ADT^A13 — Cancel Discharge / End Visit

The discharged patient has just been re-admitted onto the same encounter: A13 reopens the stay and retracts the A03 to preserve record continuity and billing.

Purpose

A13 is emitted when a patient discharged minutes or hours earlier (rarely longer) is re-admitted in the same clinical context: software bug on A03, discharge declared then cancelled by the physician, off-site radiology or external consult mistakenly recorded as a definitive discharge.

Receiver effect: the encounter is reopened, PV1-45 (discharge timestamp) is cleared, LOS KPIs resume from PV1-44 (admission). Billing started by A03 is typically blocked or cancelled.

Segment structure

ADT_A09 structure shared with A11 and A12.

PV1 — encounter reopen

• PV1-2: inpatient class I restored.
• PV1-3: location the patient returns to (often the same as before discharge).
• PV1-19: visit number — identical to A01 and the cancelled A03.
• PV1-44: original admission date/time, preserved.
• PV1-45: receiver must clear it on A13 receipt.

Real-world example

A03 recorded at 17:30 on 18 May 2026, cancelled at 18:00 by A13 (physician re-evaluates and decides to keep the patient one more night):

MSH|^~\&|HIS|HOSP01|EHR|CLINIC02|20260518180000||ADT^A13^ADT_A09|MSG00011001|P|2.5.1|||AL|NE
EVN|A13|20260518180000|20260518173000||DRJONES^Jones^Sarah^^^DR.
PID|1||MRN567890^^^HOSP^MR||DOE^JOHN^A^^MR.||19720515|M|||100 MAIN ST^^ANYTOWN^CA^90210^USA||(555)555-1234|||S||ACCT123456|123-45-6789
PV1|1|I|MED^205^B^HOSP01|EM|||DRSMITH^Smith^James^A^^DR.|||MED|||1|||DRSMITH^Smith^James^A^^DR.|ADM|||||||||||||||||||HOSP01|||||20260514102530

Acknowledgment (ACK)

MSH|^~\&|EHR|CLINIC02|HIS|HOSP01|20260518180001||ACK^A13^ACK|ACK00011001|P|2.5.1
MSA|AA|MSG00011001

Common errors

• A13 emitted long after A03: if billing has already been sent in X12 837 or in an ADRi flow, A13 alone is not enough; financial retraction must follow.
• A13 without preserving the visit number: the encounter stays a ghost; the receiver cannot identify which A03 to cancel.
• A01 sent instead: generates a fresh parallel encounter. Breaking continuity skews LOS, ALOS-per-service and PMSI consolidation.

Related ADT events

See also: ADT^A03 and ADT^A11.