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18.8.157 RXO - Pharmacy/Treatment Order Segment (4A.4.1)

This is the "master" pharmacy/treatment order segment. It contains order data not specific to components or additives. Unlike the OBR, it does not contain status fields or other data that are results-only.

It can be used for any type of pharmacy order, including inpatient (unit dose and compound unit dose), outpatient, IVs, and hyperalimentation IVs (nutritional IVs), as well as other non-pharmacy treatments, e.g., respiratory therapy, oxygen, and many nursing treatments.

In addition to the pharmaceutical/treatment information, this segment contains additional data such as provider and text comments.

A quantity/timing field is not needed in the RXO segment. The ORC segment contains the requested ORC-7-quantity/timing of the original order which does not change as the order is encoded, dispensed, or administered.

HL7 Attribute Table - RXO - Pharmacy/Treatment Order

Base Framework
Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData Type
RXO

100292Requested Give Code
C

Condition defined for this element

MAY[0..1] RequestedGiveCode (CD)
CWE

Coded with Exceptions


200293Requested Give Amount - Minimum
C

Condition defined for this element

MAY[0..1] 
NM

Numeric

300294Requested Give Amount - Maximum MAY[0..1] 
NM

Numeric


400295Requested Give Units
C

Condition defined for this element

MAY[0..1] RequestedGiveUnits (CD)
CWE

Coded with Exceptions


500296Requested Dosage Form
C

Condition defined for this element

MAY[0..1] RequestedDosageForm (CD)
CWE

Coded with Exceptions

600297Provider's Pharmacy/Treatment Instructions MAY[0..*] Provider'sPharmacy/TreatmentInstructions (CD)
CWE

Coded with Exceptions

700298Provider's Administration Instructions MAY[0..*] Provider'sAdministrationInstructions (CD)
CWE

Coded with Exceptions

800299Deliver-To Location
W

withdrawn Element

SHOULD NOT   
900300Allow Substitutions MAY[0..1][1..1]univ: AllowSubstitution (CD) hl7VS-allowSubstitution (VS) allowSubstitution (CS)
ID

Coded Value for HL7 Defined Tables

1000301Requested Dispense Code MAY[0..1] RequestedDispenseCode (CD)
CWE

Coded with Exceptions

1100302Requested Dispense Amount MAY[0..1] 
NM

Numeric

1200303Requested Dispense Units MAY[0..1] RequestedDispenseUnits (CD)
CWE

Coded with Exceptions

1300304Number Of Refills
=

Truncation not allowed!

MAY[0..1] 3
NM

Numeric

1400305Ordering Provider's DEA Number
W

withdrawn Element

SHOULD NOT  
XCN

Extended Composite ID Number and Name for Persons


1500306Pharmacist/Treatment Supplier's Verifier ID
C

Condition defined for this element

MAY[0..*] 
XCN

Extended Composite ID Number and Name for Persons

1600307Needs Human Review MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables


1700308Requested Give Per (Time Unit)
C

Condition defined for this element

=

Truncation not allowed!

MAY[0..1] 20
ST

String Data

1801121Requested Give Strength MAY[0..1] 
NM

Numeric

1901122Requested Give Strength Units MAY[0..1] RequestedGiveStrengthUnits (CD)
CWE

Coded with Exceptions

2001123Indication MAY[0..*] Indication (CD)
CWE

Coded with Exceptions

2101218Requested Give Rate Amount
=

Truncation not allowed!

MAY[0..1] 6
ST

String Data

2201219Requested Give Rate Units MAY[0..1] RequestedGiveRateUnits (CD)
CWE

Coded with Exceptions

2300329Total Daily Dose MAY[0..1] 
CQ

Composite Quantity with Units

2401476Supplementary Code MAY[0..*] SupplementaryCode (CD)
CWE

Coded with Exceptions

2501666Requested Drug Strength Volume
=

Truncation allowed.

MAY[0..1] 5
NM

Numeric

2601667Requested Drug Strength Volume Units MAY[0..1] RequestedDrugStrengthVolumeUnits (CD)
CWE

Coded with Exceptions

2701668Pharmacy Order Type MAY[0..1][1..1]univ: PharmacyOrderTypes (CD) hl7VS-pharmacyOrderTypes (VS) pharmacyOrderTypes (CS)
ID

