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					DATA ELEMENTS IN IMMUNIZATION INFORMATION SYSTEMS

Introduction
The following document references data items used in the immunization
information system(IIS) community. It has several sections (Tab) that
include A) Introduction B) Requirment status C) Item definitions and D)
change history. The purpose of this document is to illustrate and document
the collected data items used in IIS. Each section has purpose and layout
described below or within the tab.



Indended audience
Intended audience: We believe this document will be most useful for
analysts, researchers, IT staff, registry managers and program managers
interested in data collected in IIS. Please note it is to be used with a
supplement to electronic reporting guidelines such as file layouts and
message specifications. Currently the adopted reporting guidelines include
Health Level 7 specifications.

Prepared by: The American Immunization Registry Association Data Definitions Working Group.

Chairs:




Cecilie Birner            2005-2006
Rob Savage                2005-
Kimiko Gosney             2006-2007
Kelly Pearson             2008-
Revision: 5/2/08


                          See change history sheet for changes.




Category key:
admin:                     associated with data administration
vaccine or immunization    associated with immunizations and
                           vaccines
person                     client specific info
messaging transaction      associated with electronic data index
financial                  associated with financial aspects
clinical observations      clinical topic that specifies issue of
                           interest and associated value
provider and organization  provider or organization specific info
location and communication information needed to locate or
                           communicate with and entity
indicator
Data Definitions Working Group.


            If you believe that there needs to be a new data element or value for an
            existing data element, you may make a request via the AIRA website.
            Requests will be reviewed by the Data Definitions Workgroup. The
            Workgroup will respond to your request. After review, the workgroup will bring
            requests to the steering committee for prioritizing.
                         Subject                    Table
Category
                Abnormal Flags               HL7                #NAME?
                Accept/Application           HL7
                acknowledgement
HL7             conditions                                      #NAME?
HL7             Acknowledgment code          HL7 008            #NAME?
HL7             Action Code                  HL7                #NAME?
location and    Address Type                 HL7
communication                                                   #NAME?
provider/imm    Administrative Site          HL7                #NAME?
                Alternate Character set      HL7
HL7             handling scheme                                 #NAME?
                Alternative character sets   HL7
HL7                                                             #NAME?
location and    Census Tract                 User
communication                                                   #NAME?
HL7             Check digit scheme           HL7 0061           #NAME?
                CN ID Source                 User               #NAME?
HL7             Coding System                User               #NAME?
                Completion Status            HL7                #NAME?
                Contact Reason               User               #NAME?
                Contraindications,           NIP-defined
                Precautions, and
                Immunities                                      #NAME?
location and    County/Parish                User
communication                                                   #NAME?
HL7             Deferred response type       HL7                #NAME?
person          Degree                       User               #NAME?
                Delayed acknowledgement      HL7
HL7             type                                            #NAME?
person          Ethnic Group                 User               #NAME?
                Event Consequences           NIP-defined        #NAME?
HL7             Event Reason                 User 0062          #NAME?
HL7             Event Type                   HL7 0003           #NAME?
                Father's Social Security
person          Number                                          #NAME?
                Financial Class          VFC eligibility
Financial                                codes 0065             #NAME?
                Identifier Type          User                   #NAME?
                Immunization information NIP-defined
immunization    source                                          #NAME?
                Immunization Registry    User
person          Status                                          #NAME?
person          Language                 User                   #NAME?
person          Living arrangement       User                   #NAME?
                Manufacturers of vaccine MVX Code
immunization                                                    #NAME?
                Message Error Status         Rejection Status
HL7             Codes                                           #NAME?
HL7             Message Structure            HL7                #NAME?
HL7             Message Type                 HL7                #NAME?
                       Mother's Social Security
person                 Number                                    #NAME?
person                 Moved or Gone Elsewhere     HL7 0441      #NAME?
person                 Name Type                   HL7           #NAME?
location and           Name/address                HL7
communication          representation                            #NAME?
                       Namespace ID                User          #NAME?
person                 Nationality                 User          #NAME?
observation            Observation identifiers                   #NAME?
                       Observation result status   HL7
                       codes interpretation
Observation/admin                                                #NAME?
HL7                    Order Control Codes      HL7              #NAME?
                       Organizational Name Type User
provider organization                                            #NAME?
person                Patient Birth Date                         #NAME?
                       Patient Birth Order                       #NAME?
                       Patient Birth Registration
person                 Number                                    #NAME?
                       Patient Birth State,
                       Country                                   #NAME?
person                 Patient Class              user 0004      #NAME?
                       Patient Medicaid Number
person                                                           #NAME?
                       Physician ID                User 0010     #NAME?
HL7                    Processing ID               HL7           #NAME?
HL7                    Processing mode             HL7           #NAME?
person                 Publicity Code              User          #NAME?
HL7                    Quantity limited request    HL7           #NAME?
HL7                    Query priority              HL7           #NAME?
HL7                    Query response status       User          #NAME?
HL7                    Query results level         HL7           #NAME?
                       Query/Response format       HL7
HL7                    code                                      #NAME?
person                 Race                        User 0005     #NAME?
person                 Relationship                User 0063     #NAME?
                       Report Type                 NIP-defined   #NAME?
                       Reported adverse event      NIP-defined
                       previously                                #NAME?
immunization           Route of Administration     HL7           #NAME?
person                 Sex                         User 0001     #NAME?
                       Source of Comment           HL7           #NAME?
immunization           Substance refusal reason    NIP-defined   #NAME?
location and           Telecommunication use       HL7
communication          code                                      #NAME?
                       Universal ID                HL7           #NAME?
                       Vaccination Date                          #NAME?
                       Vaccination Dose Number
                                                                 #NAME?
                       Vaccine Expiration Date                   #NAME?
                       Vaccine Lot Number                        #NAME?
                       Vaccine purchase with       NIP-defined   #NAME?
immunization           Vaccine Type                CVX code      #NAME?
         Vaccination location        NIP-defined   #NAME?
HL7      Version ID                  HL7           #NAME?
HL7      What subject filter         HL7 0048      #NAME?
HL7      Yes/No Indicator            HL7           #NAME?
NIP011   vaccination take repsonse   AIRA/NIP
         Type                                           748
NIP011   Vaccination take repsonse   AIRA/NIP
         Date                                           749
NIP011   Smallpox take repsonse      AIRA/NIP
         values                                         817
The Index page provides a listing of all variables
and a row number on the Definitions page that
they can be found.


Changes since Publication Date for Implementation
Guide are highlighted in this color
??
List what codes sets, organizational requirements, or applications fields are part of.
This section is to be used to indicate the "endorsement" or requirment status for a organization or application of
direct relevance to an immunization program

Table or Item                                          Endoresment Statement
Patient Race                                           NVAC Required Core Data Element
Patient Ethnicity                                      NVAC Required Core Data Element
Patient Name: first middle, last                       NVAC Required Core Data Element
Patient Alias Name                                     NVAC Optional Core Data Element
Patient Address, phone number birthding faciliaty      NVAC Optional Core Data Element
Patient Social Security Number                         NVAC Optional Core Data Element
Patient Birth date                                     NVAC Required Core Data Element
Patient Sex                                            NVAC Required Core Data Element
Patient Primary Language                               NVAC Optional Core Data Element
Patient Birth Order                                    NVAC Required Core Data Element
Patient Birth registration number                      NVAC Optional Core Data Element
Patient Birth State/country                            NVAC Required Core Data Element
Patient Medicaid number                                NVAC Optional Core Data Element
Patient Status indicator (active, inactive, MOGE,etc   NVAC Optional Core Data Element
Mothers Name: first middle, last, maiden               NVAC Required Core Data Element
Mothers Social Security number                         NVAC Optional Core Data Element
Fathers Name: first, middle, last                      NVAC Optional Core Data Element
Fathers Social Security number                         NVAC Optional Core Data Element
Vaccine Type                                           NVAC Required Core Data Element
Vaccine Manufacturer                                   NVAC Required Core Data Element
Vaccine Dose Number                                    NVAC Optional Core Data Element
Vaccine Expiration date                                NVAC Optional Core Data Element
Vaccine Injection site                                 NVAC Optional Core Data Element
Vaccination date                                       NVAC Required Core Data Element
Vaccine Lot number                                     NVAC Required Core Data Element
Vaccine Provider                                       NVAC Optional Core Data Element
Historical Vaccination flag/indicator                  NVAC Optional Core Data Element
VFC eligibility                                        NVAC Optional Core Data Element
History of varicella indicator                         NVAC Optional Core Data Element

Reference for Moved or Gone Elsewhere

MOGE                                                   AIRA Modeling of Immunization Registry Operations Workgroup (
                                                       Moved or Gone Elsewhere (MOGE) Status and Other Patient Desig
                                                       See AIRA Web page
or application of




 stry Operations Workgroup (eds). Management of
tatus and Other Patient Designations in Immunization Information Systems. Atlanta, GA: American Immunization Registry Asso
mmunization Registry Association. December, 2005.
                                                                                                                                                                                            Active - Is
                  Source - who is                                                                                                                                          Required in
                                     Codes -                            Suggestions                                                                                                         this field
      Subject     responsible for               Codes - Description                         Description                         Rationale                   Related To   which code sets
                                     values                             on coding?                                                                                                          currently
                maintaining code set                                                                                                                                     (also see Tab 2)
                                                                                                                                                                                              used
Sex             User                F          Female                       N         This is the Patient's Sex.   In an immunization event, this is
                                                                                                                   used to identify the sex of patient.

Sex             User                M          Male
Sex             User                O          Other
Sex             User                U          Unknown
Event Type      HL7                 A28        ADT/ACK-Add person           N         Provides a finer level of    For some HL7 messages it is                           HL7 0003
                                               information                            definition in the HL7        necessary to indicate what action is
                                                                                      message type. For ADT        to be taken as the result of receiving
                                                                                      messages, it indicates       the message (e.g. "delete the patient
                                                                                      whether the message          record"). For other messages, while
                                                                                      adds, deletes, updates a     required, it provides no additional
                                                                                      person's record. For the     information.
                                                                                      immunization messages,
                                                                                      its value is always
                                                                                      determined by the HL7
                                                                                      Message type.



Event Type      HL7                 A29        ADT/ACK-Delete
                                               person information
Event Type      HL7                 A30        ADT/ACK-Merge
                                               person information
Event Type      HL7                 A31        ADT/ACK-Update
                                               person information
Event Type      HL7                 V01        VXQ-Query for
                                               vaccination record
Event Type      HL7                 V02        VXX-Response to
                                               vaccination query
                                               returning multiple PID
                                               matches
Event Type      HL7                 V03        VXR-Vaccination
                                               record response
                                                                                                                                                            Active - Is
                  Source - who is                                                                                                          Required in
                                     Codes -                           Suggestions                                                                          this field
    Subject       responsible for               Codes - Description                        Description          Rationale   Related To   which code sets
                                     values                            on coding?                                                                           currently
                maintaining code set                                                                                                     (also see Tab 2)
                                                                                                                                                              used
Event Type      HL7                 V04        VXU-Unsolicited
                                               vaccination record
                                               update
Event Type      HL7                 R01        ORU- Observation
                                               results (unsolicited)
Patient Class   User                E          Emergency                             The classification
                                                                                     describing the
                                                                                     relationship of the
                                                                                     patient to the care
                                                                                     provider relevant to the
                                                                                     message event.
Patient Class   User                I          Inpatient
Patient Class   User                O          Outpatient
Patient Class   User                P          Preadmit
Patient Class   User                R          Recurring Patient
Patient Class   User                B          Obstetrics
                                                                                                                                                                                          Active - Is
               Source - who is                                                                                                                                           Required in
                                  Codes -                             Suggestions                                                                                                         this field
   Subject     responsible for               Codes - Description                             Description                       Rationale                  Related To   which code sets
                                  values                              on coding?                                                                                                          currently
             maintaining code set                                                                                                                                      (also see Tab 2)
                                                                                                                                                                                            used
Race         User                1002-5     American Indian or       A social-         These values are            These values are consistent with the
                                            Alaska Native            political         consistent with the OMB OMB Notice of revised categories
                                                                     construct         Notice of revised           for collection of race and ethnicity
                                                                     designed for      categories for collection data-the combined format. The
                                                                     collecting data   of race and ethnicity data- complete set is available at:
                                                                     on the race and   the combined format.        http//www.cdc.gov/od/hissb/docs/R
                                                                     ethnicity of      The complete set is         ace-EthnicityCodeSet.pdf
                                                                     broad             available at:
                                                                     population        http//www.cdc.gov/od/hi
                                                                     groups. May be    ssb/docs/Race-
                                                                     thought of in     EthnicityCodeSet.pdf
                                                                     terms of social
                                                                     and cultural
                                                                     characteristics
                                                                     as well as
                                                                     ancestry.
                                                                     Patients can
                                                                     report more
                                                                     than one racial
                                                                     category. This
                                                                     is allowed to
                                                                     repeat.

Race         User                2028-9     Asian
Race         User                2076-8     Native Hawaiin or
                                            Other Pacific Islander
Race         User                2054-5     Black or African-
                                            American
Race         User                2106-3     White
Race         User                2135-2     Hispanic or Latino
Race         User                2186-5     Other race
Race         User                2131-1     Unknown
                                                                                                                                          Active - Is
               Source - who is                                                                                           Required in
                                  Codes -                         Suggestions                                                             this field
   Subject     responsible for              Codes - Description                 Description   Rationale   Related To   which code sets
                                  values                          on coding?                                                              currently
             maintaining code set                                                                                      (also see Tab 2)
                                                                                                                                            used
Acknowledgme HL7                 AA         Original mode:
nt code                                     Application Accept
                                            Enhanced Mode:
                                            Application
                                            Acknowledgement:Acc
                                            ept
Acknowledgme HL7                 AE         Original Mode:
nt code                                     Application Error
                                            Enhanced Mode:
                                            Application
                                            Acknowledgement:Err
                                            or
Acknowledgme HL7                 AR         Original mode:
nt code                                     Application Reject
                                            Enhanced Mode:
                                            Application
                                            acknowledgement
                                            Reject
Acknowledgme HL7                 CA         Enhanced mode:
nt code                                     Accept
                                            acknowledgement:
                                            Commit Accept
Acknowledgme HL7                 CE         Enhanced mode:
nt code                                     Accpet
                                            acknowledgement:
                                            Commit Error
Acknowledgme HL7                 CR         Enhanced mode:
nt code                                     Accept
                                            acknowledgement:
                                            Commit Reject
                                                                                                                                                                                                    Active - Is
                 Source - who is                                                                                                                                                   Required in
                                    Codes -                            Suggestions                                                                                                                  this field
   Subject       responsible for               Codes - Description                             Description                          Rationale                    Related To      which code sets
                                    values                             on coding?                                                                                                                   currently
               maintaining code set                                                                                                                                              (also see Tab 2)
                                                                                                                                                                                                      used
Physician ID   User                                                   Each registry      Physician ID is a unique      Physician identity is related to         Shot
                                                                      should establish   identifier for a project to   serveral aspects to a Immunization      Administered //
                                                                      a system of        link with identifying         Registry. 1 - Ideally each patient      Medical home //
                                                                      coding its         information of provider.      has a medical home which is a           Inventory //
                                                                      reporting          Not to be confused it         provider 2- each shot administered      Assessments //
                                                                      physicians. The    facility. Consideration       should be related to a physician        Regional review
                                                                      National           need to be taken when         who administered the shot or            of provider
                                                                      Provider           data is exported to           ordered the shot. 3 - Related to        participation
                                                                      Identifier (NPI)   another project that the      assessments, facilities and insurance
                                                                      adopted for the    Physician ID is unique        companies may want to assess
                                                                      HIPAA              and does not occur in the     completeness at the provider level.
                                                                      legislation may    project where the data is     4 - For VFC accountability, it may
                                                                      be used for this   being sent.                   help in assessing practices on VFC
                                                                      purpose                                          vaccine useage to break it down to
                                                                                                                       provider level



