1.3.6.1.4.1.19376.1.3.10.4.3/static-2015-11-29T170318

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Id1.3.6.1.4.1.19376.1.3.10.4.3Effective Date valid from 2015‑11‑29 17:03:18
StatusKyellow.png DraftVersion Label2.0
NameICD-O-3TypingGradingDisplay NameICD-O-3 Typing and Grading Observation
DescriptionTemplate CDA Observation (prototype, directly derived from POCD_RM000040 MIF)

Entry template for observation on ICD-O-3 Typing and Grading
ContextParent nodes of template element with id 1.3.6.1.4.1.19376.1.3.10.4.3
LabelPaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
ClassificationCDA Entry Level Template
Open/ClosedOpen (other than defined elements are allowed)
Used by / Uses
Used by 0 transactions and 0 templates, Uses 9 templates
Uses as NameVersion
1.3.6.1.4.1.19376.1.3.3.1.7ContainmentKgreen.png Laboratory Performer (2017)DYNAMIC
1.3.6.1.4.1.19376.1.8.1.4.2ContainmentKyellow.png CDA author IHEDYNAMIC
1.3.6.1.4.1.19376.1.8.1.4.6ContainmentKyellow.png CDA Informant(Header&Body) APSR2 (2.0)DYNAMIC
1.3.6.1.4.1.19376.1.8.1.4.7ContainmentKyellow.png Additional participant in an entry APSR (Body)DYNAMIC
1.3.6.1.4.1.19376.1.3.10.9.1IncludeKyellow.png X Specimen IdentifiedDYNAMIC
1.3.6.1.4.1.19376.1.3.10.9.38ContainmentKyellow.png ICD-O-3 Behavior (2.0)DYNAMIC
1.3.6.1.4.1.19376.1.3.10.9.39ContainmentKyellow.png ICD-O-3 Differentiation (2.0)DYNAMIC
1.3.6.1.4.1.19376.1.3.10.4.4ContainmentKyellow.png Assessment Scales Observation for Scoring Systems APSR2 (2.0)DYNAMIC
2.16.840.1.113883.10.12.324ContainmentKgreen.png CDA ReferenceDYNAMIC
RelationshipSpecialization: template 1.3.6.1.4.1.19376.1.8.1.4.9 (2014‑05‑14 17:09:54)
Example
example for use case #1
<observation classCode="OBS" moodCode="EVN" negationInd="false">
  <templateId root="1.3.6.1.4.1.19376.1.3.10.4.3"/>  <id root="1.3.6.1.4.1.19376.1.8.9.1" extension="A7102400008_ICDO"/>  <code code="31205-8" codeSystem="2.16.840.1.113883.6.1" displayName="Histology ICD-O-3 Cancer"/>  <statusCode code="completed"/>  <effectiveTime>
    <low value="201001041405-0500"/>  </effectiveTime>  <value xsi:type="CD" code="8500/3" codeSystem="2.16.840.1.113883.6.43.1"/>  <author>
    <!-- template 1.3.6.1.4.1.19376.1.8.1.4.2 'CDA author' (dynamic) -->
  </author>  <!-- include template 1.3.6.1.4.1.19376.1.3.10.9.1 'X Specimen Identified' (dynamic) 1..* R -->
  <specimen typeCode="SPC">
    <specimenRole classCode="SPEC">
      <id root="1.3.6.1.4.1.19376.1.8.9.1" extension="A7102400008_slide_A1_HE"/>    </specimenRole>  </specimen>  <entryRelationship typeCode="SPRT">
    <!-- template 1.3.6.1.4.1.19376.1.3.10.9.38 'ICD-O-3 Behavior' (dynamic), not used in use case #1 -->
  </entryRelationship>  <entryRelationship typeCode="SPRT">
    <!-- template 1.3.6.1.4.1.19376.1.3.10.9.39 'ICD-O-3 Differentiation' (dynamic) -->
  </entryRelationship>  <entryRelationship typeCode="COMP">
    <!-- template 1.3.6.1.4.1.19376.1.3.10.4.4 'Assessment Scales Observation for Scoring Systems APSR2' (dynamic) -->
  </entryRelationship>  <reference>
    <!-- template 2.16.840.1.113883.10.12.324 'CDA Reference' (dynamic) -->
  </reference></observation>
ItemDTCardConfDescriptionLabel
hl7:observation
0 … 1RFirst four digits of Morphology axis code. A complete code consists of 6 digits (for morphology, behavior and grading), the latter both separated by "/" after the 4th digit in morphology.