Coded Value for HL7 Defined Tables

2801669Dispensing Interval MAY[0..1] 
NM

Numeric

2902149Medication Instance Identifier MAY[0..1] 
EI

Entity Identifier

3002150Segment Instance Identifier MAY[0..1] 
EI

Entity Identifier


3102151Mood Code
C

Condition defined for this element

MAY[0..1] univ: MoodCodes (CD) hl7VS-moodCodes (VS) actMood (CS)
CNE

Coded with No Exceptions

3201681Dispensing Pharmacy
B

backward compatible use only

SHOULD NOT  DispensingPharmacy (CD)
CWE

Coded with Exceptions

3301682Dispensing Pharmacy Address
B

backward compatible use only

SHOULD NOT  
XAD

Extended Address

3401683Deliver-to Patient Location MAY[0..1] 
PL

Person Location

3501684Deliver-to Address MAY[0..1] 
XAD

Extended Address

3602309Pharmacy Phone Number MAY[0..*] 
XTN

Extended Telecommunication Number

Conditions/Invariants

The root for the expression is on the segment.

Seq. Referenced Elements Introduction Invariant Comment
1 ?

Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData Type
RXO

100292Requested Give Code
C

Condition defined for this element

MAY[0..1] RequestedGiveCode (CD)
CWE

Coded with Exceptions


200293Requested Give Amount - Minimum
C

Condition defined for this element

MAY[0..1] 
NM

Numeric

300294Requested Give Amount - Maximum MAY[0..1] 
NM

Numeric


400295Requested Give Units
C

Condition defined for this element

MAY[0..1] RequestedGiveUnits (CD)
CWE

Coded with Exceptions


500296Requested Dosage Form
C

Condition defined for this element

MAY[0..1] RequestedDosageForm (CD)
CWE

Coded with Exceptions

600297Provider's Pharmacy/Treatment Instructions MAY[0..*] Provider'sPharmacy/TreatmentInstructions (CD)
CWE

Coded with Exceptions

700298Provider's Administration Instructions MAY[0..*] Provider'sAdministrationInstructions (CD)
CWE

Coded with Exceptions

800299Deliver-To Location
W

withdrawn Element

SHOULD NOT   
900300Allow Substitutions MAY[0..1][1..1]univ: AllowSubstitution (CD) hl7VS-allowSubstitution (VS) allowSubstitution (CS)
ID

Coded Value for HL7 Defined Tables

1000301Requested Dispense Code MAY[0..1] RequestedDispenseCode (CD)
CWE

Coded with Exceptions

1100302Requested Dispense Amount MAY[0..1] 
NM

Numeric

1200303Requested Dispense Units MAY[0..1] RequestedDispenseUnits (CD)
CWE

Coded with Exceptions

1300304Number Of Refills
=

Truncation not allowed!

MAY[0..1] 3
NM

Numeric

1400305Ordering Provider's DEA Number
W

withdrawn Element

SHOULD NOT  
XCN

Extended Composite ID Number and Name for Persons


1500306Pharmacist/Treatment Supplier's Verifier ID
C

Condition defined for this element

MAY[0..*] 
XCN

Extended Composite ID Number and Name for Persons

1600307Needs Human Review MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables


1700308Requested Give Per (Time Unit)
C

Condition defined for this element

=

Truncation not allowed!

MAY[0..1] 20
ST

String Data

1801121Requested Give Strength MAY[0..1] 
NM

Numeric

1901122Requested Give Strength Units MAY[0..1] RequestedGiveStrengthUnits (CD)
CWE

Coded with Exceptions

2001123Indication MAY[0..*] Indication (CD)
CWE

Coded with Exceptions

2101218Requested Give Rate Amount
=

Truncation not allowed!

MAY[0..1] 6
ST

String Data

2201219Requested Give Rate Units MAY[0..1] RequestedGiveRateUnits (CD)
CWE

Coded with Exceptions

2300329Total Daily Dose MAY[0..1] 
CQ

Composite Quantity with Units

2401476Supplementary Code MAY[0..*] SupplementaryCode (CD)
CWE

Coded with Exceptions

2501666Requested Drug Strength Volume
=

Truncation allowed.

MAY[0..1] 5
NM

Numeric

2601667Requested Drug Strength Volume Units MAY[0..1] RequestedDrugStrengthVolumeUnits (CD)
CWE

Coded with Exceptions

2701668Pharmacy Order Type MAY[0..1][1..1]univ: PharmacyOrderTypes (CD) hl7VS-pharmacyOrderTypes (VS) pharmacyOrderTypes (CS)
ID

