The TXA segment carries the header metadata for a transcribed or dictated clinical document: what kind of document it is, who authored and authenticated it, when it was originated and transcribed, its unique number, and where it sits in its lifecycle. Where the document body lives in repeating OBX segments, TXA is the cover sheet that describes it — the metadata an MDM message routes and files on.
Purpose
TXA describes a single clinical document instance: document type, content presentation, the providers who originated, transcribed, and authenticated it, the activity/origination/transcription timestamps, the unique and parent document numbers, the associated order numbers, and the completion, confidentiality, availability, and storage statuses. It is the structured header that lets a receiver classify, version, and store the document the OBX segments carry.
Used in
TXA appears in MDM (document management messages), which announce new documents, status changes, replacements, and addenda. The document content itself follows in OBX segments, with optional NTE notes. See MDM.
Field-by-field reference
Source: the Vorro HL7 segment database (extracted from the official v2-to-FHIR IG). R = required (cardinality min ≥ 1). Repeat = field may repeat. Length is not carried by the FHIR source and is shown as —.
| Seq | Name | Data Type | Length | Req | Repeat | Table # | Description |
|---|---|---|---|---|---|---|---|
| TXA-1 | Set ID- TXA | SI | — | R | — | — | Sequence number when multiple TXAs appear; usually 1. |
| TXA-2 | Document Type | CWE | — | R | — | HL70270 | Kind of document (e.g. discharge summary, consult). |
| TXA-3 | Document Content Presentation | ID | — | O | — | HL70191 | How the content is encoded or presented. |
| TXA-4 | Activity Date/Time | DTM | — | O | — | — | When the documented activity took place. |
| TXA-5 | Primary Activity Provider Code/Name | XCN | — | O | Y | — | Provider(s) responsible for the documented activity. |
| TXA-6 | Origination Date/Time | DTM | — | O | — | — | When the document was first originated. |
| TXA-7 | Transcription Date/Time | DTM | — | O | — | — | When the document was transcribed. |
| TXA-8 | Edit Date/Time | DTM | — | O | Y | — | When the document was edited. |
| TXA-9 | Originator Code/Name | XCN | — | O | Y | — | Author(s) who originated the document. |
| TXA-10 | Assigned Document Authenticator | XCN | — | O | Y | — | Provider(s) assigned to authenticate the document. |
| TXA-11 | Transcriptionist Code/Name | XCN | — | O | Y | — | Person who transcribed the document. |
| TXA-12 | Unique Document Number | EI | — | R | — | — | The unique identifier for this document. |
| TXA-13 | Parent Document Number | EI | — | O | — | — | Identifier of a parent/original document. |
| TXA-14 | Placer Order Number | EI | — | O | Y | — | Order number(s) that placed the document request. |
| TXA-15 | Filler Order Number | EI | — | O | — | — | Filler-assigned order number. |
| TXA-16 | Unique Document File Name | ST | — | O | — | — | Document file name used for storage/retrieval. |
| TXA-17 | Document Completion Status | ID | — | R | — | HL70271 | Lifecycle status (dictated, transcribed, authenticated). |
| TXA-18 | Document Confidentiality Status | ID | — | O | — | HL70272 | Confidentiality/sensitivity level of the document. |
| TXA-19 | Document Availability Status | ID | — | O | — | HL70273 | Whether the document is available for use. |
| TXA-20 | Document Storage Status | ID | — | O | — | HL70275 | Where the document is stored (active, archived, purged). |
| TXA-21 | Document Change Reason | ST | — | O | — | — | Reason the document was changed. |
| TXA-22 | Authentication Person, Time Stamp (set) | PPN | — | O | Y | — | Who authenticated the document and when. |
| TXA-23 | Distributed Copies (Code and Name of Recipient(s) ) | XCN | — | O | Y | — | Recipient(s) who received copies. |
| TXA-24 | Folder Assignment | CWE | — | O | Y | — | Folder(s) the document is filed under. |
| TXA-25 | Document Title | ST | — | O | Y | — | Human-readable title of the document. |
| TXA-26 | Agreed Due Date/Time | DTM | — | O | — | — | Date the document is due. |
| TXA-27 | Creating Facility | HD | — | O | — | — | Facility that created the document. |
| TXA-28 | Creating Specialty | CWE | — | O | — | — | Specialty that created the document. |
Most-used fields
- TXA-2 Document Type classifies the document and is what receivers route and file on; it is required and maps to
DocumentReference.type. - TXA-12 Unique Document Number is the identifier systems match on to version, replace, or append to an existing document.
