Reference·NTE Segment·NTE-2
HL7 v2 Reference

NTE-2 in HL7 v2: A Field Guide to Source of Comment

Jul 28, 2026 · 4 min read
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NTE-2 answers a question receiving systems care about a lot more than test suites usually do: did this note come from the patient, from a lab tech, or from the ordering provider - because a lot of downstream routing and display logic branches on exactly that.

Quick answer

NTE-2 is a coded field indicating who or what produced the note carried in NTE-3. Common uses include marking a comment as coming from an ancillary department such as a lab, from the ordering provider, or from the patient directly, and systems often display or route notes differently depending on which source they came from.

What this field contains

Format
Short coded value — a brief code such as a one- or two-letter abbreviation representing the originating party or system
Cardinality
Frequently blank in practice — many source systems omit it and leave the receiving system to infer origin from the parent segment instead
Common failure
One hardcoded source — generators that always emit the same source code hide bugs in logic meant to route or flag notes differently by origin

Example

Synthetic example Generated by Synthibase
OBX|1|ST|3456-2^COMMENT^LN||See attached note
NTE|1|P|Patient states symptoms began three days prior to visit.

A synthetic NTE segment with source code P for patient-originated commentary, following an OBX result.

Where this trips people up

It is easy to build a test suite where every NTE-2 value is the same ancillary-department code because that is the scenario a lab interface happens to produce most often. When a patient-sourced or provider-sourced note eventually arrives in production, any downstream logic that treats source differently - flagging patient-reported notes for clinical review, say - never got a single test case that exercised it. If your generator only ever produces one source value, that branch is effectively untested.

Testing HL7 v2 NTE: The Fields Your System Actually Needs to Handle
How to Write EDI Test Cases
HL7 ADT Messages: A01 through A08 Explained
Cover every note source your system needs to handle
Synthibase varies the source of comment across generated NTE segments - patient, ancillary, and provider - so branching logic tied to note origin gets real test coverage instead of a single hardcoded path.
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