Coded Value for HL7 Defined Tables

2801669Dispensing Interval MAY[0..1] 
NM

Numeric

2902149Medication Instance Identifier MAY[0..1] 
EI

Entity Identifier

3002150Segment Instance Identifier MAY[0..1] 
EI

Entity Identifier


3102151Mood Code
C

Condition defined for this element

MAY[0..1] univ: MoodCodes (CD) hl7VS-moodCodes (VS) actMood (CS)
CNE

Coded with No Exceptions

3201681Dispensing Pharmacy
B

backward compatible use only

SHOULD NOT  DispensingPharmacy (CD)
CWE

Coded with Exceptions

3301682Dispensing Pharmacy Address
B

backward compatible use only

SHOULD NOT  
XAD

Extended Address

3401683Deliver-to Patient Location MAY[0..1] 
PL

Person Location

3501684Deliver-to Address MAY[0..1] 
XAD

Extended Address

3602309Pharmacy Phone Number MAY[0..*] 
XTN

Extended Telecommunication Number

Base FrameworkBase Standard Profile
Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData TypeImplementVocabulary
RXO 

100292Requested Give Code
C

Condition defined for this element

MAY[0..1] RequestedGiveCode (CD)
CWE

Coded with Exceptions

MAY

200293Requested Give Amount - Minimum
C

Condition defined for this element

MAY[0..1] 
NM

Numeric

MAY
300294Requested Give Amount - Maximum MAY[0..1] 
NM

Numeric

MAY

400295Requested Give Units
C

Condition defined for this element

MAY[0..1] RequestedGiveUnits (CD)
CWE

Coded with Exceptions

MAY

500296Requested Dosage Form
C

Condition defined for this element

MAY[0..1] RequestedDosageForm (CD)
CWE

Coded with Exceptions

MAY
600297Provider's Pharmacy/Treatment Instructions MAY[0..*] Provider'sPharmacy/TreatmentInstructions (CD)
CWE

Coded with Exceptions

MAY
700298Provider's Administration Instructions MAY[0..*] Provider'sAdministrationInstructions (CD)
CWE

Coded with Exceptions

MAY
800299Deliver-To Location
W

withdrawn Element

SHOULD NOT   SHOULD NOT
900300Allow Substitutions MAY[0..1][1..1]univ: AllowSubstitution (CD) hl7VS-allowSubstitution (VS) allowSubstitution (CS)
ID

Coded Value for HL7 Defined Tables

MAY 
1000301Requested Dispense Code MAY[0..1] RequestedDispenseCode (CD)
CWE

Coded with Exceptions

MAY
1100302Requested Dispense Amount MAY[0..1] 
NM

Numeric

MAY
1200303Requested Dispense Units MAY[0..1] RequestedDispenseUnits (CD)
CWE

Coded with Exceptions

MAY
1300304Number Of Refills
=

Truncation not allowed!

MAY[0..1] 3
NM

Numeric

MAY
1400305Ordering Provider's DEA Number
W

withdrawn Element

SHOULD NOT  
XCN

Extended Composite ID Number and Name for Persons

SHOULD NOT

1500306Pharmacist/Treatment Supplier's Verifier ID
C

Condition defined for this element

MAY[0..*] 
XCN

Extended Composite ID Number and Name for Persons

MAY
1600307Needs Human Review MAY[0..1][1..1]univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS)
ID

Coded Value for HL7 Defined Tables

MAY 

1700308Requested Give Per (Time Unit)
C

Condition defined for this element

=

Truncation not allowed!

MAY[0..1] 20
ST

String Data

MAY
1801121Requested Give Strength MAY[0..1] 
NM

Numeric

MAY
1901122Requested Give Strength Units MAY[0..1] RequestedGiveStrengthUnits (CD)
CWE

Coded with Exceptions

MAY
2001123Indication MAY[0..*] Indication (CD)
CWE

Coded with Exceptions

MAY
2101218Requested Give Rate Amount
=

Truncation not allowed!

MAY[0..1] 6
ST

String Data

MAY
2201219Requested Give Rate Units MAY[0..1] RequestedGiveRateUnits (CD)
CWE

Coded with Exceptions

MAY
2300329Total Daily Dose MAY[0..1] 
CQ

Composite Quantity with Units

MAY
2401476Supplementary Code MAY[0..*] SupplementaryCode (CD)
CWE

Coded with Exceptions

MAY
2501666Requested Drug Strength Volume
=

Truncation allowed.

