DFT^P03 — Post Detail Financial Transactions

The message that pushes one or several detailed financial transactions — charges, adjustments, payments — from the HIS to the billing system. Historic bridge between clinical and hospital back-office finance.

Purpose

DFT^P03 conveys downstream the billable acts performed during an encounter: consultation, imaging, lab, surgical procedure, device, dispensed medication. Each act is carried by a repeating FT1 segment.

The receiver consolidates FT1s by patient account number (PID-18), produces an invoice (in the US: 837 claim; in France: GHM, ATIH) and feeds the accounting chain. DFT^P03 coexists with DFT^P11 (Detailed Charge Transactions), a variant introduced in v2.4 that enriches FT1 and adds the COMMON ORDER group for traceability.

Segment structure

DFT_P03
  MSH                              Message Header (mandatory)
  [ SFT ]                          Software Segment (optional)
  EVN                              Event Type (mandatory)
  PID                              Patient Identification (mandatory)
  [ PD1 ]                          Patient Additional Demographics
  [ { ROL } ]                      Role
  [ PV1                            Patient Visit
    [ PV2 ]
  ]
  [ { DB1 } ]                      Disability
  [ { OBX } ]                      Observation/Result (clinical context)
  { FT1                            Financial Transaction (mandatory, repeatable)
    [ { NTE } ]
    [ { DG1 } ]                    Diagnosis linked to transaction
    [ DRG ]                        DRG (CMG / case-mix group)
    [ { GT1 } ]                    Guarantor
    [ { IN1 [IN2] [IN3] } ]        Insurance
  }

MSH

MSH-9 = DFT^P03^DFT_P03. See ADT^A01 for the other fields.

EVN

EVN-1 = P03, EVN-2 = DFT generation timestamp.

PID

PID-3 (patient identifier) and PID-18 (patient account number) are critical: PID-18 is what links FT1 segments to an existing billing file.

PV1

PV1-19 (visit number) carries correlation with the clinical encounter. PV1-7 and PV1-17 (attending / admitting physician) matter for fee distribution.

FT1 — Financial Transaction

• FT1-1: Set ID within the message.
• FT1-2: Transaction ID — unique transaction identifier on the HIS side.
• FT1-3: Transaction Batch ID — for billing batch grouping.
• FT1-4: Transaction Date — date of the act.
• FT1-5: Transaction Posting Date — accounting entry date.
• FT1-6: Transaction Type — table 0017 (CG=Charge, CD=Credit, AJ=Adjustment, PY=Payment, TX=Tax).
• FT1-7: Transaction Code — act code (CPT, CCAM, local table).
• FT1-10: Transaction Quantity.
• FT1-11: Transaction Amount — Extended (total amount).
• FT1-12: Transaction Amount — Unit (unit price).
• FT1-13: Department Code — producing service.
• FT1-16: Assigned Patient Location.
• FT1-19: Diagnosis Code (CWE) — diagnostic link (deprecated in favour of DG1 in v2.5+).
• FT1-20: Performed By Code — executor.
• FT1-21: Ordered By Code — orderer.

Real-world example

Three charges for John Doe's cardiology encounter: office visit (CPT 99213, 250 USD), CBC (CPT 85025, 45.50 USD), thoracic CT (CPT 71250, 580 USD). Encounter diagnosis angina pectoris (I20.9 + R07.4).

MSH|^~\&|HIS|HOSP01|BILLING|HOSP01|20260514160000||DFT^P03^DFT_P03|DFT00000001|P|2.5.1|||AL|NE
EVN|P03|20260514160000|||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
PV1|1|I|ICU^101^A^HOSP01||||DRSMITH^Smith^James^A^^DR.|||CAR|||||||||VIS20260514
FT1|1|TXN001||20260514160000|20260514160000|CG|99213^Office Visit^CPT|||1|250.00|||MED^Medicine||||CAR|||||||DRSMITH^Smith^James^A^^DR.
FT1|2|TXN002||20260514160000|20260514160000|CG|85025^CBC W AUTO DIFF^CPT|||1|45.50|||LAB^Laboratory||||LAB|||||||DRSMITH^Smith^James^A^^DR.
FT1|3|TXN003||20260514160000|20260514160000|CG|71250^CT THORAX W/O CONTRAST^CPT|||1|580.00|||RAD^Radiology||||RAD|||||||DRBROWN^Brown^Linda^^^DR.
DG1|1|ICD10|I20.9^Angina pectoris, unspecified^I10|||A
DG1|2|ICD10|R07.4^Chest pain, unspecified^I10|||A

• MSH — HIS@HOSP01 → BILLING@HOSP01, version 2.5.1.
• PID-18 = ACCT123456 — billing key.
• FT1 × 3 — three charges typed CG with CPT codes, USD amounts, MED/LAB/RAD departments.
• DG1 × 2 — ICD-10 diagnoses at the message level (apply to all FT1).

Common errors

• Empty PID-18: without a patient account number, the receiver cannot attach FT1s to a billing file. Near-systematic rejection.
• FT1-7 without coding system: a CPT/CCAM code without the 3rd component (coding system) is ambiguous. Always qualify (99213^Office Visit^CPT).
• FT1-11 vs FT1-12 × FT1-10 mismatch: if the total amount does not match unit × quantity, billing's internal controls reject.
• FT1-4 prior to PV1-44: a transaction dated before admission is suspicious (except in ER scenarios) — most systems raise a warning.
• Implicit currency: HL7 v2 has no explicit currency field in FT1. The currency is agreed out-of-band (interface configuration). A multi-currency migration usually requires a custom FT1 or a Z-segment.
• Unescaped reserved characters: as with ADT.

Related messages

• DFT^P11 — variant introduced in v2.4, enriched structure (Order Group, Detail Charge).
• ADT^A01 — admission. Required so that PV1-19 in the DFT corresponds to an open encounter.
• BAR^P01 / BAR^P02 — Add / Update Patient Account (creation / update of the billing file itself).
• X12 — 835 (Payment / Remittance Advice) and 837 (Health Care Claim) are the US payer-side counterparts.
• FHIR R5 — Claim, Invoice, ChargeItem are the equivalent resources.