The National Electronic Disease Surveillance System City and State Weekly Reporting

The National Electronic Disease Surveillance System (NEDSS)

ATT- 1F Hepatitis Notification Message Mapping Guide 06202007.xls

The National Electronic Disease Surveillance System City and State Weekly Reporting

OMB: 0920-0728

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Overview

ATT-1F
Introduction
Revisions
Data Element Index
Key
Subject-related
Generic Obs.
HEP GEN
Hep A, acute
Hep B, acute
Hep C, acute
Hep C infection
Hep B, perinatal
Notification Structure
Associated Lab Report
Assoc Vaccine Report

Sheet 1: ATT-1F

Attachment 1F.

Hepatitis Notification Message

Mapping Guide 06202007.xls

Sheet 2: Introduction

Hepatitis Notification Message Mapping Guide

VERSION: The version of this Message Mapping Guide is Draft 0.5 dated 6/20/2007.
This Message Mapping Guide describes the content and message mapping specifications for the fixed set of data elements used to communicate information to meet the requirements for Hepatitis case notification reporting to CDC. The intended audience for this document are the state/local and CDC programs and other public health related organizations interested in using the HL7 V2.5 case notification message specification for transmitting their data elements.

References
Version 1.0 of the Message Specification Guide is used to inform the mapping methodology for this guide.
NND Mapping Guide version for 1.1.5 sp1 of NEDSS Base System. Last updated 11/29/2006.

Understanding the Organization of the Mapping Guide

Revisions		This tab is intended to provide revision control for updates made to the document.
Data Element Index		This tab provides the complete list of data elements of interest requested by the program. The last column cross-references to the tab where the data element is fully specified for messaging.
Key		Key to columns in each Mapping Worksheet
Subject-related		This tab provides the mapping methodology for the demographic variables requested by the program.
Generic Obs.		This tab provides the content for the generic investigation questions. The ones that are not used for Hepatitis reporting are greyed out.
HEP GEN		Every Hepatitis condition is reported using the Generic Observations plus these Hepatitis Generic data elements. When the condition is one of those below, no further data elements are included: • 10480―Hepatitis, non A, non B, acute • 10102―Hepatitis Delta co- or super-infection, acute (Hepatitis D) • 10103―Hepatitis E, acute • 10120―Hepatitis, viral unspecified
Hep A-Acute		10110 Hepatitis A, acute is reported using the generic data elements plus this set of condition-specific elements
Hep B-Acute		10100 Hepatitis B, acute is reported using the generic data elements plus this set of condition-specific elements
Hep C-Acute		10101 Hepatitis C, acute is reported using the generic data elements plus this set of condition-specific elements
Hep C-Infection		10106 Hepatitis C infection, past or present is reported using the generic data elements plus this set of condition-specific elements.
Hep B-Perinatal		10104 Hepatitis B, virus infection perinatal is reported using the generic data elements plus this set of condition-specific elements.
Associated Lab Report		This tab provides the content requested by the program for use with a Hepatitis associated laboratory report.
Notification Structure		This tab provides the structural elements for the Notification. These variables are not negotiable. Default values are provided for HL7 structural elements that are required but not part of the surveillance data requested.

Variables as Observations
Other than the variables that map to the Patient Identifier segment (see Subject-Specific tab), all other variables are passed as a series of OBX-Observation/Result segments that are logically tied to the OBR-Observation Request “section header” segment that immediately precedes it. This content presents the real differences between the messages since all types of Notifications are handled in a standard manner up to this point.