MAY[0..1] 5
NM

Numeric

MAY
2601667Requested Drug Strength Volume Units MAY[0..1] RequestedDrugStrengthVolumeUnits (CD)
CWE

Coded with Exceptions

MAY
2701668Pharmacy Order Type MAY[0..1][1..1]univ: PharmacyOrderTypes (CD) hl7VS-pharmacyOrderTypes (VS) pharmacyOrderTypes (CS)
ID

Coded Value for HL7 Defined Tables

MAY 
2801669Dispensing Interval MAY[0..1] 
NM

Numeric

MAY
2902149Medication Instance Identifier MAY[0..1] 
EI

Entity Identifier

MAY
3002150Segment Instance Identifier MAY[0..1] 
EI

Entity Identifier

MAY

3102151Mood Code
C

Condition defined for this element

MAY[0..1] univ: MoodCodes (CD) hl7VS-moodCodes (VS) actMood (CS)
CNE

Coded with No Exceptions

MAY 
3201681Dispensing Pharmacy
B

backward compatible use only

SHOULD NOT  DispensingPharmacy (CD)
CWE

Coded with Exceptions

SHOULD NOT
3301682Dispensing Pharmacy Address
B

backward compatible use only

SHOULD NOT  
XAD

Extended Address

SHOULD NOT
3401683Deliver-to Patient Location MAY[0..1] 
PL

Person Location

MAY
3501684Deliver-to Address MAY[0..1] 
XAD

Extended Address

MAY
3602309Pharmacy Phone Number MAY[0..*] 
XTN

Extended Telecommunication Number

MAY
Base Framework Base Standard Profile
Seq# Data Element Description Flags Optionality Repetition Length C.LEN Table Data Type Optionality Table
RXO  

1 00292 Requested Give Code
C

Condition defined for this element

O      
CWE

Coded with Exceptions

  (0747)

2 00293 Requested Give Amount - Minimum
C

Condition defined for this element

O      
NM

Numeric

   
3 00294 Requested Give Amount - Maximum   O      
NM

Numeric

   

4 00295 Requested Give Units
C

Condition defined for this element

O      
CWE

Coded with Exceptions

  (0748)

5 00296 Requested Dosage Form
C

Condition defined for this element

O      
CWE

Coded with Exceptions

  (0750)
6 00297 Provider's Pharmacy/Treatment Instructions   O Y    
CWE

Coded with Exceptions

  (0751)
7 00298 Provider's Administration Instructions   O Y    
CWE

Coded with Exceptions

  (0718)
8 00299 Deliver-To Location   W            
9 00300 Allow Substitutions   O   [1..1]  
ID

Coded Value for HL7 Defined Tables

  (0161)
10 00301 Requested Dispense Code   O      
CWE

Coded with Exceptions

  (0753)
11 00302 Requested Dispense Amount   O      
NM

Numeric

   
12 00303 Requested Dispense Units   O      
CWE

Coded with Exceptions

  (0754)
13 00304 Number Of Refills   O     3=  
NM

Numeric

   
14 00305 Ordering Provider's DEA Number   W      
XCN

Extended Composite ID Number and Name for Persons

   

15 00306 Pharmacist/Treatment Supplier's Verifier ID
C

Condition defined for this element

O Y    
XCN

Extended Composite ID Number and Name for Persons

   
16 00307 Needs Human Review   O   [1..1]  
ID

Coded Value for HL7 Defined Tables

  (0136)

17 00308 Requested Give Per (Time Unit)
C

Condition defined for this element

O     20=  
ST

String Data

   
18 01121 Requested Give Strength   O      
NM

Numeric

   
19 01122 Requested Give Strength Units   O      
CWE

Coded with Exceptions

  (0756)
20 01123 Indication   O Y    
CWE

Coded with Exceptions

  (0694)
21 01218 Requested Give Rate Amount   O     6=  
ST

String Data

   
22 01219 Requested Give Rate Units   O      
CWE

Coded with Exceptions

  (0760)
23 00329 Total Daily Dose   O      
CQ

Composite Quantity with Units

   
24 01476 Supplementary Code   O Y    
CWE

Coded with Exceptions

  (0700)
25 01666 Requested Drug Strength Volume   O     5#  
NM

Numeric

   
26 01667 Requested Drug Strength Volume Units   O      
CWE

Coded with Exceptions

  (0764)
27 01668 Pharmacy Order Type   O   [1..1]  
ID

Coded Value for HL7 Defined Tables

  (0480)
28 01669 Dispensing Interval   O      
NM

Numeric

   
29 02149 Medication Instance Identifier   O      
EI

Entity Identifier

   
30 02150 Segment Instance Identifier   O      
EI

Entity Identifier

   

31 02151 Mood Code
C

Condition defined for this element

O      
CNE

Coded with No Exceptions

  (0725)
32 01681 Dispensing Pharmacy   B      
CWE

Coded with Exceptions

  (0733)
33 01682 Dispensing Pharmacy Address   B      
XAD

Extended Address

   
34 01683 Deliver-to Patient Location   O      
PL

Person Location

   
35 01684 Deliver-to Address   O      
XAD

Extended Address

   
36 02309 Pharmacy Phone Number   O Y    
XTN

Extended Telecommunication Number

   
Seq# Data Element Description Optionality Repetition Length C.LEN Table Data Type
RXO
1 00292 Requested Give Code C     (0747)
CWE

