Previous Page TOC Index Next Page

4.8.7RXE - pharmacy/treatment encoded order segment

The RXE segment details the pharmacy or treatment application’s encoding of the order. It also contains several pharmacy-specific order status fields, such as RXE-16-number of refills remaining, RXE-17-number of refills/doses dispensed, RXE-18-date/time of most recent refill/dose, and RXE-19-total daily dose.

Note that ORC-7-quantity/timing has a different meaning from RXE-1-quantity/timing and RXG-3-quantity/timing. The pharmacy or treatment department has the "authority" (and/or necessity) to schedule dispense/give events. Hence, the pharmacy or treatment department has the responsibility to encode this scheduling information in RXE-1-quantity/timing and RXG-3-quantity/timing. ORC-7-quantity/timing does not change: it always specifies the requested give/dispense schedule of the original order.

Figure 4-16. RXE attributes

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM #

ELEMENT NAME

1

200

TQ

R



00221

Quantity/Timing

2

100

CE

R


0292

00317

Give Code

3

20

NM

R



00318

Give Amount - Minimum

4

20

NM

O



00319

Give Amount - Maximum

5

60

CE

R



00320

Give Units

6

60

CE

O



00321

Give Dosage Form

7

200

CE

O

Y


00298

Provider's Administration Instructions

8

200

CM

C



00299

Deliver-to Location

9

1

ID

O


0167

00322

Substitution Status

10

20

NM

C



00323

Dispense Amount

11

60

CE

C



00324

Dispense Units

12

3

NM

O



00304

Number of Refills

13

60

XCN

C



00305

Ordering Provider's DEA Number

14

60

XCN

O



00306

Pharmacist/Treatment Supplier's Verifier ID

15

20

ST

C



00325

Prescription Number

16

20

NM

C



00326

Number of Refills Remaining

17

20

NM

C



00327

Number of Refills/Doses Dispensed

18

26

TS

C



00328

D/T of Most Recent Refill or Dose Dispensed

19

10

CQ

C



00329

Total Daily Dose

20

1

ID

O


0136

00307

Needs Human Review

21

200

CE

O

Y


00330

Pharmacy/Treatment Supplier's Special Dispensing Instructions

22

20

ST

C



00331

Give Per (Time Unit)

23

6

ST

O



00332

Give Rate Amount

24

60

CE

O



00333

Give Rate Units

25

20

NM

O



01126

Give Strength

26

60

CE

O



01127

Give Strength Units

27

200

CE

O

Y


01128

Give Indication

28

20

NM

O



01220

Dispense Package Size

29

60

CE

O



01221

Dispense Package Size Unit

30

2

ID

O


0321

01222

Dispense Method

4.8.7.0 RXE field definitions

4.8.7.1 Quantity/timing (TQ) 00221

Components: <quantity (CQ)> ^ <interval (CM)> ^ <duration> ^ <start date/time (TS)> ^ <end date/time (TS)> ^ <priority (ID)> ^ <condition (ST)> ^ <text (TX)> ^ <conjunction (ID)> ^ <order sequencing>

Definition: See Section 4.8.7, "RXE - pharmacy/treatment encoded order segment," for necessary modification for this field’s definition to cover interorder dependencies needed by pharmacy/treatment orders. This field is used by the pharmacy or non-pharmacy treatment supplier to express the fully coded version of the drug or treatment timing. It may differ from ORC-7-quantity/timing, which contains the requested quantity/timing of the original order.

4.8.7.2 Give code (CE) 00317

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 identifies the medical substance ordered to be given to the patient, as encoded by the pharmacy or treatment supplier; it is equivalent to OBR-4-universal service ID in function. In the RXE segment, this give code must be fully encoded. The dispense fields, which define the units and amount of what is to be issued to the patient (see RXE-10-dispense amount and RXE-11-dispense units below) do not necessarily correlate with the instructions of what amount is to be "given" or administered with each dose, and may or may not be specified with the order. For example, the "give" part of the order may convey the field-representation of give 250 mg of ampicillin, while the request to dispense part of the order may convey issue 30 tablets of generic equivalent for this outpatient prescription. Refer to HL7 Table 0292 - Vaccines administered for valid values.

