HL7 FHIR JP Core ImplementationGuide - Local Development build (v1.2.0-dev) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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: JP Core Document Codes CodeSystem - XML Representation

Active as of 2024-11-18

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="jp-documentcodes-cs"/>
  <url value="http://jpfhir.jp/fhir/core/CodeSystem/JP_DocumentCodes_CS"/>
  <version value="1.2.0-dev"/>
  <name value="JP_DocumentCodes_CS"/>
  <title value="JP Core Document Codes CodeSystem"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-11-18"/>
  <publisher
             value="FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI)"/>
  <contact>
    <name
          value="FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI)"/>
    <telecom>
      <system value="url"/>
      <value value="http://jpfhir.jp"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="office@hlfhir.jp"/>
    </telecom>
  </contact>
  <description value="SS MIX 標準文書コード表"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="JP"/>
      <display value="Japan"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Copyright Japan Association of Medical Informatics (JAMI)  一般社団法人日本医療情報学会 
This material contains content from LOINC (http://loinc.org). LOINC is copyright © 1995+, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc"/>
  <caseSensitive value="true"/>
  <hierarchyMeaning value="is-a"/>
  <content value="complete"/>
  <count value="122"/>
  <concept>
    <code value="34895-3"/>
    <display value="指導書"/>
    <concept>
      <code value="34107-3"/>
      <display value="在宅指導書"/>
    </concept>
    <concept>
      <code value="77430-7"/>
      <display value="免疫アレルギ指導書"/>
    </concept>
    <concept>
      <code value="78451-2"/>
      <display value="栄養指導書"/>
    </concept>
    <concept>
      <code value="78601-2"/>
      <display value="服薬指導書"/>
    </concept>
  </concept>
  <concept>
    <code value="64299-1"/>
    <display value="証明書"/>
    <concept>
      <code value="70004-7"/>
      <display value="診断書"/>
    </concept>
    <concept>
      <code value="64297-5"/>
      <display value="死亡診断書"/>
    </concept>
    <concept>
      <code value="71230-7"/>
      <display value="出生証明書"/>
    </concept>
  </concept>
  <concept>
    <code value="11488-4"/>
    <display value="意見書"/>
  </concept>
  <concept>
    <code value="64298-3"/>
    <display value="委任状"/>
  </concept>
  <concept>
    <code value="51899-3"/>
    <display value="明細書"/>
  </concept>
  <concept>
    <code value="51848-0"/>
    <display value="確認書"/>
    <concept>
      <code value="78447-0"/>
      <display value="救急部確認書"/>
    </concept>
    <concept>
      <code value="78495-9"/>
      <display value="麻酔確認書"/>
    </concept>
    <concept>
      <code value="78503-0"/>
      <display value="手術確認書"/>
    </concept>
  </concept>
  <concept>
    <code value="59284-0"/>
    <display value="同意書（説明同意書）"/>
    <concept>
      <code value="57016-8"/>
      <display value="個人情報扱い同意書"/>
    </concept>
    <concept>
      <code value="77602-1"/>
      <display value="臨床研究同意書"/>
    </concept>
    <concept>
      <code value="61358-8"/>
      <display value="手術同意書"/>
    </concept>
    <concept>
      <code value="61359-6"/>
      <display value="麻酔同意書"/>
    </concept>
    <concept>
      <code value="64300-7"/>
      <display value="臓器移植同意書"/>
    </concept>
    <concept>
      <code value="64293-4"/>
      <display value="検査同意書"/>
    </concept>
    <concept>
      <code value="89428-7"/>
      <display value="輸血同意書"/>
    </concept>
  </concept>
  <concept>
    <code value="57833-6"/>
    <display value="処方箋"/>
    <concept>
      <code value="52063-5"/>
      <display value="在宅医療機器処方"/>
    </concept>
    <concept>
      <code value="57829-4"/>
      <display value="医療機器処方"/>
    </concept>
    <concept>
      <code value="57831-0"/>
      <display value="リハビリ処方"/>
    </concept>
    <concept>
      <code value="64288-4"/>
      <display value="眼鏡処方"/>
    </concept>
  </concept>
  <concept>
    <code value="69730-0"/>
    <display value="指示書・依頼書"/>
    <concept>
      <code value="74213-0"/>
      <display value="退院時指示"/>