- TXA-17 Document Completion Status drives lifecycle logic — dictated vs transcribed vs authenticated decides whether a document is final.
- TXA-9 Originator and TXA-10 Authenticator name the author and the signer, the providers most downstream consumers care about.
- TXA-6 Origination Date/Time and TXA-7 Transcription Date/Time bound when the document came into being.
Version differences (2.3 to 2.8.2)
- 2.3/2.4: the core TXA header (type, numbers, dates, completion status) is established early and stays stable.
- 2.5: coded fields shift from
CEtowardCWE(e.g. TXA-2 Document Type, TXA-24 Folder Assignment). - 2.7+: TXA-23 Distributed Copies, TXA-24 Folder Assignment, TXA-25 Document Title, TXA-26 Agreed Due Date/Time, TXA-27 Creating Facility, and TXA-28 Creating Specialty added.
- Receivers built for 2.3 ignore the trailing fields they do not recognize.
Common mistakes
- Sending a document without TXA-12 Unique Document Number, leaving the receiver unable to version or replace it.
- Misusing TXA-17 Document Completion Status so a draft is filed as final, or an addendum is treated as an original.
- Treating TXA-13 Parent Document Number as optional on a replacement/addendum, breaking the document chain.
- Reading only the first repetition of TXA-9/TXA-10/TXA-11 when several authors or authenticators are listed.
Examples
Minimal valid TXA (required fields only):
TXA|1|DS^Discharge Summary^HL70270|||||||||DOC10001^MERCYGEN||||AU
Fully-populated TXA (authenticated discharge summary):
TXA|1|DS^Discharge Summary^HL70270|TX|20260609100000|9001^WELBY^MARCUS^^^^MD|20260609101500|20260609103000||9001^WELBY^MARCUS^^^^MD|9002^REYES^LINA^^^^MD|T500^KEActive|DOC10001^MERCYGEN|||DOC10001.txt|AU|U|AV|AC||9002^REYES^LINA^^^^MD&20260609110000|||Discharge Summary
Annotated breakdown of the fully-populated example (selected fields):
TXA ← segment ID
1 ← TXA-1 Set ID
DS^Discharge Summary^HL70270 ← TXA-2 Document Type (required)
TX ← TXA-3 Document Content Presentation
20260609100000 ← TXA-4 Activity Date/Time
9001^WELBY^MARCUS^^^^MD ← TXA-5 Primary Activity Provider
20260609101500 ← TXA-6 Origination Date/Time
20260609103000 ← TXA-7 Transcription Date/Time
9001^WELBY^MARCUS^^^^MD ← TXA-9 Originator (author)
9002^REYES^LINA^^^^MD ← TXA-10 Assigned Document Authenticator
DOC10001^MERCYGEN ← TXA-12 Unique Document Number (required)
AU ← TXA-17 Document Completion Status (required, Authenticated)
In-context inside an MDM^T02 (original document notification):
MSH|^~&|TRANSCRIPTION|MERCYGEN|EHR|MERCYGEN|20260609103000||MDM^T02^MDM_T02|MSG201|P|2.5.1
EVN|T02|20260609103000
PID|1||MR12345^^^MERCYGEN^MR||DOE^JOHN^Q||19800101|M
PV1|1|I|3WEST^301^A||||9001^WELBY^MARCUS^^^^MD|||MED|||||||||V0001|||||||||||||||||||||||20260605120000
TXA|1|DS^Discharge Summary^HL70270|TX|20260609100000|9001^WELBY^MARCUS^^^^MD|20260609101500|20260609103000||9001^WELBY^MARCUS^^^^MD|9002^REYES^LINA^^^^MD||DOC10001^MERCYGEN|||DOC10001.txt|AU
OBX|1|TX|11488-4^Consultation note^LN||Patient admitted for observation; discharged in stable condition.||||||F
In-context inside an MDM^T02 carrying a multi-line note (OBX repeats):
MSH|^~&|TRANSCRIPTION|MERCYGEN|EHR|MERCYGEN|20260609104500||MDM^T02^MDM_T02|MSG202|P|2.5.1
EVN|T02|20260609104500
