Supplement 66: Catheterization Lab Structured …dicom.nema.org/dicom/supps/Sup66_pc.doc · Web...

Digital Imaging and Communications in Medicine (DICOM)

Supplement 66: Catheterization Lab Structured Reports

DICOM Standards Committee, Working Group 1 Cardiovascular Information1300 N. 17th Street Suite 1847

Rosslyn, Virginia 22209 USA

VERSION: Public Comment Draft, December 14, 2001

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Supplement 66 - Catheterization Lab Structured Reports

Note: The templates in this document rely heavily on the Parameterized Template construct proposed in DICOM Change Proposal 274. ftp://medical.nema.org/medical/dicom/CP/cp274_04.doc The use of Baseline and Defined follow the definitions proposed in DICOM Change Proposal 275. ftp://medical.nema.org/medical/dicom/CP/cp275_04.doc

Open Issues for Public Comment

1. A. Is the definition of Observation DateTime proposed for Part 3 Section A.35.X.3.1.2 consistent with the semantics as defined in the SR Content Module? Do we need improved text in Table C.17.3-4?B. Will the use of the Synchronization Module to define the synchronization of Observation DateTime affect existing SR implementations?

2. A. Is the proposed redefinition of the Current Requested Procedure Evidence Sequence in the SR Document General Module (Part 3 Table C.17-2 and Section C.17.2.3) appropriate for a procedure log and measurement type reports, as well as clinical reports? B. Is this attribute redefinition compatible with the current definition as used for existing SR implementations?

3. Is the use of a Containerless item structure in the Procedure Log sufficient for expected uses? We propose forbidding Containers below the top-level Document Container, since this is supposed to be a time-based recording of atomic events, not a generic structured report. Containers with a rich structure may obfuscate the association of a specific time with a specific event.

4. Are the assigned Baseline / Defined classifications of invoked TIDs and CIDs appropriate?

5. Are the sets of terms in the Context Groups sufficient for initial real-world use?

6. Should the Procedure Log SOP Class IOD allow the use of alternate templates for non-cath lab logs, or only extensions to TID Tx3001 as a Defined Template?

7. Are the post-coordinated terms from CIDs 7452 Organizational Roles and 7453 Performing Roles (invoked through TID 1003 Observer Context) sufficient and appropriate for the cath lab Procedure Log? Should we have pre-coordinated terms for common cath lab use?

8. A. To what extent should measurements be reported in the log, rather than solely in a referenced hemo or QCA/QVA report? Does the clinical use case for the log require the key measurement values to be repeated, or is that just a hangover concept from pre-electronic interchange workflow? B. If repeated, how much of the structure of the measurement report (which carries an implicit acquisition context) be replicated in the log? Will that require the use of a container substructure within the log (heretofore unnecessary)?

9. Similarly, to what extent should image acquisition parameters be reported in log?

10. Is the proposed Event Logging Service Class, used to send image acquisition parameters (or other events from disparate systems) to the logging system, appropriate? Alternatives considered include using a mini-Procedure Log, but we would need to ensure that that use case is well defined somewhere (IHE?); that would also raise the issue of whether those Log objects need to be recorded in the PPS of the originating system. Alternatively, we might be able to use PPS, expanded to include procedure-log type data beyond just the instance UIDs; that would raise the issue of impact to existing implementations of PPS, and the issue of the logging system needing to be an MPPS server.

11. What should be the Modality of the Procedure log, and of the measurement reports? If not SR, how should the Series level attributes be defined (since the SR Series Module requires an enumerated value of "SR" for Modality)?

12. Should assessments on a small numeric range scale, i.e. approximately 5 values (e.g., TIMI Flow, which is a scale of 0-3 ) use a CODE with specific code values (see TID Tx3806 row 12 and CID Cx38013), or use a NUM with a units of measurement of "{scale 0:n}" or "{scale 1:m}"?

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13. The various hemo pressure measurement groups (see text and figure in proposed PS3.3 Annex N) consist of a Container labeled with the phase of the procedure and with an acquisition context of the patient state, that includes subsidiary Containers labeled with the general class of measurements and with an acquisition context of the specific anatomic site, that in turn contain (e.g.) systolic, diastolic, mean, and other measurements. This implies that the name of each measurement is effectively post-coordinated from the measurement name, the container names, and the acquisition context of the anatomic location. Is this method of post-coordination appropriate?

14. Should the lowest level hemo measurements use pre-coordinated measurement names when available? If so, how should they be defined in the Templates/Context Groups when they would be dependent on the specific context of the hierarchical tree?

15. Defining unique coded terms for all derived measurements may cause a combinatorial explosion of terms. This can be managed by post-coordinating the "molecular" measurements from "atomic" components. For example:A. Should the derived hemo measurements use post-coordinated measurement names (e.g., "Area" /has concept modifier "Anatomic Structure" "Mitral Valve", vs. a single term "Mitral Valve Area")? B. Should the derived indexed or normalized measurements use post-coordinated names (e.g., "Index" /has concept modifier "Numerator" "Pulmonary Flow" | has concept modifier "Denominator" "Body Surface Area", vs. a single term "Pulmonary Flow Index")?C. Alternatively, should derived indexed measurements use the numerator as the main concept name with only a single concept modifier (e.g., "Pulmonary Vascular Resistance" /has concept modifier "Index" "Body Surface Area")?

16. Are the value types and realtionships used appropriate? E.g., should we change hemo measurement group from Container [acq ctxt Anatomy]/Contains-measurements to Code [value Anatomy]/Has Properties-measurements?

17. The various pressure measurement groups need to identify the waveform used for the measurements; the same waveform segment/channel is used for all measurements in the group. This document uses an INFERRED FROM relationship from the CONTAINER to a TCOORD to provide a single waveform reference for all measurements within the container. Is this appropriate? I.e., should a CONTAINER be able to have an INFERRED FROM relationship to a waveform?

18. A. Is it appropriate for DICOM to codify the various equations for derived hemodynamic measurements? Should this be left to vendor-specific codes?B. Is it appropriate to specify the pairing of derived hemodynamic measurements with specific equations, as structured in TID Tx3560?

19. What is an appropriate structure of relationships between content items for the encoding of derived measurements (TID Tx0300)? This Supplement in Tx0300 proposes a NUM that may be INFERRED FROM other NUMs, or may be INFERRED FROM an equation/table that HAS PROPERTIES of the parameters of the equation/table.

20. Is Normality and Significance TID Tx0200 sufficiently general and robust to be more widely used in non-cath numeric measurements?

21. A. Is it appropriate to have one SOP Class for Cath Lab Measurements, used for Hemo, and in the future QCA/QVA and possibly IVUS, with the specific type distinguished by Report Title? Should there be separate SOP Classes, one per Measurement Report Type? Or should these mesaurements be carried in the general Enhanced SR SOP Class? This proposal specifies a SOP Class for Cath Lab Measurements since they have generally the same domain of interoperation, and a receiver of any one of them should probably be required to be able to receive all of them; moreover, the domain of interoperability for these measurements is quite distinct from that of general SR report objects of the Enhanced SR SOP Class. B. Is it appropriate to have a separate SOP Class for ECG Reports, per the reasoning in the section "Scope and Field of Application"?C. Should the Clinical Cath Results be encoded under the Enhanced SR SOP Class?

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22. A. Should the ECG Report Template be titled for ECG reports (in general), only resting ECGs (of any lead configuration), or only 12-lead resting ECGs. B. If the more general cases are appropriate, are there changes required in the Templates or Context Groups?

23. Is there a place within the DICOM Standard to document that the Clinical Cath Results should be encoded using the Enhanced SR SOP Class? Is this necessary?

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Table of Contents

Open Issues for Public Comment..............................................................................................................2Table of Contents........................................................................................................................................ 5Foreword.................................................................................................................................................... 13Scope and Field of Application................................................................................................................13Procedure Log............................................................................................................................................. 13

Procedural Event Logging....................................................................................................................14

Hemodynamics Report................................................................................................................................ 14

Electrocardiography Report......................................................................................................................... 14

Cardiac Cath Results.................................................................................................................................. 14

Conventions Used in this Document.......................................................................................................15Part 3 Addendum...................................................................................................................................... 16

A.35.x Procedure Log Information Object Definition............................................................................16

A.35.x.1 Procedure Log Information Object Description...................................................................16

A.35.x.2 Procedure Log IOD Entity-Relationship Model...................................................................16

A.35.x.3 Procedure Log IOD Module Table......................................................................................16

A.35.x.3.1 Procedure Log IOD Content Constraints..................................................................16

A.35.y Cath Lab Measurements Report Information Object Definition.................................................18

A.35.y.1 Cath Lab Measurements Report Information Object Description.......................................18

A.35.y.2 Cath Lab Measurements Report IOD Entity-Relationship Model........................................18

A.35.y.3 Cath Lab Measurements Report IOD Module Table..........................................................18

A.35.y.3.1 Cath Lab Measurements Report IOD Content Constraints.......................................18

A.35.z ECG Report Information Object Definition................................................................................20

A.35.z.1 ECG Report Information Object Description.......................................................................20

A.35.z.2 ECG Report IOD Entity-Relationship Model.......................................................................20

A.35.z.3 ECG Report IOD Module Table..........................................................................................20

A.35.z.3.1 ECG Report IOD Content Constraints......................................................................20

C.7.4.2.1 Synchronization Attribute Descriptions........................................................................22

C.17.2 SR Document General Module.................................................................................................22

C.17.2.3 Current Requested Procedure Evidence Sequence and Pertinent Other Evidence Sequence......................................................................................................................................... 22

C.17.3 SR Document Content Module.................................................................................................23

Annex N Measurement Report Structures (Informative).......................................................................24N.1 Cath Lab Measurements IOD............................................................................................................24

N.1.1 Hemodynamics Report..........................................................................................................24

Part 4 Addendum...................................................................................................................................... 26B.5 Standard SOP Classes.........................................................................................................................26

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B.5.1.5 Structured Reporting Storage SOP Classes......................................................................26

I.4 Media Standard Storage SOP Classes..................................................................................................26

I.4.1.2 Structured Reporting Storage SOP Classes..........................................................................26

Annex X APPLICATION EVENT LOGGING SERVICE CLASS (Normative)..........................................27X.1 Overview............................................................................................................................................ 27

X.1.1 Scope.................................................................................................................................... 27

X.1.2 Service Definition................................................................................................................... 27

X.2 Procedural Event Logging SOP Class Definition...............................................................................27

X.2.1 DIMSE Service Group...........................................................................................................27

X.2.2 Operation............................................................................................................................... 28

X.2.2.1 Action Information.....................................................................................................28

X.2.2.1.1 Synchronization Frame of Reference UID................................................................28

X.2.2.1.2 Constraints on Attributes of the SR Document Content Module...............................28

X.2.2.2 Service Class User Behavior....................................................................................28

X.2.2.3 Service Class Provider Behavior...............................................................................29

X.2.2.4 Status Codes............................................................................................................29

X.2.3 Procedural Event Logging SOP Class UID............................................................................29

X.2.4 Procedural Event Logging Instance Identification..................................................................29

X.2.5 Conformance Requirements..................................................................................................29

X.2.5.1 SCU Conformance....................................................................................................29

X.2.5.2 SCP Conformance....................................................................................................30

Part 6 Addendum...................................................................................................................................... 31Annex A (Normative): Registry of DICOM Unique Identifiers (UID).............................................................31

Part 16 Addendum.................................................................................................................................... 328 Coding Schemes...................................................................................................................................... 32

TID Tx0200 Normality and Significance.....................................................................................................33

TID Tx0300 Measurement.........................................................................................................................33

Tx0300 Content Item Descriptions...................................................................................................34

TID Tx0320 Image or Spatial Coordinates.................................................................................................34

TID Tx0321 Waveform or Temporal Coordinates.......................................................................................35

PROCEDURE LOG IOD TEMPLATES.......................................................................................................36

TID Tx3001 Procedure Log..........................................................................................................36


TID Tx3010 Log Entry Qualifiers..................................................................................................37

TID Tx3100 Procedure Action......................................................................................................38


TID Tx3101 Image Acquisition......................................................................................................39

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TID Tx3102 Waveform Acquisition...............................................................................................40

TID Tx3103 Referenced Object....................................................................................................40

TID Tx3104 Consumables............................................................................................................41

TID Tx3105 Lesion Identification..................................................................................................41


TID Tx3106 Drugs/Contrast Administered....................................................................................42

TID Tx3107 Device Used..............................................................................................................43

TID Tx3108 Intervention...............................................................................................................43

TID Tx3109 Measurements..........................................................................................................44

TID Tx3110 Impressions or Findings............................................................................................45

TID Tx3111 Percutaneous Entry..................................................................................................45

TID Tx3112 Specimen Obtained..................................................................................................46

TID Tx3113 Patient Support.........................................................................................................46

CATH LAB MEASUREMENTS REPORT IOD TEMPLATES......................................................................48

TID Tx3500 Hemodynamics Report.............................................................................................49

TID Tx3501 Hemodynamics Measurement Group.......................................................................49


TID Tx3504 Arterial Pressure Measurement................................................................................50

TID Tx3505 Atrial Pressure Measurement....................................................................................51

TID Tx3506 Venous Pressure Measurement................................................................................52

TID Tx3507 Ventricular Pressure Measurement...........................................................................52

TID Tx3508 Gradient Measurement.............................................................................................53

TID Tx3510 Vital Signs.................................................................................................................54

TID Tx3515 Cardiac Output Measurement...................................................................................55

TID Tx3516 Blood Lab Measurements.........................................................................................56

TID Tx3520 Clinical Context.........................................................................................................56

TID Tx3530 Hemodynamic Acquisition Context...........................................................................57

TID Tx3550 Pressure Waveform Measurements..........................................................................58

TID Tx3560 Derived Hemodynamic Measurements.....................................................................59

TID Tx3601 Lab Procedure Context.............................................................................................64

TID Tx3602 Patient Characteristics..............................................................................................65

TID Tx3603 Procedure Environmental Characteristics.................................................................65

ECG REPORT IOD TEMPLATES...............................................................................................................66

TID Tx3700 ECG Report..............................................................................................................66

TID Tx3701 Clinical Context, ECG...............................................................................................66

TID Tx3702 Prior ECG Exam.......................................................................................................67

TID Tx3708 ECG Waveform Information......................................................................................67

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TID Tx3713 ECG Global Measurements......................................................................................68

TID Tx3714 ECG Lead Measurements........................................................................................69

TID Tx3715 Qualitative Analysis, ECG.........................................................................................69

TID Tx3718 ECG Interpretive Statement......................................................................................70

TID Tx3719 Summary, ECG.........................................................................................................70

CATH LAB CLINICAL RESULTS IOD TEMPLATES...................................................................................71

TID Tx3800 Cardiac Catheterization Results Root.......................................................................71

TID Tx3802 Patient History, Cath.................................................................................................72

TID Tx3803 Patient Presentation, Cath........................................................................................73

TID Tx3806 Cath Procedure.........................................................................................................74

TID Tx3807 Percutaneous Coronary Intervention Procedure.......................................................75

TID Tx3808 Lesion Information....................................................................................................76

TID Tx3809 Other Interventional Procedures...............................................................................77

TID Tx3810 Cardiac Catheterization Findings..............................................................................77

TID Tx3812 Hemodynamic Findings............................................................................................77

TID Tx3814 Left Ventriculography................................................................................................78

TID Tx3815 Right Ventriculography..............................................................................................79

TID Tx3816 Coronary Arteriography.............................................................................................80

TID Tx3818 Aortogram................................................................................................................. 81

TID Tx3820 Complications, Cath..................................................................................................81

TID Tx3824 Summary, Cath.........................................................................................................82

TID Tx3828 Discharge Summary, Cath........................................................................................82

Annex B DCMR Context Groups (Normative)........................................................................................83Context Group Cx0000 – Procedure Log Titles...........................................................................................83

Context Group Cx0001 – Types of Log Notes.............................................................................................83

Context Group Cx0002 – Patient Events.....................................................................................................83

Context Group Cx0002a – Percutaneous Entry..........................................................................................84

Context Group Cx0002b – Laterality...........................................................................................................84

Context Group Cx0004 - Staff Actions........................................................................................................84

Context Group Cx0004a – Equipment Events.............................................................................................85

Context Group Cx0005 – Procedure Action Values....................................................................................85

Context Group Cx0006 – Non-Coronary Transcatheter Interventions.........................................................86

Context Group Cx0007 – Purpose of Reference to Object..........................................................................86

Context Group Cx0008 – Actions with Consumables..................................................................................86

Context Group Cx0009 – Administration of Drugs/Contrast........................................................................86

Context Group Cx0010 – Numeric Parameters of Drugs/Contrast..............................................................87

Context Group Cx0011 – Intracoronary Devices.........................................................................................87

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Context Group Cx0011a – Interventional Devices.......................................................................................88

Context Group Cx0012 – Intervention Actions and Status..........................................................................88

Context Group Cx0013 – Complications.....................................................................................................88

Context Group Cx0014 – Procedure Urgency.............................................................................................89

Context Group Cx0015 – Cardiac Rhythms................................................................................................89

Context Group Cx0018 – Lesion Risk.........................................................................................................91

Context Group Cx0019 – Findings Titles.....................................................................................................91

Context Group Cx0021 – Procedure Action................................................................................................91

Context Group Cx0022 – Device Use Actions.............................................................................................91

Context Group Cx0023 – Device Characteristics........................................................................................92

Context Group Cx0025 – Intervention Parameters......................................................................................92

Context Group Cx0220 - Level of Significance............................................................................................92

Context Group Cx0221 - Measurement Range Concepts...........................................................................92

Context Group Cx0222 – Normality Codes................................................................................................93

Context Group Cx0223 – Normal-Abnormal...............................................................................................93

