^T11
MDM^T11 — Document Cancel Notification
MDM^T11 notifies downstream systems that a previously sent document has been retracted or cancelled. It instructs the receiving system to remove the document from active clinical views and mark it as cancelled in the document record.
When Is This Sent?
When a previously sent document is retracted or cancelled — for example, a radiology report dictated for the wrong patient, or a document that was transmitted in error. The TXA segment identifies the specific document to cancel.
Real-World Usage
Document cancellations are infrequent but critical for patient safety. A report delivered to the wrong patient record could cause serious clinical harm if not retracted. MDM^T11 must be processed promptly and reliably. Most EMRs will mark the cancelled document with a 'cancelled' status rather than physically deleting it to preserve the audit trail. Ensure your interface engine treats T11 with high priority.
Message Structure
Segment names link to their field-level reference pages.
| # | Segment | Purpose in this message | Req | Repeat |
|---|---|---|---|---|
| 1 | MSH | Message header with MDM^T11 in MSH.9 | R | — |
| 2 | EVN | Event type with T11 trigger and cancellation timestamp | R | — |
| 3 | PID | Patient demographics for the document being cancelled | R | — |
| 4 | PV1 | Visit context from the original document | R | — |
| 5 | TXA | Document metadata identifying the specific document to cancel — TXA.12 (unique document number) is the key | R | — |
| 6 | NTE | Reason for cancellation | O | Yes |
Example Message
Realistic example with fake patient data. Paste into the HL7 Message Viewer to explore interactively.
1MSH||^~\&|RIS|HOSPITAL_A|EPIC|HOSPITAL_A|20260310170000||MDM^T11^MDM_T11|MDM_T11_001|P|2.5.1 2EVN||T11|20260310170000 3PID||1||123456^^^HOSP_A^MR||Smith^John^M^^Mr.||19850315|M 4PV1||1|I|4A^201^1^^^HOSP_A||||1234^Ahmed^Dr.^Khalid 5TXA||1|RAD|FT|20260310160000|5678^Wilson^Dr.^Sarah^R|||ACC20260310001^RIS|||5678^Wilson^Dr.^Sarah^R|ACC20260310001|||||CA
Troubleshooting Scenarios
Cancelled document still visible and accessible in EMR
Cause
EMR processed the T11 but only set a hidden flag rather than actually removing the document from clinical views. The UI still shows the document.
Fix
Work with the EMR vendor to confirm T11 processing results in the document being removed from clinical views or prominently marked as CANCELLED. Test in a UAT environment — verify the document is not visible to clinical users after T11 is processed.
T11 cannot be matched to the original document
Cause
TXA.12 (unique document number) in the T11 doesn't match what was stored when the original document was received via T01/T02.
Fix
Compare TXA.12 in the T11 against TXA.12 in the original T01/T02. They must be identical. If the original message used TXA.13 (parent document number) as the primary key instead, update the T11 accordingly.
Common Confusions
MDM^T11 (Cancel document) vs MDM^T09 (Document status change). T11 cancels/retracts a document entirely. T09 changes the document status (e.g., from preliminary to final) without cancellation. Also: T11 vs an addendum workflow — if a document needs correction, use an addendum (T05/T06) rather than cancellation; only use T11 for documents that should never have been sent or were sent to the wrong patient.
Related Message Types
Segment Reference
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