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SPM - Specimen Segment

The intent of this segment is to describe the characteristics of a specimen. It differs from the intent of the OBR in that the OBR addresses order-specific information. It differs from the SAC segment in that the SAC addresses specimen container attributes. An advantage afforded by a separate specimen segment is that it generalizes the multiple relationships among order(s), results, specimen(s) and specimen container(s).

A specimen is defined as "A physical entity that is an individual, a group, an item, or a part representative of a larger group, class or whole that is the target of an observation or analysis for the purpose of drawing conclusions about the group, class, or whole." Note that any physical entity in the universe has the potential to become a specimen

A specimen is collected or obtained from a source and may be representative of the source, or may represent a deviation within the source. A specimen may be wholly or partially consumed during an observation and any remaining portion of the specimen is persistent and can be stored.

This segment may also be used in limited cases to describe a "virtual" specimen. In particular, to identify the characteristics required for a specimen in the context of a specific observation or test.

In summary, SPM represents the attributes specific and unique to a specimen.

HL7 Attribute Table - SPM - Specimen Segment
Seq# DataElement Description Must Implement Flags Cardinality Length C.LEN Vocabulary DataType
SPM
1 01754 Set ID - SPM [0..1] [1..4] SI
2 01755 Specimen Identifier [0..1] EIP
3 01756 Specimen Parent IDs [0..*] EIP
4 01900 Specimen Type SHALL [1..1] CWE
5 01757 Specimen Type Modifier [0..*] CWE
6 01758 Specimen Additives [0..*] CWE
7 01759 Specimen Collection Method [0..1] CWE
8 01901 Specimen Source Site [0..1] CWE
9 01760 Specimen Source Site Modifier [0..*] CWE
10 01761 Specimen Collection Site [0..1] CWE
11 01762 Specimen Role [0..*] CWE
12 01902 Specimen Collection Amount [0..1] CQ
13

01763 Grouped Specimen Count MAY
True:
False:
C=
[1..1]
[0..1]
6 NM
14 01764 Specimen Description [0..*] ST
15 01908 Specimen Handling Code [0..*] CWE
16 01903 Specimen Risk Code [0..*] CWE
17 01765 Specimen Collection Date/Time [0..1] DR
18 00248 Specimen Received Date/Time * [0..1] DTM
19 01904 Specimen Expiration Date/Time [0..1] DTM
20 01766 Specimen Availability [0..1] [1..1] ID
21 01767 Specimen Reject Reason [0..*] CWE
22 01768 Specimen Quality [0..1] CWE
23 01769 Specimen Appropriateness [0..1] CWE
24 01770 Specimen Condition [0..*] CWE
25 01771 Specimen Current Quantity [0..1] CQ
26 01772 Number of Specimen Containers = [0..1] 4 NM
27 01773 Container Type [0..1] CWE
28 01774 Container Condition [0..1] CWE
29 01775 Specimen Child Role [0..1] CWE
30 02314 Accession ID [0..*] CX
31 02315 Other Specimen ID [0..*] CX
32 02316 Shipment ID [0..1] EI
33 03485 Culture Start Date/Time [0..1] DTM
34 03486 Culture Final Date/Time [0..1] DTM
35 00816 Action Code [0..1] [2..2] ID

SPM-1: Set ID - SPM (SI) 01754

Definition: This field contains the sequence number. This field is used to identify SPM segment instances in message structures where the SPM segment repeats.

SPM-2: Specimen Identifier (EIP) 01755

Definition: This field contains a unique identifier for the specimen as referenced by the Placer application, the Filler application, or both.

This field is not required, as there are use cases in which a unique specimen identifier may not exist. In the first scenario, a placer application may initiate an observation request against an existing specimen without uniquely identifying the specimen. Additionally, in the case of the TCU_U10 message structure, used in Automated equipment test code settings messages, the SPM segment is used to define required characteristics of the specimen. As such, TCU_U10 uses SPM to define a virtual specimen, and a specific specimen identifier would not exist. Filler applications would be expected to assign a Specimen Identifier and populate this field accordingly.