PID|1||MR12345^^^MERCYGEN^MR||DOE^JOHN^Q||19800101|M
TXA|1|CN^Consult Note^HL70270|TX|20260609090000|9003^OKAFOR^ADA^^^^MD|20260609093000|20260609094000||9003^OKAFOR^ADA^^^^MD|||DOC10002^MERCYGEN|||DOC10002.txt|IP
OBX|1|TX|11488-4^Consultation note^LN||Cardiology consult requested for new-onset atrial fibrillation.||||||P
OBX|2|TX|11488-4^Consultation note^LN||Recommend rate control and anticoagulation; follow-up in one week.||||||P
FHIR mapping
Primary target resource: DocumentReference. TXA also drives a Provenance resource that records the document's authoring and authenticating agents and the recorded timestamp. Official ConceptMaps: DocumentReference, Provenance.
Key DocumentReference mappings:
| TXA field | FHIR target (DocumentReference) |
|---|---|
| (constant) | status = current |
| TXA-2 Document Type | type (CodeableConcept) |
| TXA-3 Document Content Presentation | content.attachment.contentType |
| TXA-6 Origination Date/Time | date (+ extension[1] date extension) |
| TXA-9 Originator Code/Name | author (Practitioner) |
| TXA-10 Assigned Document Authenticator | authenticator (Practitioner) |
| TXA-12 Unique Document Number | masterIdentifier |
| TXA-16 Unique Document File Name | identifier[1] |
| TXA-17 Document Completion Status | docStatus |
| TXA-18 Document Confidentiality Status | securityLabel (vocab: DocumentConfidentialityStatus) |
| TXA-19 Document Availability Status | status (+ status.extension[1] alternate-codes) |
| TXA-25 Document Title | description |
Provenance target: TXA contributes recorded (instant), and two agent entries (agent[1], agent[2]) each with who as a Practitioner reference and a role coded IRCP from the v3 ParticipationType system; TXA also maps to reason.text.
Fields without a published DocumentReference or Provenance mapping (TXA-1, TXA-4, TXA-5, TXA-7, TXA-8, TXA-11, TXA-13, TXA-14, TXA-15, TXA-20, TXA-21, TXA-22, TXA-23, TXA-24, TXA-26, TXA-27, TXA-28) are header/workflow details not represented on either resource.
Engine considerations
- Required in practice: TXA-1, TXA-2, TXA-12, and TXA-17 are standard-required; real interfaces also depend on TXA-9/TXA-10 for author/signer and TXA-13 to chain replacements and addenda.
- Use TXA-17 Document Completion Status to gate filing — only
AU(authenticated) documents should be treated as final by many downstream systems. - Preserve repeating provider fields (TXA-5/9/10/11/23) and repeating numbers (TXA-14) as arrays.
- Sequence document versions by TXA-12/TXA-13 and the origination/edit timestamps rather than delivery order.
How Vorro parses and produces TXA
Vorro indexes TXA-12 as the document key and reads TXA-13 to maintain the parent/child document chain across replacements and addenda. TXA-17 gates whether a document is treated as final, repeating author and authenticator fields are preserved, and on the FHIR side Vorro emits DocumentReference with type, docStatus, masterIdentifier, and author/authenticator per the official ConceptMap, plus a Provenance resource carrying the agents and recorded time.
Related pages
- OBX — the observation segments that carry the document body.
- NTE — notes and comments that accompany the document.
- MDM messages — where TXA announces documents and their status changes.
