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4.3.1 ORC - common order segment

The Common Order segment (ORC) is used to transmit fields that are common to all orders (all types of services that are requested). The ORC segment is required in the Order (ORM) message. ORC is mandatory in Order Acknowledgment (ORR) messages if an order detail segment is present, but is not required otherwise..

If details are needed for a particular type of order segment (e.g., Pharmacy, Dietary), the ORC must precede any order detail segment (e.g., RXO, ODS). In some cases, the ORC may be as simple as the string ORC|OK|<placer order number>|<filler order number>|<CR>.

If details are not needed for the order, the order detail segment may be omitted. For example, to place an order on hold, one would transmit an ORC with the following fields completed: ORC-1-order control with a value of HD, ORC-2-placer order number, and ORC-3-filler order number.

There is some overlap between fields of the ORC and those in the order detail segments. These are described in the succeeding sections.

Figure 4-1. ORC attributes

SEQ

LEN

DT

OPT

RP/#

TBL#

ITEM#

ELEMENT NAME

1

2

ID

R


0119

00215

Order Control

2

22

EI

C



00216

Placer Order Number

3

22

EI

C



00217

Filler Order Number

4

22

EI

O



00218

Placer Group Number

5

2

ID

O


0038

00219

Order Status

6

1

ID

O


0121

00220

Response Flag

7

200

TQ

O



00221

Quantity/Timing

8

200

CM

O



00222

Parent

9

26

TS

O



00223

Date/Time of Transaction

10

120

XCN

O



00224

Entered By

11

120

XCN

O



00225

Verified By

12

120

XCN

O



00226

Ordering Provider

13

80

PL

O



00227

Enterer's Location

14

40

XTN

O

Y/2


00228

Call Back Phone Number

15

26

TS

O



00229

Order Effective Date/Time

16

200

CE

O



00230

Order Control Code Reason

17

60

CE

O



00231

Entering Organization

18

60

CE

O



00232

Entering Device

19

120

XCN

O



00233

Action By

ORC use notes

a) placer order groups

The Standard supports a mechanism to collect several orders together in a group. Most often this is used to represent an "ordering session" for a single patient.

An order group is a list of orders (ORCs) associated with a ORC-4-placer group number. A group is established when the placer supplies a placer group number with the original order. The order group consists of all the ORCs and order detail segments that have the same placer group number. Orders can be removed from the group using cancel, or added using the replacement or parent-child mechanisms. New orders cannot otherwise be added to the group.

b) duplicate fields

The ORC is intended to uniformly define the fields that are common to all orders (i.e., requested services). Some ORC fields are duplicated in some order detail segments (e.g., OBR, RXO). For example, ORC-2-placer order number has the same meaning and purpose as OBR-2-placer order number field. This promotes upward compatibility with past versions and ASTM.

The rule for using these fields is that the value must appear in the order detail segment if it does not appear in the ORC. However, it is recommended to transmit the field value in both places to avoid confusion.

c) parent/child - cancel, hold, discontinue

During transmission of a request to cancel, hold, or discontinue a parent order, the request is intended to apply recursively to the parent order and all associated child orders.

For example:

1) An EKG application receives an order for three EKGs on successive mornings.

2) The EKG application creates three child orders, one for each requested EKG.

3) The first daily EKG has already been performed when a request is received to cancel the original parent order. (The parent is beyond the point of cancellation.)

4) The remaining, unperformed, children are canceled as a result of the request.

4.3.1.0. ORC field definitions

4.3.1.1 Order control (ID) 00215

Definition: determines the function of the order segment. Refer to HL7 table 0119 - Order control for valid entries. Very detailed explanatory notes are given at the end of this section.

This field may be considered the "trigger event" identifier for orders. The codes fall roughly into the following three categories:

a) event request

Codes like "NW" (new order) and "CA" (cancel order request) are used to initiate an event.

b) event acknowledgment

Codes like "OK" (order accepted) and "CR" (canceled as requested) are used to reply to the event request.

c) event notification

Codes like "OC" (order canceled) and "OD" (order discontinued) are used to notify other applications that an event has occurred. No application reply is necessary.

