ID

24768

Beschreibung

Muster 39 - Krebsfrüherkennung - Frauen (Freigabe 22.10.2014). Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php --- Template 39 - Early Detection of Cancer Women (Released 10-22-2014). Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php

Link

www.kbv.de

Stichworte

Versionen (4)
  1. 29.01.17 29.01.17 -
  2. 16.08.17 16.08.17 -
  3. 07.09.17 07.09.17 -
  4. 07.09.17 07.09.17 -
Rechteinhaber

Kassenärztliche Bundesvereinigung

Hochgeladen am

16. August 2017

DOI

Für eine Beantragung loggen Sie sich ein.

Lizenz

Creative Commons BY-NC 3.0
Modell Kommentare :

Hier können Sie das Modell kommentieren. Über die Sprechblasen an den Itemgruppen und Items können Sie diese spezifisch kommentieren.

Zurück zu Modell Kommentaren
Itemgroup Kommentare für :

Item Kommentare für :

Um Formulare herunterzuladen müssen Sie angemeldet sein. Bitte loggen Sie sich ein oder registrieren Sie sich kostenlos.

KBV Early Detection of Cancer Women Template 39

Deutsch Englisch

KBV Early Detection of Cancer Women Template 39b

3 Formulare  
Heading
Beschreibung

Heading

Health Insurance name
Beschreibung

Health Insurance name

Datentyp

text

Alias
UMLS CUI [1]
C0021682
Patient surname
Beschreibung

Patient surname

Datentyp

text

Alias
UMLS CUI [1]
C0421448
Patient Name
Beschreibung

Patient Name

Datentyp

text

Alias
UMLS CUI [1]
C1299487
Patient address
Beschreibung

Patient address

Datentyp

text

Alias
UMLS CUI [1]
C0421449
Patient Birth Date
Beschreibung

Patient Birth Date

Datentyp

date

Alias
UMLS CUI [1]
C0421451
Insurance ID
Beschreibung

Insurance ID

Datentyp

integer

Alias
UMLS CUI [1]
C1547687
Insurance number
Beschreibung

Insurance number

Datentyp

integer

Alias
UMLS CUI [1]
C1549712
Status
Beschreibung

Status

Datentyp

integer

Alias
UMLS CUI [1]
C0449438
Facility number
Beschreibung

Facility number

Datentyp

integer

Alias
UMLS CUI [1]
C1549700
Physician ID number
Beschreibung

Physician ID number

Datentyp

integer

Alias
UMLS CUI [1]
C1548646
Date
Beschreibung

Date

Datentyp

date

Alias
UMLS CUI [1]
C0011008
Medical History
Beschreibung

Medical History

Date of birth
Beschreibung

Date of birth

Datentyp

integer

Maßeinheiten
  • JJJJ
Alias
UMLS CUI [1]
C0421451
JJJJ
Examination date
Beschreibung

Examination date

Datentyp

date

Alias
UMLS CUI [1]
C2826643
former cancer screening
Beschreibung

former cancer screening

Datentyp

boolean

Alias
UMLS CUI [1]
C0199230
date of last cancer screening
Beschreibung

date of last cancer screening

Datentyp

date

Alias
UMLS CUI [1,1]
C0199230
UMLS CUI [1,2]
C2826643
cytologic finding
Beschreibung

cytologic finding

Datentyp

integer

Alias
UMLS CUI [1]
C1265900
cytologic finding group
Beschreibung

cytologic finding group

Datentyp

text

gynecologic operation, radio- or chemotherapy of genitals
Beschreibung

gynecologic operation, radio- or chemotherapy of genitals

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0038902
UMLS CUI [1,2]
C0392920
UMLS CUI [1,3]
C1522449
gynecologic therapy
Beschreibung

