Version 2.78

75201-4 Mother's obstetric history: G

Observation ID in Form

9a

Fully-Specified Name

Component
Pregnancies
Property
Num
Time
Pt
System
^Mother
Scale
Qn
Method
Reported

Basic Attributes

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

Survey Question

Source
CS.9a

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

Unit Source
{#} Example UCUM Units

75202-2 Mother's obstetric history: P

Observation ID in Form

9b

Fully-Specified Name

Component
Births.live
Property
Num
Time
Pt
System
^Mother
Scale
Qn
Method
Reported

Basic Attributes

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

Survey Question

Source
CS.9b

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

Unit Source
{#} Example UCUM Units

75203-0 Last menstrual period (LMP) (before delivery)

Observation ID in Form

10

Fully-Specified Name

Component
Date last menstrual period^pre delivery
Property
Date
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

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

Survey Question

Source
CS.10

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

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

75200-6 Indicate date of first prenatal visit

Observation ID in Form

11a1

Skip Logic

If No prenatal care, Go to Q12

Fully-Specified Name

Component
Date first prenatal visit
Property
Date
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

Class
SURVEY.CDC
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.50
Order vs. Observation
Observation

Survey Question

Source
CS.11a

Member of these Panels

LOINC Long Common Name
85735-9 Congenital rubella case report panel
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

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

75204-8 Prenatal care indicator [CDC.CS]

Observation ID in Form

11a

Fully-Specified Name

Component
Prenatal care indicator
Property
Arb
Time
Pt
System
^Mother
Scale
Ord
Method
CDC

Basic Attributes

Class
SURVEY.CDC
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.61
Change Reason
Updated Method from "CDC.CS" since this concept is used across CDC case reports not just for congenital syphilis.
Order vs. Observation
Observation

Survey Question

Source
CS.11a1

Example Answer List LL2939-8

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
No prenatal care 0 LA21278-9
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
85735-9 Congenital rubella case report panel
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75163-6 Indicate trimester of first prenatal visit

Observation ID in Form

11b

Fully-Specified Name

Component
Trimester of first prenatal visit
Property
Time
Time
Pt
System
^Mother
Scale
Ord
Method
CDC.CS

Basic Attributes

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

Survey Question

Source
CS.11b

Normative Answer List LL2913-3

Answer Code Score Answer ID
1st trimester 1 LA21196-3
2nd trimester 2 LA21197-1
3rd trimester 3 LA21198-9
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75164-4 Did the mother have non-treponemal test or treponemal test at first prenatal visit

Observation ID in Form

14a

Fully-Specified Name

Component
Non-treponemal or treponemal test was performed at first prenatal visit
Property
Find
Time
Pt
System
^Mother
Scale
Ord
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
Did the mother have non-treponemal test or treponemal test at first prenatal visit
Source
CS.14a

Normative Answer List LL2916-6

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 2 LA32-8
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75165-1 Did the mother have non-treponemal test or treponemal test at 28-32 weeks gestation?

Observation ID in Form

14b

Fully-Specified Name

Component
Non-treponemal or treponemal test was performed at 28-32 weeks gestation
Property
Find
Time
Pt
System
^Mother
Scale
Ord
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
Did the mother have non-treponemal test or treponemal test at 28-32 weeks gestation?
Source
CS.14b

Normative Answer List LL2916-6

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 2 LA32-8
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75166-9 Did the mother have non-treponemal test or treponemal test at delivery?

Observation ID in Form

14c

Fully-Specified Name

Component
Non-treponemal or treponemal test was performed at delivery
Property
Find
Time
Pt
System
^Mother
Scale
Ord
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
Did the mother have non-treponemal test or treponemal test at delivery?
Source
CS.14c

Normative Answer List LL2916-6

Answer Code Score Answer ID
Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) 1 LA33-6
No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) 2 LA32-8
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75257-6 Mother's marital status

Observation ID in Form

15

Fully-Specified Name

Component
Marital status
Property
Type
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Source
CS.15

Normative Answer List LL2917-4

Answer Code Score Answer ID
Single, never married 1 LA21200-3
Married 2 LA48-4
Separated/Divorced 3 LA21201-1
Widow 4 LA21202-9
Other 8 LA46-8
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75167-7 Indicate during pregnancy and delivery date of most recent non-treponemal test

