ADT^A25 — Cancel Pending Discharge

The discharge planned by A16 will not happen after all: A25 cancels the preparation. No PV1-45 to clear (it was never set), but pharmacy and social services suspend their preparations.

Purpose

A25 is sent when clinical condition worsens between A16 and the planned A03 (symptoms return, post-op complications, unfavourable lab). Receivers must: pharmacy — suspend the discharge prescription; social services — postpone home return; ambulatory EHR — abandon pre-load; billing — must NOT close the encounter. The encounter remains active.

Segment structure

Structure ADT_A25: MSH, EVN, PID, PV1.

Real-world example

A16 from 18 May 09:00 cancelled at 12:00 by A25 — patient John Doe keeps his bed:

MSH|^~\&|HIS|HOSP01|EHR|CLINIC02|20260518120000||ADT^A25^ADT_A25|MSG00025001|P|2.5.1|||AL|NE
EVN|A25|20260518120000|||DRJONES^Jones^Sarah^^^DR.|CLINICAL CONDITION WORSENED
PID|1||MRN567890^^^HOSP^MR||DOE^JOHN^A^^MR.||19720515|M
PV1|1|I|MED^205^B^HOSP01|EM|||DRSMITH^Smith^James^A^^DR.|||MED|||1|||DRSMITH|ADM|||||||||||||||||||HOSP01|||||20260514102530

Acknowledgment (ACK)

MSH|^~\&|EHR|CLINIC02|HIS|HOSP01|20260518120001||ACK^A25^ACK|ACK00025001|P|2.5.1
MSA|AA|MSG00025001

Common errors

• A25 sent after A03: too late — the encounter is already closed. Use A13 (Cancel Discharge) instead.
• EVN-4 empty: why the cancellation? Without a reason, the receiver cannot adjust preparations.
• A25 with no prior A16: orphan message, rejected by compliant EHRs.

Related ADT events

See also: ADT^A16, ADT^A13.