Event request codes are intended to initiate an event. Event acknowledgment codes are intended to reply to an application that requested an event. Event notification codes are intended to notify another application that, e.g., the filler has performed some action on an order that the other application, e.g., the placer needs to know.

Fillers, placers, and other applications can use event requests, event acknowledgments, and event - notification-type trigger events interchangeably. However, certain order control codes can originate only from the filler (e.g., CR) and others can only originate from the placer (e.g., CA).

Table 0119 - Order control codes and their meaning

Value1

Description

Originator2

Field Note3

NW

New order

P

I

OK

Order accepted & OK

F

I

UA

Unable to Accept Order

F

n





CA

Cancel order request

P

a

OC

Order canceled

F


CR

Canceled as requested

F


UC

Unable to cancel

F

b





DC

Discontinue order request

P

c

OD

Order discontinued

F


DR

Discontinued as requested

F


UD

Unable to discontinue

F






HD

Hold order request

P


OH

Order held

F


UH

Unable to put on hold

F


HR

On hold as requested

F






RL

Release previous hold

P


OE

Order released

F


OR

Released as requested

F


UR

Unable to release

F






RP

Order replace request

P

e,d,h

RU

Replaced unsolicited

F

f,d,h

RO

Replacement order

P,F

g,d,h,l

RQ

Replaced as requested

F

d,e,g,h

UM

Unable to replace

F






PA

Parent order

F

I

CH

Child order

F,P

i





XO

Change order request

P


XX

Order changed, unsol.

F


UX

Unable to change

F


XR

Changed as requested

F






DE

Data errors

P,F


RE

Observations to follow

P,F

j

RR

Request received

P,F

k

SR

Response to send order status request

F


SS

Send order status request

P


SC

Status changed

F,P


SN

Send order number

F

l

NA

Number assigned

P

l

CN

Combined result

F

m





RF

Refill order request

F, P

o

AF

Order refill request approval

P

p

DF

Order refill request denied

P

q

FU

Order refilled, unsolicited

F

r

OF

Order refilled as requested

F

s

UF

Unable to refill

F

t

LI

Link order to patient care message

u


UN

Unlink order from patient care message

u


Notes:

1 The order control value field

2 "F": Values originate from the filler and are not restricted to be sent only to the placer. P": Values originate from the placer or other application with placer privileges (as agreed in interface negotiation.

3 See table notes below for explanation of codes.

4.3.1.1.1 Table notes for order control codes of ORC

a) CA

A cancellation is a request not to do a previously ordered service. Confirmation of the cancellation request is provided by the filler, e.g., a message with an ORC-1-order control value of CR.

b) UC

An unable-to-cancel code is used when the ordered service is at a point that it cannot be canceled by the filler or when local rules prevent cancellation by the filler. The use of this code is dependent on the value of ORC-6-response flag.

c) DC

A discontinue request code is used to stop an ongoing ordered service. It is not the same as a cancellation request, which is used in an attempt to prevent an order from happening.

d) RP, RQ, RU, RO

A replacement is the substitution of one or more orders for one or more previously ordered services.

The replaced orders are treated as though they were canceled. If and when an ordered service can be replaced are local site-specific determinations.

Use the parent/child order control codes if the site specifies that the original order must remain intact. Do not use the replacement codes under this circumstance.

For each order to be replaced, use an ORC-1-order control value of RP (request for a replacement going to a filler) or RU (an unsolicited replacement created by the filler) used by the filler to notify the placer and/or other systems). By local agreement, the ORC segment (with RP or RU) may be followed by its original order detail segment. The ORC segments (with RP or RU) must be followed by an ORC segment with an ORC-1-order control value of RO (indicating the replacement order). By local agreement, the ORC with the RO value may be followed by an order detail segment.