Sheet 3: Revisions

Revisions

Date	Version	Description

Sheet 4: Data Element Index

PHIN Variable ID	Label/Short Name	Description	Data Type	CDC Req/Opt	May Repeat	Valid Values	Data Validation	TAB REFERENCE
CORE DEMOGRAPHIC DATA ELEMENTS								Subject-related
DEM115	Birth Date	Date of birth in YYYYMMDD format	Date	O				Subject-related
DEM114	Patient’s birth sex	Patient’s birth sex	Code	O		Male Female Unknown		Subject-related
DEM152	Race Category	Field containing one or more codes that broadly refer to the patient’s race(s).	Code	O	Y	American Indian or Alaska Native; Asian; Black or African American; Native Hawaiian or Other Pacific Islander; White; Other Race		Subject-related
DEM165	Patient Address County	County of residence of the subject.	Code	O		FIPS county codes		Subject-related
DEM162	Patient Address State	Patient’s address state.	Code	O		FIPS state codes		Subject-related
DEM163	Patient Address Zip Code	Patient’s address Zip code.	Text	O				Subject-related
DEM155	Ethnic Group Code	Ethnic origin or ethnicity is based on the individual’s self-identity of the patient as Hispanic or Latino; choose one value from the list.	Code	O		Hispanic Non-hispanic		Subject-related
GENERIC NOTIFICATION DATA ELEMENTS								Generic Obs.
NOT109	Reporting State	State reporting the notification.	Coded	R		Standard 2-digit State FIPS code		Generic Obs.
INV169	Condition Code	Condition or event that constitutes the reason the notification is being sent.	Coded	R				Generic Obs.
INV168	Local record ID	Sending system-assigned local ID of the case investigation with which the subject is associated.	Alphanumeric	R				Generic Obs.
INV173	State Case ID	States use this field to link NEDSS (NETSS) investigations back to their own state investigations.	Text	R				Generic Obs.
INV107	Jurisdiction Code	Identifier for the physical site from which the notification is being submitted.	Code	R		state-assigned		Generic Obs.
INV108	Case Program Area Code	The organizational ownership of the investigation. Program areas (e.g., Immunization, STD) are defined at the state level by the conditions for which they provide primary prevention and control.	Code	R		state-assigned		Generic Obs.
INV109	Case Investigation Status Code	Status of the investigation. For example, open or closed.	Code	O		Open Closed		Generic Obs.
INV110	Investigation Date Assigned	Date the investigator was assigned to this investigation.	Date	O				Generic Obs.
INV111	Date of Report	Date the event or illness was first reported by the reporting source	Date	O				Generic Obs.
INV112	Reporting Source Type Code	Type of facility or provider associated with the source of information sent to Public Health.	Code	O		Blood Bank Correctional Facilities Dentist Other Federal Agencies Hospital Indian Health Service Laboratory Managed Care/HMOs Military Other Treatment Center Pharmacy Public Health Clinic Private Physician Office Data Registries Rural Health Clinic School Clinic Other State and Local Agencies Tribal Government Vital Statistics Veterinary Sources Daycare Facility Drug Treatment Facility Emergency Room/Emergency Department Family Planning Facility National Job Training Program Prenatal/Obstetrics Facility Public Health Clinic – STD Public Health Clinic – TB Public Health Clinic - HIV		Generic Obs.
INV118	Reporting Source Zip Code	Zip Code of the reporting source for this case.	Alphanumeric	O				Generic Obs.
INV120	Earliest Date Reported to County	Earliest date reported to county public health system	Date	O				Generic Obs.
INV121	Earliest Date Reported to State	Earliest date reported to state public health system	Date	O				Generic Obs.
INV128	Hospitalized	Was patient hospitalized because of this event?	Code	O		Yes No Unknown	1) If the patient was hospitalized for this illness, then enable entry of admission date 2) If the patient was hospitalized for this illness, then enable entry of discharge date 3) If the patient was hospitalized for this illness, then enable entry of total duration of stay in the hospital in days	Generic Obs.
INV132	Admission Date	Subject’s admission date to the hospital for the condition covered by the investigation.	Date	O				Generic Obs.
INV133	Discharge Date	Subject's discharge date from the hospital for the condition covered by the investigation.	Date	O			If the user enters the Discharge Date, then the date must be >= Admission Date	Generic Obs.
INV134	Duration of hospital stay in days	Subject's duration of stay at the hospital for the condition covered by the investigation.	Numeric	O				Generic Obs.
INV136	Diagnosis Date	Date of diagnosis of condition being reported to public health system	Date	O			If the user enters the Diagnosis Date, then the date must be >= Illness Onset Date	Generic Obs.
INV137	Date of Illness Onset	Date of the beginning of the illness. Reported date of the onset of symptoms of the condition being reported to the public health system	Date	O				Generic Obs.
INV138	Illness End Date	Time at which the disease or condition ends.	Date	O				Generic Obs.
INV139	Illness Duration	Length of time this person had this disease or condition.	Numeric	O			units required	Generic Obs.
INV140	Illness Duration Units	Unit of time used to describe the length of the illness or condition.	Code	O				Generic Obs.
INV145	Did the patient die from this illness	Did the patient die from this illness or complications of this illness?	Code	O		Yes No Unknown		Generic Obs.
INV147	Investigation Start Date	The date the case investigation was initiated.	Date	O				Generic Obs.
INV150	Case outbreak indicator	Denotes whether the reported case was associated with an identified outbreak.	Code	O		Yes No Unknown	If this case is part of an outbreak, then enable entry of outbreak name (INV151)	Generic Obs.
INV151	Case Outbreak Name	A state-assigned name for an indentified outbreak.	Code	O		state-assigned code		Generic Obs.
INV152	Case Disease Imported Code	Indication of where the disease/condition was likely acquired.	Code			Indigenous Out of country Out of jurisdiction Out of state Unknown		Generic Obs.
INV153	Imported Country	If the disease or condition was imported, indicates the country in which the disease was likely acquired.	Code	O		ISO Country Codes	if INV152 = Out of Country	Generic Obs.
INV154	Imported State	If the disease or condition was imported, indicates the state in which the disease was likely acquired.	Code	O		FIPS state codes	if INV152 = Out of State	Generic Obs.
INV155	Imported City	If the disease or condition was imported, indicates the city in which the disease was likely acquired.	Code	O		GNIS City Codes	if INV152 = Out of Jurisdiction	Generic Obs.
INV156	Imported County	If the disease or condition was imported, contains the county of origin of the disease or condition.	Code	O		FIPS county codes	if INV152 = Out of Jurisdiction	Generic Obs.
INV157	Transmission Mode	Code for the mechanism by which disease or condition was acquired by the subject of the investigation. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate.	Code	O		Airborne Blood borne Dermal Food borne Indeterminate Mechanical Nosocomial Other Sexually Transmitted Vector borne Water borne Zoonotic		Generic Obs.
INV159	Detection Method	Code for the method by which the public health department was made aware of the case. Includes provider report, patient self-referral, laboratory report, case or outbreak investigation, contact investigation, active surveillance, routine physical, prenatal testing, perinatal testing, prison entry screening, occupational disease surveillance, medical record review, etc.	Code	O		Provider reported Prison entry screening Prenatal testing Routine Physical Patient self-referral Other		Generic Obs.
INV161	Confirmation Method	Code for the mechanism by which the case was classified, providing information about how the case classification status was derived. More than one confirmation method may be indicated.	Code	O	Y	Clinical Diagnosis Epidemiologically linked Lab confirmed Case/outbreak investigation Lab Report Medical Record Review Occup. Disease Surveillance Active Surveillance Provider Certified Local/state specified Other		Generic Obs.
INV162	Confirmation Date	If an investigation is confirmed as a case, the confirmation date is entered.	Date	O				Generic Obs.
INV163	Case Class Status Code	Status of the case/event as suspect, probable, confirmed, or "not a case" per CSTE/CDC/ surveillance case definitions.	Code	R		Confirmed Not a Case Probable Suspect		Generic Obs.
INV165	MMWR Week	MMWR Week for which case information is to be counted for MMWR publication.	Numeric	R				Generic Obs.
INV166	MMWR Year	MMWR Year (YYYY) for which case information is to be counted for MMWR publication.	Date	R		4-digit year (####)		Generic Obs.
INV176	Date of First Report to CDC	Date the case was first reported to the CDC.	Date	O				Generic Obs.
INV177	Date First Reported PHD	Earliest date the case was reported to a public health department.	Date	O				Generic Obs.
INV178	Pregnancy status	Indicates whether the patient was pregnant at the time of the event.	Code			Yes No Unknown		Generic Obs.
INV2001	Age at case investigation	Patient age at time of case investigation	Numeric	R				Generic Obs.
INV2002	Age units at case investigation	Patient age units at time of case investigation	Code	O		Days Months Weeks Years		Generic Obs.
GENERIC HEPATITIS DATA ELEMENTS								Hep Generic Obs.
HEP100	TESTRX	The reason(s) the patient was tested for hepatitis. (MULTISELECT)	Code	O	Y	Symptoms of acute hepatitis Blood / Organ donor screening Evaluation of elevated liver enzymes Screening of asymptomatic patient w/o risk factors Other (specify) Prenatal screening Follow-up testing (prior viral hepatitis marker) Screening of asymptomatic patient w/ risk factors Unknown Symptoms of acute hepatitis		Hep Generic Obs.
HEP101	OTHREASON	Other reason the patient was tested for hepatitis.	Text	O				Hep Generic Obs.
HEP102	SYMPTOM	Is patient symptomatic?	Code	O		Yes No Unknown (YNU)		Hep Generic Obs.
HEP103	SYMTDT	Onset date of symptoms.	Date	O				Hep Generic Obs.
HEP104	JAUNDICED	Was the patient jaundiced?	Code	O		Yes No Unknown (YNU)		Hep Generic Obs.
HEP106	PREGNANT	Was the patient pregnant?	Code	O		Yes No Unknown (YNU)		Hep Generic Obs.
HEP107	DUEDT	Patient's pregnancy due date.	Date	O				Hep Generic Obs.
HEP110	TOTANTIHAV	Total antibody to hepatitis A virus [total anti-HAV].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP111	IGMHAV	IgM antibody to hepatitis A virus [IgM anti-HAV].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP112	HBSAG	Hepatitis B surface antigen [HBsAg].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP113	TOTANTIHBC	Total antibody to hepatitis B core antigen [total anti-HBc].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP114	IGMHBC	IgM antibody to hepatitis B core antigen [IgM anti-HBc].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP115	ANTIHCV	Antibody to hepatitis C virus [anti-HCV].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP116	ANTIHCVSIG	Anti-HCV signal to cut-off ratio.	Text	O				Hep Generic Obs.
HEP117	SUPANTIHCV	Supplemental anti-HCV assay [e.g., RIBA].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP118	HCVRNA	HCV RNA [e.g., PCR].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP119	ANTIHDV	Antibody to hepatitis D virus [anti-HDV].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP120	ANTIHEV	Antibody to hepatitis E virus [anti-HEV].	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP121	ALTSGPT	ALT (SGPT) result (include units).	Numeric	O				Hep Generic Obs.
HEP122	ALTSGPTUP	ALT (SGPT) result upper limit normal (include units).	Numeric	O				Hep Generic Obs.
HEP123	ASTSGOT	AST (SGOT) result (include units).	Numeric	O				Hep Generic Obs.
HEP124	ASTSGOTUP	AST (SGOT) result upper limit normal (include units).	Numeric	O				Hep Generic Obs.
HEP125	ALTDT	Date of the ALT result.	Date	O				Hep Generic Obs.
HEP126	ASTDT	Date of the AST result.	Date	O				Hep Generic Obs.
HEP127	EPILINK	If this case has a diagnosis of hepatitis A that has not been serologically confirmed, is there an epidemiologic link between this patient and a laboratory-confirmed hepatitis A case?	Code	O		Yes No Unknown (YNU)		Hep Generic Obs.
HEP128	DX	Disease diagnosis. This is a required field.	Code	R		10480-Hepatitis, non A, non B, acute 10102-Hepatitis Delta co- or super-infection, acute (Hepatitis D) 10103-Hepatitis E, acute 10110-Hepatitis A, acute 10100-Hepatitis B, acute 10101-Hepatitis C, acute 10106-Hepatitis C infection, past or present 10104-Hepatitis B, virus infection perinatal 10120-Hepatitis, viral unspecified	10480, 10102, 10120 and 10103 use generic only 10110 also uses Hep A Acute questions 10100 also uses Hep B Acute questions 10101 also uses Hep C Acute questions 10106 also uses Hep C infection, past or present 10104 also uses Hep B virus infection perinatal questions	Hep Generic Obs.
HEP255	BIRTHPLACE	Patient's country of birth.	Code	O		ISO Country Codes		Hep Generic Obs.
HEP263 <new>	Hepatitis B ‘e’ antigen [HBeAg]	Hepatitis B ‘e’ antigen [HBeAg] test result.	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEP264 <new>	HBV DNA	HBV DNA test result.	Code	O		Positive Negative Unknown		Hep Generic Obs.
HEPATITIS A ACUTE ADDITIONAL QUESTIONS								Hep A, acute
HEP129	CONTACTA	During the two to six weeks prior to the onset of symptoms, was the patient a contact of a person with confirmed or suspected hepatitis A virus infection?	Code	O		Yes No Unknown		Hep A, acute
HEP130	ATYPE	Type of contact the patient had with a person with confirmed or suspected hepatitis A virus infection during the two to six weeks prior to symptom onset.	Code	O		Babysitter of this patient Child cared for by this patient Household member (non-sexual) Other (specify) Playmate Sex partner Unknown		Hep A, acute
HEP131	AOTHCON	Other type of contact the patient had with a person with confirmed or suspected hepatitis A virus infection during the two to six weeks prior to symptom onset.	Text	O				Hep A, acute
HEP132	ADAYCARE1	Was the patient a child or employee in daycare center, nursery, or preschool?	Code	O		Yes No Unknown		Hep A, acute
HEP133	ADAYCARE2	Was the patient a household contact of a child or employee in a daycare center, nursery, or preschool?	Code	O		Yes No Unknown		Hep A, acute
HEP134	ADAYCAREAID	Was there an identified hepatitis A case in the childcare facility?	Code	O		Yes No Unknown		Hep A, acute
HEP135	ASEXMALE	Number of male sex partners the person had in the two to six weeks before symptom onset.	Code	O				Hep A, acute
HEP136	ASEXFEMALE	The number of female sex partners the person had in the two to six weeks before symptom onset.	Code	O				Hep A, acute
HEP137	AIVDRUGS	Did the patient inject street drugs in the two to six weeks before symptom onset?	Code	O		Yes No Unknown		Hep A, acute
HEP138	ADRUGS	Did the patient use street drugs, but not inject, in the two to six weeks before symptom onset?	Code	O		Yes No Unknown		Hep A, acute
HEP139	ATRAVEL	Did the patient travel outside the U.S.A. or Canada in the two to six weeks before symptom onset?	Code	O		Yes No Unknown		Hep A, acute
HEP140	AWHERE	The countries to which the patient traveled (outside the U.S.A. or Canada) in the two to six weeks before symptom onset.	Code	O	Y	2-alpha ISO country codes		Hep A, acute
HEP141	AHHTRAVEL	Did anyone in the patient's household travel outside the U.S.A. or Canada in the three months before symptom onset?	Code	O		Yes No Unknown		Hep A, acute
HEP142	AHHWHERE	The countries to which anyone in the patient's household traveled (outside the U.S.A. or Canada) in the three months before symptom onset? (MULTISELECT)	Code	O	Y	2-alpha ISO country codes		Hep A, acute
HEP143	AOUTBREAK	Is the patient suspected as being part of a common-source outbreak?	Code	O				Hep A, acute
HEP144	AOUTBRTYPE	Type of outbreak with which the patient is associated.	Code	O		Foodborne - assoc. w/ an infected food handler Foodborne - NOT assoc. w/ an infected food handler Source not identified Waterborne		Hep A, acute
HEP145	AFOODITEM	Food item with which the foodborne outbreak is associated.	Text	O				Hep A, acute
HEP146	AHANDLER	Was the patient employed as a food handler during the two weeks prior to onset of symptoms or while ill?	Code	O				Hep A, acute
HEP147	HEPAVAC	Has patient ever received the hepatitis A vaccine?	Code	O				Hep A, acute
HEP148	HEPAVACDOS	Number of doses of hepatitis A vaccine the patient received.	Code	O		1=1 2=2 3+=3 or more		Hep A, acute
HEP149	HEPAVACYR	Year the patient received the last dose of hepatitis A vaccine.	Date	O				Hep A, acute