What subject   HL7                 VXI        Vaccine Information     Will be            In a query, this code         When issuing a query, the what                            HL7 0048
filter                                                                intimately tied    denotes the kind of           subject filter indicates what kind of
                                                                      to message         information requested         information is being requested. In
                                                                      structure.         (so you get a vaccine         the VX messages, the only valid
                                                                                         history instead of a          value is "VXI" denoting Vaccine
                                                                                         financial record).            Information
Check digit    HL7                 M10        Mod 10 algorithm
scheme
Check digit    HL7                 M11        Mod 11 algorithm
scheme
Check digit    HL7                 ISO        ISO 7064: 1983
scheme
Check digit    HL7                 NPI        Check digit algorithm
scheme                                        in the US National
                                              Provider Identifier
                                                                                                                                                                                        Active - Is
                 Source - who is                                                                                                                                       Required in
                                    Codes -                           Suggestions                                                                                                       this field
   Subject       responsible for               Codes - Description                        Description                        Rationale                  Related To   which code sets
                                    values                            on coding?                                                                                                        currently
               maintaining code set                                                                                                                                  (also see Tab 2)
                                                                                                                                                                                          used
Event Reason   User                01         Patient Request                       This indicates the reason   Useful by the receiving registry for
                                                                                    given by the originator     determining how to process the
                                                                                    of the message for          message when received. Some
                                                                                    sending the                 reasons may not be supported by
                                                                                    immunization event          some registries.
                                                                                    message.
Event Reason   User                02         Physician Order
Event Reason   User                03         Census Management
Event Reason   User                04         Add person data to
                                              immunization registry

Event Reason   User                05         Delete person data
                                              from immunization
                                              registry
Event Reason   User                06         Update person data in
                                              immunization registry

Event Reason   User                07         Merge person data in
                                              immunization registry

Relationship   User                ASC        Associate                             This indicates the next of Combined with other information,
                                                                                    kin's personal             this is valuable in reminder/recall or
                                                                                    relationship with patient vaccine adverse events
                                                                                    involved in the
                                                                                    immunization event
Relationship   User                BRO        Brother
Relationship   User                CGV        Care giver
Relationship   User                CHD        Child
Relationship   User                DEP        Handicapped
                                              dependent
Relationship   User                DOM        Life partner
Relationship   User                EMC        Emergency contact
Relationship   User                EME        Employee
Relationship   User                EMR        Employer
Relationship   User                EXF        Extended family
                                                                                                                                               Active - Is
                 Source - who is                                                                                              Required in
                                    Codes -                            Suggestions                                                             this field
   Subject       responsible for               Codes - Description                   Description   Rationale   Related To   which code sets
                                    values                             on coding?                                                              currently
               maintaining code set                                                                                         (also see Tab 2)
                                                                                                                                                 used
Relationship   User                FCH        Foster child
Relationship   User                FND        Friend
Relationship   User                FTH        Father
Relationship   User                GCH        Grandchild
Relationship   User                GRD        Guardian
Relationship   User                GRP        Grandparent
Relationship   User                MGR        Manager
Relationship   User                MTH        Mother
Relationship   User                NCH        Natural child
Relationship   User                NON        None
Relationship   User                OAD        Other adult
Relationship   User                OTH        Other
Relationship   User                OWN        Owner
Relationship   User                PAR        Parent
Relationship   User                SCH        Stepchild
Relationship   User                SEL        Self
Relationship   User                SIB        Sibling
Relationship   User                SIS        Sister
Relationship   User                SPO        Spouse
Relationship   User                TRA        Trainer
Relationship   User                UNK        Unknown
Relationship   User                WRD        Ward of court
Relationship   Codes for VAERS     VAB        Vaccine administered
               reporting only                 by (Name)
Relationship   Codes for VAERS     FVP        Form completed by
               reporting only                 (Name) - Vaccine
                                              provider
Relationship   Codes for VAERS     FPP        Form completed by
               reporting only                 (Name)- Patient/Parent

Relationship   Codes for VAERS     FMN        Form completed by
               reporting only                 (Name) - Manufacturer

Relationship   Codes for VAERS     FOT        Form completed by
               reporting only                 (Name) - Other
                                                                                                                                                                                       Active - Is
                  Source - who is                                                                                                                                     Required in
                                     Codes -                                Suggestions                                                                                                this field
   Subject        responsible for               Codes - Description                             Description                   Rationale                Related To   which code sets
                                     values                                 on coding?                                                                                                 currently
                maintaining code set                                                                                                                                (also see Tab 2)
                                                                                                                                                                                         used
Financial Class VFC eligibility codes V00      VFC eligibility not                        Indicates a class or    This field can be used to indicate
                                               determined/unknown                         category of payment     VFC eligibility, state/local
                                                                                          method for              reimbursement programs, Medicaid
                                                                                          immunization services   or type of insurance plan.
                                                                                          provided. This is
                                                                                          allowed to repeat.
Financial Class VFC eligibility codes V01      Not VFC eligible

Financial Class VFC eligibility codes V02      VFC eligible-
                                               Medicaid/Medicaid
                                               Managed Care
Financial Class VFC eligibility codes V03      VFC eligible-
                                               Uninsured
Financial Class VFC eligibility codes V04      VFC eligible-
                                               American
                                               Indian/Alaskan Native

Financial Class VFC eligibility codes V05      VFC eligible-Federally
                                               Qualified Health
                                               Center Patient (under-
                                               insured)
Financial Class VFC eligibility codes V06      VFC eligible- State
                                               specific eligibility (e.g.
                                               S-CHIP plan)
Financial Class VFC eligibility codes V07      VFC eligibility- Local-
                                               specific eligibility
Financial Class S-CHIP eligibility   CH00      S-CHIP coverage-not
                codes                          VFC eligible
Financial Class S-CHIP eligibility   CH01      S-CHIP coverage-
                codes                          separate from Medicaid-
                                               not VFC eligible
                                                                                                                                                                      Active - Is
                  Source - who is                                                                                                                    Required in
                                     Codes -                               Suggestions                                                                                this field
   Subject        responsible for               Codes - Description                                  Description          Rationale   Related To   which code sets
                                     values                                on coding?                                                                                 currently
                maintaining code set                                                                                                               (also see Tab 2)
                                                                                                                                                                        used
Financial Class S-CHIP eligibility    CH02     S-CHIP coverage-
                codes                          combination of
                                               Medicaid and separate-
                                               not VFC eligible

Financial Class Health plan type      H01      Self pay
                codes
Financial Class Health plan type      H02      Medicaid (may be
                codes                          called by state-specific
                                               name, e.g. Medi-Cal)

Financial Class Health plan type      H03      Third party or private
                codes                          insurance
Financial Class Insured status        IS00     Some or all vaccine
                                               costs covered
Financial Class Insured status        IS01     Undersinsured (no
                                               vaccine costs covered
                                               and not FQC/RHC)
Financial Class State program codes                                       use state 2-letter
                                                                          abbreviation
                                                                          plus a number
                                                                          for the value

Message Type    HL7                   ACK      General                                         A field used to indicate
                                               Acknowledgement                                 the type of HL7 message
                                                                                               and convey the message
                                                                                               configuration.

Message Type    HL7                   ADR      ADT Response
Message Type    HL7                   ADT      ADT Message
Message Type    HL7                   QCK      Query general
                                               acknowledgement
Message Type    HL7                   VXQ      Query for vaccination
                                               record
                                                                                                                                                               Active - Is
                   Source - who is                                                                                                            Required in
                                      Codes -                             Suggestions                                                                          this field
    Subject        responsible for               Codes - Description                          Description          Rationale   Related To   which code sets
                                      values                              on coding?                                                                           currently
                 maintaining code set                                                                                                       (also see Tab 2)
                                                                                                                                                                 used
Message Type     HL7                 VXX        Vaccination query
                                                response with multiple
                                                PID matches
Message Type     HL7                 VXR        Vaccination query
                                                record response
Message Type     HL7                 VXU        Unsolicited vaccination
                                                record update

Message Type     HL7                 ORU        Unsolicited observation
                                                record
Abnormal Flags HL7                   L          Below low normal                        Describes how a value is
                                                                                        abnormal
Abnormal Flags HL7                   H          Above high normal

Abnormal Flags HL7                   LL         Below low panic limits

Abnormal Flags HL7                   HH         Above upper panic
                                                limits
Abnormal Flags HL7                   N          Normal (applies to non-
                                                numeric results
Abnormal Flags HL7                   A          Abnormal (applies to
                                                non-numeric results)
Abnormal Flags HL7                   AA         Very abnormal (applies
                                                to non-numeric units,
                                                analogous to panic
                                                limits for numeric
                                                units)

Observation      HL7                 C          Record coming over is                   This value explains how
result status                                   a correction and thus                   the record should be
codes                                           replaces a final result                 used/interpretted.
interpretation
                                                                                                                                                   Active - Is
                   Source - who is                                                                                                Required in
                                      Codes -                              Suggestions                                                             this field
    Subject        responsible for               Codes - Description                     Description   Rationale   Related To   which code sets
                                      values                               on coding?                                                              currently
                 maintaining code set                                                                                           (also see Tab 2)
                                                                                                                                                     used
Observation      HL7                 D          Deletes the OBX
result status                                   record
codes
interpretation
Observation      HL7                 F          Final results; can only
result status                                   be changed with a
codes                                           corrected result
interpretation
Observation      HL7                 I          Specimen in lab;
result status                                   resutls pending
codes
interpretation
Observation      HL7                 N          Not asked; used to
result status                                   affirmatively document
codes                                           that the observation
interpretation                                  identified in the OBX
                                                was not sought when
                                                the universal service ID
                                                in OBR-4 implies that
                                                it would be sought


Observation      HL7                 O          Order detail description
result status                                   only (no result)
codes
interpretation
Observation      HL7                 P          Preliminary results
result status
codes
interpretation
Observation      HL7                 R          Results entered -not
result status                                   verified
codes
interpretation
                                                                                                                                                                                         Active - Is
                   Source - who is                                                                                                                                     Required in
                                      Codes -                             Suggestions                                                                                                    this field
    Subject        responsible for               Codes - Description                          Description                      Rationale                Related To   which code sets
                                      values                              on coding?                                                                                                     currently
                 maintaining code set                                                                                                                                (also see Tab 2)
                                                                                                                                                                                           used
Observation      HL7                 S          Partial results
result status
codes
interpretation
Observation      HL7                 X          Results cannot be
result status                                   obtained for this
codes                                           observation
interpretation
Observation      HL7                 U          Results status change
result status                                   to Final without
codes                                           retransmitting results
interpretation                                  already sent as
                                                'preliminary' e.g.,
                                                radiology changes
                                                status from preliminary
                                                to final
Observation      HL7                 W          Post original as wrong;
result status                                   e.g., transmited for
codes                                           wrong patient
interpretation
Query priority   HL7                 D          Deferred                                Time frame in which the In a limited resource situation, this                HL7 0091
                                                                                        response is expected.   field could be used to prioritize
                                                                                                                queries.
Query priority HL7                   I          Immediate
Delayed        HL7                   D          Message received,                       Indicates that a message                                                                        Not actively
acknowledgeme                                   stored for later                        has been received and                                                                           used in IIS
nt type                                         processing                              when a response will
                                                                                        occur.
Delayed       HL7                    F          Acknowledgement
acknowledgeme                                   after processing
nt type
                                                                                                                                                                                          Active - Is
                  Source - who is                                                                                                                                        Required in
                                     Codes -                            Suggestions                                                                                                       this field
   Subject        responsible for               Codes - Description                           Description                      Rationale                  Related To   which code sets
                                     values                             on coding?                                                                                                        currently
                maintaining code set                                                                                                                                   (also see Tab 2)
                                                                                                                                                                                            used
Processing ID   HL7                 D          Debugging                                Used to indicate how to   When testing messages or training                    HL7 0103
                                                                                        process the message as    users, it is not desirable to update
                                                                                        defined in HL7            live patient data. This field can
                                                                                        processing rules.         indicate whether to update live data.

Processing ID   HL7                 P          Production
Processing ID   HL7                 T          Training
Version ID      HL7                 2.0        Release 2.0 September                    HL7 standards version
                                               1988                                     number.
Version ID      HL7                 2.0D       Demo 2.0 October
                                               1998
Version ID      HL7                 2.1        Release 2.1 March
                                               1990
Version ID      HL7                 2.2        Release 2.2 December
                                               1994
Version ID      HL7                 2.3        Release 2.3 March
                                               1997
Version ID      HL7                 2.3.1      Release 2.3.1 May
                                               1999
Version ID      HL7                 2.4        Release 2.4 October
                                               2000
Source of       HL7                 L          Ancillary (filler)                       This code indicates who
Comment                                        department is source of                  the source of this
                                               comment                                  comment is.
Source of     HL7                   P          Orderer (placer) is
Comment                                        source of comment
Source of     HL7                   O          Other system is source
Comment                                        of comment
Query/Respons HL7                   D          Response is in display Closely tied to   Indicates in what format Query responses can be returned as
e format code                                  format                  message          a query response is      text, structured documentes, etc.
                                                                       definition       requested or returned    This field indicates which one.
                                                                                                                 Immunization messages will
                                                                                                                 probably always use "R".
Query/Respons HL7                   R          Response is in record-
e format code                                  oriented format
                                                                                                                                                                                             Active - Is
                     Source - who is                                                                                                                                        Required in
                                        Codes -                              Suggestions                                                                                                     this field
   Subject           responsible for               Codes - Description                           Description                      Rationale                  Related To   which code sets
                                        values                               on coding?                                                                                                      currently
                   maintaining code set                                                                                                                                   (also see Tab 2)
                                                                                                                                                                                               used
Query/Respons      HL7                 T          Repsonse is in tabular
e format code                                     format
Deferred           HL7                 B          Before the date/time                     Time reference for the
response type                                     specified                                query request reply.
Deferred           HL7                 L          Later than the date/time
response type                                     specified
Query results      HL7                 O          Order plus order status                  Controls the level of
level                                                                                      detail in a query
                                                                                           response.
Query results      HL7                 R          Results without bult
level                                             text
Query results      HL7                 S          Status only
level
Query results      HL7                 T          Full results
level
Order Control      HL7                 OK         Order accepted & OK                      Determines the function
Codes                                                                                      of the order segment

Order Control HL7                      RE         Observations to follow
Codes
Quantity limited HL7                   CH         Characters                               Indicates the maximum
request                                                                                    length that can be
                                                                                           accepted
Quantity limited   HL7                 LI         Lines
request
Quantity limited   HL7                 PG         Pages
request
Quantity limited   HL7                 RD         Records
request
Quantity limited   HL7                 ZO         Locally defined
request
Yes/No             HL7                 Y          Yes                                      This is used to show an   For example, Yes/No is used as a
Indicator                                                                                  affirmative or nagative   Multiple Birth Indicator, a Death
                                                                                           status of an item         Indicator, and a Protection Indicator
                                                                                                                                                                                           Active - Is
                    Source - who is                                                                                                                                       Required in
                                       Codes -                              Suggestions                                                                                                    this field
    Subject         responsible for               Codes - Description                           Description                      Rationale                 Related To   which code sets
                                       values                               on coding?                                                                                                     currently
                  maintaining code set                                                                                                                                  (also see Tab 2)
                                                                                                                                                                                             used
Yes/No            HL7                 N          No
Indicator
Yes/No            HL7                 <null>     Not obtained (when
Indicator                                        used by immunization
                                                 registries as defined in
                                                 PD1-12)