    </concept>
    <concept>
      <code value="78583-2"/>
      <display value="退院時処方指示"/>
    </concept>
    <concept>
      <code value="55115-0"/>
      <display value="画像検査詳細依頼"/>
    </concept>
    <concept>
      <code value="57830-2"/>
      <display value="入院依頼書"/>
    </concept>
    <concept>
      <code value="89429-5"/>
      <display value="手術依頼書"/>
    </concept>
    <concept>
      <code value="42348-3"/>
      <display value="AdvanceDirective"/>
    </concept>
  </concept>
  <concept>
    <code value="74465-6"/>
    <display value="問診票・調査書"/>
    <concept>
      <code value="89430-3"/>
      <display value="外来問診票"/>
    </concept>
  </concept>
  <concept>
    <code value="72170-4"/>
    <display value="画像"/>
  </concept>
  <concept>
    <code value="47045-0"/>
    <display value="報告書"/>
    <concept>
      <code value="28010-7"/>
      <display value="心電図報告書"/>
    </concept>
    <concept>
      <code value="12132-7"/>
      <display value="超音波検査報告書"/>
    </concept>
    <concept>
      <code value="18759-1"/>
      <display value="スパイロメトリー検査報告書"/>
    </concept>
    <concept>
      <code value="58477-1"/>
      <display value="肺機能検査報告書"/>
    </concept>
    <concept>
      <code value="76641-0"/>
      <display value="脳神経検査報告書"/>
    </concept>
    <concept>
      <code value="77199-8"/>
      <display value="PWV-CABI-ABI 報告書"/>
    </concept>
    <concept>
      <code value="18745-0"/>
      <display value="心カテ報告書"/>
    </concept>
    <concept>
      <code value="18748-4"/>
      <display value="画像検査報告書"/>
    </concept>
    <concept>
      <code value="39712-5"/>
      <display value="心筋血流 SPECT 検査報告書"/>
    </concept>
    <concept>
      <code value="39650-7"/>
      <display value="心臓核医学検査報告書"/>
    </concept>
    <concept>
      <code value="11526-1"/>
      <display value="病理検査報告書"/>
    </concept>
    <concept>
      <code value="47526-9"/>
      <display value="細胞診報告書"/>
    </concept>
    <concept>
      <code value="18743-5"/>
      <display value="剖検報告書"/>
    </concept>
    <concept>
      <code value="47048-4"/>
      <display value="IVR 報告書"/>
    </concept>
    <concept>
      <code value="59281-6"/>
      <display value="心エコー報告書"/>
    </concept>
    <concept>
      <code value="59282-4"/>
      <display value="ストレス心エコー報告書"/>
    </concept>
    <concept>
      <code value="77198-0"/>
      <display value="動脈硬化検査報告書"/>
    </concept>
    <concept>
      <code value="75218-8"/>
      <display value="研究報告書"/>
    </concept>
    <concept>
      <code value="18747-6"/>
      <display value="CT 検査報告書"/>
    </concept>
    <concept>
      <code value="18755-9"/>
      <display value="MRI 検査報告書"/>
    </concept>
    <concept>
      <code value="18751-8"/>
      <display value="上部消化管内視鏡報告書"/>
    </concept>
    <concept>
      <code value="18746-8"/>
      <display value="下部消化管内視鏡報告書"/>
    </concept>
    <concept>
      <code value="28018-0"/>
      <display value="小腸内視鏡報告書"/>
    </concept>
    <concept>
      <code value="28016-4"/>
      <display value="ERCP 報告書"/>
    </concept>
    <concept>
      <code value="18744-3"/>
      <display value="気管支鏡検査報告書"/>
    </concept>
    <concept>
      <code value="19805-1"/>
      <display value="内視鏡検査報告書"/>
    </concept>
    <concept>
      <code value="55750-4"/>
      <display value="医療安全報告書"/>
    </concept>
    <concept>
      <code value="51896-9"/>
      <display value="感染症報告書"/>
    </concept>
    <concept>
      <code value="18758-3"/>
      <display value="PET 検査報告書"/>
    </concept>
    <concept>
      <code value="17787-3"/>
      <display value="核医学検査報告書"/>
    </concept>
    <concept>
      <code value="53576-5"/>
      <display value="検診・健診報告書"/>
    </concept>
    <concept>
      <code value="11502-2"/>
      <display value="検体検査報告書"/>
    </concept>
    <concept>
      <code value="18725-2"/>
      <display value="微生物学的検査報告書"/>
    </concept>
    <concept>
      <code value="32453-3"/>
      <display value="口腔診査報告書"/>
    </concept>
  </concept>
  <concept>
    <code value="34109-9"/>
    <display value="記録"/>
    <concept>
      <code value="11492-6"/>
      <display value="既往症・理学的所見"/>
    </concept>
    <concept>
