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KBV Report to Health Insurance for Persistence of Inability to Work Template 52

1 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
1. Diagnosis
Beschreibung

1. Diagnosis

Diagnosis
Beschreibung

Diagnosis

Datentyp

text

Alias
UMLS CUI [1,1]
C4049481
UMLS CUI [1,2]
C0011900
2. Occupation
Beschreibung

2. Occupation

Employment
Beschreibung

Employment

Datentyp

boolean

Alias
UMLS CUI [1]
C0014003
occupation
Beschreibung

occupation

Datentyp

text

Alias
UMLS CUI [1]
C0028811
unemployment benefits
Beschreibung

unemployment benefits

Datentyp

boolean

Alias
UMLS CUI [1]
C0425014
working hours
Beschreibung

working hours

Datentyp

integer

Maßeinheiten
  • Stunden
Alias
UMLS CUI [1,1]
C0556976
UMLS CUI [1,2]
C0043227
Stunden
undefined item
Beschreibung

undefined item

Datentyp

boolean

Alias
UMLS CUI [1,1]
C4274891
UMLS CUI [1,2]
C2987220
3. recovery to work ability
Beschreibung

3. recovery to work ability

recovery to work ability
Beschreibung

recovery to work ability

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0237820
UMLS CUI [1,2]
C4274891
date of recovery to work ability
Beschreibung

date of recovery to work ability

Datentyp

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0237820
UMLS CUI [1,3]
C4274891
4. diagnostic or therapeutic procedures
Beschreibung

4. diagnostic or therapeutic procedures

Conservative Treatment
Beschreibung

Conservative Treatment

Datentyp

text

Alias
UMLS CUI [1]
C0459914
operative procedure
Beschreibung

operative procedure

Datentyp

text

Alias
UMLS CUI [1]
C0038895
5. treating physicians
Beschreibung

5. treating physicians

Alias
UMLS CUI-1
C1710470
treating physician
Beschreibung

treating physician

Datentyp

text

Alias
UMLS CUI [1]
C1710470
6. Other measures
Beschreibung

6. Other measures

Alias
UMLS CUI-1
C0079809
no measures necessary
Beschreibung

no measures necessary

Datentyp

boolean

Alias
UMLS CUI [1]
C0079809
job rotation
Beschreibung

job rotation

Datentyp

boolean

Alias
UMLS CUI [1]
C1261323
reintegration
Beschreibung

reintegration

Datentyp

boolean

Alias
UMLS CUI [1]
C3527099
other measures
Beschreibung

other measures

Datentyp

text

Alias
UMLS CUI [1]
C0079809
medical rehabilitation
Beschreibung

medical rehabilitation

Datentyp

boolean

Alias
UMLS CUI [1]
C0034991
Psychotherapy
Beschreibung

Psychotherapy

Datentyp

boolean

Alias
UMLS CUI [1]
C0033968
participate in labour market
Beschreibung

participate in labour market

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0079809
UMLS CUI [1,2]
C0679823
UMLS CUI [1,3]
C0014003
7. other issues for overcoming unemployment
Beschreibung

7. other issues for overcoming unemployment

other issues for overcoming unemployment
Beschreibung

other issues for overcoming unemployment

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0033213
UMLS CUI [1,2]
C0014003
which issues
Beschreibung

which issues

Datentyp

text

Alias
UMLS CUI [1,1]
C0033213
UMLS CUI [1,2]
C0014003
8. reduction in earning capacity
Beschreibung

8. reduction in earning capacity

Alias
UMLS CUI-1
C0392756
UMLS CUI-2
C0014003
reduction in earning capacity
Beschreibung

reduction in earning capacity

Datentyp

boolean

Alias
UMLS CUI [1,1]
C0392756
UMLS CUI [1,2]
C0014003
9. Comments to state of health
Beschreibung

9. Comments to state of health

Alias
UMLS CUI-1
C0947611
UMLS CUI-2
C0683314
comments on state of health
Beschreibung

comments on state of health

Datentyp

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0683314
Signature
Beschreibung

Signature

Alias
UMLS CUI-1
C1519316
Signature date
Beschreibung

Signature date

Datentyp

date

Alias
UMLS CUI [1]
C0807937
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Ähnliche Modelle

KBV Report to Health Insurance for Persistence of Inability to Work Template 52

1 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])
Item Group
Diagnosis
Item
text
C4049481 (UMLS CUI [1,1])
C0011900 (UMLS CUI [1,2])
Item Group
Employment
Item
boolean
C0014003 (UMLS CUI [1])
occupation
Item
text
C0028811 (UMLS CUI [1])
unemployment benefits
Item
boolean
C0425014 (UMLS CUI [1])
working hours
Item
integer
C0556976 (UMLS CUI [1,1])
C0043227 (UMLS CUI [1,2])
undefined item
Item
boolean
C4274891 (UMLS CUI [1,1])
C2987220 (UMLS CUI [1,2])
recovery to work ability
Item
boolean
C0237820 (UMLS CUI [1,1])
C4274891 (UMLS CUI [1,2])
date of recovery to work ability
Item
date
C0011008 (UMLS CUI [1,1])
C0237820 (UMLS CUI [1,2])
C4274891 (UMLS CUI [1,3])
Conservative Treatment
Item
text
C0459914 (UMLS CUI [1])
operative procedure
Item
text
C0038895 (UMLS CUI [1])
Item Group
C1710470 (UMLS CUI-1)
treating physician
Item
text
C1710470 (UMLS CUI [1])
Item Group
C0079809 (UMLS CUI-1)
no measures necessary
Item
boolean
C0079809 (UMLS CUI [1])
job rotation
Item
boolean
C1261323 (UMLS CUI [1])
reintegration
Item
boolean
C3527099 (UMLS CUI [1])
other measures
Item
text
C0079809 (UMLS CUI [1])
medical rehabilitation
Item
boolean
C0034991 (UMLS CUI [1])
Psychotherapy
Item
boolean
C0033968 (UMLS CUI [1])
participate in labour market
Item
boolean
C0079809 (UMLS CUI [1,1])
C0679823 (UMLS CUI [1,2])
C0014003 (UMLS CUI [1,3])
other issues for overcoming unemployment
Item
boolean
C0033213 (UMLS CUI [1,1])
C0014003 (UMLS CUI [1,2])
which issues
Item
text
C0033213 (UMLS CUI [1,1])
C0014003 (UMLS CUI [1,2])
Item Group
C0392756 (UMLS CUI-1)
C0014003 (UMLS CUI-2)
reduction in earning capacity
Item
boolean
C0392756 (UMLS CUI [1,1])
C0014003 (UMLS CUI [1,2])
Item Group
C0947611 (UMLS CUI-1)
C0683314 (UMLS CUI-2)
comments on state of health
Item
text
C0947611 (UMLS CUI [1,1])
C0683314 (UMLS CUI [1,2])
Item Group
Signature
C1519316 (UMLS CUI-1)
Signature date
Item
Signature date
date
C0807937 (UMLS CUI [1])
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