Carries financial adjustment details applied to a healthcare claim or invoice line, including the adjustment category, amount, quantity, reason code, and the responsible organization. It appears in claims and remittance advice messages (EHC^E01, EHC^E02, EHC^E04) to communicate payer-initiated or provider-initiated modifications to billed amounts, enabling reconciliation between submitted and adjudicated charges.
from zato.hl7v2 import ADJ
adj = ADJ()
adj.adjustment_sequence_number = '1'
adj.adjustment_amount = '150.00'
adj.adjustment_description = 'Contractual write-off'How to construct and work with real-world ADJ segments.
Payer adjustment reducing the billed amount due to a contractual agreement with the provider
from zato.hl7v2.v2_9 import ADJ
from zato.hl7v2.v2_9 import EI, CWE
adj = ADJ()
adj.provider_adjustment_number = EI(
entity_identifier='ADJ001',
namespace_id='HOSP'
)
adj.payer_adjustment_number = EI(
entity_identifier='PAY001',
namespace_id='INS'
)
adj.adjustment_category = CWE(
identifier='CO',
text='Contractual',
name_of_coding_system='HL70564'
)
adj.adjustment_amount = '150.00'
adj.adjustment_description = (
'Contractual write-off'
)
adj.original_value = '500.00'
adj.substitute_value = '350.00'
adj.adjustment_date = '20240315'Full denial of a claim line with the reason code and adjustment action indicating a reversal
from zato.hl7v2.v2_9 import ADJ
from zato.hl7v2.v2_9 import EI, CWE
adj = ADJ()
adj.provider_adjustment_number = EI(
entity_identifier='ADJ002',
namespace_id='HOSP'
)
adj.payer_adjustment_number = EI(
entity_identifier='PAY002',
namespace_id='INS'
)
adj.adjustment_sequence_number = '1'
adj.adjustment_category = CWE(
identifier='PR',
text='Patient responsibility',
name_of_coding_system='HL70564'
)
adj.adjustment_amount = '250.00'
adj.adjustment_reason_pa = CWE(
identifier='NCA',
text='Not covered',
name_of_coding_system='HL70565'
)
adj.adjustment_description = (
'Non-covered service'
)
adj.original_value = '250.00'
adj.substitute_value = '0.00'
adj.adjustment_action = CWE(
identifier='REV',
text='Reversal',
name_of_coding_system='HL70569'
)
adj.adjustment_date = '20240501'Adjustment reducing billed quantity with a cross-reference to the original line item
from zato.hl7v2.v2_9 import ADJ
from zato.hl7v2.v2_9 import EI, CWE, XON
adj = ADJ()
adj.provider_adjustment_number = EI(
entity_identifier='ADJ003',
namespace_id='HOSP'
)
adj.payer_adjustment_number = EI(
entity_identifier='PAY003',
namespace_id='INS'
)
adj.adjustment_sequence_number = '2'
adj.adjustment_category = CWE(
identifier='OA',
text='Other adjustment',
name_of_coding_system='HL70564'
)
adj.adjustment_amount = '75.00'
adj.adjustment_description = (
'Qty correction'
)
adj.original_value = '300.00'
adj.substitute_value = '225.00'
adj.provider_product_service_line_item_number_cross_reference = EI(
entity_identifier='PSL001',
namespace_id='HOSP'
)
adj.adjustment_date = '20240610'
adj.responsible_organization = XON(organization_name='Blue Cross')Step-by-step guides for working with HL7 v2 in Zato.
ADJ communicates financial adjustments to healthcare claims. It carries the adjustment category (contractual, patient responsibility, etc.), the amount, a reason code, original and substitute values, and the date. It appears in EHC claim and remittance messages to reconcile billed vs. paid amounts.
The adjustment_category field uses the CWE datatype with HL7 table 0564:
from zato.hl7v2.v2_9 import ADJ, CWE
adj = ADJ()
adj.adjustment_category = CWE(
identifier='CO',
text='Contractual',
name_of_coding_system='HL70564'
)The adjustment_reason_pa field uses CWE with HL7 table 0565:
from zato.hl7v2.v2_9 import ADJ, CWE
adj = ADJ()
adj.adjustment_reason_pa = CWE(
identifier='NCA',
text='Not covered',
name_of_coding_system='HL70565'
)Use the provider_product_service_line_item_number_cross_reference field with the EI datatype:
from zato.hl7v2.v2_9 import ADJ, EI
adj = ADJ()
adj.provider_product_service_line_item_number_cross_reference = EI(
entity_identifier='PSL001',
namespace_id='HOSP'
)The responsible_organization field uses the XON (extended composite name and identification number for organizations) datatype:
from zato.hl7v2.v2_9 import ADJ, XON
adj = ADJ()
adj.responsible_organization = XON(organization_name='Blue Cross')Zato connects to any system that speaks HL7v2 over MLLP or FHIR over REST. This includes Epic, Cerner, Meditech, Allscripts, and other EHR platforms.
Yes, Zato has built-in MLLP support for sending and receiving HL7v2 messages. MLLP channels handle the framing protocol automatically.
Zato supports HL7 v2.9, which is backward compatible with earlier versions including v2.3, v2.5, and v2.7. Standard segments and datatypes are available as typed Python classes.
Yes. Zato handles both HL7v2 and FHIR natively, so you can parse v2 messages and build FHIR resources with IG-specific extensions in the same service. Typed Python classes are available for both protocols, including extensions from US Core, UK Core, Da Vinci, and other Implementation Guides.
Complete list of fields in the ADJ segment, HL7 v2.9.
| # | Python name | Datatype | Usage | Repeatable | Table |
|---|---|---|---|---|---|
| 1 | provider_adjustment_number | EI | Required | No | - |
| 2 | payer_adjustment_number | EI | Required | No | - |
| 3 | adjustment_sequence_number | SI | Required | No | - |
| 4 | adjustment_category | CWE | Required | No | HL70564 |
| 5 | adjustment_amount | CP | Optional | No | - |
| 6 | adjustment_quantity | CQ | Optional | No | HL70560 |
| 7 | adjustment_reason_pa | CWE | Optional | No | HL70565 |
| 8 | adjustment_description | ST | Optional | No | - |
| 9 | original_value | NM | Optional | No | - |
| 10 | substitute_value | NM | Optional | No | - |
| 11 | adjustment_action | CWE | Optional | No | HL70569 |
| 12 | provider_adjustment_number_cross_reference | EI | Optional | No | - |
| 13 | provider_product_service_line_item_number_cross_reference | EI | Optional | No | - |
| 14 | adjustment_date | DTM | Required | No | - |
| 15 | responsible_organization | XON | Optional | No | - |
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