HEP150	IMMUGLOB	Has the patient ever received immune globulin?	Code	O				Hep A, acute
HEP151	IMMUGLOBYR	Date the patient received the last dose of immune globulin.	Date	O				Hep A, acute
HEPATITIS B ACUTE ADDITIONAL QUESTIONS								Hep B, acute
HEP152	CONTACTB	During the six weeks to six months prior to onset of symptoms, was the patient a contact of a person with confirmed or suspected acute or chronic hepatitis B virus infection?	Code	O		Yes No Unknown		Hep B, acute
HEP153	BTYPE	Type of contact the patient had with a person with confirmed or suspected acute or chronic hepatitis B virus infection during the two to six weeks prior to symptom onset. (MULTISELECT)	Code	O	Y	Babysitter of this patient Child cared for by this patient Household member (non-sexual) Other (specify) Playmate Sex partner Unknown		Hep B, acute
HEP154	BOTHCON	Other type of contact the patient had with a person with confirmed or suspected acute or chronic hepatitis B virus infection during the two to six weeks prior to symptom onset.	Text	O				Hep B, acute
HEP155	BMALESEX	Number of male sex partners the person had in the six months before symptom onset.	Code	O		0=0 1=1 2=2-5 5= >5 U=Unknown		Hep B, acute
HEP156	BFEMALESEX	Number of female sex partners the person had in the six months before symptom onset.	Code	O		0=0 1=1 2=2-5 5= >5 U=Unknown		Hep B, acute
HEP157	BSTD	Was patient ever treated for a sexually transmitted disease?	Code	O		Yes No Unknown		Hep B, acute
HEP158	BSTDYR	Year the patient received the most recent treatment for a sexually transmitted disease.	Date	O				Hep B, acute
HEP159	BIVDRUGS	Did the patient inject street drugs not prescribed by a doctor in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP160	BDRUGS	Did the patient use street drugs, but not inject, in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP161	BDIALYSIS	Did the patient undergo hemodialysis in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP162	BSTICK	Did the patient have an accidental stick or puncture with a needle or other object contaminated with blood in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP163	BTRANS	Did the patient receive blood or blood products (transfusion) in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP164	BTRANSDT	Date the patient received blood or blood products (transfusion) in the six weeks to six months before symptom onset.	Date	O				Hep B, acute
HEP165	BBLOOD	Did the patient have other exposure to someone else's blood in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP166	BBLOODTYPE	Patient's blood exposure in the six weeks to six months before symptom onset other than through transfusion or an accidental stick or puncture.	Text	O				Hep B, acute
HEP167	BMEDEMP	Was the patient employed in a medical or dental field involving direct contact with human blood in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP168	BFREQ1	Patient's frequency of blood contact as an employee in a medical or dental field involving direct contact with human blood in the six weeks to six months before symptom onset.	Code	O		Frequent (several times weekly) Infrequent Unknown		Hep B, acute
HEP169	BPUBSAFEMP	Was the patient employed as a public safety worker (fire fighter, law enforcement, or correctional officer) having direct contact with human blood in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP170	BFREQ2	Patient's frequency of blood contact as a public safety worker (fire fighter, law enforcement, or correctional officer) having direct contact with human blood in the six weeks to six months before symptom onset.	Code	O		Frequent (several times weekly) Infrequent Unknown		Hep B, acute
HEP171	BTATTOO	Did the patient receive a tattoo in the six weeks to six months before symptom onset?	Code	O				Hep B, acute
HEP172	BTATTOOLOC	Location(s) where the patient received a tattoo in the six weeks to six months before symptom onset.	Code	O	Y	Commercial parlor/shop Correctional facility Other (specify) Unknown		Hep B, acute
HEP173	BTATTOOOTH	Other location where the patient received a tattoo in the six weeks to six months before symptom onset.	ST	O				Hep B, acute
HEP174	BPIERCE	Did the patient have any part of their body pierced (other than ear) in the six weeks to six months before symptom onset?	Code	O				Hep B, acute
HEP175	BPIERCELOC	The location(s) where the patient received a piercing in the six weeks to six months before symptom onset.	Code	O	Y	Commercial parlor/shop Correctional facility Other (specify) Unknown		Hep B, acute
HEP176	BPEIRCEOTH	Other location where the patient received a piercing in the six weeks to six months before symptom onset.	Text	O				Hep B, acute
HEP177	BDENTAL	Did the patient have dental work or oral surgery in the six weeks to six months before symptom onset?	Code	O				Hep B, acute
HEP178	BSURGERY	Did the patient have surgery (other than oral surgery) in the six weeks to six months before symptom onset?	Code	O				Hep B, acute
HEP179	BHOSP	Was the patient hospitalized in the six weeks to six months before symptom onset?	Code	O				Hep B, acute
HEP180	BNURSHOME	Was the patient a resident of a long-term care facility in the six weeks to six months before symptom onset?	Code	O				Hep B, acute
HEP181	BINCAR	Was the patient incarcerated for longer than 24 hours in the six weeks to six months before symptom onset?	Code	O		Yes No Unknown		Hep B, acute
HEP182	BINCARTYPE	Type of facility where the patient was incarcerated for longer than 24 hours in the six weeks to six months before symptom onset. (MULTISELECT)	Code	O	Y	Jail Juvenile facility Prison		Hep B, acute
HEP183	BEVERINCAR	Was the patient ever incarcerated for longer than six months during his or her lifetime?	Code	O		Yes No Unknown		Hep B, acute
HEP184	INCARYR	Year the patient was most recently incarcerated for longer than six months.	Date	O				Hep B, acute
HEP185	INCARDUR	Length of time the patient was most recently incarcerated for longer than six months.	Text	O				Hep B, acute
HEP186	INCARUNIT	Length of time (units) the patient was most recently incarcerated for longer than six months.	Code	O		Days Hours Minutes Months Unknown Weeks Years		Hep B, acute
HEP187	BVACCINE	Did the patient ever receive hepatitis B vaccine?	Code	O		Yes No Unknown		Hep B, acute
HEP188	BVACCINENO	Number of shots of hepatitis B vaccine the patient received.	Code	O		1=1 2=2 3+=3 or more		Hep B, acute
HEP189	BVACCINEYR	Year in which the patient received the last shot of hepatitis B vaccine.	Date	O				Hep B, acute
HEP190	BANTIBODY	Was the patient tested for antibody to HBsAg (anti-HBs) within one to two months after the last dose?	Code	O		Yes No Unknown		Hep B, acute
HEP191	BRESULT	Was the serum anti-HBs >= 10ml U/ml? (Answer 'Yes' if lab result reported as positive or reactive.)	Code	O		Yes No Unknown		Hep B, acute
HEP252	BIVOUTPT	Did the patient receive any IV infusions and/or injections in the outpatient setting during the six weeks to six months prior to onset of symptoms?	Code	O		Yes No Unknown		Hep B, acute
HEPATITIS C ACUTE ADDITIONAL QUESTIONS								Hep C, acute
HEP192	CCONTACT	Was the patient a contact of a person with confirmed or suspected acute or chronic hepatitis C infection in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP193	CTYPE	Type of contact the patient had with a person with confirmed or suspected acute or chronic hepatitis C infection in the two weeks to six months before symptom onset.	Coded	O		Babysitter of this patient Child cared for by this patient Household member (non-sexual) Other (specify) Playmate Sex partner Unknown		Hep C, acute
HEP194	COTHCON	Other type of contact the patient had with a person with confirmed or suspected acute or chronic hepatitis C infection in the two weeks to six months before symptom onset.	Alphanumeric	O				Hep C, acute
HEP195	CMALESEC	Number of male sex partners the person had in the six months before symptom onset.	Coded	O		0=0 1=1 2=2-5 5= >5 U=Unknown		Hep C, acute
HEP196	CFEMALESEX	Number of female sex partners the person had in the six months before symptom onset.	Coded	O		0=0 1=1 2=2-5 5= >5 U=Unknown		Hep C, acute
HEP197	CSTD	Was patient ever treated for a sexually transmitted disease?	Coded	O		Yes No Unknown		Hep C, acute
HEP198	CSTDYR	Year the patient received the most recent treatment for a sexually transmitted disease.	Date	O				Hep C, acute
HEP199	CMEDEMP	Was the patient employed in a medical or dental field involving direct contact with human blood in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP200	CFREQ1	Patient's frequency of blood contact as an employee in a medical or dental field involving direct contact with human blood in the two weeks to six months before symptom onset.	Coded	O		Frequent (several times weekly) Infrequent Unknown		Hep C, acute
HEP201	CPUBSAFEMP	Was the patient employed as a public safety worker (fire fighter, law enforcement, or correctional officer) having direct contact with human blood in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP202	CFREQ2	The patient's frequency of blood contact as a public safety worker (fire fighter, law enforcement, or correctional officer) having direct contact with human blood in the two weeks to six months before symptom onset.	Coded	O		Frequent (several times weekly) Infrequent Unknown		Hep C, acute
HEP203	CTATTOO	Did the patient receive a tattoo in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP204	CTATTOOLOC	Location where the patient received a tattoo in the two weeks to six months before symptom onset.	Coded	O		Commercial parlor/shop Correctional facility Other (specify) Unknown		Hep C, acute
HEP205	CTATTOOOTH	Other location where the patient received a tattoo in the two weeks to six months before symptom onset.	Alphanumeric	O				Hep C, acute
HEP206	CPIERCE	Did the patient have any part of their body pierced (other than ear) in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP207	CPIERCELOC	Location where the patient received a piercing in the two weeks to six months before symptom onset.	Coded	O		Commercial parlor/shop Correctional facility Other (specify) Unknown		Hep C, acute
HEP208	CPIERCEOTH	Other location where the patient received a piercing in the two weeks to six months before symptom onset.	Alphanumeric	O				Hep C, acute
HEP209	CIVDRUGS	Did the patient inject street drugs not prescribed by a doctor in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP210	CDRUGS	Did the patient use street drugs, but not inject, in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP211	CDIALYSIS	Did the patient undergo hemodialysis in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP212	CSTICK	Did the patient have an accidental stick or puncture with a needle or other object contaminated with blood in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP213	CTRANSF	Did the patient receive blood or blood products (transfusion) in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP214	CTRANSDT	Date the patient received blood or blood products (transfusion) in the two weeks to six months before symptom onset.	Date	O				Hep C, acute
HEP215	CBLOOD	Did the patient have other exposure to someone else's blood in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP216	CBLOODEX	Patient's blood exposure in the two weeks to six months before symptom onset other than through transfusion or an accidental stick or punture.	Alphanumeric	O				Hep C, acute
HEP217	CDENTAL	Did the patient have dental work or oral surgery in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP218	CSURGEY	Did the patient have surgery (other than oral surgery) in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP219	CHOSP	Was the patient hospitalized in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP220	CNURSHOME	Was the patient a resident of a long-term care facility in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP221	CINCAR	Was the patient incarcerated for longer than 24 hours in the two weeks to six months before symptom onset?	Coded	O		Yes No Unknown		Hep C, acute
HEP222	CINCARTYPE	Type of facility where the patient was incarcerated for longer than 24 hours in the two weeks to six months before symptom onset.	Coded	O		Jail Juvenile facility Prison		Hep C, acute
HEP223	CEVERINCAR	Was the patient ever incarcerated for longer than six months during his or her lifetime?	Coded	O		Yes No Unknown		Hep C, acute
HEP224	CINCARYR	Year the patient was most recently incarcerated for longer than six months.	Date	O				Hep C, acute
HEP225	CINCARDUR	Length of time the patient was most recently incarcerated for longer than six months.	Alphanumeric	O				Hep C, acute
HEP226	CINCARUNIT	Length of time (units) the patient was most recently incarcerated for longer than six months.	Coded	O		Days Hours Minutes Months Unknown Weeks Years		Hep C, acute
HEP253	CIVOUTPT	Did the patient receive any IV infusions and/or injections in the outpatient setting during the two weeks to six months prior to onset of symptoms?	Coded	O		Yes No Unknown		Hep C, acute
HEPATITIS C INFECTION ADDITIONAL QUESTIONS								Hep C, chronic
HEP227	HAVTRANSF	Did the patient receive a blood transfusion prior to 1992?	Coded	O		Yes No Unknown		Hep C, chronic
HEP228	HACTRANSP	Did the patient receive an organ transplant prior to 1992?	Coded	O		Yes No Unknown		Hep C, chronic
HEP229	HCVCLOT	Did the patient receive clotting factor concentrates prior to 1987?	Coded	O		Yes No Unknown		Hep C, chronic
HEP230	HCVDIAL	Was the patient ever on long-term hemodialysis?	Coded	O		Yes No Unknown		Hep C, chronic
HEP231	HCVIVDRUGS	Has the patient ever injected drugs not prescribed by a doctor, even if only once or a few times?	Coded	O		Yes No Unknown		Hep C, chronic
HEP232	HCVNUMPART	How many sex partners has patient had (approximate) in lifetime?	Alphanumeric	O				Hep C, chronic
HEP233	HCVINCAR	Was the patient ever incarcerated?	Coded	O		Yes No Unknown		Hep C, chronic
HEP234	HCVSTD	Was the patient ever treated for a sexually transmitted disease?	Coded	O		Yes No Unknown		Hep C, chronic
HEP235	HCVCONTACT	Was the patient ever a contact of a person who had hepatitis?	Coded	O		Yes No Unknown		Hep C, chronic
HEP236	HCVTYPE	Type of contact the patient had with a person with hepatitis.	Coded	O		Babysitter of this patient Child cared for by this patient Household member (non-sexual) Other (specify) Playmate Sex partner Unknown		Hep C, chronic
HEP237	HCVOTHCON	Other type of contact the patient had with a person with hepatitis.	Alphanumeric	O				Hep C, chronic
HEP238	HCVMEDEMP	Was the patient ever employed in a medical or dental field involving direct contact with human blood?	Coded	O		Yes No Unknown		Hep C, chronic
HEPATITIS B PERINATAL INFECTION ADDITIONAL QUESTIONS								Hep B, perinatal
HEP239	HBVMOMRACE	Race of the patient's mother.	Coded	O	Y	2106-3 White 2054-5=Black 2028-9=Asian 2076-8=Pacific Islander 1002-5=Indian 2131-1=Other U = U		Hep B, perinatal
HEP240	HBVMOMETH	Ethnicity of the patient's mother.	Coded	O		Hispanic or Latino Not Hispanic or Latino		Hep B, perinatal
HEP241	HBVMOMBORN	Was mother born outside the U.S.A.?	Coded	O		Yes No Unknown		Hep B, perinatal
HEP242	HBVMOMCTRY	Mother's birth country (other than the U.S.A.).	Coded	O		2-char country code		Hep B, perinatal
HEP243	HBVCONF	Was the mother confirmed HBsAg positive prior to or at time of delivery?	Coded	O		Yes No Unknown		Hep B, perinatal
HEP244	HBVCONFDEL	Was the mother confirmed HBsAg positive after delivery?	Coded	O		Yes No Unknown		Hep B, perinatal
HEP245	HBVCONFDT	Date of HBsAg positive test result.	Date	O				Hep B, perinatal
HEP246	HBVVACDOSE	How many doses of hepatitis B vaccine did the child receive?	Coded	O				Hep B, perinatal
HEP247	HBVVACDT1	Date the child received the first dose of hepatitis B vaccine.	Date	O				Hep B, perinatal
HEP248	HBVVACDT2	Date the child received the second dose of hepatitis B vaccine.	Date	O				Hep B, perinatal
HEP249	HBVVACDT3	Date the child received the third dose of hepatitis B vaccine.	Date	O				Hep B, perinatal
HEP250	HBIG	Did the child receive hepatitis B immune globulin (HBIG)?	Coded	O		Yes No Unknown		Hep B, perinatal
HEP251	HBIGDT	Date the child received HBIG.	Date	O				Hep B, perinatal
HEP256	HBVMRACECD	Mother's detailed race category. (MULTISELECT)	Coded	O	Y	<<detailed race list>>		Hep B, perinatal
HEP257	HBVMETHCD	Mother's detailed ethnicity category. (MULTISELECT)	Coded	O	Y	<<detailed ethnicity list>>		Hep B, perinatal
HEP258	HBVMOMRDES	The mothers race - if other than the provided race categories.	Alphanumeric	O				Hep B, perinatal

