Version 2.78

Fully-Specified Name

Component
Note
Property
Find
Time
Pt
System
Outpatient
Scale
Doc
Method
{Role}

Additional Names

Short Name
OP Note

Basic Attributes

Class
DOC.ONTOLOGY
Type
Clinical
First Released
Version 2.09
Last Updated
Version 2.54
Change Reason
Component was changed from 'Evaluation and management note' to 'Note' based on Clinical LOINC Committee approval at 8/16/2011 meeting. The Committee agreed that Nursing evaluation and management note, for example, is essentially the same as a Nursing note.; Based on Clinical LOINC Committee decision during the September 2014 meeting, {Provider} was changed to {Author Type} to emphasize a greater breadth of potential document authors. At the September 2015 Clinical LOINC Committee meeting, the Committee decided to change {Author Type} to {Role} to align with the 'Role' axis name in the LOINC Document Ontology.
Order vs. Observation
Both

Member of these Groups Get Info

LOINC Group Group Name
LG38748-6 Note|ANYRole|ANYSetting
LG41828-1 Outpatient|ANYTypeofService|ANYKindofDocument|ANYRole|ANYSubjectMatterDomain

Language Variants Get Info

Tag Language Translation
de-AT German (Austria) Befund:Ergebnis:Zeitpunkt:ambulant:Dokument:{Typ des Autors}
Synonyms: Bericht
es-AR Spanish (Argentina) evaluación y manejo:hallazgo:punto en el tiempo:paciente ambulatorio:Documento:{proveedor}
es-MX Spanish (Mexico) Nota:Tipo:Punto temporal:Paciente externo:Documento:{Role}
it-IT Italian (Italy) Nota:Osservazione:Pt:Paziente esterno:Doc:{Role}
Synonyms: Documentazione dell''ontologia Osservazione Paziente ambulatoriale;Paziente non ricoverato Punto nel tempo (episodio) Ruolo non specificato
nl-NL Dutch (Netherlands) verslag:bevinding:moment:poliklinisch:document:{rol}
Synonyms: poli
zh-CN Chinese (China) 记录:发现:时间点:门诊病人:文档型:{角色}
Synonyms: 临床文档型;临床文档;文档;文书;医疗文书;临床医疗文书 发现是一个原子型临床观察指标,并不是作为印象的概括陈述。体格检查、病史、系统检查及其他此类观察指标的属性均为发现。它们的标尺对于编码型发现可能是名义型,而对于叙述型文本之中所报告的发现,则可能是叙述型。;发现物;所见;结果;结论 文档本体;临床文档本体;文档本体;文书本体;医疗文书本体;临床医疗文书本体 时刻;随机;随意;瞬间 未加明确说明的角色 笔记;按语;注释;说明;票据;单据;证明书 门诊患者

LOINC Terminology Service (API) using HL7® FHIR® Get Info

CodeSystem lookup
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=34108-1