Coded with Exceptions

2 00293 Requested Give Amount - Minimum C      
NM

Numeric

3 00294 Requested Give Amount - Maximum O      
NM

Numeric

4 00295 Requested Give Units C     (0748)
CWE

Coded with Exceptions

5 00296 Requested Dosage Form C     (0750)
CWE

Coded with Exceptions

6 00297 Provider's Pharmacy/Treatment Instructions O Y   (0751)
CWE

Coded with Exceptions

7 00298 Provider's Administration Instructions O Y   (0718)
CWE

Coded with Exceptions

8 00299 Deliver-To Location W        
9 00300 Allow Substitutions O   [1..1] (0161)
ID

Coded Value for HL7 Defined Tables

10 00301 Requested Dispense Code O     (0753)
CWE

Coded with Exceptions

11 00302 Requested Dispense Amount O      
NM

Numeric

12 00303 Requested Dispense Units O     (0754)
CWE

Coded with Exceptions

13 00304 Number Of Refills O     3=  
NM

Numeric

14 00305 Ordering Provider's DEA Number W      
XCN

Extended Composite ID Number and Name for Persons

15 00306 Pharmacist/Treatment Supplier's Verifier ID C Y    
XCN

Extended Composite ID Number and Name for Persons

16 00307 Needs Human Review O   [1..1] (0136)
ID

Coded Value for HL7 Defined Tables

17 00308 Requested Give Per (Time Unit) C     20=  
ST

String Data

18 01121 Requested Give Strength O      
NM

Numeric

19 01122 Requested Give Strength Units O     (0756)
CWE

Coded with Exceptions

20 01123 Indication O Y   (0694)
CWE

Coded with Exceptions

21 01218 Requested Give Rate Amount O     6=  
ST

String Data

22 01219 Requested Give Rate Units O     (0760)
CWE

Coded with Exceptions

23 00329 Total Daily Dose O      
CQ

Composite Quantity with Units

24 01476 Supplementary Code O Y   (0700)
CWE

Coded with Exceptions

25 01666 Requested Drug Strength Volume O     5#  
NM

Numeric

26 01667 Requested Drug Strength Volume Units O     (0764)
CWE

Coded with Exceptions

27 01668 Pharmacy Order Type O   [1..1] (0480)
ID

Coded Value for HL7 Defined Tables

28 01669 Dispensing Interval O      
NM

Numeric

29 02149 Medication Instance Identifier O      
EI

Entity Identifier

30 02150 Segment Instance Identifier O      
EI

Entity Identifier

31 02151 Mood Code C     (0725)
CNE

Coded with No Exceptions

32 01681 Dispensing Pharmacy B     (0733)
CWE

Coded with Exceptions

33 01682 Dispensing Pharmacy Address B      
XAD

Extended Address

34 01683 Deliver-to Patient Location O      
PL

Person Location

35 01684 Deliver-to Address O      
XAD

Extended Address

36 02309 Pharmacy Phone Number O Y    
XTN

Extended Telecommunication Number

18.8.157.1 RXO field definitions (4A.4.1.0)

18.8.157.2 RXO-1 Requested Give Code (CWE) 00292 (4A.4.1.1)

Definition: This field identifies the treatment product or treatment ordered to be given to the patient; it is analogous to OBR-4-universal service ID in function. Examples of treatments products include medications and certain devices or supplies, e.g., inhaler spacers, blood glucose monitors, syringes, infusion sets, which might require prescription. Refer to Table 0747 - Requested Give Code in Chapter 2C for valid values.

Often the coded entry implies dosage form and a dosage form is required in addition to the product name. When the give code does not include the dosage form, use RXO-5-requested dosage form. When the give code does not include the strength, use RXO-18-requested give strength and the RXO-19-requested give units. Realize that strengths do not apply to some such orders.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription/treatment is transmitted as free text using RXO-6; then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Use of the RXO-6.2 versus the RXO-1.2 for a free text order is dependent on whether or not the free text describes a product or if it is more commentary in nature.

Please refer to the request -to-dispense fields RXO-10, RXO-11, and RXO-12 for a discussion of the interrelationship with the request-to-give fields.

18.8.157.3 RXO-2 Requested Give Amount - Minimum (NM) 00293 (4A.4.1.2)

Definition: This field is the ordered amount. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription/treatment is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Note: This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount.Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the Requested Give Amount field).

