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
Definition: This field contains the same value as the sequence number of the associated OM1 segment.
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 |
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.
Definition: This field contains the capacity of the container.
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.
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.
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 |
Definition: This field contains the special processing that should be applied to the container, e.g., add acidifying tablets before sending.
Definition: This field contains the special handling requirements here (e.g., ice specimen, deliver within two hours of obtaining).
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).
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).
Definition: This field contains the other requirements for specimen delivery and special handling (e.g., delivery within one hour, iced).
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) |
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.