KBV Remedy Prescription for Speech Therapy Template 13

Briefkopf
Description

Briefkopf

Name der Krankenversicherung
Description

Health Insurance name

Data type

text

Alias
UMLS CUI [1]
C0021682
Nachname
Description

Patient surname

Data type

text

Alias
UMLS CUI [1]
C0421448
Patientenname
Description

Patient Name

Data type

text

Alias
UMLS CUI [1]
C1299487
Adresse des Patienten
Description

Patient address

Data type

text

Alias
UMLS CUI [1]
C0421449
Patient Geburtsdatum
Description

Patient Birth Date

Data type

date

Alias
UMLS CUI [1]
C0421451
Kostenträgerkennung
Description

Insurance ID

Data type

integer

Alias
UMLS CUI [1]
C1547687
Versichertennummer
Description

Insurance number

Data type

integer

Alias
UMLS CUI [1]
C1549712
Status
Description

Status

Data type

integer

Alias
UMLS CUI [1]
C0449438
Betriebsstättennummer
Description

Facility number

Data type

integer

Alias
UMLS CUI [1]
C1549700
Arzt- Nr.
Description

Physician ID number

Data type

integer

Alias
UMLS CUI [1]
C1548646
Datum
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
Verordnung nach Maßgabe des Kataloges (Regelfall)
Description

Verordnung nach Maßgabe des Kataloges (Regelfall)

Erstverordnung
Description

primary prescription

Data type

boolean

Alias
UMLS CUI [1,1]
C0033080
UMLS CUI [1,2]
C0205225
Folgeverordnung
Description

subsequent prescription

Data type

boolean

Alias
UMLS CUI [1,1]
C0033080
UMLS CUI [1,2]
C0332282
group therapy
Description

group therapy

Data type

boolean

Alias
UMLS CUI [1]
C1527374
Verordnung außerhalb des Regelfalles
Description

prescription

Data type

boolean

Alias
UMLS CUI [1,1]
C0033080
UMLS CUI [1,2]
C0015370
Behandlungsbeginn spätest. am
Description

