ID

25584

Descripción

Muster 10A - Anforderungsschein für Laboratoriumsuntersuchungen bei Laborgemeinschaften Freigabe: 01.09.2014) - 10.2014, Formulare für die vertragsärztliche Versorgung 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 Forms for contract medical care 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

Palabras clave

Versiones (2)
  1. 21/12/16 21/12/16 -
  2. 6/9/17 6/9/17 -
Titular de derechos de autor

KBV

Subido en

6 de septiembre de 2017

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0
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KBV Request form laboratory services Template 10A

Alemán

KBV Request form laboratory services Template 10A

1 formularios  
Briefkopf
Descripción

Briefkopf

Krankenkasse bzw. Kostenträger
Descripción

Health Insurance name

Tipo de datos

text

Alias
UMLS CUI [1]
C0021682
Name, Vorname des Versicherten
Descripción

Patient Name

Tipo de datos

text

Alias
UMLS CUI [1]
C1299487
Adresse des Versicherten
Descripción

Patient address

Tipo de datos

text

Alias
UMLS CUI [1]
C0421449
geb. am
Descripción

Patient Birth Date

Tipo de datos

date

Alias
UMLS CUI [1]
C0421451
Kostenträgerkennung
Descripción

Insurance Company ID

Tipo de datos

integer

Alias
UMLS CUI [1]
C1547687
Versicherten-Nr.
Descripción

Insurance number

Tipo de datos

integer

Alias
UMLS CUI [1]
C1549712
Status
Descripción

Status

Tipo de datos

integer

Alias
UMLS CUI [1]
C0449438
Betriebsstätten-Nr.
Descripción

Facility ID

Tipo de datos

integer

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

Physician ID

Tipo de datos

integer

Alias
UMLS CUI [1]
C1548646
Datum
Descripción

Date

Tipo de datos

date

Alias
UMLS CUI [1]
C0011008
Anforderungsschein für Laboratoriumsuntersuchungen bei Laborgemeinschaften
Descripción

Anforderungsschein für Laboratoriumsuntersuchungen bei Laborgemeinschaften

Datum
Descripción

Date

Tipo de datos

date

Alias
UMLS CUI [1]
C0011008
Kurativ
Descripción

Curative

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1276305
Präventiv
Descripción

Preventive

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0199176
Bei Belegärztlicher Behandlung
Descripción

Treatment by affiliate physician

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0087111
UMLS CUI [1,2]
C1510825
UMLS CUI [1,3]
C0031831
Unfall und Unfallfolgen
Descripción

Accident

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0000924
Barcode
Descripción

Barcode

Tipo de datos

text

Alias
UMLS CUI [1]
C0004738
Kennziffer
Descripción

Code number

Tipo de datos

text

Alias
UMLS CUI [1]
C0600091
Geschlecht
Descripción

Gender

Tipo de datos

text

Alias
UMLS CUI [1]
C0079399
Abnahmedatum
Descripción

Date of blood collection

Tipo de datos

date

Unidades de medida
  • TTMMJJ
Alias
UMLS CUI [1]
C1302413
TTMMJJ
Abnahmezeit
Descripción

Time of blood collection

Tipo de datos

time

Unidades de medida
  • hhmm
Alias
UMLS CUI [1]
C0944745
hhmm
Diagnose
Descripción

Diagnosis

Tipo de datos

text

Alias
UMLS CUI [1]
C0011900
Befundübermittlung eilt
Descripción

Urgent procedure

Tipo de datos

boolean

Alias
UMLS CUI [1]
C3272275
EDTA Blut
Descripción

EDTA Blut

Großes Blutbild
Descripción

Blood count

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0005771
Kleines Blutbild
Descripción

Blood count

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0005771
HbA1c
Descripción

HbA1C

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0019018
Retikulozyten
Descripción

Reticulocytes

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0206161
Blutsenkung
Descripción

ESR

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1176468
Diff. Blutbild/Ausstrich
Descripción

Differential blood count

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0162401
Citrat
Descripción

Citrat

Quick
Descripción

Quick

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0086890
Quick unter Marcumar-Therapie
Descripción