18.8.157.4 RXO-3 Requested Give Amount - Maximum (NM) 00294 (4A.4.1.3)

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

18.8.157.5 RXO-4 Requested Give Units (CWE) 00295 (4A.4.1.4)

Definition: This field indicates the units for the give amount. Refer to Table 0748 - Requested Give Units in Chapter 2C for valid values.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Note: These units can be a "compound quantity"; i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight). See Chapter 7 for full definition of ISO+ units.

A table of standard units is needed to define standard abbreviations for compound units. Until such a table is agreed on, a user-defined table is needed for each site. If the interpretation of a compound unit requires knowledge of some observation results (such as body weight or height), these results can be sent in the same order message using the optional OBX segments.

18.8.157.6 RXO-5 Requested Dosage Form (CWE) 00296 (4A.4.1.5)

Definition: This field indicates the manner in which the treatment is aggregated for dispensing, e.g., tablets, capsules suppositories. In some cases, this information is implied by the dispense/give code in RXO-1-requested give code or RXO-10-Requested dispense code. Required when both RXO-1-Requested give code and RXO-10-Requested dispense code do not specify the drug/treatment form; optionally included otherwise. Refer to Table 0750 - Requested Dosage Form in Chapter 2C for valid values.

18.8.157.7 RXO-6 Provider's Pharmacy/Treatment Instructions (CWE) 00297 (4A.4.1.6)

Definition: This field identifies the ordering provider's instructions to the pharmacy or the non-pharmacy treatment provider (e.g., respiratory therapy). If coded, a user-defined table must be used. If transmitted as a free text field, place a null in the first component and the text in the second, e.g., |^this is a free text treatment instruction|.Refer to Table 0751 - Provider's Pharmacy/Treatment Instructions in Chapter 2C for valid values.

If the prescription is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank. Otherwise, RXO-1, RXO-2 and RXO-4 are mandatory.

18.8.157.8 RXO-7 Provider's Administration Instructions (CWE) 00298 (4A.4.1.7)

Definition: This field identifies the ordering provider's instructions to the patient or to the provider administering the drug or treatment. If coded, a user-defined table must be used. If transmitted as free text, place a null in the first component and the text in the second, e.g., |^this is a free text administration instruction|.Refer to Table 0752 - Provider's Administration Instructions in Chapter 2C for valid values.

18.8.157.9 RXO-8 Deliver-to Location (4A.4.1.8)

Attention: The RXO-8 field was retained for backward compatibilty only as of v 2.6 and the detail was withdrawn and removed from the standard as of v 2.8.

18.8.157.10 RXO-9 Allow Substitutions (ID) 00300 (4A.4.1.9)

Definition: Coded values indicate whether substitutions are allowed, and, if yes, what type of substitutions. Refer to HL7 Table 0161 - Allow Substitution in Chapter 2C, Code Tables, for valid codes.

18.8.157.11 RXO-10 Requested Dispense Code (CWE) 00301 (4A.4.1.10)

Definition: This field indicates what is to be/was dispensed; it is analogous to OBR-4-universal service ID in function. It may be present in the order or not, depending on the application. If not present, and values are given for RXO-11-requested dispense amount and RXO-12-requested dispense units, the RXO-1-requested give code is assumed. If the requested dispense code does not include the dosage form, then RXO-5-requested dosage form is required. Refer to Table 0753 - Requested Dispense Code in Chapter 2C for valid values.

Note on request-to-dispense fields:
Sometimes an order will be written in which the total amount of the drug or treatment requested to be dispensed has no direct relationship with the give amounts and schedule. For example, an outpatient pharmacy/treatment order might be take four tablets a day of , Q6H (every 6 hours) -- dispense 30 tablets. An inpatient order might be NS/D5W (normal saline with 5% dextrose) at 1000cc/hour—dispense 3 1-liter bottles of NSD5W solution. The request-to-dispense fields support this common style of ordering.

18.8.157.12 RXO-11 Requested Dispense Amount (NM) 00302 (4A.4.1.11)

Definition: This field specifies the amount to be dispensed. See above note.

18.8.157.13 RXO-12 Requested Dispense Units (CWE) 00303 (4A.4.1.12)

Definition: This field identifies the units for the dispense amount. This must be in simple units that reflect the actual quantity of the substance to be dispensed. It does not include compound units. See above note. Refer to Table 0754 - Requested Dispense Units in Chapter 2C for valid values.

18.8.157.14 RXO-13 Number of Refills (NM) 00304 (4A.4.1.13)

Definition: This field defines the number of times the requested dispense amount can be given to the patient, subject to local regulation. Refers to outpatient only.

