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ID

41954

Description

Report for insurance (G0260)

Keywords

Versions (3)
  1. 9/23/14 9/23/14 - Martin Dugas
  2. 9/28/14 9/28/14 - Martin Dugas
  3. 2/22/21 2/22/21 -
Uploaded on

February 22, 2021

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License

Creative Commons BY-NC 3.0 Legacy
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    AHB Report MS

    German English

    AHB Diagnosis Report MS

    1 forms  
    1. StudyEvent: ODM-Test
      1. AHB Diagnosis Report MS
    General Info
    Description

    General Info

    Alias
    UMLS CUI-1
    C1508263 (General information section)
    LOINC
    MTHU015719
    insurance number
    Description

    insurance number

    Data type

    text

    tag
    Data type

    text

    address of rehabilitation clinic
    Data type

    text

    hospital address
    Data type

    text

    Contact person
    Data type

    text

    Alias
    UMLS CUI-1
    C0337611 (contact person)
    SNOMED
    70862002
    Administrative procedure
    Data type

    integer

    Proposed rehabilitation method
    Data type

    text

    Patient data
    Description

    Patient data

    Name
    Data type

    text

    Alias
    UMLS CUI-1
    C0421448 (Patient surname)
    SNOMED
    184096005
    First name
    Data type

    text

    Alias
    UMLS CUI-1
    C1443235 (First Name)
    SNOMED
    408677003
    LOINC
    MTHU048693
    Date of Birth
    Data type

    date

    Alias
    UMLS CUI-1
    C0421451 (Patient date of birth)
    SNOMED
    184099003
    LOINC
    LP57552-9
    Patient address
    Data type

    text

    Hospital
    Description

    Hospital

    Admission date
    Data type

    date

    Alias
    UMLS CUI-1
    C1302393 (Date of admission)
    SNOMED
    399423000
    Reason for rehabilitation
    Data type

    integer

    Date of event
    Data type

    date

    Accident while engaged in work-related activity
    Data type

    boolean

    Alias
    UMLS CUI-1
    C0586557 (Accident while engaged in work-related activity)
    SNOMED
    17542004
    ASR-Revisionseingriff
    Data type

    boolean

    mögliche Schädigung durch Dritte
    Data type

    text

    Discharge date (Planned)
    Data type

    date

    Alias
    UMLS CUI-1
    C2361123 (Discharge date)
    SNOMED
    442864001
    LOINC
    MTHU028123
    UMLS CUI-2
    C1301732 (Planned)
    SNOMED
    397943006
    LOINC
    LA20099-0
    Transfer date (planned)
    Data type

    date

    Diagnosis
    Description

    Diagnosis

    Alias
    UMLS CUI-1
    C0011900 (Diagnosis)
    SNOMED
    439401001
    LOINC
    LP30831-9
    Diagnosis
    Data type

    text

    Alias
    UMLS CUI-1
    C0011900 (Diagnosis)
    SNOMED
    439401001
    LOINC
    LP30831-9
    Diagnosis (ICD-10-GM)
    Data type

    text

    DRG group
    Data type

    text

    Clinical course
    Description

    Clinical course

    Alias
    UMLS CUI-1
    C0449259 (Clinical course)
    SNOMED
    263502005
    LOINC
    LP267073-7
    Clinical course
    Data type

    text

    Alias
    UMLS CUI-1
    C0449259 (Clinical course)
    SNOMED
    263502005
    LOINC
    LP267073-7
    Current status
    Data type

    text

    Further steps
    Data type

    text

    Further diseases or disabilities
    Description

    Further diseases or disabilities

    Further relevant diseases or disabilities
    Data type

    text

    Clinical and medical-technical findings
    Description

    Clinical and medical-technical findings

    Clinical and medical-technical findings
    Data type

    text

    Patient characteristics
    Description

    Patient characteristics

    Alias
    UMLS CUI-1
    C0815172 (Client Characteristics)
    eat without assistance
    Data type

    boolean

    wash and dress without assistance
    Data type

    boolean

    walk without assistance
    Data type

    boolean

    Closed wound
    Data type

    boolean

    Alias
    UMLS CUI-1
    C0679319 (Closed wound)
    SNOMED
    125194009
    Multiresistant germs
    Data type

    text

    Urinary Incontinence
    Data type

    boolean

    Alias
    UMLS CUI-1
    C0042024 (Urinary Incontinence)
    SNOMED
    165232002
    Drainage procedure
    Data type

    text

    Alias
    UMLS CUI-1
    C0013103 (Drainage procedure)
    SNOMED
    129289008
    LOINC
    LP35023-8
    Fecal Incontinence
    Data type

    boolean

    Alias
    UMLS CUI-1
    C0015732 (Fecal Incontinence)
    SNOMED
    72042002
    Wheelchair user
    Data type

    boolean

    Alias
    UMLS CUI-1
    C0853966 (Wheelchair user)
    Cognitive Orientation
    Data type

