1.3.6.1.4.1.19376.1.5.3.1.3.24

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Development Only

The PCC Wiki Content is used only for development of IHE PCC Content. The Normative content of the PCC Technical Framework and the current supplements can be found at http://www.ihe.net/Technical_Framework/index.cfm#PCC

Trial.gif Physical Exam Section
Template ID 1.3.6.1.4.1.19376.1.5.3.1.3.24
General Description The physical exam section shall contain a narrative description of the patient’s physical findings.
LOINC Code Opt Description
29545-1 R PHYSICAL EXAMINATION



Sample Physical Exam Section
<component>
  <section>
    <templateId root='1.3.6.1.4.1.19376.1.5.3.1.3.24'/>
    <id root=' ' extension=' '/>
    <code code='29545-1' displayName='PHYSICAL EXAMINATION'
      codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/>
    <text>
      Text as described above
    </text>  
       
  </section>
</component>
Schematron
<pattern name='Template_1.3.6.1.4.1.19376.1.5.3.1.3.24'> 
 <rule context='*[cda:templateId/@root="1.3.6.1.4.1.19376.1.5.3.1.3.24"]'> 
     <!-- Verify that the template id is used on the appropriate type of object --> 
   <assert test='../cda:section'> 
      Error: The Physical Exam can only be used on sections. 
   </assert> 
   <!-- Verify the section type code --> 
   <assert test='cda:code[@code = "29545-1"]'> 
     Error: The section type code of a Physical Exam must be 29545-1 
   </assert> 
   <assert test='cda:code[@codeSystem = "2.16.840.1.113883.6.1"]'> 
     Error: The section type code must come from the LOINC code  
     system (2.16.840.1.113883.6.1). 
   </assert> 
 </rule> 
</pattern>
Uses

See Templates using the Physical Exam Section