Context Group Cx0225 – Measurement Uncertainty Concepts..................................................................93

Context Group Cx0230 – Yes-No...............................................................................................................94

Context Group Cx0500 – Pressure Units....................................................................................................94

Context Group Cx0502 – Hemodynamic Resistance Units.........................................................................94

Context Group Cx0503 – Indexed Hemodynamic Resistance Units...........................................................94

Context Group Cx0510 – Catheter Size Units.............................................................................................94

Context Group Cx0520 – Blood Source Type.............................................................................................95

Context Group Cx0524 – Blood Gas Pressures..........................................................................................95

Context Group Cx0525 – Blood Gas Content..............................................................................................95

Context Group Cx0526 – Blood Gas Saturation..........................................................................................96

Context Group Cx0527 – Blood Base Excess.............................................................................................96

Context Group Cx0528 – Blood pH.............................................................................................................96

Context Group Cx0529 – Arterial / Venous Content....................................................................................96

Context Group Cx0530 – Oxygen Administration Actions...........................................................................97

Context Group Cx0531 – Oxygen Administration........................................................................................97

Context Group Cx0550 – Circulatory Support Actions................................................................................97

Context Group Cx0551 – Ventilation Actions..............................................................................................97

Context Group Cx0552 – Pacing Actions....................................................................................................97

Context Group Cx0553 – Circulatory Support.............................................................................................98

Context Group Cx0554 – Ventilation...........................................................................................................98

Context Group Cx0555 – Pacing................................................................................................................. 98

Context Group Cx0560 – Blood Pressure Measurement Techniques.........................................................98

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Context Group Cx0600 – Relative time.......................................................................................................98

Context Group Cx0602 – Hemodynamic Patient State...............................................................................99

Context Group Cx0606 – Arterial source locations......................................................................................99

Context Group Cx0607 – Venous Source locations..................................................................................101

Context Group Cx0608 – Atrial source locations.......................................................................................102

Context Group Cx0609 – Ventricle source locations.................................................................................102

Context Group Cx0610 – Gradient Source Locations...............................................................................103

Context Group Cx0611 – Pressure Measurements...................................................................................103

Context Group Cx0612 – Blood Velocity Measurements...........................................................................104

Context Group Cx0613 – Hemodynamic Time Measurements.................................................................104

Context Group Cx0614 – Valve Areas......................................................................................................104

Context Group Cx0615 – Valve Area Indexes...........................................................................................104

Context Group Cx0616 – Hemodynamic Period Measurements...............................................................105

Context Group Cx0617 – Valve Flows......................................................................................................105

Context Group Cx0619 – Indexed Hemodynamic Resistence Measurements..........................................105

Context Group Cx0627 – Measurement Type...........................................................................................105

Context Group Cx0628 – Cardiac Output Methods...................................................................................106

Context Group Cx0629 – Procedure Type................................................................................................106

Context Group Cx0630 - Cardiovascular Anatomical locations.................................................................106

Context Group Cx0651 - Hemodynamic Measurement phase..................................................................106

Context Group Cx0702 - Fractional Flow Reserve....................................................................................107

Context Group Cx0703 - Body Surface Area Equations............................................................................107

Context Group Cx0704 - Oxygen Consumption Equations and Tables.....................................................107

Context Group Cx0706 - P50 Equations...................................................................................................108

Context Group Cx0707 - Framingham Scores..........................................................................................108

Context Group Cx0708 - Framingham Tables...........................................................................................108

Context Group Cx0900 - ECG Report Titles..............................................................................................109

Context Group Cx0901 - Reason for Exam...............................................................................................109

Context Group Cx0902 - Pacemakers.......................................................................................................109

Context Group Cx0903 Diagnosis..........................................................................................................110

Context Group Cx0905 - Other Filters.......................................................................................................110

Context Group Cx0906 - Lead Measurement Technique..........................................................................111

Context Group Cx0907 - Summary Codes ECG.......................................................................................111

Context Group Cx0908 - QT Correction Algorithms..................................................................................111

Context Group Cx0909 - ECG Morphology Descriptions...........................................................................112

Context Group Cx0910 - ECG Lead Noise Descriptions...........................................................................112

Context Group Cx0911 - ECG Lead Noise Modifiers................................................................................113

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Context Group Cx0912 - Probability..........................................................................................................113

Context Group Cx0913 - Modifiers............................................................................................................113

Context Group Cx0914 - Trend.................................................................................................................115

Context Group Cx0915 - Conjunctive Terms.............................................................................................115

Context Group Cx0916 ECG Interpretive Statements............................................................................116

Context Group Cx0917 - Electrophysiology Waveform Durations.............................................................126

Context Group Cx0918 Electrophysiology Waveform Voltages.............................................................126

Context Group Cx1002 Cath Diagnosis.................................................................................................127

Context Group Cx1003 Cardiac Valves and Tracts...............................................................................128

Context Group Cx1004 Wall Motion.......................................................................................................129

Context Group Cx1005 Chamber Size...................................................................................................129

Context Group Cx1006 Overall Contractility..........................................................................................129

Context Group Cx1007 VSD Description...............................................................................................130

Context Group Cx1008 Valve Stenosis and Regurgitation....................................................................130

Context Group Cx1009 Aortic Root Description.....................................................................................130

Context Group Cx1010 Coronary Dominance.......................................................................................131

Context Group Cx1011 Valvular Abnormalities......................................................................................131

Context Group Cx1012 Coronary Lesion Descriptors............................................................................131

Context Group Cx38013 TIMI Flow Characteristics...............................................................................132

Context Group Cx1014 Thrombus.........................................................................................................132

Context Group Cx1015 Morphology.......................................................................................................133

Context Group Cx1016 Severity............................................................................................................133

Context Group Cx1017 Ventriculography Wall Segments.....................................................................133

Context Group Cx1019 Canadian Clinical Classification.......................................................................134

Context Group Cx1020 Cardiac History Dates..........................................................................................134

Context Group Cx1021 Cath Patient History / Risk Factors...................................................................134

Context Group Cx1022 Diabetic Therapy..............................................................................................135

Context Group Cx1023 MI Types...........................................................................................................135

Context Group Cx1024 Smoking History...............................................................................................135

Context Group Cx1027 Indications for Catheterization..........................................................................136

Context Group Cx1028 Cath Findings...................................................................................................136

Context Group Cx1029 Admission Status..............................................................................................137

Context Group Cx1030 Insurance Payor...............................................................................................138

Context Group Cx1031 CAB Status This Admission..............................................................................138

Context Group Cx1032 Discharge Status..............................................................................................138

Context Group Cx1033 Primary Cause of Death...................................................................................138

Context Group Cx1034 Location of Death.............................................................................................139

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Context Group Cx1035 Acute Coronary Syndrome Time Period...........................................................139

Context Group Cx1036 NYHA Classification.........................................................................................139

Context Group Cx1037 Non-Invasive Test - Ischemia...........................................................................140

Context Group Cx1038 Pre-Cath Angina Type......................................................................................140

Context Group Cx1039 Cath Procedure Type.......................................................................................140

Context Group Cx1040 Thrombolytic Administration.............................................................................141

Context Group Cx1041 Medication Administration, Lab Visit.................................................................141

Context Group Cx1042 Medication Administration, PCI........................................................................141

Context Group Cx1043 Clopidogrel/Ticlopidine Administration.............................................................142

Context Group Cx1044 EF Testing Method...........................................................................................142

Context Group Cx1045 EF Testing Calculation Method........................................................................142

Context Group Cx1046 Percutaneous Entry Site...................................................................................143

Context Group Cx1047 Closure Device.................................................................................................143

Context Group Cx1049 PCI Procedure Result.......................................................................................143

Context Group Cx1050 Previously Dilated Lesion.................................................................................144

Context Group Cx1051 Location in Graft...............................................................................................144

Context Group Cx1053 Coronary Intervention Devices.........................................................................144

Context Group Cx1054 Vascular Complications....................................................................................145

Context Group Cx1055 Cath Complications..........................................................................................145

Context Group Cx1058 Catheterization Hemodynamic Support............................................................145

Annex D DICOM Controlled Terminology Definitions (Normative).....................................................147

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Foreword

This Supplement to the DICOM Standard introduces IODs, Templates, and SOP Classes for the following classes of cath lab structured reports:

Procedure Log

Hemodynamic Measurements Report

Electrocardiography Report

Cath Lab Clinical Report

Additionally, it introduces a new Service Class for Application Event Logging, and a specific SOP Class for Procedural Event Logging. This SOP Class would be used for multiple independent devices to cooperatively participate in the construction of a Procedure Log.

This Supplement was developed by Working Group 1 (Cardiovascular Information) of the DICOM Standards Committee, with significant input from the European Society of Cardiology and the American College of Cardiology.

Scope and Field of Application

The information objects and services defined in this Supplement are part of the effort to fully digitize and integrate data flow within and beyond the cardiac catheterization laboratory. The cath procedure is an image-guided interventional procedure, involving the acquisition and analysis of images and waveforms, the administration of drugs and therapies, and consultation and interaction between many medical disciplines. The cath lab is a multi-modality mix of many types of equipment from many different manufacturers.

Integration of this mix involves various structured data interchanges in the cath lab. This structured data includes procedure logs, quantitative and qualitative measurements, and clinical reports, and requires several specializations of the DICOM Structured Report capabilities.

Procedure LogOne of the critical items in coordinating the information products of the cath lab is a time-stamped record of all events that occur during a procedure which may last several hours. This is essential to documenting the acquisition context for images, waveforms, and measurements. In the cath lab, acquisition context is a complex set of interrelated components, including various aspects of patient medical state, current and prior therapies, and diagnostic task. Because the particular aspects of acquisition context that may be relevant for any specific data acquisition cannot be predetermined or known at the time of acquisition, it is crucial to have a comprehensive record of all procedural events for retrospective clinical analysis.

The procedure logs also may be mined for administrative measures of the efficacy or efficiency of particular procedures or devices.

The Procedure Log defined in this Supplement, while initially developed for the cardiac catheterization lab, is sufficiently generic that it may be adapted by extension of the templates and context groups for use in other image-guided interventional procedures.

The fundamental log entry is a time-stamped free text comment (e.g., under the concept category of General Notes). This is supplemented by log entries of structured data (coded and numeric values), which are critical for effective automatic data extraction. Note that many types of log entries may be represented either as free text or as structured data; which form is used will be dependent on the capabilities of the logging system to record structured data, and on the desire to be able to apply automatic extraction and analysis (data mining) tools to the Procedure Log objects. The template defined for the Procedure Log defines a quite comprehensive set of structured data constructs to facilitate advanced applications, but it does not cover all possible desires for coded data logging.

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Procedural Event LoggingIn the multi-modality catheterization laboratory, there may be as many as ten devices (or more) which will be generating information that could be included in the procedure log. To facilitate the distributed contribution of item to the log, this Supplement defines a Procedural Event Logging SOP Class. The Service Class Provider for this SOP Class would be the device constructing the Procedure Log SOP Instance. The Service Class Users would create mini-procedure logs (typically with a single log entry), which are passed by this SOP Class to the SCP. Even "dumb" devices without knowledge of the patient or study identification can act as SCUs if they can provide enough context information (e.g., device location) for the SCP to match their submissions to the proper procedure log.

Hemodynamics ReportThe purpose of the Hemodynamics Report is to detail the scientific findings obtained from waveforms and other measurements taken during a catheterization procedure, together with data derived from these measurements. It does not contain any clinical interpretation, which is more appropriate to other DICOM SR documents such as the cath lab clinical results.

The report contains one or more measurement containers, each corresponding to a phase of the cath procedure. Within each container may be one or more sub-containers, each associated with a single measurement set. A full description is provided in a new Annex N to Part 3.

The Hemodynamics Waveform SOP Class is a critical adjunct to the Hemodynamics Report. It provides the means to transfer the raw data from which the hemodynamics measurements were made, so that a receiver of the Hemodynamics Report can, if desired, review the data and perhaps recalculate some of the measurement values.

This Supplement defines a Cath Lab Measurements Report SOP Class for all quantitative measurement objects created in the cath lab, including Hemodynamics and, in the future, Quantitative Arteriography, Quantitative Ventriculography, Intravascular Ultrasound Measurements, and other reports with a similar domain of interoperation. While use of a more generic SOP Class, such as the Enhanced SR SOP Class, would be possible, the separate workflow pattern of object interchange for the cath lab warrants a SOP Class constrained to this domain.

Electrocardiography ReportThe Electrocardiography Report provides the findings associated with an ECG acquisition, including standard resting 12-lead ECGs, stress ECGs, pediatric 15-lead ECGs, and others. Findings may also include serial comparison with one or more prior ECGs.

The Electrocardiography Report may be generated by the ECG device, an ECG management system, or a physician. In the machine-generated reports, the Verification Flag in the report header will indicate "unverified".

The Electrocardiography Report and the Electrocardiography Waveform SOP Classes are together essential for effective clinical use of ECGs under DICOM. Both the SCP-ECG standard and proprietary ECG interchange formats include aspects of both waveform and report data. The DICOM standard formats provide for a robust and extensible ECG interchange environment.

This Supplement defines a separate SOP Class for Electrocardiography Reports. This will facilitate conformance to DICOM for the well-established class of ECG management systems, which handle both ECG waveforms and ECG reports. The separate SOP Class also supports the quite different domain of interoperation for ECGs, whose use in the cath lab is just one part of a very broad use model.

Cardiac Cath ResultsThe Cardiac Cath Results provides the overall clinical results of the catheterization procedure. This report, or a subset thereof, may be used for interchange between database applications, or may distributed to the referring physician, to the attending physician, to a surgeon, or to a consulting physician. This broad use

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argues for its role as a general clinical report, and hence this Supplement presumes that the Cardiac Cath Results will be encoded using the Enhanced SR SOP Class.

In using this general SOP Class, the Cardiac Cath Results template defined herein is simply another baseline report template that may be replaced; it is therefore in no sense binding for exchange of this type of report. It is solely an example of a possible encoding of Cardiac Cath Results. One salient feature of this template is that it provides a large set of coded concepts that may be useful in automatically extracting data for submission to regional or national outcomes registries, such as the ACC NCDR™.

Conventions Used in this Document

TxNNNN, CxNNNN, and VxNNNN are the temporary identifiers for (respectively) Templates, Context Groups, and Coded Values defined in this Supplement. These identifiers will be replaced when Final Text of the Supplement is prepared following a successful Letter Ballot.

Similarly, SOP Class UIDs have temporary identifiers that will be replaced in Final Text.

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Part 3 Addendum

Add the following to PS3.3 Annex A for Procedure Log:

A.35.x Procedure Log Information Object DefinitionA.35.x.1 Procedure Log Information Object DescriptionThe Procedure Log IOD is intended for the representation of reports or logs of time-stamped events occurring during an extended diagnostic or interventional procedure, typical of the cardiac catheterization lab.

A.35.x.2 Procedure Log IOD Entity-Relationship ModelThe E-R Model in Section A.1.2 of this Part applies to the Procedure Log IOD. Table A.35.x-1 specifies the Modules of the Procedure Log IOD.

Note: Unlike other SR IODs, the Frame of Reference IE is critical to the synchronized time stamping of events in the Procedure Log IOD and to multi-modality coordination.

A.35.x.3 Procedure Log IOD Module Table

Table A.35.x-1PROCEDURE LOG IOD MODULES

IE Module Reference UsagePatient Patient C.7.1.1 M

Study General Study C.7.2.1 M

Series SR Document Series C.17.1 M

Frame of Reference

Synchronization C.7.4.2 M

Equipment General Equipment C.7.5.1 M

Document SR Document General C.17.2 M

SR Document Content C.17.3 M

SOP Common C.12.1 M

A.35.x.3.1 Procedure Log IOD Content ConstraintsA.35.X.3.1.1 Template The document shall be constructed from DTID Tx3001 "Procedure Log" (defined in PS3.16) invoked at the root node.

Note: This template defines a container (the root) with subsidiary content items, each of which represents a single procedure log entry. There is a defined recording observer (the person responsible for recording the log, generally a technician or nurse). The log entries follow a canonical model of a coded log entry type (the concept name of the content item), the value associated with the concept name as one of the SR Value Types, and optionally a subsidiary free text comment and/or an identifier of the author or device source of the log entry (which may be other than the recording observer).

A.35.X.3.1.2 Observation DateTimeEach Item in the Content Sequence (0040,A730) of the SR Document Content Module that is a target of a "CONTAINS" relationship from the root node, i.e., the first level Log Content Items, shall include the Observation DateTime (0040,A032) as a Type 1 attribute. This attribute shall represent the datetime at which the event recorded in the Content Item occurred, not the time at which the Item was recorded.

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The first level Procedure Log Content Items in the Content Sequence shall be strictly ordered by increasing Observation DateTime values.

A.35.x.3.1.3 Value TypeValue Type (0040,A040) in the Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-1 for Value Type definitions):

CODECONTAINERCOMPOSITEDATETIMEIMAGENUMPNAMETEXTUIDREFWAVEFORM

A.35.x.3.1.4 Relationship ConstraintsRelationships between Content Items in the content of this IOD shall be conveyed in the by-value mode. See Table C.17.3-2 for Relationship Type definitions.

Notes: 1. Relationships by-reference are forbidden. Therefore, Referenced Content Item Identifier (0040,DB73) is not present in any of the Content Items within the SR Document Content Module.2. CONTAINERs are not permitted as a target of any relationship.

Table A.35.x-2 specifies the relationship constraints of this IOD.

