.2 - Insured's Relationship to Patient Description

This description must match the value provided in IN1.17.1.

Accepted Values:

Value	Description
Self	Use when providing SEL in IN1.17.1.
Spouse	Use when providing SPO in IN1.17.1.
Dependent	Use when providing DEP in IN1.17.1.

IN1.17.3 - Insured's Relationship to Patient Coding System

Must be "HL70063".

IN1.18 - Insured's Date of Birth

If known, the ordering system, the subscribers' date of birth must be reported in this field when the lab test is billed to a third party. The time of birth or time zone indicator must not be transmitted.

Format: YYYYMMDD

IN1.19.1 - Insured's Address

Insured's street or mailing address.

IN1.19.3 - Insured's City

Insured's city.

IN1.19.4 - Insured's State

Insured's state.

IN1.19.5 - Insured's Zip Code

Insured's zip code.

IN1.31 - Insurance Type of Agreement Code

If an Insurance company is providing coverage for a patient as part of a workman’s compensation claim and the ordering system is aware of this fact, the ordering system must populate this field with a value of "W" (Workman’s compensation). This flag informs the performing lab that the insurance information transmitted in the current IN1 segment is covering the patient under a special type of agreement and may not be the patient’s regular insurance provider.

Accepted Values:

Value	Description
S	Standard
U	Unified
M	Maternity
W	Workman's Compensation

IN1.36 - Insurance Policy Number

The ordering system must include the policy number, Medicare ID, Medicaid ID, case number, or member ID of the insured person when the lab test is billed to a third-party. The actual content of this field depends on the type of third-party payer.

GT1 - Guarantor Segment

The GT1 segment contains guarantor data for patient and insurance billing purposes (i.e., data about the person or the organization with financial responsibility for payment of a patient account). The GT1 segment is required in all order messages. Only a single instance of a GT1 segment is allowed in an order message.

GT1.1 - Guarantor Set ID

This specification allows a maximum of 1 occurrence of the GT1 segment. Hence, this field must be populated with the value "1".

GT1.3.1.1 - Guarantor Last Name

If the guarantor for payment of lab services is an individual, the ordering system must provide that person's name when placing an order for lab service. The first and last name of the guarantor must be sent at minimum.

If the guarantor is an organization rather than an individual, then this field must be empty and the GT1.21 Guarantor Organization Name must be populated instead.

GT1.3.2 - Guarantor First Name

If the guarantor for payment of lab services is an individual, the ordering system must provide that person's name when placing an order for lab service. The first (GT1.3.2) and last (GT1.3.1) name of the guarantor must be sent at minimum.

If the guarantor is an organization rather than an individual, then this field must be empty and the GT1.21 Guarantor Organization Name must be populated instead.

GT1.5.1.1 - Guarantor Address

Guarantor street or mailing address.

GT1.5.3 - Guarantor City

Guarantor city.

GT1.5.4 - Guarantor State

Guarantor state.

GT1.5.5 - Guarantor Zip Code

Guarantor zip code.

GT1.21.1 - Guarantor Organization Name

If the guarantor for payment of lab service is an organization, the ordering system must provide that organization’s name when placing an order for lab service. If the guarantor is an individual rather than an organization, then this field shall be empty and the GT1.3 Guarantor Name must be populated instead.

ORC - Order

The ORC and OBR segments are used together to represent an order. Each test order should have corresponding ORC and OBR segments.

ORC.1 - Order Control (Type)

Accepted Values:

Value	Description
NW	New Order
CA	Cancel

ORC.2.1 - Unique Test Order Number

Unique test order identifier. This value must match exactly the corresponding OBR.2.1 value.

ORC.9.1 - Date/Time of Order

CCYYMMDDHHMMSS (4-digit year, month, day, hour, minute, second)

ORC.13.1 - Enterer's Location

PAML Assigned Location of the person placing the order. This field is optional and is used when the location of the person entering the order is required. For example, when printing PAML generated specimen labels.