    text

    Alias
    UMLS CUI-1
    C0029266 (Mental Orientation)
    SNOMED
    43173001
    Transfer options
    Data type

    integer

    person accompanying patient
    Data type

    boolean

    Alias
    UMLS CUI-1
    C2079578 (person accompanying patient)
    Taxi
    Data type

    boolean

    Alias
    UMLS CUI-1
    C0336814 (Taxi)
    SNOMED
    52387005
    Ambulance
    Data type

    boolean

    Alias
    UMLS CUI-1
    C0002422 (Ambulances)
    SNOMED
    49122002
    Comments
    Data type

    text

    Alias
    UMLS CUI-1
    C0947611 (Comment)
    LOINC
    LP72293-1
    active participation in rehabilitation
    Data type

    boolean

    Signature
    Description

    Signature

    Alias
    UMLS CUI-1
    C1519316 (Signature)
    LOINC
    LP248948-4
    Date of signature
    Data type

    date

    Physician signature
    Data type

    text

    Alias
    UMLS CUI-1
    C1519316 (Signature)
    LOINC
    LP248948-4
    Physician stamp
    Data type

    text

    Telephone
    Data type

    text

    Back to the top of the page

    Similar models

    AHB Diagnosis Report MS

    1 forms
    1. StudyEvent: ODM-Test
      1. AHB Diagnosis Report MS
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    General Info
    C1508263 (UMLS CUI-1)
    insurance number
    Item
    insurance number
    text
    tag
    Item
    text
    address of rehabilitation clinic
    Item
    text
    hospital address
    Item
    text
    Contact person
    Item
    text
    C0337611 (UMLS CUI-1)
    Administrative procedure
    Code List
    Administrative procedure
    CL Item
     (1)
    CL Item
     (2)
    Proposed rehabilitation method
    Code List
    Proposed rehabilitation method
    CL Item
     (1)
    CL Item
     (2)
    Item Group
    Name
    Item
    text
    C0421448 (UMLS CUI-1)
    First name
    Item
    text
    C1443235 (UMLS CUI-1)
    Date of Birth
    Item
    date
    C0421451 (UMLS CUI-1)
    Patient address
    Item
    text
    Item Group
    Admission date
    Item
    date
    C1302393 (UMLS CUI-1)
    Reason for rehabilitation
    Code List
    Reason for rehabilitation
    CL Item
     (1)
    CL Item
     (2)
    CL Item
     (3)
    CL Item
     (4)
    CL Item
     (5)
    Date of event
    Item
    date
    Accident while engaged in work-related activity
    Item
    boolean
    C0586557 (UMLS CUI-1)
    ASR-Revisionseingriff
    Item
    boolean
    mögliche Schädigung durch Dritte
    Item
    text
    Discharge date (Planned)
    Item
    date
    C2361123 (UMLS CUI-1)
    C1301732 (UMLS CUI-2)
    Transfer date (planned)
    Item
    date
    Item Group
    C0011900 (UMLS CUI-1)
    Diagnosis
    Item
    text
    C0011900 (UMLS CUI-1)
    Diagnosis (ICD-10-GM)
    Item
    text
    DRG group
    Item
    text
    Item Group
    C0449259 (UMLS CUI-1)
    Clinical course
    Item
    text
    C0449259 (UMLS CUI-1)
    Current status
    Item
    text
    Further steps
    Item
    text
    Further relevant diseases or disabilities
    Item
    text
    Clinical and medical-technical findings
    Item
    text
    Item Group
    C0815172 (UMLS CUI-1)
    eat without assistance
    Item
    boolean
    wash and dress without assistance
    Item
    boolean
    walk without assistance
    Item
    boolean
    Closed wound
    Item
    boolean
    C0679319 (UMLS CUI-1)
    Multiresistant germs
    Item
    text
    Urinary Incontinence
    Item
    boolean
    C0042024 (UMLS CUI-1)
    Drainage procedure
    Item
    text
    C0013103 (UMLS CUI-1)
    Fecal Incontinence
    Item
    boolean
    C0015732 (UMLS CUI-1)
    Wheelchair user
    Item
    boolean
    C0853966 (UMLS CUI-1)
    Cognitive Orientation
    Item
    text
    C0029266 (UMLS CUI-1)
    Item
    integer
    Transfer options
    Code List
    Transfer options
    CL Item
     (1)
    CL Item
     (2)
    person accompanying patient
    Item
    boolean
    C2079578 (UMLS CUI-1)
    Taxi
    Item
    boolean
    C0336814 (UMLS CUI-1)
    Ambulance
    Item
    boolean
    C0002422 (UMLS CUI-1)
    Comments
    Item
    text
    C0947611 (UMLS CUI-1)
    active participation in rehabilitation
    Item
    boolean
    Item Group
    C1519316 (UMLS CUI-1)
    Date of signature
    Item
    date
    Physician signature
    Item
    text
    C1519316 (UMLS CUI-1)
    Physician stamp
    Item
    text
    Telephone
    Item
    text
    Back to the top of the page 

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