Treatment start date

Data type

date

Alias
UMLS CUI [1]
C3173309
Hausbesuch
Description

Home Visit

Data type

boolean

Alias
UMLS CUI [1]
C0020043
Therapiebericht
Description

Therapy Report

Data type

boolean

Alias
UMLS CUI [1]
C0684224
Heilmittelverordnung
Description

Heilmittelverordnung

IK des Leistungserbringers
Description

Institution number

Data type

text

Alias
UMLS CUI [1]
C0489558
Gesamt-Zuzahlung
Description

additional payment

Data type

float

Gesamt-Brutto
Description

total costs

Data type

float

Alias
UMLS CUI [1]
C0010186
Heilmittel-Pos.-Nr.
Description

drug id

Data type

text

Alias
UMLS CUI [1,1]
C4256366
UMLS CUI [1,2]
C0600091
Faktor
Description

factor

Data type

integer

Alias
UMLS CUI [1]
C1521761
Heilmittel-Pos.-Nr.
Description

drug id

Data type

text

Alias
UMLS CUI [1,1]
C4256366
UMLS CUI [1,2]
C0600091
Faktor
Description

factor

Data type

integer

Alias
UMLS CUI [1]
C1521761
Wegegeld-/Pauschale
Description

Allowance

Data type

text

Alias
UMLS CUI [1,1]
C0556660
UMLS CUI [1,2]
C0020043
km
Description

Distance

Data type

integer

Alias
UMLS CUI [1]
C0012751
Faktor
Description

factor

Data type

integer

Alias
UMLS CUI [1]
C1521761
Hausbesuch
Description

Home Visit

Data type

text

Alias
UMLS CUI [1]
C0020043
Faktor
Description

factor

Data type

integer

Alias
UMLS CUI [1]
C1521761
Hausbesuch
Description

Home Visit

Data type

text

Alias
UMLS CUI [1]
C0020043
Faktor
Description

factor

Data type

integer

Alias
UMLS CUI [1]
C1521761
Rechnungsnummer
Description

Account number

Data type

text

Alias
UMLS CUI [1]
C1549676
Belegnummer
Description

Billing code

Data type

text

Alias
UMLS CUI [1]
C1547149
Therapie
Description

Therapie

Stimmtherapie
Description

voice therapy

Data type

boolean

Alias
UMLS CUI [1]
C2202690
Sprechtherapie
Description

speech therapy

Data type

boolean

Alias
UMLS CUI [1]
C0037831
Sprachtherapie
Description

language therapy

Data type

boolean

Alias
UMLS CUI [1]
C0023017
Therapiedauer pro Sitzung
Description

Therapy duration

Data type

integer

Measurement units
  • Minuten
Alias
UMLS CUI [1]
C0444917
Minuten
Verordnungsmenge
Description

prescription quantity

Data type

integer

Alias
UMLS CUI [1,1]
C0449788
UMLS CUI [1,2]
C0033080
Therapiefrequenz
Description

therapy frequency

Data type

integer

Measurement units
  • pro Woche
Alias
UMLS CUI [1,1]
C0439603
UMLS CUI [1,2]
C0087111
pro Woche
Indikationsschlüssel
Description

Indication Number

Data type

text

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C0805701
Ggf. neurologische, pädiatrische Besonderheiten (z.B. psychointellektueller Befund)
Description

neurologic abnormalities

Data type

text

Alias
UMLS CUI [1]
C0027765
UMLS CUI [2]
C0679381
Ggf. Spezifizierung der Therapieziele
Description

therapy goal

Data type

text

Alias
UMLS CUI [1]
C0679840
Medizinische Begründung bei Verordnungen außerhalb des Regelfalles (Beiblatt)
Description

indication

Data type

text

Alias
UMLS CUI [1]
C3146298
Diagnose mit Leitsymptomatik, störungsspezifischer Befund
Description

Diagnose mit Leitsymptomatik, störungsspezifischer Befund

ICD-10 - Code
Description

ICD Code

Data type

text

Alias
UMLS CUI [1]
C2598420
Diagnose mit Leitsymptomatik, gegebenenfalls wesentliche Befunde
Description

Diagnosis

Data type

text

Alias
UMLS CUI [1]
C0011900
Tonaudiogram
Description

Tonaudiogram

Tonaudiogramm vom
Description

Bitte bei pathologischem oder unsicherem Tonschwellenaudiogramm Tympanogramm und Sprachaudiogramm beifügen.

Data type

date

Alias
UMLS CUI [1,1]
C0018786
UMLS CUI [1,2]
C0011008
Freifeldbefunde ermittelt durch:
Description

audiogram finding

Data type

integer

Alias
UMLS CUI [1,1]
C0018786
UMLS CUI [1,2]
C0243095
Trommelfellbefund rechts
Description

eardrum rechts

Data type

text

Alias
UMLS CUI [1,1]
C0041445
UMLS CUI [1,2]
C0205090
Trommelfellbefund links
Description

eardrum left

Data type

text

Alias
UMLS CUI [1,1]
C0041445
UMLS CUI [1,2]
C0205091
Tonaudiogramm links
Description

Tonaudiogramm links

Schalldruckpegel
Description

sound pressure level left

Data type

integer

Measurement units
  • dB
Alias
UMLS CUI [1,1]
C0178733
UMLS CUI [1,2]
C0205091
dB
Schallfrequenz
Description

tone frequency

Data type

integer

Measurement units
  • Hz
Alias
UMLS CUI [1,1]
C0237917
UMLS CUI [1,2]
C0205091
Hz
Tonaudiogramm rechts
Description

Tonaudiogramm rechts

Schalldruckpegel
Description

sound pressure level left

Data type

integer

Measurement units
  • dB
Alias
UMLS CUI [1,1]
C0178733
UMLS CUI [1,2]
C0205090
dB
Schallfrequenz
Description

tone frequency

Data type

integer

Measurement units
  • Hz
Alias
UMLS CUI [1,1]
C0237917
UMLS CUI [1,2]
C0205090
Hz
Laryngologischer Befund (bei Stimmstörungen)
Description

