1.3.6.1.4.1.19376.1.3.3.2.2

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Laboratory Report Item Section Section

Template ID	1.3.6.1.4.1.19376.1.3.3.2.2
General Description	description of lab speciality secton
LOINC Code	Opt	Description
TEST CODE	R	test code display name
Entries	Opt	Description
1.3.6.1.4.1.19376.1.3.1	R	Lab Report Data Processing Entry

Sample Laboratory Report Item Section Section

<component> <section> <templateId root='1.3.6.1.4.1.19376.1.3.3.2.2'/> <id root=' ' extension=' '/> <code code='TEST CODE' displayName='test code display name' codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/> <text> Text as described above </text>   <entry> : <!-- Required Lab Report Data Processing Entry element --> <templateId root='1.3.6.1.4.1.19376.1.3.1'/> : </entry>     </section> </component>

Schematron

<pattern name='Template_1.3.6.1.4.1.19376.1.3.3.2.2'> 
 <rule context='*[cda:templateId/@root="1.3.6.1.4.1.19376.1.3.3.2.2"]'> 
     <!-- Verify that the template id is used on the appropriate type of object --> 
   <assert test='../cda:section'> 
      Error: The Laboratory Report Item Section can only be used on sections. 
   </assert> 
   <!-- Verify the section type code --> 
   <assert test='cda:code[@code = "TEST CODE"]'> 
     Error: The section type code of a Laboratory Report Item Section must be TEST CODE 
   </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> 
   <assert test='.//cda:templateId[@root = "1.3.6.1.4.1.19376.1.3.1"]'> 
     <!-- Verify that all required data elements are present -->
     Error: The Laboratory Report Item Section Section must contain a(n) Lab Report Data Processing Entry Entry.
     See http://wiki.ihe.net/index.php?title=1.3.6.1.4.1.19376.1.3.3.2.2
   </assert> 
 </rule> 
</pattern>

Uses

See Templates using the Laboratory Report Item Section Section

Laboratory Summary StructuredBody Report Item Section rendering

Laboratory Summary StructuredBody Report Item Section constraints

Example:

<ClinicalDocument 
  ...
  <component typeCode="COMP">
    <structuredBody classCode="DOCBODY" moodCode="EVN">
      <component typeCode="COMP">
        <section classCode="DOCSECT">
          <templateId extension="??" root="1.3.6.1.4.1.19376.1.3.3.2.1"/>
          <code code="18723-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="HEMATOLOGY STUDIES"/>
          <title>Laboratory Hematology Results</title>
          <component>
            <section>
              <templateId extension="??" root="1.3.6.1.4.1.19376.1.3.3.2.2"/>
              <code code="18768-2" codeSystem="2.16.840.1.113883.6.1" displayName="CELL COUNT & DIFF"/>
              <text/>
              <entry typeCode="DRIV">
                <templateId extension="Lab.Report.Data.Processing.Entry" root="1.3.6.1.4.1.19376.1.3"/>
                <act classCode="ACT" moodCode="EVN">
                  ...
                </act>
              </entry>
            </section>
          </component>
          <component>
            <section>
              <templateId extension="??" root="1.3.6.1.4.1.19376.1.3.3.2.2"/>
              <code code="14196-0" codeSystem="2.16.840.1.113883.6.1" displayName="RETIC COUNT"/>
              <text/>
              <entry typeCode="DRIV">
                <templateId extension="Lab.Report.Data.Processing.Entry" root="1.3.6.1.4.1.19376.1.3"/>
                <act classCode="ACT" moodCode="EVN">
                  ...
                </act>
              </entry>
            </section>
          </component>
        </section>
      </component>
    </structuredBody>
  </component>
</ClinicalDocument>

<section>

The Leaf Section under one Root Specialty Section shall contain one Report Item

<templateId extension="??" root="1.3.6.1.4.1.19376.1.3.3.2.2"/>

The <templateId> element identifies this <section> as a leaf section to a specialty section. The templateId shall be recorded as shown above, root="1.3.6.1.4.1.19376.1.3.3.2.2".

The Leaf Section shall contain one Report Item identified uniquely with this element. For example, a LOINC test code. The code, codeSystem, and displayName is required. The use of codeSystemName and orginalText is optional.

<title/>

The Leaf Section <title> MAY be present. If it is present, it is the local translation of the displayName.

<text/>

The Leaf Section <text/> SHALL be present and not blank. This narrative block SHALL present to the human reader, the observations produced for this reported item, using the various structures available in the CDA Narrative Block schema (NarrativeBlock.xsd): tables, lists, paragraphs, hyperlinks, footnotes, references to attached or embedded multimedia objects. The narrative block is fully derived from the entry containing the machine-readable result data.

<entry typeCode="DRIV">

The Leaf Section <entry> SHALL be present and attribute <typeCode> SHALL be "DRIV". This <event> contains the machine-readable result data from which the narrative block of this section is derived.