Clarification on Use of CVX vs. NDC Codes in HL7 Vaccine Messaging

[Jyothi Yella]

Hi Team, 

In our EMR system, we currently maintain CVX codes to represent vaccine information in our HL7 VXU messages, as per the usual immunization data exchange standards. 

However, during validation using the NIST tool, we noticed that NDC codes are being referenced or expected in the message structure. We would like to clarify the following: 

• Is it acceptable to maintain only CVX codes in our HL7 messages, or is it mandatory to include NDC codes as well?
• Are there specific test scenarios or implementation guides that require NDC codes in addition to or instead of CVX codes?
• Would the absence of NDC codes cause any validation failures or compliance issues during certification or production-level data exchange?

 

We want to ensure that our implementation aligns with the latest standards and certification expectations, and would appreciate your guidance on this. 

Looking forward to your response. 

 

Regards,

Jyothi Yella

[Snelick, Robert D. (Fed)]

Hi Jyothi,

 

It depends on what you are referring to as “certification”.

 

For ONC certification, NDC codes are required. ONC using the HL7 2.5.1 Immunization Implementation Guide but also adds additional criterion in the final rule. Use of NDC is one of those.

 

Here is a summary for your question in the NIST documentation:

 

Vaccine Codes Required for Immunization Messages

 

ONC Certification Testing Only

• Codes from the NDC Directory are required for vaccines in new vaccine administered records in
• Z22 VXU (send unsolicited immunization update message)
• CVX codes are required for vaccines in vaccine historical records in
• Z22 VXU (send unsolicited immunization update message)
• Z42 RSP (return evaluated history and forecast message)

Example Scenario

•        A Z22 VXU message is transmitted from an EHR to an IIS with an NDC for a new vaccine administered

•        A query for an Evaluated Immunization History and Forecast (Z44 QBP message) is performed via the EHR the next day

•        The response for the Evaluated Immunization History and Forecast (Z42 RSP message) is transmitted from the IIS with a CVX code for the vaccine sent with an NDC in the Z22 VXU the day before, as this vaccine now exists as a historical record in the IIS

 

 

Regards,

Rob

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