18.8.157.15 RXO-14 Ordering Provider's DEA Number (4A.4.1.14)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

18.8.157.16 RXO-15 Pharmacist/Treatment Supplier's Verifier ID (XCN) 00306 (4A.4.1.15)

Definition: This field is the provider ID of the pharmacist/treatment supplier verifier. Use if required by the pharmacy or treatment application or site on orders (or some subgroup of orders), in addition to ORC-11-verified by.

Example:

The site requires a "verified by" provider (such as a nurse) and a "verifying pharmacist/treatment supplier" on the order. In this case the first field, ORC-11-verified by, is already present; but the second field, RXO-15-pharmacist/treatment supplier's verifier ID, is needed.

18.8.157.17 RXO-16 Needs Human Review (ID) 00307 (4A.4.1.16)

Definition: This field uses HL7 Table 0136 - Yes/No Indicator in Chapter 2C, Code Tables. The values have the following meaning for this field:

YYes - Indicates that the pharmacist or non-pharmacist treatment supplier filling the order needs to pay special attention to the text in the RXO-6-provider's pharmacy/treatment instructions. A warning is present.

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

An example of the use of this field is given by the following case:

A smart Order Entry application knows of a possible drug or treatment interaction on a certain order, but the provider issuing the order wants to override the condition. In this case, the pharmacy or treatment application receiving the order will want to have a staff pharmacist or non-pharmacist treatment supplier review the interaction and contact the ordering physician.

18.8.157.18 RXO-17 Requested Give Per (Time Unit) (ST) 00308 (4A.4.1.17)

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

Format:

S

=

seconds

M

=

minutes

H

=

hours

D

=

days

W

=

weeks

L

=

months

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

This field is defined as conditional because it is required when the ordered substance is to be administered continuously at a prescribed rate (e.g., certain IVs). For example, if the "give amount/units" are 300 ml and the "give per" time unit is H1, the rate is 300ml/hr and the duration of this dose is 1 hour. Thus the give amount and give per time unit define the duration of the service.

This field is distinct from the "interval" component of the quantity/timing field, but it could be used in conjunction with it, as in give 300ml of NS per hr for 1 hour, repeat twice a day.

18.8.157.19 RXO-18 Requested Give Strength (NM) 01121 (4A.4.1.18)

Definition: Required when RXO-1-requested give code does not specify the strength; optionally included otherwise. This is the numeric part of the strength, used in combination with RXO-19-requested give strength units.

The need for strength and strength unit fields in addition to the amount and amount units fields included in various RX_ segments requires explanation. Physicians can write a prescription for a drug such as Ampicillin in two ways. One way would be: "Ampicillin 250 mg capsules, 2 capsules four times a day." In this case the give amount would be 2, the give units would be capsules, the strength would be 250 and the strength units would milligrams.

However, the provider could also write the pharmaceutical treatment as "Ampicillin 500 mg four times a day." In this case the give amount would be 500 and the give units would be milligrams. The strength would not be reported in the RXO segment because it is not specified; the drug could be given in two 250 mg caps or one 500 mg cap. But the pharmacist would dispense a specific capsule size and would record the strength in the RXE segment as 250 or 500, depending upon which capsule size was dispensed.

Some coding systems imply the strength, units, route of administration, and manufacturer of substances within a single instructional code. NDC codes, for example, usually imply not only the medical substance, but also the strength, the units, and the form, e.g., 0047-0402-30^Ampicillin 250 MG CAPS^NDC. So all of this information can also be completely specified in RXO-1-requested give code and in the analogous CWE/CNE fields in other pharmacy/treatment segments. In this case, it is not necessary to use the strength and strength units fields to specify this information.

18.8.157.20 RXO-19 Requested Give Strength Units (CWE) 01122 (4A.4.1.19)

Definition: Required when both RXO-1-requested give code and RXO-10-requested dispense code do not specify the strength; optionally included otherwise. This is the unit of the strength, used in combination with RXO-18-requested give strength. Refer to Table 0756 - Requested Give Strength Units in Chapter 2C for valid values.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

18.8.157.21 RXO-20 Indication (CWE) 01123 (4A.4.1.20)

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant. Refer to Table 0758 - Indication in Chapter 2C for valid values.

18.8.157.22 RXO-21 Requested Give Rate Amount (ST) 01218 (4A.4.1.21)

Definition: This field contains the rate at which to administer a treatment, e.g., 150 ml/hr (for an IV) or 4 liters/min for nasal oxygen.

18.8.157.23 RXO-22 Requested Give Rate Units (CWE) 01219 (4A.4.1.22)

Definition: This field contains the units in which RXO-21-requested give rate amount is denominated. Refer to Table 0760 - Requested Give Rate Units in Chapter 2C for valid values.