SPM-3: Specimen Parent IDs (EIP) 01756

Definition: This field contains the identifiers for the specimen or specimens that contributed to the specimen that is described by the segment instance.

If this field repeats, then SPM-11-Specimen Role should be valued with "L" (pooled). The repetitions of this field then carry the specimen IDs of the parent specimens contributing to the pool.

SPM-4: Specimen Type (CWE) 01900

Definition: This field describes the precise nature of the entity that will be the source material for the observation.

Any physical entity that may have observations made about it may qualify as a specimen. The entry in this attribute describes the specific entity as precisely as possible, whether that is a complex organism (e.g., an ostrich) or a specific cellular mass (e.g., a specific muscle biopsy).

A nationally recognized coding system is to be used for this field. Valid coding sources for this field include:

SPM-5: Specimen Type Modifier (CWE) 01757

Definition: This field contains modifying or qualifying description(s) about the specimen type

The use of this attribute is to modify, qualify or further specify, the entity described by SPM-4 -Specimen Type. This is particularly useful when the code set used in SPM-4-Specimen Type does not provide the precision required to fully describe the specimen. For example, if the specimen was precisely described as 'capillary venous blood' but the code set employed only provided 'venous blood,' this attribute could be employed to add the modifier 'capillary.'

Refer to User-Defined Table 0541 Specimen Type Modifier for suggested values.

SPM-6: Specimen Additives (CWE) 01758

Definition: This field identifies any additives introduced to the specimen before or at the time of collection. These additives may be introduced in order to preserve, maintain or enhance the particular nature or component of the specimen. Refer to HL7 Table 0371 – Additive/Preservative for valid values. When multiple additives are introduced and valid individual additive codes exist but a valid value for the combination does not exist, repeating the field with individual values is most appropriate.

SPM-7: Specimen Collection Method (CWE) 01759

Definition: Describes the procedure or process by which the specimen was collected.

Any nationally recognized coding system might be used for this field including SNOMED; alternatively the HL7 Table 0488 – Specimen Collection Method may be used. Veterinary medicine may choose the tables supported for the components of this field as decided by their industry.

SPM-8: Specimen Source Site (CWE) 01901

Definition: specifies the source from which the specimen was obtained. For example, in the case where a liver biopsy is obtained via a percutaneous needle, the source would be 'liver'. Refer to Table 0784 - Specimen Source Site in Chapter 2C for valid values.Any nationally recognized coding system might be used for this field including SNOMED; alternatively the HL7 Table 0163 – Body Site may be used. Veterinary medicine may choose the tables supported for the components of this field as decided by their industry.

SPM-9: Specimen Source Site Modifier (CWE) 01760

Definition: This field contains modifying or qualifying description(s) about the specimen source site

The use of this attribute is to modify, qualify or further specify, the entity described by SPM-8 – Specimen Source Site. This is particularly useful when the code set used in SPM-8 does not provide the precision required to fully describe the site from which the specimen originated. For example, if the specimen source site was precisely described as 'left radial vein' but the code set employed only provided 'radial vein,' this attribute could be employed to add the modifier 'left.'

Veterinary medicine may choose the tables supported for the components of this field as decided by their industry.

Refer to User-Defined Table 0542 – Specimen Source Type Modifier for suggested values.

SPM-10: Specimen Collection Site (CWE) 01761

Definition: This field differs from SPM-8-Specimen Source Site in those cases where the source site must be approached via a particular site (e.g., anatomic location). For example, in the case where a liver biopsy is obtained via a percutaneous needle, the collection site would be the point of entry of the needle. For venous blood collected from the left radial vein, the collection site could be "antecubital fossa".

Veterinary medicine may choose the tables supported for the components of this field as decided by their industry.

