ADT^A05 — Pre-admit a Patient

Before the patient arrives: A05 registers the record, reserves a bed, fires the insurance eligibility check and stages the upcoming stay.

Purpose

A05 fires when the HIS creates a record for a scheduled patient: elective surgery, planned day-case, scheduled delivery. Pre-admission allows you to:

• generate a reserved visit number;
• transmit insurance data for upfront eligibility check (X12 270/271 or proprietary flow);
• pre-allocate a bed;
• pre-load home medications into the pharmacy system;
• generate the admission paperwork printed on D-day.

A05 is typically converted into A01 on the day of arrival: same visit number, patient class updated from P to I, bed confirmed, PV1-44 populated.

Segment structure

ADT_A05
  MSH                    Message Header (mandatory)
  [ SFT ]                Software Segment (optional)
  EVN                    Event Type (mandatory)
  PID                    Patient Identification (mandatory)
  [ PD1 ]                Patient Additional Demographics (optional)
  [ { ROL } ]            Role (optional, repeatable)
  [ { NK1 } ]            Next of Kin (optional, repeatable)
  PV1                    Patient Visit (mandatory)
  [ PV2 ]                Patient Visit - Additional Info (optional)
  [ { OBX } ]            Observation (optional, repeatable)
  [ { AL1 } ]            Allergy (optional, repeatable)
  [ { DG1 } ]            Diagnosis (optional, repeatable)
  [ DRG ]                Diagnosis Related Group (optional)
  [ { PR1 [ { ROL } ] } ] Procedure (optional, repeatable)
  [ { GT1 } ]            Guarantor (optional, repeatable)
  [ { IN1 [IN2] [IN3] } ] Insurance (optional, repeatable)

MSH — EVN

• MSH-9: ADT^A05^ADT_A05.
• EVN-2: pre-admission recording timestamp.
• EVN-6: clinical event timestamp (pre-admission date in functional sense).

PID — PV1

• PV1-2: P — Preadmit (table 0004).
• PV1-44: forecast admission date/time.
• PV1-19: reserved visit number — preserved across the A01 conversion.

Financial segments

GT1 and IN1 are especially useful in A05: they trigger coverage checks before the patient arrives, reducing bad debt and enabling a stay quote to be sent to the patient.

Real-world example

Pre-admission on 10 May 2026 for scheduled surgery on 20 May at 08:00:

MSH|^~\&|HIS|HOSP01|EHR|CLINIC02|20260510140000||ADT^A05^ADT_A05|MSG00006001|P|2.5.1|||AL|NE
EVN|A05|20260510140000|||DRJONES^Jones^Sarah^^^DR.
PID|1||MRN112233^^^HOSP^MR||LEROY^MARIE^^^MRS.||19590303|F|||12 RUE DE LA PAIX^^PARIS^^75002^FR||+33611223344|||M||ACCT2026-PA001
PV1|1|P|SUR^PROG^^HOSP01|R|||DRCHIRA^Chirac^Paul^^^DR.|||SUR|||||||PRE|||||||||||||||||||HOSP01|||||20260520080000
IN1|1|AMELI^AMELI Régime Général^HL70072|18 11 75 110 134 56|CPAM|^^^CPAM 75^Paris^^75001|||||||20260101|20261231
GT1|1||LEROY^MARIE^^^MRS.||12 RUE DE LA PAIX^^PARIS^^75002|+33611223344||19590303|F||SE^Self^HL70063

A05 vs A01

Acknowledgment (ACK)

MSH|^~\&|EHR|CLINIC02|HIS|HOSP01|20260510140001||ACK^A05^ACK|ACK00006001|P|2.5.1
MSA|AA|MSG00006001

Common errors

• PV1-2 = I in A05: inconsistent. Class must be P.
• Visit number changed between A05 and A01: breaks correlation, generates an orphan encounter.
• A05 without IN1: the admission desk cannot verify eligibility before arrival.

Related ADT events

See also: ADT^A01 and FHIR Encounter (status planned).