HL7 TXA Segment: Document Header

The HL7 TXA segment (Transcription Document Header) identifies a clinical document’s metadata — type, author, transcriptionist, authentication status, and unique document identifier. It appears in MDM messages as the primary document descriptor, linking document lifecycle events to their content in OBX segments.

TXA Field Reference

Seq	Name	Type	Opt	Description
`TXA-1`	Set ID	SI	R	Sequence number (usually 1)
`★ TXA-2`	Document Type	IS	R	OP, DS, HP, CN, PN, RA, PA
OP=Operative Note, DS=Discharge Summary, HP=History & Physical, CN=Consultation, PN=Progress Note, RA=Radiology Report, PA=Pathology Report.
`★ TXA-3`	Document Content Presentation	ID	O	TX (Text), FT (Formatted Text), NS (Non-Standard)
Determines how OBX-5 content should be parsed. TX=plain text with \.br\ line breaks, FT=HL7 formatted text, ED in OBX-2 means Base64-encoded PDF.
`TXA-4`	Activity Date/Time	TS	O	When the clinical activity occurred
`★ TXA-5`	Primary Activity Provider	XCN	O	Physician who performed the activity
`TXA-6`	Origination Date/Time	TS	O	When the document was originally created
`TXA-7`	Transcription Date/Time	TS	O	When transcription was completed
`TXA-8`	Edit Date/Time	TS	O	Most recent edit timestamp
`TXA-9`	Originator Code/Name	XCN	O	Person who dictated or originated the document
`★ TXA-10`	Assigned Document Authenticator	XCN	O	Physician assigned to sign the document
The physician responsible for reviewing and electronically signing. Required by CMS and Joint Commission before the document becomes part of the permanent record.
`TXA-11`	Transcriptionist Code/Name	XCN	O	Person who transcribed the document
`★ TXA-12`	Unique Document Number	EI	R	Unique document identifier
Primary document identifier across systems. Must be globally unique and preserved across all MDM events for version tracking.
`★ TXA-13`	Parent Document Number	EI	O	Links addenda/replacements to original
Creates version chains: empty for originals, populated for addenda (T06) and replacements (T10). Receiving systems must maintain the full chain.
`TXA-14`	Placer Order Number	EI	O	Order that generated this document
`TXA-15`	Filler Order Number	EI	O	Fulfilling system's order number
`TXA-16`	Unique Document File Name	ST	O	File name for stored document
`★ TXA-17`	Document Completion Status	ID	R	DI, DO, IP, IN, AU, LA
DI=Dictated, DO=Documented, IP=In Progress, IN=Incomplete, AU=Authenticated (e-signed), LA=Legally Authenticated. Transition from DO to AU is the physician e-signature.
`★ TXA-18`	Document Confidentiality Status	ID	O	V (Very Restricted), R (Restricted), U (Usual)
V=Psychiatric/substance abuse/HIV (42 CFR Part 2) — requires consent-based access controls. Integration engines should route restricted documents through privacy workflows.
`TXA-19`	Document Availability Status	ID	O	AV (Available), CA (Cancelled), OB (Obsolete)
`TXA-20`	Document Storage Status	ID	O	AA (Active/Archived), AC (Active), AR (Archived), PU (Purged)
`TXA-21`	Document Change Reason	ST	O	Reason for document modification
`★ TXA-22`	Authentication Person/Timestamp	PPN	O	Who signed and when

TXA-1 R

Set ID SI

Sequence number (usually 1)

★ TXA-2 R

Document Type IS

OP, DS, HP, CN, PN, RA, PA

OP=Operative Note, DS=Discharge Summary, HP=History & Physical, CN=Consultation, PN=Progress Note, RA=Radiology Report, PA=Pathology Report.

★ TXA-3 O

Document Content Presentation ID

TX (Text), FT (Formatted Text), NS (Non-Standard)

Determines how OBX-5 content should be parsed. TX=plain text with \.br\ line breaks, FT=HL7 formatted text, ED in OBX-2 means Base64-encoded PDF.

TXA-4 O

Activity Date/Time TS

When the clinical activity occurred

★ TXA-5 O

Primary Activity Provider XCN

Physician who performed the activity

TXA-6 O

Origination Date/Time TS

When the document was originally created

TXA-7 O

Transcription Date/Time TS

When transcription was completed

TXA-8 O

Edit Date/Time TS

Most recent edit timestamp

TXA-9 O

Originator Code/Name XCN

Person who dictated or originated the document

★ TXA-10 O

Assigned Document Authenticator XCN

Physician assigned to sign the document

The physician responsible for reviewing and electronically signing. Required by CMS and Joint Commission before the document becomes part of the permanent record.

TXA-11 O

Transcriptionist Code/Name XCN

Person who transcribed the document

★ TXA-12 R

Unique Document Number EI

Unique document identifier

Primary document identifier across systems. Must be globally unique and preserved across all MDM events for version tracking.

★ TXA-13 O

Parent Document Number EI

Links addenda/replacements to original

Creates version chains: empty for originals, populated for addenda (T06) and replacements (T10). Receiving systems must maintain the full chain.