Refer to User-Defined Table 0543 – Specimen Collection Site for suggested values.

SPM-11: Specimen Role (CWE) 01762

This field indicates the role of the sample. Refer to User-defined Table 0369 – Specimen role for suggested values. Each of these values is normally identifiable by the systems and its components and can influence processing and data management related to the specimen.

If this field is not populated, then the specimen described has no special, or specific, role other than serving as the focus of the observation. Such specimens include patient, environmental and other specimens that are intended for analysis.

A grouped specimen consists of identical specimen types from multiple individuals that do not have individual identifiers and upon which the same services will be performed. If the specimen role value is "G" then the Grouped Specimen Count (SPM-13) must be valued with the total number of specimens contained in the group.

If the specimen role is "L", the repetitions of Parent Specimen ID (SPM-4) represent the individual parent specimens that contribute to the pooled specimen.

SPM-12: Specimen Collection Amount (CQ) 01902

Definition: This field specifies the volume or mass of the collected specimen. For laboratory tests, the collection volume is the volume of a specimen. Specifically, units should be expressed in the ISO Standard unit abbreviations (ISO-2955, 1977). This is a results-only field except when the placer or a party has already drawn the specimen. Use of UCUM is strongly recommended as one of the delivered units (could be in addition to the local units). (See Chapter 7 Section 7.4.2.6 for a full discussion regarding units.)

SPM-13: Grouped Specimen Count (NM) 01763

Definition: This field refers to the number of individual specimens of a particular type represented by this instance of a specimen. The use of this field is restricted to specimens upon which all specimen related attributes are identical. This field would only be valued if SPM-11 Specimen Role has the value "G" or “L”.

SPM-14: Specimen Description (ST) 01764

Definition: This is a text field that allows additional information specifically about the specimen to be sent in the message

SPM-15: Specimen Handling Code (CWE) 01908

(Definition from SPM.15 in Ch. 7)

Definition: This describes how the specimen and/or container need to be handled from the time of collection through the initiation of testing. As this field is not required, no assumptions can be made as to meaning when this field is not populated.

Refer to User-defined Table 0376 – Special Handling Code for suggested values.

(Definition from OM4.15 in Ch. 8)

Definition: This describes how the specimen and/or container need to be handled from the time of collection through the initiation of testing. As this field is not required, no assumptions can be made as to meaning when this field is not populated.

Refer to User-defined Table 0376 – Special Handling Code in Chapter 2C, Code Tables, for suggested values.

SPM-16: Specimen Risk Code (CWE) 01903

Definition: This field contains any known or suspected specimen hazards, e.g., exceptionally infectious agent or blood from a hepatitis patient. Either code and/or text may be absent. However, the code is always placed in the first component position and any free text in the second component. Thus, a component delimiter must precede free text without a code. Refer to User-defined Table 0489 – Risk Codes for suggested entries

SPM-17: Specimen Collection Date/Time (DR) 01765

Definition: The date and time when the specimen was acquired from the source. The use of the Date Range data type allows for description of specimens collected over a period of time, for example, 24-hour urine collection. For specimens collected at a point in time, only the first component (start date/time) will be populated.

SPM-18: Specimen Received Date/Time * (DTM) 00248

(Definition from OBR.14 in Ch. 4)

Attention: The OBR-14 element was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7. See SPM in Chapter 7.

(Definition from OBR.14 in Ch. 7)

Attention: The OBR-14 element was retained for backward compatibility only as of v 2.5 and the detail was withdrawn and removed from the standard as of v 2.7. See SPM in Chapter 7.

(Definition from SPM.18 in Ch. 7)

Definition: The specimen received date/time is the time that the specimen is received at the diagnostic service facility. The actual time that is recorded is based on how specimen receipt is managed and may correspond to the time the sample is logged in. This is fundamentally different from SPM-17 Specimen Collection date/time.

