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RXA - Pharmacy/Treatment Administration Segment

The ORC must have the filler order number and the order control code RE. As a site-specific variant, the RXO and associated RXCs and/or the RXE (and associated RXCs) may be present if the receiving application needs any of their data. The RXA carries the administration data.

HL7 Attribute Table - RXA - Pharmacy/Treatment Administration Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
RXA
1 00342 Give Sub-ID Counter SHALL = [1..1] 4 NM
2 00344 Administration Sub-ID Counter SHALL = [1..1] 4 NM
3 00345 Date/Time Start of Administration SHALL [1..1] DTM
4 00346 Date/Time End of Administration SHALL [1..1] DTM
5 00347 Administered Code SHALL [1..1] CWE
6 00348 Administered Amount SHALL [1..1] NM
7

00349 Administered Units MAY
True:
False:
C
[1..1]
[0..1]
CWE
8 00350 Administered Dosage Form [0..1] CWE
9 00351 Administration Notes [0..*] CWE
10 00352 Administering Provider SHALL NOT W [0..0]
11 00353 Administered-at Location SHALL NOT W [0..0]
12

00354 Administered Per MAY
True:
False:
C=
[1..1]
[0..1]
20 ST
13 01134 Administered Strength [0..1] NM
14 01135 Administered Strength Units [0..1] CWE
15 01129 Substance Lot Number = [0..*] 20 ST
16 01130 Substance Expiration Date [0..*] DTM
17 01131 Substance Manufacturer Name [0..*] CWE
18 01136 Substance/Treatment Refusal Reason [0..*] CWE
19 01123 Indication [0..*] CWE
20 01223 Completion Status [0..1] [2..2] ID
21 01224 Action Code – RXA [0..1] [1..1] ID
22 01225 System Entry Date/Time [0..1] DTM
23 01696 Administered Drug Strength Volume = [0..1] 5 NM
24 01697 Administered Drug Strength Volume Units [0..1] CWE
25 01698 Administered Barcode Identifier [0..1] CWE
26 01699 Pharmacy Order Type [0..1] [1..1] ID
27 02264 Administer-at [0..1] PL
28 02265 Administered-at Address [0..1] XAD
29 03396 Administered Tag Identifier [0..*] EI

RXA-1: Give Sub-ID Counter (NM) 00342

(Definition from RXG.1 in Ch. 4A)

Definition: Use if this RXG segment carries information about a single administration. This field must contain a unique number for the placer order number. This field along with the placer order number provides a unique reference to the specific scheduled give date/time transmitted by the pharmacy/treatment supplier for this order.

If the RXG segment carries information about multiple administrations, this field's value is zero (0), since in this case a one-to-one matching with the RXA segment is ambiguous.

(Definition from RXA.1 in Ch. 4A)

Definition: Use this field if matching this RXA segment to its corresponding RXG segment. If the two applications are not matching RXG and RXA segments, this field's value is zero (0).

RXA-2: Administration Sub-ID Counter (NM) 00344

Definition: This field starts with 1 the first time that medication/treatment is administered for this order. Increments by one with each additional administration of the medication/treatment.

Note: More than one RXA segment can be "matched" to a single RXG segment, as is the case when recording a change of the rate of administration of an IV solution.


RXA-3: Date/Time Start of Administration (DTM) 00345

Definition: If the order is for a continuous administration (such as an IV), and the rate is changed at a certain time after the start, an RAS message can be issued to record the change. For such an RAS message, this field records the time the rate was changed to the new value recorded in the RXA-12-Administered Per (time unit) of the same message.

RXA-4: Date/Time End of Administration (DTM) 00346

Definition: If null, the date/time of RXA-3-Date/Time Start of Administration is assumed.