For example, suppose that an ancillary application were replacing two OBR orders with three different orders. The sequence of segments would be as follows:

Figure 4-2. RU and RO usage (example)

Segment

Order Control

Comment

ORC

RU

1st replaced ORC

OBR


1st replaced order's detail segment




ORC

RU

2nd replaced ORC

OBR


2nd replaced order's detail segment




ORC

RO

1st replacement ORC

OBR


1st replacement order's detail segment




ORC

RO

2nd replacement ORC

OBR


2nd replacement order's detail segment




ORC

RO

3rd replacement ORC

OBR


3rd replacement order's detail segment

Whether the OBR segments must be present is determined by the value of ORC-6-response flag.

The described replacement method will handle all possible cases of replacement: one-into-one, many-into-one, one-into-many, and many-into-many. If the placer sent this request to the filler with two RPs, and this was a response back from the filler to the placer, the two RUs (replaced unsolicited) would be two RQs (replaced as requested).

Figure 4-3. RQ and RO usage (example)

Segment

Order Control

Comment

ORC

RQ

1st replaced ORC

OBR


1st replaced order's detail segment




ORC

RQ

2nd replaced ORC

OBR


2nd replaced order's detail segment




ORC

RO

1st replacement ORC

OBR


1st replacement order's detail segment




ORC

RO

2nd replacement ORC

OBR


2nd replacement order's detail segment




ORC

RO

3rd replacement ORC

OBR


3rd replacement order's detail segment

e) RP, RQ

The order replace request code permits the order filler to replace one or more new orders with one or more new orders, at the request of the placer application.

f) RU

The unsolicited replacement code permits the filler application to notify another application without being requested from the placer application.

g) RO, RQ

The replacement order code is sent by the filler application to another application indicating the exact replacement ordered service. It is used with the RP and RU order control codes as described above.

h) RP, RQ, RU, RO

The rules for the order numbers in ORC segments with an order control value of RO are determined by the replacement type (RP or RU).

In the case of the RU type (i.e., unsolicited replacement by the filler), the filler order number is generated as usual by the filler application. The placer order number is identical to the placer order number of the first transmitted ORC with an order control value of RU.

In the case of the RP type (i.e., a replacement request from another application to the filler), the placer order number is generated by the placer application using the procedure for new orders. The filler order number is generated by the filler application using the procedure identical for new orders.

If a replacement sequence is used in an ORU message (i.e., during results reporting), the following are the recommended segments to be used for the replacement orders:

1) ORC with an order control value of RO

2) Any OBR segments (can be replaced by any order detail segments)

3) Optionally followed by observation result segments (OBX)

4) NTE segments can appear after the OBR (or any order detail segment) or after an OBX segment as in a regular ORU message

i) PA, CH

The parent (PA) and child (CH) order control codes allow the spawning of "child" orders from a "parent" order without changing the parent (original order). One or more ORC segments with an ORC-1-order control value of PA are followed by one or more ORC segments with an ORC-1-order control value of CH. Whether OBR segments must be present is determined by the value of ORC-6-response flag.

For example, suppose that a microbiology culture produced two organisms and corresponding susceptibility reports. Then the sequence of segments would be as follows:

Figure 4-4. Example of two child orders

Segment

Order Control

Comment

ORC

PA

1st parent ORC

ORC

CH

1st child ORC

OBR


1st child order




ORC

CH

2nd child ORC

OBR


2nd child order

The assignment of placer numbers in the parent-child paradigm depends on whether the placer or filler creates the child order and in the latter case, on whether the placer supports the SN/NA transaction. If the placer creates the child orders it will assign their placer numbers according to its usual procedures. If the filler creates the child orders there are two possibilities: each child will inherit the placer number of its parent, or the filler will use the SN/NA transaction to request that the placer assign a placer number. In either case, the filler application creates the filler numbers of the children according to its usual procedures.

Whenever a child order is transmitted in a message the ORC segment’s ORC-8-parent is valued with the parent’s filler number (if originating from the filler) and with the parent’s placer number (if originating from the filler or if originating from the placer).