Yes/No            HL7                 U          Unknown
Indicator
Accept/Applicat   HL7                 AL         Always                                   Indicates what kind of
ion                                                                                       acknowledgement the
acknowledgeme                                                                             sending application
nt conditions                                                                             wants returned
Accept/Applicat   HL7                 VE         Never
ion
acknowledgeme
nt conditions
Accept/Applicat   HL7                 ER         Error/Reject conditions
ion                                              only
acknowledgeme
nt conditions
Accept/Applicat   HL7                 SU         Successful completion
ion                                              only
acknowledgeme
nt conditions
Route of          HL7                 ID         Intradermal                              Route by which the        Combined with other information,
Administration                                                                            vaccine is administered   such as site of administration, this
                                                                                          to the patient (only      information is useful in the case of
                                                                                          selected values listed)   vaccine adverse events and accurate
                                                                                                                    avvination history

Route of       HL7                    IM         Intramuscular
Administration
                                                                                                                                                                                       Active - Is
                   Source - who is                                                                                                                                    Required in
                                      Codes -                           Suggestions                                                                                                    this field
   Subject         responsible for               Codes - Description                        Description                      Rationale                 Related To   which code sets
                                      values                            on coding?                                                                                                     currently
                 maintaining code set                                                                                                                               (also see Tab 2)
                                                                                                                                                                                         used
Route of       HL7                   IN         Intranasal
Administration

Route of       HL7                   IV         Intravenous
Administration

Route of       HL7                   PO         Oral
Administration

Route of       HL7                   OTH        Other/Miscellaneous
Administration

Route of       HL7                   SCH        Subcutaneous
Administration

Route of       HL7                   TD         Transdermal
Administration

Administrative HL7                   LT         Left Thigh                            This is the site on the  Combined with other information,
Site                                                                                  patient where vaccine is such as route of administration, this
                                                                                      administered             information is useful in vaccing
                                                                                                               adverse events, planning for
                                                                                                               vaccination site distribution, and
                                                                                                               accurate vaccination history

Administrative   HL7                 LA         Left Arm
Site
Administrative   HL7                 LD         Left Deltoid
Site
Administrative   HL7                 LG         Left Gluteous Medius
Site
Administrative   HL7                 LVL        Left Vastus Lateralis
Site
Administrative   HL7                 LLFA       Left Lower Forearm
Site
                                                                                                                                                                                            Active - Is
                   Source - who is                                                                                                                                         Required in
                                      Codes -                            Suggestions                                                                                                        this field
   Subject         responsible for               Codes - Description                         Description                          Rationale                 Related To   which code sets
                                      values                             on coding?                                                                                                         currently
                 maintaining code set                                                                                                                                    (also see Tab 2)
                                                                                                                                                                                              used
Administrative   HL7                 RA         Right Arm
Site
Administrative   HL7                 RT         Right Thigh
Site
Administrative   HL7                 RVL        Right Vastus Lateralis
Site
Administrative   HL7                 RG         Right Gluteus Medius
Site
Administrative   HL7                 RD         Right Deltoid
Site
Administrative   HL7                 RLFA       Right Lower Forearm
Site
Ethnic Group     User                H          Hispanic or Latino                     A segment of a larger         These values are consistent with the
                                                                                       society whose members         IMB Notice of revised categories
                                                                                       have a common origin          for collection of race and ethnicity
                                                                                       and share a common            data and with HL7's Version 2.4
                                                                                       culture. This field further
                                                                                       defines patient ancestry.
                                                                                       This is allowed to repeat


Ethnic Group     User                N          Not Hispanic or Latino

Ethnic Group     User                U          Unknown
Address Type     HL7                 C          Current or temporary                   This describes the type       Some registries keep various types
                                                                                       or category of address.       of address for a person or
                                                                                                                     organizatoin. This allows the
                                                                                                                     system to specify which is being
                                                                                                                     used.
Address Type     HL7                 P          Permanent
Address Type     HL7                 M          Mailing
Address Type     HL7                 B          Firm/Business
Address Type     HL7                 O          Office
Address Type     HL7                 H          Home
Address Type     HL7                 N          Birth (nee)
                                                                                                                                                                                          Active - Is
                  Source - who is                                                                                                                                        Required in
                                     Codes -                              Suggestions                                                                                                     this field
   Subject        responsible for               Codes - Description                           Description                       Rationale                 Related To   which code sets
                                     values                               on coding?                                                                                                      currently
                maintaining code set                                                                                                                                   (also see Tab 2)
                                                                                                                                                                                            used
Address Type    HL7                 F          Country of origin
Address Type    HL7                 L          Legal address
Address Type    HL7                 BDL        Birth delivery location
                                               (use for birth facility)

Address Type    HL7                 BRO        Residence at birth (use
                                               for residence at birth)

Address Type    HL7                 RH         Registry home
Address Type    HL7                 BA         Bad address
Name Type       HL7                 A          Alias name                               This describes the type     Some registries keep various types
                                                                                        or category of name.        of names. This allows the system to
                                                                                                                    specify which one is given.

Name Type       HL7                            Legal name
Name Type       HL7                 D          Display name
Name Type       HL7                 M          Maiden name
Name Type       HL7                 C          Adopted name
Name Type       HL7                 B          Name at birth
Name Type       HL7                 P          Name of partner/spouse

Name Type     HL7                   U          Unspecified
Telecommunica HL7                   PRN        Primary residence                        Used to distinguish the
tion use code                                  number                                   location, type and/or use
                                                                                        of a telecommunication
                                                                                        number.

Telecommunica   HL7                 ORN        Other residence
tion use code                                  number
Telecommunica   HL7                 WPN        Work number
tion use code
Telecommunica   HL7                 VHN        Vacation home number
tion use code
Telecommunica   HL7                 ASN        Answering service
tion use code                                  number
                                                                                                                                                 Active - Is
                    Source - who is                                                                                             Required in
                                       Codes -                           Suggestions                                                             this field
   Subject          responsible for               Codes - Description                  Description   Rationale   Related To   which code sets
                                       values                            on coding?                                                              currently
                  maintaining code set                                                                                        (also see Tab 2)
                                                                                                                                                   used
Telecommunica     HL7                 EMR        Emergency number
tion use code
Telecommunica     HL7                 NET        Network (email)
tion use code                                    address
Telecommunica     HL7                 BPN        Beeper number
tion use code
Telecommunica     HL7                 PH         Telephone
tions equipment
Type

Telecommunica HL7                     FX         Fax
tions equipment
Type

Telecommunica HL7                     MD         Modem
tions equipment
Type

Telecommunica HL7                     CP         Cellular phone
tions equipment
Type

Telecommunica HL7                     BP         Beeper number
tions equipment
Type

Telecommunica HL7                     Internet   Internet address: use
tions equipment                                  only if
Type                                             telecommunication use
                                                 code is NET
Telecommunica HL7                     X.400      X.400 email address:
tions equipment                                  Use only if
Type                                             telecomunication use
                                                 code is NET
                                                                                                                                                                                         Active - Is
                 Source - who is                                                                                                                                        Required in
                                    Codes -                           Suggestions                                                                                                        this field
   Subject       responsible for               Codes - Description                        Description                        Rationale                   Related To   which code sets
                                    values                            on coding?                                                                                                         currently
               maintaining code set                                                                                                                                   (also see Tab 2)
                                                                                                                                                                                           used
Identifier Type User               AM         American Express                      This describes the type     Registries assign various identifiers.
                                                                                    or category of identifier   This allows the system to indicate
                                                                                    used.                       which is being used.

Identifier Type User               AN         Account Number

Identifier Type User               ANON       Anonymouse Identifier

Identifier Type User               BRO        Birth Registry Number

Identifier Type User               DI         Diner's Club Card

Identifier Type User               DL         Driver's License
                                              Number
Identifier Type User               DN         Doctor's Number

Identifier Type User               DS         Discover Card

Identifier Type User               EI         Employee Number

Identifier Type User               EN         Employer Number

Identifier Type User               FI         Facility Identifier

Identifier Type User               GI         Guarantee Internal
                                              Identifier
Identifier Type User               GN         Guarantee External
                                              Identifier
Identifier Type User               LN         License Number

Identifier Type User               LR         Local Registry ID

Identifier Type User               MS         MasterCard
                                                                                                                                             Active - Is
                 Source - who is                                                                                            Required in
                                    Codes -                          Suggestions                                                             this field
   Subject       responsible for               Codes - Description                 Description   Rationale   Related To   which code sets
                                    values                           on coding?                                                              currently
               maintaining code set                                                                                       (also see Tab 2)
                                                                                                                                               used
Identifier Type User               MA         Medicaid Number

Identifier Type User               MC         Medicare Number

Identifier Type User               MR         Medical Record
                                              Number
Identifier Type User               NET        National Employer
                                              Identifier
Identifier Type User               NH         National Health Plan
                                              Identifier
Identifier Type User               NI         Nationa Inique
                                              Idividual Identifier
Identifier Type User               NPI        National Provider
                                              Identifier
Identifier Type User               PI         Patient Internal
                                              Identifier
Identifier Type User               PN         Person Number

Identifier Type User               PRN        Provider Number

Identifier Type User               PT         Patient External
                                              Identifier
Identifier Type User               RRI        Regional Registry ID

Identifier Type User               RRI        Railroad Retirement
                                              Number
Identifier Type User               SL         State License

Identifier Type User               SR         State Registry ID

Identifier Type User               SS         Social Security
                                              Number
Identifier Type User               U          Unspecified
                                                                                                                                                                                        Active - Is
                   Source - who is                                                                                                                                     Required in
                                      Codes -                             Suggestions                                                                                                   this field
   Subject         responsible for               Codes - Description                          Description                     Rationale                 Related To   which code sets
                                      values                              on coding?                                                                                                    currently
                 maintaining code set                                                                                                                                (also see Tab 2)
                                                                                                                                                                                          used
Identifier Type User                 UPIN       Medicare/CMS's
                                                Universal Physician ID
                                                Numbers
Identifier Type User                 VS         VISA

Identifier Type User                 VN         Visit Number

Identifier Type User                 WC         WIC Identifier

Identifier Type User                 XX         Organization Identifier

Identifier Type NIP Suggested        VEI        Vaccinator Employee
                addition                        Number
Identifier Type NIP Suggested        OEI        Order Employee
                addition                        Number
Identifier Type NIP Suggested        REI        Recorder Employee
                addition                        Number
Organizational User                  A          Alias name                              This describes the type Registries may store various names
Name Type                                                                               or category of name for a for a provider organization. This
                                                                                        provider organization.    allows the system to indicate which
                                                                                                                  is being used.

Organizational   User                L          Legal Name
Name Type
Organizational   User                D          Display Name
Name Type
Organizational   User                SL         Stock exchange listing
Name Type                                       name
Processing       HL7                 A          Archive                                 A value that defines
mode                                                                                    whether the message is
                                                                                        part of an archival
                                                                                        process or an initial load.

Processing       HL7                 R          Restor from archive
mode
                                                                                                                                                                                            Active - Is
                   Source - who is                                                                                                                                         Required in
                                      Codes -                              Suggestions                                                                                                      this field
    Subject        responsible for               Codes - Description                           Description                       Rationale                  Related To   which code sets
                                      values                               on coding?                                                                                                       currently
                 maintaining code set                                                                                                                                    (also see Tab 2)
                                                                                                                                                                                              used
Processing       HL7                 I          Initial load
mode
Processing       HL7                 T          Current processing,
mode                                            transmitted at intervals
                                                (scheduled or on
                                                demand)
Processing       HL7                 <blank>    not present (The
mode                                            default, meaning
                                                current processing)
Query response User                  OK         Data found, no eror                      This allows a responding
status                                          (this is default)                        system to return a
                                                                                         precise response status.

Query response User                  NF         No data found, no
status                                          errors

Query response User                  AE         Application error
status

Query response User                  AR         Application reject
status

Alternative      HL7                 ASCII      The printable 7-bit                      Contains the character
character sets                                  ASCII character set                      set for the entire
                                                (This is the default if                  message.
                                                this field is omitted)
Nationality      User                CAN        Canada                                   This describes the         This establishes USA or other
                                                                                         country from which the     country as the patient's nationality.
                                                                                         patient came               This should be used in extended
                                                                                                                    adressess as well. Full ISO 3166
                                                                                                                    country codes set is available at:
                                                                                                                    ftp://ftp.ripe.net/iso3166-
                                                                                                                    countrycodes.txt

Nationality      User                MEX        Mexico
                                                                                                                                                                                          Active - Is
                Source - who is                                                                                                                                          Required in
                                   Codes -                              Suggestions                                                                                                       this field
    Subject     responsible for               Codes - Description                           Description                         Rationale                 Related To   which code sets
                                   values                               on coding?                                                                                                        currently
              maintaining code set                                                                                                                                     (also see Tab 2)
                                                                                                                                                                                            used
Nationality   User                USA        United States
Nationality   User                UMI        United States Minor
                                             Outlying Islands
Publicity Code User               01         No reminder/recall                       This indicates               This provides level of privacy
                                                                                      whether/which                requested by petient or parent
                                                                                      reminder/recall actions
                                                                                      may be used for the
                                                                                      patient
Publicity Code User               02         Reminder/recall - any
                                             method
Publicity Code User               03         Reminder/recall - no
                                             calls
Publicity Code User               04         Reminder only- any
                                             method
Publicity Code User               05         Reminder only- no
                                             calls
Publicity Code User               06         Recall only- any
                                             method
Publicity Code User               07         Recall only- no calls
Publicity Code User               08         Reminder/recall- to
                                             provider
Publicity Code User               09         Reminder to provider
Publicity Code User               10         Only reminder to
                                             provider, no recall
Publicity Code User               11         Recall to provider
Publicity Code User               12         Only recall to provider,
                                             no reminder
Living        User                A          Alone                                    This shows the situation     This information is useful for
arrangement                                                                           that the associated party    reminder/rcall, adverse evernts, or
                                                                                      or next of kin lives in at   other situations in which contacting
                                                                                      his or her residence.        the next of kin or other associated
                                                                                                                   party is important

Living        User                F          Family
arrangement
                                                                                                                                                                                    Active - Is
                   Source - who is                                                                                                                                 Required in
                                      Codes -                            Suggestions                                                                                                this field
   Subject         responsible for               Codes - Description                         Description                    Rationale               Related To   which code sets
                                      values                             on coding?                                                                                                 currently
                 maintaining code set                                                                                                                            (also see Tab 2)
                                                                                                                                                                                      used
Living           User                I          Institution
arrangement
Living           User                R          Relative
arrangement
Living           User                U          Unknown
arrangement
Living           User                S          Spouse only
arrangement
Living           User                W          with patient
arrangement
Living           User                N          not with patient
arrangement
Contact Reason   User                RR         NK1 is reminder/recall                 This variable describes This information is important with
                                                contact for                            the role of the next of    reminder/recall procedures, and
                                                immunization registry                  kin to that of the patient general patient care


