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8.7.6 OM4 - observations that require specimens segment

This segment applies to observations/batteries that require a specimen for their performance. When an observation or battery requires multiple specimens for their performance (e.g., creatinine clearance requires a 24-hour urine specimen and a serum specimen), multiple segments may be included, one for each specimen type.

Figure 8-10. OM4 attributes

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

4

NM

O



00586

Sequence Number

2

1

ID

O


0170

00642

Derived Specimen

3

60

TX

O



00643

Container Description

4

20

NM

O



00644

Container Volume

5

60

CE

O



00645

Container Units

6

60

CE

O



00646

Specimen

7

60

CE

O



00647

Additive

8

10K

TX

O



00648

Preparation

9

10K

TX

O



00649

Special Handling Requirements

10

20

CQ

O



00650

Normal Collection Volume

11

20

CQ

O



00651

Minimum Collection Volume

12

10K

TX

O



00652

Specimen Requirements

13

1

ID

O

Y

0027

00653

Specimen Priorities

14

20

CQ

O



00654

Specimen Retention Time

8.7.6.0 OM4 field definitions

8.7.6.1 Sequence number (NM) 00586

Definition: This field contains the same value as the sequence number of the associated OM1 segment.

8.7.6.2 Derived specimen (ID) 00642

Definition: This field contains the codes that identify the parents and children for diagnostic studies -- especially in microbiology -- where the initial specimen (e.g., blood) is processed to produce results (e.g., the identity of the bacteria grown out of the culture). The process also produces new "specimens" (e.g., pure culture of staphylococcus, and E. Coli), and these are studied by a second order process (bacterial sensitivities). The parents (e.g., blood culture) and children (e.g., penicillin MIC) are identified in such cases. The codes are the following:

Table 0170 - Derived specimen

Value

Description

P

Parent Observation

C

Child Observation

N

Not Applicable

8.7.6.3 Container description (TX) 00643

Definition: This field contains the physical appearance, including color of tube tops, shape, and material composition (e.g., red-top glass tube). Note that the color is not necessarily a unique identifier of the additive and/or use of the tube. This is especially true for black and some blue tube tops, as can be seen above. Color is included here for user convenience.

8.7.6.4 Container volume (NM) 00644

Definition: This field contains the capacity of the container.

8.7.6.5 Container units (CE) 00645

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains the units of measure of the container volume. If the units are ISO+ units, they should be recorded as single case abbreviations. If the units are ANS+ or L (local), the units and the source code table must be recorded, except that in this case, component delimiters should be replaced by subcomponent delimiters. For example, 1 indicates liters, whereas pt&&ANS+ indicates pints (ANSI units). The default unit is milliliters (ml), which should be assumed if no units are reported.

8.7.6.6 Specimen (CE) 00646

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field reports the specimen as one of the specimen codes described in ASTM Table 14 of 1238-91. If multiple kinds of specimen are associated with this observation (as in the case for a creatinine clearance), separate them with repeat delimiters.

8.7.6.7 Additive (CE) 00647

Components: <identifier (ST)> ^ <text (ST)> ^ <name of coding system (ST)> ^ <alternate identifier (ST)> ^ <alternate text (ST)> ^ <name of alternate coding system (ST)>

Definition: This field contains the codes that should be those provided by NCCLS [ NCCLS Document H1-A3: Evacuated tubes for blood specimen collection -- Third Edition, Volume 11, Number 9, Approved standard. July 1991.] . The following list is not exhaustive; it includes only examples.

NAME

NCCLS

Code Color

DESCRIPTION

(1) Lithium Heparin -- anticoagulant

LIH Green

Dry powder. 10 to 30 USP units per mL of blood

(2) Sodium Heparin -- anticoagulant

NAH Green

Dried solution. 10 to 30 U.S.P. units per mL of blood

(3) Ethylenediaminetetraacetic acid; dipotassium salt [EDTA(K2)]

K2E Lavender

Dry powder. 1.5 to 2.2 mg per mL of blood

(4) Ethylenediaminetetraacetic acid; tripotassium salt [EDTA (K3)]

K3E Lavender

Clear solution. 1.5 to 2.2 mg per mL of blood

(5) Ethylenediaminetetraacetic acid; disodium salt [EDTA (Na2)]

N2E Lavender


8.7.6.8 Preparation (TX) 00648

Definition: This field contains the special processing that should be applied to the container, e.g., add acidifying tablets before sending.

8.7.6.9 Special handling requirements (TX) 00649

Definition: This field contains the special handling requirements here (e.g., ice specimen, deliver within two hours of obtaining).

8.7.6.10 Normal collection volume (CQ) 00650

Components: <quantity> ^ <units>

Definition: This field contains the normal specimen volume required by the lab. This is the amount used by the normal methods and provides enough specimens to repeat the procedure at least once if needed. The default unit is milliliters (ml).

8.7.6.11 Minimum collection volume (CQ) 00651

Components: <quantity> ^ <units>

Definition: This field contains the amount of specimen needed by the most specimen sparing method (e.g., using micro techniques). The minimum amount allows for only one determination. The default unit is milliliters (ml).

8.7.6.12 Specimen requirements (TX) 00652

Definition: This field contains the other requirements for specimen delivery and special handling (e.g., delivery within one hour, iced).

8.7.6.13 Specimen priorities (ID) 00653

Definition: This field contains the allowed priorities for obtaining the specimen. Note that they may be different from the processing priorities given in OM1-25-processing priority. When a test is requested, the specimen priority given in OBR-27-quantity/timing should be one of the priorities listed here. Multiple priorities are separated by repeat delimiters. Refer to HL7 table 0027 - Priority for valid values.

Table 0027 - Priority

Value

Description

S

Stat (do immediately)

A

As soon as possible (a priority lower than stat)

R

Routine

P

Preoperative (to be done prior to surgery)

T

Timing critical (do as near as possible to requested time)

8.7.6.14 Specimen retention time (CQ) 00654

Components: <quantity> ^ <units>

Definition: This field contains the usual time that a specimen for this observation is retained after the observation is completed, for the purpose of additional testing. The first component is the duration, and the second component is an ISO time unit.

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