ID

19668

Description

Muster 52 - Bericht für die Krankenkasse bei Fortbestehen der Arbeitsunfähigkeit (Freigabe 21.058.2015). 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 52 - Report to Health Insurance for Persistence of Inability to Work (Released 05-21-2015). 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

Keywords

Versions (3)
  1. 21-01-17 21-01-17 -
  2. 28-01-17 28-01-17 -
  3. 07-09-17 07-09-17 -
Uploaded on

21 januari 2017

DOI

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License

Creative Commons BY-NC 3.0
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KBV Report to Health Insurance for Persistence of Inability to Work Template 52

German English

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

1 forms  
Heading
Description

Heading

Health Insurance name
Description

Health Insurance name

Data type

text

Alias
UMLS CUI [1]
C0021682
Patient surname
Description

Patient surname

Data type

text

Alias
UMLS CUI [1]
C0421448
Patient Name
Description

Patient Name

Data type

text

Alias
UMLS CUI [1]
C1299487
Patient address
Description

Patient address

Data type

text

Alias
UMLS CUI [1]
C0421449
Patient Birth Date
Description

Patient Birth Date

Data type

date

Alias
UMLS CUI [1]
C0421451
Insurance ID
Description

Insurance ID

Data type

integer

Alias
UMLS CUI [1]
C1547687
Insurance number
Description

Insurance number

Data type

integer

Alias
UMLS CUI [1]
C1549712
Status
Description

Status

Data type

integer

Alias
UMLS CUI [1]
C0449438
Facility number
Description

Facility number

Data type

integer

Alias
UMLS CUI [1]
C1549700
Physician ID number
Description

Physician ID number

Data type

integer

Alias
UMLS CUI [1]
C1548646
Date
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
1. Diagnosis
Description

1. Diagnosis

Diagnosis
Description

Diagnosis

Data type

text

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

2. Occupation

Employment
Description

Employment

Data type

boolean

Alias
UMLS CUI [1]
C0014003
occupation
Description

occupation

Data type

text

Alias
UMLS CUI [1]
C0028811
unemployment benefits
Description

unemployment benefits

Data type

boolean

Alias
UMLS CUI [1]
C0425014
working hours
Description

working hours

Data type

integer

Measurement units
  • Stunden
Alias
UMLS CUI [1,1]
C0556976
UMLS CUI [1,2]
C0043227
Stunden
undefined item
Description

undefined item

Data type

boolean

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

3. recovery to work ability

recovery to work ability
Description

recovery to work ability

Data type

boolean

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

date of recovery to work ability

Data type

date

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

4. diagnostic or therapeutic procedures

Conservative Treatment
Description

Conservative Treatment

Data type

text

Alias
UMLS CUI [1]
C0459914
operative procedure
Description

operative procedure

Data type

text

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

5. treating physicians

Alias
UMLS CUI-1
C1710470
treating physician
Description

treating physician

Data type

text

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

6. Other measures

Alias
UMLS CUI-1
C0079809
no measures necessary
Description

no measures necessary

Data type

boolean

Alias
UMLS CUI [1]
C0079809
job rotation
Description

job rotation

Data type

boolean

Alias
UMLS CUI [1]
C1261323
reintegration
Description

reintegration

Data type

boolean

Alias
UMLS CUI [1]
C3527099
other measures
Description

other measures

Data type

text

Alias
UMLS CUI [1]
C0079809
medical rehabilitation
Description

medical rehabilitation

Data type

boolean

Alias
UMLS CUI [1]
C0034991
Psychotherapy
Description

Psychotherapy

Data type

boolean

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

participate in labour market

Data type

boolean

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

7. other issues for overcoming unemployment

other issues for overcoming unemployment
Description

other issues for overcoming unemployment

Data type

boolean

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

which issues

Data type

text

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

8. reduction in earning capacity

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

reduction in earning capacity

Data type

boolean

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

9. Comments to state of health

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

comments on state of health

Data type

text

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

Signature

Alias
UMLS CUI-1
C1519316
Signature date
Description

Signature date

Data type

date

Alias
UMLS CUI [1]
C0807937
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Similar models

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

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
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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