The parent-child mechanism can be used to "expand" a parent order (e.g., an order for three EKGs on successive mornings).

j) RE

The observations-to-follow code is used to transmit patient-specific information with an order. An order detail segment (e.g., OBR) can be followed by one or more observation segments (OBX). Any observation that can be transmitted in an ORU message can be transmitted with this mechanism. When results are transmitted with an order, the results should immediately follow the order or orders that they support.

The following example shows the sequence of segments for three Pharmacy orders. It illustrates the use of the RE code:

Figure 4-5. RE usage (example)

Segment

Order Control

Comment

MSH



PID



ORC

NW

First new order

RXO


First order segment




ORC

NW

2nd new order

RXO


2nd order segment

[ORC

RE

Patient-specific observation, optional in V 2.2

OBR]


Observation OBR, optional in V 2.2

OBX


An observation segment

OBX


Another observation segment

OBX


Another observation segment

OBX


Another observation segment




ORC

NW

3rd order

RXO


3rd order segment

In this version of HL7, results can be transmitted with an order as one or more OBX segments without the necessity of including the ORC and OBR segments.

Observations can be transmitted in an ORU message without using an ORC. There are times when it is necessary to transmit information not included in the OBR segments of the ORU message. In this case, it is recommended that the ORC be included in the ORU message.

The order control value of RE is required only in ORM messages to indicate that an order is followed by observation results (OBX). The RE code is not necessary in the ORU message because it is expected that the OBR segments can be followed by observation results (OBX).

k) RR

Left in for backwards compatibility. In the current version it is equivalent to an accept acknowledgment. The request-received code indicates that an order message has been received and will be processed later. The order has not yet undergone the processing that would permit a more exact response.

l) SN, NA, NW

There are three circumstances that involve requesting an order number (ORC-2-placer order number or ORC-3-filler order number):

1) When the filler application needs to request an ORC-3-filler order number from a centralized application (e.g., HIS)

2) When the filler application needs to request an ORC-2-placer order number from some other application (e.g., Order Entry)

3) When an application (not the filler application) wants to assign an ORC-3-filler order number for a new order

1) The filler application needs a centralized filler order number

SN The send order number code provides a mechanism for the filler to request an ORC-3-filler order number from some centralized application (called "other" in the table below), such as a central HIS, by sending an ORM message containing an ORC-1-order control value of SN. This ORC has a null ORC-3-filler order number and an ORC-2-placer order number created by the filler application when the filler originates the order.

The ORM (SN type) message can be acknowledged by two methods:

i) By an ORR message containing an ORC-1-order control value of OK. An unsolicited ORM message can be sent at a future time, containing an ORC with ORC-1-order control value of NA.

ii) By an ORR message containing an ORC-1-order control value of NA as described below.

NA The number assigned code allows the "other" application to notify the filler application of the newly assigned filler order number. ORC-1-order control contains value of NA, ORC-2-placer order number (from the ORC with the SN value), and the newly assigned filler order number.

Note: Both the placer order number and the filler order number have the filler's application ID.

Code

From

ORC-2-Placer Order Number

ORC-3-Filler Order Number

SN

filler application

placer order number^filler application ID

null

NA

other application

placer order number^filler application ID

filler order number^filler application ID

2) The filler application needs a placer order number

SN The send order number code provides a mechanism for the filler application to request an ORC-2-placer order number from another application (called "other" in the table below) by sending an ORM message containing an ORC-1-order control value of SN. This ORC has a null ORC-2-placer order number and an ORC-3-filler order number created by the filler application when the filler originates the order.

The ORM (SN type) message can be acknowledged by two methods:

i) By an ORR message containing an ORC-1-order control value of OK. An unsolicited ORM message can be sent at a future time, containing an ORC-1-order control value of NA.

ii) By an ORR message containing an ORC-1-order control value of NA as described below.