Contact Reason User                  PC         NK1 is reponsible for
                                                patient care
                                                                                                                                                                                     Active - Is
                  Source - who is                                                                                                                                   Required in
                                     Codes -                          Suggestions                                                                                                    this field
   Subject        responsible for               Codes - Description                       Description                        Rationale               Related To   which code sets
                                     values                           on coding?                                                                                                     currently
                maintaining code set                                                                                                                              (also see Tab 2)
                                                                                                                                                                                       used
Manufacturers   MVX Code            AB         Abbot Laboratories                   This shows the              It was intended that a MVX code
of vaccine                                     (includes Ross                       manufacturer of the         would be paired with the code for
                                               Products Division )                  vaccine administered to     vaccine (code=CVX) and this pair
                                                                                    the patient in the          would indicate a specific vaccing,
                                                                                    immunization event.         i.e., brand name. (Note: see also
                                                                                    Developed by CDC, this      CVX code set)
                                                                                    code set assigned a two
                                                                                    letter (later three) code
                                                                                    to manufacturers existing
                                                                                    at the time. For purposes
                                                                                    of consistency in
                                                                                    maintaining accurate
                                                                                    historical immunization
                                                                                    records, the codes have
                                                                                    remained intact (or
                                                                                    additions made) while
                                                                                    the manufacturer names
                                                                                    have been updated (e.g.
                                                                                    due to mergers of
                                                                                    acquisitions) to show the
                                                                                    current names. Inactive
                                                                                    codes and pointers to
                                                                                    current codes are
                                                                                    indicated in brackets []
                                                                                    following the
                                                                                    manufacturer name.
                                                                                    Notes in italics indicate
                                                                                    predecessor organization




Manufacturers   MVX Code            ACA        Acambis, Inc
of vaccine
                                                                                                                                               Active - Is
                  Source - who is                                                                                             Required in
                                     Codes -                           Suggestions                                                             this field
   Subject        responsible for               Codes - Description                  Description   Rationale   Related To   which code sets
                                     values                            on coding?                                                              currently
                maintaining code set                                                                                        (also see Tab 2)
                                                                                                                                                 used
Manufacturers   MVX Code            AD         Adams Laboratories,
of vaccine                                     Inc.
Manufacturers   MVX Code            ALP        Alpha Therapeutic
of vaccine                                     Corporation
Manufacturers   MVX Code            AR         Armour [inactive use
of vaccine                                     ZLB]
Manufacturers   MVX Code            AVB        Aventis Behrig L.L.C.
of vaccine                                     (formerly Centeon
                                               L.L.C.;includes
                                               Armour
                                               Pharmaceutical
                                               Company ) [inactive
                                               use ZLB]

Manufacturers   MVX Code            AVI        Aviron
of vaccine
Manufacturers   MVX Code            BA         Baxter Healthcare
of vaccine                                     Corporation [inactive
                                               use BAH]
Manufacturers   MVX Code            BAH        Baxter Healthcare
of vaccine                                     Corporation (includes
                                               Hyland Immuno,
                                               Immuno International
                                               AG, and North
                                               American Vaccine,
                                               Inc. )
Manufacturers   MVX Code            BAY        Bayer Corporation
of vaccine                                     (includes Miles, Inc.
                                               and Cutter
                                               Laboratories )
Manufacturers   MVX Code            BP         Berna Products
of vaccine                                     [inactive use BPC]
                                                                                                                                                Active - Is
                  Source - who is                                                                                              Required in
                                     Codes -                            Suggestions                                                             this field
   Subject        responsible for               Codes - Description                   Description   Rationale   Related To   which code sets
                                     values                             on coding?                                                              currently
                maintaining code set                                                                                         (also see Tab 2)
                                                                                                                                                  used
Manufacturers   MVX Code            BPC        Berna Products
of vaccine                                     Corporation (includes
                                               Swiss Serum and
                                               Vaccine Institute
                                               Berne )
Manufacturers   MVX Code            BTP        Biotest
of vaccine                                     Pharmaceuticals
                                               Corporation (New
                                               owner of NABI HB as
                                               of December 2007,
                                               Does NOT replace
                                               NABI
                                               Biopharmaceuticals in
                                               this code list.) new
                                               June 3, 2009
Manufacturers   MVX Code            CNJ        Cangene Corporation
of vaccine
Manufacturers   MVX Code            CEN        Centeon L.L. C.
of vaccine                                     [inactive use ZLB]
Manufacturers   MVX Code            CHI        Chiron Corporation
of vaccine                                     [Inactive use NOV]
Manufacturers   MVX Code            CSL        CSL Biotherapies, Inc.
of vaccine
Manufacturers   MVX Code            CMP        Celltech Medeva
of vaccine                                     Pharmaceuticals
                                               [inactive use NOV]
Manufacturers   MVX Code            CON        Connaught [inactive
of vaccine                                     use PMC]
Manufacturers   MVX Code            DVC        DynPort Vaccine
of vaccine                                     Company, LLC
Manufacturers   MVX Code            EVN        Evans Medical Limited
of vaccine                                     [inactive use NOV]

Manufacturers   MVX Code            GEO        GeoVax Labs, Inc
of vaccine
                                                                                                                                                 Active - Is
                  Source - who is                                                                                               Required in
                                     Codes -                             Suggestions                                                             this field
   Subject        responsible for               Codes - Description                    Description   Rationale   Related To   which code sets
                                     values                              on coding?                                                              currently
                maintaining code set                                                                                          (also see Tab 2)
                                                                                                                                                   used
Manufacturers   MVX Code            GRE        Greer Laboratories,
of vaccine                                     Inc.
Manufacturers   MVX Code            IAG        Immuno International
of vaccine                                     AG [inactive use
                                               BAH]
Manufacturers   MVX Code            IM         Merieux [inactive use
of vaccine                                     PMC]
Manufacturers   MVX Code           INT         Intercell Biomedical
of vaccine
Manufacturers   MVX Code            IUS        Immuno-U.S.,Inc.
of vaccine
Manufacturers   MVX Code            JPN        The Research
of vaccine                                     Foundation for
                                               Microbial Diseases of
                                               Osaka University
                                               (BIKEN)
Manufacturers   MVX Code            KGC        Korea Green Corss
of vaccine                                     Corporationa
Manufacturers   MVX Code            LED        Lederle [inactive use
of vaccine                                     WAL]
Manufacturers   MVX Code            MA         Massachusetts Public
of vaccine                                     Health Biological
                                               Laboratories [inactive
                                               use MBL]
Manufacturers   MVX Code            MBL        Massachusetts
of vaccine                                     Biological Laboratories
                                               (formerly
                                               Massachusetts Public
                                               Health Biologic
                                               Laboraties )

Manufacturers   MVX Code            MED        MedImmune, Inc.
of vaccine
Manufacturers   MVX Code            MIL        Miles [inactive use
of vaccine                                     BAY]
                                                                                                                                                 Active - Is
                  Source - who is                                                                                               Required in
                                     Codes -                             Suggestions                                                             this field
   Subject        responsible for               Codes - Description                    Description   Rationale   Related To   which code sets
                                     values                              on coding?                                                              currently
                maintaining code set                                                                                          (also see Tab 2)
                                                                                                                                                   used
Manufacturers   MVX Code            MIP        BioPort Corporation
of vaccine                                     (formerly Michigan
                                               Biologic Products
                                               Institute )
Manufacturers   MVX Code            MSD        Merck & Co, Inc.
of vaccine
Manufacturers   MVX Code            NAB        NABI (formerly
of vaccine                                     Michigan Biologic
                                               Products Institute )
Manufacturers   MVX Code            NYB        New York Blood
of vaccine                                     Center
Manufacturers   MVX Code            NAV        North American
of vaccine                                     Vaccine, Inc. [inactive
                                               use BAH]
Manufacturers   MVX Code            NOV        Novartis
of vaccine                                     Pharmaceutical
                                               Corporation (includes
                                               Celltech Medeva
                                               Vaccines and Evans
                                               Medical Limited)

Manufacturers   MVX Code            NVX        Novavax, Inc
of vaccine
Manufacturers   MVX Code            OTC        Organon Teknika
of vaccine                                     Corporation
Manufacturers   MVX Code            ORT        Ortho-Clinical
of vaccine                                     Diagnostics (formerly
                                               Ortho Diagnostic
                                               Systems, Inc. )

Manufacturers   MVX Code            PD         Parkedale
of vaccine                                     Pharmaceuticals
                                               (formerly Parke-
                                               Davis )
                                                                                                                                                 Active - Is
                  Source - who is                                                                                               Required in
                                     Codes -                             Suggestions                                                             this field
   Subject        responsible for               Codes - Description                    Description   Rationale   Related To   which code sets
                                     values                              on coding?                                                              currently
                maintaining code set                                                                                          (also see Tab 2)
                                                                                                                                                   used
Manufacturers   MVX Code            PMC        Aventis Pasteur Inc.
of vaccine                                     (formerly Pasteur
                                               Merieux Connaught;
                                               includes Connaught
                                               Laboratories and
                                               Pasteur Merieux )
Manufacturers   MVX Code            PRX        Praxis Biologics
of vaccine                                     [inactive use WAL]
Manufacturers   MVX Code            PWJ        PowerJect
of vaccine                                     Pharmaceuticals
                                               (includes Celtech
                                               Medeva Vaccines and
                                               Evans Medical
                                               Limited ) [Inactive use
                                               NOV]
Manufacturers   MVX Code            SCL        Sclavo, Inc.
of vaccine
Manufacturers   MVX Code            SI         Swiss Serum and
of vaccine                                     Vaccine Inst. [inactive
                                               use BPC]
Manufacturers   MVX Code            SKB        GlaxoSmithKline
of vaccine                                     (formerly SmithKline
                                               Beecham; includes
                                               SmithKline Beecham
                                               and Glaxo Wellcome )
Manufacturers   MVX Code            SOL        Solvay Pharmaceuticals
of vaccine
Manufacturers   MVX Code            TAL        Talecris
of vaccine
Manufacturers   MVX Code            USA        United States Army
of vaccine                                     Medical Research and
                                               Material Command
Manufacturers   MVX Code            VXG        VaxGen
of vaccine
                                                                                                                                                                                       Active - Is
                  Source - who is                                                                                                                                     Required in
                                     Codes -                            Suggestions                                                                                                    this field
   Subject        responsible for               Codes - Description                         Description                       Rationale                Related To   which code sets
                                     values                             on coding?                                                                                                     currently
                maintaining code set                                                                                                                                (also see Tab 2)
                                                                                                                                                                                         used
Manufacturers   MVX Code            WA         Wyeth-Ayerst [inactive
of vaccine                                     use WAL]
Manufacturers   MVX Code            WAL        Wyeth-Ayerst
of vaccine                                     (includes Wyeth-
                                               Lederke Vaccines and
                                               Pediatrics, Wyeth
                                               Laboratories, Lederle
                                               Laboratories, and
                                               Praxis Biologics )

Manufacturers   MVX Code            ZLB        ZLB Behring (includes
of vaccine                                     Aventis Behring and
                                               Armour Pharmaceutical
                                               Company

Manufacturers   MVX Code            OTH        Other
of vaccine
Manufacturers   MVX Code            UNK        Unknown
of vaccine                                     Manufacturer
Census Tract    User                           For information about                  This variable identifies   This is useful in reminder/recall,
                                               identifying Census                     census tract of the        deduplication, analyzing and
                                               Tracts see                             patient at time of the     correcting returned mail, and other
                                               http://www.census.gov/                 immunization event         activities including Geographic
                                               geo/www/tractez.html                                              Information Systems (GIS). It
                                                                                                                 should be used in all extended
                                                                                                                 addresses for the patient
                                                                                                                                                                                               Active - Is
                  Source - who is                                                                                                                                             Required in
                                     Codes -                              Suggestions                                                                                                          this field
   Subject        responsible for               Codes - Description                              Description                         Rationale                 Related To   which code sets
                                     values                               on coding?                                                                                                           currently
                maintaining code set                                                                                                                                        (also see Tab 2)
                                                                                                                                                                                                 used
County/Parish   User                           A complete list of FIPS   According to      This information             This is useful in reminder/recall,
                                               6-4 county codes is       the FIPS          pinpoints blocks and         deduplication, analyzing and
                                               available at              guidelines, the   other geocode                correcting returned mail, and other
                                               www.itl.nist.gov/div89    2-letter state    characteristics. It should   activities such as Geographic
                                               7/pubs/fip6-4.htm         code plus the     be used in all extended      Information Systems. (GIS)
                                                                         numeric county    addresses for the patient
                                                                         code should be
                                                                         used.

Vaccine Type    CVX code            54         adenovirus, type 4                          Numerical code               Created to be used in conjunction
                                                                                           designating vaccine          with manufacturer (MVX) codeset
                                                                                           administered. Codes can      to specify a distinct vaccine.
                                                                                           indicate antigens, route     Multiple codes exist for different
                                                                                           of administration, dose      formulations and dosages of a single
                                                                                           schedule and age             vaccine type.
                                                                                           formulation.

Vaccine Type    CVX code            55         adenovirus, type .7                         Code indicating which
                                                                                           vaccine is being
                                                                                           recorded
Vaccine Type    CVX code            82         adenovirus, NOS
Vaccine Type    CVX code            24         Anthrax
Vaccine Type    CVX code            19         BCG
Vaccine Type    CVX code            27         botulinum antitoxin
Vaccine Type    CVX code            26         Cholera
Vaccine Type    CVX code            29         CMVIG
Vaccine Type    CVX code            56         Dengue fever
Vaccine Type    CVX code            12         diptheria antitoxin
Vaccine Type    CVX code            28         DT (pediatric)
Vaccine Type    CVX code            20         DTaP
Vaccine Type    CVX code            106        DTaP, 5 pertussis
                                               antigen
Vaccine Type    CVX code            107        DTaP, NOS
Vaccine Type    CVX code            50         DTaP-Hib
Vaccine Type    CVX code            110        DTaP-Hep B-IPV
                                                                                                                                              Active - Is
                 Source - who is                                                                                             Required in
                                    Codes -                           Suggestions                                                             this field
   Subject       responsible for               Codes - Description                  Description   Rationale   Related To   which code sets
                                    values                            on coding?                                                              currently
               maintaining code set                                                                                        (also see Tab 2)
                                                                                                                                                used
Vaccine Type   CVX code            120        DTaP-Hib-IPV
Vaccine Type   CVX code            130        Dtap-IPV
Vaccine Type   CVX code                  132 DTAP-IPV-HIB-HEP B,
                                             historical



Vaccine Type   CVX code            01         DTP
Vaccine Type   CVX code            22         DTP-Hib
Vaccine Type   CVX code            102        DTP-Hib-HepB
Vaccine Type   CVX code            57         hantavirus
Vaccine Type   CVX code            52         Hep A, adult
Vaccine Type   CVX code            83         Hep A, ped/adol, 2
                                              dose
Vaccine Type   CVX code            84         Hep A, ped/adol, 3
                                              dose
Vaccine Type   CVX code            31         Hep A, pediatric, NOS