      <code value="11506-3"/>
      <display value="経過記録"/>
    </concept>
    <concept>
      <code value="28570-0"/>
      <display value="処置記録"/>
    </concept>
    <concept>
      <code value="28579-1"/>
      <display value="理学療法記録"/>
    </concept>
    <concept>
      <code value="28623-7"/>
      <display value="看護記録"/>
    </concept>
    <concept>
      <code value="34098-4"/>
      <display value="会議記録"/>
    </concept>
    <concept>
      <code value="34108-1"/>
      <display value="外来診療録"/>
    </concept>
    <concept>
      <code value="34112-3"/>
      <display value="入院診療録"/>
    </concept>
    <concept>
      <code value="34129-7"/>
      <display value="在宅記録"/>
    </concept>
    <concept>
      <code value="34750-0"/>
      <display value="麻酔記録"/>
    </concept>
    <concept>
      <code value="34751-8"/>
      <display value="術前麻酔評価"/>
    </concept>
    <concept>
      <code value="34821-9"/>
      <display value="薬局記録"/>
    </concept>
    <concept>
      <code value="34874-8"/>
      <display value="手術記録"/>
    </concept>
    <concept>
      <code value="34875-5"/>
      <display value="術後評価"/>
    </concept>
    <concept>
      <code value="34876-3"/>
      <display value="術前評価"/>
    </concept>
    <concept>
      <code value="51855-5"/>
      <display value="患者記録"/>
    </concept>
    <concept>
      <code value="68629-5"/>
      <display value="免疫アレルギ記録"/>
    </concept>
    <concept>
      <code value="68839-0"/>
      <display value="研究記録"/>
    </concept>
    <concept>
      <code value="75500-9"/>
      <display value="トリアージ記録"/>
    </concept>
    <concept>
      <code value="75492-9"/>
      <display value="リスク評価"/>
    </concept>
    <concept>
      <code value="77401-8"/>
      <display value="術前麻酔所見"/>
    </concept>
    <concept>
      <code value="18761-7"/>
      <display value="転科転棟引継"/>
    </concept>
    <concept>
      <code value="57057-2"/>
      <display value="分娩記録"/>
    </concept>
    <concept>
      <code value="29749-9"/>
      <display value="透析記録"/>
    </concept>
    <concept>
      <code value="75282-4"/>
      <display value="栄養評価記録"/>
    </concept>
    <concept>
      <code value="28656-7"/>
      <display value="MSW 記録"/>
    </concept>
    <concept>
      <code value="73709-8"/>
      <display value="処方疑義照会（記録）"/>
    </concept>
  </concept>
  <concept>
    <code value="Z0001"/>
    <display value="歴※"/>
    <definition
                value="日付（診療日）の概念と分類に関して、特定の日付がある文書は「記録」に分類され、複数の日付がある文書や日時を特定しないで作成する文書は「歴」に分類される。"/>
    <concept>
      <code value="11504-8"/>
      <display value="手術歴"/>
    </concept>
    <concept>
      <code value="74166-0"/>
      <display value="職歴"/>
    </concept>
    <concept>
      <code value="57828-6"/>
      <display value="薬歴"/>
    </concept>
    <concept>
      <code value="34133-9"/>
      <display value="現病歴"/>
    </concept>
  </concept>
  <concept>
    <code value="Z0002"/>
    <display value="要約"/>
    <concept>
      <code value="60591-5"/>
      <display value="サマリ"/>
    </concept>
    <concept>
      <code value="18842-5"/>
      <display value="退院時サマリ"/>
    </concept>
    <concept>
      <code value="34746-8"/>
      <display value="看護サマリ"/>
    </concept>
  </concept>
  <concept>
    <code value="78454-6"/>
    <display value="パス"/>
    <concept>
      <code value="78292-0"/>
      <display value="手術パス"/>
    </concept>
  </concept>
  <concept>
    <code value="56447-6"/>
    <display value="計画書"/>
    <concept>
      <code value="59772-4"/>
      <display value="入院時診療計画書"/>
    </concept>
    <concept>
      <code value="60281-3"/>
      <display value="退院時指導計画書"/>
    </concept>
  </concept>
  <concept>
    <code value="57133-1"/>
    <display value="診療情報提供書"/>
  </concept>
  <concept>
    <code value="11503-0"/>
    <display value="カルテ"/>
    <concept>
      <code value="64289-2"/>
      <display value="１号用紙"/>
    </concept>
  </concept>
  <concept>
    <code value="51897-7"/>
    <display value="届出書"/>
    <concept>
      <code value="75219-6"/>
      <display value="症例登録"/>
    </concept>
  </concept>
  <concept>
    <code value="51852-2"/>
    <display value="その他書類"/>
  </concept>
</CodeSystem>