4.8.7.3 Give amount - minimum (NM) 00318

Definition: This field contains the ordered amount as encoded by the pharmacy or treatment supplier. In a variable dose order, this is the minimum ordered amount. In a nonvarying dose order, this is the exact amount of the order.

Note: This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount.

Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the requested Give Amount field).

4.8.7.4 Give amount - maximum (NM) 00319

Definition: In a variable dose order, this is the maximum ordered amount. In a nonvarying dose, this field is not used.

4.8.7.5 Give units (CE) 00320

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 for the give amount as encoded by the pharmacy or treatment (e.g., respiratory therapy) application.

Note: These units can be a "compound quantity"; i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight).

A table of standard units that contains compound units is needed. Until such a table is agreed on, a user-defined table is needed for each site.

4.8.7.6 Give dosage form (CE) 00321

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

Definition: The dosage form indicates the manner in which the medication is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the give code in RXE-2-give code. Use the RXE-6-give dosage form when the give code does not specify the dosage form.

4.8.7.7 Provider's administration instructions (CE) 00298

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 ordering provider’s instructions to the patient or the provider administering the drug or treatment. If coded, a user defined table must be used; if free text (describing a custom IV, mixture, or salve, for example, place the text in the second component, e.g., |^this is a free text administration instruction|.

4.8.7.8 Deliver-to location (CM) 00299

Components: <point of care (ST)> & <room (IS)>& <bed (IS)> & <facility (HD)> & <location status (ID)> & <patient location type (IS)> & <building (IS)> & <floor (IS)> ^ <street address (ST)> & <other designation (ST)> & <city (ST)> & <state or province (ST)> & <zip or postal code (ST)> & <country (ID)> & <address type (ID)> & <other geographic designation (ST)>

Definition: The first component contains the inpatient or outpatient location to which the pharmacy or treatment supplier is to deliver the drug or treatment (if applicable). The default (null) value is the current census location for the patient. Site specific table. This component has the same form as PV1-3-assigned patient location.

The second component can be used to specify an address. This could be used to fill mail orders to a patient or provider, or to account for home health care.

4.8.7.9 Substitution status (ID) 00322

Definition: Refer to HL7 table 0167 - Substitution status for valid values. If a substitution has been made, and a record of the original requested give code (RXO-1-requested give code) is needed, the optional RXO segment can be included in the RDE message.

Table 0167 - Substitution status

Value

Description

N

No substitute was dispensed. This is equivalent to the default (null) value.

G

A generic substitution was dispensed.

T

A therapeutic substitution was dispensed.

0

No product selection indicated

1

Substitution not allowed by prescriber

2

Substitution allowed - patient requested product dispensed

3

Substitution allowed - pharmacist selected product dispensed

4

Substitution allowed - generic drug not in stock

5

Substitution allowed - brand drug dispensed as a generic

7

Substitution not allowed - brand drug mandated by law

8

Substitution allowed - generic drug not available in marketplace

4.8.7.10 Dispense amount (NM) 00323

Definition: This field contains the amount dispensed as encoded by the pharmacy or treatment supplier.

4.8.7.11 Dispense units (CE) 00324

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 for the dispense amount as encoded by the pharmacy or treatment supplier. This must be in simple units that reflect the actual quantity of the substance dispensed. It does not include compound units.

4.8.7.12 Number of refills (NM) 00304

Definition: This field contains the total original number of refills. Outpatient only.

4.8.7.13 Ordering provider's DEA number (XCN) 00305

Components: <ID number (ST)> ^ <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code(ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID )> ^ <identifier type code (IS)> ^ <assigning facility (HD)>

Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)

Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)

Definition: This field is defined as conditional because it is required when the substance requested is a controlled substance (e.g., a narcotic).

4.8.7.14 Pharmacist/treatment supplier's verifier ID (XCN) 00306

Components: <ID number (ST)> ^ <family name (ST)> ^ <given name (ST)> ^ <middle initial or name (ST)> ^ <suffix (e.g., JR or III) (ST)> ^ <prefix (e.g., DR) (ST)> ^ <degree (e.g., MD) (ST)> ^ <source table (IS)> ^ <assigning authority (HD)> ^ <name type code(ID)> ^ <identifier check digit (ST)> ^ <code identifying the check digit scheme employed (ID )> ^ <identifier type code (IS)> ^ <assigning facility (HD)>

Subcomponents of assigning authority: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)

Subcomponents of assigning facility: <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (ID)

Definition: This field contains the provider ID of Pharmacist/treatment supplier’s verifier. Use if required by the pharmacy or treatment application or site on orders (or some subgroup of orders).