Vaccine Type   CVX code            85         Hep A, NOS
Vaccine Type   CVX code            104        Hep A- Hep B
Vaccine Type   CVX code            30         HBIG
Vaccine Type   CVX code            08         Hep B, adolescent or
                                              pediatric
Vaccine Type   CVX code            42         Hep B, adolescent
                                              /high risk infant
Vaccine Type   CVX code            43         Hep B, adult
Vaccine Type   CVX code            44         Hep B, dialysis
Vaccine Type   CVX code            45         Hep B, NOS
Vaccine Type   CVX code            58         Hep C
Vaccine Type   CVX code            59         Hep E
Vaccine Type   CVX code            60         herpes simplex 2
Vaccine Type   CVX code            46         Hib (PRP-D)
Vaccine Type   CVX code            47         Hib (HbOC)
Vaccine Type   CVX code            48         Hib (PRP-T)
Vaccine Type   CVX code            49         Hib (PRP-OMP)
Vaccine Type   CVX code            17         Hib, NOS
                                                                                                                                                             Active - Is
                 Source - who is                                                                                                            Required in
                                    Codes -                             Suggestions                                                                          this field
   Subject       responsible for               Codes - Description                          Description          Rationale   Related To   which code sets
                                    values                              on coding?                                                                           currently
               maintaining code set                                                                                                       (also see Tab 2)
                                                                                                                                                               used
Vaccine Type   CVX code            51         Hib-Hep B
Vaccine Type   CVX code            61         HIV
Vaccine Type   CVX code            118        HPV, bivalent
Vaccine Type   CVX code            62         HPV,quadrivalent
Vaccine Type   CVX code            86         IG
Vaccine Type   CVX code            87         IGIV
Vaccine Type   CVX code            14         IG, NOS
Vaccine Type   CVX code            111        Influenza, live,
                                              intranasal
Vaccine Type   CVX code            15         influenza, split (incl.
                                              purified surface
                                              antigen)
Vaccine Type   CVX code            16         influenza, whole
Vaccine Type   CVX code            88         influenza, NOS
Vaccine Type   CVX code            123        influenza, 1203                         influenza virus vaccine,
                                                                                      H5N1,A/Viewtname/120
                                                                                      3/2004 (national
                                                                                      stockpile)
Vaccine Type   CVX code            10         IPV
Vaccine Type   CVX code            02         OPV
Vaccine Type   CVX code            89         polio, NOS
Vaccine Type   CVX code            39         Japanese encephalitis-
                                              SC
Vaccine Type   CVX code                  134 Japanese Encephalitis-IM

Vaccine Type   CVX code            63         Junin virus
Vaccine Type   CVX code            64         leishmaniasis
Vaccine Type   CVX code            65         leprosy
Vaccine Type   CVX code            66         Lyme disease
Vaccine Type   CVX code            03         MMR
Vaccine Type   CVX code            04         M/R
Vaccine Type   CVX code            94         MMRV
Vaccine Type   CVX code            67         malaria
Vaccine Type   CVX code            05         measles
Vaccine Type   CVX code            68         melanoma
                                                                                                                                               Active - Is
                 Source - who is                                                                                              Required in
                                    Codes -                            Suggestions                                                             this field
   Subject       responsible for               Codes - Description                   Description   Rationale   Related To   which code sets
                                    values                             on coding?                                                              currently
               maintaining code set                                                                                         (also see Tab 2)
                                                                                                                                                 used
Vaccine Type   CVX code            32         meningococcal(MPSV
                                              4)
Vaccine Type   CVX code            103        meningococcal C
                                              conjugate
Vaccine Type   CVX code            114        meningococcal
                                              (MCV4)
Vaccine Type   CVX code            108        meningococcal, NOS
Vaccine Type   CVX code            07         mumps
Vaccine Type   CVX code            69         parainfluenza-3
Vaccine Type   CVX code            11         pertussis
Vaccine Type   CVX code            23         plague
Vaccine Type   CVX code            33         pneumococcal-
                                              polysaccharide
Vaccine Type   CVX code                  133 Pneumococcal, PCV-13

Vaccine Type   CVX code            100        pneumococcal PCV7
Vaccine Type   CVX code            109        pneumococcal, NOS
Vaccine Type   CVX code            70         Q fever
Vaccine Type   CVX code            18         rabies, intramuscular
                                              injection
Vaccine Type   CVX code            40         rabies, intradermal
                                              injection
Vaccine Type   CVX code            90         rabies, NOS
Vaccine Type   CVX code            72         rheumatic fever
Vaccine Type   CVX code            73         Rift Valley fever
Vaccine Type   CVX code            34         RIG
Vaccine Type   CVX code            119        rotavirus, monovalent
Vaccine Type   CVX code            122        rotavirus,NOS
Vaccine Type   CVX code            116        rotavirus, pentavalent
Vaccine Type   CVX code            74         rotavirus
Vaccine Type   CVX code            71         RSV-IGIV
Vaccine Type   CVX code            93         RSV-Mab
Vaccine Type   CVX code            06         rubella
Vaccine Type   CVX code            38         rubella/mumps
Vaccine Type   CVX code            75         smallpox (vaccinia)
                                                                                                                                                              Active - Is
                 Source - who is                                                                                                             Required in
                                    Codes -                             Suggestions                                                                           this field
   Subject       responsible for               Codes - Description                          Description           Rationale   Related To   which code sets
                                    values                              on coding?                                                                            currently
               maintaining code set                                                                                                        (also see Tab 2)
                                                                                                                                                                used
Vaccine Type   CVX code            105        smallpox, diluted
Vaccine Type   CVX code            76         Staphylococcus
                                              bacterio lysate
Vaccine Type   CVX code            09         Td
Vaccine Type   CVX code            113        Td, preservative free
Vaccine Type   CVX code            115        Tdap
Vaccine Type   CVX code            35         tetanus toxoid
Vaccine Type   CVX code            112        tetanus toxoid, NOS
Vaccine Type   CVX code            77         tick-borne encephalitis

Vaccine Type   CVX code            13         TIG
Vaccine Type   CVX code            95         TST-OT tine test
Vaccine Type   CVX code            96         TST-PPD intradermal

Vaccine Type   CVX code            97         TST-PPD tine test
Vaccine Type   CVX code            98         TST, NOS
Vaccine Type   CVX code            78         tularemia vaccine
Vaccine Type   CVX code            25         typhoid, oral
Vaccine Type   CVX code            41         typhoid parenteral
Vaccine Type   CVX code            53         typhoid, parenteral,
                                              AKD (U.S. Military)
Vaccine Type   CVX code            101        typhoid, ViCPs
Vaccine Type   CVX code            91         typhoid, NOS
Vaccine Type   CVX code                  131 Typhus, historical
Vaccine Type   CVX code            79         vaccinia immune                         see smallpox for vaccinia
                                              globulin                                vaccine
Vaccine Type   CVX code            21         varicella
Vaccine Type   CVX code            81         VEE, inactivated
Vaccine Type   CVX code            80         VEE, live
Vaccine Type   CVX code            92         VEE, NOS
Vaccine Type   CVX code            36         VZIG
Vaccine Type   CVX code            117        VZIG (IND)
Vaccine Type   CVX code            37         yellow fever
Vaccine Type   CVX code            121        Zoster
                                                                                                                                                                                 Active - Is
                 Source - who is                                                                                                                                Required in
                                    Codes -                          Suggestions                                                                                                 this field
   Subject       responsible for               Codes - Description                        Description                   Rationale                Related To   which code sets
                                    values                           on coding?                                                                                                  currently
               maintaining code set                                                                                                                           (also see Tab 2)
                                                                                                                                                                                   used
Vaccine Type   CVX code            998        no vaccine
                                              administered
Vaccine Type   CVX code            999        unknown
Vaccine Type   CVX code            99         RESERVED - do not
                                              use
Language       User                ASE        America Sign                         This is the patient's   This information is important for
                                              Language                             primary language        communication with the patient or
                                                                                                           parents, including recall/reminder,
                                                                                                           consent, adverse events, health
                                                                                                           promotion, and similar situations

Language       User                Ar         Arabic
Language       User                Hy         Armenian
Language       User                Bn         Bengali
Language       User                Km         Cambodian
Language       User                CJD        Chamorro
Language       User                YUH        Chinese, Cantonese
Language       User                zh         Chinese, Mandarin
Language       User                hr         Croatian
Language       User                cs         Czech
Language       User                nl         Dutch
Language       User                en         English
Language       User                fa         Farsi (Persian)
Language       User                fr         French
Language       User                de         German
Language       User                el         Greek
Language       User                hi         Hindi
Language       User                BLU        Hmong
Language       User                hu         Hungarian
Language       User                ILO        Ilocano
Language       User                id         Indonesian
Language       User                it         Italian
Language       User                ja         Japanese
Language       User                ko         Korean
Language       User                lo         Loatian
                                                                                                                                                                                           Active - Is
                 Source - who is                                                                                                                                          Required in
                                    Codes -                              Suggestions                                                                                                       this field
   Subject       responsible for               Codes - Description                            Description                       Rationale                  Related To   which code sets
                                    values                               on coding?                                                                                                        currently
               maintaining code set                                                                                                                                     (also see Tab 2)
                                                                                                                                                                                             used
Language       User                pl         Polish
Language       User                pt         Portuguese
Language       User                ro         Romanian
Language       User                ru         Russian
Language       User                sm         Samoan
Language       User                sr         Serbian
Language       User                sk         Slovak
Language       User                so         Somali
Language       User                es         Spanish
Language       User                tl         Tagalog
Language       User                th         Thai
Language       User                to         Tongan
Language       User                uk         Ukranian
Language       User                ur         Urdu
Language       User                vi         Vietnamese
Language       User                yi         Yiddish
Language       User                OTH        Other (must add text
                                              component of the CE
                                              field with description)

CN ID Source   User                                                     use in all XCN Used to delineate the       Because patient identifiers are not
                                                                        data types     first component of an       universal, it is necessary to further
                                                                                       XCN identifier (ID)         qualify an ID number by either
                                                                                                                   identifying what kind of ID number
                                                                                                                   it is (Source ID) or the assigning
                                                                                                                   authority.
Namespace ID   User                                                  use in all EL,
                                                                     HD data types
Universal ID   HL7                 DNS        An internet dotted      use in HD data Describes the type of         Immediately useful for routing in
                                              name - either in ASCII       types     name given in the             sites where an interface engine is in
                                              or as integers                         sending                       place. Will be greater importance to
                                                                                     application/facility and      implement for national data sharing
                                                                                     receiving                     schema.
                                                                                     application/facility fields
                                                                                     in the MSH
                                                                                                                                                 Active - Is
                 Source - who is                                                                                                Required in
                                    Codes -                              Suggestions                                                             this field
   Subject       responsible for               Codes - Description                     Description   Rationale   Related To   which code sets
                                    values                               on coding?                                                              currently
               maintaining code set                                                                                           (also see Tab 2)
                                                                                                                                                   used
Universal ID   HL7                 GUID       Same as UUID
Universal ID   HL7                 HCD        The CEN Healthcare
                                              Coding Scheme
                                              Designator. (Identifiers
                                              used in DICOM follow
                                              this assignment
                                              scheme)
Universal ID   HL7                 HL7        Reserved for HL7
                                              registration schemes
Universal ID   HL7                 ISO        An internation
                                              Standard Organization
                                              Object Identifier

Universal ID   HL7                 L,M,N      These are reserved for
                                              locally defined coding
                                              schemes
Universal ID   HL7                 Random     Usually a base64
                                              encoded string of
                                              random bits. The
                                              uniqueness depends on
                                              the length of the bits.
                                              Mail systems often
                                              generate ASCII string
                                              "unique names," from a
                                              combination of random
                                              bits and system names.
                                              Obviously, such
                                              identifiers will not be
                                              contrained to the
                                              base64 character set.



Universal ID   HL7                 UUID       The DCE Universal
                                              Unique Identifier
                                                                                                                                                                            Active - Is
                 Source - who is                                                                                                                           Required in
                                    Codes -                            Suggestions                                                                                          this field
   Subject       responsible for               Codes - Description                        Description                    Rationale     Related To        which code sets
                                    values                             on coding?                                                                                           currently
               maintaining code set                                                                                                                      (also see Tab 2)
                                                                                                                                                                              used
Universal ID   HL7                 x400       An X.400 MHS format
                                              identifier
Universal ID   HL7                 x500       An X.500 directory
                                              name
Completion     HL7                 CP         Complete                               Describes whether       Research.               However, RXA-
Status                                                                               vaccination attempt was                         21 Action code,
                                                                                     completed, and if not,                          determines
                                                                                     status.                                         whether shot is
                                                                                                                                     added to registry

Completion     HL7                 RE         Refused
Status
Completion     HL7                 NA         Not Administered
Status
Completion     HL7                 PA         Partially Administered
Status
                                                                                                                                                                                           Active - Is
                Source - who is                                                                                                                                           Required in
                                   Codes -                         Suggestions                                                                                                             this field
    Subject     responsible for              Codes - Description                       Description                         Rationale                    Related To      which code sets
                                   values                          on coding?                                                                                                              currently
              maintaining code set                                                                                                                                      (also see Tab 2)
                                                                                                                                                                                             used
Action Code   HL7                 A          Add                                 Identies the action the      This field will determine the
                                                                                 project should take when     appropriate action the receiving
                                                                                 receiving the complete       project should take. There are
                                                                                 message                      variations on how the project will
                                                                                                              act on this values though. A Delete
                                                                                                              in one project may mean complete
                                                                                                              emlimination of any information
                                                                                                              from this system, while another
                                                                                                              may only "flag' it as deleted. What
                                                                                                              isn't clear is if a message comes in
                                                                                                              with only some fields completed,
                                                                                                              does the delete related to only that
                                                                                                              information provided or the whole
                                                                                                              record? Before transmitting these
                                                                                                              values to a project outside your
                                                                                                              system, business rules should be
                                                                                                              discussed to ensure the appropriate
                                                                                                              action is being taken.