Quick during marcoumar treatment

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0086890
UMLS CUI [1,2]
C0918269
Thrombinzeit
Descripción

Thrombin time

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0677634
PTT
Descripción

PTT value

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0030605
Fibrinogen
Descripción

Fibrinogen

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0337428
Serum Vollblut
Descripción

Serum Vollblut

Alkalische Phosphatase
Descripción

Alkaline Phosphatase

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0484638
Amylase
Descripción

Amylase measurement

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201883
ASL
Descripción

Antistreptolysin

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1318462
Bilirubin direkt
Descripción

Direct Bilirubin

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201916
Gesamtbilirubin
Descripción

total bilirubin

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201913
Calcium
Descripción

Calcium

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201925
Cholesterin
Descripción

Cholesterin

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1445957
Cholinesterase
Descripción

Cholinesterase

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202207
CK
Descripción

Creatin kinase

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201973
CK-MB
Descripción

Creatine Kinase MB Measurement

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0523584
CRP
Descripción

CRP

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0006560
Eisen
Descripción

Iron

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0337439
Eiweiß Elektrophorese
Descripción

Protein electrophoresis

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201720
Gesamteiweiß
Descripción

Total protein

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0555903
y-GT
Descripción

gamma GT

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202035
Glukose
Descripción

Glucose

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0337438
GOT
Descripción

GOT

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0004002
GPT
Descripción

GPT

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201836
Harnsäure
Descripción

Uric acid

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202239
Harnstoff
Descripción

Urea measurement

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0523961
HBDH
Descripción

HBDH

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1278046
HDL-Cholesterin
Descripción

HDL-Cholesterol

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0023822
IgA
Descripción

IgA

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202083
IgG
Descripción

IgG

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202087
IgM
Descripción

IgM

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202084
Kalium
Descripción

Potassium

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202194
Kreatinin
Descripción

Creatinine

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201976
Kreatinin Clearance
Descripción

Creatinine clearance

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0373595
LDH
Descripción

LDH

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202113
LDL-Cholesterin
Descripción

LDL-Cholesterol

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202117
Lipase
Descripción

Lipase measurement

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0373670
Natrium
Descripción

Sodium

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0337443
OP-Vorbereitung
Descripción

OP-Prep

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0543467
UMLS CUI [1,2]
C1521827
Phosphat, anorganisches
Descripción

Phosphate inorganic

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0031603
Transferrin
Descripción

Transferrin

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202105
Triglyceride
Descripción

Triglycerides

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202236
TSH basal
Descripción

TSH

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0202230
TSH nach TRH
Descripción

TSH post TRH

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0800893
Glukose
Descripción

Glukose

Glukose 1
Descripción

Glucose

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0337438
Glukose 2
Descripción

Glucose

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0337438
Glukose 3
Descripción

Glucose

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0337438
Glukose 4
Descripción

Glucose

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0337438
Urin
Descripción

Urin

Urin Status
Descripción

Urine status

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0421368
Mikroalbumin
Descripción

Microalbumin measurement

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0740086
Schwangerschaftstest
Descripción

Pregnancy test

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0032976
Glucose
Descripción

Glucose measurement, urine

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0004076
Amylase
Descripción

Amylase measurement urine

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0201886
Sediment
Descripción

Urine Sediment Analysis Measurement

Tipo de datos

boolean

Alias
UMLS CUI [1]
C2700128
Sonstiges
Descripción

Sonstiges

Sonstiges
Descripción

Other

Tipo de datos

text

Alias
UMLS CUI [1]
C0205394
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Similar models

