ID

25544

Description

Muster 2 - Verordnung von Krankenhausbehandlung (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

Keywords

Versions (5)
  1. 9/5/16 9/5/16 -
  2. 8/10/17 8/10/17 -
  3. 8/10/17 8/10/17 -
  4. 9/5/17 9/5/17 -
  5. 9/5/17 9/5/17 -
Copyright Holder

KBV

Uploaded on

September 5, 2017

DOI

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License

Creative Commons BY-NC 3.0
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KBV Referral to hospital Template 2

German

KBV Referral to hospital Template 2b

3 forms  
Briefkopf
Description

Briefkopf

Krankenkasse bzw. Kostenträger
Description

Health Insurance name

Data type

text

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

Patient Name

Data type

text

Alias
UMLS CUI [1]
C1299487
Adresse des Versicherten
Description

Patient address

Data type

text

Alias
UMLS CUI [1]
C0421449
geb. am
Description

Patient Birth Date

Data type

date

Alias
UMLS CUI [1]
C0421451
Kostenträgerkennung
Description

Insurance Company ID

Data type

integer

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

Insurance number

Data type

integer

Alias
UMLS CUI [1]
C1549712
Status
Description

Status

Data type

integer

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

Facility ID

Data type

integer

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

Physician ID

Data type

integer

Alias
UMLS CUI [1]
C1548646
Datum
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
Verordnung von Krankenhausbehandlung
Description

Verordnung von Krankenhausbehandlung

Art der Krankenhauseinweisung
Description

Type of hospital referral

Data type

integer

Alias
UMLS CUI [1,1]
C0019982
UMLS CUI [1,2]
C0332307
Nächsterreichbare, geeignete Krankenhäuser
Description

Next suitable hospital

Data type

text

Alias
UMLS CUI [1]
C0019982
Diagnose
Description

Diagnosis

Data type

text

Alias
UMLS CUI [1]
C0011900
Brieffuß
Description

Brieffuß

Vertragsarztstempel / Unterschrift des Arztes
Description

Physician Stamp and signature

Data type

text

Alias
UMLS CUI [1]
C1519316
Weitere Informationen
Description

Weitere Informationen

Untersuchungsergebnisse
Description

Examination results

Data type

text

Alias
UMLS CUI [1]
C0582103
Bisherige Maßnahmen (z.B Medikation)
Description

Previous measures

Data type

text

Alias
UMLS CUI [1]
C0087111
Fragestellung/Hinweise (z.B Allergie)
Description

Question

Data type

text

Alias
UMLS CUI [1]
C1522634
Mitgegebene Befunde
Description

Medical records transfer

Data type

text

Alias
UMLS CUI [1]
C0583100
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Similar models

KBV Referral to hospital Template 2b

3 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
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
Verordnung von Krankenhausbehandlung
Item
Art der Krankenhauseinweisung
integer
C0019982 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Type of hospital referral
Code List
Art der Krankenhauseinweisung
CL Item
Belegarztbehandlung (1)
CL Item
Notfall (2)
CL Item
Unfall/ Unfallfolgen (3)
CL Item
Versorgungsleiden (BVG) (4)
Next suitable hospital
Item
Nächsterreichbare, geeignete Krankenhäuser
text
C0019982 (UMLS CUI [1])
Diagnosis
Item
Diagnose
text
C0011900 (UMLS CUI [1])
Item Group
Brieffuß
Physician Stamp and signature
Item
Vertragsarztstempel / Unterschrift des Arztes
text
C1519316 (UMLS CUI [1])
Item Group
Weitere Informationen
Examination results
Item
Untersuchungsergebnisse
text
C0582103 (UMLS CUI [1])
Previous measures
Item
Bisherige Maßnahmen (z.B Medikation)
text
C0087111 (UMLS CUI [1])
Question
Item
Fragestellung/Hinweise (z.B Allergie)
text
C1522634 (UMLS CUI [1])
Medical records transfer
Item
Mitgegebene Befunde
text
C0583100 (UMLS CUI [1])
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