NA The number assigned code allows the "other" application to notify the filler application of the newly assigned ORC-2-placer order number. The ORC contains an ORC-1-order control value of NA, the newly assigned ORC-2-placer order number, and the ORC-3-filler order number (from the ORC with the SN value).

Note: The new ORC-2-placer order number has the placer's application ID.

Code

From

ORC-2-Placer Order Number

ORC-3-Filler Order Number

SN

filler application

null

filler order number^filler application ID

NA

other application

placer order number^placer application ID

filler order number^filler application ID

3) An application wants to assign a filler order number

NW When the application creating an order (not the filler application) wants to assign a filler order number for a new order

or

RO (RO following an RP). In this case, the "other" application completes ORC-3-filler order number, using the filler application ID as the second component of the filler order number.

Code

From

ORC-2-Placer Order Number

ORC-3-Filler Order Number

NW or RO

other application to the filler

placer order number^placer application ID

filler order number^filler application ID

m) CN

The combined result code provides a mechanism to transmit results that are associated with two or more orders. This situation occurs commonly in radiology reports when the radiologist dictates a single report for two or more exams represented as two or more orders. For example, knee and hand films for a rheumatoid arthritis patient might generate a single dictation on the part of the radiologist.

When such results are reported the CN code replaces the RE code in all but the last ORC, and the results follow the last ORC and its OBR. An example follows of a single report following three ORCs:

MSH|...
PID|...
ORC|CN|...
OBR||A4461XA^HIS|81641^RAD|73666^Bilateral Feet|...
ORC|CN|...
OBR||A4461XB^HIS|81642^RAD|73642^Bilateral Hand PA|... 
ORC|RE|...
OBR||A4461XC^HIS|81643^RAD|73916^Bilateral Knees|...
OBX||CE|73916&IMP||Radiologist's Impression|...
OBX||CE|73642&IMP||Radiologist's Impression|...
OBX||FT|73642&GDT||Description|...

n) UA

An unable-to-accept code is used when a new order cannot be accepted by the filler. Possible reasons include requesting a prescription for a drug which the patient is allergic to or for an order which requires certain equipment resources which are not available such that the order cannot be filled. Note that this is different from the communication level acceptance as defined within the MSA segment.

o) RF

RF accommodates requests by both the filler or the placer. The filler may be requesting refill authorization from the placer. A placer system may be requesting a refill to be done by the filler system.

p) AF

AF is a response back from the placer authorizing a refill or quantity of refills.

q) DF

DF indicates that the placer will not authorize refills for the order. The order control code reason may be used to indicate the reason for the request denial. Some suggested values include:

AA

Patient unknown to the provider

AB

Patient never under provider care

AC

Patient no longer under provider care

AD

Patient has requested refill too soon

AE

Medication never prescribed for the patient

AF

Patient should contact provider first

AG

Refill not appropriate

Note that these values originate from the NCPDP SCRIPT Response Segment Code List Qualifiers.

r) FU

FU notifies the placer that the filler issued a refill for the order at the patient’s request.

s) OF

OF directly responds to the placer system’s request for a refill

t) UF

UF indicates an application level denial by the filler system to an authorized refill request.

u) LI, UN

Use only with patient care messages, Chapter 12.

4.3.1.2 Placer order number ( EI) 00216

Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>

Definition: This field is the placer application's order number.

This field is a case of the Entity Identifier data type (2.8.13). The first component is a string that identifies an individual order (e.g., OBR). A limit of fifteen (15) characters is suggested but not required. It is assigned by the placer (ordering application). It identifies an order uniquely among all orders from a particular ordering application. The second through fourth components contain the application ID of the placing application in the same form as the HD data type (Section 2.8.18, "HD - Hierarchic designator"). The second components, namespace ID, is a user-defined coded value that will be uniquely associated with an application. A limit of six (6) characters is suggested but not required. A given institution or group of intercommunicating institutions should establish a unique list of applications that may be potential placers and fillers and assign unique application IDs. The two components are separated by a component delimiter.

