81958-1
National Health Care Surveys report R1 - recommended CDA set
Active
75617-1 Residence
Term Description
The patient's home type such as; patient home, nursing home, or homeless.
Source: Centers for Disease Control and Prevention
Fully-Specified Name
- Component
- Residence
- Property
- Type
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- NAMCS
Long Common Name
Residence [NAMCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.73 (MIN)
- Order vs. Observation
- Observation
- Common Test Rank Get Info
- 11200
Example Answer List LL3031-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Client's or patient's home | 1 | LA21588-1 | |
| Nursing Home | 2 | LA27-8 | |
| Homeless | 3 | LA20561-9 | |
| Other | 4 | LA46-8 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 5 | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
75636-1 Emergency severity index [ESI]
Part Descriptions
LP185954-7 Emergency severity index
The Emergency Severity Index© Version 4 (ESI) is an emergency department (ED) triage tool. The ESI© triage algorithm yields rapid, reproducible, and clinically relevant stratification of patients into five groups, from level 1 (most urgent) to level 5 (least urgent). The ESI provides a method for categorizing ED patients by both acuity and resource needs.
Source: Regenstrief LOINC, ESI© Triage Research Team
Fully-Specified Name
- Component
- Emergency severity index
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- ESI
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.54 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL3056-0
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Requires immediate life-saving intervention | ESI-1 | LA21567-5 | |
| High risk or confused/lethargic/disoriented or severe pain/distress | ESI-2 | LA21752-3 | |
| Needs 2 or more resources | ESI-3 | LA21753-1 | |
| Needs 1 resource | ESI-4 | LA21754-9 | |
| Needs no resources | ESI-5 | LA21755-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Copyright
- Organization
- ESI Triage Research Team
- Copyright
- ESI Copyright © 2004, ESI Triage Research Team
- Terms of Use
- Used with permission.
75910-0 Canadian triage and acuity scale [CTAS]
Part Descriptions
LP185955-4 Canadian triage and acuity scale
The Canadian Triage and Acuity Score (CTAS) is a 5-level scale designed to support triage nurses prioritize ED patients based on acuity and time sensitive conditions. It is built on a 17 group, 166 standardized complaints, each of which draws on a list of first order (vital sign, pain score, mechanism of injury, and bleeding risk) modifiers and complaint specific special modifiers to assign the most appropriate acuity score and to then stream patients to the right care area. For patient safety and quality of care it is recommended for CTAS level 1 to be seen immediately, CTAS 2 within 15 minutes, CTAS 3 within 30 minutes, CTAS 4 within 1 hour and CTAS 5 within 2 hours.
Source: Regenstrief LOINC, Canadian Triage And Acuity Scale (CTAS)
Fully-Specified Name
- Component
- Canadian triage and acuity scale
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- CTAS
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3059-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| 1 | LA6112-2 | ||
| 2 or more | LA6113-0 | ||
| 3 | LA6114-8 | ||
| 4 | LA6115-5 | ||
| 5 | LA10137-0 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Copyright
- Organization
- Canadian Triage and Acuity Scale
- Copyright
- Copyright © Canadian Triage and Acuity Scale
- Terms of Use
- Used with permission
- URL
- https://caep.ca
75616-3 Generic five level triage system
Part Descriptions
LP185965-3 Generic five level triage system
A triage acuity system that has five levels, (for example, 1-resuscitation, 2- emergent, 3- urgent, 4- less urgent, 5- nonurgent).
Source: Centers for Disease Control and Prevention
Fully-Specified Name
- Component
- Generic five level triage system
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- NAMCS
Long Common Name
Generic five level triage system [NAMCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL3052-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Resuscitation | 1 | LA21538-6 | |
| Emergent | 2 | LA19759-2 | |
| Urgent | 3 | LA21544-4 | |
| Less urgent | 4 | LA21587-3 | |
| Nonurgent | 5 | LA21545-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
75615-5 Four level triage system
Part Descriptions
LP185966-1 Four level triage system
A triage acuity systems with four-level scales.
Source: Centers for Disease Control and Prevention
Fully-Specified Name
- Component
- Four level triage system
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- NAMCS
Long Common Name
Four level triage system [NAMCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL3053-7
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Resuscitation | 1 | LA21538-6 | |
| Emergent | 2 | LA19759-2 | |
| Urgent | 3 | LA21544-4 | |
| Nonurgent | 4 | LA21545-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
75614-8 Three level triage system
Part Descriptions
LP185967-9 Three level triage system
A triage acuity systems with three-level scales (e.g., 1-emergent, 2- urgent, 3-nonurgent).