OBR - Observation Request (Order Detail)

The OBR and ORC segments are used together to represent an order. Each test order should have corresponding OBR and ORC segments.

OBR.1 - Set ID

Should be: 1

OBR.2.1 - Unique Test Order Number

Unique test order identifier. This value must match exactly the corresponding ORC.2.1 value.

OBR.3.1 - Laboratory Accession Number

Laboratory accession number.

OBR.4.1 - Laboratory Test Order Code

See PAML Test Directory for a listing of order codes and additional details.

OBR.4.2 - Laboratory Order Code Description

See PAML Test Directory for a listing of order codes and additional details.

OBR.5 - Order Priority

Accepted Values:

Value	Description
S	Stat - 4 hour turn-around requested
S2	Stat 2 - 12 hour turn-around requested
R	Routine

NOTE: Turn-around times vary by test, testing location and other factors. The requested order priority does not guarantee turn-around time.

OBR.7.1 - Start Date/Time of Order

OBR.8.1 - End Date/Time of Order

OBR.16.1.1 - Ordering Provider Identifier

NPI or account number of the provider ordering the test. The account number should only be used if the test is being ordered directly by the patient or the NPI number of the ordering provider is not available.

OBR.16.2.1 - Ordering Provider Description

OBR.19 - Billing Indicator

Accepted Values:

Value	Description
T	Third Party. Requires IN1, GT1 and DG1 segments.
P	Patient
C	Client

OBR.25 - Order Status

Values:

Value	Description
P	Partial result.
F	Final result.
C	Corrected result.

NTE - Notes and Comments Segment

The NTE segment is commonly used for sending notes and comments that accompany test orders. Information transmitted in NTE segments is limited to general notes of a non-clinical nature. Any supporting clinical information relevant to the performance of a test must be transmitted as Ask At Order Enter (AOE) question responses in OBX segments or in the designated DG1 and OBR segments.

NTE.1 - Notes and Comments Set ID

An integer set identifier that increments by 1 for each NTE segment sent that relates to an ordered test (i.e. OBR). The first NTE segment related to an ordered test must have a Set ID value of "1". The set ID of the second NTE segment must have a value of "2", and so on.

NTE.3 - Comment

This field contains the relevant message that needs to be communicate to the lab. Information transmitted is limited to general notes of a non-clinical nature. Any supporting clinical information relevant to the performance of a test must be transmitted as Ask At Order Enter (AOE) question responses in OBX segments or in the designated DG1 and OBR segments.

DG1 - Diagnosis Segment

The DG1 segment contains patient diagnose information of various types, for example, primary, etc. The DG1 segment is used to send multiple diagnoses for the patient for whom test are being ordered. The DG1 segment is required, but may be empty. If the patient diagnoses are known by the sending system, the DG1 segment(s) must be populated. In the case of third-party billing, diagnosis information is typically required to be submitted in order for the payer to process a claim. In other cases (e.g. patient bill or client bill), diagnosis information may not generally be needed, but could be important for certain tests.
The sending system must provide as many diagnoses (in multiple DG1 segments) as deemed necessary for the lab test. The ordering system must indicate the priority of each included diagnosis (e.g. primary or secondary).

DG1.1 - Diagnosis Set ID

An integer set identifier that increments by 1 for each DG1 segment sent that relates to an ordered test (i.e. OBR). The first DG1 segment related to an ordered test must have a Set ID value of "1". The set ID of the second DG1 segment must have a value of "2", and so on.

DG1.3.1 - Diagnosis Code

The ordering system must provide a diagnosis code and diagnosis description that can support the reimbursement for lab services when a lab test is paid for by a third-party payer and the ordering system has a record of the diagnosis code. Either the lCD-9 or lCD-10 coding system shall be used to identify the patient’s diagnosis. Only a single diagnosis code may be provided for a given diagnosis (i.e., either the lCD-9 identifier or the lCD-10 identifier may be sent, not both). The diagnosis code must be part of the code system specified in DG1.3.3.

