HL7 Table HL70443: Provider Role

HL70443 is the HL7 v2 code table for provider role — the relationship between a clinician and a patient encounter. It is carried in ROL-3 Role-ROL on the ROL (Role) segment, which sits under PID/PV1 on ADT and order messages to enumerate the providers involved with a visit beyond the single attending recorded in PV1-7. HL70443 is the older of two overlapping v2 provider-role tables: HL70443 was introduced in v2.3.1 alongside ROL, and HL70912 was added in v2.7 alongside the newer PRT (Participation) segment. The two tables describe the same conceptual space and a site that sends both ROL and PRT must keep them aligned.

Purpose

HL70443 lets sending systems list every provider attached to an encounter with their functional role: who admitted the patient, who is attending, who consulted, who referred. Downstream systems use the role to drive routing (orders flow to the AT provider's worklist), billing (admitting provider claim modifiers), and care-team displays. Because the table is user-defined, real-world traffic includes many local extensions — particularly for surgery-specific roles (assistant surgeon, anesthesiologist) and for case-management roles that the published set does not cover.

Where it's used

ROL-3 Role-ROL — the canonical home of HL70443; carried on every ROL segment.
A handful of legacy provider-role fields in OBR and ORC on older profiles also reference HL70443 by convention.
Note: PRT-4 Participation on the v2.7+ PRT segment uses HL70912, not HL70443.

Code list

Code	Display	Comment/Description
AD	Admitting	Provider who admitted the patient to the encounter.
AT	Attending	Provider with primary clinical responsibility during the encounter.
CP	Consulting Provider	Provider consulted for a specific question or service.
FHCP	Family Health Care Professional	Family/primary health care professional outside the encounter.
PP	Primary Care Provider	The patient's primary care provider (typically external to the encounter).
RP	Referring Provider	Provider who referred the patient into the encounter.
RT	Referred to Provider	Provider the patient was referred to (outbound referral).

Code system OID

OID: 2.16.840.1.113883.18.290
Canonical URI: http://terminology.hl7.org/CodeSystem/v2-0443

The OID resolves on the HL7 Terminology server. In v2.7+ profiles where ROL-3 is CWE, Vorro emits this OID in CWE.14 so downstream FHIR consumers can bind the code.

HL7-defined vs user-defined

HL70443 is user-defined. The published set above is a starting point; sites routinely extend with codes for assistant surgeon, anesthesiologist, case manager, social worker, and discharge planner. Receivers must accept site-local codes and surface unknowns for curation rather than NAK the ROL segment.

Version differences

v2.3.1 — HL70443 and the ROL segment introduced together; initial codes AT, CP, PP, RP.
v2.4 — AD (Admitting) and RT (Referred to Provider) added.
v2.5 – v2.6 — FHCP (Family Health Care Professional) added.
v2.7 — PRT (Participation Information) segment introduced; HL70912 published as the PRT-4 binding. HL70443 retained for ROL-3 backward compatibility.
v2.8 – v2.8.1 — Set frozen; sites are encouraged to migrate ROL to PRT over time but both remain valid.

Common mistakes

Mixing HL70443 and HL70912 codes in the same field. ROL-3 binds HL70443; PRT-4 binds HL70912. A receiver looking up AP (Admitting Provider) in HL70443 will not find it — AP is HL70912 only.
Treating PP (Primary Care Provider) as the encounter attending. PP is the patient's external PCP; AT is the in-encounter attending.
Sending the display word (Attending) instead of the code (AT).
Rejecting site-local codes (e.g. ASSURG for assistant surgeon). HL70443 is user-defined; preserve and curate, do not NAK.
Failing to map FHCP and PP cleanly to FHIR — both describe out-of-encounter relationships and typically land on Patient.generalPractitioner rather than Encounter.participant.

Examples

A ROL segment listing the attending provider:

ROL|1|UP|AT|1234^SMITH^JOHN^A^^^MD^^NPI^L^^^NPI||20260612083000

ROL listing the referring provider:

ROL|2|UP|RP|5678^GREEN^ALICE^B^^^MD^^NPI^L^^^NPI||20260610

Same AT value translated to a FHIR Encounter.participant snippet:

{
  "resourceType": "Encounter",
  "id": "enc-10456",
  "participant": [{
    "type": [{
      "coding": [{
        "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
        "code": "ATND",
        "display": "attender"
      }]
    }],
    "individual": { "reference": "Practitioner/1234" }
  }]
}

Mapping failure example — local site code:

ROL|3|UP|ASSURG|9999^WHITE^BOB^C^^^MD^^NPI^L^^^NPI||20260612090000

ASSURG is not in the published HL70443 set. A conformant engine preserves the raw code, holds the FHIR mapping pending curation, and surfaces the value so an administrator can either bind it (e.g., to Encounter.participant.type with system v3-ParticipationType, code ASSIST) or formally accept it as a site extension.

FHIR mapping

The HL7 v2-to-FHIR Implementation Guide publishes ConceptMap-table-hl70443-to-v3-participationtype, which maps HL70443 onto the HL7 v3 ParticipationType ValueSet used by FHIR Encounter.participant.type.

HL7 v2 (HL70443)	FHIR (v3-ParticipationType)
AD	ADM (admitter)
AT	ATND (attender)
CP	CON (consultant)
RP	REF (referrer)
RT	(typically `Patient.generalPractitioner` outbound referral, or omitted)
PP	(Patient.generalPractitioner — out-of-encounter PCP)
FHCP	(Patient.generalPractitioner — family health professional)

PP and FHCP do not have a clean ParticipationType counterpart because they describe out-of-encounter relationships; the v2-to-FHIR IG instead routes them to Patient.generalPractitioner.

Engine considerations

ROL vs PRT awareness — When parsing, bind ROL-3 to HL70443 and PRT-4 to HL70912 separately. Do not fall back to one table when the other lookup fails.
User-defined — never NAK — Receivers must accept site-local roles and surface unknowns for curation.
PP/FHCP routing — These codes typically map to Patient.generalPractitioner rather than Encounter.participant, even though they appear on a ROL segment under PV1.
CWE upgrade path — In v2.7+ profiles ROL-3 is CWE; populate CWE.14 with 2.16.840.1.113883.18.290.

How Vorro handles HL70443

Vorro accepts any value in ROL-3, normalizes case, and looks up the code in a per-source mapping table. Codes that match the published HL70443 set flow through to downstream channels and are mapped to FHIR Encounter.participant.type via the published ConceptMap. PP and FHCP are routed to Patient.generalPractitioner rather than Encounter.participant per the IG guidance. Unknown codes are preserved verbatim and surfaced to the terminology curation queue.

When the same site sends both ROL and PRT segments, Vorro reconciles the two against each other (HL70443 ↔ HL70912) and flags any disagreement — for example, ROL says AT but PRT says RP for the same provider — for operator review rather than silently choosing one.

Sources

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