Sheet 5: Key

Key to Mapping Tabs - Applies to remainder of tabs
Column	Description
Program Variables Section
PHIN Variable ID	PHIN element UID drawn from the coding system PH_PHINQuestions_CDC
Label	Short name for the data element, which is passed in the message.
Description	Description of the data element as in PHIN Questions.
Data Type	Data type for the variable response expected by the program area
Prog. Req/Opt	Indicator whether the program specifies the field as: R - Required - mandatory for sending the message O - Optional - if the data is available it should be passed
May Repeat	Indicator whether the response to the data element may repeat. “Yes” in the field indicates that it may; otherwise, the field is not populated. Repeats require special processing.
Value Set Name	Name of the pre-coordinated value set from which the response is drawn. The value sets and coding systems are accessible via the Public Health Information Network Vocabulary Access and Distribution Services at http://www.cdc.gov/PhinVSBrowser/StrutsController.do.
Data Validation	Business rules used for validating data integrity.
Message Mapping Methodology Section
Message Context	Specific HL7 segment and field mapping for the element.
HL7 Data Type	HL7 data type used by PHIN to express the variable.
HL7 Usage	Use of the field for PHIN. Indicates if the field is required, optional, or conditional in a segment. The only values that appear in the Message Mapping are: • R – Required. Must always be populated • O – Optional. May optionally be populated.
HL7 Cardinality	Indicator of the minimum and maximum number of times the element may appear. • [0..0] Element never present. • [0..1] Element may be omitted and it can have at most, one Occurrence. • [1..1] Element must have exactly one Occurrence. • [0..n] Element may be omitted or may repeat up to n times. • [1..n] Element must appear at least once, and may repeat up to n times. • [0..] Element may be omitted or repeat for an unlimited number of times. • [1..] Element must appear at least once, and may repeat unlimited number of times. • [m..n] Element must appear at least m, and at most, n times.
Implementation Notes	Related implementation comments.

Sheet 6: Subject-related

Subject/Demographic Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

DEM115

Birth Date

Date of birth in YYYYMMDD format

Date

PID-7 Date/Time of Birth (does not pass Variable ID or label)

[0..1]

DEM114

Patient’s birth sex

Code

Sex (MFU)

PID-8 Administrative Sex (does not pass Variable ID or label)

[0..1]

DEM152

Race Category

Field containing one or more codes that broadly refer to the patient’s race(s).

Code

Race Category

PID-10 Race (does not pass Variable ID or label)

[0..1]

this does not include detailed race

DEM165

Patient Address County

County of residence of the subject.

