ID

19804

Beschrijving

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

Trefwoorden

Versies (3)
  1. 21-01-17 21-01-17 -
  2. 28-01-17 28-01-17 -
  3. 07-09-17 07-09-17 -
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28 januari 2017

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

Duits Engels

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

1 Formulieren  
Heading
Beschrijving

Heading

Health Insurance name
Beschrijving

Health Insurance name

Datatype

text

Alias
UMLS CUI [1]
C0021682
Patient surname
Beschrijving

Patient surname

Datatype

text

Alias
UMLS CUI [1]
C0421448
Patient Name
Beschrijving

Patient Name

Datatype

text

Alias
UMLS CUI [1]
C1299487
Patient address
Beschrijving

Patient address

Datatype

text

Alias
UMLS CUI [1]
C0421449
Patient Birth Date
Beschrijving

Patient Birth Date

Datatype

date

Alias
UMLS CUI [1]
C0421451
Insurance ID
Beschrijving

Insurance ID

Datatype

integer

Alias
UMLS CUI [1]
C1547687
Insurance number
Beschrijving

Insurance number

Datatype

integer

Alias
UMLS CUI [1]
C1549712
Status
Beschrijving

Status

Datatype

integer

Alias
UMLS CUI [1]
C0449438
Facility number
Beschrijving

Facility number

Datatype

integer

Alias
UMLS CUI [1]
C1549700
Physician ID number
Beschrijving

Physician ID number

Datatype

integer

Alias
UMLS CUI [1]
C1548646
Date
Beschrijving

Date

Datatype

date

Alias
UMLS CUI [1]
C0011008
1. Diagnosis
Beschrijving

1. Diagnosis

Diagnosis
Beschrijving

Diagnosis

Datatype

text

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

2. Occupation

Employment
Beschrijving

Employment

Datatype

boolean

Alias
UMLS CUI [1]
C0014003
occupation
Beschrijving

occupation

Datatype

text

Alias
UMLS CUI [1]
C0028811
unemployment benefits
Beschrijving

unemployment benefits

Datatype

boolean

Alias
UMLS CUI [1]
C0425014
working hours
Beschrijving

working hours

Datatype

integer

Maateenheden
  • Stunden
Alias
UMLS CUI [1,1]
C0556976
UMLS CUI [1,2]
C0043227
Stunden
undefined item
Beschrijving

undefined item

Datatype

boolean

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

3. recovery to work ability

recovery to work ability
Beschrijving

recovery to work ability

Datatype

boolean

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

date of recovery to work ability

Datatype

date

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

4. diagnostic or therapeutic procedures

Conservative Treatment
Beschrijving

Conservative Treatment

Datatype

text

Alias
UMLS CUI [1]
C0459914
operative procedure
Beschrijving

operative procedure

Datatype

text

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

5. treating physicians

treating physician
Beschrijving

treating physician

Datatype

text

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

6. Other measures

no measures necessary
Beschrijving

no measures necessary

Datatype

boolean

Alias
UMLS CUI [1]
C0079809
job rotation
Beschrijving

job rotation

Datatype

boolean

Alias
UMLS CUI [1]
C1261323
reintegration
Beschrijving

reintegration

Datatype

boolean

Alias
UMLS CUI [1]
C3527099
other measures
Beschrijving

other measures

Datatype

text

Alias
UMLS CUI [1]
C0079809
medical rehabilitation
Beschrijving

medical rehabilitation

Datatype

boolean

Alias
UMLS CUI [1]
C0034991
Psychotherapy
Beschrijving

Psychotherapy

Datatype

boolean

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

participate in labour market

Datatype

boolean

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

7. other issues for overcoming unemployment

other issues for overcoming unemployment
Beschrijving

other issues for overcoming unemployment

Datatype

boolean

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

which issues

Datatype

text

8. reduction in earning capacity
Beschrijving

8. reduction in earning capacity

reduction in earning capacity
Beschrijving

reduction in earning capacity

Datatype

boolean

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

9. Comments to state of health

comments on state of health
Beschrijving

comments on state of health

Datatype

text

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

Signature

Signature date
Beschrijving

Signature date

Datatype

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 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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])
treating physician
Item
text
C1710470 (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
reduction in earning capacity
Item
boolean
C0392756 (UMLS CUI [1,1])
C0014003 (UMLS CUI [1,2])
comments on state of health
Item
text
C0947611 (UMLS CUI [1,1])
C0683314 (UMLS CUI [1,2])
Item Group
Signature
Signature date
Item
Signature date
date
C0807937 (UMLS CUI [1])
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