Action Code   HL7                 D       Delete
Action Code   HL7                 U       Update
Message       HL7                 ADT A01 A01, A04, A05, A08,                    A variable used to define    It is used by receiving systems to to   Triggering
Structure                                 A13, A14, A28, A31                     the inbound data in an       recongize, parse and route the          events used to
                                                                                 electronic feed. It          message data. Primarily used in         automate
                                                                                 clarifies the type of data   Health Level 7 messaging                transmission of
                                                                                 and purpose of the           approaches                              an electronic
                                                                                 inbound information                                                  transaction

Message       HL7                 ADT A02 A02, A21, A22, A23,
Structure                                 A25, A26, A27, A29,
                                          A32, A33
Message       HL7                 ADT A30 A30, A34, A35, A36,
Structure                                 A46, A47, A48, A49
                                                                                                                                                 Active - Is
                  Source - who is                                                                                               Required in
                                     Codes -                             Suggestions                                                             this field
    Subject       responsible for               Codes - Description                    Description   Rationale   Related To   which code sets
                                     values                              on coding?                                                              currently
                maintaining code set                                                                                          (also see Tab 2)
                                                                                                                                                   used
Message         HL7                 VXQ V01 V01
Structure
Message         HL7                 VXR V03 V03
Structure
Message         HL7                 VXU V04 V04
Structure
Message         HL7                 VXX V02 V02
Structure
Message         HL7                 ORU R01 R01
Structure
Alternate       HL7                 ISO 2022- This standard titled
Character set                       1994      "Information
handling                                      Technology-Character
scheme                                        Code Structure and
                                              Extension Technique."
                                              This standard specifies
                                              an escape sequence
                                              from basic one byte
                                              character set to
                                              specified other
                                              character set, and vice
                                              versa. The escape
                                              sequence explicitly
                                              specifies what alternate
                                              character set is to be
                                              evoked ... This value is
                                              allowed only for HL7
                                              v.2.3.1
                                                                                                                                                             Active - Is
                  Source - who is                                                                                                           Required in
                                     Codes -                             Suggestions                                                                         this field
    Subject       responsible for               Codes - Description                          Description         Rationale   Related To   which code sets
                                     values                              on coding?                                                                          currently
                maintaining code set                                                                                                      (also see Tab 2)
                                                                                                                                                               used
Alternate       HL7                 2.3        The character set
Character set                                  switching mode
handling                                       specified in HL7 2.3,
scheme                                         sections 2.8.28.6.1 and
                                               2.9.2. Note that the
                                               escape sequences used
                                               in this mode are "HL7
                                               escape sequences" as
                                               defined in HL7 2.3,
                                               section 2.9 and do not
                                               use the ASCII
                                               "esc"character, as
                                               defined in ISO 2022-
                                               1994

Alternate       HL7                 <null>   This is default,
Character set                                indicating that there is
handling                                     no character set
scheme                                       switching occuring in
                                             this message
Message Error   Success             0-       Success. Optional, as                     This code reports what
Status Codes                        Message the AA conveys this.                       caused the receiving
                                    accepted Used for systems that                     system to error off for
                                             must always return a                      the specified message.
                                             status code
Message Error   Error Status        100-     The message segments
Status Codes                        Segment were not in the proper
                                    sequence order or required
                                    error    segments are missing

Message Error   Error Status        101-     A required field is
Status Codes                        Required missing from the
                                    Field    segment
                                    Missing
                                                                                                                                                  Active - Is
                  Source - who is                                                                                                Required in
                                     Codes -                              Suggestions                                                             this field
   Subject        responsible for               Codes - Description                     Description   Rationale   Related To   which code sets
                                     values                               on coding?                                                              currently
                maintaining code set                                                                                           (also see Tab 2)
                                                                                                                                                    used
Message Error   Error Status        102-Data The field contained
Status Codes                        type error data of the wrong data
                                               type, e.g., an NM field
                                               contained letters of the
                                               alphabet
Message Error   Error Status        103-Table A field of data type ID
Status Codes                        value not or IS was compared
                                    found      against the
                                               corresponding table,
                                               and no match was
                                               found
Message Error   Rejection Status    200-       The Message type is
Status Codes                        Unsupoor not supported
                                    ted
                                    Message
                                    Type
Message Error   Rejection Status    201-       The Event code is not
Status Codes                        Unsuppor supported
                                    ted Event
                                    Code

Message Error   Rejection Status    202-       The Processing ID is
Status Codes                        Unsuppor   not supported
                                    ted
                                    Process
                                    ID
Message Error   Rejection Status    203-       The Version ID is not
Status Codes                        Unsuppor   supported
                                    ted
                                    version
                                    ID
                                                                                                                                                                  Active - Is
                  Source - who is                                                                                                                Required in
                                     Codes -                              Suggestions                                                                             this field
   Subject        responsible for                 Codes - Description                         Description         Rationale      Related To    which code sets
                                     values                               on coding?                                                                              currently
                maintaining code set                                                                                                           (also see Tab 2)
                                                                                                                                                                    used
Message Error   Rejection Status    204        The ID of the patient,
Status Codes                        Unknown    order, etc. was not
                                    Key        found. Used for
                                    Identifier transactions other than
                                               additions, e.g. transfer
                                               of a non-existent
                                               patient
Message Error   Rejection Status    205-       The ID of the patient,
Status Codes                        Duplicate order, etc. already
                                    key        exists. Used in
                                    identifier response to addition
                                               transactions (Admit,
                                               New Order, etc.)

Message Error   Rejection Status    206-      The transaction could
Status Codes                        Applicati not be performed at the
                                    on record application storage
                                    locked    level, e.g. database
                                              locked.
Message Error   Rejection Status    207-      A catchall for internal
Status Codes                        Applicati errors not explicitly
                                    on        covered by other codes.
                                    Internal
                                    Error
Degree          User                PN        Advanced Practice            See col E    Used to describe the                  Provider
                                              Nurse                                     academic setting of the               charactertiscs
                                                                                        person adminstering the
                                                                                        vaccine
Degree          User                AA           Associate of Arts
Degree          User                AS           Associate of Science
Degree          User                BA           Bachelor of Arts
Degree          User                BN           Bachelor of Nursing
Degree          User                BS           Bachelor of Science
Degree          User                BSN          Bachelor of Science in
                                                 Nursing
                                                                                                                                            Active - Is
               Source - who is                                                                                             Required in
                                  Codes -                           Suggestions                                                             this field
   Subject     responsible for               Codes - Description                  Description   Rationale   Related To   which code sets
                                  values                            on coding?                                                              currently
             maintaining code set                                                                                        (also see Tab 2)
                                                                                                                                              used
Degree       User                CER        Certificate
Degree       User                CANP       Certified Adult Nurse
                                            Practitioner
Degree       User                CMA        Certified Medical
                                            Assistant
Degree       User                CNP        Certified Nurse
                                            Practitioner
Degree       User                CNM        Certified Nurse
                                            Midwife
Degree       User                CAN        Certified Nurse's
                                            Assistant
Degree       User                CRN        Certified Registered
                                            Nurse
Degree       User                CNS        Certified Nurse
                                            Specialist
Degree       User                CPNP       Certified Pediatric
                                            Nurse Practitioner
Degree       User                DIP        Diploma
Degree       User                PHD        Doctor of Philosophy

Degree       User                MD         Doctor of Medicine
Degree       User                DO         Doctor of Osteopathy

Degree       User                EMT        Emergency Medical
                                            Technician
Degree       User                EMT-P      Emergency Medical
                                            Technician-Paramedic
Degree       User                FPNP       Family Practice Nurse
                                            Practitioner
Degree       User                HS         High School Graduate
Degree       User                JD         Juris Doctor
Degree       User                LPN        Licensed Practical
                                            Nurse
Degree       User                MA         Master of Arts
                                                                                                                                                          Active - Is
                Source - who is                                                                                                          Required in
                                   Codes -                             Suggestions                                                                        this field
   Subject      responsible for               Codes - Description                         Description         Rationale   Related To   which code sets
                                   values                              on coding?                                                                         currently
              maintaining code set                                                                                                     (also see Tab 2)
                                                                                                                                                            used
Degree        User                MBA        Master of Business
                                             Administration
Degree        User                MPH        Master of Public
                                             Health
Degree        User                MS         Master of Science
Degree        User                MSN        Master of Science-
                                             Nursing
Degree        User                MDA        Medical Assistant
Degree        User                MT         Medical Technician
Degree        User                NG         Non-Graduate
Degree        User                NP         Nurse Practitioner
Degree        User                PharmD     Doctor of Pharmacy
Degree        User                PA         Physician Assistant
Degree        User                PHN        Public Health Nurse
Degree        User                RMA        Registered Medical
                                             Assistant
Degree        User                RN         Registered Nurse
Degree        User                RPH        Registered Pharmacist

Degree        User                SEC        Secretarial Certificate
Degree        User                TS         Trade School Graduate

Coding System User                99zzz or   Local general code                      Describes which coding
                                  L          (where z is an                          system was used in the
                                             alphanumeric                            segment.
                                             character)
Coding System User                ART        WHO adverse reaction
                                             terms
Coding System User                C4         CPT-4

Coding System User                C5         CPT-5

Coding System User                CDCA       CDC Analyte Codes
                                                                                                                                               Active - Is
                Source - who is                                                                                               Required in
                                   Codes -                             Suggestions                                                             this field
   Subject      responsible for               Codes - Description                    Description   Rationale   Related To   which code sets
                                   values                              on coding?                                                              currently
              maintaining code set                                                                                          (also see Tab 2)
                                                                                                                                                 used
Coding System User                CDCM       CDC
                                             Methods/Instruments
                                             Codes
Coding System User                CDS        CDC Surveillance

Coding System User                CPTM       CPT Modifier Code

Coding System User                CST        COSTART

Coding System User                CVX        CDC Vaccine Codes

Coding System User                E          EUCLIDES

Coding System User                E5         Euclides quantity codes

Coding System User                E6         Euclides Lab method
                                             codes
Coding System User                E7         Euclides Lab
                                             equipment codes
Coding System User                ENZC       Enzyme codes

Coding System User                HB         HIBCC

Coding System User                HCPCS      HCFA Common
                                             Procedure Codes
                                             (HCPCS)
Coding System User                HHC        Home Health Care

Coding System User                HL7nnnn HL7 Defined Codes
                                          where nnnn is the HL7
                                          table number
Coding System User                HPC     HCFA Procedure codes
                                          (HCPCS)
Coding System User                I10     ICD-10
                                                                                                                                              Active - Is
                Source - who is                                                                                              Required in
                                   Codes -                            Suggestions                                                             this field
   Subject      responsible for               Codes - Description                   Description   Rationale   Related To   which code sets
                                   values                             on coding?                                                              currently
              maintaining code set                                                                                         (also see Tab 2)
                                                                                                                                                used
Coding System User                I10P       ICD-10 Procedure
                                             Codes
Coding System User                I9         ICD9

Coding System User                I9C        ICD-9CM

Coding System User                ISOnnnn ISO defined codes
                                          where nnnn is the ISO
                                          table number
Coding System User                LB      Local billing code

Coding System User                LN         Logical Observation
                                             Identifier Names and
                                             Codes (LOINC)
Coding System User                MCD        Medicaid

Coding System User                MCR        Medicare

Coding System User                MEDR       Medical Dictionary for
                                             Drug Regulatory
                                             Affairs (MEDDRA)
Coding System User                MVX        CDC Vaccine
                                             Manufacturer Codes
Coding System User                NDC        National Drug codes

Coding System User                NPI        National Provider
                                             Identifier
Coding System User                SNM        Systemized
                                             Nomenclature of
                                             Medicine
Coding System User                SNM3       SNOMED
                                             International
Coding System User                SNT        SNOMED topology
                                             codes (anatomic sites)
                                                                                                                                            Active - Is
                Source - who is                                                                                            Required in
                                   Codes -                          Suggestions                                                             this field
   Subject      responsible for               Codes - Description                 Description   Rationale   Related To   which code sets
                                   values                           on coding?                                                              currently
              maintaining code set                                                                                       (also see Tab 2)
                                                                                                                                              used
Coding System User                UML        Unified Medical
                                             Language
Coding System User                UPC        Universal Product
                                             Code
Coding System User                UPIN       UPIN

Coding System User                W1         WHO record # drug
                                             codes (6 digit)
Coding System User                W2         WHO record # drug
                                             codes (8 digit)
Coding System User                W4         WHO record # code
                                             with ASTM extension

Coding System User                WC         WHO ATC
                                                                                                                                                                                                 Active - Is
               Source - who is                                                                                                                                                  Required in
                                  Codes -                              Suggestions                                                                                                               this field
   Subject     responsible for               Codes - Description                           Description                        Rationale                     Related To        which code sets
                                  values                               on coding?                                                                                                                currently
             maintaining code set                                                                                                                                             (also see Tab 2)
                                                                                                                                                                                                   used
Immunization User                A          Active                                   is a ranking term used to   This indicates whether the patient       See AIRA                               Yes
Registry Status                                                                      describe a standing of      is, for example, active or inactive in   document
                                                                                     the individual in           the IIS, or Moved-Or-Gone-               titled:AIRA
                                                                                     reference to the level of   Elsewhere. It is important to track      Modeling of
                                                                                     immunization tracking       this variable at the provider and the    Immunization
                                                                                     activity at a provider or   geographic juristicational level.        Registry
                                                                                     geographic jurisdiction     These definations are at the             Operations
                                                                                     level.                      provider level. Please see the AIRA      Workgroup
                                                                                                                 document on this subject for further     (eds).
                                                                                                                 details.                                 Management of
                                                                                                                                                          Moved or Gone
                                                                                                                                                          Elsewhere
                                                                                                                                                          (MOGE) Status
                                                                                                                                                          and Other
                                                                                                                                                          Patient
                                                                                                                                                          Designations in
                                                                                                                                                          Immunization
                                                                                                                                                          Information
                                                                                                                                                          Systems. Atlanta,
                                                                                                                                                          GA: American
                                                                                                                                                          Immunization
                                                                                                                                                          Registry
                                                                                                                                                          Association.
                                                                                                                                                          December, 2005.




Immunization User                I          Inactive
Registry Status

Immunization User                L          Inactive-Lost to follow-
Registry Status                             up (cannot contact)
                                                                                                                                                                                          Active - Is
                   Source - who is                                                                                                                                       Required in
                                      Codes -                             Suggestions                                                                                                     this field
    Subject        responsible for               Codes - Description                          Description                       Rationale                 Related To   which code sets
                                      values                              on coding?                                                                                                      currently
                 maintaining code set                                                                                                                                  (also see Tab 2)
                                                                                                                                                                                            used
Immunization User                    M          Inactive-Moved or
Registry Status                                 gone elsewhere
                                                (transferred)
Immunization User                    P          Inactive-Permanently
Registry Status                                 inactive (do not re-
                                                activate or add new
                                                entries to this record)
Immunization User                    O          Other/unsepecified
Registry Status

Immunization User                    U          Unknown
Registry Status

Name/address     HL7                 I          Ideographic (e.g.                       alphabetic coding
representation                                  Kanji)                                  scheme to record words.

Name/address     HL7                 A          Alphabetic (e.g.
representation                                  Default or some single-
                                                byte)
Name/address     HL7                 P          Phonetic (e.g. ASCII,
representation                                  Katakana, Hirigana,
                                                etc.)
Immunization     NIP-defined         00         New immunization                        This indicates where the   This information enables an
information                                     record                                  historical vaccination     accurate and complete vaccination
source                                                                                  information cam from.      history, and thus allows planning
                                                                                        This may repeat.           for continuation and completion of
                                                                                                                   vaccination. Use of this information
                                                                                                                   may vary with state or local laws,
                                                                                                                   rules, or regulations.