Code

County

PID-11.9 Patient Address - County

[0..1]

DEM162

Patient Address State

Patient’s address state.

Code

State

PID-11.4 Patient Address - State

[0..1]

DEM163

Patient Address Zip Code

Patient’s address Zip code.

Text

PID-11.5 Patient Address - Postal Code

[0..1]

DEM155

Ethnic Group Code

Ethnic origin or ethnicity is based on the individual’s self-identity of the patient as Hispanic or Latino; choose one value from the list.

Code

Ethnicity Group

PID-22 Ethnic Group (does not pass Variable ID or label)

[0..1]

HL7 defines as repeating but PHIN constrains; this does not include detailed ethnicity

Sheet 7: Generic Obs.

The generic surveillance elements that are not used for Hepatitis reporting are shaded.

Generic Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

NOT109

Reporting State

State reporting the notification.

Coded

State

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

NOT113

Reporting County

County reporting the notification.

Code

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV169

Condition Code

Condition or event that constitutes the reason the notification is being sent.

Coded

Nationally Notifiable Disease Surveillance System (NNDSS) & Other Conditions of Public Health Importance

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV168

Local record ID

Sending system-assigned local ID of the case investigation with which the subject is associated.

Alphanumeric

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[1..1]

INV172

Local Case ID

Official local (city/county) identification number for the case

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV173

State Case ID

States use this field to link NEDSS (NETSS) investigations back to their own state investigations.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV107

Jurisdiction Code

Identifier for the physical site from which the notification is being submitted.

Code

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV108

Case Program Area Code

The organizational ownership of the investigation. Program areas (e.g., Immunization, STD) are defined at the state level by the conditions for which they provide primary prevention and control.

Code

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV109

Case Investigation Status Code

Status of the investigation. For example, open or closed.

Code

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV2006

Case Close Date

Date the case investigation status was marked as Closed.

Date

If the user enters the Date Closed for a case then the date must be >= Date Opened

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV110

Investigation Date Assigned

Date the investigator was assigned to this investigation.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV111

Date of Report

Date the event or illness was first reported by the reporting source

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV112

Reporting Source Type Code

Type of facility or provider associated with the source of information sent to Public Health.

Code

Reporting Source Type NND

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV114

Reporting Source Name

Name of the provider reporting the case (typically the patient's primary care provider)

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV115a

Reporting Source Address Line 1

Reporting source street address Line 1

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV115b

Reporting Source Address Line 2

Reporting source street address Line 2

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV116

Reporting Source Address City

Reporting source address city

Code

City

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV117

Reporting Source Address State

Reporting source address state

Code

State

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV118

Reporting Source Zip Code

Zip Code of the reporting source for this case.

Alphanumeric

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV119

Reporting Source Address County

Reporting source address county

Code

County

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV120

Earliest Date Reported to County

Earliest date reported to county public health system

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV121

Earliest Date Reported to State

Earliest date reported to state public health system

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV122

Reporting Source Telephone Number

Reporting source telephone number

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV128

Hospitalized

Was patient hospitalized because of this event?

Code

Yes No Unknown (YNU)

1) If the patient was hospitalized for this illness, then enable entry of admission date
2) If the patient was hospitalized for this illness, then enable entry of discharge date
3) If the patient was hospitalized for this illness, then enable entry of total duration of stay in the hospital in days

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV129

Hospital Name

Name of the healthcare facility in which the subject was hospitalized.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV132

Admission Date

Subject’s admission date to the hospital for the condition covered by the investigation.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV133

Discharge Date

Subject's discharge date from the hospital for the condition covered by the investigation.

Date

If the user enters the Discharge Date, then the date must be >= Admission Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV134

Duration of hospital stay in days

Subject's duration of stay at the hospital for the condition covered by the investigation.

Numeric

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV136

Diagnosis Date

Date of diagnosis of condition being reported to public health system

Date

If the user enters the Diagnosis Date, then the date must be >= Illness Onset Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV137

Date of Illness Onset

Date of the beginning of the illness. Reported date of the onset of symptoms of the condition being reported to the public health system

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV138

Illness End Date

Time at which the disease or condition ends.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV139

Illness Duration

Length of time this person had this disease or condition.

Numeric

units required

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV140

Illness Duration Units

Unit of time used to describe the length of the illness or condition.

Code

Age Unit

uses the INV139 observation - maps to OBX-6-Units (does not use INV140 ID or label)

[0..1]

INV143

Illness Onset Age

Age at onset of illness

Numeric

units required

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV144

Illness Onset Age Units

Age units at onset of illness

Code

Age Unit

uses the INV143 observation - maps to OBX-6-Units (does not use INV144 ID or label)

CWE

[0..1]

INV145

Did the patient die from this illness

Did the patient die from this illness or complications of this illness?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV146

Date of death

The date and time the subject’s death occurred.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV147

Investigation Start Date

The date the case investigation was initiated.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV150

Case outbreak indicator

Denotes whether the reported case was associated with an identified outbreak.

Code

If this case is part of an outbreak, then enable entry of outbreak name (INV151)

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV151

Case Outbreak Name

A state-assigned name for an indentified outbreak.

Code

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV152

Case Disease Imported Code

Indication of where the disease/condition was likely acquired.

Code

Disease Acquired Jurisdiction

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV153

Imported Country

If the disease or condition was imported, indicates the country in which the disease was likely acquired.

Code

Country

if INV152 = Out of Country

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV154

Imported State

If the disease or condition was imported, indicates the state in which the disease was likely acquired.

Code

State

if INV152 = Out of State

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV155

Imported City

If the disease or condition was imported, indicates the city in which the disease was likely acquired.

Code

City

if INV152 = Out of Jurisdiction

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV156

Imported County

If the disease or condition was imported, contains the county of origin of the disease or condition.

Code

County

if INV152 = Out of Jurisdiction

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV157

Transmission Mode

Code for the mechanism by which disease or condition was acquired by the subject of the investigation. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate.

Code

Case Transmission Mode

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV159

Detection Method

Code for the method by which the public health department was made aware of the case. Includes provider report, patient self-referral, laboratory report, case or outbreak investigation, contact investigation, active surveillance, routine physical, prenatal testing, perinatal testing, prison entry screening, occupational disease surveillance, medical record review, etc.

Code

Case Detection Method

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

Note required by program

INV161

Confirmation Method

Code for the mechanism by which the case was classified, providing information about how the case classification status was derived. More than one confirmation method may be indicated.

Code

Case Confirmation Method

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV162

Confirmation Date

If an investigation is confirmed as a case, the confirmation date is entered.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV163

Case Class Status Code

Status of the case/event as suspect, probable, confirmed, or "not a case" per CSTE/CDC/ surveillance case definitions.

Code

Case Class Status

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV165

MMWR Week

MMWR Week for which case information is to be counted for MMWR publication.

Numeric

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV166

MMWR Year

MMWR Year (YYYY) for which case information is to be counted for MMWR publication.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV176

Date of First Report to CDC

Date the case was first reported to the CDC.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV177

Date First Reported PHD

Earliest date the case was reported to a public health department.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV178

Pregnancy status

Indicates whether the patient was pregnant at the time of the event.

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV179

PID

Indicates whether or not the patient has pelvic inflammatory disease (PID).

Code

Only valid for female patients.

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

INV2001

Age at case investigation

Patient age at time of case investigation

Numeric

age unit required

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

INV2002

Age units at case investigation

Patient age units at time of case investigation

Code

Age Unit

uses the INV2001 observation - maps to OBX-6-Units (does not use INV2002 ID or label)

CWE

[0..1]

Sheet 8: HEP GEN

Hepatitis Generic Case Notification Variables - these observations apply to all hepatitis case reports.

Program-Specific Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

HEP100

TESTRX

The reason(s) the patient was tested for hepatitis. (MULTISELECT)

Code

Reason For Test (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..*]

HEP101

OTHREASON

Other reason the patient was tested for hepatitis.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP102

SYMPTOM

Is patient symptomatic?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP103

SYMTDT

Onset date of symptoms.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP104

JAUNDICED

Was the patient jaundiced?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP106

PREGNANT

Was the patient pregnant?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP107

DUEDT

Patient's pregnancy due date.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP110

TOTANTIHAV

Total antibody to hepatitis A virus [total anti-HAV].

Code

Positive Negative Unknown

Observation/OBX Segment with this variable ID and label

CWE

[0..1]

HEP111

IGMHAV

IgM antibody to hepatitis A virus [IgM anti-HAV].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP112

HBSAG

Hepatitis B surface antigen [HBsAg].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP113

TOTANTIHBC

Total antibody to hepatitis B core antigen [total anti-HBc].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP114

IGMHBC

IgM antibody to hepatitis B core antigen [IgM anti-HBc].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP115

ANTIHCV

Antibody to hepatitis C virus [anti-HCV].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP116

ANTIHCVSIG

Anti-HCV signal to cut-off ratio.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP117

SUPANTIHCV

Supplemental anti-HCV assay [e.g., RIBA].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP118

HCVRNA

HCV RNA [e.g., PCR].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP119

ANTIHDV

Antibody to hepatitis D virus [anti-HDV].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP120

ANTIHEV

Antibody to hepatitis E virus [anti-HEV].

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP121

ALTSGPT

ALT (SGPT) result (include units).

Numeric

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP122

ALTSGPTUP

ALT (SGPT) result upper limit normal (include units).

Numeric

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP123

ASTSGOT

AST (SGOT) result (include units).

Numeric

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP124

ASTSGOTUP

AST (SGOT) result upper limit normal (include units).

Numeric

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP125

ALTDT

Date of the ALT result.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP126

ASTDT

Date of the AST result.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP127

EPILINK

If this case has a diagnosis of hepatitis A that has not been serologically confirmed, is there an epidemiologic link between this patient and a laboratory-confirmed hepatitis A case?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP128

Disease diagnosis. This is a required field.