KBV Request form laboratory services Template 10A

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Briefkopf
Health Insurance name
Item
Krankenkasse bzw. Kostenträger
text
C0021682 (UMLS CUI [1])
Patient Name
Item
Name, Vorname des Versicherten
text
C1299487 (UMLS CUI [1])
Patient address
Item
Adresse des Versicherten
text
C0421449 (UMLS CUI [1])
Patient Birth Date
Item
geb. am
date
C0421451 (UMLS CUI [1])
Insurance Company ID
Item
Kostenträgerkennung
integer
C1547687 (UMLS CUI [1])
Insurance number
Item
Versicherten-Nr.
integer
C1549712 (UMLS CUI [1])
Status
Item
Status
integer
C0449438 (UMLS CUI [1])
Facility ID
Item
Betriebsstätten-Nr.
integer
C1549700 (UMLS CUI [1])
Physician ID
Item
Arzt-Nr.
integer
C1548646 (UMLS CUI [1])
Date
Item
Datum
date
C0011008 (UMLS CUI [1])
Item Group
Anforderungsschein für Laboratoriumsuntersuchungen bei Laborgemeinschaften
Date
Item
Datum
date
C0011008 (UMLS CUI [1])
Curative
Item
Kurativ
boolean
C1276305 (UMLS CUI [1])
Preventive
Item
Präventiv
boolean
C0199176 (UMLS CUI [1])
Treatment by affiliate physician
Item
Bei Belegärztlicher Behandlung
boolean
C0087111 (UMLS CUI [1,1])
C1510825 (UMLS CUI [1,2])
C0031831 (UMLS CUI [1,3])
Accident
Item
Unfall und Unfallfolgen
boolean
C0000924 (UMLS CUI [1])
Barcode
Item
Barcode
text
C0004738 (UMLS CUI [1])
Code number
Item
Kennziffer
text
C0600091 (UMLS CUI [1])
Item
Geschlecht
text
C0079399 (UMLS CUI [1])
Gender
Code List
Geschlecht
CL Item
W (W)
CL Item
M (M)
Date of blood collection
Item
Abnahmedatum
date
C1302413 (UMLS CUI [1])
Time of blood collection
Item
Abnahmezeit
time
C0944745 (UMLS CUI [1])
Diagnosis
Item
Diagnose
text
C0011900 (UMLS CUI [1])
Urgent procedure
Item
Befundübermittlung eilt
boolean
C3272275 (UMLS CUI [1])
Item Group
EDTA Blut
Blood count
Item
Großes Blutbild
boolean
C0005771 (UMLS CUI [1])
Blood count
Item
Kleines Blutbild
boolean
C0005771 (UMLS CUI [1])
HbA1C
Item
HbA1c
boolean
C0019018 (UMLS CUI [1])
Reticulocytes
Item
Retikulozyten
boolean
C0206161 (UMLS CUI [1])
ESR
Item
Blutsenkung
boolean
C1176468 (UMLS CUI [1])
Differential blood count
Item
Diff. Blutbild/Ausstrich
boolean
C0162401 (UMLS CUI [1])
Item Group
Citrat
Quick
Item
Quick
boolean
C0086890 (UMLS CUI [1])
Quick during marcoumar treatment
Item
Quick unter Marcumar-Therapie
boolean
C0086890 (UMLS CUI [1,1])
C0918269 (UMLS CUI [1,2])
Thrombin time
Item
Thrombinzeit
boolean
C0677634 (UMLS CUI [1])
PTT value
Item
PTT
boolean
C0030605 (UMLS CUI [1])
Fibrinogen
Item
Fibrinogen
boolean
C0337428 (UMLS CUI [1])
Item Group
Serum Vollblut
Alkaline Phosphatase
Item
Alkalische Phosphatase
boolean
C0484638 (UMLS CUI [1])
Amylase measurement
Item
Amylase
boolean
C0201883 (UMLS CUI [1])
Antistreptolysin
Item
ASL
boolean
C1318462 (UMLS CUI [1])
Direct Bilirubin
Item
Bilirubin direkt
boolean
C0201916 (UMLS CUI [1])
