Difference between revisions of "1.3.6.1.4.1.19376.1.5.3.1.1.11.2.3.2"

Revision as of 22:27, 28 May 2007

Development Only

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ACOG Visit Summary Battery 1.3.6.1.4.1.19376.1.5.3.1.11.2.3.2

This entry describes a single row in the Visit Summary flowsheet. The single observation date and provider is applied to all other observations.

Uses

See Templates using ACOG Visit Summary Battery

Specification

ACOG Visit Summary Battery Example

<entry>

  <organizer classCode='BATTERY' moodCode='EVN'>
    <templateId root='1.3.6.1.4.1.19376.1.5.3.1.11.2.3.2'/>
    <id root=' ' extension=' '/>
    <code code='(xx-acog-battery)' displayName='ACOG Summary Visit Battery---PT--'
          codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/>
    <effectiveTime value=' '/>
    <activityTime value=' '/>
    <statusCode code='complete'/>
    <author typeCode='AUT'><reference value=' '/></author>
    <component>
       <observation classCode='OBS' moodCode='EVN'>
          <templateId root='1.3.6.1.4.1.19376.1.5.3.1.4.13'/>
          ...
       </observation>
    </component>
    <component>
       <observation classCode='OBS' moodCode='EVN'>
          <templateId root='1.3.6.1.4.1.19376.1.5.3.1.4.13'/>
       ...
       </observation>
    </component>
    ...
  </organizer>
</entry>

<templateId root='1.3.6.1.4.1.19376.1.5.3.1.11.2.3.2'/>

<code code='(xx-acog-battery)' codeSystem='2.16.840.1.113883.6.1'/>

<effectiveTime value=' '/>

<activityTime value=' '/>

<author typeCode='AUT'/>

<statusCode code='complete'/>

<component>

The battery is made of several component simple observations. The following table lists the allowable LOINC codes, displayNames, and observation types, and unit of measures for these observations.

code	displayName	xsi:type	units
11884-4	GESTATIONAL AGE-TIME-PT-^FETUS-QN-CLINICAL.ESTIMATED	PQ	week
11881-0	FUNDAL HEIGHT-LEN-PT-UTERUS-QN-TAPE MEASURE	PQ	cm
18849-0 (by PE) or 18850-8 (by US)	FETAL PRESENTATION-TYPE-PT-PELVIS-NAR-PALPATION or FETAL PRESENTATION-TYPE-PT-PELVIS-NAR-US	ED
11948-7	HEART RATE-NRAT-PT-^FETUS-QN-US.MEASURED	RTO	min
?11632-7	?BIOPHYSICAL PROFILE.BODY MOVEMENT-FCN-PT-^FETUS-ORD-US	BL
(xx-SS-Preterm-Labor)	PRETERM LABOR SYMPTOMS-FIND-PT-^PATIENT-QL-CLINICAL JUDGEMENT	BL
(xx-cerv-dil)	DILATION-LEN-PT-CERVIX-QN-PALPATION	PQ	cm
11867-9	EFFACEMENT-PRCTL-PT-CERVIX-ORD-PALPATION	CO	?todo:value-set
11961-0	LONG AXIS-LEN-PT-CERVIX-QN-US.MEASURED	PQ	cm
8480-6	INTRAVASCULAR SYSTOLIC-PRES-PT-ARTERIAL SYSTEM-QN-	PQ	mm[Hg]
8462-4	INTRAVASCULAR DIASTOLIC-PRES-PT-ARTERIAL SYSTEM-QN-	PQ	mm[Hg]
3141-9 (measured) or 3138-5(stated) or 29463-7(unstated)	BODY WEIGHT-MASS-PT-^PATIENT-QN-MEASURED or BODY WEIGHT-MASS-PT-^PATIENT-QN-STATED or BODY WEIGHT-MASS-PT-^PATIENT-QN-	PQ	g, kg, lb_av, or oz_av
1753-3	ALBUMIN-ACNC-PT-UR-ORD-	CO	?value-set
2349-9 or 25428-4(test strip)	GLUCOSE-ACNC-PT-UR-ORD- or GLUCOSE-ACNC-PT-UR-ORD-TEST STRIP	CO	?value-set
?44966-0 or 45700-2	(edema)	CO	[+,2+,3+,4+]
38208-5	PAIN SEVERITY-FIND-PT-^PATIENT-ORD-REPORTED	CO	[0(no pain) -10(worst possible pain]
?(xx-next-appt:SNOMED)	TIME TO NEXT VISIT	PQ	day,week,mo

@@ Line 105: / Line 105: @@
 |mm[Hg]
 |-
-|3141-9 (measured)<br/> or 3138-5(stated) or 29463-7(unstated)
+|3141-9 (measured)<br/> or 3138-5(stated)<br/> or 29463-7(unstated)
 |BODY WEIGHT-MASS-PT-^PATIENT-QN-MEASURED<br/> or BODY WEIGHT-MASS-PT-^PATIENT-QN-STATED<br/> or BODY WEIGHT-MASS-PT-^PATIENT-QN-
 |PQ
@@ Line 119: / Line 119: @@
 |CO
 |?value-set
+|-
+|?44966-0 or 45700-2
+|(edema)
+|CO
+|[+,2+,3+,4+]
+|-
+|38208-5
+|PAIN SEVERITY-FIND-PT-^PATIENT-ORD-REPORTED
+|CO
+|[0(no pain) -10(worst possible pain]
+|-
+|?(xx-next-appt:SNOMED)
+|TIME TO NEXT VISIT
+|PQ
+|day,week,mo
 |-
 |}