Code

Notifiable Condition (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[1..1]

HEP255

BIRTHPLACE

Patient's country of birth.

Code

Country

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP263

Hepatitis B ‘e’ antigen [HBeAg]

Hepatitis B ‘e’ antigen [HBeAg] test result.

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP264

HBV DNA

HBV DNA test result.

Code

Positive Negative Unknown

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

Sheet 9: Hep A, acute

Hepatitis A Acute Specific Case Notification Variables

Program-Specific Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

HEP129

CONTACTA

During the two to six weeks prior to the onset of symptoms, was the patient a contact of a person with confirmed or suspected hepatitis A virus infection?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP130

ATYPE

Type of contact the patient had with a person with confirmed or suspected hepatitis A virus infection during the two to six weeks prior to symptom onset.

Code

Contact Type (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP131

AOTHCON

Other type of contact the patient had with a person with confirmed or suspected hepatitis A virus infection during the two to six weeks prior to symptom onset.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP132

ADAYCARE1

Was the patient a child or employee in daycare center, nursery, or preschool?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP133

ADAYCARE2

Was the patient a household contact of a child or employee in a daycare center, nursery, or preschool?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP134

ADAYCAREAID

Was there an identified hepatitis A case in the childcare facility?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP135

ASEXMALE

Number of male sex partners the person had in the two to six weeks before symptom onset.

Code

Number Of Sex Partners (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP136

ASEXFEMALE

The number of female sex partners the person had in the two to six weeks before symptom onset.

Code

Number Of Sex Partners (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP137

AIVDRUGS

Did the patient inject street drugs in the two to six weeks before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP138

ADRUGS

Did the patient use street drugs, but not inject, in the two to six weeks before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP139

ATRAVEL

Did the patient travel outside the U.S.A. or Canada in the two to six weeks before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP140

AWHERE

The countries to which the patient traveled (outside the U.S.A. or Canada) in the two to six weeks before symptom onset.

Code

Country

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..*]

HEP141

AHHTRAVEL

Did anyone in the patient's household travel outside the U.S.A. or Canada in the three months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP142

AHHWHERE

The countries to which anyone in the patient's household traveled (outside the U.S.A. or Canada) in the three months before symptom onset? (MULTISELECT)

Code

Country

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..*]

HEP143

AOUTBREAK

Is the patient suspected as being part of a common-source outbreak?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP144

AOUTBRTYPE

Type of outbreak with which the patient is associated.

Code

Outbreak Type (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP145

AFOODITEM

Food item with which the foodborne outbreak is associated.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP146

AHANDLER

Was the patient employed as a food handler during the two weeks prior to onset of symptoms or while ill?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP147

HEPAVAC

Has patient ever received the hepatitis A vaccine?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP148

HEPAVACDOS

Number of doses of hepatitis A vaccine the patient received.

Code

Vaccine Dose Number (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP149

HEPAVACYR

Year the patient received the last dose of hepatitis A vaccine.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP150

IMMUGLOB

Has the patient ever received immune globulin?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP151

IMMUGLOBYR

Date the patient received the last dose of immune globulin.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

Sheet 10: Hep B, acute

Hepatitis B, Acute Specific Case Notification Variables

Program-Specific Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

HEP152

CONTACTB

During the six weeks to six months prior to onset of symptoms, was the patient a contact of a person with confirmed or suspected acute or chronic hepatitis B virus infection?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP153

BTYPE

Type of contact the patient had with a person with confirmed or suspected acute or chronic hepatitis B virus infection during the two to six weeks prior to symptom onset. (MULTISELECT)

Code

Contact Type (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..*]

HEP154

BOTHCON

Other type of contact the patient had with a person with confirmed or suspected acute or chronic hepatitis B virus infection during the two to six weeks prior to symptom onset.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP155

BMALESEX

Number of male sex partners the person had in the six months before symptom onset.

Code

Number of Sex Partners (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP156

BFEMALESEX

Number of female sex partners the person had in the six months before symptom onset.

Code

Number of Sex Partners (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP157

BSTD

Was patient ever treated for a sexually transmitted disease?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP158

BSTDYR

Year the patient received the most recent treatment for a sexually transmitted disease.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP159

BIVDRUGS

Did the patient inject street drugs not prescribed by a doctor in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP160

BDRUGS

Did the patient use street drugs, but not inject, in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP161

BDIALYSIS

Did the patient undergo hemodialysis in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP162

BSTICK

Did the patient have an accidental stick or puncture with a needle or other object contaminated with blood in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP163

BTRANS

Did the patient receive blood or blood products (transfusion) in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP164

BTRANSDT

Date the patient received blood or blood products (transfusion) in the six weeks to six months before symptom onset.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP165

BBLOOD

Did the patient have other exposure to someone else's blood in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP166

BBLOODTYPE

Patient's blood exposure in the six weeks to six months before symptom onset other than through transfusion or an accidental stick or puncture.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP167

BMEDEMP

Was the patient employed in a medical or dental field involving direct contact with human blood in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP168

BFREQ1

Patient's frequency of blood contact as an employee in a medical or dental field involving direct contact with human blood in the six weeks to six months before symptom onset.

Code

Blood Contact Frequency (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP169

BPUBSAFEMP

Was the patient employed as a public safety worker (fire fighter, law enforcement, or correctional officer) having direct contact with human blood in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP170

BFREQ2

Patient's frequency of blood contact as a public safety worker (fire fighter, law enforcement, or correctional officer) having direct contact with human blood in the six weeks to six months before symptom onset.

Code

Blood Contact Frequency (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP171

BTATTOO

Did the patient receive a tattoo in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP172

BTATTOOLOC

Location(s) where the patient received a tattoo in the six weeks to six months before symptom onset.

Code

Tattoo Obtained From (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..*]

HEP173

BTATTOOOTH

Other location where the patient received a tattoo in the six weeks to six months before symptom onset.

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP174

BPIERCE

Did the patient have any part of their body pierced (other than ear) in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP175

BPIERCELOC

The location(s) where the patient received a piercing in the six weeks to six months before symptom onset.

Code

Tattoo Obtained From (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..*]

HEP176

BPEIRCEOTH

Other location where the patient received a piercing in the six weeks to six months before symptom onset.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP177

BDENTAL

Did the patient have dental work or oral surgery in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP178

BSURGERY

Did the patient have surgery (other than oral surgery) in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP179

BHOSP

Was the patient hospitalized in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP180

BNURSHOME

Was the patient a resident of a long-term care facility in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP181

BINCAR

Was the patient incarcerated for longer than 24 hours in the six weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP182

BINCARTYPE

Type of facility where the patient was incarcerated for longer than 24 hours in the six weeks to six months before symptom onset. (MULTISELECT)

Code

Incarceration Type (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..*]

HEP183

BEVERINCAR

Was the patient ever incarcerated for longer than six months during his or her lifetime?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP184

INCARYR

Year the patient was most recently incarcerated for longer than six months.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP185

INCARDUR

Length of time the patient was most recently incarcerated for longer than six months.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP186

INCARUNIT

Length of time (units) the patient was most recently incarcerated for longer than six months.

Code

Age Unit

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP187

BVACCINE

Did the patient ever receive hepatitis B vaccine?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP188

BVACCINENO

Number of shots of hepatitis B vaccine the patient received.

Code

Vaccine Dose Number (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP189

BVACCINEYR

Year in which the patient received the last shot of hepatitis B vaccine.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP190

BANTIBODY

Was the patient tested for antibody to HBsAg (anti-HBs) within one to two months after the last dose?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP191

BRESULT

Was the serum anti-HBs >= 10ml U/ml? (Answer 'Yes' if lab result reported as positive or reactive.)

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP252

BIVOUTPT

Did the patient receive any IV infusions and/or injections in the outpatient setting during the six weeks to six months prior to onset of symptoms?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

Sheet 11: Hep C, acute

Hepatitis C Acute Specific Case Notification Variables

Program-Specific Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

HEP192

CCONTACT

Was the patient a contact of a person with confirmed or suspected acute or chronic hepatitis C infection in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP193

CTYPE

Type of contact the patient had with a person with confirmed or suspected acute or chronic hepatitis C infection in the two weeks to six months before symptom onset.

Code

Contact Type (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP194

COTHCON

Other type of contact the patient had with a person with confirmed or suspected acute or chronic hepatitis C infection in the two weeks to six months before symptom onset.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP195

CMALESEC

Number of male sex partners the person had in the six months before symptom onset.

Code

Number Of Sex Partners (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP196

CFEMALESEX

Number of female sex partners the person had in the six months before symptom onset.

Code

Number Of Sex Partners (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP197

CSTD

Was patient ever treated for a sexually transmitted disease?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP198

CSTDYR

Year the patient received the most recent treatment for a sexually transmitted disease.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP199

CMEDEMP

Was the patient employed in a medical or dental field involving direct contact with human blood in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP200

CFREQ1

Patient's frequency of blood contact as an employee in a medical or dental field involving direct contact with human blood in the two weeks to six months before symptom onset.

Code

Blood Contact Frequency (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP201

CPUBSAFEMP

Was the patient employed as a public safety worker (fire fighter, law enforcement, or correctional officer) having direct contact with human blood in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP202

CFREQ2

Patient's frequency of blood contact as a public safety worker (fire fighter, law enforcement, or correctional officer) having direct contact with human blood in the two weeks to six months before symptom onset.

Code

Blood Contact Frequency (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP203

CTATTOO

Did the patient receive a tattoo in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP204

CTATTOOLOC

Location where the patient received a tattoo in the two weeks to six months before symptom onset.

Code

Tattoo Obtained From (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP205

CTATTOOOTH

Other location where the patient received a tattoo in the two weeks to six months before symptom onset.