Source: Centers for Disease Control and Prevention
Fully-Specified Name
- Component
- Three level triage system
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- NAMCS
Long Common Name
Three level triage system [NAMCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL3054-5
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Emergent | 1 | LA19759-2 | |
| Urgent | 2 | LA21544-4 | |
| Nonurgent | 3 | LA21545-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
75613-0 ED episode of care
Part Descriptions
LP185956-2 ED episode of care
Indicates whether a patient's emergency department (ED) visit is an initial or follow-visit. An ED episode of care begins with the initial visit for care for a particular problem and ends when the patient is no longer continuing treatment. A subsequent visit for the problem is considered a follow-up ED episode of care. An initial visit may be diagnostic in nature whereas a follow-up visit may be to check progress or continue therapy.
Source: Centers for Disease Control and Prevention
Fully-Specified Name
- Component
- ED episode of care
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL3034-7
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Initial patient assessment | 1 | 1 | LA21589-9 |
| Follow-up visit | 2 | 2 | LA21590-7 |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 3 | 3 | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
75527-2 Vital status at discharge
Term Description
The patient's vital status (alive or expired/deceased) at discharge.
Fully-Specified Name
- Component
- Vital status^at discharge
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
Basic Attributes
- Class
- SURVEY.PCORNET
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.50 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL3017-2
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Discharged alive | A | LA21431-4 | |
| Expired | E | LA10325-1 | |
| No information | NI | LA21413-2 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | UN | LA4489-6 | |
| Other | OT | LA46-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
| 75854-0 | PCORnet common data model set - version 1.0 [PCORnet] |
| 85057-8 | PCORnet Common Data Model set - version 3.0 [PCORnet] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
75618-9 Comorbid condition
Part Descriptions
LP185958-8 Comorbid condition
Medical diagnoses or clinical conditions the patient has at the time of the encounter that may or may not be associated with the primary or any other reason for the encounter.
Source: Centers for Disease Control and Prevention
Fully-Specified Name
- Component
- Comorbid condition
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
Basic Attributes
- Class
- H&P.HX
- Type
- Clinical
- First Released
- Version 2.50
- Last Updated
- Version 2.70 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL3043-8
- Externally Defined
- Yes
- Code System
- Code System OID
- 1.3.6.1.4.1.12009.10.1.1957
- Link to External List
- https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.3.88.12.3221.7.4
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 103991-6 | CMS - Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.2 during assessment period [CMS Assessment] |
| 98871-7 | COVID-19 comorbidity and healthcare questionnaire |
| 83265-9 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.4 [CMS Assessment] |
| 87414-9 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 1.5 [CMS Assessment] |
| 88329-8 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 2.0 [CMS Assessment] |
| 89963-3 | Deprecated Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 3.0 during assessment period [CMS Assessment] |
| 113114-3 | Inpatient Rehabilitation Facility - Patient Assessment Instrument - version 4.4 during assessment period [CMS Assessment] |
| 93128-7 | Inpatient Rehabilitation Facility - Patient Assessment Instrument (IRF-PAI) - version 4.0 during assessment period [CMS Assessment] |
| 96569-9 | LACE index panel |
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Language Variants Get Info
| Tag | Language | Translation |
|---|---|---|
| el-GR | Greek (Greece) | Κατάσταση συννοσηρότητας: Synonyms: - H& |
| es-MX | Spanish (Mexico) | Condición comórbida: |
| fr-FR | French (France) | Comorbidité: |
| it-IT | Italian (Italy) | Condizione di comorbilità: Synonyms: Anamnesi Osservazione paziente Punto nel tempo (episodio) |
| zh-CN | Chinese (China) | 共病情况: Synonyms: 健康状况; |
75612-2 Number of visits to this healthcare entity in the last 12 months
Part Descriptions
LP185960-4 Number of visits to this healthcare entity in the last 12Mo
The number of times the patient was seen by the reporting healthcare entity in the past 12 months.
Source: Regenstrief Institute
Fully-Specified Name
- Component
- Number of visits to this healthcare entity in the last 12Mo
- Property
- NRat
- Time
- 12Mo
- System
- ^Patient
- Scale
- Qn
- Method
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.66 (MIN)
- Order vs. Observation
- Observation
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Example Units
| Unit | Source |
|---|---|
| /a | Example UCUM Units |
75611-4 Patient seen in this ED in last 72 hours and discharged
Part Descriptions
LP185961-2 Patient seen in this ED in last 72H and discharged
Indicates whether the patient was seen in this emergency department within the 72 hours prior to the current visit and then was discharged from the emergency department.