total bilirubin
Item
Gesamtbilirubin
boolean
C0201913 (UMLS CUI [1])
Calcium
Item
Calcium
boolean
C0201925 (UMLS CUI [1])
Cholesterin
Item
Cholesterin
boolean
C1445957 (UMLS CUI [1])
Cholinesterase
Item
Cholinesterase
boolean
C0202207 (UMLS CUI [1])
Creatin kinase
Item
CK
boolean
C0201973 (UMLS CUI [1])
Creatine Kinase MB Measurement
Item
CK-MB
boolean
C0523584 (UMLS CUI [1])
CRP
Item
CRP
boolean
C0006560 (UMLS CUI [1])
Iron
Item
Eisen
boolean
C0337439 (UMLS CUI [1])
Protein electrophoresis
Item
Eiweiß Elektrophorese
boolean
C0201720 (UMLS CUI [1])
Total protein
Item
Gesamteiweiß
boolean
C0555903 (UMLS CUI [1])
gamma GT
Item
y-GT
boolean
C0202035 (UMLS CUI [1])
Glucose
Item
Glukose
boolean
C0337438 (UMLS CUI [1])
GOT
Item
GOT
boolean
C0004002 (UMLS CUI [1])
GPT
Item
GPT
boolean
C0201836 (UMLS CUI [1])
Uric acid
Item
Harnsäure
boolean
C0202239 (UMLS CUI [1])
Urea measurement
Item
Harnstoff
boolean
C0523961 (UMLS CUI [1])
HBDH
Item
HBDH
boolean
C1278046 (UMLS CUI [1])
HDL-Cholesterol
Item
HDL-Cholesterin
boolean
C0023822 (UMLS CUI [1])
IgA
Item
IgA
boolean
C0202083 (UMLS CUI [1])
IgG
Item
IgG
boolean
C0202087 (UMLS CUI [1])
IgM
Item
IgM
boolean
C0202084 (UMLS CUI [1])
Potassium
Item
Kalium
boolean
C0202194 (UMLS CUI [1])
Creatinine
Item
Kreatinin
boolean
C0201976 (UMLS CUI [1])
Creatinine clearance
Item
Kreatinin Clearance
boolean
C0373595 (UMLS CUI [1])
LDH
Item
LDH
boolean
C0202113 (UMLS CUI [1])
LDL-Cholesterol
Item
LDL-Cholesterin
boolean
C0202117 (UMLS CUI [1])
Lipase measurement
Item
Lipase
boolean
C0373670 (UMLS CUI [1])
Sodium
Item
Natrium
boolean
C0337443 (UMLS CUI [1])
OP-Prep
Item
OP-Vorbereitung
boolean
C0543467 (UMLS CUI [1,1])
C1521827 (UMLS CUI [1,2])
Phosphate inorganic
Item
Phosphat, anorganisches
boolean
C0031603 (UMLS CUI [1])
Transferrin
Item
Transferrin
boolean
C0202105 (UMLS CUI [1])
Triglycerides
Item
Triglyceride
boolean
C0202236 (UMLS CUI [1])
TSH
Item
TSH basal
boolean
C0202230 (UMLS CUI [1])
TSH post TRH
Item
TSH nach TRH
boolean
C0800893 (UMLS CUI [1])
Item Group
Glukose
Glucose
Item
Glukose 1
boolean
C0337438 (UMLS CUI [1])
Glucose
Item
Glukose 2
boolean
C0337438 (UMLS CUI [1])
Glucose
Item
Glukose 3
boolean
C0337438 (UMLS CUI [1])
Glucose
Item
Glukose 4
boolean
C0337438 (UMLS CUI [1])
Item Group
Urin
Urine status
Item
Urin Status
boolean
C0421368 (UMLS CUI [1])
Microalbumin measurement
Item
Mikroalbumin
boolean
C0740086 (UMLS CUI [1])
Pregnancy test
Item
Schwangerschaftstest
boolean
C0032976 (UMLS CUI [1])
Glucose measurement, urine
Item
Glucose
boolean
C0004076 (UMLS CUI [1])
Amylase measurement urine
Item
Amylase
boolean
C0201886 (UMLS CUI [1])
Urine Sediment Analysis Measurement
Item
Sediment
boolean
C2700128 (UMLS CUI [1])
Item Group
Sonstiges
Other
Item
Sonstiges
text
C0205394 (UMLS CUI [1])
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