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP206

CPIERCE

Did the patient have any part of their body pierced (other than ear) in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP207

CPIERCELOC

Location where the patient received a piercing in the two weeks to six months before symptom onset.

Code

Tattoo Obtained From (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP208

CPIERCEOTH

Other location where the patient received a piercing in the two weeks to six months before symptom onset.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP209

CIVDRUGS

Did the patient inject street drugs not prescribed by a doctor in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP210

CDRUGS

Did the patient use street drugs, but not inject, in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP211

CDIALYSIS

Did the patient undergo hemodialysis in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP212

CSTICK

Did the patient have an accidental stick or puncture with a needle or other object contaminated with blood in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP213

CTRANSF

Did the patient receive blood or blood products (transfusion) in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP214

CTRANSDT

Date the patient received blood or blood products (transfusion) in the two weeks to six months before symptom onset.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP215

CBLOOD

Did the patient have other exposure to someone else's blood in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP216

CBLOODEX

Patient's blood exposure in the two weeks to six months before symptom onset other than through transfusion or an accidental stick or puncture.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP217

CDENTAL

Did the patient have dental work or oral surgery in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP218

CSURGEY

Did the patient have surgery (other than oral surgery) in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP219

CHOSP

Was the patient hospitalized in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP220

CNURSHOME

Was the patient a resident of a long-term care facility in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP221

CINCAR

Was the patient incarcerated for longer than 24 hours in the two weeks to six months before symptom onset?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP222

CINCARTYPE

Type of facility where the patient was incarcerated for longer than 24 hours in the two weeks to six months before symptom onset.

Code

Incarceration Type (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP223

CEVERINCAR

Was the patient ever incarcerated for longer than six months during his or her lifetime?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP224

CINCARYR

Year the patient was most recently incarcerated for longer than six months.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP225

CINCARDUR

Length of time the patient was most recently incarcerated for longer than six months.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP226

CINCARUNIT

Length of time (units) the patient was most recently incarcerated for longer than six months.

Code

Age Unit (UCUM)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP253

CIVOUTPT

Did the patient receive any IV infusions and/or injections in the outpatient setting during the two weeks to six months prior to onset of symptoms?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

Sheet 12: Hep C infection

Hepatitis C Infection Specific Case Notification Variables

Program-Specific Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

HEP227

HAVTRANSF

Did the patient receive a blood transfusion prior to 1992?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP228

HACTRANSP

Did the patient receive an organ transplant prior to 1992?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP229

HCVCLOT

Did the patient receive clotting factor concentrates prior to 1987?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP230

HCVDIAL

Was the patient ever on long-term hemodialysis?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP231

HCVIVDRUGS

Has the patient ever injected drugs not prescribed by a doctor, even if only once or a few times?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP232

HCVNUMPART

How many sex partners has patient had (approximate) in lifetime?

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP233

HCVINCAR

Was the patient ever incarcerated?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP234

HCVSTD

Was the patient ever treated for a sexually transmitted disease?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP235

HCVCONTACT

Was the patient ever a contact of a person who had hepatitis?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP236

HCVTYPE

Type of contact the patient had with a person with hepatitis.

Code

Contact Type (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP237

HCVOTHCON

Other type of contact the patient had with a person with hepatitis.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP238

HCVMEDEMP

Was the patient ever employed in a medical or dental field involving direct contact with human blood?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

Sheet 13: Hep B, perinatal

Hepatitis B Virus Perinatal Infection Specific Case Notification Variables

Program-Specific Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

HEP239

HBVMOMRACE

Race of the patient's mother.

Code

Race Category

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP240

HBVMOMETH

Ethnicity of the patient's mother.

Code

Ethnicity Group

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP241

HBVMOMBORN

Was mother born outside the U.S.A.?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP242

HBVMOMCTRY

Mother's birth country (other than the U.S.A.).

Code

Country

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP243

HBVCONF

Was the mother confirmed HBsAg positive prior to or at time of delivery?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP244

HBVCONFDEL

Was the mother confirmed HBsAg positive after delivery?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP245

HBVCONFDT

Date of HBsAg positive test result.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP246

HBVVACDOSE

How many doses of hepatitis B vaccine did the child receive?

Code

Vaccine Dose Number (Hepatitis)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP247

HBVVACDT1

Date the child received the first dose of hepatitis B vaccine.

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP248

HBVVACDT2

Date the child received the second dose of hepatitis B vaccine.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP249

HBVVACDT3

Date the child received the third dose of hepatitis B vaccine.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP250

HBIG

Did the child receive hepatitis B immune globulin (HBIG)?

Code

Yes No Unknown (YNU)

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP251

HBIGDT

Date the child received HBIG.

Date

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

HEP256

HBVMRACECD

Mother's detailed race category. (MULTISELECT)

Code

Detailed Race

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP257

HBVMETHCD

Mother's detailed ethnicity category. (MULTISELECT)

Code

Detailed Ethnicity

Observation (OBX segment) under an OBR-4 value of 'NOTF'

CWE

[0..1]

HEP258

HBVMOMRDES

Mother”s race, if other than the provided race categories.

Text

Observation (OBX segment) under an OBR-4 value of 'NOTF'

[0..1]

Sheet 14: Notification Structure

Notification Structural Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

NOT108

Notification ID

The unique identifier for the notification record. No UID or label is passed in the message.

Text

MSH-10-Message Control ID. No UID or label is passed in the message.

[1..1]

DEM197

Local patient ID

The local ID of the patient/entity.

Text

PID-3.1 Patient Identifier List – ID Number
PID-3.4 Assigning Authority format <localID&OID&ISO>
Does not pass Variable ID or label.

[1..1]

Only the sending system's internally assigned patient id used for these de-identified messages

DEM100

Patient name type

Name is not requested by the program, but the Patient Name field is required to be populated for the HL7 message to be valid. PHIN has adopted the HL7 convention for processing a field where the name has been removed for de-identification purposes.

Code

Name Type

PID-5.7 Patient Name Type - second instance (does not pass Variable ID or label). HL7 reserves the first instance of the name for Legal Name.

[1..2]

Literal value: |~^^^^^^S|

INV168

Local record ID

Sending system-assigned local ID of the case investigation with which the subject is associated.

Text

OBR-3-Filler Order Number where OBR-3.1 is the internally assigned case/investigation ID, OBR-3.3 is the OID for sending application as assigning authority, and OBR-3.4 is the literal value 'ISO'. The UID and label are not passed in the message.

[1..1]

NOT099

Subject Type

Type of subject for the notification.

Code

Notification Section Header

OBR|1|: Maps to the HL7 attribute OBR-4-Universal Service ID. No UID or label is passed in the message.

[1..1]

Literal Value: 'PERSUBJ^Person Subject^2.16.840.1.114222.4.5.274 - Note that this notification does not have any observations (OBX segments) specified to appear after the Subject OBR.

NOT101

Notification Type

Type of notification. Main notification types are "Individual Case", "Environmental", "Summary", and "Laboratory Report".

Code

Notification Section Header

OBR|2|: Maps to the HL7 attribute OBR-4-Universal Service ID. No UID or label is passed in the message.

[1..1]

Literal Value: 'NOTF^Case Notification^2.16.840.1.114222.4.5.274'

NOT098

Supplemental Notification Type

Supplemental Notification Types which may optionally be passed are "Associated Laboratory Report" and "Associated Vaccine Report". Multiple reports may be passed.

Code

Notification Section Header

OBR|3|: Maps to the HL7 attribute OBR-4-Universal Service ID. No UID or label is passed in the message.

CWE

[0..*]

Literal Value: 'LABRPT^Associated Laboratory Report^2.16.840.1.114222.4.5.274'

NOT103

Date First Submitted

Date the notification was first sent to CDC. This value does not change after the original notification. No UID or label is passed in the message.

Date

Maps to the HL7 attribute OBR-7-Observation Date/time. No UID or label is passed in the message.

[1..1]

NOT106

Date of Report

Date/time this version of the notification was sent. It will be the same value as NOT103 for the original notification. For updates, this is the update/send date/time.

Date

Maps to the HL7 attribute OBR-22-Result Report/Status Chg Date/time. No UID or label is passed in the message.

[1..1]

INV169

Condition Code

Condition or event that constitutes the reason the notification is being sent.

Code

Nationally Notifiable Disease Surveillance System (NNDSS) & Other Conditions of Public Health Importance

Maps to HL7 attribute OBR-31-Reason for Study. The UID and label are not passed in the message.

CWE

[1..1]

Sheet 15: Associated Lab Report

This is the set of variables that may be passed if the Case Notification has an associated Laboratory report event. The laboratory report is not required to be included with the Notification. Associated Laboratory reports are not required to be included with the Notification. If present, each Lab report event is carried under a segment header with OBR-4 of 'LABRPT".

Program-Specific Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

LAB143

Reporting Lab Name

Name of Laboratory that reported test result.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB144

Reporting Lab CLIA Number

CLIA (Clinical Laboratory Improvement Act) identifier for the laboratory that performed the test.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB112

Ordered Test Name

Ordered Test Name is the lab test ordered by the physician. It will always be included in an ELR, but there are many instances in which the user entering manual reports will not have access to this information.

Coded

Lab Test Orderables

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB163

Date of Specimen Collection

The date the specimen was collected.

Date

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB166

Specimen Site

This indicates the physical location, of the subject, where the specimen originated. Examples include: Right Internal Jugular, Left Arm, Buttock, Right Eye, etc.

Coded

Specimen (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB503

Date Sample Received at Lab

Date Sample Received at Lab (accession date).

Date

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB108

Sample Analyzed date

The date and time the sample was analyzed by the laboratory.

Date

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB197

Lab Report Date

Date result sent from Reporting Laboratory.