DG1.3.2 - Diagnosis Code Description

Diagnosis description that applies to the diagnosis code specified in DG1.3.1.

DG1.3.3 - Diagnosis Code System

Diagnosis Code System that applies to the code specified in DG1.3.1.

Values:

Value	Description
I9C	ICD-9 CM
I10C	ICD-10 CM

DG1.6 - Diagnosis Type

The ordering system shall indicate whether the diagnosis type is "W" (working) or "F" (final). A 'working' diagnosis is a presumptive diagnosis that has not yet been established, whereas a 'final' diagnosis has been established.

Values:

Value	Description
W	Working, presumptive diagnosis that has not yet been established
F	Final, established diagnosis.

DG1.15 - Diagnosis Priority

If available, the ordering system must indicate the priority (e.g., primary, secondary, etc.) of the diagnosis indicated in the DG1.3.1 Diagnosis Code field. Primary diagnoses have the value "1", secondary diagnoses have the value "2", and unranked diagnoses have the value "0".

Values:

Value	Description
0	Not included in diagnosis ranking
1	The primary diagnosis
2	For ranked secondary diagnoses

OBX - Order Observation Segment (Ask At Order Entry Questions)

In general, the OBX segment is used in an HL7 message to transmit a single observation or observation fragment that provides clinical context. For the purposes of the Order message, OBX segments are specifically and solely used to report response to ask at order entry (AOE) question. When AOE response are applicable to an ordered test, each AOE response is transmitted as an individual OBX segment beneath the OBR segment that specifies the corresponding test order. IF an ordered test does not have any associated AOE questions, the OBX segment should not be sent. Multiple OBX segment may be included for an ordered test to support those tests with multiple AOE questions. NOTE: The OBX segment has a different function for order and result messages.

OBX.1 - Order Set ID

This field must be populated with an integer that enumerates the AOE question response(s) for a specific test order (ORC/OBR combination). Multiple OBX segments can be sent that relate to a single test order and should follow the OBR segment which for which they correspond. The first OBX segment related to an ordered test must have a Set ID value of "1", the Set ID of the second OBX segment must have a value of "2", and so on.

OBX.2 - Order Value Type

This field contains the data type of the AOE question response value sent in OBX.5. The value sent in this field must correspond to the response data type for the AOE question response listed in the PAML Test Directory. If no data type is specified in the test directory, then the default value of "ST" (string date) should be used. Values:

Value	Description
CE	Coded Element
DT	Date
NM	Numeric
SN	Structured Numeric
ST	String Data
TM	Time
TS	Timestamp
TX	Text Data
FT	Formatted Text

OBX.3.1 - Order Observation Identifier

AOE identifier for the AOE question. The value sent in the Identifier component (OBX.3.1) of this filed must correspond to the AOE question identifier from the PAML Test Directory.

OBX.3.2 - Order Observation Description

This field must contain the text of the AOE question from the PAML Test Directory.

OBX.5 - Order Observation Value

This filed must contain the value of the AOE question response. The value of the AOE question response must be consistent with the data type sent in the OBX.2 Value Type field. For example, if the value type in OBX.2 is "DT" (date), the the value of OBX.5 must be a valid HL7 formatted date (e.g. "20130109").
NOTE: Do not include units of measure in this field. Units of measure should be specified in OBX.6.

OBX.6.1 - Order Units

If the AOE question response can have units of measure associated with a value send in OBX.5 Observation Value, then this field may be used to indicate the applicable units.

OBX.11 - Order Observation Status

This field must be populated with the value of "F" for final.
Values:

Value	Description
F	Final

OBX - Result Observation Segment

OBX.1 - Result Set ID

OBX.2 - Result Value Type

OBX.3.1 - Result Observation Identifier (LOINC)

LOINC result code.

OBX.3.2 - Result Observation (Result) Description

Result description.

OBX.5 - Result Observation Value (Result)

Result value.

OBX.6.1 - Result Units

Result units.

OBX.7 - Result Reference Range

Result reference range.

OBX.8 - Result Abnormal Flags

Result abnormal flags.