Laryngologischer Befund (bei Stimmstörungen)

Lupenlaryngoskopie
Description

laryngoscopy

Data type

text

Alias
UMLS CUI [1]
C0023072
Lupenstroboskopie links
Description

stroboscopy left

Data type

text

Alias
UMLS CUI [1,1]
C1450459
UMLS CUI [1,2]
C0205091
Lupenstroboskopie rechts
Description

stroboscopy right

Data type

text

Alias
UMLS CUI [1,1]
C1450459
UMLS CUI [1,2]
C0205090
Amplitude links
Description

amplitude left

Data type

text

Alias
UMLS CUI [1,1]
C2346753
UMLS CUI [1,2]
C0205091
Amplitude rechts
Description

amplitude right

Data type

text

Alias
UMLS CUI [1,1]
C2346753
UMLS CUI [1,2]
C0205090
Randkantenverschiebung rechts
Description

Margin Vocal Cord Shifted right

Data type

text

Alias
UMLS CUI [1,1]
C0042930
UMLS CUI [1,2]
C0026724
UMLS CUI [1,3]
C0205284
UMLS CUI [1,4]
C2347509
UMLS CUI [1,5]
C0205090
Randkantenverschiebung links
Description

Margin Vocal Cord Shifted left

Data type

text

Alias
UMLS CUI [1,1]
C0042930
UMLS CUI [1,2]
C0026724
UMLS CUI [1,3]
C0205284
UMLS CUI [1,4]
C2347509
UMLS CUI [1,5]
C0205091
Regularität
Description

normal finding

Data type

boolean

Alias
UMLS CUI [1]
C0205307
Kompletter Glottisschluss
Description

closure of glottis

Data type

boolean

Alias
UMLS CUI [1]
C1408723
Laryngologischer Befund geschlossen rechts
Description

laryngoscopic finding right closed

Data type

text

Alias
UMLS CUI [1,1]
C0426538
UMLS CUI [1,2]
C0234772
UMLS CUI [1,3]
C0205090
Laryngologischer Befund geschlossen links
Description

laryngoscopic finding left closed

Data type

text

Alias
UMLS CUI [1,1]
C0426538
UMLS CUI [1,2]
C0234772
UMLS CUI [1,3]
C0205091
Laryngologischer Befund offen rechts
Description

laryngoscopic finding right open

Data type

text

Alias
UMLS CUI [1,1]
C0426538
UMLS CUI [1,2]
C0234775
UMLS CUI [1,3]
C0205090
Laryngologischer Befund offen links
Description