There are three situations in which the true placer is somewhat arbitrary (and thus not unique):

a) in ORC-1-order control value of RO, following an RU replacement;

b) in ORC-1-order control value of CH (child orders); and

c) in ORC-1-order control value of SN (send number).

See the Table Notes under ORC-1-order control for the details of how the ORC-2-placer order number is assigned in these cases.

A given institution or group of intercommunicating institutions should establish a list of applications that may be potential placers and fillers of orders and assign each a unique application ID. The application ID list becomes one of the institution’s master dictionary lists that is documented in Chapter 8. Since third-party applications (those other than the placer and filler of an order) can send and receive ORM and ORR messages, the placer application ID in this field may not be the same as any sending and receiving application on the network (as identified in the MSH segment).

ORC-2-placer order number is the same as OBR-2-placer order number. If the placer order number is not present in the ORC, it must be present in the associated OBR and vice versa. If both fields, ORC-2-placer order number and OBR-2-placer order number are valued, they must contain the same value. When results are transmitted in an ORU message, an ORC is not required, and the identifying placer order number must be present in the OBR segments.

These rules apply to the few other fields that are present in both ORC and OBR for upward compatibility (e.g., quantity/timing, parent numbers, ordering provider, and ordering call back numbers).

4.3.1.3 Filler order number ( EI) 00217

Components: <entity identifier (ST)> ^ <namespace ID (IS)> ^ <universal ID )ST)> ^ <universal ID type (ID)>

Definition: This field is the order number associated with the filling application. It is a case of the Entity Identifier data type (2.8.13). Its first component is a string that identifies an order detail segment (e.g., OBR). A limit of fifteen (15) characters is suggested but not required. It is assigned by the order filler (receiving) application. This string must uniquely identify the order (as specified in the order detail segment) from other orders in a particular filling application (e.g., clinical laboratory). This uniqueness must persist over time.

The second through fourth components contain the filler application ID, in the form of the HD data type (see Section 2.8.18, "HD - hierarchic designator"). The second component is a user-defined coded value that uniquely defines the application from other applications on the network. A limit of six (6) characters is suggested but not required. The second component of the filler order number always identifies the actual filler of an order.

A given institution or group of intercommunicating institutions should establish a list of applications that may be potential placers and fillers of orders and assign each a unique application ID. The application ID list becomes one of the institution's master dictionary lists that is documented in Chapter 8. Since third- party applications (those other than the placer and filler of an order) can send and receive ORM and ORR messages, the filler application ID in this field may not be the same as any sending and receiving application on the network (as identified in the MSH segment).

ORC-3-filler order number is the same as OBR-3-filler order number. If the filler order number is not present in the ORC, it must be present in the associated OBR. (This rule is the same for other identical fields in the ORC and OBR and promotes upward and ASTM compatibility.) This is particularly important when results are transmitted in an ORU message. In this case, the ORC is not required and the identifying filler order number must be present in the OBR segments.

The filler order number (OBR-3 or ORC-3) also uniquely identifies an order and its associated observations. For example, suppose that an institution collects observations from several ancillary applications into a common database and this common database is queried by yet another application for observations. In this case, the filler order number and placer order number transmitted by the common database application would be that of the original filler and placer, respectively, rather than a new one assigned by the common database application.

Similarly, if a third-party application, not the filler or placer, of an order were authorized to modify the status of an order (say, cancel it), the third-party application would send the filler an ORM message containing an ORC segment with ORC-1-order control equal to "CA" and containing the original placer order number and filler order number, rather than assign either itself.

4.3.1.4 Placer group number (EI) 00218

Components: <entity identifier (ST)> ^ <namespace (D (IS)> ^ <universal ID (ST)> ^ <universal ID type (ID)>

Definition: This field allows an order placing application to group sets of orders together and subsequently identify them. It is a case of an Entity Identifier data type (2.8.13).