Table A.35.x-2RELATIONSHIP CONTENT CONSTRAINTS FOR PROCEDURE LOG IOD

Source Value Type Relationship Type (Enumerated Values)

Target Value Type

CONTAINER CONTAINS TEXT, CODE, NUM, DATETIME, UIDREF, PNAME, COMPOSITE, IMAGE, WAVEFORM

any type HAS OBS CONTEXT TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME

CONTAINER, IMAGE, WAVEFORM, COMPOSITE

HAS ACQ CONTEXT TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME

any type HAS CONCEPT MOD TEXT, CODE

any type HAS PROPERTIES TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME

TEXT, CODE INFERRED FROM IMAGE, WAVEFORM, COMPOSITE

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Add the following to PS3.3 Annex A for Cath Lab Measurements:

A.35.y Cath Lab Measurements Report Information Object DefinitionA.35.y.1 Cath Lab Measurements Report Information Object DescriptionThe Cath Lab Measurements Report IOD is intended for the representation of measurements based on images or waveforms acquired during a cardiac catheterization procedure, including hemodynamics, and coronary and ventricular analyses.

A.35.y.2 Cath Lab Measurements Report IOD Entity-Relationship ModelThe E-R Model in Section A.1.2 of this Part applies to the Cath Lab Measurements Report IOD. Table A.35.y-1 specifies the Modules of the Cath Lab Measurements IOD.

A.35.y.3 Cath Lab Measurements Report IOD Module Table

Table A.35.y-1Cath Lab Measurements Report IOD MODULES




Frame of Reference

Synchronization C.7.4.2 M




SOP Common C.12.1 M

A.35.y.3.1 Cath Lab Measurements Report IOD Content ConstraintsA.35.y.3.1.1 Template The Cath Lab Measurements Report may be constructed from any of the following Baseline Templates (defined in PS3.16) invoked at the root node:

TID Tx3500 "Hemodynamics Report"

Notes 1. This list of Baseline Templates may be extended.2. See Annex N for an informative description of these templates.

A.35.y.3.1.2 Observation DateTimeEach Item in the Content Sequence (0040,A730) of the SR Document Content Module which is a direct measurement shall include the Observation DateTime (0040,A032) as a Type 1 attribute. This attribute shall represent the datetime at which the measurement recorded in the Content Item was acquired, not the time at which Item was recorded.

A.35.y.3.1.3 Value TypeValue Type (0040,A040) in the Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-1 for Value Type definitions):

CODE

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CONTAINERCOMPOSITEDATETIMEIMAGENUMPNAMETEXTUIDREFWAVEFORM

A.35.y.3.1.4 Relationship ConstraintsRelationships between Content Items in the content of this IOD may be conveyed in the by-value or the by-reference mode. See Table C.17.3-2 for Relationship Type definitions.

Table A.35.y-2 specifies the relationship constraints of this IOD.

Table A.35.y-2RELATIONSHIP CONTENT CONSTRAINTS FOR CATH LAB MEASUREMENTS LOG IOD


Target Value Type

CONTAINER CONTAINS TEXT, CODE, NUM, DATETIME, UIDREF, PNAME, COMPOSITE, IMAGE, WAVEFORM, CONTAINER


CONTAINER HAS ACQ CONTEXT TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME



TEXT, CODE, NUM INFERRED FROM IMAGE, WAVEFORM, COMPOSITE

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Add the following to PS3.3 Annex A for ECG Measurements:

A.35.z ECG Report Information Object DefinitionA.35.z.1 ECG Report Information Object DescriptionThe ECG Report IOD provides the findings associated with an ECG acquisition, including standard resting 12-lead ECGs, stress ECGs, pediatric 15-lead ECGs, and others. Findings may also include serial comparison with one or more prior ECGs.

A.35.z.2 ECG Report IOD Entity-Relationship ModelThe E-R Model in Section A.1.2 of this Part applies to the ECG Report IOD. Table A.35.z-1 specifies the Modules of the ECG IOD.

A.35.z.3 ECG Report IOD Module Table

Table A.35.z-1ECG Report IOD MODULES




Frame of Reference

Synchronization C.7.4.2 U




SOP Common C.12.1 M

A.35.z.3.1 ECG Report IOD Content ConstraintsA.35.z.3.1.1 Template The ECG Report may be constructed from any of the following Baseline Templates (defined in PS3.16) invoked at the root node:

TID Tx3700 "ECG Report"

Note: This list of Baseline Templates may be extended.

A.35.z.3.1.2 Value TypeValue Type (0040,A040) in the Content Sequence (0040,A730) of the SR Document Content Module is constrained to the following Enumerated Values (see Table C.17.3-1 for Value Type definitions):

CODECONTAINERCOMPOSITEDATETIMENUMPNAMETEXTWAVEFORM

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A.35.z.3.1.4 Relationship ConstraintsRelationships between Content Items in the content of this IOD may be conveyed in the by-value or the by-reference mode. See Table C.17.3-2 for Relationship Type definitions.

Table A.35.z-2 specifies the relationship constraints of this IOD.

Table A.35.z-2RELATIONSHIP CONTENT CONSTRAINTS FOR ECG REPORT IOD


Target Value Type

CONTAINER CONTAINS TEXT, CODE, NUM, DATETIME, UIDREF, PNAME, COMPOSITE, IMAGE, WAVEFORM, CONTAINER


CONTAINER HAS ACQ CONTEXT TEXT, CODE, NUM, DATETIME, DATE, TIME, UIDREF, PNAME



TEXT, CODE, NUM INFERRED FROM IMAGE, WAVEFORM, COMPOSITE

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Update PS3.3 Section C.7.4.2.1.4:

C.7.4.2.1 Synchronization Attribute Descriptions…

C.7.4.2.1.4 Acquisition Time SynchronizedThe Acquisition Time Synchronized (0018,1800) attribute specifies whether the Acquisition Datetime (0008,002A) attribute of the Waveform Identification Module or the General Image Module represents an accurate synchronized timestamp for the acquisition of the waveform and/or image data . For triggered multi-frame images, the Acquisition Datetime applies to the trigger for the first image frame (see attribute Image Trigger Delay (0018,1067) in the Cine Module).

For IODs which include the SR Document Content Module, the Acquisition Time Synchronized (0018,1800) attribute specifies whether the Observation Datetime (0040,A032) attribute of Items in the Content Sequence (0040,A730) of the SR Document Content Module represents an accurate synchronized timestamp for the Item.

Update PS3.3 Table C.17-2 and Section C.17.2.3

C.17.2 SR Document General Module…

Table C.17-2SR DOCUMENT GENERAL MODULE ATTRIBUTES

Attribute Name Tag Type Attribute Description…

Current Requested Procedure Evidence Sequence

(0040,A375) 1C Full set of Composite SOP Instances in created to satisfy the current Requested Procedure(s) evidenced for which this SR Document is generated. One or more Items may be included in this sequence.Required if Composite Objects are referenced in the content tree, or were acquired in order to satisfy the Requested Procedure(s) for which the SR Document is generated. See C.17.2.3 for further explanation.

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C.17.2.3 Current Requested Procedure Evidence Sequence and Pertinent Other Evidence SequenceThe intent of the Current Requested Procedure Evidence Sequence is to reference all evidence created in order to satisfy the current Requested Procedure(s) evaluated for this SR Document. This shall include, but is not limited to, all current evidence referenced in the content tree. For an SR Document satisfying (i.e., being the final report for) the current Requested Procedure(s), this sequence shall contain the full set of Composite SOP Instances created for the current Requested Procedure(s). For an SR Document satisfying a Procedure Step or Action Item (i.e., a part of the Requested Procedure), this

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sequence shall contain at minimum the set of Composite SOP Instances referenced in the content tree.

Update PS3.3 Table C.17.3-4:

C.17.3 SR Document Content Module…

Table C.17.3-4DOCUMENT RELATIONSHIP MACRO ATTRIBUTES

Attribute Name Tag Type Attribute DescriptionObservation DateTime (0040,A032) 1C The date and time on which this Content

Item was completed, or the time of data acquisition for measurements. Required if the date and time are different from the Content Date (0008,0023) and Content Time (0008,0033) or the Observation DateTime (0040,A032) defined in higher items.

Note: When Content Items are copied into successor reports, the Content Date (0008,0023) and Content Time (0008,0033) of the new report are likely to be different than the date and time of the original observation. Therefore this attribute may need to be included in any copied Content Items to satisfy the condition.

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Add new informative Annex to PS3.3:

Annex N Measurement Report Structures (Informative)

N.1 Cath Lab Measurements IOD The Cath Lab Measurements IOD is used to encode various quantitative analysis reports associated with a catheterization procedure. Templates for each report type are defined in PS3.16.

N.1.1 Hemodynamics ReportThe Hemodynamics Report, using the Cath Lab Measurements IOD, is based on TID Tx3500. The report contains one or more measurement containers, each corresponding to a phase of the cath procedure. Within each container may be one or more sub-containers, each associated with a single measurement set. A measurement set consists of measurements from a single anatomic location. The resulting hierarchical structure is depicted in Figure N-1.

Figure N-1 Hemodynamics Report Structure

The container for each phase has an optional subsidiary container for Clinical Context with a parent-child relationship of has-acquisition-context. This Clinical Context container allows the recoding of pertinent patient state information that may be essential to understanding the measurements made during that procedure phase. It should be noted that any such patient state information is necessarily only a summary; a more complete clinical picture may be obtained by review of the cath procedure log.

The lowest level containers for the measurement sets are specialized by the class of anatomic location - arterial, venous, atrial, ventricular - for the particular measurements appropriate to that type of location.

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These containers explicitly identify the anatomic location with a has-acquisition-context relationship. Since such measurement sets are typically measured on the same source (e.g., pressure waveform), the container may also have a has-acquisition-context relationship with a source DICOM waveform SOP Instance.

The "atomic" level of measurements within the measurement set containers includes three types of data. First is the specific measurement data acquired from waveforms related to the site. Second is general measurement data that may include any hemodynamic, patient vital sign, or blood chemistry data. Third, derived data are produced from a combination of other data using a mathematical formula or table, and may provide reference to the equation.

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Part 4 Addendum

Add to PS3.4 Annex B

B.5 Standard SOP ClassesTable B.5-1

STANDARD SOP CLASSES

SOP Class Name SOP Class UID IOD (See PS 3.3)Procedure Log 1.2.840.10008.5.1.4.1.1.x Procedure Log

Cath Lab Measurements Report 1.2.840.10008.5.1.4.1.1.y Cath Lab Measurements Report

ECG Report 1.2.840.10008.5.1.4.1.1.z ECG Report

B.5.1.5 Structured Reporting Storage SOP ClassesThe requirements of Annex O apply to the following SOP Classes:

Basic Text SREnhanced SRComprehensive SRProcedure LogCath Lab Measurements ReportECG Report

Add to PS3.4 Annex I

I.4 Media Standard Storage SOP ClassesTable I.4-1

Media Storage Standard SOP Classes

SOP Class Name SOP Class UID IOD (See PS 3.3)Procedure Log 1.2.840.10008.5.1.4.1.1.x Procedure Log

Cath Lab Measurements Report 1.2.840.10008.5.1.4.1.1.y Hemodynamics Report

ECG Report 1.2.840.10008.5.1.4.1.1.z ECG Report

I.4.1.2 Structured Reporting Storage SOP ClassesThe requirements of Annex O apply to the following SOP Classes:

Basic Text SREnhanced SRComprehensive SRProcedure LogCath Lab Measurements ReportECG Report

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Add new Annex X to PS3.4

Annex X APPLICATION EVENT LOGGING SERVICE CLASS (Normative)

X.1 OverviewX.1.1 ScopeThe Application Event Logging Service Class defines an application-level class-of-service which facilitates the network transfer of Event Log Records to be logged or recorded in a central location.

The Application Event Logging Service Class covers a set of application specific logs (e.g., procedural event logs, traffic logs, access logs) which all share a similar behavior.

The Application Event Logging Service Class does not specify the means of accessing the central logs.

X.1.2 Service DefinitionTwo peer DICOM AEs implement a SOP Class of the Application Event Logging Service Class with one serving in the SCU role and one serving in the SCP role. SOP Classes of the Application Event Logging Service Class are implemented using the DIMSE-N N-ACTION service as defined in PS 3.7.

The N-ACTION service conveys the following semantics:

— The SCU notifies the SCP that an event has occurred that the SCP should record in a log. The Action Information of the N-ACTION-RQ contains the information about the event.

— The SCP responds with a confirmation of the status of the recording action.The association negotiation procedure is used to negotiate the supported SOP Classes. PS 3.7 specifies the association procedure. The Application Event Logging Service Class does not support extended negotiation.

The release of an association shall not have any effect on the contents of the log managed by the SCP.

X.2 Procedural Event Logging SOP Class Definition The Procedural Event Logging SOP Class allows SCUs to report to an SCP the events which are to be recorded in a Procedure Log SOP Instance, as described in PS3.3. This allows multiple devices participating in a Study to cooperatively construct a log of events that occur during that Study.

The multiple procedural events reported through this SOP Class are related by Patient ID, Study Instance UID, and/or Performed Location. The mechanism by which multiple devices obtain these shared identifiers is not defined by this SOP Class.

Note: The Modality Worklist or General Purpose Worklist SOP Classes may be used for this purpose.The SCP may also provide for recording events which are not given specific identifiers by the SCU. The mechanism by which the SCP determines the association of such an unidentified event with the log for a specific procedure is not defined by this SOP Class.

Note: The network address and/or AE Title of the SCU may be used to identify the device as a participant in a particular procedure.

X.2.1 DIMSE Service GroupThe DIMSE-N Services applicable to the Procedural Event Logging SOP Class are shown in Table X.2-1.

TABLE X.2-1DIMSE service group

DIMSE Service Element Usage SCU/SCP

N-ACTION M/M

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The DIMSE-N Services and Protocol are specified in PS 3.7.

X.2.2 OperationThe DICOM AEs which claim conformance to this SOP Class as an SCU shall invoke the N-ACTION request. The DICOM AEs which claim conformance to this SOP Class as an SCP shall support the N-ACTION request.

X.2.2.1 Action InformationThe DICOM AEs which claim conformance to this SOP Class as an SCU and/or an SCP shall support the Action Type and Action Information in the N-ACTION-RQ as specified in Table X.2-2.

Table X.2-2PROCEDURAL EVENT LOGGING INFORMATION

Action Type Name

Action Type ID

Attribute Tag Requirement Type SCU/SCP

Record Procedural Event

1 Specific Character Set (0008,0005) 1C/1C(Required if an extended or

replacement character set is used)

Patient ID (0010,0020) 2/2

Study Instance UID (0020,000D) 2/2

Synchronization Frame of Reference UID

(0020,0200) 2/2

Performed Location (0040,0243) 2/2

All other Attributes of the SR Document Content Module (PS3.3) using Procedure Log IOD Content Constraints

See Section X.2.2.1.2

X.2.2.1.1 Synchronization Frame of Reference UIDThe Synchronization Frame of Reference UID (0020,0200) attribute identifies the temporal frame of reference for the Observation DateTime (0040,A032) attributes in the Procedural Event record. If the Observation DateTime attribute values are not synchronized in a identifiable Frame of Reference, the attribute shall be zero length.

X.2.2.1.2 Constraints on Attributes of the SR Document Content ModuleThe Procedural Event record shall be conveyed in a (top level) Content Item, and subsidiary Content Items, as specified by the SR Document Content Module definition in PS3.3.

The top level and subsidiary Content Items shall be constructed in accordance with the Procedure Log IOD Content Constraints of PS3.3.

Notes: 1. These constraints specify use of DTID Tx3001 Procedure Log defined in PS3.16, and specific particular use of the Observation DateTime (0040,A032) attributes.2. TID Tx3001 requires the explicit identification of the Observer Context of the top level CONTAINER through TID 1002.3. There may be multiple events (subsidiary Content Items) included in a single N-ACTION-RQ message.

X.2.2.2 Service Class User BehaviorThe SCU shall request logging of events that occur during a Study, using the N-ACTION request primitive.

X.2.2.3 Service Class Provider BehaviorThe SCP shall manage the creation of SOP Instances of the Procedure Log Storage Service. It shall receive, via the N-ACTION request primitive, requests for logging of events that occur during a Study. The SCP shall

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(consonant with application dependent constraints) incorporate those event records into a Procedure Log SOP Instance for the specified Study.

The SCP shall return, via the N-ACTION response primitive, the N-ACTION Response Status Code applicable to the associated action request.

X.2.2.4 Status CodesThe Service Class specific status values defined for the N-ACTION Service are specified in Table X.2-3. See PS 3.7 for additional general response status codes.

Table X.2-3RESPONSE STATUS

Service Status Response Status Code

Further Meaning

Success 0000Warning B101 Specified Synchronization Frame of

Reference UID does not match SCP Synchronization Frame of Reference

Warning B102 Study Instance UID coercion; Event logged under a different Study Instance UID

Warning B104 IDs inconsistent in matching a current study; Event logged

Failure C101 Procedural Logging not available for specified Study Instance UID

Failure C102 Event Information does not match TemplateFailure C103 Cannot match event to a current studyFailure C104 IDs inconsistent in matching a current

study; Event not logged

With response status code B104, an identifier of the study into which the event has been logged shall be returned in the N-ACTION-RSP Command Element Error Comment (0000,0902).

X.2.3 Procedural Event Logging SOP Class UIDThe Procedural Event Logging SOP Class shall be uniquely identified by the Procedural Event Logging SOP Class UID which shall have the value "1.2.840.10008.1.xxx".

X.2.4 Procedural Event Logging Instance IdentificationThe well-known UID of the Procedural Event Logging SOP Instance shall have the value "1.2.840.10008.1.xxx.1".

X.2.5 Conformance RequirementsThe DICOM AE's Conformance Statement shall be formatted as defined in PS 3.2.

X.2.5.1 SCU ConformanceThe SCU shall document in its Conformance Statement the behavior and actions which cause the SCU to generate an N-ACTION primitive (Procedural Event Notification). It shall specify the Template used for constructing the Event Information, and the Coding Schemes used for coded entries in the Event Information.