OBX.11 - Result Observation Status

Values:

Value	Description
F	Final. Final results should replace preliminary results and should indicate that the result is final.
P	Preliminary. Preliminary results should indicate that the result is preliminary.
C	Corrected. Corrected results should replace previous final and preliminary results and should indicate that the result is corrected.

OBX.15.1 - Result Performing Laboratory Identifier (CLIA Code)

Performing laboratory identifier. This is the CLIA number of the performing laboratory.

OBX.15.2 - Result Performing Laboratory Name and Address

Performing laboratory name and address.

Sample ER7 Messages

Order Message Structure

Sample ER7 Order Messages

Sample Base64 Encoded ER7 Order Message

Sample SOAP Envelope (PlaceBase64Order)

Sample ER7 Result Message

Sample v2.xml Messages

Sample v2.xml Order Message

Sample SOAP Envelope (PlaceOrder)

Sample v2.xml Result Message

MSH - Message Header

MSH.3.1 - Sending Application. PAML Assigned Interface Identifier.

MSH.4.1 - Sending Facility

MSH.5.1 - Receiving Application. PAML Assigned Interface Identifier.

MSH.6.1 - Receiving Facility

MSH.7.1 - Date/Time of Message

MSH.8

MSH.9.1 - Message Type

MSH.9.2 - Message Type

MSH.9.3 - Message Type

MSH.10 - Message Control Identifier

MSH.11.1 - Processing Identifier

MSH.12.1.1 - HL7 Message Version

PID - Patient Identification

PID.1 - Set ID

PID.3.1 - Client Assigned Patient Identifier

PID.5.1 - Patient Last Name

PID.5.2 - Patient First Name

PID.7.1 - Patient Date of Birth (DOB)

PID.8 - Patient Gender

PID.10.1 - Patient Race

PID.11.1 - Patient Address

PID.11.3 - City

PID.11.4 - State

PID.11.5 - Zip Code

PID.13.1 - Patient Area Code and Phone Number

PID.13.4 - Patient Email Address

PID.13.6 - Patient Area Code

PID.13.7 - Patient Phone Number

PID.18.1 - Laboratory Assigned Patient Identifier

PV1 - Patient Visit

PV1.1.1 - Set ID

PV1.3.1 -

PV1.3.4 - Patient Location Facility

PV1.3.7 - Patient Location Building

PV1.3.9 - Patient Location Description

PV1.7.1.1 - Attending Provider Identifier

PV1.7.2.1 - Attending Provider Description

PV1.39 - Laboratory Assigned Patient Visit Facility Identifier

IN1 - Insurance

IN1.1 - Set ID

IN1.2.1 - Insurance Plan ID

IN1.3.1 - Insurance Company ID

IN1.4.1 - Insurance Company Name

IN1.5.1 - Insurance Company Address

IN1.5.3 - Insurance Company City

IN1.5.4 - Insurance Company State

IN1.5.5 - Insurance Company Zip Code

IN1.8 - Insurance Group Number

IN1.11.1 - Insured's Group Employer Name

IN1.13 - Insurance Plan Expiration Date

IN1.16.1 - Last Name of Insured

IN1.16.2 - First Name of Insured

IN1.17.1 - Insured's Relationship to Patient Identifier

IN1.17.2 - Insured's Relationship to Patient Description

IN1.17.3 - Insured's Relationship to Patient Coding System

IN1.18 - Insured's Date of Birth

IN1.19.1 - Insured's Address

IN1.19.3 - Insured's City

IN1.19.4 - Insured's State

IN1.19.5 - Insured's Zip Code

IN1.31 - Insurance Type of Agreement Code

IN1.36 - Insurance Policy Number

GT1 - Guarantor Segment

GT1.1 - Guarantor Set ID

GT1.3.1.1 - Guarantor Last Name

GT1.3.2 - Guarantor First Name

GT1.5.1.1 - Guarantor Address

GT1.5.3 - Guarantor City

GT1.5.4 - Guarantor State