The first component is a string that uniquely identifies all order groups from the given placer application. A limit of fifteen (15) characters is suggested but not required. It is assigned by the placer application and may come from the same series as the placer order number of the ORC, but this is not required.

The second through fourth components constitute a placer application ID identical to the analogous components of ORC-2-placer order number. Order groups and how to use them are described in detail in Section 4.3.1, "PRC - common order segment."

4.3.1.5 Order status (ID) 00219

Definition: This field is the status of an order. Refer to HL7 table 0038 - Order status for valid entries. The purpose of this field is to report the status of an order either upon request (solicited), or when the status changes (unsolicited). It does not initiate action. It is assumed that the order status always reflects the status as it is known to the sending application at the time that the message is sent. Only the filler can originate the value of this field.

Although HL7 table 0038 - Order status contains many of the same values contained in HL7 table 0119 - Order control, the purpose is different. Order status may typically be used in a message with an ORC-1-order control value of SR or SC to report the status of the order on request or to any interested party at any time.

Table 0038 - Order status

Value

Description

A

Some, but not all, results available

CA

Order was canceled

CM

Order is completed

DC

Order was discontinued

ER

Error, order not found

HD

Order is on hold

IP

In process, unspecified

RP

Order has been replaced

SC

In process, scheduled

4.3.1.6 Response flag (ID) 00220

Definition: This field allows the placer (sending) application to determine the amount of information to be returned from the filler. Sometimes the requested level of response may not be possible immediately, but when it is possible, the filler (receiving) application must send the information. When the field is null, D is the default value of the field. Refer to HL7 table 0121 - Response flag for valid entries.

Table 0121 - Response flag

Value

Description

E

Report exceptions only

R

Same as E, also Replacement and Parent-Child

D

Same as R, also other associated segments

F

Same as D, plus confirmations explicitly

N

Only the MSA segment is returned

4.3.1.7 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: This field determines the priority, quantity, frequency, and timing of an atomic service. Order segments should be thought of as describing an atomic service. It is a composite field that is defined in detail in Section 4.4, "Quantity/Timing (TQ) Definition."

For example, if an OBR segment describes a unit of blood, this field might request that 3 such units be given on successive mornings. In this case ORC-7-quantity/timing would be "1^XQAM^X3". ORC-7-quantity/timing is the same as OBR-27-quantity/timing.

4.3.1.8 Parent (CM) 00222

Components: <parent's placer order number (EI)> ^ <parent's filler order number (EI)>

Subomponents of parent’s placer order number: <entity identifier (ST)> & <namespace ID (IS) & <universal ID (ST)> & <universal ID type (IS)>

Subomponents of parent’s filler order number: <entity identifier (ST)> & <namespace ID (IS)> & <universal ID (ST)> & <universal ID type (IS)>

Definition: This field relates a child to its parent when a parent-child relationship exists. The parent-child mechanism is described under ORC-1-order control notes. The first component contains the placer order number of the parent order. It is required when the order is a child.

The second through fourth components contain the filler order number of the parent order.

The components of the placer order number and the filler order number are transmitted in sub-components of the two components of this field. ORC-8-parent is the same as OBR-29-parent.

4.3.1.9 Date/time of transaction (TS) 00223

Definition: This field is the date and time the current transaction enters the ordering application. For messages creating new orders, this is the date and time the order was entered.

For other messages, this is the date and time the current transaction (e.g., cancellation) enters the sending application. This date and time is for the current transaction and is not a "replacement" time for a correction to the original order. Similarly, ORC-10-entered by, ORC-11-verified by, and ORC-13-enterers location of this segment relate to the current transaction, not the original order.

4.3.1.10 Entered by (XCN) 00224

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 the identity of the person who actually keyed the request into the application. It provides an audit trail in case the request is entered incorrectly and the ancillary department needs to clarify the request. By local agreement, either the ID number or name component may be omitted.

4.3.1.11 Verified by (XCN) 00225

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 the identity of the person who verified the accuracy of the entered request. It is used in cases where the request is entered by a technician and needs to be verified by a higher authority (e.g., a nurse). By local agreement, either the ID number or name component may be omitted.