Source: Regenstrief Institute
Fully-Specified Name
- Component
- Patient seen in this ED in last 72H and discharged
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL1362-4
| 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 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 3 | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
75610-6 Oxygen therapy at arrival
Part Descriptions
LP185962-0 Oxygen therapy at arrival
The patient was on oxygen upon arrival to the hospital.
Source: Regenstrief Institute
Fully-Specified Name
- Component
- Oxygen therapy at arrival
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL1362-4
| 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 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 3 | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
75912-6 Observation unit stay discharge
Part Descriptions
LP187151-8 Observation unit stay discharge
The date and time the patient was discharged from a designated observation unit operated by the Emergency Department (ED) for evaluation and management.
Source: Centers for Disease Control and Prevention
Fully-Specified Name
- Component
- Observation unit stay discharge
- Property
- TmStp
- Time
- Pt
- System
- ^Patient
- Scale
- Qn
- Method
- NAMCS
Long Common Name
Observation unit stay discharge [NAMCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.50
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Example Units
| Unit | Source |
|---|---|
| {mm/dd/yyyy} | Example UCUM Units |
78020-5 Admission priority
Term Description
The type of admission, which is an indication of how quickly the patient needs clinical intervention or resuscitation. This term was created for, but not limited in use to, the Priority (Type) of Admission or Visit in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1.
Part Descriptions
LP193698-0 Admission priority
The admission priority indicates the general level of acuity of the patient and how quickly clinical intervention or resuscitation is necessary, from newborn to elective to emergent. The priority and diagnosis or reason for admission have some overlap but are not the same. For example, one patient with leukemia might be admitted emergently for sepsis, while another patient with the same diagnosis might have a scheduled admission for chemotherapy.
Source: Regenstrief LOINC
Fully-Specified Name
- Component
- Admission priority
- Property
- Type
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
- NHCS
Long Common Name
Admission priority [NHCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Normative Answer List LL3652-6
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Emergent | LA19759-2 | ||
| Urgent | LA21544-4 | ||
| Elective | LA19760-0 | ||
| Newborn | LA10403-6 | ||
| Non-urgent Trauma | LA24212-5 | ||
| Emergent Trauma | LA24213-3 | ||
| Information not available | LA21297-9 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
78021-3 Specialty unit type
Term Description
The kind of hospital unit having any necessary specialized equipment and/or personnel for handling critically ill or injured patients. This term was created for, but not limited in use to, the Specialty Unit Type in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1.
Fully-Specified Name
- Component
- Specialty care unit
- Property
- Type
- Time
- Pt
- System
- Hospital
- Scale
- Nom
- Method
- NHCS
Long Common Name
Specialty care unit Type [NHCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Normative Answer List LL3653-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Adult Burn Critical Care Unit | LA10143-8 | ||
| Adult Medical Cardiac Critical Care Unit | LA24094-7 | ||
| Adult Medical Critical Care Unit | LA10146-1 | ||
| Adult Med-Surg Critical Care Unit | LA24095-4 | ||
| Adult Neurology Critical Care and Stroke Unit | LA24098-8 | ||
| Adult Neurosurgery Critical Care Unit | LA24099-6 | ||
| Adult Pulmonary Critical Care Unit | LA10148-7 | ||
| Adult Surgical Critical Care Unit | LA10149-5 | ||
| Adult Cardiothoracic Critical Care Unit | LA10144-6 | ||
| Adult Trauma Critical Care Unit | LA10150-3 | ||
| Prenatal Critical Care Unit | LA24103-6 | ||
| Neonatal Critical Care Unit (Level II/III) | LA24096-2 | ||
| Neonatal Critical Care Unit (Level III) | LA24097-0 | ||
| Pediatric Burn Critical Care Unit | LA10197-4 | ||
| Pediatric Medical Critical Care Unit | LA10200-6 | ||
| Pediatric Med-Surg Critical Care Unit | LA24100-2 | ||
| Pediatric Neurology Critical Care Unit | LA10201-4 | ||
| Pediatric Neurosurgery Critical Care Unit | LA24102-8 | ||
| Pediatric Pulmonary Critical Care Unit | LA10202-2 | ||
| Pediatric Cardiothoracic Critical Care Unit | LA10198-2 | ||
| Pediatric Surgical Critical Care Unit | LA10203-0 | ||
| Pediatric Trauma Critical Care Unit | LA10204-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
78022-1 Type of clinic/location
Term Description
The location or setting where a health care service (e.g. procedure, treatment) was provided. This term was created for, but not limited in use to, the Service Delivery Location template in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1. The value set associated with this term is based on the National Healthcare Safety Network (NHSN) location code system that has been developed over a number of years through CDC's interaction with a variety of healthcare facilities and is intended to serve a variety of reporting needs where coding of healthcare service locations is required.