The SCU shall document the behavior and actions performed when a success, warning, or failure status is received.

The SCU shall document the mechanisms used for establishing time synchronization and specifying the Synchronization Frame of Reference UID.

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X.2.5.2 SCP ConformanceThe SCP shall document in its Conformance Statement the behavior and actions which cause the SCP to generate a success, warning, or failure status for a received N-ACTION (Procedural Event Notification).

The SCP shall document the behavior and actions which cause the SCP to generate a Procedure Log SOP Instance including the received Event Information.

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Part 6 Addendum

Add the following UID to PS3.6 Annex A:

Annex A (Normative): Registry of DICOM Unique Identifiers (UID)

UID Value UID NAME UID TYPE Part…

1.2.840.10008.5.1.4.1.1.x Procedure Log Storage SOP Class PS 3.4

1.2.840.10008.5.1.4.1.1.y Cath Lab Measurements Report Storage

SOP Class PS 3.4

1.2.840.10008.5.1.4.1.1.z ECG Report Storage SOP Class PS 3.4

1.2.840.10008.1.xxx Procedural Event Logging SOP Class

SOP Class PS 3.4

1.2.840.10008.1.xxx.1 Procedural Event Logging SOP Instance

Well-known SOP Instance

PS 3.4

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Part 16 Addendum

Update PS3.16 Table 8-1:

8 Coding SchemesTable 8-1 Coding Schemes

Coding Scheme Designator

Description

…NCDR American College of Cardiology National Cardiovascular Data Registry™ Cath

Lab ModuleVersion 1.1, 1997; Version 2.0b, 1999

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Add the following to PS3.16 Annex A:

TID Tx0200 Normality and Significance

TID Tx0200Normality and Significance

NL Relation with Parent

Value Type Concept Name VM Req Type

Condition Value Set Constraint

1 HAS PROPERTIES

CODE EV (Vx640035, DCM, “Normality”)

1 U DCID (Cx0222) Normality Codes

2 HAS PROPERTIES

CONTAINER EV (Vx640041, DCM, “Normal Range”)

1 U

3 > CONTAINS NUM DCID (Cx0221) Measurement Range Concepts

1-n U

4 > CONTAINS TEXT EV (Vx640040, DCM, ”Normal Range description”)

1 U

5 > CONTAINS TEXT EV (Vx640038, DCM, “Normal Range Authority”)

1 U

6 HAS PROPERTIES

CODE EV (Vx640039, DCM, “Level of Significance”)

1 U DCID (Cx0220) Level of Significance

7 HAS PROPERTIES

NUM DCID (Cx0225) Measurement Uncertainty Concepts

1-n U

TID Tx0300 MeasurementThis Measurement Template provides a general structure for a numeric measurement, together with evaluations of its normality and/or significance, and the inference source(s) for its value.

Input Parameters:$Measurement $Units $ModType $ModValue $Equation

TID Tx0300 Measurement




1 NUM $Measurement 1 M Units = $Units

2 > HAS CONCEPT MOD

CODE $ModType 1 U $ModValue

3 > HAS PROPERTIES

INCLUDE DTID Tx0200 Normality and Significance

1 U

4 > INFERRED FROM

NUM 1-n U

5 > R-INFERRED FROM

NUM 1-n U

6 > INFERRED CODE DT (Vx0100, DCM, 1 U $Equation

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FROM "Equation") or (Vx0099, DCM, "Table")

7 >> HAS PROPERTIES

NUM 1-n U

8 >> R-HAS PROPERTIES

NUM 1-n U

Tx0300 Content Item DescriptionsRow 2 - The HAS CONCEPT MOD item allows the explicit definition of terms for post-coordination of the measurement concept name. Additional post-coordinated modifier terms may be included in a SOP Instance based on this template, in accordance with section 6.2.4.

Row 4 - The INFERRED FROM allows the specification of numeric values that were used in the derivation of the numeric measurement of Row 1. The nature of the inference is not explicitly conveyed; it may be implicit in the Concept Names of the measurements.

Row 5 - The INFERRED FROM allows the specification by-reference of numeric values that were used in the derivation of the numeric measurement of Row 1. This row is valid only in SOP Classes that permit the INFERRED FROM relationship by-reference.

Row 6 - The INFERRED FROM allows the specification of an equation or table, identified by a coded term, that was used in the derivation of the numeric measurement of Row 1.

Row 7 - The HAS PROPERTIES allows the specification of the numeric values used as input to the equation or table for the derivation of the numeric measurement of Row 1.

Row 8 - The HAS PROPERTIES allows the specification by-reference of the numeric values used as input to the equation or table. This row is valid only in SOP Classes that permit the HAS PROPERTIES relationship by-reference.

Note: For example, if Row 1 is a measurement with Concept Name meaning Body Surface Area, and Row 6 identifies a specific BSA equation, Rows 7 and 8 can be used to convey (by-value or by-reference) the Patient Height and Patient Weight numeric measurements used in the BSA computation.

TID Tx0320 Image or Spatial CoordinatesNote: This template is included in CP274, and will be removed from this document if CP274 is approved.

This Image or Spatial Coordinates Template provides a general structure for referencing an image, either as a whole, or with specific spatial coordinates, as a single included Template in the invoking Template.

Input Parameters:$Purpose

TID Tx0320Image or Spatial Coordinates




1 IMAGE $Purpose 1 MC XOR Row 2

2 SCOORD $Purpose 1 MC XOR Row 1

3 > SELECTED FROM

IMAGE 1 M

905

910

915

920

925

930


TID Tx0321 Waveform or Temporal CoordinatesNote: This template is included in CP274, and will be removed from this document if CP274 is approved.

This Waveform or Temporal Coordinates Template provides a general structure for referencing a waveform, either as a whole, or with specific temporal coordinates, as a single included Template in the invoking Template.

Input Parameters:$Purpose

TID Tx0321Waveform or Temporal Coordinates




1 WAVEFORM $Purpose 1 MC XOR Row 2

2 TCOORD $Purpose 1 MC XOR Row 1

3 > SELECTED FROM

WAVEFORM 1 M

935

940


Add the following to PS3.16 Annex A:

PROCEDURE LOG IOD TEMPLATESTID Tx3001 Procedure LogThe Procedure Log template is intended for the representation of reports or logs of time-stamped events occurring during an image-guided interventional or other procedure.

This Template does not require a particular ordering of the subsidiary Content Items.

Notes: 1. The (PS3.3) requires ordering by Observation Datetime; thus log entries of different types (i.e., specified by different Rows in the Template) may appear in any order. 2. While this Template is extesible, the Procedure Log IOD forbids Container Content Items subsidiary to the top level Container.

Type: Extensible Version: 2002

Template Tx3001 Procedure Log




1 CONTAINER DCID (Cx0000) Procedure Log Titles

1 M

2 > HAS OBS CONTEXT

INCLUDE DTID (1002) Observer Context

1-n M

3 > HAS ACQ CONTEXT

INCLUDE DTID (Tx3601) Lab Procedure Context

1 M

4 > HAS ACQ CONTEXT

TEXT EV (Vx0005, DCM, "Room identification")

1 U

5 > HAS ACQ CONTEXT

TEXT EV (Vx0006, DCM, "Equipment identification")

1-n U

6 > CONTAINS TEXT DCID (Cx0001) Types of Log Notes

1-n U

7 >> INCLUDE DTID (Tx3010) Log Entry Qualifiers

1 U

8 > CONTAINS CODE EV (Vx0010, DCM, “Patient Event”)

1-n U DCID Cx0002 Patient Events


1 U

10 > CONTAINS PNAME DCID (Cx0004) Staff Actions

1-n


1 U

12 > CONTAINS TEXT DCID (Cx0004a) Equipment Events

1-n U Equipment identifier


1 U

14 > CONTAINS INCLUDE DTID (Tx3111) Percutaneous Entry

1-n U

15 > CONTAINS INCLUDE DTID (Tx3112) Specimen Obtained

1-n U

16 > CONTAINS INCLUDE DTID (Tx3100) Procedure Action

1-n U

70

945

950

955





17 > CONTAINS INCLUDE DTID (Tx3101) Image Acquisition

1-n U

18 > CONTAINS INCLUDE DTID (Tx3102) Waveform Acquisition

1-n U

19 > CONTAINS INCLUDE DTID (Tx3103) Referenced Object

1-n U

20 > CONTAINS INCLUDE DTID (Tx3104) Consumables

1-n U

21 > CONTAINS INCLUDE DTID (Tx3105) Lesion Identification

1-n U

22 > CONTAINS INCLUDE DTID (Tx3109) Measurements

1-n U

23 > CONTAINS INCLUDE DTID (Tx3106) Drugs/Contrast Administered

1-n U

24 > CONTAINS INCLUDE DTID (Tx3107) Device Used 1-n U

25 > CONTAINS INCLUDE DTID (Tx3108) Intervention 1-n U

26 > CONTAINS CODE EV (Vx0012, DCM, “Complication")

1-n U DCID (Cx0013) Complications


1 U

28 > CONTAINS INCLUDE DTID (Tx3113) Patient Support

1-n U

29 > CONTAINS INCLUDE DTID (Tx3110) Impressions or Findings

1-n U

Tx3001 Content Item DescriptionsRow 2 includes TID 1002 Observer Context. TID 1002 shall be used to record the identity of the person responsible for recording the log, as well as all other participants in the procedure, even though these personnel may not technically be "observers" of the Procedure Log. As participants in the procedure, they are potential sources for events and observations recorded in the Log.

Row 5 shall be used to record the identity of the major equipment used in the procedure.

Row 6 may be used to record any event not covered by a specific log entry template.

TID Tx3010 Log Entry QualifiersThe Log Entry Qualifiers Template provides a common means for adding additional description to a procedure log content item. It allows identification of a source for the procedure log entry (other than the recording observer for the log as a whole), a free text comment, a link to a particular Procedure Action item, a link to a particular lesion, or the date/time of recording (if different than the time of the event occurrence recorded in the Observation Datetime of the parent content item).


Template Tx3010 Log Entry Qualifiers




1 INCLUDE DTID (1000) Quotation 1 U

2 HAS PROPERTIES

TEXT EV (Vx0011, DCM, “Comment”)

1 U

960

965

970

975





3 HAS OBS CONTEXT

TEXT EV (Vx0013, DCM, "Procedure Action ID")

1-n U

4 HAS OBS CONTEXT

TEXT EV (Vx0050, DCM, "Lesion Identifier")

1-n U Up to 3 numeric characters

5 HAS OBS CONTEXT

DATETIME EV (Vx0014, DCM, "DateTime of Recording of Log Entry")

1 U

6 INFERRED FROM

IMAGE 1-n U

7 INFERRED FROM

WAVEFORM 1-n U

8 INFERRED FROM

COMPOSITE 1-n U

Note (to be removed before Letter Ballot): TID 1000 is defined in DICOM Part 16 (Supplement 53). It includes the following Observation Context content nodes:

Quotation Mode - Document or VerbalObserver Type - Person or DeviceObserver Identifiers (for Person or Device)

TID Tx3100 Procedure Action The Procedure Action Template is intended for the recording of the beginning or end of procedure steps or action items in a procedure. The level of granularity of the recorded events is not specified, and may vary between institutions, or even be at multiple levels within a single procedure log. There is no requirement for the real-world procedure step or action item recorded with this template to end before another one begins; there may be overlapping or simultaneous procedure steps or action items.

This log entry template may be used to record the start or stop of timers.

Other recorded events in the procedure may be linked to a particular step or action item by Procedure Action ID (see TID Tx3010 Log Entry Qualifiers).


TID Tx3100Procedure Action




1 CODE DCID (Cx0021) Procedure Action

1 M BCID (Cx0005) Procedure Step or Action Values

2 > HAS PROPERTIES


1 M

3 > HAS PROPERTIES

PNAME BCID (7453) Performing Roles

1-n U

4 > HAS PROPERTIES

NUM EV (Vx0017, DCM, "Procedure Action Duration")

1 U

5 > INCLUDE DTID (Tx3010) Log Entry Qualifiers

1 U

6 > HAS PROPERTIES

UIDREF EV (Vx0015, DCM, "Performed Procedure Step SOP Instance UID")

1 MC Shall be present if DICOM PPS Service is used to provide

75

980

985

990

995





status of the Procedure Step

7 > HAS PROPERTIES

UIDREF EV (Vx0016, DCM, "Performed Procedure Step SOP Class UID")

1 MC Shall be present if DICOM PPS Service is used to provide status of the Procedure Step

Tx3100 Content Item DescriptionsRow 2 - The value of the Procedure Action ID shall be uniquely associated with the step or action within the context of the Study, and may be used to associate various Procedure Log entries with the step or action.

Row 3 may be used to record the identity of staff roles for the purpose of this Procedure Action, which may differ from their roles in the procedure as a whole.

TID Tx3101 Image AcquisitionThe Image Acquisition Template allows recording of the essential parameters of a digital image acquired during the procedure.


TID Tx3101Image Acquisition




1 IMAGE EV (Vx0030, DCM, “Image Acquired”)

1 M

2 > HAS ACQ CONTEXT

UIDREF EV (Vx00, DCM, "Series UID")

1 M

3 > HAS ACQ CONTEXT

TEXT EV (Vx0031, DCM, “Modality”)

1 M

4 > HAS PROPERTIES

NUM EV (Vx0032, DCM, “Number of Frames”)

1 M

5 > HAS PROPERTIES

TEXT EV (Vx0033, DCM, “Image Type”)

1 M From referenced image SOP Instance attribute (0008,0008)

6 > HAS ACQ CONTEXT

NUM EV (Vx0034, DCM, “Positioner Primary Angle”)

1 MC Required if Row 3 value is "XA"

UNITS = EV (deg, UCUM, “º”)

7 > HAS ACQ CONTEXT

NUM EV (Vx0035, DCM, “Positioner Secondary Angle”)

1 MC Required if Row 3 value is "XA"

UNITS = EV (deg, UCUM, “º”)

8 > HAS ACQ CONTEXT

NUM EV (Vx0040, DCM, “Peak X-ray Generator Voltage”)

1 U UNITS = EV (kV, UCUM, “kV”)

9 > HAS ACQ CONTEXT

NUM EV (Vx0041, DCM, “X-ray Generator Current”)

1 U UNITS = EV (mA, UCUM, “mA”)

10 > HAS ACQ CONTEXT

NUM EV (Vx0036, DCM, “Image Area Dose Product”)

1 U UNITS = EV (dGy(cm2), UCUM, “dGy*cm^2”)

11 > HAS PROPERTIES

NUM EV (Vx0037, DCM, “Cine Rate”)

1 MC Required for multiframe cine image

UNITS = EV (Hz, UCUM, “Hz”)


1 U

1000

1005

1010


Notes (to be removed before Letter Ballot): The IMAGE content type includes the SOP Class/Instance UIDs for the referenced image, and optionally an icon and/or a grayscale presentation state.

The NUM content type allows an empty value, so that Mandatory NUM content items may be empty if the data is unknown.

TID Tx3102 Waveform AcquisitionThe Waveform Acquisition Template allows recording of the essential parameters of a digital waveform acquired during the procedure.


TID Tx3102Waveform Acquisition




1 WAVEFORM EV (Vx0038, DCM, “Waveform Acquired”)

1 M

2 > HAS ACQ CONTEXT

TEXT EV (Vx0031, DCM, “Modality”)

1 M

3 > HAS PROPERTIES

NUM EV (Vx00, DCM, “Number of Channels”)

1 M

3 > HAS ACQ CONTEXT

CODE EV (Vx00, DCM, “Channel Source”)

1-n M From referenced SOP Instance attributes (003A,0208)

4 >> HAS CONCEPT MOD

CODE EV (Vx00, DCM, “Channel Source Modifiers”)

1-n MC Required if Channel Source Modifiers present in referenced SOP Instance waveform channel definition

From referenced SOP Instance attributes (003A,0209)

5 > HAS ACQ CONTEXT

NUM EV (Vx00, DCM, “Acquisition Duration”)

1 U


1 U

Note (to be removed before Letter Ballot): The WAVEFORM content type includes the SOP Class/Instance UIDs for the referenced waveform.

TID Tx3103 Referenced ObjectThe Referenced Object Template allows reference to measurement or report objects, such as prior medical reports, laboratory results, hemodynamic measurement reports, or quantitative analysis reports.


TID Tx3103Referenced Object




1 COMPOSITE BCID (Cx0007) Purpose of Reference to Object

1 M

2 > HAS CODE EV (Vx0039, DCM, 1 MC IF Row 1 references Root node concept of

1015

1020

1025

1030

1035





PROPERTIES “Document Title") an SR object referenced SR object


1 U

Note (to be removed before Letter Ballot): The COMPOSITE content type includes the SOP Class/Instance UIDs for the referenced object.

TID Tx3104 ConsumablesThe Consumables Template allows recording of devices (e.g., catheters or stents), drugs, or contrast agents accessed in a procedure. This content item is directed towards inventory control and billing. The actual clinical use of the particular consumable is recorded using TID Tx3106 Drugs/Contrast Administered or TID Tx3107 Device Used.

This template allows recording both consumable retrieval from, and return to, inventory or stock, and disposal of used material. The quantity involved in each recorded transaction may be specified.