Observation ID in Form

16a

Fully-Specified Name

Component
Date of most recent non-treponemal test
Property
Date
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

Class
SURVEY.CDC
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.50
Order vs. Observation
Observation

Survey Question

Source
CS.16a

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

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

75168-5 Indicate during pregnancy and delivery most recent non-treponemal test result

Observation ID in Form

16a1

Fully-Specified Name

Component
Most recent non-treponemal test result
Property
Find
Time
Pt
System
^Mother
Scale
Ord
Method
CDC.CS

Basic Attributes

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

Survey Question

Source
CS.16a1

Normative Answer List LL2918-2

Answer Code Score Answer ID
Reactive Copyright http://snomed.info/sct ID:11214006 Reactive (qualifier value) 1 LA15255-5
Nonreactive Copyright http://snomed.info/sct ID:131194007 Non-reactive (qualifier value) 2 LA15256-3
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75169-3 Indicate during pregnancy and delivery most recent non-treponemal test titer

Observation ID in Form

16a2

Fully-Specified Name

Component
Most recent non-treponemal test titer
Property
Titr
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

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

Survey Question

Source
CS.16a2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

Unit Source
{titer} Example UCUM Units

75170-1 Indicate during pregnancy and delivery date of first non-treponemal test

Observation ID in Form

16b

Fully-Specified Name

Component
Date first non-treponemal test
Property
Date
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

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

Survey Question

Source
CS.16b

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

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

75171-9 Indicate during pregnancy and delivery first non-treponemal test result

Observation ID in Form

16b1

Fully-Specified Name

Component
First non-treponemal test result
Property
Find
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Source
CS.16b1

Normative Answer List LL2918-2

Answer Code Score Answer ID
Reactive Copyright http://snomed.info/sct ID:11214006 Reactive (qualifier value) 1 LA15255-5
Nonreactive Copyright http://snomed.info/sct ID:131194007 Non-reactive (qualifier value) 2 LA15256-3
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75172-7 Indicate during pregnancy and delivery first non-treponemal test titer

Observation ID in Form

16b2

Fully-Specified Name

Component
First non-treponemal test titer
Property
Titr
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

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

Survey Question

Source
CS.16b2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

Unit Source
{titer} Example UCUM Units

75173-5 Indicate during pregnancy and delivery date of first treponemal test

Observation ID in Form

17a1

Fully-Specified Name

Component
Date of first treponemal test
Property
Date
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

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

Survey Question

Source
CS.17a1

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

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

75174-3 Indicate during pregnancy and delivery first treponemal test type

Observation ID in Form

17b1

Fully-Specified Name

Component
First treponemal test type
Property
Type
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Source
CS.17b1

Normative Answer List LL2936-4

Answer Code Score Answer ID
EIA or CLIA 1 LA21250-8
TP-PA 2 LA21251-6
Other 3 LA46-8
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75175-0 Indicate during pregnancy and delivery first treponemal test result

Observation ID in Form

17c1

Fully-Specified Name

Component
First treponemal test result
Property
Find
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Source
CS.17c1

Normative Answer List LL2918-2

Answer Code Score Answer ID
Reactive Copyright http://snomed.info/sct ID:11214006 Reactive (qualifier value) 1 LA15255-5
Nonreactive Copyright http://snomed.info/sct ID:131194007 Non-reactive (qualifier value) 2 LA15256-3
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75176-8 Indicate during pregnancy the date of most recent treponemal test

Observation ID in Form

17a2

Fully-Specified Name

Component
Date of most recent treponemal test
Property
Date
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

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

Survey Question

Source
CS.17a2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

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

75177-6 Indicate during pregnancy most recent treponemal test type

Observation ID in Form

17b2

Fully-Specified Name

Component
Most recent treponemal test type
Property
Type
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Source
CS.17b2

Normative Answer List LL2936-4

Answer Code Score Answer ID
EIA or CLIA 1 LA21250-8
TP-PA 2 LA21251-6
Other 3 LA46-8
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75178-4 Indicate during pregnancy most recent treponemal test result

Observation ID in Form

17c2

Fully-Specified Name

Component
Most recent treponemal result
Property
Find
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Source
CS.17c2

Normative Answer List LL2918-2

Answer Code Score Answer ID
Reactive Copyright http://snomed.info/sct ID:11214006 Reactive (qualifier value) 1 LA15255-5
Nonreactive Copyright http://snomed.info/sct ID:131194007 Non-reactive (qualifier value) 2 LA15256-3
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75179-2 What was the mother's HIV status during pregnancy?