Fully-Specified Name
- Component
- Care setting
- Property
- Type
- Time
- Pt
- System
- Facility
- Scale
- Nom
- Method
- NHCS
Long Common Name
Care setting Facility [NHCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3654-2
- Externally Defined
- Yes
- Code System
- Code System OID
- 1.3.6.1.4.1.12009.10.1.2289
- Link to External List
- https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.13.19
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
74290-8 Discharge disposition IP
Part Descriptions
LP72749-2 Hospital discharge disposition
The hospital discharge status or disposition of the patient having a hospitalization associated with the encounter at the emergency department.
Source: Centers for Disease Control and Prevention
Fully-Specified Name
- Component
- Hospital discharge disposition
- Property
- Type
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- NTDS
Long Common Name
Hospital discharge disposition [NTDS]
Basic Attributes
- Class
- TRAUMA
- Type
- Clinical
- First Released
- Version 2.46
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Normative Answer List LL2766-5
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Discharged/Transferred to a short-term general hospital for inpatient care | 1 | LA20616-1 | |
| Discharged/Transferred to an Intermediate Care Facility (ICF) | 2 | LA20617-9 | |
| Discharged/Transferred to home under care of organized home health service | 3 | LA20613-8 | |
| Left against medical advice or discontinued care | 4 | LA20622-9 | |
| Expired | 5 | LA10325-1 | |
| Discharged home with no home services | 6 | LA20614-6 | |
| Discharged/Transferred to Skilled Nursing Facility | 7 | LA20619-5 | |
| Discharged/Transferred to hospice care | 8 | LA20615-3 | |
| Discharged/Transferred to another type of rehabilitation or long-term care facility | 9 | LA20618-7 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
| 87825-6 | National Trauma Data Standard - version 2018 set |
Language Variants Get Info
| Tag | Language | Translation |
|---|---|---|
| el-GR | Greek (Greece) | Διάθεση εξιτηρίου από το νοσοκομείο: Synonyms: - Nom NTDS Pt Type Ασθενής Διάθεση Διάθεση εξιτηρίου Διάθεση εξιτηρίου από το νοσοκομείο ΤΡΑΥΜΑ |
| es-MX | Spanish (Mexico) | Disposición de alta hospitalaria: |
| it-IT | Italian (Italy) | Dimissione ospedaliera, disposizioni: Synonyms: Disposizioni di dimissione ospedaliera paziente Punto nel tempo (episodio) Trauma |
| zh-CN | Chinese (China) | 医院出院去向: Synonyms: 允许...离开(医院、 |
11302-7 ED discharge disposition
Fully-Specified Name
- Component
- ED discharge disposition
- Property
- Type
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
Basic Attributes
- Class
- ED
- Type
- Clinical
- First Released
- Version 1.0j-a
- Last Updated
- Version 2.66 (MAJ)
- Change Reason
- Previous Releases: ; Updated System from "?" to "^Patient" since this term is meant to represent the disposition of the patient at discharge from an emergency department.
