^A05
ADT^A05 — Pre-Admit a Patient
Sent when a patient is pre-admitted to the facility before physically arriving. It creates a pending encounter record in downstream systems so that orders, imaging requests, and bed assignments can be prepared in advance of the patient's arrival.
When Is This Sent?
When a patient is scheduled for a planned inpatient admission — such as an elective surgery admission or a scheduled ICU transfer from another facility. The patient has not yet arrived; PV1.2 (patient class) is typically P (preadmit).
Real-World Usage
Pre-admission messages are critical for surgical workflows. The operating room, pharmacy, and PACS all benefit from knowing a patient is expected before arrival so they can pre-stage orders and imaging history. If pre-admit records don't convert to full admissions (A01) automatically, staff may end up with duplicate records in downstream systems.
Message Structure
Segment names link to their field-level reference pages.
| # | Segment | Purpose in this message | Req | Repeat |
|---|---|---|---|---|
| 1 | MSH | Message header with ADT^A05 in MSH.9 | R | — |
| 2 | EVN | Event type with A05 trigger and pre-admission timestamp | R | — |
| 3 | PID | Patient demographics including MRN | R | — |
| 4 | PV1 | Visit information with PV1.2=P (preadmit) and expected admission details | R | — |
| 5 | PD1 | Additional patient demographics | O | — |
| 6 | NK1 | Next of kin and emergency contacts | O | Yes |
| 7 | PV2 | Extended visit information including expected admit date/time | O | — |
| 8 | AL1 | Known patient allergies | O | Yes |
| 9 | DG1 | Admitting diagnosis | O | Yes |
| 10 | IN1 | Insurance information for pre-authorization | O | Yes |
Example Message
Realistic example with fake patient data. Paste into the HL7 Message Viewer to explore interactively.
1MSH||^~\&|EPIC|HOSPITAL_A|MIRTH_PROD|PACS|20260312080000||ADT^A05^ADT_A05|MSG00030|P|2.5.1 2EVN||A05|20260312080000 3PID||1||345678^^^HOSP_A^MR||Brown^Robert^W||19680422|M|||200 Birch Rd^^Springfield^IL^62704^US^H||2175552345^PRN^PH 4PV1||1|P|4B^220^1^^^HOSP_A||||2345^Roberts^Dr.^Emily|||SUR|||||ADM|||3456^Park^Dr.^James|PA||||||||||||||||||||||||||20260313070000
Troubleshooting Scenarios
Pre-admit record becomes a duplicate after actual admission
Cause
Downstream system creates a new encounter on A01 without linking it to the pending A05 encounter, resulting in two records for the same patient visit.
Fix
Ensure PV1.19 (visit number) is identical in both the A05 and the subsequent A01. Downstream systems must use the visit number to match the pending pre-admit record and update it rather than create a new one.
Pre-admit patient not visible in PACS for pre-procedure imaging review
Cause
PACS is not subscribed to A05 events, only A01 and A04.
Fix
Add A05 to the PACS interface event subscription. Confirm with the PACS vendor whether pre-admit patient class (P) is treated the same as inpatient (I) for worklist and study linking.
Common Confusions
ADT^A05 (Pre-Admit) vs ADT^A14 (Pending Admit). A05 pre-registers the patient and creates an actual pre-admission record. A14 is a notification that an admission is pending — it is advisory only and does not create an encounter. Use A05 when a full pre-admission workflow is needed; use A14 for lightweight advance notification.
Related Message Types
Segment Reference
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