^A44
ADT^A44 — Move Account Information
Sent to move an account (visit/encounter) from one patient record to another without merging the patients themselves. The PID segment identifies the patient the account is moving TO, and the MRG segment identifies the patient the account is moving FROM.
When Is This Sent?
When a visit was registered or orders were placed under the wrong patient's MRN, and the encounter must be moved to the correct patient without merging both patient identities.
Real-World Usage
A44 is the surgical tool for correcting wrong-patient encounter errors — one of the most dangerous data quality problems in healthcare. Unlike A40 (which merges patient identities), A44 moves only the encounter while keeping both patient records intact. Downstream systems must move all clinical data — orders, results, images, charges — associated with that encounter from the wrong patient to the correct one.
Message Structure
Segment names link to their field-level reference pages.
| # | Segment | Purpose in this message | Req | Repeat |
|---|---|---|---|---|
| 1 | MSH | Message header with ADT^A44 in MSH.9 | R | — |
| 2 | EVN | Event type with A44 trigger | R | — |
| 3 | PID | The CORRECT (destination) patient record — account moves TO this patient | R | — |
| 4 | MRG | The INCORRECT (source) patient identifier — account moves FROM this patient; MRG.3 (prior visit number) identifies the specific account to move | R | — |
Example Message
Realistic example with fake patient data. Paste into the HL7 Message Viewer to explore interactively.
1MSH||^~\&|EPIC|HOSPITAL_A|MIRTH_PROD|PACS|20260312120000||ADT^A44^ADT_A44|MSG00110|P|2.5.1 2EVN||A44|20260312120000 3PID||1||123456^^^HOSP_A^MR||Smith^John^M^^Mr.||19850315|M 4MRG||234567^^^HOSP_A^MR||VIS_WRONG_20260312
Troubleshooting Scenarios
Images in PACS still associated with wrong patient after A44
Cause
PACS received A44 but only updated the patient identifier on the encounter record — it did not relink the actual DICOM studies to the correct patient.
Fix
Confirm with the PACS vendor that A44 triggers study-level relinking using the visit/accession number in MRG.3. If not, a manual PACS administration operation may be required to relink the studies.
Charges remain on wrong patient account in billing system
Cause
Billing system does not support A44 account move and did not relink the DFT charges to the correct patient.
Fix
Work with billing staff to manually move the charges in the billing system. Document A44 as a known gap and establish a manual correction workflow until the billing system can be upgraded to handle A44.
Common Confusions
ADT^A44 (Move Account) vs ADT^A40 (Merge Patient). A44 moves only an encounter from one patient to another — both patients remain as separate records. A40 merges two patient identities into one. Use A44 when the patients are different people but an encounter was created under the wrong person. Use A40 when two records refer to the same person.
Related Message Types
Segment Reference
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