Immunization     NIP-defined         01         Historical information-
information                                     source unspecified
source
                                                                                                                                                                                         Active - Is
                   Source - who is                                                                                                                                      Required in
                                      Codes -                             Suggestions                                                                                                    this field
    Subject        responsible for               Codes - Description                          Description                      Rationale                 Related To   which code sets
                                      values                              on coding?                                                                                                     currently
                 maintaining code set                                                                                                                                 (also see Tab 2)
                                                                                                                                                                                           used
Immunization     NIP-defined         02         Historical information-
information                                     from other provider
source
Immunization     NIP-defined         03         Historical information-
information                                     from parent's written
source                                          record

Immunization     NIP-defined         04         Historical information-
information                                     from parent's recall
source
Immunization     NIP-defined         05         Historical information-
information                                     from other registry
source
Immunization     NIP-defined         06         Historical information-
information                                     from birth certificate
source
Immunization     NIP-defined         07         Historical information-
information                                     from school record
source
Immunization     NIP-defined         08         Historical information-
information                                     from public agency
source
Substance        NIP-defined         00         Parental decision                       This indicates the reason This enables and accurate historical
refusal reason                                                                          the patient or parent     vaccination record, including
                                                                                        refused the vaccine       documentation of decision not to
                                                                                                                  vaccinate by patient or parent

Substance        NIP-defined         01         Religious exemption
refusal reason
Substance        NIP-defined         02         Other (must add text
refusal reason                                  component of the CE
                                                field with description)

Substance        NIP-defined         03         Patient decision
refusal reason
                                                                                                                                                          Active - Is
                Source - who is                                                                                                          Required in
                                   Codes -                             Suggestions                                                                        this field
   Subject      responsible for               Codes - Description                          Description        Rationale   Related To   which code sets
                                   values                              on coding?                                                                         currently
              maintaining code set                                                                                                     (also see Tab 2)
                                                                                                                                                            used
Observation   NIP-defined (Dose   30936-9    DTAP/DTP dose count                     describes what kind of
identifiers   Number for                     in combination vaccine                  observation is being
              Combination                                                            made in this OBX
              Vaccines)
Observation   NIP-defined (Dose   30937-7    Heptatis B dose count
identifiers   Number for                     in combination vaccine
              Combination
              Vaccines)
Observation   NIP-defined (Dose   30938-5    Haemophilus Influenza
identifiers   Number for                     B dose count in
              Combination                    combination vaccine
              Vaccines)
Observation   NIP-defined (Dose   30939-3    Measles dose count in
identifiers   Number for                     combination vaccine
              Combination
              Vaccines)
Observation   NIP-defined (Dose   30940-1    MMR dose count in
identifiers   Number for                     combination vaccine
              Combination
              Vaccines)
Observation   NIP-defined (Dose   30941-9    Mumps dose count in
identifiers   Number for                     combination vaccin
              Combination
              Vaccines)
Observation   NIP-defined (Dose   30942-7    Rubella dose count in
identifiers   Number for                     combination vaccine
              Combination
              Vaccines)
Observation   NIP-defined (Dose   30943-5    Varicella does count in
identifiers   Number for                     combination vaccine
              Combination
              Vaccines)
                                                                                                                                                      Active - Is
                Source - who is                                                                                                      Required in
                                   Codes -                                 Suggestions                                                                this field
   Subject      responsible for                  Codes - Description                        Description   Rationale   Related To   which code sets
                                   values                                  on coding?                                                                 currently
              maintaining code set                                                                                                 (also see Tab 2)
                                                                                                                                                        used
Observation   NIP-defined             30946-8   Vaccination
identifiers   (Contraindications,               contraindication/precau
              Precautions, and                  tion effective date
              Immunities)
Observation   NIP-defined             30944-3   Vaccination temporary
identifiers   (Contraindications,               contraindication/precau
              Precautions, and                  tion expiration date
              Immunities)
Observation   NIP-defined             30945-0   Vaccination temporary NIP-defined
identifiers   (Contraindications,               contraindication/precau Table NIP004
              Precautions, and                  tion
              Immunities)
Observation   NIP-defined             31044-1   Reaction                  Locally Defined
identifiers   (Contraindications,
              Precautions, and
              Immunities)
Observation   NIP-defined (Vaccine    29768-9   Date vaccine
identifiers   Infromation Statement             Information Statement
              Dates)                            Published

Observation   NIP-defined (Vaccine 29769-7      Date Vaccine
identifiers   Infromation Statement             Information Statement
              Dates)                            Presented

Observation   NIP-defined             30979-9   Vaccines due next         HL70292
identifiers   (Vaccines Due Date)
Observation   NIP-defined             30980-7   Date vaccine due
identifiers   (Vaccines Due Date)
Observation   NIP-defined             30973-2   Vaccine due next dose
identifiers   (Vaccines Due Date)               number
Observation   NIP-defined             30981-5   Earliest date to give
identifiers   (Vaccines Due Date)
                                                                                                                                                   Active - Is
                Source - who is                                                                                                   Required in
                                   Codes -                               Suggestions                                                               this field
   Subject      responsible for                Codes - Description                       Description   Rationale   Related To   which code sets
                                   values                                on coding?                                                                currently
              maintaining code set                                                                                              (also see Tab 2)
                                                                                                                                                     used
Observation   NIP-defined           30982-3   Reason applied by         Codes for
identifiers   (Vaccines Due Date)             forecast logic to project forecast logic
                                              this vaccine              reason locally
                                                                        defined
Observation   NIP-defined (Vaccine 30947-6    Date form completed
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30948-4    Vaccination adverse         NIP-defined
identifiers   Adverse Event                   event(s)(symptoms,         Table NIP005
              Reporting System                signs, time course) and
                                              treatment if any
Observation   NIP-defined (Vaccine 30949-2    Vaccination adverse
identifiers   Adverse Event                   event outcome
              Reporting System

Observation   NIP-defined (Vaccine 30950-0    Number of days            HL7 table
identifiers   Adverse Event                   hospitalized due to       HL70136
              Reporting System                vaccination adverse
                                              event
Observation   NIP-defined (Vaccine 30951-8    Patient revocered
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30952-6    Date and time of
identifiers   Adverse Event                   vaccination
              Reporting System

Observation   NIP-defined (Vaccine 30953-4    Vaccination adverse
identifiers   Adverse Event                   event onset date and
              Reporting System                time
                                                                                                                                              Active - Is
                Source - who is                                                                                              Required in
                                   Codes -                            Suggestions                                                             this field
   Subject      responsible for               Codes - Description                   Description   Rationale   Related To   which code sets
                                   values                             on coding?                                                              currently
              maintaining code set                                                                                         (also see Tab 2)
                                                                                                                                                used
Observation   NIP-defined (Vaccine 30954-2   Relevant diagnostic
identifiers   Adverse Event                  tests/laboratory data
              Reporting System

Observation   NIP-defined (Vaccine 30955-9   All vaccines given on
identifiers   Adverse Event                  date listed in no. 10
              Reporting System

Observation   NIP-defined (Vaccine 30956-7   Vaccine type            HL7 table
identifiers   Adverse Event                                          HL70292
              Reporting System

Observation   NIP-defined (Vaccine 30957-5   Vaccine manufacturer    HL7 table
identifiers   Adverse Event                                          HL70227
              Reporting System

Observation   NIP-defined (Vaccine 30959-1   Lot
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30958-3   Vaccine route           HL7 table
identifiers   Adverse Event                                          HL70162
              Reporting System

Observation   NIP-defined (Vaccine 31034-2   Vaccine site            HL7 table
identifiers   Adverse Event                                          HL70163
              Reporting System

Observation   NIP-defined (Vaccine 30960-9   Number of previous
identifiers   Adverse Event                  doses
              Reporting System
                                                                                                                                                 Active - Is
                Source - who is                                                                                                 Required in
                                   Codes -                               Suggestions                                                             this field
   Subject      responsible for               Codes - Description                      Description   Rationale   Related To   which code sets
                                   values                                on coding?                                                              currently
              maintaining code set                                                                                            (also see Tab 2)
                                                                                                                                                   used
Observation   NIP-defined (Vaccine 30961-7   any other vaccination
identifiers   Adverse Event                  within 4 weeks prior to
              Reporting System               the date listed in no. 10

Observation   NIP-defined (Vaccine 30956-7   Vaccine Type                 HL7 table
identifiers   Adverse Event                                               HL70292
              Reporting System

Observation   NIP-defined (Vaccine 30957-5   Vaccine manufacturer         HL7 table
identifiers   Adverse Event                                               HL70227
              Reporting System

Observation   NIP-defined (Vaccine 30959-1   Lot number
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30958-3   Vaccine route                HL7 table
identifiers   Adverse Event                                               HL70162
              Reporting System

Observation   NIP-defined (Vaccine 31034-2   Vaccine site                 HL7 table
identifiers   Adverse Event                                               HL70163
              Reporting System

Observation   NIP-defined (Vaccine 30960-9   number of previous
identifiers   Adverse Event                  doses
              Reporting System

Observation   NIP-defined (Vaccine 31035-9   date given
identifiers   Adverse Event
              Reporting System
                                                                                                                                                 Active - Is
                Source - who is                                                                                                 Required in
                                   Codes -                             Suggestions                                                               this field
   Subject      responsible for               Codes - Description                      Description   Rationale   Related To   which code sets
                                   values                              on coding?                                                                currently
              maintaining code set                                                                                            (also see Tab 2)
                                                                                                                                                   used
Observation   NIP-defined (Vaccine 30962-5   Vaccinated at             NIP table NIP
identifiers   Adverse Event                                                 007
              Reporting System

Observation   NIP-defined (Vaccine 30963-3   Vaccine purchased           NIP table
identifiers   Adverse Event                  with                        NIP008
              Reporting System

Observation   NIP-defined (Vaccine 30964-1   Other medications
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30965-8   Illness present at time
identifiers   Adverse Event                  of vaccination
              Reporting System

Observation   NIP-defined (Vaccine 30966-6   Pre-existing physician
identifiers   Adverse Event                  diagnosed allergies,
              Reporting System               birth defects, medical
                                             conditions

Observation   NIP-defined (Vaccine 30967-4   adverse event reported
identifiers   Adverse Event                  previously
              Reporting System

Observation   NIP-defined (Vaccine 30968-2   Adverse event
identifiers   Adverse Event                  following prior
              Reporting System               vaccination in patient

Observation   NIP-defined (Vaccine 30971-6   adverse event
identifiers   Adverse Event
              Reporting System
                                                                                                                                              Active - Is
                Source - who is                                                                                              Required in
                                   Codes -                            Suggestions                                                             this field
   Subject      responsible for               Codes - Description                   Description   Rationale   Related To   which code sets
                                   values                             on coding?                                                              currently
              maintaining code set                                                                                         (also see Tab 2)
                                                                                                                                                used
Observation   NIP-defined (Vaccine 30972-4   onset age
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30956-7   vaccine type              HL7 table
identifiers   Adverse Event                                            HL70292
              Reporting System

Observation   NIP-defined (Vaccine 30973-2   dose number in series
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30969-0   adverse event
identifiers   Adverse Event                  following prior
              Reporting System               vaccination in brother

Observation   NIP-defined (Vaccine 30971-6   adverse event
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30972-4   onset age
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30956-7   Vaccine type              HL7 table
identifiers   Adverse Event                                            HL70292
              Reporting System

Observation   NIP-defined (Vaccine 30973-2   dose number in series
identifiers   Adverse Event
              Reporting System
                                                                                                                                                  Active - Is
                Source - who is                                                                                                  Required in
                                   Codes -                              Suggestions                                                               this field
   Subject      responsible for               Codes - Description                       Description   Rationale   Related To   which code sets
                                   values                               on coding?                                                                currently
              maintaining code set                                                                                             (also see Tab 2)
                                                                                                                                                    used
Observation   NIP-defined (Vaccine 30970-8   adverse event
identifiers   Adverse Event                  following prior
              Reporting System               vaccination in sister

Observation   NIP-defined (Vaccine 30971-6   adverse event
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30972-4   onset age
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 30956-7   vaccine type                HL7 table
identifiers   Adverse Event                                              HL70292
              Reporting System

Observation   NIP-defined (Vaccine 30973-2   dose number in series
identifiers   Adverse Event
              Reporting System

Observation   NIP-defined (Vaccine 8339-4    Birth weight at birth      HL7 Figure 7-
identifiers   Adverse Event                                             11 ANSI+unit
              Reporting System                                              codes

Observation   NIP-defined (Vaccine 30974-0   Number of brothers
identifiers   Adverse Event                  and sisters
              Reporting System

Observation   NIP-defined (Vaccine 3075-7    Manufacturer/immuniz
identifiers   Adverse Event                  ation project report no.
              Reporting System
                                                                                                                                                                                         Active - Is
                 Source - who is                                                                                                                                        Required in
                                    Codes -                           Suggestions                                                                                                        this field
   Subject       responsible for               Codes - Description                        Description                      Rationale                  Related To      which code sets
                                    values                            on coding?                                                                                                         currently
               maintaining code set                                                                                                                                   (also see Tab 2)
                                                                                                                                                                                           used
Observation    NIP-defined (Vaccine 30976-5   date received by
identifiers    Adverse Event                  manufacturer/immuniza
               Reporting System               tion project

Observation    NIP-defined (Vaccine 30977-3   15 days report           HL7 table
identifiers    Adverse Event                                           HL70136
               Reporting System

Observation    NIP-defined (Vaccine 30978-1   Report type              NIP table
identifiers    Adverse Event                                           NIP010
               Reporting System

Observation    AIRA/NIP            46249-9    VACCINATION                           Allows messaging of                                             NIP011 take
identifiers                                   TAKE-RESPONSE                         smallpox take response                                          response values
                                              TYPE
Observation    AIRA/NIP            46250-7     VACCINATION                          Allows messaging of
identifiers                                   TAKE-RESPONSE                         smallpox take read date
                                              DATE
Contraindicatio NIP-defined        01         recipient condition-                  Provides list of known    The explanations include advice
ns, Precautions,                              unspecified                           patient conditions        against vaccination
and Immunities                                                                      together with             (contraindications), use of caution
                                                                                    explanation and           in considering vaccination
                                                                                    Advisory Committee on     (precautions), and consideration of
                                                                                    Immunization Practice     immunities in vaccination.
                                                                                    recommendations           Explanations are summarized from
                                                                                                              Appendix A of the January 2002
                                                                                                              Epidemiology and Prevention of
                                                                                                              Vaccine-Preventable Diseases.

Contraindicatio NIP-defined        02         household condition-
ns, Precautions,                              unspecified
and Immunities
                                                                                                                                                 Active - Is
                 Source - who is                                                                                                Required in
                                    Codes -                              Suggestions                                                             this field
   Subject       responsible for               Codes - Description                     Description   Rationale   Related To   which code sets
                                    values                               on coding?                                                              currently
               maintaining code set                                                                                           (also see Tab 2)
                                                                                                                                                   used
Contraindicatio NIP-defined        03         allergy to baker's yeast
ns, Precautions,                              (anaphylactic)
and Immunities


Contraindicatio NIP-defined        04         allergy to egg ingestion
ns, Precautions,                              (anaphylactic)
and Immunities


Contraindicatio NIP-defined        05         allergy to gelatin
ns, Precautions,                              (anaphylactic)
and Immunities


Contraindicatio NIP-defined        06         allergy to neomycin
ns, Precautions,                              (anaphylactic)
and Immunities


Contraindicatio NIP-defined        07         allergy to streptomycin
ns, Precautions,                              (anaphylactic)
and Immunities


Contraindicatio NIP-defined        08         allergy to thimerosal
ns, Precautions,                              (anaphylactic)
and Immunities
                                                                                                                                                 Active - Is
                 Source - who is                                                                                                Required in
                                    Codes -                              Suggestions                                                             this field
   Subject       responsible for               Codes - Description                     Description   Rationale   Related To   which code sets
                                    values                               on coding?                                                              currently
               maintaining code set                                                                                           (also see Tab 2)
                                                                                                                                                   used
Contraindicatio NIP-defined        09         allergy to previous
ns, Precautions,                              dose of this vaccine or
and Immunities                                to any of it unlisted
                                              vaccine components
                                              (anaphylactic)

Contraindicatio NIP-defined        10         anaphylactic (life-
ns, Precautions,                              threatening) reaction to
and Immunities                                previous dose of this
                                              vaccine or any of its
                                              components
Contraindicatio NIP-defined        11         collapse or shock like
ns, Precautions,                              state within 48 hours of
and Immunities                                previous dose of
                                              DTP/DTaP

Contraindicatio NIP-defined        12         convulsions (fits,
ns, Precautions,                              seizures) within 72
and Immunities                                hours of previous dose
                                              of DTP/DTaP

