HL7 Table HL70271: Document Completion Status

HL70271 is the HL7-defined vocabulary for where a clinical document sits in its authoring and authentication lifecycle. It lives in TXA-17 Document Completion Status and answers: has this note been dictated yet, has the author signed it, has a legal attestation happened. The seven values trace the lifecycle from a blank in-progress draft through to a legally authenticated final document, and they drive whether the receiving EHR shows the document as a draft (red border, watermark) or as a finalized note in the chart.

Purpose

HL70271 lets receivers gate downstream behavior by completion stage. Most EHRs will not let a draft (IP, IN) propagate to billing, will refuse to fold a pre-authenticated note (PA) into the discharge packet, and will reject claims that cite an unauthenticated note as the basis for a charge. Conversely, a legally authenticated document (LA) triggers retention policy, locks the source-of-truth flag, and disables in-place edits — any further changes must come through an addendum.

The values are also load-bearing for audit. Compliance teams reconstruct the dictation-to-signature timeline from successive MDM messages bearing different HL70271 values on the same document control number, so the codes must accurately reflect authoring state rather than being defaulted to AU on every send.

Where it's used

• TXA-17 Document Completion Status — the canonical home, present on every MDM^T01 through MDM^T11 message.
• Some hand-off profiles populate OBR-25 (Result Status) with a parallel completion signal, but HL70271 itself is referenced only from TXA-17.

Code list

Code system OID

• OID: 2.16.840.1.113883.18.117
• Canonical URI: http://terminology.hl7.org/CodeSystem/v2-0271

The OID is what Vorro emits in CWE.14 when downstream profiles demand OID-bound coded TXA-17 values.

HL7-defined vs user-defined

HL70271 is HL7-defined. The seven values form a complete lifecycle ladder and are not intended to be extended locally — extensions almost always reflect a real workflow that already maps to one of the seven canonical values (for example, "Cosigned" maps to LA when the cosignature carries legal weight, otherwise to AU). Sites should resist minting local codes here; the lifecycle is well-trodden and the value of conformance with downstream FHIR mappers is high.

Version differences

• v2.3 — HL70271 introduced alongside the MDM message family with the initial set: DI, DO, IN, IP, AU, LA.
• v2.3.1 — PA (Pre-authenticated) added to capture the common state where transcription is complete but the author has not yet signed.
• v2.4 – v2.8.1 — Set frozen at seven codes; no further additions.

Common mistakes

• Defaulting every outbound TXA-17 to AU regardless of true state. Audit reconstructions will catch this immediately, and downstream billing will treat unauthenticated drafts as fully signed.
• Sending the display string (Authenticated) instead of the two-letter code (AU).
• Confusing AU with LA. AU is an author signature; LA is a legal attestation (often by a supervising physician or a counter-signing role). Many systems require LA before a document can be cited on a claim.
• Treating PA as a final state. Pre-authenticated means content is complete but the signature is still pending — receivers should not promote a PA document to the source-of-truth slot.
• Reverting completion status backwards (AU → IP) on the same document control number. The lifecycle is forward-only; corrections come through an amendment MDM (T05/T06) with the new state, not by rewinding the old one.

Examples

A discharge summary at the authenticated stage:

TXA|1|DS|TX|202606101430|||||1234^SMITH^JOHN^A^^^MD|||||DOC-99821||AU||AV

The same document later legally authenticated by a supervising physician:

TXA|1|DS|TX|202606101430|||||1234^SMITH^JOHN^A^^^MD|||||DOC-99821||LA||AV

AU translated to a FHIR DocumentReference.docStatus snippet — note this is lossy:

{
  "resourceType": "DocumentReference",
  "docStatus": "final",
  "extension": [{
    "url": "https://terminology.hl7.org/CodeSystem/v2-0271",
    "valueCode": "AU"
  }]
}

Mapping failure example — unknown vendor code:

TXA|1|DS|TX|202606101430|||||1234^SMITH^JOHN^A^^^MD|||||DOC-99821||SIGNED||AV

SIGNED is not in HL70271. A conformant engine should quarantine the message, preserve the original code in the audit log, and either resolve through a local remap rule (SIGNED → AU or SIGNED → LA depending on workflow) or surface for curation.

FHIR mapping

The v2-to-FHIR IG does not publish a ConceptMap for this table; the mapping below follows the obvious correspondence, collapsing the seven HL7 codes onto the four-value FHIR DocumentReference.docStatus:

Because four v2 codes collapse to preliminary and three collapse to final, the original HL70271 code must be preserved as an extension if the receiver needs to round-trip back to HL7 v2 — otherwise the distinction between, say, AU and LA is lost. FHIR DocumentReference.docStatus is a code element bound to http://hl7.org/fhir/ValueSet/composition-status.

Engine considerations

• Two-character validation — TXA-17 codes are exactly two characters; engines should reject longer payloads rather than truncate.
• Case sensitivity — HL70271 codes are uppercase; lowercase au must be normalized or rejected.
• Forward-only lifecycle — Engines should warn (or hard-reject, depending on profile) on backwards lifecycle transitions on a single document control number. An LA document downgraded to IP almost always indicates a bug upstream.
• Round-trip preservation — When mapping to FHIR docStatus, store the original HL70271 code as an extension so the v2 outbound channel can restore AU/LA/PA distinction.

How Vorro handles HL70271

Vorro validates TXA-17 against the seven HL70271 codes on ingest. Values that match pass through untouched. Values that fail validation — vendor mnemonics, display strings, lowercase variants — are routed to the terminology curation queue, where a remap rule resolves them to the canonical HL70271 code or surfaces them for human review. Vorro also tracks the lifecycle history per document control number and emits a soft warning when a backwards transition is detected.

On outbound, Vorro emits HL70271 as IS for v2.5 and earlier profiles and as CWE with CWE.14 populated for v2.7+ destinations. When a FHIR DocumentReference.docStatus arrives upstream as preliminary or final with no v2 extension, Vorro picks the safest default (DO for preliminary, AU for final) and flags the message so authoring systems can re-emit with the precise lifecycle state.

Related pages

• TXA segment — Transcription Document Header
• HL70270 code table — Document Type
• HL70273 code table — Document Availability Status

Sources

• HL7 Terminology — CodeSystem v2-0271 Document Completion Status
• HL7 v2 product brief