RXA-5: Administered Code (CWE) 00347

Definition: This field contains the identifier of the medical substance/treatment administered. It is equivalent to OBR-4-universal service ID in function. If the substance administered is a vaccine, CVX codes may be used to code this field (see HL7 Table 0292 - Vaccines Administered). If CVX code is used to identify vaccines, the coding system component (RXA-5.3) should be valued as "CVX", not as "HL70292."

RXA-6: Administered Amount (NM) 00348

Definition: This field contains the amount administered.

RXA-7: Administered Units (CWE) 00349

Definition: This field is conditional because it is required if the administered amount code does not imply units. This field must be in simple units that reflect the actual quantity of the substance administered. It does not include compound units. Refer to Table 0689 - Administered Units in Chapter 2C for valid values.

RXA-8: Administered Dosage Form (CWE) 00350

Definition: The dosage form indicates the manner in which the medication/treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the dispense/give code in RXA-5-Administered Code. Use this field when the administered code does not specify the dosage form. Refer to Table 0690 - Administered Dosage Form in Chapter 2C for valid values.

RXA-9: Administration Notes (CWE) 00351

(Definition from RXG.9 in Ch. 4A)

Definition: This field contains notes to the person administering the medication/treatment (may include the ordering provider's original notes, as well as any notes from the formulary or the pharmacy or treatment supplier). If coded, a user-defined table must be used. If free text, place a null in the first component and the text in the second, e.g., |^this is a free text administration note|. Refer to Table 0737 - Administration Notes in Chapter 2C for valid values.

(Definition from RXA.9 in Ch. 4A)

Definition: This field contains notes from the provider administering the medication/treatment. If coded, requires a user-defined table. If free text (describing a custom IV, mixture, or salve, for example) place a null in the first component and the text in the second, e.g., |^this is a free text administration note|. Refer to Table 0691 - Administration Notes in Chapter 2C for valid values.

RXA-10: Administering Provider

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

RXA-11: Administered-at Location

Definition: This field is retained for backward compatibility only as of v 2.6 and withdrawn from the standard as of v 2.8. The reader is referred to RXA-27 and RXA-28..

RXA-12: Administered Per (ST) 00354

Definition: This field contains the rate at which this medication/treatment was administered as calculated by using RXA-6-administered amount and RXA-7-administered units. This field is conditional because it is required when a treatment is administered continuously at a prescribed rate, e.g., certain IV solutions.

RXA-13: Administered Strength (NM) 01134

Definition: Use when RXA-5-Administered Code does not specify the strength. This is the numeric part of the strength, used in combination with RXA-14-Administered Strength Units.

RXA-14: Administered Strength Units (CWE) 01135

Definition: Use when RXA-5-Administered Code does not specify the strength. This is the unit of the strength, used in combination with RXA-13-Administered Strength. Refer to Table 0692 - Administered Strength Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.


RXA-15: Substance Lot Number (ST) 01129

(Definition from RXD.18 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from RXG.19 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from RXA.15 in Ch. 4A)

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.


(Definition from SID.2 in Ch. 13)

Definition: This field specifies the lot number assigned by the manufacturer during production of the substance.

RXA-16: Substance Expiration Date (DTM) 01130

(Definition from RXD.19 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM^L.


(Definition from RXG.20 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.


(Definition from RXA.16 in Ch. 4A)

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.


RXA-17: Substance Manufacturer Name (CWE) 01131

(Definition from RXD.20 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered when it is a manufactured substance.

Note: For vaccines, code system MVX may be used to code this field. See Section 4A.7.1, "Vaccine administration data". This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-Administered code.


(Definition from RXG.21 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field (see section4A.7.1, "Vaccine administration data"). This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-administered code.


(Definition from RXA.17 in Ch. 4A)

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field. See section 4A.7.1, "Vaccine administration data." This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5- administered code. When using this code system to identify vaccines, the coding system component of the CWE field should be valued as "MVX", not as "HL70227."


RXA-18: Substance/Treatment Refusal Reason (CWE) 01136

Definition: This field contains the reason the patient refused the medical substance/treatment. Any entry in the field indicates that the patient did not take the substance. Refer to Table 0693 - Substance/Treatment Refusal Reason in Chapter 2C for valid values.