4.8.7.15 Prescription number (ST) 00325

Definition: This field contains the prescription number as assigned by the pharmacy or treatment application. Equivalent in uniqueness to the pharmacy/treatment filler order number. At some sites, this may be the pharmacy or treatment system (internal) sequential form. At other sites, this may be an external form. This is a required field in RXE when used in pharmacy/treatment messages, but it is not required when used in product experience messages (see Chapter 7).

4.8.7.16 Number of refills remaining (NM) 00326

Definition: This field is for outpatient only.

4.8.7.17 Number of refills/doses dispensed (NM) 00327

Definition: This field is for outpatient only.

4.8.7.18 D/T of most recent refill or dose dispensed (TS) 00328

Definition: For the date/time of the most recent refill or dose dispensed, use time stamp format.

4.8.7.19 Total daily dose (CQ) 00329

Components: <quantity (NM)> ^ <units (CE)>

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

4.8.7.20 Needs human review (ID) 00307

Definition: This field uses HL7 table 0136 - Yes/no indicator. The values have the following meaning for this field:

Table 0136 - Yes/no indicator

Value

Description

Y

Yes - Indicates that a warning is present. The application receiving the encoded order needs to warn the person administering the drug or treatment to pay attention to the text in RXE-22-pharmacy/treatment special dispensing instructions.

N

No - Indicates no warning is present. This is the equivalent default (null) value.

4.8.7.21 Pharmacy/treatment special dispensing instructions (CE) 00330

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 pharmacy or treatment supplier’s provider-generated special instructions to the provider dispensing/administering the order.

4.8.7.22 Give per (time unit) as encoded by the pharmacy/treatment supplier (ST) 00331

Definition: This field contains the time unit to use to calculate the rate at which the pharmaceutical is to be administered.

Format:

S<integer>

=

<integer> seconds

M<integer>

=

<integer> minutes

H<integer>

=

<integer> hours

D<integer>

=

<integer> days

W<integer>

=

<integer> weeks

L<integer>

=

<integer> months

T<integer>

=

at the interval and amount stated until a total of <integer> "DOSAGE" is accumulated. Units would be assumed to be the same as in the QUANTITY field.

INDEF

=

do indefinitely - also the default

This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.

This field is defined as conditional because it is required when the ordered substance is to be adminstered continuously at a prescribed rate (e.g., certain IVs). For example, if the "give amount/units" were 300 ml and the "give per" time unit were H1 (equivalent to one hour), the rate is 300ml/hr.

4.8.7.23 Give rate amount (ST) 00332

Definition: This field contains the rate at which the substance should be administered.

4.8.7.24 Give rate units (CE) 00333

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 for Give Rate Amount. May be composite. The ratio of the Give Rate Amount and Give Rate Units fields define the actual rate of administration. Thus, if Give Rate Amount = 100 and Give Rate Units = ml/hr, the requested rate of administration is 100 ml/hr. (See ISO+ Figure 7-13 in Chapter 7 for possible compound units codes.)

4.8.7.25 Give strength (NM) 01126

Definition: Use when RXE-2-give code does not specify the strength. This is the numeric part of the strength, used in combination with RXE-26-give strength unit.

4.8.7.26 Give strength unit (CE) 01127

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

Definition: Use when RXE-2-give code does not specify the strength. This is the unit of the strength, used in combination with RXE-25-give strength.

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 (ug/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

4.8.7.27 Give indication (CE) 01128

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 identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant.

4.8.7.28 Dispense package size (NM) 01220

Definition: This field contains the size of package to be dispensed. Units are transmitted in RXE-29-dispense package size unit.

4.8.7.29 Dispense package size unit (CE) 01221

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 in which RXE-28-dispense package size is denominated.

4.8.7.30 Dispense method (ID) 01222

Definition: This field contains the method by which treatment is dispensed. Refer to HL7 table 0321 - Dispense method for valid values.

Table 0321 - Dispense method

Value

Description

TR

Traditional

UD

Unit Dose

F

Floor Stock

AD

Automatic Dispensing

Previous Page TOC Index Next Page