gynecologic therapy

Datentyp

text

date of gynecologic therapy
Beschreibung

date of gynecologic therapy

Datentyp

date

Alias
UMLS CUI [1]
C2584899
count of pregnancies and
Beschreibung

count of pregnancies and

Datentyp

integer

Alias
UMLS CUI [1]
C0032967
UMLS CUI [2]
C0000786
current medical history
Beschreibung

current medical history

Datentyp

text

Last menstrual period
Beschreibung

Last menstrual period

Datentyp

date

Alias
UMLS CUI [1]
C0369661
pregnancy
Beschreibung

pregnancy

Datentyp

boolean

Alias
UMLS CUI [1]
C0032961
pathologic gynecologic bleedings
Beschreibung

pathologic gynecologic bleedings

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0019080
UMLS CUI [1,2]
C0205480
discharge
Beschreibung

discharge

Datentyp

boolean

Alias
UMLS CUI [1]
C0012621
intrauterine device
Beschreibung

intrauterine device

Datentyp

boolean

Alias
UMLS CUI [1]
C0021900
ovulation inhibitor
Beschreibung

ovulation inhibitor

Datentyp

boolean

Alias
UMLS CUI [1]
C0029968
hormone therapy
Beschreibung

hormone therapy

Datentyp

boolean

Alias
UMLS CUI [1]
C0279025
which hormone therapy
Beschreibung

which hormone therapy

Datentyp

text

hormone therapy indication
Beschreibung

hormone therapy indication

Datentyp

text

Alias
UMLS CUI [1,1]
C0279025
UMLS CUI [1,2]
C3146298
Finding
Beschreibung

Finding

vulva inspection
Beschreibung

vulva inspection

Datentyp

boolean

Alias
UMLS CUI [1,1]
C2381411
UMLS CUI [1,2]
C0425834
portio and vagina
Beschreibung

portio and vagina

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0425844
UMLS CUI [1,2]
C1185877
physical examination of inner genital
Beschreibung

physical examination of inner genital

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0037088
UMLS CUI [1,2]
C0200048
inguinal lymph nodes conspicuous
Beschreibung

inguinal lymph nodes conspicuous

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0729596
UMLS CUI [1,2]
C0437527
other findings requiring treatment
Beschreibung

other findings requiring treatment

Datentyp

boolean

Alias
UMLS CUI [1]
C0243095
Skin
Beschreibung

Skin

Datentyp

boolean

Alias
UMLS CUI [1]
C0007114
Mamma
Beschreibung

Mamma

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0006141
UMLS CUI [1,2]
C0437086
axillary lymph nodes
Beschreibung

axillary lymph nodes

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0729594
UMLS CUI [1,2]
C0243095
hematochezia
Beschreibung

hematochezia

Datentyp

boolean

Alias
UMLS CUI [1]
C0018932
abnormalities in stool
Beschreibung

abnormalities in stool

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1704258
UMLS CUI [1,2]
C0011135
Rectum palpation finding conspicious
Beschreibung

Rectum palpation finding conspicious

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1384593
UMLS CUI [1,2]
C1290912
Rectum stool sample
Beschreibung

Rectum stool sample

Datentyp

boolean

Alias
UMLS CUI [1]
C1550661
Stool test positive
Beschreibung

Stool test positive

Datentyp

boolean

Alias
UMLS CUI [1]
C0202010
gynacologic finding
Beschreibung

gynacologic finding

Datentyp

text

Alias
UMLS CUI [1,1]
C0243095
UMLS CUI [1,2]
C0205480
Blood Pressure
Beschreibung

Blood Pressure

Datentyp

text

Maßeinheiten
  • ___/___
Alias
UMLS CUI [1]
C0005823
___/___
Blood Pressure remeasurement
Beschreibung

