ADT^A07 — Change an Inpatient to an Outpatient

An admitted patient is reclassified as outpatient or observation: A07 updates the class without closing the encounter and preserves the visit number.

Purpose

A07 is the inverse of A06: an inpatient (PV1-2 = I) flips into day-case, observation or ambulatory. Typical cases: post-PMSI reclassification, conversion of a stay into a day-case after medical reassessment, transfer to an outpatient programme.

Segment structure

ADT_A07
  MSH                    Message Header (mandatory)
  [ SFT ]                Software Segment (optional)
  EVN                    Event Type (mandatory)
  PID                    Patient Identification (mandatory)
  [ PD1 ]                Patient Additional Demographics (optional)
  [ { ROL } ]            Role (optional, repeatable)
  [ MRG ]                Merge Patient Information (optional)
  PV1                    Patient Visit (mandatory)
  [ PV2 ]                Patient Visit - Additional Info (optional)
  [ { ROL } ]            Role (optional, repeatable)
  [ { DB1 } ]            Disability (optional, repeatable)
  [ { OBX } ]            Observation (optional, repeatable)
  [ { AL1 } ]            Allergy (optional, repeatable)
  [ { DG1 } ]            Diagnosis (optional, repeatable)
  [ DRG ]                Diagnosis Related Group (optional)
  [ { PR1 [ { ROL } ] } ] Procedure (optional, repeatable)
  [ { GT1 } ]            Guarantor (optional, repeatable)
  [ { IN1 [IN2] [IN3] } ] Insurance (optional, repeatable)

PV1 — Patient Visit (flip)

• PV1-2: new class O, R (Recurring) or B (Obstetrics).
• PV1-3: new location (day-case bed, clinic room).
• PV1-6: prior location (inpatient room).
• PV1-19: visit number — UNCHANGED.

Real-world example

Patient Luisa Garcia, admitted the previous day (A06), flips to day-case on 16 May 2026 at 09:00 after stabilisation:

MSH|^~\&|HIS|HOSP01|EHR|CLINIC02|20260516090000||ADT^A07^ADT_A07|MSG00008001|P|2.5.1|||AL|NE
EVN|A07|20260516090000|||DRJONES^Jones^Sarah^^^DR.
PID|1||MRN334455^^^HOSP^MR||GARCIA^LUISA^^^MRS.||19651128|F|||25 RAMBLA CATALUNYA^^BARCELONA^^08007^ES||+34931112233|||M||ACCT2026-OBS01
PV1|1|O|HDJ^CARDIO^^HOSP01|R|||DRBERNARD^Bernard^Philippe^^^DR.|||CAR|||1||||OUT||||||||||||||||||HOSP01|||||20260516090000||||||||MED^310^A^HOSP01

Acknowledgment (ACK)

MSH|^~\&|EHR|CLINIC02|HIS|HOSP01|20260516090001||ACK^A07^ACK|ACK00008001|P|2.5.1
MSA|AA|MSG00008001

Common errors

• Visit number changed: PV1-19 must remain identical to the originating A06 or A01.
• A03 + A04 sent instead: produces a closed encounter followed by an open one; breaks billing chain and statistics.
• Premature flip: A07 emitted before the service has validated the administrative move creates billing tech debt.

Related ADT events

See also: ADT^A06 and FHIR Encounter.