TID Tx3104Consumables




1 CODE DCID (Cx0008) Actions with Consumables

1 M Vendor or local bar coded values

2 > HAS PROPERTIES

TEXT EV (Vx0042, DCM, "Description of Material")

1 U

3 > HAS PROPERTIES

NUM EV (Vx0043, DCM, "Quantity of Material")

1 U

4 > HAS PROPERTIES

CODE EV (Vx0044, DCM, "Billing Code")

1 U local billing codes


1 U

TID Tx3105 Lesion IdentificationThe Lesion Identification Template allows recording the identification of each lesion addressed in a procedure. The lesion identifier may be used to relate diagnostic or therapeutic actions with their target lesion (see Row 4 in TID Tx3010 Log Entry Qualifiers). This content item may include the initial visually estimated measurements of stenosis or TIMI flow; measured values from a quantitative measurement report may be referenced indirectly (through TID Tx3103 Referenced Object), or by quotation (TID Tx3109 Measurements template). Subsequent (e.g., post-intervention) stenosis measurements may be encoded using TID Tx3109 Measurements, with the Lesion Identifier conveyed through its subsidiary TID Tx3010 Log Entry Qualifiers template.


80

1040

1045

1050

1055

1060


TID Tx3105Lesion Identification




1 TEXT EV (Vx0050, DCM, “Lesion Identifier")

1 M Up to 3 numeric characters

2 > HAS PROPERTIES

CODE EV (Vx0051, DCM, “Anatomic Location")

1 M DCID (3014) Coronary artery segments


CODE EV (Vx0052, DCM, “Anatomic Location modifier")

1 U DCID (3019) Cardio-vascular Anatomic Location Modifiers

4 > HAS PROPERTIES

CODE EV (Vx0055, DCM, “Lesion Risk")

1 U DCID (Cx0018) Lesion Risk

5 > HAS PROPERTIES

NUM EV (Vx70351, DCM, "Pre-Intervention Stenosis Measurement")

1 U UNITS = EV (%, UCUM, "%")

6 >> HAS ACQ CONTEXT

CODE EV (Vx1053, DCM, “Method of measurement")

1 U

7 > HAS PROPERTIES

CODE EV (Vx70353, DCM, "Pre- Intervention TIMI Flow")

1 U DTID (Cx38013) TIMI flow

8 > HAS PROPERTIES

IMAGE DT (121080, DCM, "Best illustration of finding"

1 U


1 U

Tx3105 Content Item DescriptionsRow 1 Lesion Identifier is specified as a numeric string in order to facilitate transcoding to DICOM Attribute (0018,3105) Lesion Number and to formats for outcomes registries, such as the ACC National Cardiovascular Data Registry™.

TID Tx3106 Drugs/Contrast AdministeredThe Drugs/Contrast Administered Template allows the recording of the start or end of that type of event, together with its parameters. If start and end are represented by a single log entry (e.g., for an injection), the concept name “Drug/contrast administered” shall be used.


TID Tx3106Drugs/Contrast Administered




1 CODE DCID (Cx0009) Administration of Drugs/Contrast

1 M BCID (10) Interventional Drug, or BCID (12) Radiographic Contrast Agent

2 > HAS PROPERTIES


1 U

3 > HAS PROPERTIES

CODE EV (Vx0060, DCM, "Route of administration")

1 U BCID (11) Route of Administration

4 > HAS PROPERTIES

NUM DCID (Cx0010) Numeric Parameters of Drugs/Contrast

1-n U

5 > INCLUDE DTID (Tx3010) Log Entry 1 U

1065

1070

1075

1080





Qualifiers

TID Tx3107 Device UsedThe Device Used Template allows recording of the use of interventional diagnostic and therapeutic devices.

The identification of one device used to deploy another device (e.g., a balloon catheter to deploy a stent) may be described with two entries, with one identified as a deployment device in the Concept Modifier of Row 6 of this template, and linked by the same Procedure Action ID in the Log Entry Qualifiers of the included TID Tx3010.


TID Tx3107Device Used




1 CODE DCID (Cx0022) Device use actions

1 M BCID (Cx0011a) Interventional Devices

2 > HAS PROPERTIES

CODE EV (Vx0061, DCM, "Device Code")

1-n U Vendor or local bar coded values

3 > HAS PROPERTIES


1 U

4 > HAS PROPERTIES

NUM DCID (Cx0023) Device Characteristics

1-n U

5 > HAS PROPERTIES


1 U BCID (Cx0630) Cardiovascular source locations

6 > HAS CONCEPT MOD

CODE EV (Vx00510, DCM, “Device use")

1 U DT (Vx00511, DCM, “Deployment")


1 U

TID Tx3108 InterventionThe Intervention Template allows recording of interventions, including atherectomy, angioplasty, stent placement, brachytherapy, etc. The record may include reference to an image that documents the intervention.


TID Tx3108Intervention




1 CODE EV (Vx1057, DCM, "Intervention Action")

1 U

2 > HAS PROPERTIES

CODE EV (Vx0057, DCM, "Intervention Type")

1 U

3 > HAS PROPERTIES



85

1085

1090

1095

1100






CODE EV (Vx0052, DCM, “Anatomic Location modifier")


5 > HAS PROPERTIES

TEXT EV (Vx0058, DCM, "Intervention attempt identifier")


6 > HAS PROPERTIES

CODE EV (Vx0059, DCM, "Device type")

1-n U BCID (Cx0011) Intracoronary Devices

7 > HAS PROPERTIES

NUM DCID (Cx0025) Intervention Parameters

1-n U

8 > HAS PROPERTIES

CODE EV (Vx0056, DCM, "Intervention Status")

1 M DCID (Cx0012) Intervention Status

9 > HAS PROPERTIES

IMAGE BCID (7003) Diagnostic Imaging Report Purposes of Reference

1 U


1 U

TID Tx3109 MeasurementsThe Measurements Template allows recording of significant measurements, such as vital signs, laboratory results, hemodynamic measurements, or quantitative analysis measurements. These measurements are often quoted from another source, which would be documented in the included TID Tx3010 Log Entry Qualifiers.


TID Tx3109Measurements




1 NUM No BCID 1 U


1 U

3 > HAS PROPERTIES

INCLUDE DTID (Tx0200) Normality and Significance

1 U

4 CODE No BCID 1 U


1 U

6 > HAS PROPERTIES

INCLUDE DTID (Tx0200) Normality and Significance

1 U

1105

1110


TID Tx3110 Impressions or FindingsThe Impressions or Findings Template allows the recording of unconfirmed (provisional) impressions or findings noted during the procedure. It is not intended to convey the Cath Lab Clinical Report (the formal report from the performing physician), although it may be used (like any Procedure Log entry) for the subsequent construction of the Cath Lab Clinical Report.

A finding that is supported by a specific image frame may reference that image in the INFERRED FROM / IMAGE row of the included TID Tx3010 Log Entry Qualifiers template.


TID Tx3110 Impressions or Findings




1 CODE BCID (Cx0019) Findings Titles

1 U


1 U

3 TEXT BCID (Cx0019) Findings Titles

1 U


1 U

TID Tx3111 Percutaneous EntryThe Percutaneous Entry Template allows recording of the opening or closing of invasive access ports.


TID Tx3111Percutaneous Entry




1 CODE EV (Vx0064, DCM, “Percutaneous Entry Action”)

1 M DCID (Cx0002a) Percutaneous Entry

2 > HAS CONCEPT MOD

CODE EV (Vx0065, DCM, “Laterality")

1 U DCID (Cx0002b) Laterality


1 U

1115

1120

1125

1130


TID Tx3112 Specimen ObtainedThe Specimen Obtained Template allows recording of obtaining a specimen, and the identifiers for that specimen. This is particularly designed for blood samples that will be analyzed for blood oxygen-related measurements. The analysis of the sample may be recorded in one or more log entries using TID Tx3109 Measurements Template, or in a separate Structured Report SOP Instance referenced by a log entry using TID Tx3103 Referenced Object Template.


TID Tx3112Specimen Obtained




1 CODE EV (Vx0010, DCM, “Patient Event”)

1 M EV (Vx3333, DCM, "Specimen Obtained")

2 > HAS ACQ CONTEXT

CODE EV (Vx640503, DCM, "Blood Source Type")

1 UC IFF specimen is blood sample

DCID (Cx0520) Blood Source Type

3 > HAS ACQ CONTEXT

CODE EV (Vx0051, DCM, “Anatomic Site”)

1 U BCID (Cx0630) Cardiovascular Anatomic locations

4 > HAS PROPERTIES

INCLUDE DTID (1009) Subject Context, Specimen

1 U

Note (to be removed before Letter Ballot): TID 1009 is defined in DICOM Part 16 (Supplement 53). It includes the following content nodes:

Specimen Accession NumberSpecimen IdentifierSpecimen Type Code

TID Tx3113 Patient SupportThe Patient Support Template allows recording of the use of various support technologies, including oxygen, ventillation, pacing, etc..


TID Tx3113Patient Support




1 CODE DCID (Cx0530) Oxygen Administration Actions

1 U DCID (Cx0531) Oxygen Administration

2 > HAS PROPERTIES

NUM EV (Vx31130, DCM, “Oxygen Administration Rate")

1 MC Required if Row 1 Concept is (Vx05301, DCM, "Begin Oxygen Administration")

Units = DT (ml/s, UCUM, "ml/s")


1 U

4 CODE DCID (Cx0550) Circulatory Support Actions

1 U DCID (Cx0553) Circulatory Support


1 U

6 CODE DCID (Cx0551) Ventilation Actions

1 U DCID (Cx0554) Ventilation

90

1135

1140

1145

1155






1 U

8 CODE DCID (Cx0552) Pacing Actions

1 U DCID (Cx0555) Pacing


1 U


CATH LAB MEASUREMENTS REPORT IOD TEMPLATES

The templates that comprise the Hemodynamic Report within the Cath Lab Measurements Report IOD are interconnected as shown in Figure A-x.

Figure A-x Hemodynamic Report Template Hierarchy

The figure shows only the use of templates specific to the Hemodynamic Report; it does not show common structural templates such as TID Tx0300.

Note: The figure shows the relationship of templates; it does not show the structural hierarchy of Content Items in the IOD. See PS 3.3 Annex M.

95

1160

1165


TID Tx3500 Hemodynamics ReportThe Hemodynamic Report template is the root structure for the representation of measurements acquired during a procedure in a cardiac catheterization lab.


TID Tx3500 Hemodynamics Report




1 CONTAINER EV (Vx50001, DCM, “Hemodynamics Report”)

1 M

2 > HAS OBS CONTEXT

INCLUDE DTID (1002) Observer Context

1-n M

3 > HAS OBS CONTEXT

INCLUDE DTID (Tx3601) Lab Procedure Context

1 M

4 > HAS ACQ CONTEXT

INCLUDE DTID (Tx3602) Patient Characteristics

1 M

5 > HAS ACQ CONTEXT

INCLUDE DTID (Tx3603) Procedure Environmental Characteristics

1 U

6 > CONTAINS INCLUDE DTID (Tx3501) Hemodynamic Measurement Group

1-n M

TID Tx3501 Hemodynamics Measurement GroupThe Hemodynamic Measurement Group template provides a structure for measurements acquired during a single procedure phase in a cardiac catheterization lab.


TID Tx3501 Hemodynamics Measurement Group




1 CONTAINER DCID (Cx0651) Hemodynamic Measurement phase

1 M

2 > HAS ACQ CONTEXT

INCLUDE DTID (Tx3520) Clinical Context

1 U

3 > HAS ACQ CONTEXT


1 U

4 > CONTAINS INCLUDE DTID (Tx3510) Vital signs 1-n U

5 > CONTAINS INCLUDE DTID (Tx3504) Arterial Pressure Measurement

1-n U

6 > CONTAINS INCLUDE DTID (Tx3505) Atrial Pressure Measurement

1-n U

7 > CONTAINS INCLUDE DTID (Tx3506) Venous Pressure Measurement

1-n U

8 > CONTAINS INCLUDE DTID (Tx3507) Ventricular Pressure Measurement

1-n U

1170

1175

1180

1185





9 > CONTAINS INCLUDE DTID (Tx3508) Gradient Measurement

1-n U

10 > CONTAINS INCLUDE DTID (Tx3515) Cardiac Output

1-n U

11 > CONTAINS INCLUDE DTID (Tx3516) Blood lab measurements

1-n U

12 > CONTAINS INCLUDE DTID (Tx3560) Derived Hemodynamic Measurements

1-n U

Tx3501 Content Item DescriptionsRow 3 Procedure Action ID allows linkage between the hemodynamic measurements recorded in this Template and a procedure step or phase recorded in the Procedure Log, e.g., using TID Tx3100.

TID Tx3504 Arterial Pressure MeasurementThe Arterial Pressure Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing systolic, diastolic, and mean measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (anatomic location) value.


TID Tx3504Arterial Pressure Measurement




1 CONTAINER EV(Cx50401, DCM, “Arterial pressure measurements")

1 M

2 > INCLUDE DTID (Tx3530) Hemodynamic Acquisition Context

1 M $LocationName = EV (Vx0051, DCM, “Anatomic Location”)

$LocationValue = DCID (Cx0606,”Arterial source locations”)

3 > CONTAINS INCLUDE DTID (Tx0300) Measurement

1 M $Measurement = EV (8480-6, LN, “Intravascular arterial Systolic pressure”)

$Units = DCID (Cx0500) Pressure Units


1 M $Measurement = EV (8462-4, LN, “Intravascular arterial Diastolic pressure”)



1 M $Measurement = EV (8478-0, LN, “Intravascular arterial

1190

1195

1200





mean pressure”)


6 > CONTAINS INCLUDE DTID (Tx3550) Pressure waveform measurements

1-n U

TID Tx3505 Atrial Pressure MeasurementThe Atrial Pressure Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing a-wave, v-wave, and mean measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (anatomic location) value.


TID Tx3505Atrial Pressure Measurement




1 CONTAINER EV (Vx50501, DCM, “Atrial pressure measurements")

1 M



$LocationValue = DCID (Cx0608) Atrial source locations


1 M $Measurement = EV (109016, DCM, “a-wave pressure”)



1 M $Measurement = EV (109034, DCM, “v-wave pressure”)



1 M $Measurement = EV (109027, DCM, “mean pressure”)



1-n U

100

1205

1210


TID Tx3506 Venous Pressure MeasurementThe Venous Pressure Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing a mean measurement. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (anatomic location) value.


TID Tx3506Venous Pressure Measurement




1 CONTAINER EV (Vx50601, DCM, “Venous pressure measurements")

1 M



$LocationValue = DCID (Cx0607) Venous source locations


1 M $Measurement = EV (109027, DCM, “mean pressure”)



1-n U

TID Tx3507 Ventricular Pressure MeasurementThe Ventricular Pressure Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing systolic and end-diastolic measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (anatomic location) value.


TID Tx3507Ventricular Pressure Measurement




1 CONTAINER EV (Vx50701, DCM, “Ventricular pressure measurements")

1 M



$LocationValue = DCID (Cx0609) Ventricular source locations

1215

1220

1225

1230






1 M $Measurement = EV (Vx605036, DCM, “Systolic pressure”)



1 M $Measurement = EV (Vx605015, DCM, “End Diastolic pressure”)



1-n U

TID Tx3508 Gradient MeasurementThe Gradient Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing the gradient measurement. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (anatomic location) value.


TID Tx3508Gradient Measurement




1 CONTAINER EV (Vx50801, DCM, “Gradient assessment”)

1 M


1 MC XOR with Rows 3 & 4

Shall be used if single location is appropriate

$LocationName = EV (Vx0051, DCM, “Anatomic Location”)

$LocationValue = DCID (Cx0610) Gradient source locations


1 MC XOR with Row 2

shall be used if a dual location is appropriate

$LocationName = EV (Vx640009, DCM, “Proximal Anatomic Location”)

$LocationValue = DCID (Cx0630) Cardiovascular source locations


1 MC XOR with Row 2

shall be used if a dual location is appropriate

$LocationName = EV (Vx640010, DCM, “Distal Anatomic Location”)

$LocationValue = DCID (Cx0630) Cardiovascular source locations


1 M $Measurement = EV (Vx605016, DCM,

105

1235

1240





”Pressure Gradient”)


$ModType = EV (Vx640012, DCM, “Measurement Type”)

$ModValue = DCID (Cx0627) Measurement Type


1-n U

TID Tx3510 Vital SignsThe Vital Signs template consists of a CONTAINER containing the various vital signs measurements. These measurements may be acquired automatically from patient monitoring equipment, or may be entered based on manual measurements.


Template Tx3510 Vital Signs




1 CONTAINER EV (Vx0008, DCM, “Vital Signs”)

1 M

2 CONTAINS INCLUDE TID (Tx0300) Measurement

1-n U $Measurement = EV (Vx605036, DCM, "Systolic blood pressure")

$Units = DCID (Cx0500)

$ModType = EV (Vx35105, DCM, "Method of measurement")

$ModValue = BCID (Cx0560) Blood Pressure Methods


1-n U $Measurement = EV (Vx605008, DCM, "Diastolic blood pressure")


4 > CONTAINS INCLUDE TID (Tx0300) Measurement

1 U $Measurement = EV (8867-4, LN, "Heart rate")

$Units = ("{H.B.}/min", UCUM, "BPM")


1 U $Measurement = EV (8310-5, LN, "Body temperature")

$Units = (Cel, UCUM, “°C”)


1 U $Measurement = DCID (Cx0526) Blood gas saturation

$Units = (%, UCUM, "%")


1 U $Measurement = EV (Vx605030, DCM, "Respiration rate")

$Units = (/min, UCUM, "breaths/min")

8 > CONTAINS INCLUDE TID (Tx0300) 1 U $Measurement = EV (Vx606003,

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1250





Measurement DCM, "Pulse Strength")

$Units = DT("{0:4}", UCUM, "scale 0:4")


1 U $Measurement = EV (Vx606xxx, DCM, Pain)

$Units = DT("{1:10}", UCUM, "scale 1:10")

10 > CONTAINS CODE DT (8884-9, LN, "Cardiac Rhythm")

1 U BCID (Cx0015) Cardiac Rhythms

11 > CONTAINS CODE DT (9304-7, LN, "Respiration Rhythm")

1 U No BCID

TID Tx3515 Cardiac Output MeasurementThe Cardiac Output Measurement template consists of a CONTAINER containing the measurement and significant parameters of the technical method. If the measurement is based on a DICOM Hemodynamic Waveform SOP Instance, that object may also be referenced.