Blood Pressure remeasurement

Datentyp

text

Maßeinheiten
  • ___/___
___/___
Cytologic finding
Beschreibung

Cytologic finding

cytologic specimen not applicable
Beschreibung

cytologic specimen not applicable

Datentyp

boolean

Alias
UMLS CUI [1]
C1610044
endocervical cells
Beschreibung

endocervical cells

Datentyp

integer

Alias
UMLS CUI [1,1]
C4038423
UMLS CUI [1,2]
C0370003
proliferation
Beschreibung

proliferation

Datentyp

text

Alias
UMLS CUI [1]
C1514485
Lactobacillus
Beschreibung

Lactobacillus

Datentyp

boolean

Alias
UMLS CUI [1]
C0022938
vaginal flora
Beschreibung

vaginal flora

Datentyp

boolean

Alias
UMLS CUI [1]
C1982070
vaginal flora cocci
Beschreibung

vaginal flora cocci

Datentyp

boolean

Alias
UMLS CUI [1]
C0314746
Trichomonaden
Beschreibung

Trichomonaden

Datentyp

boolean

Alias
UMLS CUI [1]
C0040923
candida
Beschreibung

candida

Datentyp

boolean

Alias
UMLS CUI [1]
C0006837
Gardnerella
Beschreibung

Gardnerella

Datentyp

boolean

Alias
UMLS CUI [1]
C0017098
group
Beschreibung

group

Datentyp

text

comments
Beschreibung

comments

Datentyp

text

Alias
UMLS CUI [1]
C0947611
further treatment
Beschreibung

further treatment

Datentyp

integer

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C1517331
cytologic control after therapy
Beschreibung