Date

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB202

Specimen ID

A laboratory generated number that identifies the specimen related to this test.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB196

Report Status

The status of the lab report.

Coded

Result Status (HL7)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB101

Resulted Test

Resulted test name.

Coded

Lab Test Result Name (CDC)

identification of resulted test with a LOINC code is a minimum data requirement

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB334

Date received in state public health lab

Date the isolate was received in state public health laboratory.

Date

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB125

Specimen Number

A laboratory generated number that identifies the specimen related to this test.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB165

Specimen Source

The medium from which the specimen originated. Examples include whole blood, saliva, urine, etc.

Code

Specimen

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB262

Specimen Details

Specimen details if specimen information entered as text.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

LAB101

Resulted Test Name

The lab test that was run on the specimen.

Code

Lab Test Name

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB192

Coded Result Value

Coded qualitative result value.

Code

Lab Test Result Qualitative

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB508

Sent to CDC for Genotyping

Indicate whether the specimens were sent to CDC for genotyping.

Code

Yes No Unknown (YNU)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB509

Genotyping Sent Date

If the specimen was sent to the CDC for genotyping, date on which the specimens were sent.

Date

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

[0..1]

LAB510

Sent For Strain ID

Indicate whether the specimen was sent for strain identification.

Code

Yes No Unknown (YNU)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB511

Strain Type

If the specimen was sent for strain identification, indicate the strain.

Code

StrainType (specific to condition TBD)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

The following group of observations make up a single quantitative (numeric) result. The OBX segment contains 'SN' in OBX-2 and 'LAB114^Numeric Result^2.16.840.1.114222.4.5.254' in OBX-3. All of the data elements map to OBX-5 and untis maps to OBX-6 of the same observation.

LAB113

Lab Quantitative Result Operator

A quantitative result may contain a comparative operator. Valid values are: <, <=, <>, =, >, >=.

Alphanumeric

OBX-5.1-Comparator value when OBX-3 is LAB114 Numeric Result.

[0..1]

LAB114

Numeric Result

The numeric value in component 2 of the Structured Numeric results field.

Numeric

required if there is a numeric result

OBX-5.2-Numeric value when OBX-3 is LAB114 Numeric Result.

[1..1]

LAB116

Result Ratio

The quantitative result ratio separator can be used when two numbers must be expressed together. The separator is based on the context of the two numbers. Example: a colon is used when expressing a lab result index, i.e. "1:256".

Coded

OBX-5.1-Comparator value when OBX-3 is LAB114 Numeric Result.

[0..1]

LAB117

Numeric Result 2

The second numeric value that may be used in a quantitative result. Example: a ratio of "1:4" - 4 is the second numeric value.

Numeric

OBX-5.3-Separator value when OBX-3 is LAB114 Numeric Result.

CWE

[0..1]

LAB115

Result Units

The unit of measure for numeric result value.

Coded

Units Of Measure

OBX-6-Units when OBX-3 is LAB114 Numeric Result.

CWE

[0..1]

End of Quantitative Result

LAB207

Result Status

The Result Status is the degree of completion of the lab test.

Coded

Observation Result Status (HL7)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB208

Lab Result Text Value

Textual result value, used if result is neither numeric nor coded.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB118

Interpretation Flag

The interpretation flag identifies a result that is not typical as well as how it's not typical. Examples: Susceptible, Resistant, Normal, Above upper panic limits, below absolute low.

Coded

Abnormal Flag (HL7)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB119

Reference Range From

The reference range from value allows the user to enter the value on one end of a expected range of results for the test. This is used mostly for quantitative results.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB120

Reference Range To

The reference range to value allows the user to enter the value on the other end of a valid range of results for the test. This is used mostly for quantitative results.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB104

Lab Result Comments

Comments having to do specifically with the lab result test. These are the comments from the NTE segment if the result was originally an Electronic Laboratory Report.

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB105

Test Method

The technique or method used to perform the test and obtain the test results. Examples: Serum Neutralization, Titration, dipstick, test strip, anaerobic culture.

Coded

Lab Test Method (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB278

Organism Name

The organism name as a test result. This element is used when the result was reported as an organism.

Coded

Infectious Agent (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB222

Susceptibility Test?

User selects "Yes" to indicate need to enter susceptibility results.

Coded

Yes No Indicator (HL7)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

This section is used to carry susceptibility testing results that are logically attached to the organism reported in LAB278. These sensitivity results are carried as a repeating block tied together using the same Observation sub-id value in all the OBX segments that apply to that instance. There may be up to 20 different drugs in a susceptibility panel, so there will be the same number of repeating blocks. The “order” or OBR segment for the sensitivity is not carried in this message – the results are tied directly to the organism the antibiotics are tested against.

LAB110

Drug Name

Name of the antibiotic for which the organism was susceptibility tested. For ELR, it could also contain reflex test name.

Coded

Lab Test Name (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB105

Test Method

The technique or method used to perform the test and obtain the Microbiology Susceptibility results: MIC (Minimum Inhibitory Concentration, KB (Kirby Bauer), etc.

Coded

Lab Test Method (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB304

Drug Result Code

Depending on the test method, the susceptibility result may be reported as a qualitative result. This element captures susceptibility result as a coded value

Coded

Lab Test Result Qualitative

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB523

Susceptibility Interpretation

The interpretation by the lab specific to susceptibility results. Examples: Susceptible, Resistant, Indeterminate.

Coded

Abnormal Flag (HL7)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

End of Drug Sensitivity data elements repeating block.

Isolate Tracking Data Elements Start Here

LAB329

Track Isolate

Track Isolate functionality indicator

Coded

True False (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB330

Patient status at specimen collection

Coded

Patient Status At Specimen Collection

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB331

Isolate received in state public health lab

Coded

Yes No Unknown (YNU)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB332

Reason isolate not received

Coded

Isolate Not Received Reason

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB333

Reason isolate not received (Other)

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB334

Date received in state public health lab

Date/time

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB335

State public health lab isolate id number

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB336

Case confirmed at state public health lab

Coded

Yes No Unknown (YNU)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB337

PulseNet Isolate

PulseNet Isolate Indicator

Coded

True False (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB338

Isolate PFGE sent to central PulseNet

Isolate PFGE sent to central PulseNet database

Coded

Yes No Unknown (YNU)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB339

PulseNet PFGE Designation Enzyme 1

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB340

State Health Dept Lab PFGE Designation Enzyme 1

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB341

PulseNet PFGE Designation Enzyme 2

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB342

State Health Dept Lab PFGE Designation Enzyme 2

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB343

PulseNet PFGE Designation Enzyme 3

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB344

State Health Dept Lab PFGE Designation Enzyme 3

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB345

NARMS Isolate Indicator

NARMS Isolate

Coded

True False (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB346

Isolate sent to NARMS

Coded

Yes No Unknown (YNU)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB347

Reason isolate not sent to NARMS

Coded

Isolate Not Sent To NARMS Reason

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB348

State-assigned NARMS ID number

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB349

NARMS Isolate Expected Ship Date

Date/time

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB350

NARMS Isolate Actual Ship Date

Date/time

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB351

EIP Isolate

EIP Isolate Indicator

Coded

True False (CDC)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB352

Specimen available for further EIP testing

Coded

Isolate Availability EIP Testing

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB353

Reason specimen not available for further EIP test

Coded

Isolate Not Available EIP Test Reason

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB354

Other reason why specimen is not available

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB355

If "Yes", where will the specimen be shipped

Coded

Specimen Shipped

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB356

EIP Isolate Expected Ship Date

Date/time

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB357

EIP Isolate Actual Ship Date

Date/time

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB358

Was specimen requested for reshipment

Coded

Yes No (HL7)

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB359

Reason specimen requested for reshipment

Coded

Specimen Reshipment Reason

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB360

Other reason for reshipment

Alphanumeric

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB361

EIP Isolate Expected Reship Date

Date/time

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

LAB362

EIP Isolate Actual Reship Date

Date/time

Observation/OBX segment under an OBR with Universal Service ID of 'LABRPT'

CWE

[0..1]

Sheet 16: Assoc Vaccine Report

This is the set of variables that may be passed if the Case Notification has an associated Vaccine event report. Vaccine reports are not required to be included with the Notification. If present, each vaccine event is carried under a segment header with OBR-4 of 'VACRPT'.

Program-Specific Surveillance Variables

Mapping Methodology

PHIN Variable ID

Label/Short Name

Description

Data Type

CDC Req/Opt

May Repeat

Value Set Name

Data Validation

Message Context

HL7 Data Type

HL7 Usage

HL7 Cardinality

Implementation Notes

VAC101

Vaccine Administered

The type of vaccine administered, (e.g., MMR, DaPT, HepB).

Coded

Vaccines Administered (CVX)

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

VAC102

Vaccination Record ID

A system generated ID for a vaccination record.

Alphanumeric

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

VAC103

Vaccine Administered Date

The date that the vaccine was administered.

Date

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

VAC104

Vaccination Anatomical Site

The anatomical site where the vaccination was given.

Coded

Body Site (HL7)

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

VAC105

Age At Vaccination

The person's age at the time the vaccination was given.

Numeric

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

VAC106

Age At Vaccination Unit

The age units of the person at the time the vaccination was given.

Coded

Age Unit

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

VAC107

Vaccine Manufacturer

Manufacturer of the vaccine

Coded

Manufacturers Of Vaccines (MVX)

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

VAC108

Vaccine Lot Number

The vaccine lot number of the vaccine administered.

Alphanumeric

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

VAC109

Vaccine Expiration Date

The expiration date of the vaccine administered.

Date

Observation (OBX segment) under an OBR-4 value of 'VACRPT'

[0..1]

File Type	application/vnd.ms-excel
Author	zvx6
Last Modified By	wsb2
File Modified	2007-10-19
File Created	2006-11-07