Behavior and differentiation are coded as sub-observations
PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treetree.png@classCode
cs1 … 1FOBS
Treetree.png@moodCode
cs1 … 1FEVN
Treetree.png@negationInd
bl0 … 1 
Treetree.pnghl7:templateId
II1 … 1MPaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treeblank.pngTreetree.png@root
uid1 … 1F1.3.6.1.4.1.19376.1.3.10.4.3
Treetree.pnghl7:id
II0 … *RPaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treetree.pnghl7:code
CV (extensible)1 … 1MPaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
 CONF
@code shall be "31205-8"
@codeSystem shall be "2.16.840.1.113883.6.1"
@codeSystemName shall be "LOINC"
@displayName shall be "Histology ICD-O-3 Cancer"
or
@code shall be "397005006"
@codeSystem shall be "2.16.840.1.113883.6.96"
@codeSystemName shall be "SNOMED-CT"
@displayName shall be "WHO tumor classification (observable entity)"
Treetree.pnghl7:statusCode
CS (required)1 … 1MPaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
 CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.19376.1.3.11.2 (DYNAMIC)
Alert.pngError: Cannot find value set "1.3.6.1.4.1.19376.1.3.11.2"
Treetree.pnghl7:effectiveTime
IVL_TS1 … 1MPaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treetree.pnghl7:value
CD1 … 1RFirst four digits of Morphology axis codePaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
 CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.19376.1.3.11.33 ICD-O-3 Morphology (DYNAMIC)
 Example
for use case #1: invasive breast cancer, NST, well differentiated
<value xsi:type="CD" code="8500" codeSystem="2.16.840.1.113883.6.43.1"/>
Treetree.pnghl7:performer
II0 … 1CPerforming lab

Source: PaLM TF-3: 6.3.2.20

Contains 1.3.6.1.4.1.19376.1.3.3.1.7 Laboratory Performer (DYNAMIC)		PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treeblank.png where [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.3.3.1.7']]
Treetree.pnghl7:author
II0 … 1CContains 1.3.6.1.4.1.19376.1.8.1.4.2 CDA author IHE (DYNAMIC)PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treeblank.png where [hl7:author [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.8.1.4.2']]]
Treetree.pnghl7:informant
II0 … *RInformant

Source: PaLM TF Suppl. APSR 2.0-3: 6.3.6.5

Contains 1.3.6.1.4.1.19376.1.8.1.4.6 CDA Informant(Header&Body) APSR2 (DYNAMIC)		PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treeblank.png where [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.8.1.4.6']]
Treetree.pnghl7:participant
II0 … *RAdditional participants

Source: PaLM TF Suppl. APSR 2.0-3: 6.3.6.6

Contains 1.3.6.1.4.1.19376.1.8.1.4.7 Additional participant in an entry APSR (Body) (DYNAMIC)		PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treeblank.png where [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.8.1.4.7']]
Included1 … *R from 1.3.6.1.4.1.19376.1.3.10.9.1 X Specimen Identified (DYNAMIC)
Treetree.pnghl7:specimen
1 … *RRequired in XD-LAB when more than one specimen is documented at this level. Always required in APSR.
PaLM Suppl. APSR 2.0‑3: 6.3.6.9 X Specimen identified
Treeblank.pngTreetree.png@typeCode
cs0 … 1FSPC
Treeblank.pngTreetree.pnghl7:specimenRole
1 … 1MPaLM Suppl. APSR 2.0‑3: 6.3.6.9 X Specimen identified
Treeblank.pngTreeblank.pngTreetree.png@classCode
cs0 … 1FSPEC
Treeblank.pngTreeblank.pngTreetree.pnghl7:id
II1 … 1RSpecimen ID, coming from the LISPaLM Suppl. APSR 2.0‑3: 6.3.6.9 X Specimen identified
Treetree.pnghl7:entryRelationship
1 … 1R5th digit in the morphology axis code
Contains 1.3.6.1.4.1.19376.1.3.10.9.38 ICD-O-3 Behavior (DYNAMIC)		PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treeblank.png where [@typeCode='SPRT'] [hl7:observation [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.3.10.9.38']]]
Treeblank.pngTreetree.png@typeCode
cs1 … 1FSPRT
Treetree.pnghl7:entryRelationship
0 … 1R6th digit in the morphology axis code
Contains 1.3.6.1.4.1.19376.1.3.10.9.39 ICD-O-3 Differentiation (DYNAMIC)		PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treeblank.png where [@typeCode='SPRT'] [hl7:observation [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.3.10.9.39']]]
Treeblank.pngTreetree.png@typeCode
cs1 … 1FSPRT
Treetree.pnghl7:entryRelationship
0 … 1Roptional grading by a scoring system, e.g. by means of the Elston-Ellis-Scoring-System in case of invasive breast cancer (ICD-O C50)

Contains 1.3.6.1.4.1.19376.1.3.10.4.4 Assessment Scales Observation for Scoring Systems APSR2 (DYNAMIC)		PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
Treeblank.png where [@typeCode='COMP'] [hl7:observation [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.3.10.4.4']]]
Treeblank.pngTreetree.png@typeCode
cs1 … 1FCOMP
Treetree.pnghl7:reference
0 … *RContains 2.16.840.1.113883.10.12.324 CDA Reference (DYNAMIC)PaLM Suppl. APSR 2.0‑3: 6.3.6.11 ICD‑O‑3
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