ADT^A38 — Cancel Pre-Admit

Cancellation of a scheduled pre-admission (triggered by A05). Typical cases: postponed surgery, contraindicating infection, patient refusal, deferred exam. Distinct from A11 which cancels an effective admission.

Purpose

A38 cancels a pre-admission created by A05 (Pre-Admit a Patient). The patient has not crossed any admission threshold: the bracelet is not posted, no bed allocated, billing has not started. The pre-admission is simply de-scheduled. If the admission has happened, use A11 (Cancel Admit) instead.

Segment structure

Structure ADT_A38: MSH, EVN, PID, [PD1], [ROL], [PV1], [PV2], [DB1], [DG1], [DRG], [OBX].

Key fields:

• EVN-6 — cancellation reason (Event Reason Code, HL7 table 0062).
• PV1-44 — Admit Date/Time (planned time, kept for audit).
• PV1-50 — Alternate Visit ID (sometimes the pre-admit #).

Real-world example

Surgery pre-admission of May 20, 2026 cancelled due to pre-op COVID:

MSH|^~\&|HIS|HOSP01|EHR|HOSP01|20260518090000||ADT^A38^ADT_A38|MSGA38001|P|2.5.1|||AL|NE
EVN|A38|20260518090000|||ADM005^Admis^Office^^^MS.|REASON: COVID PRE-OP / DEFERRED
PID|1||MR200201^^^HOSP^MR||DIALLO^FATOU^^^MS.||19880214|F
PV1|1|P|CHIR^^^HOSP01|||||DR_GARNIER^Garnier^Olivier|||CHIR||||||||PREADM-20260520-44|||||||||||||||||||||||||20260520080000

Acknowledgment (ACK)

MSH|^~\&|EHR|HOSP01|HIS|HOSP01|20260518090002||ACK^A38^ACK|ACKA38001|P|2.5.1
MSA|AA|MSGA38001

Common errors

• A38 on an effective admission: if A04/A01 has been issued, use A11 (Cancel Admit) or A13 (Cancel Discharge), not A38.
• Empty EVN-6: hard for KPI reports (cancellation rate by reason).
• Missing PV1-19: the pre-visit # is needed to identify which one to cancel.
• Confusion with A28 (Add Person): A38 does not delete the patient ; only A29 (Delete Person Information) would.

Related ADT events

See also: ADT^A05, ADT^A11, ADT^A13.