TID Tx3515Cardiac Output Measurement




1 CONTAINER EV (Vx640017, DCM, “Cardiac Output measurement”)

1 M

2 > CONTAINS NUM EV (8737-9, LN, “Cardiac Output by Indicator Dilution”)

1 M UNITS = EV (l/min,, UCUM, ”l/min”)

3 > HAS ACQ CONTEXT

CODE EV (Vx640018, DCM, “Cardiac Output Method”)

1 M DCID (Cx0628) Cardiac Output Methods

4 > HAS ACQ CONTEXT

NUM EV (Vx640019, DCM, “Catheter Size”)

1 MC IF Row 3 indicates a thermal method

UNITS = DCID (Cx0510) Catheter Size Units

5 > HAS ACQ CONTEXT

NUM EV (Vx640020, DCM, “Injectate Temperature”)

1 MC IF Row 3 indicates a thermal method

UNITS = EV (Cel, UCUM, “°C”)

6 > HAS ACQ CONTEXT

NUM EV (Vx640021, DCM, “Injectate Volume”)

1 M UNITS = DT (ml, UCUM, “ml”)

7 > HAS ACQ CONTEXT

NUM EV (Vx640022, DCM, “Calibration Factor”)

1 M UNITS = DT (1, UCUM, “no units”)

13 > INFERRED FROM

INCLUDE DTID (Tx0321) Waveform or Temporal Coordinates

1 U $Purpose = DT (Vx0080, DCM, "Source of measurement”)

TID Tx3516 Blood Lab MeasurementsThe Blood Lab Measurements template provides for the recording of measurements made on blood samples obtained during a catheterization procedure. The type and anatomic source of the blood is recorded as acquisition context. The results from the blood chemistry measurement system are quoted; the measurement names may be

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pre-coordinated with the type or source of the blood, or generic measurement names may be reported. In the latter case, the full measurement concept name may be effectively post-coordinated using the recorded acquisition context.


TID Tx3516Blood Lab Measurements




1 CONTAINER EV (Vx640502, DCM, ”Blood lab measurements”)

1 M

2 > HAS ACQ CONTEXT

CODE EV (Vx640503, DCM, "Blood Source Type")

1 M DCID (Cx0520) Blood Source Type

3 > HAS ACQ CONTEXT

CODE EV (Vx0051, DCM, “Anatomic Location”)

1 M BCID (Cx0630) Cardiovascular Anatomic locations

4 > INCLUDE DTID (1000) Quotation 1 U


1 U $Measurement = EV (718-7, LN, Hemoglobin)

$Units = DT (g/dl, UCUM, "g/dl")


1 U $Measurement = DCID (Cx0524) Blood gas pressures



1 U $Measurement = DCID (Cx0525) Blood gas content

$Units = DT (ml/dl, UCUM, "ml/dl")


1 U $Measurement = DCID (Cx0528) Blood pH

$Units = EV ([pH], UCUM, "pH")


1 U $Measurement = DCID (Cx0526) Blood gas saturation

$Units = EV (%, UCUM, "%")


1 U $Measurement = DCID (Cx0526) Blood base excess

$Units = DT (meq/dl, UCUM, "meq/dl")


1 U $Measurement = EV (Vx601003, DCM, "Blood temperature")

$Units = EV (Cel, UCUM, “°C”)

TID Tx3520 Clinical Context The Clinical Context template allows the recording of information about the patient's clinical state that may affect interpretation of the hemodynamic measurements.

110

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TID Tx3520Clinical Context




1 CONTAINER EV (Vx70032, DCM, "Clinical Context")

1 M

2 > CONTAINS CODE EV (109054,DCM,”Patient State”)

1-n U BCID (Cx0602) Hemodynamic Patient State

3 > CONTAINS TEXT EV (109054,DCM,”Patient State”)

1 U

4 > CONTAINS INCLUDE EV (Vx0012, DCM, “Complication")

1-n U DCID (Cx0013)


CODE EV (Vx70148, DCM, "Relative time")

1 U BCID (Cx0600) Relative time

6 > CONTAINS INCLUDE EV (Vx70106, DCM, "Drugs")

1-n U




8 > CONTAINS INCLUDE EV (109059, DCM, ”Physiological challenges”)

1 U BCID (3271)




10 > CONTAINS INCLUDE EV (Vx70108, DCM, "Circulatory Support")

1 U DCID (Cx0603)




12 > CONTAINS INCLUDE EV (Vx70147, DCM, "Ventilation")

1 U DCID (Cx0604)




14 > CONTAINS INCLUDE EV (Vx70148 , DCM, "Pacing")

U BCID (Cx0605)




TID Tx3530 Hemodynamic Acquisition ContextThe Hemodynamic Acquisition Context template is invoked by the various hemodynamic measurement templates.

Input Parameters:$LocationName $LocationValue

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1290



TID Tx3530Hemodynamic Acquisition Context




1 HAS ACQ CONTEXT

CODE $LocationName 1 M $LocationValue

2 > HAS CONCEPT MOD

CODE EV (Vx0052, DCM, “Anatomic Location modifier”)

1 U BCID (3019) Cardiovascular anatomic location modifiers

3 HAS ACQ CONTEXT

CODE EV (Vx640011, DCM, “Hemodynamic Measurement Technique”)

1 U BCID (3241) Hemodynamic Measurement Technique

4 INFERRED FROM

INCLUDE DTID (Tx0321) Waveform or Temporal Coordinates

1 U $Purpose = DT (Vx0080, DCM, "Source of measurement”)

TID Tx3550 Pressure Waveform MeasurementsThe Pressure Waveform Measurements template is invoked by the various hemodynamic measurement templates for recording general measurements made in conjunction with the specific required mesurements for that anatomic location.


TID Tx3550Pressure Waveform Measurements




CONTAINS INCLUDE TID (Tx0300) Measurement

1-n U $Measurement = DCID (Cx0611) Pressure Measurements



1-n U $Measurement = DCID (Cx0612) Blood Velocity Measurements

$Units = EV (mm/s, UCUM, "mm/s")


1 U $Measurement = DCID (Cx0613) Hemodynamic Time Measurements

$Units = DT (ms, UCUM, "ms")


1 U $Measurement = EV (Vx605003, DCM, "Cardiac Output")

$Units = (l/min, UCUM, "l/min")


1 U $Measurement = EV (Vx605032, DCM, "Stroke Volume”)

$Units = (ml, UCUM, "ml")


1 U $Measurement = EV (10230-1, LN, "LV Ejection Fraction")

$Units = (%, UCUM, "%")

CONTAINS INCLUDE TID (Tx0300) 1 U $Measurement = EV (8867-4, LN,

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1300

1305





Measurement "Heart rate")

$Units = ("{H.B.}/min", UCUM, "BPM")


1 U $Measurement = EV (Vx605030, DCM, "Respiration rate")

$Units = (/min, UCUM, "breaths/min")


1 U $Measurement = EV (Vx605011, DCM, "Dicrotic notch")

$Units = (mm[Hg]/s, UCUM, "mmHg/s")


1 U $Measurement = EV (109025, DCM, "Max dp/dt")



1 U $Measurement = EV (109026, DCM, "Max neg dp/dt")



1 U $Measurement = EV (Vx605013, DCM, "Max dp/dt/P")

$Units = (s-1, UCUM, "/s")


1 U $Measurement = EV (Vx605019, DCM, "Indicator appearance time")

$Units = (s, UCUM, "s")


1 U $Measurement = EV (Vx605020, DCM, "Maximum acceleration")

$Units = (mm[Hg]/s2, UCUM, "mmHg/s/s")


1 U $Measurement = EV (Vx605040, DCM, "Valve flow")

$Units = (ml/min, UCUM, "ml/min")

TID Tx3560 Derived Hemodynamic MeasurementsThe Derived Hemodynamic Measurements template consists of a CONTAINER containing measurements derived from one or more other measurements. These measurements are associated with a particular procedure phase, but not necessarily with a particular anatomic location.


TID Tx3560Derived Hemodynamic Measurements




CONTAINER EV (Vx702510, DCM, "Derived Hemodynamic Measurements")

1 U

> CONTAINS INCLUDE TID (Tx0300) Measurement

1 U $Measurement = DCID (Cx0614) Valve Areas

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1315





$Units = EV (cm2, UCUM, "cm2")

$Equation = DT (Vx703006, DCM, “Area = Flow / 44.5 * sqrt(Gradient[mmHg])”)


1 U $Measurement = EV (Vx702033, DCM, "Mitral Valve Area”)

$Units = EV (cm2, UCUM, "cm2")

$Equation = DT (Vx703033, DCM, “MVA= Flow / 38.0 * sqrt(Gradient[mmHg])”)


1 U $Measurement = DCID (Cx0615) Valve Area Indexes

$Units = DT (cm2/m2, UCUM, "cm2/m2")

$Equation = DT (Vx703067, DCM, "Index = Area / BSA")


1 U $Measurement = DCID (Cx0616) Hemodynamic Period Measurements

$Units = DT ("s/min" UCUM, "s/min")

$Equation = DT (Vx703003, DCM, “Period = Time * HR”)


1 U $Measurement = DCID (Cx0617) Valve Flows

$Units = DT (ml/s, UCUM, "ml/s")

$Equation = DT (Vx703005, DCM, “Flow = CO / Period”)


1 U $Measurement = EV (Vx702012, DCM, "Cardiac Index”)

$Units = DT (l/min/m2, UCUM, "l/min/m2")

$Equation = DT (Vx703012, DCM, "CI = CO / BSA")


1 U $Measurement = DCID (Cx0529) Arterial / Venous Content


$Equation = DT (Vx703007, DCM, "FC = (sat[%] / 100) * Hb * 1.36 + (PO2 * 0.002934)" )


1 U $Measurement = EV (Vx702040, DCM, "Pulmonary Flow”)

$Units = DT (l/min, UCUM, "l/min")

$Equation = DT (Vx703040, DCM, "Qp = VO2 / (FCpv – FCpa)" )


1 U $Measurement = EV (Vx702054, DCM, "Systemic Flow”)


$Equation = DT (Vx703054, DCM, "Qs = VO2 / (FCa – FCv)" )


1 U $Measurement = EV (8736-1, LN, "FICK Cardiac Output”)


$Equation = DT (Vx703022, DCM, "COf = VO2 / (FCa – FCv) ")

> CONTAINS INCLUDE TID (Tx0300) 1 U $Measurement = EV (8750-2, LN,





Measurement "FICK Cardiac Index”)


$Equation = DT (Vx703021, DCM, "CIf = COf / BSA")


1 U $Measurement = EV (Vx702008, DCM, "Atrio-Venous difference”)


$Equation = DT (Vx703008, DCM, "AVdiff = FCa - FCp" )


1 U $Measurement = EV (Vx702024, DCM, "Flow Ratio”)

$Units = DT (1, UCUM, "ratio")

$Equation = DT (Vx703024, DCM, "Qp/Qs")


1 U $Measurement = EV (Vx702001, DCM, "Ankle brachial index”)

$Units = DT (1, UCUM, ”ratio”)

$Equation = DT (Vx703001, DCM, “ABI = Ankle pressure / brachial pressure”)


1 U $Measurement = EV (Vx702014, DCM, "Coronary Flow reserve”)

$Units = (1,UCUM,"ratio")

$Equation = DT (Vx703014, DCM, "AVPh/AVP")


1 U $Measurement = EV (Vx702015, DCM, "Corrected Sinus Node Recovery Time”)

$Units = DT (ms, UCUM, "ms")

$Equation = DT (Vx703015, DCM, "CSNRT = SNRT – SCL")


1 U $Measurement = EV (Vx702016, DCM, "Diastolic/Systolic velocity ratio”)


$Equation = DT (Vx703016, DCM, "DV/SV'")


1 U $Measurement = DCID (Cx0702) Fractional Flow Reserve


$Equation = DT (Vx703019, DCM, (Pd-Pv/(Pa-Pv))


1 U $Measurement = EV (Vx702026, DCM, "Hyperemic ratio”)


$Equation = DT (Vx703026, DCM, AVPhyp / AVP)


1 U $Measurement = EV (8861-7, LN, "Left Ventricular Stroke Work”)

$Units = DT (g.m, UCUM, "g.m")

$Equation = DT (Vx703028, DCM, "LVSW = (AOm – LAm) * (CO / HRao) * 0.0136")

120






1 U $Measurement = EV (8862-5, LN, "Right Ventricular Stroke Work”)

$Units = DT (g.m, UCUM, "g.m")

$Equation = DT (Vx703051, DCM, "RVSW = (PAm - RAm) * (CO/HRpa) * 0.0136" )


1 U $Measurement = EV (8863-3, LN, "Left Ventricular Stroke Work Index”)

$Units = DT (g.m/m2, UCUM, "g.m/m2")

$Equation = DT (Vx703029, DCM, "LVSWI = LVSW / BSA")


1 U $Measurement = EV (8864-1, LN, "Right Ventricular Stroke Work Index”)

$Units = DT (g.m/m2, UCUM, "g.m/m2")

$Equation = DT (Vx703052, DCM, "RVSWI = RVSW / BSA)


1 U $Measurement = EV (Vx702030, DCM, "Max volume normalized to 50mmHg pulse pressure”)

$Units = DT (ml, UCUM, "ml")


1 U $Measurement = EV (Vx702035, DCM, "Oxygen Consumption”)

$Units = DT (ml/min, UCUM, "ml/min")

$Equation = BCID (Cx0704) Oxygen Consumption Equations and Tables


1 U $Measurement = EV (19217-9, LN, "Oxygen partial pressure at 50% saturation (P50)")


$Equation = BCID (Cx0706) P50 Equations


1 U $Measurement = EV (11556-8, LN, "Blood Oxygen partial pressure”)


$Equation = DT (Vx703037, DCM, "(P50 * 10^(0.48 * (7.4 – pH) + 0.013 * BE + 0.024 (Temp – 37) ) / (Sat / 100 – Sat)")


1 U $Measurement = EV (Vx702041, DCM, "Pulmonary Flow Index”)


$Equation = DT (Vx703041, DCM, "Qpi = Qp / BSA")


1 U $Measurement = EV (Vx702055, DCM, "Systemic Flow Index”)


$Equation = DT (Vx703055, DCM, "Qsi = Qs / BSA")


1 U $Measurement = EV (Vx702046, DCM, "Pulmonary Vascular





Resistance”)

$Units = BCID (Cx0502) Hemodynamic Resistance Units

$Equation = DT (Vx703046, DCM, "PVR = 79.98 * (PAm – LAm) / CO") or DT (Vx703047, DCM, "PVR[Wood] = (PAm – LAm) / CO")


1 U $Measurement = EV (Vx702056, DCM, "Systemic Vascular Resistance”)


$Equation = DT (Vx703056, DCM, "SVR = 79.98 * (SAm - RAm) / CO") or DT (Vx703057, DCM, "SVR[Wood] = (SAm - RAm) / CO")


1 U $Measurement = EV (Vx702059, DCM, "Total Pulmonary Resistance”)


$Equation = DT (Vx703059, DCM, "TPR = 79.98 * PAm / CO") or DT (Vx703060, DCM, "TPR[Wood] = PAm / CO")


1 U $Measurement = EV (Vx702061, DCM, "Total Vacular Resistance”)


$Equation = DT (Vx703061, DCM, "TVR = 79.98 * SAm / CO") or DT (Vx703062, DCM, "TVR[Wood] = SAm / CO")


1 U $Measurement = DCID (Cx0619) Indexed Hemodynamic Resistence Measurements

$Units = BCID (Cx0503)

$Equation = DT (Vx703047, DCM, "Resistance / BSA")


1 U $Measurement = EV (Vx702013, DCM, "Cardiometrics Pulsitility Index”)

$Units = DT (1,UCUM,"ratio")

$Equation = DT (Vx703013, DCM, "(IPVmax- IPVmin)/APV")


1 U $Measurement = EV (Vx702049, DCM, "Resistance Index”)

$Units = DT (UCUM, 1, "ratio")

$Equation = DT (Vx703049, DCM, "(IPVmax-IPVmin)/ IPVmax")


1 U $Measurement = EV (Vx702027, DCM, "Left to Right Flow”)


$Equation = DT (Vx703027, DCM, "Qp * (FCv – Fcpa) / (FCv – FCpv)")


1 U $Measurement = EV (Vx702050, DCM, "Right to Left Flow”)

125






$Equation = DT (Vx703050, DCM, "Qp*(FCpv-FCa)*(FCpa-FCpv) / (FCa -FCv)*(FCv-FCpv)" )


1 U $Measurement = EV (20562-5, LN, "Stroke Volume”)

$Units = DT (ml, UCUM, "ml")

$Equation = DT (Vx703053, DCM, "SV = CO / HR")


1 U $Measurement = EV (Vx702058, DCM, "Total blood volume”)

$Units = DT (l, UCUM, "l")


1 U $Measurement = DCID (Cx0707) Framingham Scores

$Units = DT (%, UCUM, "%")

$Equation = DCID (Cx0708) Framingham Tables

TID Tx3601 Lab Procedure ContextThe Lab Procedure Context template describes acquisition context for measurements made or events recorded in a procedure.