Observation ID in Form

18

Fully-Specified Name

Component
HIV status during pregnancy
Property
Find
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
What was the mother's HIV status during pregnancy?
Source
CS.18

Normative Answer List LL2919-0

Answer Code Score Answer ID
Positive Copyright http://snomed.info/sct ID:10828004 Positive (qualifier value) P LA6576-8
equivocal test E LA21206-0
Negative Copyright http://snomed.info/sct ID:260385009 Negative (qualifier value) N LA6577-6
patient not tested X LA21205-2
Unk U LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75180-0 What clinical stage of syphilis did mother have during pregnancy?

Observation ID in Form

19

Fully-Specified Name

Component
Clinical stage of syphilis during pregnancy
Property
Find
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
What clinical stage of syphilis did mother have during pregnancy?
Source
CS.19

Normative Answer List LL2921-6

Answer Code Score Answer ID
Primary 1 LA21208-6
Secondary 2 LA18924-3
early latent 3 LA21207-8
late or late latent 4 LA21210-2
previously treated/serofast 5 LA21211-0
Other 8 LA46-8
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75181-8 What surveillance stage of syphilis did mother have during pregnancy?

Observation ID in Form

20

Fully-Specified Name

Component
Surveillance stage of syphilis during pregnancy
Property
Find
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
What surveillance stage of syphilis did mother have during pregnancy?
Source
CS.20

Normative Answer List LL2922-4

Answer Code Score Answer ID
Primary 1 LA21208-6
Secondary 2 LA18924-3
early latent 3 LA21207-8
late or late latent 4 LA21210-2
Other 8 LA46-8
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75182-6 When (date) did mother receive her first dose of benzathine penicillin?

Observation ID in Form

21a

Skip Logic

If No treatment, go to Q24

Fully-Specified Name

Component
Date of first syphilis treatment during pregnancy
Property
Date
Time
Pt
System
^Mother
Scale
Qn
Method

Basic Attributes

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

Survey Question

Text
When (date) did mother receive her first dose of benzathine penicillin?
Source
CS.21a

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

Example Units

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

75183-4 When (trimester) did mother receive her first dose of benzathine penicillin?

Observation ID in Form

21b

Fully-Specified Name

Component
When mother received first dose of benzathine penicillin
Property
Find
Time
Pt
System
^Mother
Scale
Ord
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
When (trimester) did mother receive her first dose of benzathine penicillin?
Source
CS.21b

Normative Answer List LL2924-0

Answer Code Score Answer ID
Before pregnancy 1 LA21212-8
1st trimester 2 LA21196-3
2nd trimester 3 LA21197-1
3rd trimester 4 LA21198-9
No Treatment 5 LA21213-6
Unk 9 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75184-2 What was the mother's treatment?

Observation ID in Form

22

Fully-Specified Name

Component
Amount of benzathine penicillin treatment
Property
Find
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
What was the mother's treatment?
Source
CS.22

Normative Answer List LL2925-7

Answer Code Score Answer ID
2.4 M units benzathine penicillin 1 LA21214-4
4.8 M units benzathine penicillin 2 LA21215-1
7.2 M units benzathine penicillin 3 LA21216-9
Other 8 LA46-8
Unk 0 LA14945-2

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]

75185-9 Did the mother have an appropriate serologic response?

Observation ID in Form

23

Fully-Specified Name

Component
Mother had appropriate serologic response following syphilis treatment
Property
Find
Time
Pt
System
^Mother
Scale
Nom
Method
CDC.CS

Basic Attributes

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

Survey Question

Text
Did the mother have an appropriate serologic response?
Source
CS.23

Normative Answer List LL2926-5

Answer Code Score Answer ID
Yes, appropriate response 1 LA21217-7
No, inappropriate response: evidence of treatment failure or reinfection 2 LA21218-5
Response could not be determined from available non-treponemal titer information 3 LA21219-3
Not enough time for titer to change 4 LA21220-1

Member of these Panels

LOINC Long Common Name
75199-0 Congenital syphilis case investigation and report panel [CDC.CS]