Non-Normative Content The Normative content for these specifications may be found on the HL7, IHE, and HITSP web sites.

Preoperative Diagnosis Section

[Section: templateId 2.16.840.1.113883.]

The Preoperative Diagnosis section records the surgical diagnosis or diagnoses assigned to the patient before the surgical procedure and is the reason for the surgery. The preoperative diagnosis is, in the opinion of the surgeon, the diagnosis that will be confirmed during surgery.

  1. SHALL contain exactly one [1..1] templateId ( CONF:8097, CONF:10439 ) such that it
    1. SHALL contain exactly one [1..1] @root="2.16.840.1.113883."
  2. SHALL contain exactly one [1..1] code (CONF:15405)/@code="10219-4" Preoperative Diagnosis (CodeSystem: 2.16.840.1.113883.6.1 LOINC) (CONF:15406)
  3. SHALL contain exactly one [1..1] text (CONF:8100)
  4. SHALL contain exactly one [1..1] title (CONF:8099)
  5. SHOULD contain zero or one [0..1] entry (CONF:10096, CONF:10097)
    1. Contains exactly one [1..1] Preoperative Diagnosis (templateId: 2.16.840.1.113883.