Contraindicatio NIP-defined        13         persistent, inconsolable
ns, Precautions,                              crying >= 3 hours
and Immunities                                within 48 hours of
                                              previous dose of
                                              DTP/DTaP
Contraindicatio NIP-defined        14         current diarrhea,
ns, Precautions,                              moderate to severe
and Immunities
                                                                                                                                                Active - Is
                 Source - who is                                                                                               Required in
                                    Codes -                             Suggestions                                                             this field
   Subject       responsible for               Codes - Description                    Description   Rationale   Related To   which code sets
                                    values                              on coding?                                                              currently
               maintaining code set                                                                                          (also see Tab 2)
                                                                                                                                                  used
Contraindicatio NIP-defined        15         encephalopathy within
ns, Precautions,                              7 days of previous dose
and Immunities                                of DTP or DTaP


Contraindicatio NIP-defined        16         current fever with
ns, Precautions,                              moderate-to-severe
and Immunities                                illness


Contraindicatio NIP-defined        17         fever of >=40.5C
ns, Precautions,                              (105F) within 48 hours
and Immunities                                of previus dose of
                                              DTP/DTaP

Contraindicatio NIP-defined        18        Guillain-Barre
ns, Precautions,                             syndrome (GBS)
and Immunities                               within 6 weeks of
                                             previous dose of
                                             DTP/DTaP
Contraindicatio NIP-defined        19        HIV infection (in
ns, Precautions,                   [inactive household contact)
and Immunities                     use 36]


Contraindicatio NIP-defined        20        HIV infection (in
ns, Precautions,                   [inactive recipient)
and Immunities                     use 36]
                                                                                                                                                 Active - Is
                 Source - who is                                                                                                Required in
                                    Codes -                              Suggestions                                                             this field
   Subject       responsible for               Codes - Description                     Description   Rationale   Related To   which code sets
                                    values                               on coding?                                                              currently
               maintaining code set                                                                                           (also see Tab 2)
                                                                                                                                                   used
Contraindicatio NIP-defined        21         current acute illenss,
ns, Precautions,                              moderate to severe
and Immunities                                (with or without fever)
                                              (e.g. diarrhea, otitis
                                              media, vomiting)

Contraindicatio NIP-defined        22         chronic illness (e.g.
ns, Precautions,                              chronic gastrointestinal
and Immunities                                disease)


Contraindicatio NIP-defined        23         recent or simultaneous
ns, Precautions,                              administration of an
and Immunities                                antibody-containing
                                              blood product (immune
                                              globulin)

Contraindicatio NIP-defined        24         immunity:diptheria
ns, Precautions,
and Immunities


Contraindicatio NIP-defined        25         immunity:
ns, Precautions,                              Haemophilus influenza
and Immunities                                type B (Hib)


Contraindicatio NIP-defined        26         immunity: hepatitis B
ns, Precautions,
and Immunities
                                                                                                                                             Active - Is
                 Source - who is                                                                                            Required in
                                    Codes -                          Suggestions                                                             this field
   Subject       responsible for               Codes - Description                 Description   Rationale   Related To   which code sets
                                    values                           on coding?                                                              currently
               maintaining code set                                                                                       (also see Tab 2)
                                                                                                                                               used
Contraindicatio NIP-defined        27         immunity: measles
ns, Precautions,
and Immunities


Contraindicatio NIP-defined        28         immunity: mumps
ns, Precautions,
and Immunities


Contraindicatio NIP-defined        29         immunity: pertussis
ns, Precautions,
and Immunities


Contraindicatio NIP-defined        30         immunity: poliovirus
ns, Precautions,
and Immunities


Contraindicatio NIP-defined        31         immunity: rubella
ns, Precautions,
and Immunities


Contraindicatio NIP-defined        32         immunity: tetanus
ns, Precautions,
and Immunities


Contraindicatio NIP-defined        33         immunity: varicella
ns, Precautions,
and Immunities
                                                                                                                                                Active - Is
                 Source - who is                                                                                               Required in
                                    Codes -                             Suggestions                                                             this field
   Subject       responsible for               Codes - Description                    Description   Rationale   Related To   which code sets
                                    values                              on coding?                                                              currently
               maintaining code set                                                                                          (also see Tab 2)
                                                                                                                                                  used
Contraindicatio NIP-defined        34        immunideficiency
ns, Precautions,                   [inactive (family history)
and Immunities                     use 36]


Contraindicatio NIP-defined        35        immunideficiency
ns, Precautions,                   [inactive (household contact)
and Immunities                     use 36]


Contraindicatio NIP-defined        36         immunodeficiency due
ns, Precautions,                              to any cause, including
and Immunities                                HIV (hematologic and
                                              solid tumors,
                                              congential
                                              immunodeficiency,
                                              long-term
                                              immunosuppressive
                                              therapy, including
                                              steroids)

Contraindicatio NIP-defined        37         underlying unstable,
ns, Precautions,                              evolving neurologic
and Immunities                                disorders, (including
                                              seizure disorders,
                                              cerebral palsy, and
                                              developmental delay)
Contraindicatio NIP-defined        38         otitis media (ear
ns, Precautions,                              infection) moderate to
and Immunities                                severe (with or without
                                              fever)
                                                                                                                                                                             Active - Is
                 Source - who is                                                                                                                            Required in
                                    Codes -                              Suggestions                                                                                         this field
   Subject       responsible for               Codes - Description                            Description                    Rationale       Related To   which code sets
                                    values                               on coding?                                                                                          currently
               maintaining code set                                                                                                                       (also see Tab 2)
                                                                                                                                                                               used
Contraindicatio NIP-defined        39         pregnancy (in
ns, Precautions,                              recipient)
and Immunities


Contraindicatio NIP-defined        40         thromboctopenia
ns, Precautions,
and Immunities


Contraindicatio NIP-defined        41         thrombocytopenic
ns, Precautions,                              pupura (history)
and Immunities


Contraindicatio NIP-defined        42         other
ns, Precautions,                              contraindication/precau
and Immunities                                tion/immunity not
                                              listed (must add text
                                              component of the CE
                                              field with description)

Contraindicatio NIP-defined        43         Unknown (valid only
ns, Precautions,                              for historical
and Immunities                                immunization)


Event          NIP-defined         D          Patient died               NIP table 005 Describes the outcome      question 8 on VAERS form
Consequences                                                                           of an event, generally a
                                                                                       negative event.
Event          NIP-defined         L          Life threatening illness
Consequences
Event          NIP-defined         E          Required emergency
Consequences                                  room/doctor visit
                                                                                                                                                                                  Active - Is
                   Source - who is                                                                                                                               Required in
                                      Codes -                            Suggestions                                                                                              this field
    Subject        responsible for               Codes - Description                        Description                   Rationale               Related To   which code sets
                                      values                             on coding?                                                                                               currently
                 maintaining code set                                                                                                                          (also see Tab 2)
                                                                                                                                                                                    used
Event            NIP-defined         H          Required
Consequences                                    hospitalization
                                                (indicate # of days in
                                                another OBX segment)

Event            NIP-defined         P          Resulted in
Consequences                                    prolongation of
                                                hospitalization
Event            NIP-defined         J          Resulted in permanent
Consequences                                    disability
Event            NIP-defined         O          None of the above
Consequences
Patient Registry Table is inactive              Use User-defined Table
Status                                          0441

Vaccination      NIP-defined         PVT        Private doctor's                       Type of location where Research and VAERS response
location                                        office/hospital                        vaccine administered for
                                                                                       VAERS reporting only.


                                     PUB        Public Health
                                                Clinic/Hospital
                                     MIL        Military
                                                Clinic/Hospital
                                     WRK        Workplace
                                     OTH        Other
                                     UNK        Unknown
Vaccine          NIP-defined         PVF        Private funds                          Vaccine purchased by   To support on-line order process
purchase with                                                                          physician              direct to distributor (VMBIP) and
                                                                                                              VAERS analysis
Vaccine          NIP-defined         PBF        Public funds                           Vaccine purchased by   To support on-line order process,
purchase with                                                                          VFC program            VAERS, and to maintain inventory
                                                                                                              management for VFC stock
                                                                                                                                                                                            Active - Is
                  Source - who is                                                                                                                                          Required in
                                     Codes -                           Suggestions                                                                                                          this field
   Subject        responsible for               Codes - Description                           Description                      Rationale                    Related To   which code sets
                                     values                            on coding?                                                                                                           currently
                maintaining code set                                                                                                                                     (also see Tab 2)
                                                                                                                                                                                              used
Vaccine         NIP-defined         MLF        Military Funds                          Vaccine purchased by       To support on-line order process
purchase with                                                                          military                   direct to distributor and VAERS
Vaccine         NIP-defined         OTH        Other                                   Vaccine purchased by
purchase with                                                                          other sources; requires
                                                                                       NTE
Reported        NIP-defined         N          No                                      VAERS status               for VAERS analysis
adverse event
previously
Reported        NIP-defined         D          To doctor
adverse event
previously
Reported        NIP-defined         H          To health department
adverse event
previously
Reported        NIP-defined         M          To manufacturer
adverse event
previously
Report Type     NIP-defined         I          Initial                                 Indicates the type of
                                                                                       report being sent
Report Type     NIP-defined         F          Follow-up
Smallpox take   AIRA/NIP            1          Major take                                                         Used in OBX to record take              NIP003
response                                                                                                          response
Smallpox take   AIRA/NIP            2          Equivocal
response
Smallpox take   AIRA/NIP            3          Not available
response
Vaccine Lot                                                           This is a sample This is the lot number of This information is used in recall, or
Number                                                                of a lot number the administered            adverse events.
                                                                      500018P          vaccine(s), as shown on
                                                                                       the vaccine vial, syringe,
                                                                                       or box. This is allowed
                                                                                       to repeat.
                                                                                                                                                                                         Active - Is
                   Source - who is                                                                                                                                      Required in
                                      Codes -                               Suggestions                                                                                                  this field
    Subject        responsible for               Codes - Description                             Description                     Rationale               Related To   which code sets
                                      values                                on coding?                                                                                                   currently
                 maintaining code set                                                                                                                                 (also see Tab 2)
                                                                                                                                                                                           used
Vaccination                                                                This is an      This is the date and time The date and time format provides
Date                                                                       example of a    of an event               the highest degree of specificity
                                                                           time stamp                                available
                                                                           199705221605
                                                                           it represents
                                                                           May 22, 1997
                                                                           at 4:05 p.m.
Patient Birth                                                              This is an      This is the date and time The date and time format provides
Date                                                                       example of a    of an event               the highest degree of specificity
                                                                           time stamp                                available
                                                                           199705221605
                                                                           it represents
                                                                           May 22, 1997
                                                                           at 4:05 p.m.
Patient Birth                                   The complete set of US     This is an      Shows state and ountry   This is useful in forming and
State, Country                                  state abbreviations can    example of      in which patient was     directing queries for immunization
                                                be found at:               patient birth   born                     records as well as patient
                                                http://www.usps.com/n      state and                                identification, deduplication, and
                                                csc/lookups/usps_abbre     country codes                            remind/recall
                                                viations.html . The        CA US
                                                complete set of country
                                                codes can be found at:
                                                http//www.iso.org/iso/e
                                                n/prods-
                                                services/iso3166ma/02i
                                                so-3166-code-lists/list-
                                                en1.html
                                                                                                                                                                                            Active - Is
                    Source - who is                                                                                                                                        Required in
                                       Codes -                          Suggestions                                                                                                         this field
    Subject         responsible for              Codes - Description                           Description                        Rationale                 Related To   which code sets
                                       values                           on coding?                                                                                                          currently
                  maintaining code set                                                                                                                                   (also see Tab 2)
                                                                                                                                                                                              used
Vaccine                                                                This is an        This is the date after  Together with other information,
Expiration Date                                                        example of an     which the vaccine/batch this enables management of
                                                                       expiration date   must not be used        vaccine, and patient scheduling
                                                                       20061231 It
                                                                       represent
                                                                       December 31,
                                                                       2006
Vaccination                                                            The dose       This is the dose number Some vaccine require several
Dose Number                                                            number is      of a vaccine, or a         vaccinations to comlete a series.
                                                                       recorded as an combination vaccine        This is important in adverse events
                                                                       integer                                   and reminder/recall. This ensures
                                                                                                                 accurate records
Patient Birth                                                          The number is This is a number            In cases of multiple birth, this
Order                                                                  recorded as an representing the patient's information may be of valie in
                                                                       integer        order of birth             reminder/recall; adverse events;
                                                                                                                 contraindications, precautions, and
                                                                                                                 immunities, and deduplication.

Patient                                                                This number is    This is a number            Taken together with the type of
Medicaid                                                               recorded as       assigned to the patient     identifier, this number may indicate
Number                                                                 configured by     for medicaid purposes       eligibility for services, and
                                                                       the issuing                                   deduplication.
                                                                       entity
Patient Birth                                                          The number is     This is a number            Taken together with the type of
Registration                                                           recorded as       assigned to the patient     identifier, this number may assist
Number                                                                 configured by     by state for birth record   with identification, and
                                                                       the issuing       puposes                     deduplication
                                                                       entity
Mother's Social                                                        The number is     This is a number is     Taken together with the type of
Security                                                               recorded as       assigned by the Social  identifier, and/or linked with the
Number                                                                 configured by     Security Administration patient birth registration number,
                                                                       the issuing                               this number may assist with the
                                                                       entity                                    patient's identification,
                                                                                                                 dedpulication, recall/reminder, and
                                                                                                                 adverse events.
                                                                                                                                                                                        Active - Is
                    Source - who is                                                                                                                                    Required in
                                       Codes -                          Suggestions                                                                                                     this field
    Subject         responsible for              Codes - Description                         Description                      Rationale                 Related To   which code sets
                                       values                           on coding?                                                                                                      currently
                  maintaining code set                                                                                                                               (also see Tab 2)
                                                                                                                                                                                          used
Father's Social                                                        The number is   This is a number        Taken together with the type of
Security                                                               recorded as     assigned by the Social  identifier (usually in the next-of-kin
Number                                                                 configured by   Security Administration field), this number may assist with
                                                                       the issuing                             the patient's identification,
                                                                       entity                                  deduplication, reminder/recall, and
                                                                                                               adverse events
                                           definitions
                                           page cells                         implementation
change date   changed by   type change     when changed change                guide updated
                                                            add small pox
                           add new data                     take read
     10/2/2006 R Savage    sets and values      748,749,807 elements
                           add new data                     add new
    11/20/2006 R Savage    values          table 0292       vaccines
                           add new data                     add new
    11/20/2006 R Savage    values          table 0227       manufacturers
                                                            add
                                                            manufacturers
                                                            and update
                                                            those that have
                                                            been replaced
      1/5/2007 R Savage    add new data    table 0227       by others.
                                                            add note
                                                            re:requesting
                                                            new data
      2/7/2007 R Savage    Update intro    intro tab        elements

                           add new data
      7/9/2007 R Savage    and correct data table 0292
                                                            add CSL (new
                                                            manufacturer),
                                            tables 0227,    influenza, 1203
    10/15/2007 R Savage    add new data     0292            (new vaccine)
                                                            add ACA, new
      4/4/2008 R Savage    add new data     table 0027      manufacturer
                           update NVAC                      updated NVAC
      5/2/2008 R Savage    info             Req for Org tab table
                                                            add new
     7/28/2008 R Savage    add new data                     vaccines
                                                            add new
                           add new data                     vaccines and
      5/5/2009 R Savage    and correct data                 mvx codes
      6/3/2009 R Savage    add new data                     mvx code
Note that
changes are
highlighted

				
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Description: Printable 2009 W4 Form document sample