cytologic control after therapy

Datentyp

text

Signature
Beschreibung

Signature

Signature date
Beschreibung

Signature date

Datentyp

date

Alias
UMLS CUI [1]
C0807937
Zum Seitenanfang zurückkehren

Ähnliche Modelle

KBV Early Detection of Cancer Women Template 39b

3 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Health Insurance name
Item
text
C0021682 (UMLS CUI [1])
Patient surname
Item
text
C0421448 (UMLS CUI [1])
Patient Name
Item
text
C1299487 (UMLS CUI [1])
Patient address
Item
text
C0421449 (UMLS CUI [1])
Patient Birth Date
Item
date
C0421451 (UMLS CUI [1])
Insurance ID
Item
integer
C1547687 (UMLS CUI [1])
Insurance number
Item
integer
C1549712 (UMLS CUI [1])
Status
Item
integer
C0449438 (UMLS CUI [1])
Facility number
Item
integer
C1549700 (UMLS CUI [1])
Physician ID number
Item
integer
C1548646 (UMLS CUI [1])
Date
Item
date
C0011008 (UMLS CUI [1])
Date of birth
Item
integer
C0421451 (UMLS CUI [1])
Examination date
Item
date
C2826643 (UMLS CUI [1])
former cancer screening
Item
boolean
C0199230 (UMLS CUI [1])
date of last cancer screening
Item
date
C0199230 (UMLS CUI [1,1])
C2826643 (UMLS CUI [1,2])
cytologic finding
Item
integer
C1265900 (UMLS CUI [1])
cytologic finding group
Item
text
gynecologic operation, radio- or chemotherapy of genitals
Item
boolean
C0038902 (UMLS CUI [1,1])
C0392920 (UMLS CUI [1,2])
C1522449 (UMLS CUI [1,3])
gynecologic therapy
Item
text
date of gynecologic therapy
Item
date
C2584899 (UMLS CUI [1])
count of pregnancies and
Item
integer
C0032967 (UMLS CUI [1])
C0000786 (UMLS CUI [2])
current medical history
Item
text
Last menstrual period
Item
date
C0369661 (UMLS CUI [1])
pregnancy
Item
boolean
C0032961 (UMLS CUI [1])
pathologic gynecologic bleedings
Item
boolean
C0019080 (UMLS CUI [1,1])
C0205480 (UMLS CUI [1,2])
discharge
Item
boolean
C0012621 (UMLS CUI [1])
intrauterine device
Item
boolean
C0021900 (UMLS CUI [1])
ovulation inhibitor
Item
boolean
C0029968 (UMLS CUI [1])
hormone therapy
Item
boolean
C0279025 (UMLS CUI [1])
which hormone therapy
Item
text
hormone therapy indication
Item
text
C0279025 (UMLS CUI [1,1])
C3146298 (UMLS CUI [1,2])
Item Group
vulva inspection
Item
boolean
C2381411 (UMLS CUI [1,1])
C0425834 (UMLS CUI [1,2])
portio and vagina
Item
boolean
C0425844 (UMLS CUI [1,1])
C1185877 (UMLS CUI [1,2])
physical examination of inner genital
Item
boolean
C0037088 (UMLS CUI [1,1])
C0200048 (UMLS CUI [1,2])
inguinal lymph nodes conspicuous
Item
boolean
C0729596 (UMLS CUI [1,1])
C0437527 (UMLS CUI [1,2])
other findings requiring treatment
Item
boolean
C0243095 (UMLS CUI [1])
Skin
Item
boolean
C0007114 (UMLS CUI [1])
Mamma
Item
boolean
C0006141 (UMLS CUI [1,1])
C0437086 (UMLS CUI [1,2])
axillary lymph nodes
Item
boolean
C0729594 (UMLS CUI [1,1])
C0243095 (UMLS CUI [1,2])
hematochezia
Item
boolean
C0018932 (UMLS CUI [1])
abnormalities in stool
Item
boolean
C1704258 (UMLS CUI [1,1])
C0011135 (UMLS CUI [1,2])
Rectum palpation finding conspicious
Item
boolean
C1384593 (UMLS CUI [1,1])
C1290912 (UMLS CUI [1,2])
Rectum stool sample
Item
boolean
C1550661 (UMLS CUI [1])
Stool test positive
Item
boolean
C0202010 (UMLS CUI [1])
gynacologic finding
Item
text
C0243095 (UMLS CUI [1,1])
C0205480 (UMLS CUI [1,2])
Blood Pressure
Item
text
C0005823 (UMLS CUI [1])
Blood Pressure remeasurement
Item
text
cytologic specimen not applicable
Item
boolean
C1610044 (UMLS CUI [1])
Item
integer
C4038423 (UMLS CUI [1,1])
C0370003 (UMLS CUI [1,2])
endocervical cells
Code List
endocervical cells
CL Item
 (1)
CL Item
 (2)
proliferation
Item
text
C1514485 (UMLS CUI [1])
Lactobacillus
Item
boolean
C0022938 (UMLS CUI [1])
vaginal flora
Item
boolean
C1982070 (UMLS CUI [1])
vaginal flora cocci
Item
boolean
C0314746 (UMLS CUI [1])
Trichomonaden
Item
boolean
C0040923 (UMLS CUI [1])
candida
Item
boolean
C0006837 (UMLS CUI [1])
Gardnerella
Item
boolean
C0017098 (UMLS CUI [1])
group
Item
text
comments
Item
text
C0947611 (UMLS CUI [1])
Item
integer
C0087111 (UMLS CUI [1,1])
C1517331 (UMLS CUI [1,2])
further treatment
Code List
further treatment
CL Item
 (1)
CL Item
 (2)
CL Item
 (3)
CL Item
 (4)
CL Item
 (5)
cytologic control after therapy
Item
text
Item Group
Signature
Signature date
Item
Signature date
date
C0807937 (UMLS CUI [1])
Zum Seitenanfang zurückkehren 

Kontakt

Benutzen Sie dieses Formular für Rückmeldungen, Fragen und Verbesserungsvorschläge.

Mit * gekennzeichnete Felder sind notwendig.

Hilfe

Benötigen Sie Hilfe bei der Suche? Um mehr Details zu erfahren und die Suche effektiver nutzen zu können schauen Sie sich doch das entsprechende Video auf unserer Tutorial Seite an.

Zum Video