TID Tx3601Lab Procedure Context


VT Concept Name VM Req Type


1 HAS ACQ CONTEXT

TEXT EV (Vx640002, DCM, “Procedure Name”)

1 U Defaults to Study Description (0008,1030) of the General Study Module

2 HAS ACQ CONTEXT

CODE EV (Vx640003, DCM, “Procedure Type”)

1 U BCID (Cx0629) Procedure Type

3 HAS ACQ CONTEXT

CODE EV (Vx0007, DCM, "Procedure Urgency")

1 U BCID (Cx0014) Procedure Urgency

4 HAS OBS CONTEXT

CODE EV (121023, DCM, ”Procedure Code”)

1-n U Defaults to Procedure Code Sequence (0008,1032) of General Study Module

TID Tx3602 Patient CharacteristicsPatient Characteristics in this template, which may replicate values in the Patient Study Module, are included here as possible targets of by-reference relationships from other content items in the SR tree.


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TID Tx3602Patient Characteristics




1 CONTAINER EV (Vx640023, DCM, “Patient Characteristics”)

1 M

2 > CONTAINS NUM EV (121033, DCM, "Subject Age”)

1 M Units = DCID (7456) Units of Measure for Age

3 > CONTAINS CODE EV (121032, DCM, "Subject Sex”)

1 M DCID (7455) Sex

4 > CONTAINS NUM EV (8302-2, LN, “Patient Height”)

1 M UNITS = EV (cm, UCUM, “cm”)

5 > CONTAINS NUM EV (29463-7, LN, “Patient Weight”)

1 M UNITS = EV (kg, UCUM, “kg”)

6 > CONTAINS NUM EV (Vx640028, DCM, “Thorax diameter, sagittal”)

1 U UNITS = EV (cm, UCUM, “cm”)

7 > CONTAINS NUM EV (8277-6, LN, “Body Surface Area”)

1 M UNITS = EV (m2, UCUM, "m^2")

8 >> INFERRED FROM

CODE EV (8248-4, LN, "Body Surface Area Formula" )

1 U BCID (Cx0703) Body Surface Area Equations

9 > CONTAINS NUM EV (Vx702009, DCM, “Body Mass Index”)

1 U UNITS = EV (kg/m2, UCUM, "kg/m^2")

10 >> INFERRED FROM

CODE EV (Vx0100, DCM, "Equation")

1 U DT (Vx703009, DCM, "BMI = Wt/Ht^2")

TID Tx3603 Procedure Environmental Characteristics


TID Tx3603Procedure Environmental Characteristics




1 CONTAINER EV (Vx640031, DCM, “Procedure Environmental Characteristics”)

1 M

2 > CONTAINS NUM EV (Vx640032, DCM, “Room oxygen concentration”)

1 U UNITS = EV (%, UCUM, “%”)

3 > CONTAINS NUM EV (Vx640033, DCM, “Room temperature”)

1 U UNITS = EV (Cel, UCUM, “ºC”)

4 > CONTAINS NUM EV (Vx640034, DCM, “Room Barometric pressure”)

1 U UNITS = DT (mbar, UCUM, “millibar”)

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ECG REPORT IOD TEMPLATES

TID Tx3700 ECG ReportThe ECG Report template is the root structure for the representation of analysis of an ECG waveform, potentially in comparison to a prior ECG waveform analysis. The analyzed waveform may or may not be stored as a DICOM SOP Instance.


TID Tx3700 ECG Report




1 CONTAINER DCID (Cx0900) ECG Report Titles

1 M

2 > CONTAINS INCLUDE DTID (1002) Observer Context

1 M

3 > CONTAINS INCLUDE DTID (Tx3701) "Clinical Context, ECG"

1 U

8 > CONTAINS INCLUDE DTID (Tx3702) Prior ECG Exam

1 U

13 > CONTAINS INCLUDE DTID (Tx3708) ECG Waveform Information

1 M

14 > CONTAINS CONTAINER EV (Vx70172, DCM, "Quantitative Analysis")

1 M

15 >> CONTAINS INCLUDE DTID (Tx3713) Global Measurements

1 M

16 >> CONTAINS INCLUDE DTID (Tx3714) Lead Measurements

1-n U

17 > CONTAINS INCLUDE DTID (Tx3715) "Qualitative Analysis, ECG"

1 M

20 > CONTAINS CONTAINER DTID (Tx3719) "Summary, ECG"

1 U

TID Tx3701 Clinical Context, ECG


TID Tx3701Clinical Context, ECG




CONTAINS CONTAINER EV (Vx70032, DCM, "Clinical Context")

1 U

> CONTAINS CODE EV (Vx70149, DCM, "Reason for Exam")

1-n U DCID (Cx0901) Reason for Exam

> CONTAINS TEXT EV (Vx70149, DCM, "Reason for Exam")

1 U

> CONTAINS CODE EV (Vx70150, DCM, "Medications")

1-n U DCID (xx) Cardiovascular Drugs

130

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1355





> CONTAINS TEXT EV (Vx70150, DCM, "Medications")

1 U

> CONTAINS CODE EV (Vx70151, DCM, "Pacemaker")

1-n U DCID (Cx0902) Pacemakers

> CONTAINS TEXT EV (Vx70151, DCM, "Pacemaker")

1 U

> CONTAINS CODE EV (Vx70152, DCM, "Medical History")

1-n U DCID (Cx0903) Diagnosis

> CONTAINS TEXT EV (Vx70152, DCM, "Medical History")

1 U

TID Tx3702 Prior ECG Exam


TID Tx3702Prior ECG Exam




1 CONTAINS CONTAINER EV (121066, DCM, "Prior Procedure Descriptions ")

1 M

2 > CONTAINS CODE EV (Vx70154, DCM, "Comparison with Prior Exam Done")

1 M DCID (Cx0230) Yes-No

3 > CONTAINS DATETIME EV (Vx70155, DCM, "Exam DateTime")

1 U

4 > CONTAINS COMPOSITE EV (Vx70158, DCM, "Referenced Report")

1 U

5 > CONTAINS WAVEFORM EV (Vx70159, DCM, "Referenced Waveform")

1 U

TID Tx3708 ECG Waveform InformationThe ECG Waveform Information template provides reference to, and important parameters of, the analyzed waveform.


TID Tx3708 ECG Waveform Information




1 CONTAINER EV (Vx70160, DCM, "ECG Waveform Information")

1 M

2 > CONTAINS WAVEFORM EV (Vx70171, DCM, "Waveform Reference")

1 U

3 > HAS ACQ CONTEXT

CODE EV (Vx70161, DCM, "Electrode Placement")

1 U DCID (3263) Electrode Placement Values

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4 > HAS ACQ CONTEXT

TEXT EV (Vx70162, DCM, "Acquisition Device Type")

1 U

5 > HAS ACQ CONTEXT

TEXT EV (Vx70163, DCM, "Acquisition Device ID")

1 U

6 > HAS ACQ CONTEXT

INCLUDE DTID (1003) Person Observer Identifying Attributes

1 U

7 > HAS ACQ CONTEXT

TEXT EV (Vx70165, DCM, "Room/Location")

1 U

8 > HAS ACQ CONTEXT

DATETIME EV (Vx70166, DCM, "Acquisition DateTime")

1 M

9 > HAS ACQ CONTEXT

NUM EV (Vx70168, DCM, "Baseline Filter")

1 U UNITS = EV (Hz, UCUM,"Hertz")


NUM EV (Vx70169, DCM, "Lo Pass Filter")

1 U UNITS = EV (Hz, UCUM,"Hertz")


CODE EV (Vx70170, DCM, "Other Filters")

1-n U DCID (Cx0905) Other Filters

TID Tx3713 ECG Global MeasurementsThe ECG Global Measurements Template provides a structure for measurements calculated across the ECG waveform as a whole.


TID Tx3713ECG Global Measurements




1 CONTAINER EV (Vx70192, DCM, "ECG Global Measurements")

1 M

2 > CONTAINS CODE EV (Vx70193, DCM, "Lead Measurement Technique")

1 U DCID (Cx0906, "Lead Measurement Technique")

3 > CONTAINS NUM EV (Vx70194, DCM, "Atrial Rate")

1 U UNITS = EV ({H.B.}/min, UCUM, "heart beats per minute")

4 > CONTAINS NUM EV (Vx70195, DCM, "Ventricular Rate")

1 M UNITS = EV ({H.B.}/min, UCUM, "heart beats per minute")

5 > CONTAINS NUM EV (Vx70196, DCM, "QT Duration")

1 M UNITS = EV (ms, UCUM,"milliseconds")

6 > CONTAINS NUM EV (Vx70197, DCM, "QT Corrected Duration")

1 U UNITS = EV (ms, UCUM,"milliseconds")

7 > CONTAINS CODE EV (Vx70198, DCM, "Correction Algorithm")

1 U DCID (Cx0908, "QT Correction Algorithms")

8 > CONTAINS NUM EV (Vx70199, DCM, "PR Duration")


9 > CONTAINS NUM EV (Vx70200, DCM, "QRS Duration")


10 > CONTAINS NUM EV (Vx70201, DCM, "P 1 U UNITS = EV (deg,

135

1380





Axis") UCUM,"degrees")

11 > CONTAINS NUM EV (Vx70202, DCM, "QRS Axis")

1 U UNITS = EV (deg, UCUM,"degrees")

12 > CONTAINS NUM EV (Vx70203, DCM, "T Axis")

1 U UNITS = EV (deg, UCUM,"degrees")

TID Tx3714 ECG Lead MeasurementsThe ECG Lead Measurements Template provides a structure for measurements calculated on individual ECG leads.


TID Tx3714ECG Lead Measurements




1 CONTAINER EV (Vx70203, DCM, "ECG Lead Measurements")

1 U

2 > CONTAINS CODE EV (Vx70204, DCM, "Lead ID")

1 M BCID (3001) ECG Leads

3 > CONTAINS NUM EV (Vx70205, DCM, "Beat Number")

1 U

4 > CONTAINS NUM DCID (Cx0917, "Electrophysiology waveform durations")

1-n U UNITS = EV (ms, UCUM,"ms")

5 > CONTAINS NUM DCID (Cx0918, "Electrophysiology waveform voltages")

1-n U UNITS = EV (mv, UCUM,"mv")

6 > CONTAINS CODE EV (Vx70226, DCM, "T Morphology Description")

1 U DCID (Cx0909) ECG Morphology Descriptions

7 > CONTAINS CODE EV (Vx70225, DCM, "P Morphology Description")

1 U DCID (Cx0909) ECG Morphology Descriptions

8 > CONTAINS NUM EV (Vx70224, DCM, "ST Slope")

1 U UNITS = EV (uV/S, UCUM,"microvolts per second")

9 > CONTAINS CODE EV (Vx70156, DCM, "ECG Quality Descriptor")

1-n U DCID (Cx0910, "ECG Lead Noise Descriptions")

10 >> CONTAINS CODE EV (Vx70167, DCM, "ECG Quality Modifier")

1 U DCID (Cx0911, "ECG Lead Noise Modifiers")

TID Tx3715 Qualitative Analysis, ECG


1385

1390

1395


TID Tx3715 Qualitative Analysis, ECG




1 CONTAINS CONTAINER EV (Vx70175, DCM, "Qualitative Analysis")

1 M

2 > CONTAINS TEXT EV (Vx70179, DCM, "Clinical Interpretation")

1 M

3 > CONTAINS INCLUDE DTID (Tx3718) ECG Interpretive Statement

1-n U

TID Tx3718 ECG Interpretive StatementThe ECG Interpretive Statement template provides a structure for a coded analysis.


TID Tx3718 ECG Interpretive Statement




1 CONTAINER EV (Vx70180, DCM, "Interpretive Statement")

1 M

2 > CONTAINS CODE EV (Vx70181, DCM, "Trend")

1 U DCID (Cx0914) Trend


CODE EV (Vx70187, DCM, "Probability")

1 U DCID (Cx0912) Probability

4 > CONTAINS CODE EV (Vx70182, DCM, "Statement")

1 M DCID (Cx0916) ECG Interpretive Statements


CODE EV (Vx70183, DCM, "Statement Modifier")

1 U DCID (Cx0913) Modifiers

6 > CONTAINS CODE EV (Vx70184, DCM, "Conjunctive Term")

1 U DCID (Cx0915) Conjunctive Terms

TID Tx3719 Summary, ECG


TID Tx3719Summary, ECG




1 CONTAINS CONTAINER EV (Vx70004, DCM, "Summary")

1 M

2 > CONTAINS TEXT EV (Vx70004, DCM, "Summary")

1 U

3 > CONTAINS CODE EV (Vx70004, DCM, "Summary")

1 U DCID (Cx0907) Summary Codes ECG

1400

1405

1410

1415


CATH LAB CLINICAL RESULTS IOD TEMPLATES

The templates that comprise the Cardiac Catheterization Results are interconnected as shown in Figure A-y.

Figure A-y Cardiac Catheterization Results Template Hierarchy

Note: The figure shows the relationship of templates; it does not show the structural hierarchy of Content Items in the IOD.

TID Tx3800 Cardiac Catheterization Results RootThe Cardiac Cath Results provides the overall clinical results of the catheterization procedure and interventions. In many cases, more detailed information is optionally available in other reports (Cardiac Catheterization Measurements, Procedure Log, etc.). That information is collected and summarized here (and referenced when available).

When a Discharge Summary section (row 11) is included, this report template covers the full set of information required for submission to the ACC NCDR™ (version 2.0) registry.

Note: The information required for such a submission must sometimes be reformatted from a single concept in these templates to two data elements for the registry, or vice versa.

140

1420

1425

1430

1435



TID Tx3800Cardiac Catheterization Results Root




1 CONTAINER EV (18745-0, LN, "Cardiac Catheterization Report")

1 M

2 > CONTAINS INCLUDE DTID (Tx3601) Lab Procedure Context

1 M

3 > CONTAINS INCLUDE DTID (Tx3802) "Patient History, Cath"

1 M

4 > CONTAINS INCLUDE DTID (Tx3803) "Patient Presentation, Cath"

1 M

5 > CONTAINS INCLUDE DTID (Tx3806) Cath Procedure

1 M

6 > CONTAINS INCLUDE DTID (Tx3807) Percutaneous Coronary Intervention Procedure

1 U

7 > CONTAINS INCLUDE DTID (Tx3809) Other Interventional Procedures

1 U

8 > CONTAINS INCLUDE DTID (Tx3810) Cardiac Catheterization Findings

1 M

9 > CONTAINS INCLUDE DTID (Tx3820) "Complications, Cath"

1 M

10 > CONTAINS INCLUDE DTID (Tx3824) "Summary, Cath"

1 M

11 > CONTAINS INCLUDE DTID (Tx3828) "Discharge Summary, Cath"

1 U

TID Tx3802 Patient History, CathThis template contains information about the catheterization patient’s past medical history. This information is considered to have some degree of “persistence” across different episodes.


TID Tx3802Patient History, Cath




1 CONTAINER EV (121060, DCM, "History")

1 M

2 > CONTAINS TEXT EV (121060, DCM, "History")

1 U

3 > CONTAINS CODE DCID (Cx1021, "Cath Patient History / Risk Factors")

1-n U DCID (Cx0230) Yes-No

4 > CONTAINS DATE DCID (Cx1020) Cardiac History Dates

1-n U

5 > CONTAINS CODE EV (36, NCDR [2.0b], "Previous Myocardial Infarction, > 1 week prior")

1 U DCID (Cx1023) MI Types

1440

1445





6 > CONTAINS CODE EV (31.1, NCDR [2.0b], "Diabetic Therapy")

1-n U DCID (Cx1022, "Diabetic Therapy")

7 > CONTAINS CODE EV (38, NCDR [2.0b], "Smoking History")

1 U DCID (Cx1024, "Smoking History")

8 > CONTAINS COMPOSITE EV (Vx0705, DCM, "Prior report for current patient")

1-n U

9 >> HAS PROPERTIES

CODE EV (Vx0039, DCM, “Document Title")

1 U

TID Tx3803 Patient Presentation, CathThis template describes the aspects of the patient that are specific to this clinical presentation (admission).


TID Tx3803Patient Presentation, Cath




1 CONTAINER EV (Vx38031, DCM, "Patient Presentation")

1 M

2 > CONTAINS TEXT EV (Vx70034, DCM, "Transferred From")

1 U

3 > CONTAINS DATETIME EV (15, NCDR [2.0b], "Admission Date/Time")

1 U

4 > CONTAINS CODE EV (17, NCDR [2.0b], "Admission Status")

1 U DCID (Cx1029, "Admission Status")

5 > CONTAINS CODE EV (18, NCDR [2.0b], "Insurance Payor Type")

1 U DCID (Cx1030, "Insurance Payor")

6 > CONTAINS CODE EV (46, NCDR [2.0b], "Congestive Heart Failure Prior to Procedure")

1 U DCID (Cx0230) Yes-No

7 > CONTAINS CODE EV (47, NCDR [2.0b], "NYHA Classification")

1 UC IF Row 6 Value code meaning is <yes>

DCID (Cx1036, "NYHA Classification")

8 > CONTAINS CODE EV (48, NCDR [2.0b], "Noninvasive Testing - Ischemia")

1 M DCID (Cx1037, "Non-Invasive Test - Ischemia")

9 > CONTAINS CODE EV (49, NCDR [2.0b], "Pre-Cath Angina Type")

1 M DCID (Cx1038, "Pre-Cath Angina Type")

10 > CONTAINS CODE EV (50, NCDR [2.0b], "Pre-Cath Canadian Classification")

1 M DCID (Cx1019, "Canadian Clinical Classification")

11 > CONTAINS CODE EV (51, NCDR [2.0b], "Acute Coronary Syndrome Time Period")

1 MC IF Row 9 Value code meaning is <ACS>

DCID (Cx1035, "Acute Coronary Syndrome Time Period")

12 > CONTAINS CODE EV (Vx70053, DCM, "Indication for Catheterization")

1-n U DCID (Cx1027, "Indications for Catheterization")

13 > CONTAINS CODE EV (78, NCDR [2.0b], "Catheterization Urgency Status")

1 M DCID (Cx0014, "Procedure Urgency")

145

1450

1455


TID Tx3806 Cath ProcedureThis template describes the patient-related information about this specific clinical encounter (catheterization).