4.3.1.12 Ordering provider (XCN) 00226

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 the identity of the person who is responsible for creating the request (i.e., ordering physician). ORC-12-ordering provider is the same as OBR-16-ordering provider.

4.3.1.13 Enterer's location (PL) 00227

Components: <point of care (IS)> ^ <room (IS)> ^ <bed (IS)> ^ <facility (HD)> ^ <location status (IS)> ^ <person location type (IS)> ^ <building (IS)> ^ <floor (IS)> ^ <location description (ST)>

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

Definition: This field is the location (e.g., nurse station, ancillary service location, clinic, floor) where the person who entered the request was physically located when the order was entered. Only those subcomponents relevant to enterer’s location should be valued (commonly nursing unit; facility; building; floor). The person who entered the request is defined in ORC-10-entered by.

4.3.1.14 Call back phone number (XTN) 00228

Components: [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ <telecommunication use code (ID)> ^ <telecommunication equipment type (ID)> ^ <email address (ST)> ^ <country code (NM)> ^ <area/city code (NM)> ^ <phone number (NM)> ^ <extension (NM)> ^ <any text (ST)>

Definition: This field is the telephone number to call for clarification of a request or other information regarding the order. ORC-14-call back phone number is the same as OBR-17-order call back phone number.

4.3.1.15 Order effective date/time (TS) 00229

Definition: This field is the date/time that the changes to the request took effect or are supposed to take effect.

If ORC-9-transaction date/time is after or equal to ORC-16-order effective date/time, the data values in the ORC and its subordinate segments took effect on the order effective date/time.

If ORC-9-transaction date/time is before the time specified in ORC-15-order effective date/time, the data values in ORC and its subordinate segments are planned to take effect on the order effective date/time.

If ORC-15-order effective date/time is left blank, its value is assumed to be equal to that specified in ORC-9-transaction date/time or MSH-7-message date/time if the transaction date/time is blank.

In the case where the time specified in ORC-15-effective date/time (for the order control code event in the same ORC segment) is different from the corresponding date/time in ORC-7-quantity/timing, the time specified in ORC-15-order effective date/time takes precedence. Thus if the ORC event is a discontinue request to the filler for a continuing order, and the order-effective date/time is prior to the end date/time of ORC-7-quantity/timing, the order effective date/time should take precedence. If the order identified in the ORC has children, the children which have not started should be canceled; if there is a child in process, it should be discontinued; if a child has progressed beyond the point where it can be discontinued, its status is unaffected.

4.3.1.16 Order control code reason (CE) 00230

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 is the explanation (either in coded or text form) of the reason for the order event described by the order control code (HL7 table 0119). Whereas an NTE after the order specific segment (e.g., RXO, ORO, OBR) would provide a comment for that specific segment, the purpose of the order control code reason is only to expand on the reason for the order event.

ORC-16-order control code reason is typically not valued when ORC-1-order control is NW, although it could be. In the case of a canceled order, for example, this field is commonly used to explain the cancellation. A Pharmacy system that canceled a drug order from a physician because of a well documented allergy would likely report the fact of the allergy in this field.

If it canceled the order because of a drug interaction this field might contain at least the names (and codes, if needed) of the interacting substances, the text describing the interaction, and the level of severity of the interaction.

4.3.1.17 Entering organization (CE) 00231

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 is the organization that the enterer belonged to at the time he/she enters/maintains the order, such as medical group or department. The person who entered the request is defined in ORC-10 -entered by.

4.3.1.18 Entering device (CE) 00232

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 is the identifier of the physical device (terminal, PC) used to enter the order.

4.3.1.19 Action by (XCN) 00233

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 the identity of the person who initiated the event represented by the corresponding order control code. For example, if the order control code is CA (cancel order request), this field represents the person who requested the order cancellation. This person is typically a care provider but may not always be the same as ORC-12 ordering provider.

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