TXA-14 O

Placer Order Number EI

Order that generated this document

TXA-15 O

Filler Order Number EI

Fulfilling system's order number

TXA-16 O

Unique Document File Name ST

File name for stored document

★ TXA-17 R

Document Completion Status ID

DI, DO, IP, IN, AU, LA

DI=Dictated, DO=Documented, IP=In Progress, IN=Incomplete, AU=Authenticated (e-signed), LA=Legally Authenticated. Transition from DO to AU is the physician e-signature.

★ TXA-18 O

Document Confidentiality Status ID

V (Very Restricted), R (Restricted), U (Usual)

V=Psychiatric/substance abuse/HIV (42 CFR Part 2) — requires consent-based access controls. Integration engines should route restricted documents through privacy workflows.

TXA-19 O

Document Availability Status ID

AV (Available), CA (Cancelled), OB (Obsolete)

TXA-20 O

Document Storage Status ID

AA (Active/Archived), AC (Active), AR (Archived), PU (Purged)

TXA-21 O

Document Change Reason ST

Reason for document modification

★ TXA-22 O

Authentication Person/Timestamp PPN

Who signed and when

R = Required, O = Optional, C = Conditional, W = Withdrawn (backward compatibility only)

TXA-2: Document Type Codes

Code	Document Type	Typical Source
OP	Operative Note	Surgery/OR system
DS	Discharge Summary	Clinical documentation
HP	History and Physical	Admissions/intake
CN	Consultation Note	Specialist referral
PN	Progress Note	Daily rounding/charting
RA	Radiology Report	RIS/PACS
PA	Pathology Report	Pathology/lab system
PR	Procedure Note	Procedure documentation
ED	Emergency Department Note	ED documentation system
AN	Anesthesia Note	Anesthesia information system
NR	Nursing Note	Nursing documentation

TXA-17: Document Completion Status

Code	Status	Description
DI	Dictated	Dictation recorded, not yet transcribed
DO	Documented	Transcribed or entered, awaiting review
IP	In Progress	Document actively being edited
IN	Incomplete	Missing required sections or content
AU	Authenticated	Reviewed and electronically signed by author
LA	Legally Authenticated	Full legal signature applied (highest level)

Document Lifecycle Flow

DI (Dictated)
  → DO (Documented)
    → AU (Authenticated)
      → LA (Legally Authenticated)

Each transition generates an MDM^T03 (status change notification) or MDM^T04 (status change with content). The transition from DO → AU is the physician’s electronic signature — required by CMS and The Joint Commission before the document becomes part of the permanent medical record.

TXA-18: Confidentiality Status

Code	Level	Description
V	Very Restricted	Psychiatric, substance abuse, HIV/STD (42 CFR Part 2)
R	Restricted	Sensitive but not subject to federal restrictions
U	Usual	Standard clinical document — normal access controls
N	Normal	Same as Usual

Documents with V (Very Restricted) status require additional consent-based access controls per federal regulations. Integration engines should check TXA-18 and route restricted documents through appropriate privacy workflows.

TXA + OBX Pairing

TXA carries document metadata; OBX carries the actual content:

TXA|1|OP^Operative Note^HL70270|TX|||202603011600|||||SUR5678^WILLIAMS^MARK^^^MD||||DOC54321||AU
OBX|1|TX|OP_NOTE^Operative Note^LOCAL||Procedure: Laparoscopic cholecystectomy\.br\Patient tolerated procedure well.||||||F

TXA-3 = TX: Content is plain text in OBX-5 with \.br\ line breaks
TXA-3 = FT: Content is formatted text with HL7 escape sequences
When OBX-2 = ED: Content is Base64-encoded PDF or image (preserves formatting)

Key Implementation Considerations

Document Versioning

TXA-13 (Parent Document Number) creates a version chain:

Scenario	TXA-13	MDM Event	Result
Original	Empty	T02	New document created
Addendum	Original DOC ID	T06	Both documents active
Replacement	Replaced DOC ID	T10	Original superseded
Cancellation	N/A	T11	Document retracted

Receiving systems must maintain the complete version chain for audit trails. When displaying documents, show the most recent version with links to prior versions and addenda.

Authentication Requirements

Clinical documentation regulations require physician authentication:

CMS Conditions of Participation: Operative reports must be authenticated within 30 days
Joint Commission: History and physical must be completed within 24 hours of admission
State regulations: May impose stricter timelines

Integration engines can monitor TXA-17 status and alert when documents remain in DO (Documented) status beyond the required authentication window.

TXA-12: Unique Document Number

TXA-12 is the document’s primary identifier across systems. It must be:

Globally unique within the document management system
Preserved across all MDM events for the same document
Used as the correlation key when matching addenda, edits, and status changes to the original

HL7 MDM Messages MDM message structure — the primary carrier of TXA segments for clinical document lifecycle management.

HL7 Workbench Parse and validate HL7 messages with segment highlighting and field lookup.

HL7 Resource Center Message types, segments, reference guides, and integration tools.

HL7 Integration Services HL7 v2 clinical document integration — MDM interfaces, transcription systems, and document management.