laryngoscopic finding left open

Data type

text

Alias
UMLS CUI [1,1]
C0426538
UMLS CUI [1,2]
C0234775
UMLS CUI [1,3]
C0205091

Similar models

KBV Remedy Prescription for Speech Therapy Template 13

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Briefkopf
Health Insurance name
Item
Name der Krankenversicherung
text
C0021682 (UMLS CUI [1])
Patient surname
Item
Nachname
text
C0421448 (UMLS CUI [1])
Patient Name
Item
Patientenname
text
C1299487 (UMLS CUI [1])
Patient address
Item
Adresse des Patienten
text
C0421449 (UMLS CUI [1])
Patient Birth Date
Item
Patient Geburtsdatum
date
C0421451 (UMLS CUI [1])
Insurance ID
Item
Kostenträgerkennung
integer
C1547687 (UMLS CUI [1])
Insurance number
Item
Versichertennummer
integer
C1549712 (UMLS CUI [1])
Status
Item
Status
integer
C0449438 (UMLS CUI [1])
Facility number
Item
Betriebsstättennummer
integer
C1549700 (UMLS CUI [1])
Physician ID number
Item
Arzt- Nr.
integer
C1548646 (UMLS CUI [1])
Date
Item
Datum
date
C0011008 (UMLS CUI [1])
Item Group
Verordnung nach Maßgabe des Kataloges (Regelfall)
primary prescription
Item
Erstverordnung
boolean
C0033080 (UMLS CUI [1,1])
C0205225 (UMLS CUI [1,2])
subsequent prescription
Item
Folgeverordnung
boolean
C0033080 (UMLS CUI [1,1])
C0332282 (UMLS CUI [1,2])
group therapy
Item
boolean
C1527374 (UMLS CUI [1])
prescription
Item
Verordnung außerhalb des Regelfalles
boolean
C0033080 (UMLS CUI [1,1])
C0015370 (UMLS CUI [1,2])
Treatment start date
Item
Behandlungsbeginn spätest. am
date
C3173309 (UMLS CUI [1])
Home Visit
Item
Hausbesuch
boolean
C0020043 (UMLS CUI [1])
Therapy Report
Item
Therapiebericht
boolean
C0684224 (UMLS CUI [1])
Item Group
Heilmittelverordnung
Institution number
Item
IK des Leistungserbringers
text
C0489558 (UMLS CUI [1])
additional payment
Item
Gesamt-Zuzahlung
float
total costs
Item
Gesamt-Brutto
float
C0010186 (UMLS CUI [1])
drug id
Item
Heilmittel-Pos.-Nr.
text
C4256366 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
factor
Item
Faktor
integer
C1521761 (UMLS CUI [1])
drug id
Item
Heilmittel-Pos.-Nr.
text
C4256366 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
factor
Item
Faktor
integer
C1521761 (UMLS CUI [1])
Allowance
Item
Wegegeld-/Pauschale
text
C0556660 (UMLS CUI [1,1])
C0020043 (UMLS CUI [1,2])
Distance
Item
km
integer
C0012751 (UMLS CUI [1])
factor
Item
Faktor
integer
C1521761 (UMLS CUI [1])
Home Visit
Item
Hausbesuch
text
C0020043 (UMLS CUI [1])
factor
Item
Faktor
integer
C1521761 (UMLS CUI [1])
Home Visit
Item
Hausbesuch
text
C0020043 (UMLS CUI [1])
factor
Item
Faktor
integer
C1521761 (UMLS CUI [1])
Account number
Item
Rechnungsnummer
text
C1549676 (UMLS CUI [1])
Billing code
Item
Belegnummer
text
C1547149 (UMLS CUI [1])
Item Group
Therapie
voice therapy
Item
Stimmtherapie
boolean
C2202690 (UMLS CUI [1])
speech therapy
Item
Sprechtherapie
boolean
C0037831 (UMLS CUI [1])
language therapy
Item
Sprachtherapie
boolean
C0023017 (UMLS CUI [1])
Therapy duration
Item
Therapiedauer pro Sitzung
integer
C0444917 (UMLS CUI [1])
prescription quantity
Item
Verordnungsmenge
integer
C0449788 (UMLS CUI [1,1])
C0033080 (UMLS CUI [1,2])
therapy frequency
Item
Therapiefrequenz
integer
C0439603 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
Indication Number
Item
Indikationsschlüssel
text
C3146298 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