Preferred Answer List LL3677-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| No follow-up planned | LA24304-0 | ||
| Return to ED | LA24286-9 | ||
| Return/refer to physician/clinic for outpatient mental health treatment | LA24287-7 | ||
| Return/refer to physician/clinic for substance abuse treatment | LA24288-5 | ||
| Return/refer to physician/clinic for follow-up | LA24289-3 | ||
| Left without being seen | LA24301-6 | ||
| Left before treatment was complete | LA24300-8 | ||
| Left against medical advice | LA20595-7 | ||
| Dead on arrival | LA24302-4 | ||
| Died in ED | LA24303-2 | ||
| Return/transfer to nursing home | LA24290-1 | ||
| Return/transfer to jail/prison/law enforcement | LA24291-9 | ||
| Transfer to psychiatric inpatient treatment - involuntary status | LA24292-7 | ||
| Transfer to psychiatric inpatient treatment - voluntary status | LA24293-5 | ||
| Transfer to psychiatric inpatient treatment - status not documented | LA24294-3 | ||
| Transfer to substance abuse treatment facility | LA24295-0 | ||
| Transfer to inpatient behavioral healthcare facility - type unknown | LA24296-8 | ||
| Transfer to other non-psychiatric hospital | LA24297-6 | ||
| Admit to this hospital | LA24305-7 | ||
| Admit to observation unit then hospitalized | LA24306-5 | ||
| Admit to observation unit then discharged | LA24307-3 | ||
| Other | LA46-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81898-9 | Composite triage and nursing note - recommended IHE set |
| 55169-7 | Data Elements for Emergency Department Systems (DEEDS) Release 1.0 |
| 55168-9 | Data Elements for Emergency Department Systems (DEEDS) Release 1.1 |
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
| 87825-6 | National Trauma Data Standard - version 2018 set |
Language Variants Get Info
| Tag | Language | Translation |
|---|---|---|
| el-GR | Greek (Greece) | Διάθεση εξιτηρίου ΤΕΠ: Synonyms: - ED Nom Pt Type Ασθενής Διάθεση Διάθεση εξιτηρίου Διάθεση εξιτηρίου ΤΕΠ |
| es-AR | Spanish (Argentina) | disposición del servicio de emergencias: |
| es-MX | Spanish (Mexico) | Disposición de alta en urgencias: |
| it-IT | Italian (Italy) | PS, disposizione: Synonyms: Disposizione di Pronto Soccorso Emergenza (DEEDS - Data Elements for Emergency Dep paziente Punto nel tempo (episodio) |
| pt-BR | Portuguese (Brazil) | Disposição do PS: Synonyms: ; |
| ru-RU | Russian (Russian Federation) | ОЭП диспозиция: Synonyms: Выписка Номинальный; |
| zh-CN | Chinese (China) | 急诊科出院处置: Synonyms: ED 允许...离开(医院、 |
78025-4 Disposition OPD
Term Description
The location and type of care arranged for the patient at the end of an outpatient visit.This term was created for, but not limited in use to, the Outpatient Visit Discharge Disposition observation in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1.
Fully-Specified Name
- Component
- Outpatient visit discharge disposition
- Property
- Type
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- NHCS
Long Common Name
Outpatient visit discharge disposition [NHCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3676-5
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Return to referring physician/provider | LA24271-1 | ||
| Refer to other physician/provider | LA24277-8 | ||
| Return in less than 1 week | LA24272-9 | ||
| Return in 1 week to less than 2 months | LA24273-7 | ||
| Return in 2 months or greater | LA24275-2 | ||
| Return at unspecified time | LA24274-5 | ||
| Return as needed (p.r.n.) | LA24276-0 | ||
| Refer to E.R. for Admission to Hospital | LA24278-6 | ||
| Other | LA46-8 | ||
| Routine discharge to customary residence | LA24279-4 | ||
| Discharge to observation status | LA24280-2 | ||
| Discharge to post-surgical/recovery care facility | LA24281-0 | ||
| Admitted to hospital as inpatient | LA24282-8 | ||
| Referred to ED | LA24324-8 | ||
| Surgery terminated | LA24283-6 | ||
| Procedure cancelled on arrival to Ambulatory Surgical Unit | LA24284-4 | ||
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | LA4489-6 | ||
| Move to observation/post surgical/recovery area in the same hospital, i.e., not admitted as an inpatient | LA24285-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
78026-2 Present on admission
Term Description
Indicates whether or not the diagnosis was present on admission (POA) when the patient was admitted into the hospital as an inpatient. This term was created for, but not limited in use to, the Present on Admission observation in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1.
Whether or not a specific condition was present at the time a patient was admitted. Note that the concept of "diagnosis" is different than a "condition". Conditions include symptoms, diseases, injuries, and non-pathologic states, while diagnoses are specifically identified by a provider as the source of a patient's signs and symptoms. For example, a patient admitted to the hospital with conditions that include abdominal pain, fever, and vomiting may be diagnosed with appendicitis by a provider based on the history, physical exam, and various test results. To report whether a condition was present on admission, use LOINC 89251-3.