18.8.157.24 RXO-23 Total Daily Dose (CQ) 00329 (4A.4.1.23)

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

18.8.157.25 RXO-24 Supplementary Code (CWE) 01476 (4A.4.1.24)

This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC). Refer to Table 0762 - Supplementary Code in Chapter 2C for valid values.

18.8.157.26 RXO-25 Requested Drug Strength Volume (NM) 01666 (4A.4.1.25)

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML, which would be encoded in RXO-18, RXO-19, RXO-25 and RXO-26 as:

RXO||||||||||||||||||120|mg^^ISO||||||5|ml^^ISO ...

18.8.157.27 RXO-26 Requested Drug Strength Volume Units (CWE) 01667 (4A.4.1.26)

Description: This field indicates the volumetric unit associated with RXO-25 Requested Drug Strength Volume. See example in RXO-25. Refer to Table 0764 - Requested Drug Strength Volume Units in Chapter 2C for valid values.

18.8.157.28 RXO-27 Pharmacy Order Type (ID) 01668 (4A.4.1.27)

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 — Pharmacy Order Types in Chapter 2C, Code Tables, for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

18.8.157.29 RXO-28 Dispensing Interval (NM) 01669 (4A.4.1.28)

Definition: This field specifies the minimum number of days that must occur between dispensing events

18.8.157.30 RXO-29 Medication Instance Identifier (EI) 02149 (4A.4.1.29)

Definition: This field contains a value that uniquely identifies the medication associated with this segment. Rather than identifying the product to be given, as in RXO-1 Requested Give Code, this field serves to identify the medication in association with the order represented by the segment instance. This identifier is persistent within and across message instances.

Note: RXO-29 Medication Instance Identifier was introduced in v2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-29 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established.

18.8.157.31 RXO-30 Segment Instance Identifier (EI) 02150 (4A.4.1.30)

Definition: This field contains a value that uniquely identifies this segment across time and messages. This is not intended as a "Set ID", but as a unique identifier allowing references not only to segments of the same message, but also to segments of other messages and indirectly to the entities described in those segments if the necessary persistence was manageable by the applications. This identifier is persistent within and across message instances.

Note: RXO-30 Segment Instance Identifier was introduced in v 2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-30 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established.

18.8.157.32 RXO-31 Mood Code (CNE) 02151 (4A.4.1.31)

Definition: This field represents the functional state of the order represented by this segment instance. Refer to HL7 Table 0725 - Mood Codes in Chapter 2C, Code Tables, for valid values. This field may only be used with new trigger events and new messages from v2.6 onward. When this field is not valued in a message that qualifies, then the value is assumed to be 'EVN'.

There may appear to be overlap between this field and ORC-5 Order Status. However, the intent of Mood Code is to support the description and documentation of historical events. In this context, Mood codes may clash with Order Status codes, a Mood code may apply for different Order Status values, or this segment may be being used outside of the order paradigm (e.g., in a patient care plan). Moods are meant to change the semantics of clinical data in a message when it is not inferable from the trigger event: when the data can represent a past medication, a future medication (e.g., in a patient care plan), or in a request (e.g., as a reason for referral). The reader is referred to Chapter 12, Patient Care, for further discussion of patient care plans and referrals.

Note: RXO-31 Mood Code was introduced in v2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-31 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established. While a similar note exists for RXO-29 Medication Instance Identifier and RXO-30 Segment Instance Identifier, particular care should be taken with RXO-31 as this could modify the intent of the segment/message and create backward compatibility problems.

18.8.157.33 RXO-32 Dispensing Pharmacy (4A.4.1.32)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7. Refer to Table 0765 - Dispensing Pharmacy in Chapter 2C for valid values.

ense the prescription.

18.8.157.34 RXO-33 Dispensing Pharmacy Address (4A.4.1.33)

Attention: This field was retained for backward compatibilty only as of v 2.7 and the detail was withdrawn and removed from the standard as of v 2.9. The reader is referred to the PRT segment described in Chapter 7.

18.8.157.35 RXO-34 Deliver-to Patient Location (PL) 01683 (4A.4.1.34)

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

18.8.157.36 RXO-35 Deliver-to Address (XAD) 01684 (4A.4.1.35)

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

18.8.157.37 RXO-36 Pharmacy Phone Number (XTN) 02309 (4A.4.1.36)

Definition: This field contains the telecommunication contact information for the pharmacy. Repetitions may be supplied for various device types or use codes, or multiple instances of the same type or use. This concept also exists as RXE-45 and RXD-34 to support pharmacy contact information in the context of the order, the encoded order and the dispense.