neurologic abnormalities
Item
Ggf. neurologische, pädiatrische Besonderheiten (z.B. psychointellektueller Befund)
text
C0027765 (UMLS CUI [1])
C0679381 (UMLS CUI [2])
therapy goal
Item
Ggf. Spezifizierung der Therapieziele
text
C0679840 (UMLS CUI [1])
indication
Item
Medizinische Begründung bei Verordnungen außerhalb des Regelfalles (Beiblatt)
text
C3146298 (UMLS CUI [1])
Item Group
Diagnose mit Leitsymptomatik, störungsspezifischer Befund
ICD Code
Item
ICD-10 - Code
text
C2598420 (UMLS CUI [1])
Diagnosis
Item
Diagnose mit Leitsymptomatik, gegebenenfalls wesentliche Befunde
text
C0011900 (UMLS CUI [1])
Item Group
Tonaudiogram
audiogram date
Item
Tonaudiogramm vom
date
C0018786 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Freifeldbefunde ermittelt durch:
integer
C0018786 (UMLS CUI [1,1])
C0243095 (UMLS CUI [1,2])
Code List
Freifeldbefunde ermittelt durch:
CL Item
Reaktion (1)
CL Item
Konditionierung (2)
CL Item
eigene Angaben (3)
eardrum rechts
Item
Trommelfellbefund rechts
text
C0041445 (UMLS CUI [1,1])
C0205090 (UMLS CUI [1,2])
eardrum left
Item
Trommelfellbefund links
text
C0041445 (UMLS CUI [1,1])
C0205091 (UMLS CUI [1,2])
Item Group
Tonaudiogramm links
sound pressure level left
Item
Schalldruckpegel
integer
C0178733 (UMLS CUI [1,1])
C0205091 (UMLS CUI [1,2])
tone frequency
Item
Schallfrequenz
integer
C0237917 (UMLS CUI [1,1])
C0205091 (UMLS CUI [1,2])
Item Group
Tonaudiogramm rechts
sound pressure level left
Item
Schalldruckpegel
integer
C0178733 (UMLS CUI [1,1])
C0205090 (UMLS CUI [1,2])
tone frequency
Item
Schallfrequenz
integer
C0237917 (UMLS CUI [1,1])
C0205090 (UMLS CUI [1,2])
Item Group
Laryngologischer Befund (bei Stimmstörungen)
laryngoscopy
Item
Lupenlaryngoskopie
text
C0023072 (UMLS CUI [1])
stroboscopy left
Item
Lupenstroboskopie links
text
C1450459 (UMLS CUI [1,1])
C0205091 (UMLS CUI [1,2])
stroboscopy right
Item
Lupenstroboskopie rechts
text
C1450459 (UMLS CUI [1,1])
C0205090 (UMLS CUI [1,2])
amplitude left
Item
Amplitude links
text
C2346753 (UMLS CUI [1,1])
C0205091 (UMLS CUI [1,2])
amplitude right
Item
Amplitude rechts
text
C2346753 (UMLS CUI [1,1])
C0205090 (UMLS CUI [1,2])
Margin Vocal Cord Shifted right
Item
Randkantenverschiebung rechts
text
C0042930 (UMLS CUI [1,1])
C0026724 (UMLS CUI [1,2])
C0205284 (UMLS CUI [1,3])
C2347509 (UMLS CUI [1,4])
C0205090 (UMLS CUI [1,5])
Margin Vocal Cord Shifted left
Item
Randkantenverschiebung links
text
C0042930 (UMLS CUI [1,1])
C0026724 (UMLS CUI [1,2])
C0205284 (UMLS CUI [1,3])
C2347509 (UMLS CUI [1,4])
C0205091 (UMLS CUI [1,5])
normal finding
Item
Regularität
boolean
C0205307 (UMLS CUI [1])
closure of glottis
Item
Kompletter Glottisschluss
boolean
C1408723 (UMLS CUI [1])
laryngoscopic finding right closed
Item
Laryngologischer Befund geschlossen rechts
text
C0426538 (UMLS CUI [1,1])
C0234772 (UMLS CUI [1,2])
C0205090 (UMLS CUI [1,3])
laryngoscopic finding left closed
Item
Laryngologischer Befund geschlossen links
text
C0426538 (UMLS CUI [1,1])
C0234772 (UMLS CUI [1,2])
C0205091 (UMLS CUI [1,3])
laryngoscopic finding right open
Item
Laryngologischer Befund offen rechts
text
C0426538 (UMLS CUI [1,1])
C0234775 (UMLS CUI [1,2])
C0205090 (UMLS CUI [1,3])
laryngoscopic finding left open
Item
Laryngologischer Befund offen links
text
C0426538 (UMLS CUI [1,1])
C0234775 (UMLS CUI [1,2])
C0205091 (UMLS CUI [1,3])