Fully-Specified Name
- Component
- Diagnosis present on admission
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Diagnosis present on admission
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.70 (MIN)
- Change Reason
- Added to the term description in order to distinguish the concepts of "diagnosis" and "condition"
- Order vs. Observation
- Observation
Example Answer List LL3044-6
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | Y | LA33-6 | |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | N | LA32-8 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | UNK | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
78027-0 Follow-up attempt made within 24-hours after surgery
Term Description
Health care staff made effort to contact the patient within one day following an outpatient surgical procedure in order to ascertain the patient's state of well being. This term was created for, but not limited in use to, the Follow-Up Attempt observation in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1.
Fully-Specified Name
- Component
- Follow-up attempt within 24H
- Property
- Find
- Time
- 24H
- System
- ^Patient
- Scale
- Ord
- Method
Long Common Name
Follow-up attempt within 24 hours
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.70 (MIN)
- Order vs. Observation
- Observation
Example Answer List LL3044-6
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | Y | LA33-6 | |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | N | LA32-8 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | UNK | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
78028-8 Follow-up attempt outcome
Term Description
The finding(s) or result(s) of contact made by healthcare staff with a patient after an outpatient surgical procedure. This term was created for, but not limited in use to, the Follow-Up Attempt Outcome observation in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1.
Fully-Specified Name
- Component
- Follow-up attempt outcome
- Property
- Type
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- NHCS
Long Common Name
Follow-up attempt outcome [NHCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Normative Answer List LL3656-7
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Patient unavailable | LA24214-1 | ||
| No complaints | LA24215-8 | ||
| Patient reported problems and sought medical care | LA24216-6 | ||
| Patient reported problems and was advised by ambulatory surgical staff to seek medical care | LA24217-4 | ||
| Patient reported problems, but no follow-up medical care was needed | LA24218-2 | ||
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | LA4489-6 | ||
| Other | LA46-8 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.
78029-6 Point of origin
Term Description
Where the patient was located immediately prior to arriving at the health care facility.This term was created for, but not limited in use to, the Point of Origin observation in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1.
Fully-Specified Name
- Component
- Arrived from
- Property
- Type
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- NHCS
Long Common Name
Patient Point of origin [NHCS]
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.52 (MIN)
- Order vs. Observation
- Observation
Normative Answer List LL3674-0
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Information not available | LA21297-9 | ||
| Transfer from a different hospital | LA24308-1 | ||
| Transfer from one distinct unit of the hospital to another distinct unit of the hospital resulting in a separate claim to the payer | LA24312-3 | ||
| Transfer from jail or court under supervision of law enforcement | LA24310-7 | ||
| Transfer from Ambulatory Surgery Center | LA24313-1 | ||
| Transfer from a Hospice Facility | LA24314-9 | ||
| Transfer from Skilled Nursing Facility | LA24315-6 | ||
| Transfer from Intermediate Care Facility | LA24316-4 | ||
| Transfer from Assisted Living Facility | LA24317-2 | ||
| Clinic | LA24318-0 | ||
| Physician's Office | LA4685-9 | ||
| Newborn born inside this hospital | LA24321-4 | ||
| Newborn born outside this hospital | LA24322-2 | ||
| Transfer from another type of Healthcare facility NOS | LA24311-5 | ||
| Non-Healthcare facility point of origin | LA24323-0 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
78030-4 Episode of care
Term Description
Indicates whether a patient's visit is an initial or follow-visit. An episode of care begins with the initial visit for care for a particular problem and ends when the patient is no longer continuing treatment. An initial visit may be diagnostic in nature whereas a follow-up visit may be to check progress or continue therapy. This term was created for, but not limited in use to, the Episode of Care observation in the HL7 Implementation Guide for CDA® Release 2: National Health Care Surveys Release 1.
Fully-Specified Name
- Component
- Type of encounter
- Property
- Type
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
Long Common Name
Episode of care Type
Basic Attributes
- Class
- SURVEY.NHCS
- Type
- Surveys
- First Released
- Version 2.52
- Last Updated
- Version 2.70 (MIN)
- Order vs. Observation
- Observation
Preferred Answer List LL3034-7
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Initial patient assessment | 1 | 1 | LA21589-9 |
| Follow-up visit | 2 | 2 | LA21590-7 |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | 3 | 3 | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 81958-1 | National Health Care Surveys report R1 - recommended CDA set |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to https://www.snomed.org/get-snomed or [email protected]<mailto:[email protected]>. This may incur a fee in SNOMED International non-Member countries.