HL7 BAR_P05 Update Account

The account already exists; now billing context needs to change.
HL7 message structure BAR_P05 groups and segments from HL7 v2.5.1 Hide structure

These are the generated groups and segments for the version selected at the top of the page. The article explains the workflow, and this panel follows the chosen HL7 version.

Message Structure

SegmentNameRequiredRepeatable
MSH
 Message Header Yes No
SFT
 Software Segment No Yes
EVN
 Event Type Yes No
PID
 Patient Identification Yes No
PD1
 Patient Additional Demographic No No
ROL
 Role No Yes
BAR_P05.VISIT
 Visit group Yes Yes
PV1
 Patient Visit No No
PV2
 Patient Visit - Additional Information No No
ROL
 Role No Yes
DB1
 Disability No Yes
OBX
 Observation/Result No Yes
AL1
 Patient Allergy Information No Yes
DG1
 Diagnosis No Yes
DRG
 Diagnosis Related Group No No
BAR_P05.PROCEDURE
 Procedure group No Yes
PR1
 Procedures Yes No
ROL
 Role No Yes
GT1
 Guarantor No Yes
NK1
 Next of Kin / Associated Parties No Yes
BAR_P05.INSURANCE
 Insurance group No Yes
IN1
 Insurance Yes No
IN2
 Insurance Additional Information No No
IN3
 Insurance Additional Information, Certification No Yes
ROL
 Role No Yes
ACC
 Accident No No
UB1
 UB82 No No
UB2
 UB92 Data No No
ABS
 Abstract No No
BLC
 Blood Code No Yes
RMI
 Risk Management Incident No No

BAR_P05 updates an existing patient account. It is the account-maintenance counterpart to BAR_P01. Use it when the account exists and the billing receiver needs updated diagnosis, procedure, guarantor, insurance, billing, or related financial-administrative context.

In practice, P05 is where inpatient coding and account maintenance often show up. It is not a patient movement event and it is not the same thing as posting a charge line through DFT_P03.

A small BAR_P05 example

MSH|^~\&|REG|CITYHOSP|BILLING|CITYHOSP|20260715113000||BAR^P05^BAR_P05|BAR050001|P|2.5.1 EVN|P05|20260715112900 PID|1||123456^^^CITYHOSP^MR||Smith^Jane^Anne^^Ms^^L||19800314|F||||||||||ACC000789^^^CITYHOSP^AN PV1|1|I|WARD1^101^1^CITYHOSP||||12345^Careful^Clara|||||||||||VN000345^^^CITYHOSP^VN DG1|1||I10^Essential hypertension^I10|||A DRG|001^Example medical DRG^L GT1|1|G12345|Smith^Jane||12 High Street^^Auckland^^1010^NZ^H IN1|1|PLAN-A|INS001|City Health Plan

What systems do with it

The sender is usually registration, coding, ADT/accounting, or an integration engine consolidating account updates. The receiver updates the existing account record and may re-evaluate billing, coding, coverage, claims, or reporting from the supplied data.

Because the structure is broad, local profiles matter a lot. Some sites send only insurance updates. Others use P05 for diagnosis-related group, UB fields, account notes, or coding changes.

How to read the structure

BAR_P05 starts with MSH, EVN, PID, optional PD1, and optional provider role information. The required repeating visit group can include PV1, PV2, DG1, DRG, PR1, GT1, IN1, ABS, BLC, and RMI.

Implementation traps

Do not create the account when P05 arrives unless the trading partner explicitly designed that fallback. P05 assumes the account is already known. If it is not, reject or queue it with a clear error so the sender can send P01 first or correct the identifiers.

Also separate patient updates from account updates. If the patient address changed, A08 may be the right ADT event. If the account coverage changed, P05 is more precise.

Reference notes

The HL7 v2+ BAR_P05 page says P05 updates an existing account and should be used instead of P01 for account updates. It also distinguishes inpatient coding via P05 from outpatient APC grouping via P10.