RXA-19: Indication (CWE) 01123

(Definition from RXO.20 in Ch. 4A)

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0758 - Indication in Chapter 2C for valid values.

(Definition from RXD.21 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0708 - Indication in Chapter 2C for valid values.

(Definition from RXG.22 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0743 - Indication in Chapter 2C for valid values.

(Definition from RXA.19 in Ch. 4A)

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0694 - Indication in Chapter 2C for valid values.

RXA-20: Completion Status (ID) 01223

Definition: Status of treatment administration event. Refer to HL7 Table 0322 - Completion Status in Chapter 2C, Code Tables, for valid values.

RXA-21: Action Code – RXA (ID) 01224

Definition: Status of record. The information in this field enables the use of the RXA in the vaccine messages (see Section 4A.8, "Vaccine Segments"), where a method of correcting vaccination information transmitted with incorrect patient identifying information is needed. Refer To HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

RXA-22: System Entry Date/Time (DTM) 01225

Definition: Date/time the administration information was entered into the source system. This field is used to detect instances where treatment administration information is inadvertently entered multiple times by providing a unique identification field. Under usual circumstances, this field would be provided automatically by the computer system rather than being entered by a person.

RXA-23: Administered Drug Strength Volume (NM) 01696

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML , which would be encoded in RXA-13, RXA-14, RXA-23 and RXA-24 as:

RXA|||||||||||||120|mg^^ISO|||||||||5|ml^^ISO ...<cr>

RXA-24: Administered Drug Strength Volume Units (CWE) 01697

Description: This field indicates the volumetric unit associated with RXA-23 Administered Drug Strength Volume. See example in RXA-23. Refer to Table 0695 - Administered Drug Strength Volume Units in Chapter 2C for valid values.

RXA-25: Administered Barcode Identifier (CWE) 01698

Definition: This field contains the pharmacy system's assigned barcode number for the give occurrence. For IV orders, many pharmacy systems generate a barcode number to identify a specific bag/bottle of the order. This number can be an instance identifier; unique for the patient, drug combination, and schedule instance or it may be just a drug identifier. Refer to Table 0696 - Administered Barcode Identifier in Chapter 2C for valid values.

The composition and use of the barcode number is dependent on application negotiation. An example of this field follows: The barcode number is in the following format, 9XXXXXXX000. The number '9' is a constant, XXXXXXX is seven (7) characters for a unique identifier assigned or derived from the patient account and order ID and 000 is the zero-filled three (3) character IV bottle number.

The maximum length of the first component of this field is 40 characters to allow for the maximum existing barcode length in use today. The second component contains the description of the item being coded and the third component may define the barcode type.

Example: 12345678901^IV bottle^3X9

RXA-26: Pharmacy Order Type (ID) 01699

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 - Pharmacy Order Types in Chapter 2C, Code Tables, for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

RXA-27: Administer-at (PL) 02264

Definition: This field specifies the location where the drug or treatment was administered.

RXA-28: Administered-at Address (XAD) 02265

Definition: This field specifies the address of the location where the drug or treatment was administered.

RXA-29: Administered Tag Identifier (EI) 03396

Definition: This field contains an identifier for the individual product instance for the dispense occurrence. This may represent a barcode, RFID or other means of automatically-readable product instance. Repetitions represent the same instance where more than one barcode, RFID or other identification is present.

For example, the medication preparer, e.g., a semi-automatic system, can inform the nurse that “for the 8.am administration event, the medication that has been assigned and available at the patient bedside has the barcode BBBBBBBBBBB.” The nurse would scan the barcode, to ensure that the right medication is being administered.

This differs from RXA-25 Administered Barcode Identifier in that RXA-25 may include other workflow content or the product at various levels of granularity. RXA-29 specifically identifies the product instance.