DICOM Attribute

Performed Procedure Step Start Date (0040,0244)

Keyword
PerformedProcedureStepStartDate
VR
DA
VM
1

Attribute Metadata

Tag
(0040,0244)
Keyword
PerformedProcedureStepStartDate
Name
Performed Procedure Step Start Date
Value Representation (VR)
DA
Value Multiplicity (VM)
1
Status
Active
Source
NEMA PS3.6 (table_6-1)

This attribute is part of the current DICOM Standard. Its value representation is DA with multiplicity 1.

This attribute uses the DA Value Representation. Multiplicity 1 governs how many values may be encoded.

Integration Notes

Real-world integration guidance for engineers implementing this attribute in Mirth Connect, FHIR gateways, HL7 v2 bridges, and cloud DICOM services. Authoritative source data where available; reference examples and operational notes where they add value.

FHIR Mapping

No direct FHIR ImagingStudy mapping published for this attribute. Some tags map indirectly via the Patient, Endpoint, or ImagingSelection resources — Phase 2b will expand coverage to those.

HL7 v2 Equivalent

  • MSH-7 (of MPPS message) Message Date/Time site-dependent
    MPPS-N-CREATE

    DICOM PerformedProcedureStepStartDate is set when the modality emits an MPPS N-CREATE message. The HL7 v2 equivalent is the message timestamp.

    Source: common convention

Verify against IHE Radiology TF Vol 2 and your facility's interface specification before production use.

Cloud DICOM Support

  • AWS HealthImaging Queryable
  • Azure DICOM Queryable
  • Google Cloud Healthcare Queryable

Performed Procedure Step Start Date is a Series-level QIDO-RS matching key. Often used for date-range queries on completed procedures.

Per-vendor source URLs and verification date in src/content/dicom/cloud-support.json#_meta. Status taxonomy: required (mandated on Store), queryable (QIDO-RS matching key), preserved (stored as-is), promoted (AWS top-level metadata), unsupported (stripped/rejected).

Real-World Sample Values

No representative sample value available — this attribute isn't present in the de-identified pydicom fixture set. Add a fixture covering this attribute to expand coverage.

Mirth Connect Example

MPPS performed-procedure-step start timestamp — MPPS (Modality Performed Procedure Step) workflows fire N-CREATE / N-SET message

MPPS (Modality Performed Procedure Step) workflows fire N-CREATE / N-SET messages. Mirth often acts as the receiver; persist the start time for downstream billing or workflow.

// (0040,0244) Performed Procedure Step Start Date + (0040,0245) PPSStartTime
var d = String(msg.dataset.attr.(@tag == '00400244').value).trim();
var t = String(msg.dataset.attr.(@tag == '00400245').value).trim();
if (d.length === 8 && t.length >= 6) {
  var ts = d + t.substring(0, 6); // YYYYMMDDHHMMSS — HL7 v2 TS format
  channelMap.put('mpps_start_ts', ts);
}

Reference only — validate before production. Snippets are starting points, not turnkey solutions. Always test against your channel's specific message structure and your facility's interface specification. See Mirth Connect User Guide + NEMA PS3.6 + your vendor conformance statement for authoritative specification.

Common Operational Errors

  • medium MPPS N-CREATE arrives without N-SET completion

    Diagnosis: Modality sends N-CREATE for performed procedure step but never sends the corresponding N-SET when the procedure completes (often due to mid-procedure cancellation or modality crash). RIS shows perpetually 'In Progress' studies.

    Fix: Scheduled batch job: any MPPS open >24h gets a synthetic 'DISCONTINUED' N-SET injected so RIS state can settle. Mirth Database Reader pattern + custom Z-segment to flag the synthetic completion for audit.

Reference only — validate before applying a fix. Scenarios are drawn from common DICOM/HL7 v2 integration patterns; reproduce against your environment before acting on any diagnosis. See NEMA PS3.6 + your vendor conformance statement for authoritative specification. Severity levels: high (data-loss / patient-safety), medium (workflow disruption), low (cosmetic).

DICOM Integration Services

Saga IT builds production DICOM integrations across Mirth Connect, FHIR gateways, and cloud imaging platforms. If you're working with PerformedProcedureStepStartDate or the broader (0040,0244) context: