Version 2.78

74081-1 Event ID:

Observation ID in Form

DE2

Observation Required in Panel

Required

Fully-Specified Name

Component
Patient safety event
Property
ID
Time
Pt
System
^Event
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.46
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]
74495-3 Patient safety event report - hospital - healthcare event reporting form (HERF) - version 1.2 [AHRQ]
74080-3 Patient safety event report - hospital - medication or other substance - version 1.2 [AHRQ]
74502-6 Patient safety event report - hospital - patient information form (PIF) - version 1.2 [AHRQ]
74501-8 Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ]

30947-6 Initial Report Date (HERF Q1):

Observation ID in Form

DE30

Observation Required in Panel

Required

Fully-Specified Name

Component
Date form completed
Property
Date
Time
Pt
System
Form
Scale
Qn
Method

Additional Names

Short Name
Date form completed

Basic Attributes

Class
ADMIN
Type
Clinical
First Released
Version 2.04
Last Updated
Version 2.61
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
97887-4 Core Outcome Measures Index for the Back [COMI]
97327-1 Core Outcome Measures Index for the Neck [COMI]
69412-5 Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0
85645-0 Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment]
85671-6 Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment]
85662-5 Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment]
85668-2 Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment]
100203-9 Knee Society Score post-op panel [Knee Society Score]
100159-3 Knee Society Score pre-op panel [Knee Society Score]
103949-4 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.1 during assessment period [CMS Assessment]
103948-6 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 5.1 during assessment period [CMS Assessment]
103946-0 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.1 during assessment period [CMS Assessment]
103947-8 Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.1 during assessment period [CMS Assessment]
101111-3 MDS v3.0 - RAI v1.18.11 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment]
101105-5 MDS v3.0 - RAI v1.18.11 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
101107-1 MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
101109-7 MDS v3.0 - RAI v1.18.11 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment]
101110-5 MDS v3.0 - RAI v1.18.11 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
101106-3 MDS v3.0 - RAI v1.18.11 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
101113-9 MDS v3.0 - RAI v1.18.11 - Swing bed discharge (SD) item set during assessment period [CMS Assessment]
101112-1 MDS v3.0 - RAI v1.18.11 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
104608-5 MDS v3.0 - RAI v1.19.1 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment]
103564-1 MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
104606-9 MDS v3.0 - RAI v1.19.1 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
105201-8 MDS v3.0 - RAI v1.19.1 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment]
104552-5 MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
104554-1 MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
104607-7 MDS v3.0 - RAI v1.19.1 - Swing Bed discharge (SD) item set during assessment period [CMS Assessment]
104609-3 MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
46611-0 Mental residual functional capacity (RFC) assessment form
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]
74495-3 Patient safety event report - hospital - healthcare event reporting form (HERF) - version 1.2 [AHRQ]
74080-3 Patient safety event report - hospital - medication or other substance - version 1.2 [AHRQ]
74502-6 Patient safety event report - hospital - patient information form (PIF) - version 1.2 [AHRQ]
74501-8 Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ]
105485-7 PhenX - healthcare communications protocol 281101
60687-1 Test of Infant Motor Performance Version 5.1
55140-8 Vaccine Adverse Event Reporting System (VAERS) panel

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Formulario de fecha completado:Fecha:Punto temporal:Formulario:Cuantitativo:
es-AR Spanish (Argentina) fecha de formulario completo:marca de tiempo:fecha y hora:punto en el tiempo:forma:cuantitativo:
it-IT Italian (Italy) Data completamento form:Data:Pt:Modulo:Qn:
Synonyms: Amministrativo Punto nel tempo (episodio)
pt-BR Portuguese (Brazil) Data formulário preenchido:TmStp:Pt:Forma:Qn:
Synonyms: Time stamp; Date and time; Timestamp; Point in time; Random; Quantitative; QNT; Quant; Quan; VACCINE
ru-RU Russian (Russian Federation) Дата форма заполнение:Дата:ТчкВрм:Форма:Колич:
Synonyms: Дата заполнения формы Количественный Точка во времени;Момент
zh-CN Chinese (China) 表单完成日期:日期:时间点:表单:定量型:
Synonyms: 可用数量表示的;定量性;数值型;数量型;连续数值型标尺 日子;几号 时刻;随机;随意;瞬间 行政;管理;施行;执行;经营 表单填写日期 表格;表;窗体

Example Units

Unit Source
{mm/dd/yyyy} Example UCUM Units

74724-6 Which of the following best describes the event or unsafe condition?

Observation ID in Form

DE156

Observation Required in Panel

Required

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Best description of the event or unsafe condition
Property
Find
Time
Pt
System
^Event
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2838-2

Answer Code Score Answer ID
Device defect or failure, including HIT a LA20875-3
Use error b LA20876-1
Combination or interaction of device defect or failure and use error c LA20877-9
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) d LA4489-6

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74723-8 What type of device was involved in the event or unsafe condition?

Observation ID in Form

DE141

Observation Required in Panel

Required

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Device involved in patient safety event or unsafe condition
Property
Type
Time
Pt
System
{Device}
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2839-0

Answer Code Score Answer ID
Implantable device (i.e., device intended to be inserted into, and remain permanently in, tissue) a LA20878-7
Medical equipment (e.g., walker, hearing aid) b LA20879-5
Medical/surgical supply, including disposable product (e.g., incontinence supply) c LA20880-3
HIT device d LA20881-1

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74722-0 At the time of the event, was the device placed within the patient's tissue?

Observation ID in Form

DE144

Observation Required in Panel

Conditional

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
At the time of the event, the device was placed within the patient's tissue
Property
Find
Time
Pt
System
^Patient
Scale
Ord
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2817-6

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) a LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) b LA32-8
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) c LA4489-6

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74721-2 Did the event result in the device being removed?

Observation ID in Form

DE147

Observation Required in Panel

Conditional

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Event resulted in the device being removed
Property
Find
Time
Pt
System
^Event
Scale
Ord
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2817-6

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) a LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) b LA32-8
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) c LA4489-6

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74720-4 What is the name (brand or generic) of the device, product, software, or medical/surgical supply?

Observation ID in Form

DE150

Observation Required in Panel

Optional

Fully-Specified Name

Component
Device name
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Device name

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.73
Order vs. Observation
Observation
Common Test Rank Get Info
4204

Member of these Panels

LOINC Long Common Name
95405-7 Assay related variables panel [PhenX]
92254-2 Microorganism identification and resistance pattern determination panel by Molecular genetics method
89724-9 Minimum Data Set (MDS) for Public Health Emergency Operations Centers (EOC) [CDC Emergency Operations Centers]
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]
62863-6 PhenX domain - Infectious diseases and immunity
97782-7 Spine Tango Surgery 2017
89577-1 Troponin I.cardiac panel - Serum or Plasma by High sensitivity method
89576-3 Troponin T.cardiac panel - Serum or Plasma by High sensitivity method
82307-0 Vendor device information panel

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Nombre del dispositivo:ID:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Dispositivo, nome:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Nome dispositivo Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Устройство наименование:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 装置名称:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 姓名;名字;名 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 装置（设备、器械、仪器设备）名称 装置;设备;仪器

74719-6 What is the name of the manufacturer?

Observation ID in Form

DE153

Observation Required in Panel

Optional

Fully-Specified Name

Component
Manufacturer name
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Manufacturer name

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
95405-7 Assay related variables panel [PhenX]
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]
62787-7 PhenX domain - Diabetes
62949-3 PhenX domain - Gastrointestinal
62863-6 PhenX domain - Infectious diseases and immunity
62896-6 PhenX domain - Skin, bone, muscle and joint
97782-7 Spine Tango Surgery 2017
89577-1 Troponin I.cardiac panel - Serum or Plasma by High sensitivity method
89576-3 Troponin T.cardiac panel - Serum or Plasma by High sensitivity method

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Nombre del Fabricante:Identificador:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Costruttore, nome:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Nome del costruttore Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Производитель наименование:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 制造商名称:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 制造厂名;厂名;制造厂商名称;厂商名称 姓名;名字;名 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 装置;设备;仪器

74718-8 Which of the following identifiers are known?

Observation ID in Form

DE168

Observation Required in Panel

Required

Form Coding Instructions

Check all that apply:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Device identifier
Property
Type
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Device ID

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2840-8

Answer Code Score Answer ID
Model number a LA20882-9
Software version b LA20883-7
Firmware version c LA20884-5
Serial number d LA20885-2
Lot or batch number e LA20886-0
Other unique product identifier f LA20887-8
Date of expiration g LA20888-6
Unique Device Identifier h LA20889-4
Asset tag i LA20890-2
No identifiers known j LA20891-0

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Identificador de dispositivo:Tipo:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Dispositivo, identificatore:Tipo:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore dispositivo Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Устройство идентификатор:Тип:ТчкВрм:{Устройство}:Ном:
Synonyms: Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 装置标识符:类型:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 型 时刻;随机;随意;瞬间 标识;身份标识符;身份标识;ID 装置（设备、器械、仪器设备）标识符 装置;设备;仪器

74717-0 What is the model number?

Observation ID in Form

DE171

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Vendor model number
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Model #

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
92254-2 Microorganism identification and resistance pattern determination panel by Molecular genetics method
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]
89577-1 Troponin I.cardiac panel - Serum or Plasma by High sensitivity method
89576-3 Troponin T.cardiac panel - Serum or Plasma by High sensitivity method
82307-0 Vendor device information panel

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Número de modelo del proveedor:Identificador:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Rivenditore, numero modello:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Numero di modello del rivenditore Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Производитель модель номер:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 厂商型号:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 个数;数目 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 厂商（厂家、供货商、供应商、供应方、卖主、卖方、销售公司、销售方）设备型号;厂商设备机型编号;厂家型号;厂家设备型号;厂家设备机型编号 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 装置;设备;仪器

55081-4 Product version code Software

Term Description

Software version code is a unique version name or number used to identify unique states or versions of computer software. Within a given version number category (major, minor), these numbers are generally assigned in increasing order and correspond to new developments in the software. At a fine-grained level, revision control is often used for keeping track of incrementally different versions of electronic information, whether or not this information is computer software.
Source: Wikipedia

Observation ID in Form

DE172

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Product version code
Property
ID
Time
Pt
System
Software
Scale
Nom
Method

Basic Attributes

Class
SURVEY.MDS
Type
Surveys
First Released
Version 2.27
Last Updated
Version 2.27

Member of these Panels

LOINC Long Common Name
54580-6 Deprecated Minimum Data Set - version 3.0
90480-5 MDS v3.0 - RAI v1.17.1, 1.17.2 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment]
90473-0 MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
90477-1 MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
90474-8 MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
90475-5 MDS v3.0 - RAI v1.17.1, 1.17.2 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
90481-3 MDS v3.0 - RAI v1.17.1, 1.17.2 - Optional State Assessment (OSA) item set during assessment period [CMS Assessment]
91552-0 MDS v3.0 - RAI v1.17.1, 1.17.2 - Swing bed discharge (SD) item set during assessment period [CMS Assessment]
90476-3 MDS v3.0 - RAI v1.17.1, 1.17.2 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
101111-3 MDS v3.0 - RAI v1.18.11 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment]
101105-5 MDS v3.0 - RAI v1.18.11 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
101107-1 MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
101110-5 MDS v3.0 - RAI v1.18.11 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
101106-3 MDS v3.0 - RAI v1.18.11 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
101113-9 MDS v3.0 - RAI v1.18.11 - Swing bed discharge (SD) item set during assessment period [CMS Assessment]
101112-1 MDS v3.0 - RAI v1.18.11 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
104608-5 MDS v3.0 - RAI v1.19.1 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment]
103564-1 MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment]
104606-9 MDS v3.0 - RAI v1.19.1 - Nursing home discharge (ND) item set during assessment period [CMS Assessment]
104552-5 MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment]
104554-1 MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment]
104607-7 MDS v3.0 - RAI v1.19.1 - Swing Bed discharge (SD) item set during assessment period [CMS Assessment]
104609-3 MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment]
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74716-2 What is the firmware version?

Observation ID in Form

DE173

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Vendor firmware version
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Vendor firmware version

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
92254-2 Microorganism identification and resistance pattern determination panel by Molecular genetics method
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]
82307-0 Vendor device information panel

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Versión de firmware del proveedor:Identificador:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Rivenditore, versione firmware:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Punto nel tempo (episodio) Versione di firmware del venditore
ru-RU Russian (Russian Federation) Изготовитель встроенная программа версия:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 厂商固件版本:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 厂家固件版本;供应商固件版本;供货商固件版本 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 版;版次;变化形式;变体 装置;设备;仪器

74715-4 What is the serial number?

Observation ID in Form

DE174

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Vendor serial number
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Serial #

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
92254-2 Microorganism identification and resistance pattern determination panel by Molecular genetics method
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]
89577-1 Troponin I.cardiac panel - Serum or Plasma by High sensitivity method
89576-3 Troponin T.cardiac panel - Serum or Plasma by High sensitivity method
82307-0 Vendor device information panel

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Número de serie del proveedor:Identificador:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Rivenditore, numero di serie:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Numero di serie del rivenditore Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Производитель серийный номер:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 厂商序列号:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 个数;数目 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 厂商（厂家、供货商、供应商、供应方、卖主、卖方、销售公司、销售方）序号;厂商设备序列号;厂商设备序号;厂家序列号;厂家序号;厂家设备序列号;厂家设备序号 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 装置;设备;仪器

74714-7 What is the lot or batch number?

Observation ID in Form

DE177

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Lot or batch number
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Lot or batch no.

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Lote o número de lote:ID:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Numero di lotto o batch:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Партия или заказ номер:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 批号:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 个数;数目 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 批次编号;批次号;批次代码;;批次标识符;生产批号 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 装置;设备;仪器

74713-9 What is the type of other unique product identifier?

Observation ID in Form

DE180

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Other unique product identifier
Property
Type
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Other UDI [Type]

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Otro identificador único de producto:Tipo:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Altro identificativo univoco del prodotto:Tipo:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Другой уникальный идентификатор продукта:Тип:ТчкВрм:{Устройство}:Ном:
Synonyms: Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 其他唯一性产品标识符:类型:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 其他唯一性的产品标识符;其他独特性产品标识符 其他的 其它 其它的 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 别的 另外的 型 时刻;随机;随意;瞬间 标识;身份标识符;身份标识;ID 装置;设备;仪器

74726-1 What is the other unique product identifier?

Observation ID in Form

DE183

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Other unique product identifier
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Other UDI

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Otro identificador único de producto:ID:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Altro identificativo univoco del prodotto:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Другой уникальный идентификатор продукта:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 其他唯一性产品标识符:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 其他唯一性的产品标识符;其他独特性产品标识符 其他的 其它 其它的 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 别的 另外的 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 标识;身份标识符;身份标识;ID 装置;设备;仪器

74712-1 What is the expiration date?

Observation ID in Form

DE186

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Expiration date
Property
Date
Time
Pt
System
{Device}
Scale
Qn
Method

Additional Names

Short Name
Expiration date

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Fecha de caducidad:Fecha:Punto temporal:{Dispositivo}:Cuantitativo:
it-IT Italian (Italy) Data di scadenza:Data:Pt:{Dispositivo}:Qn:
Synonyms: {Strumento} Dispositivi medici Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Срок годности:Дата:ТчкВрм:{Устройство}:Колич:
Synonyms: Количественный Точка во времени;Момент
zh-CN Chinese (China) 有效日期:日期:时间点:{装置}:定量型:
Synonyms: {仪器设备};{设备};{仪器} 可用数量表示的;定量性;数值型;数量型;连续数值型标尺 吐气 呼 呼出 呼出;呼出气体 日子;几号 时刻;随机;随意;瞬间 有效期;截止日期;产品有效期;失效日期;失效期;过期日 装置;设备;仪器

Example Units

Unit Source
{mm/dd/yyyy} Example UCUM Units

74711-3 What is the Unique Device Identifier (UDI)?

Observation ID in Form

DE189

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Unique device identifier
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
UDI

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Identificador de dispositivo único:ID:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Identificatore univoco del dispositivo:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Identificatore dispositivo Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Уникальный идентификатор устройства:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 唯一性装置标识符:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 标识;身份标识符;身份标识;ID 独特性装置标识符;唯一性装置（设备、器械、仪器设备）标识符 装置（设备、器械、仪器设备）标识符 装置;设备;仪器

74710-5 What is the asset tag number?

Observation ID in Form

DE187

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Asset tag number
Property
ID
Time
Pt
System
{Device}
Scale
Nom
Method

Additional Names

Short Name
Asset tag number

Basic Attributes

Class
DEVICES
Type
Clinical
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

Language Variants Get Info

Tag Language Translation
es-MX Spanish (Mexico) Número de etiqueta de activo:ID:Punto temporal:{Dispositivo}:Nominal:
it-IT Italian (Italy) Numero di matricola:ID:Pt:{Dispositivo}:Nom:
Synonyms: {Strumento} Dispositivi medici Identificatore Punto nel tempo (episodio)
ru-RU Russian (Russian Federation) Актив кодовая метка:ID:ТчкВрм:{Устройство}:Ном:
Synonyms: Идентификатор Номинальный;Именной Точка во времени;Момент
zh-CN Chinese (China) 资产标签编号:标识符:时间点:{装置}:名义型:
Synonyms: {仪器设备};{设备};{仪器} 个数;数目 分类型应答;分类型结果;名义性;名称型;名词型;名词性;标称性;没有自然次序的名义型或分类型应答 时刻;随机;随意;瞬间 标识;身份标识符;身份标识 装置;设备;仪器 资产标签号;资产标记号;资产标签号码;资产标签标识符;资产标签ID

74709-7 Was a device intended for single use involved in the event or unsafe condition (including use of a reprocessed single-use device)?

Term Description

Determination if a device intended for single use was reused in the event or unsafe condition.
Source: Regenstrief LOINC

Observation ID in Form

DE190

Observation Required in Panel

Required

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Device intended for single use was involved in the event or unsafe condition
Property
Find
Time
Pt
System
^Event
Scale
Ord
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2817-6

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) a LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) b LA32-8
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) c LA4489-6

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74708-9 Was a device intended for a single use reused in the event or unsafe condition?

Observation ID in Form

DE165

Observation Required in Panel

Conditional

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Device intended for single use was reused in the event or unsafe condition
Property
Find
Time
Pt
System
^Event
Scale
Ord
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2817-6

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) a LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) b LA32-8
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) c LA4489-6

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74707-1 Did the event or unsafe condition involve a medication or other substance?

Observation ID in Form

DE531

Observation Required in Panel

Required

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Medication or other substance was involved
Property
Find
Time
Pt
System
^Event
Scale
Ord
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2817-6

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) a LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) b LA32-8
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) c LA4489-6

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74706-3 Did the event or unsafe condition involve an HIT device?

Observation ID in Form

DE0534

Observation Required in Panel

Conditional

Fully-Specified Name

Component
Health information technology device was involved
Property
Find
Time
Pt
System
^Event
Scale
Ord
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2828-3

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) a LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) b LA32-8

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74705-5 Which of the following best characterizes the type of HIT device related to the event or unsafe condition?

Observation ID in Form

DE534

Observation Required in Panel

Conditional

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Best characterization of health information technology device
Property
Find
Time
Pt
System
{Device}
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2841-6

Answer Code Score Answer ID
Administrative/billing or practice management system a LA20892-8
Automated dispensing system b LA20893-6
Electronic health record (EHR) or component of EHR c LA20894-4
Human interface device (e.g., keyboard, mouse, touchscreen, speech recognition system, monitor/display, printer) d LA20895-1
Laboratory information system (LIS), including microbiology and pathology systems e LA21152-6
Radiology/diagnostic imaging system, including picture archiving and communications system (PACS) f LA21153-4
Other: PLEASE SPECIFY g LA20318-4

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74704-8 Which component of the administrative/billing system?

Observation ID in Form

DE537

Observation Required in Panel

Conditional

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Administrative or billing system component
Property
Type
Time
Pt
System
Administrative or billing system
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2842-4

Answer Code Score Answer ID
Master patient index a LA20896-9
Registration/appointment scheduling system b LA20897-7
Coding/billing system c LA20898-5
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) d LA4489-6
Other: PLEASE SPECIFY e LA20318-4

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74703-0 Which type or component of the EHR?

Observation ID in Form

DE540

Observation Required in Panel

Conditional

Form Coding Instructions

Check one:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Electronic health record system component
Property
Type
Time
Pt
System
Electronic health record
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2843-2

Answer Code Score Answer ID
Computerized provider order entry (CPOE) system a LA20899-3
Pharmacy system b LA20900-9
Electronic medication administration record (e-MAR) c LA20901-7
Clinical documentation system (e.g., progress notes) d LA20902-5
Clinical decision support (CDS) system e LA20903-3
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) f LA4489-6
Other: PLEASE SPECIFY g LA20318-4

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74702-2 Which of the following describes the circumstances involving the HIT device in the event or unsafe condition?

Observation ID in Form

DE543

Observation Required in Panel

Conditional

Form Coding Instructions

Check all that apply:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Circumstances involving the health information technology device in the event or unsafe condition
Property
Type
Time
Pt
System
{Device}
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2844-0

Answer Code Score Answer ID
Incompatibility between devices a LA20905-8
Equipment/device function b LA20906-6
Equipment/device maintenance c LA20907-4
Hardware failure or problem d LA20908-2
Network failure or problem e LA20909-0
Ergonomics, including human/device interface issue f LA20910-8
Security, virus, or other malware issue g LA20911-6
Unexpected software design issue h LA21155-9
Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) i LA4489-6
Other: PLEASE SPECIFY j LA20318-4

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74701-4 Which problem(s) resulted from the equipment/device function problem?

Observation ID in Form

DE546

Observation Required in Panel

Conditional

Form Coding Instructions

Check all that apply:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Problem that resulted from the equipment or device function problem
Property
Type
Time
Pt
System
{Device}
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2845-7

Answer Code Score Answer ID
Loss or delay of data a LA20912-4
System returns or stores data that does not match patient b LA20913-2
Image measurement/corruption issue c LA20914-0
Image orientation incorrect d LA20915-7
Incorrect test results e LA20916-5
Incorrect software programming calculation f LA20917-3
Incorrect or inappropriate alert g LA20918-1
Other: PLEASE SPECIFY h LA20318-4

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]

74700-6 Which ergonomics or human/device interface issue(s)?

Observation ID in Form

DE549

Observation Required in Panel

Conditional

Form Coding Instructions

Check all that apply:

Source: Agency for Healthcare Research and Quality

Fully-Specified Name

Component
Ergonomics or human &or device interface issue
Property
Type
Time
Pt
System
{Device}
Scale
Nom
Method
AHRQ

Basic Attributes

Class
SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.66
Order vs. Observation
Observation

Normative Answer List LL2846-5

Answer Code Score Answer ID
Hardware location (e.g., awkward placement for use) a LA20919-9
Data entry or selection (e.g., entry or selection of wrong patient, wrong provider, wrong drug, wrong dose) b LA20920-7
Information display or interpretation (e.g., font size, color of font, location of information in display screen) c LA20921-5
Alert fatigue/alarm fatigue d LA21156-7
Other: PLEASE SPECIFY e LA20318-4

Member of these Panels

LOINC Long Common Name
74725-3 Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ]