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ID

20064

Description

Muster 22 - Konsiliarbericht vor Aufnahme einer Psychotherapie durch Psychologische Psychotherapeuten und Kinder- und Jugendlichenpsycho therapeuten (Freigabe 01.09.2014). 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 22 - Consultation Report (Released 09-01-2014). 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

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www.kbv.de

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  1. 2/4/17 2/4/17 -
  2. 8/16/17 8/16/17 -
  3. 9/7/17 9/7/17 -
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February 4, 2017

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Creative Commons BY-NC 3.0
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    KBV Consultation Report Template 22

    German

    KBV Consultation Report Template 22

    1 forms  
    Briefkopf
    Description

    Briefkopf

    Name der Krankenversicherung
    Description

    Health Insurance name

    Data type

    text

    Alias
    UMLS CUI [1]
    C0021682 (Health Insurance)
    Nachname
    Description

    Patient surname

    Data type

    text

    Alias
    UMLS CUI [1]
    C0421448 (Patient surname)
    SNOMED
    184096005
    Patientenname
    Description

    Patient Name

    Data type

    text

    Alias
    UMLS CUI [1]
    C1299487 (Patient name)
    SNOMED
    371484003
    Adresse des Patienten
    Description

    Patient address

    Data type

    text

    Alias
    UMLS CUI [1]
    C0421449 (Patient address)
    SNOMED
    184097001
    Patient Geburtsdatum
    Description

    Patient Birth Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0421451 (Patient date of birth)
    SNOMED
    184099003
    LOINC
    LP57552-9
    Kostenträgerkennung
    Description

    Insurance ID

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1547687 (Insurance company ID codes)
    Versichertennummer
    Description

    Insurance number

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1549712 (Patient's Medicare number)
    Status
    Description

    Status

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0449438 (Status)
    SNOMED
    263490005
    LOINC
    LP73412-6
    Betriebsstättennummer
    Description

    Facility number

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1549700 (Facility ID)
    Arzt- Nr.
    Description

    Physician ID number

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1548646 (Unique physician ID no.)
    Datum
    Description

    Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008 (Date in time)
    SNOMED
    410671006
    Auf Veranlassung von:
    Description

    Auf Veranlassung von:

    Arztnummer
    Description

    Physician ID

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1550333 (Physician ID)
    Name des Therapeuten
    Description

    physician name

    Data type

    text

    Alias
    UMLS CUI [1]
    C2361125 (Attending physician name)
    LOINC
    MTHU028124
    Betriebsstättennummer
    Description

    Facility number

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1549700 (Facility ID)
    Konsiliarbericht
    Description

    Konsiliarbericht

    Psychiatrische bzw. kinder- und jugendpsychiatrische Abklärung ist
    Description

    psychiatric consult for children

    Data type

    integer

    Alias
    UMLS CUI [1,1]
    C0547439 (Request psychiatric consult.)
    UMLS CUI [1,2]
    C0870269 (Child Psychiatric Clinics)
    Sind ärztliche/ärztlich veranlasste Maßnahmen bzw. Untersuchungen notwendig bzw. veranlasst und ggf. welche?
    Description

    therapeutic procedures

    Data type

    text

    Alias
    UMLS CUI [1]
    C0087111 (Therapeutic procedure)
    SNOMED
    277132007
    LOINC
    LP21090-3
    Aufgrund somatischer/psychiatrischer Befunde bestehen derzeit Kontra- indikationen für eine psychotherapeutische Behandlung (Begründung s. o.)
    Description

    Contraindication for psychotherapy

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C1301624 (Medical contraindication)
    SNOMED
    397745006
    LOINC
    LA27164-5
    UMLS CUI [1,2]
    C0033968 (Psychotherapy)
    SNOMED
    75516001
    Ärztliche Mitbehandlung ist erforderlich
    Description

    psychiatric therapy needed

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0204523 (Psychiatric therapeutic procedure)
    SNOMED
    31205005
    Art der Maßnahme
    Description

    type of therapy

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0332307 (Type - attribute)
    SNOMED
    261664005
    UMLS CUI [1,2]
    C0087111 (Therapeutic procedure)
    SNOMED
    277132007
    LOINC
    LP21090-3
    Ausstellungsdatum
    Description

    Date of completion

    Data type

    date

    Alias
    UMLS CUI [1,1]
    C0011008 (Date in time)
    SNOMED
    410671006
    UMLS CUI [1,2]
    C0850287 (document completion)
    Back to the top of the page

    Similar models

    KBV Consultation Report Template 22

    1 forms
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Briefkopf
    Health Insurance name
    Item
    Name der Krankenversicherung
    text
    C0021682 (UMLS CUI [1])
    Patient surname
    Item
    Nachname
    text
    C0421448 (UMLS CUI [1])
    Patient Name
    Item
    Patientenname
    text
    C1299487 (UMLS CUI [1])
    Patient address
    Item
    Adresse des Patienten
    text
    C0421449 (UMLS CUI [1])
    Patient Birth Date
    Item
    Patient Geburtsdatum
    date
    C0421451 (UMLS CUI [1])
    Insurance ID
    Item
    Kostenträgerkennung
    integer
    C1547687 (UMLS CUI [1])
    Insurance number
    Item
    Versichertennummer
    integer
    C1549712 (UMLS CUI [1])
    Status
    Item
    Status
    integer
    C0449438 (UMLS CUI [1])
    Facility number
    Item
    Betriebsstättennummer
    integer
    C1549700 (UMLS CUI [1])
    Physician ID number
    Item
    Arzt- Nr.
    integer
    C1548646 (UMLS CUI [1])
    Date
    Item
    Datum
    date
    C0011008 (UMLS CUI [1])
    Item Group
    Auf Veranlassung von:
    Physician ID
    Item
    Arztnummer
    integer
    C1550333 (UMLS CUI [1])
    physician name
    Item
    Name des Therapeuten
    text
    C2361125 (UMLS CUI [1])
    Facility number
    Item
    Betriebsstättennummer
    integer
    C1549700 (UMLS CUI [1])
    Item Group
    Konsiliarbericht
    Item
    Psychiatrische bzw. kinder- und jugendpsychiatrische Abklärung ist
    integer
    C0547439 (UMLS CUI [1,1])
    C0870269 (UMLS CUI [1,2])
    psychiatric consult for children
    Code List
    Psychiatrische bzw. kinder- und jugendpsychiatrische Abklärung ist
    CL Item
    erforderlich (1)
    CL Item
    nicht erforderlich (2)
    CL Item
    erfolgt (3)
    CL Item
    veranlasst (4)
    therapeutic procedures
    Item
    Sind ärztliche/ärztlich veranlasste Maßnahmen bzw. Untersuchungen notwendig bzw. veranlasst und ggf. welche?
    text
    C0087111 (UMLS CUI [1])
    Contraindication for psychotherapy
    Item
    Aufgrund somatischer/psychiatrischer Befunde bestehen derzeit Kontra- indikationen für eine psychotherapeutische Behandlung (Begründung s. o.)
    boolean
    C1301624 (UMLS CUI [1,1])
    C0033968 (UMLS CUI [1,2])
    psychiatric therapy needed
    Item
    Ärztliche Mitbehandlung ist erforderlich
    boolean
    C0204523 (UMLS CUI [1])
    type of therapy
    Item
    Art der Maßnahme
    text
    C0332307 (UMLS CUI [1,1])
    C0087111 (UMLS CUI [1,2])
    Date of completion
    Item
    Ausstellungsdatum
    date
    C0011008 (UMLS CUI [1,1])
    C0850287 (UMLS CUI [1,2])
    Back to the top of the page 

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