SPM-19: Specimen Expiration Date/Time (DTM) 01904

Definition: This field is the date and time the specimen can no longer be used for the purpose implied by the order. For example, in the Blood Banking environment the specimen can no longer be used for pre-transfusion compatibility testing. The specimen segment will include a SPM-21-Specimen Reject Reason of 'EX' indicating 'Expired' for message instances created after this date and time.

SPM-20: Specimen Availability (ID) 01766

Definition: This describes whether the specimen, as it exists, is currently available to use in an analysis. Refer to HL7 Table 0136 – Yes/No Indicator for valid values.

SPM-21: Specimen Reject Reason (CWE) 01767

Definition: This describes one or more reasons the specimen is rejected for the specified observation/result/analysis. Refer to HL7 Table 0490 – Specimen Reject Reason for valid values.

SPM-22: Specimen Quality (CWE) 01768

Definition: The degree or grade of excellence of the specimen at receipt. The filler populates this attribute. Refer to User-defined Table 0491 – Specimen Quality for suggested entries.

SPM-23: Specimen Appropriateness (CWE) 01769

Definition: The suitability of the specimen for the particular planned use as determined by the filler. Refer to User-defined Table 0492 – Specimen Appropriateness for suggested entries.

SPM-24: Specimen Condition (CWE) 01770

Definition: A mode or state of being that describes the nature of the specimen. Refer to User-defined Table 0493 – Specimen Condition for suggested entries.

SPM-25: Specimen Current Quantity (CQ) 01771

Definition: This attributes contains the amount of specimen that currently exists or is available for use in further testing.

SPM-26: Number of Specimen Containers (NM) 01772

Definition: This field identifies the number of containers for a given sample. For sample receipt verification purposes; may be different from the total number of samples that accompany the order.

SPM-27: Container Type (CWE) 01773

Definition: The container in or on which a specimen is transported. Refer to Table 0785 - Container Type in Chapter 2C for valid values.

Note:     If the container type is categorized (e.g., FBT (false-bottom-tube), Cup, …), the specific codes should be transferred in the SPM-27 field "Container Type". If the container is characterized by dimensions and other characteristics this information should be transferred as specific values in the SAC segment (fields: SAC-16 … SAC-21).


SPM-28: Container Condition (CWE) 01774

Definition: In chain of custody cases where specimens are moved from lab to lab, the status of the container that the specimen is shipped in must be recorded at each receipt. If the container is compromised in any way (seal broken, container cracked or leaking, etc) then this needs to be recorded for legal reasons.

Refer to HL7 Table 0544 – Container Condition for suggested values.

SPM-29: Specimen Child Role (CWE) 01775

Definition: For child specimens, this field identifies the relationship between this specimen and the parent specimen. If this field is populated, then SPM-3-Specimen Parent ID must be populated. This field differs from SPM-15-Specimen Role in that this field refers to the role of this specimen relative to a parent role rather than the role of this specimen to the ordered service.

Refer to HL7 Table 0494 – Specimen Child Role for valid values.

SPM-30: Accession ID (CX) 02314

Definition: This field contains accession identifier(s) associated with the specimen. In many cases, applications involved in the collection, transportation or testing of the specimen will assign their own accession identifiers. This field allows communication of these accession identifiers.

An accession id may or may not, depending up laboratory practice, identify a single specimen. Best practice is to use accession identifiers that are globally unique (typically ID Number + Assigning Facility components). However, an accession id may or may not, depending up laboratory practice, identify a single specimen. In addition, accession ids are commonly re-used over time, so the accession id may not uniquely identify a specimen.

SPM-31: Other Specimen ID (CX) 02315

Definition: This field contains other identifier(s) for the specimen as referenced in an application. Normally this field is used to carry additional identifiers for the specimen in addition to those identified in SPM-2, Specimen ID. In may cases other applications involved in the collection, transportation or testing of the specimen will assign additional specimen identifiers. This field allows communication of those other specimen identifiers.

