BAR^P12 — Update Diagnosis/Procedure

Update of diagnosis/procedure coding attached to a patient account. Used for DRG corrections (GHM in France), post-stay ICD-10 reclassification, addition of forgotten procedures. Sent by the HIM (Health Information Management) to the billing system.

Purpose

P12 transmits a post-discharge coding revision. The HIM re-reads the patient chart, adds missing principal diagnosis, redeploys related ICD-10-PCS procedures, recodes secondary diagnoses. The new DG1/PR1 structure replaces the one on the account. On the billing side, the recalculated DRG can swing the valuation by several thousand euros.

Segment structure

Structure BAR_P12: MSH, [SFT], { EVN, PID, [PD1], PV1, [PV2], {DG1}, [DRG], {PR1}, {GT1}, {NK1}, {IN1, [IN2], [IN3]} }.

• DG1 — Diagnosis (repeatable).
• DG1-3 — Diagnosis Code (ICD-10 / ICD-10-CM / SNOMED CT).
• DG1-6 — Diagnosis Type: A (Admitting), W (Working), F (Final).
• DG1-15 — Diagnosis Priority (1 = principal, 2 = related, 3 = associated).
• PR1 — Procedures (repeatable).
• PR1-3 — Procedure Code (CCAM in France, ICD-10-PCS in US).
• PR1-6 — Procedure Functional Type: S (Surgical), D (Diagnostic).

Real-world example

HIM adds pneumonia as related diagnosis + DDD pacemaker insertion:

MSH|^~\&|HIM|HOSP01|BILL|BILLING01|20260519201000||BAR^P12^BAR_P12|BARP12001|P|2.5.1|||AL|NE
EVN|P12|20260519201000|||HIM^HIM^HIM
PID|1||MR400607^^^HOSP^MR||SANCHEZ^ROBERTO^^^MR.||19720112|M
PV1|1|I|CARDIO|||||DR_HENRI^Henri^Paul|||CARDIO|||||||||SEJ-2026-04-09971
DG1|1|I10|I50.1^Left ventricular failure^ICD10|Left ventricular failure|20260418|F|||||||||||1
DG1|2|I10|J18.9^Pneumonia, unspecified organism^ICD10|Pneumonia, unspecified|20260419|F|||||||||||2
PR1|1|C|02HK40Z^Insertion of DDD pacemaker^ICD10PCS|Insertion of DDD pacemaker|20260420|S
GT1|1|GT1-887|SANCHEZ^ROBERTO|||||||||||||||1.501.72.011.122.999

Common errors

• DG1-15 (Priority) missing: French T2A valuation strictly depends on DP/DR/DA hierarchy. Without priority, GHM grouping fails.
• PR1-5 (date) after PV1-44 (admit): a procedure dated before admission is rejected.
• P12 without prior P05: some billing systems require the account to be "updated" (P05) before coding update.
• DG1-3 as free text: coding must be coded (ICD-10) — not free text in component 1.

BAR family (Billing & Accounts)

See also: BAR^P01, BAR^P02, BAR^P05, DFT^P03.