SPM-32: Shipment ID (EI) 02316

Definition: The shipment identifier is the identifier assigned by the shipment transportation provider that uniquely identifies this shipment from all other shipments by the same provider. The addressee for the shipment should be able to use this identifier to match a physical shipment with the electronic manifest for the shipment.

SPM-33: Culture Start Date/Time (DTM) 03485

Definition: The Culture Start date/time is the time that the specimen is plated, or inoculated to selective and differential growth mediums that are used in organism identification in microbiology. This is the start of differential diagnosis and is a clinically relevant date and time. The actual time that is recorded is based on when specimen is directly inoculated onto growth media and may correspond to the time the sample is logged in or received.

SPM-34: Culture Final Date/Time (DTM) 03486

Definition: The Culture Final date/time is the time in which the order filler is communicating to the clinician that all work on a cultured specimen is completed and no further updates will be received. All work, including determination of growth, Organism Identification, and sensitivity testing are completed. The clinician should expect no further updates on this cultured specimen.

SPM-35: Action Code (ID) 00816

(Definition from OH1.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH2.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH3.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OH4.2 in Ch. 3)

Definition: This field contains a code defining the action to be taken for this segment. It allows this segment to be sent to delete or update, for example, previously sent information. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from ORC.35 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either ORC-2 and/or ORC 3 is valued with a unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBR.55 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when either an OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from IPC.10 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when the combination of IPC-1, IPC-2, IPC-3, and IPC-4 represents a unique identifier according to Chapter 2, Section 2.10.4.2.

(Definition from BPX.22 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BPX is uniquely identified sufficiently within the specific implementation using BPX-17 or BPX-6 as agreed to by the trading partners and in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BTX.21 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BTX is uniquely identified sufficiently within the specific implementation using BTX-20 or BTX-3 as agreed to by the trading partners in accordance with Chapter 2, Section 2.10.4.2.

(Definition from DON.34 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an DON is uniquely identified sufficiently within the specific implementation using DON-1 in accordance with Chapter 2, Section 2.10.4.2.

(Definition from BUI.13 in Ch. 4)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an BUI is uniquely identified sufficiently within the specific implementation using BUI-2 in accordance with Chapter 2, Section 2.10.4.2

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

Definition: The intended handling by the receiver of the infusion order is represented by this segment. Refer to HL7 Table 0206 – Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from CDO.2 in Ch. 4A)

Definition: The Action Code indicates whether the cumulative dosage segment is intended to be added, deleted, updated, or did not change. If the field is not valued in any CDO segments for the order, the segments are considered to have been sent in snapshot mode. If some but not all CDO segments for the order do not have the action code valued, the default value is Add. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from OBR.55 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an either OBR-2 and/or OBR-3 is valued with unique identifier in accordance with Chapter 2, Section 2.10.4.2.

(Definition from OBX.31 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an OBX-21 is valued in accordance with guidance in Chapter 2, Section 2.10.4.2.

(Definition from SPM.35 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when an SPM-2 or SPM-31 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PRT.2 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.

(Definition from CSR.17 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CSR-1 and CSR-4, or CSR-2 and CSR-5 are valued as agreed to by the trading partners in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from CTI.4 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when CTI-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from SHP.12 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when SHP-1 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from PAC.9 in Ch. 7)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0206 - Segment Action Code for valid values.

The action code can only be used when PAC-2 is valued in accordance with the guidance in Chapter 2, Section 2.10.4.2.

(Definition from GOL.1 in Ch. 12)

Definition: The action code field gives the intent of the problem or goal. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PRB.1 in Ch. 12)

Definition: This field contains the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from PTH.1 in Ch. 12)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/Goal Action Code in Chapter 2C, Code Tables, for valid values.

(Definition from DEV.1 in Ch. 17)

Definition: This field reveals the intent of the message. Refer to HL7 Table 0287 – Problem/goal action code for valid values.