TID Tx3806Cath Procedure




1 CONTAINER EV (Vx38061, DCM, "Cath Procedure Description")

1 M

2 > CONTAINS DATETIME EV (52, NCDR [2.0b], "Procedure DateTime")

1 M

3 > CONTAINS NUM EV (53, NCDR [2.0b], "Procedure Number (this admission)")

1 M

4 > CONTAINS CODE EV (54, NCDR [2.0b], "Catheterization Procedure Type")

1-n M DCID (Cx1039, "Cath Procedure Type")

7 > CONTAINS TEXT EV (121065, DCM, "Procedure Description")

1 U

8 > CONTAINS COMPOSITE EV (Vx0000, DCM, "Cath Lab Procedure Log")

1-n U

5 > CONTAINS NUM EV (55, NCDR [2.0b], "Fluoroscopy Time")

1 U UNITS = DT (min, UCUM, "min")

8 > CONTAINS PNAME EV (76, NCDR [2.0b], "Catheterization Operator")

1 M

9 > CONTAINS PNAME EV (121088, DCM, "Fellow") 1-n U

10 > CONTAINS CODE EV (121071, DCM, "Finding")

1-n M DCID (Cx1002, "Cath Diagnosis")

11 > CONTAINS CODE EV (Vx70052, DCM, "PCI during this procedure")


12 > CONTAINS CONTAINER EV (Vx70150, DCM, "Medications")

1 M

13 >> CONTAINS CODE EV (57, NCDR [2.0b], "Thrombolytics")

1 U DCID (Cx1040) Thrombolytic Administration

14 >> CONTAINS CODE EV (58, NCDR [2.0b], "IIb/IIIa Blockade")

1 U DCID (Cx1041) Medication Administration, Lab Visit

15 >> CONTAINS CODE EV (59, NCDR [2.0b], "Heparin")

1-n U DCID (Cx1041) Medication Administration, Lab Visit

16 >> CONTAINS CODE EV (60, NCDR [2.0b], "Aspirin")

1 U DCID (Cx1042) Medication Administration, PCI

17 >> CONTAINS CODE EV (61, NCDR [2.0b], "Clopidogrel/Ticlopidine")

1 U DCID (Cx1043) Clopidogrel/Ticlopidine Administration

18 > CONTAINS CODE EV (Vx70375, DCM, "Hemodynamic Support")

1-n U DCID (Cx1058) Catheterization Hemodynamic Support

1460





19 > CONTAINS CODE EV (74, NCDR [2.0b], "Percutaneous Entry Site")

1 M DCID (Cx1046) Percutaneous Entry Site

20 > CONTAINS CODE EV (75, NCDR [2.0b], "Closure Device")

1 M DCID (Cx1047) Closure Device

TID Tx3807 Percutaneous Coronary Intervention ProcedureThis template describes the various aspects of a coronary intervention.


TID Tx3807Percutaneous Coronary Intervention Procedure




1 CONTAINER EV (Vx380012, DCM, "Percutaneous Coronary Intervention Procedure Description")

1 M

2 > CONTAINS PNAME EV (Vx70339, DCM, "PCI Primary Operator's Name")

1 M

3 > CONTAINS PNAME EV (Vx70038, DCM, "Fellow")

1-n U

4 > CONTAINS CODE EV (Vx70340, DCM, "PCI Status")

1 M DCID (Cx0014, "Procedure Urgency")

5 > CONTAINS CONTAINER EV (Vx70053, DCM, "Indications")

1 M

6 >> CONTAINS CODE EV (Vx70341, DCM, "Coronary lesion >= 50%")

1 U

7 >> CONTAINS CODE EV (Vx70342, DCM, "Acute MI Present")

1 M DCID (Cx1023, "MI Types")

8 >>> HAS CONCEPT MOD

DATETIME EV (Vx70343, DCM, "ST Elevation Onset")

1 MC

9 >> CONTAINS CODE EV (Vx70055, DCM, "Cardiogenic Shock")


10 > CONTAINS DATETIME EV (Vx70344, DCM, "Balloon/Stent Deployment Time")

1 UC

11 > CONTAINS NUM EV (Vx70345, DCM, "Number of lesions attempted")

1 M UNITS = (1, UCUM, "units")

12 > CONTAINS NUM EV (Vx70346, DCM, "Number of lesions successful")

1 M UNITS = (1, UCUM, "units")

13 > CONTAINS CODE EV (Vx70347, DCM, "PCI Procedure Result")

1 M DCID (Cx1049, "PCI Procedure Result")

14 > CONTAINS INCLUDE DTID (3808) Lesion Information

1-n M

1465

1470


TID Tx3808 Lesion Information


TID Tx3808Lesion Information




CONTAINER EV (Vx70348, DCM, "Lesion Information")

1 M

> CONTAINS TEXT EV (Vx0050, DCM, “Lesion Identifier")


> CONTAINS CODE EV (Vx0051, DCM, “Anatomic site")


>> HAS CONCEPT MOD

CODE EV (Vx0052, DCM, “Anatomic site modifier")


> CONTAINS NUM EV (Vx70351, DCM, "Pre-Intervention Stenosis Measurement")

1 M UNITS = EV (%, UCUM, "%")

> CONTAINS CODE EV (Vx70353, DCM, "Pre- Intervention TIMI Flow")

1 U DCID (Cx38013) TIMI Flow

> CONTAINS CODE EV (Vx70355, DCM, "Previous Dilation")

1 U DCID (Cx1050, "Previously Dilated Lesion")

> CONTAINS CODE EV (Vx0055, DCM, “Lesion Risk")

1 M DCID (Cx0018) Lesion Risk

> CONTAINS IMAGE DT (121080, DCM, "Best illustration of finding"

1 U

> CONTAINS CODE EV (Vx70350, DCM, "Guidewire crossed successfully")


> CONTAINS CONTAINER EV (Vx70359, DCM, "Device used")

1-n M

>> CONTAINS NUM EV (Vx70360, DCM, "Device number")

1 M UNITS =

>> CONTAINS CODE EV (Vx70361, DCM, "Coronary Intervention Device")

1 M DCID (Cx1053, "Coronary Intervention Devices")

>>> HAS CONCEPT MOD

CODE EV (Vx70362, DCM, "Is the primary device")


> CONTAINS NUM EV (Vx70352, DCM, "Post- Intervention Stenosis Measurement ")

1 M UNITS = EV (%, UCUM, "%")

> CONTAINS CODE EV (Vx70354, DCM, "Post- Intervention TIMI Flow")

1 U DCID (Cx38013) TIMI Flow

> CONTAINS CODE EV (Vx70364, DCM, "Dissection in segment")

?? U DCID (Cx0230) Yes-No

> CONTAINS CODE EV (Vx70365, DCM, "Acute closure observed")


>> HAS CONCEPT MOD

CODE EV (Vx70366, DCM, "Acute closure re-opened")


> CONTAINS CODE EV (Vx70367, DCM, "Perforation occurred")


150

1475

1480


TID Tx3809 Other Interventional Procedures


TID Tx3809Other Interventional Procedures




1 CONTAINER EV (Vx38091, DCM, "Other Interventional Procedures")

1 M

2 > CONTAINS TEXT EV (121065, DCM, "Procedure Description")

1-n M


CODE EV (Vx38092, DCM, "Intervention Type")

1 U BCID (Cx0006) Non-Coronary Transcatheter Interventions

TID Tx3810 Cardiac Catheterization Findings


TID Tx3810Cardiac Catheterization Findings




1 CONTAINS CONTAINER EV (121070, DCM, "Findings")

1 M

2 > CONTAINS INCLUDE DTID (Tx3812) Hemodynamic Findings

1-n U

3 > CONTAINS INCLUDE DTID (Tx3814) Left Ventriculography

1 U

4 > CONTAINS INCLUDE DTID (Tx3815) Right Ventriculography

1 U

5 > CONTAINS INCLUDE DTID (Tx3816) Coronary Arteriography

1 U

6 > CONTAINS INCLUDE DTID (Tx3818) Aortogram 1 U

TID Tx3812 Hemodynamic Findings


TID Tx3812Hemodynamic Findings




1 CONTAINS CONTAINER EV (, DCM, "Hemodynamic Findings")

1 M

1485

1490

1495

1500





2 > CONTAINS COMPOSITE EV (Vx50001, DCM, “Hemodynamics Report”)

1-n U

3 > CONTAINS NUM No BCID 1-n U

4 > CONTAINS TEXT EV (, DCM, "Hemodynamics Description")

TID Tx3814 Left VentriculographyThe information contained here about left ventricle is relatively qualitative in nature. It is a high-level summary of the more detailed information that may be contained in an optional QCA/QVA report.


TID Tx3814Left Ventriculography




1 CONTAINER EV (TT-0004, DCM, "Left Ventriculography")

1 M

2 > CONTAINS CODE EV (Vx70064, DCM, "LV Status")

1 M DCID (Cx0223) Normal-Abnormal

3 > CONTAINS NUM EV (10230-1, LN, "LV Ejection Fraction")

1 M UNITS = EV (%, UCUM,"Percent")

4 > CONTAINS CODE EV (Vx70335, DCM, "EF Testing method")

1 MC DCID (Cx1044, "EF Testing Method")

5 > CONTAINS CODE EV (Vx70336, DCM, "EF Testing calculation")

1 MC DCID (Cx1045, "EF Testing Calculation Method")

6 > CONTAINS CODE EV (Vx70067, DCM, "Pulmonary Hypertension")


7 > CONTAINS CODE DCID (Cx1017, "Ventriculography Wall Segments")

1-10

U DCID (Cx1004, "Wall Motion")

8 > CONTAINS CODE EV (Vx70081, DCM, "Chamber Size")

1 U DCID (Cx1005, "Chamber Size")

9 > CONTAINS CODE EV (Vx70082, DCM, "Overall Contractility")

1 U DCID (Cx1006, "Overall Contractility")

10 > CONTAINS CODE EV (Vx70083, DCM, "Ventricular Septal Defect")

1 U DCID (Cx1007, "VSD Description")

11 > CONTAINS CONTAINER EV (Vx70084, DCM, "LV Valvular and Subvalvular Abnormalities")

1-n U

12 >> CONTAINS CODE EV (Vx70085, DCM, "Valve")

1 U DCID (Cx1003, "Cardiac Valves and Tracts")

13 >>> HAS PROPERTIES

CODE EV (Vx70086, DCM, "Abnormality")

1 U DCID (Cx1011, "Valvular Abnormalities")

14 >>>>

HAS CONCEPT

CODE EV (Vx70005, DCM, "Severity")

1 U DCID (Cx1008, "Valve Stenosis and

155

1505

1510





MOD Regurgitation")

15 > CONTAINS CODE EV (Vx70087, DCM, "Aortic Root")

1 U DCID (Cx1009, "Aortic Root Description")

16 > CONTAINS TEXT EV (Vx70265, DCM, "Left Ventriculogram Description")

1 U

17 > CONTAINS IMAGE DT (121080, DCM, "Best illustration of finding"

1-n U

18 > CONTAINS COMPOSITE DT (?, DCM, "Quantitative Ventriculography Report")

1-n U

TID Tx3815 Right VentriculographyThe information contained here about right ventricle is relatively qualitative in nature. It is a high-level summary of the more detailed information that may be contained in an optional QCA/QVA report.


TID Tx3815Right Ventriculography




1 CONTAINER EV (TT-0005, DCM, "Right Ventriculography")

1 M

2 > CONTAINS NUM EV (10231-9, LN, "RV Ejection Fraction")

1 U UNITS = DT (%, UCUM,"Percent")

3 > CONTAINS CODE EV (Vx70081, DCM, "Chamber Size")

1 U DCID (Cx1005, "Chamber Size")

4 > CONTAINS CODE EV (Vx70082, DCM, "Overall Contractility")

1 U DCID (Cx1006, "Overall Contractility")

5 > CONTAINS CODE EV (Vx70083, DCM, "Ventricular Septal Defect")

1 U DCID (Cx1007, "VSD Description")

6 > CONTAINS CONTAINER EV (Vx70270, DCM, "RV Valvular and Subvalvular Abnormalities")

1-n U

7 >> CONTAINS CODE EV (Vx70085, DCM, "Valve")

1 U DCID (Cx1003, "Cardiac Valves and Tracts")

8 >>> HAS PROPERTIES

CODE EV (Vx70086, DCM, "Abnormality")

1 U DCID (Cx1011, "Valvular Abnormalities")

9 >>>>

HAS CONCEPT MOD


1 U DCID (Cx1008, "Valve Stenosis and Regurgitation")

10 > CONTAINS TEXT EV (Vx70266, DCM, "Right Ventriculogram Description")

1 U


1-n U

12 > CONTAINS COMPOSITE DT (?, DCM, "Quantitative Ventriculography Report")

1-n U

1515

1520


TID Tx3816 Coronary ArteriographyThe information contained here about with regards to coronary artery lesions is relatively qualitative in nature. It is a high-level summary of the more detailed information that may be contained in an optional QCA/QVA report.


TID Tx3816 Coronary Arteriogaphy




1 CONTAINER EV (TT-0006, DCM, "Coronary Arteriography")

1 M

2 > CONTAINS CODE EV (Vx70088, DCM, "Coronary Dominance")

1 U DCID (Cx1010, "Coronary Dominance")

3 > CONTAINS NUM EV (Vx70089, DCM, "Percent Stenosis - Left Main")


4 > CONTAINS NUM EV (Vx70090, DCM, "Percent Stenosis - Proximal Left Anterior Descending")


5 > CONTAINS NUM EV (Vx70091, DCM, "Percent Stenosis - Other Left Anterior Descending")


6 > CONTAINS NUM EV (Vx70092, DCM, "Percent Stenosis - Right Coronary Artery")


7 > CONTAINS NUM EV (Vx70093, DCM, "Percent Stenosis - Circumflex")


8 > CONTAINS CONTAINER EV (Vx70094, DCM, "Coronary Artery Lesion")

1-n U

9 >> CONTAINS CODE EV (Vx70095, DCM, "Coronary Artery Segment")

1 M BCID (3014, "Coronary Artery Segments")

10 >> CONTAINS CODE EV (Vx70096, DCM, "Coronary Artery Vessel Segment Modifier")

1 U BCID (3019, "Cardiovascular Anatomic Location Modifiers")

11 >> CONTAINS NUM EV (Vx70097, DCM, "Percent Stenosis")

1 U UNITS = EV (%, UCUM,"Percent")

12 >> CONTAINS CODE EV (Vx70098, DCM, "TIMI Flow")

1 U DCID (Cx38013, "TIMI Flow Characteristics")

13 >> CONTAINS CODE EV (Vx70099, DCM, "Thrombus")

1 U DCID (Cx1014, "Thrombus")

14 >> CONTAINS CODE EV (Vx70100, DCM, "Lesion Morphology")

1 U DCID (Cx1015, "Morphology")

15 >> CONTAINS CODE EV (Vx70101, DCM, "Lesion Calcification")

1 U DCID (Cx1016, "Severity")

16 >> CONTAINS CODE EV (Vx70102, DCM, "Coronary Lesion Descriptors")

1-n U DCID (Cx1012, "Coronary Lesion Descriptors")

17 > CONTAINS TEXT EV (Vx70267, DCM, "Coronary Arteriography Description")

1 U

18 > CONTAINS COMPOSITE DT (?, DCM, "Quantitative 1-n U

1525

1530





Arteriography Report")

TID Tx3818 Aortogram


TID Tx3818Aortogram




1 CONTAINS CONTAINER EV (, DCM, "Aortogram") 1 M

2 > CONTAINS TEXT EV (, DCM, "Aortogram Description")

1 U


1-n U

TID Tx3820 Complications, Cath


TID Tx3820Complications, Cath




1 CONTAINER EV (Vx70103, DCM, "Complications")

1 U

2 > CONTAINS CODE EV (Vx70372, DCM, "Cath Complications")

1-9 U DCID (Cx1055, "Cath Complications")

3 > CONTAINS CODE EV (Vx70373, DCM, "Vascular Complications")

1-6 U DCID (Cx1054, "Vascular Complications")

4 > CONTAINS TEXT EV (Vx70272, DCM, "Complications")

1 U

5 > CONTAINS CODE EV (Vx70368, DCM, "Peri-procedural MI occurred")


6 >> INFERRED FROM

NUM EV (Vx70370, DCM, "CK-MB baseline")

1 U UNITS = EV ([iU], UCUM,"International unit")

7 >> INFERRED FROM

NUM EV (Vx70371, DCM, "CK-MB peak")


8 >> INFERRED FROM

NUM EV (Vx70369, DCM, "CK-MB upper limit of normal")



1-n U

160

1535

1540

1545


TID Tx3824 Summary, Cath


TID Tx3824Summary, Cath




CONTAINS CONTAINER EV (Vx70004, DCM, "Summary")

1 U

> CONTAINS CODE EV (121071, DCM, "Finding")

1-n U DCID (Cx1028, "Cath Findings")

>> HAS PROPERTIES


1 U DCID (Cx1016, "Severity")

> CONTAINS TEXT EV (Vx70004, DCM, "Summary")

1 U

> CONTAINS TEXT EV (121075, DCM, "Recommendation")

1-n U

TID Tx3828 Discharge Summary, Cath


TID Tx3828Discharge Summary, Cath




1 CONTAINS CONTAINER EV (Vx70008, DCM, "Discharge Summary")

1 U

2 > CONTAINS DATETIME EV (TI-0307, DCM, "Discharge Date/Time")

1 U

3 > CONTAINS CODE EV (TI-0312, DCM, "Coronary Artery Bypass During This Admission ")


4 >> HAS PROPERTIES

CODE EV (DCM Vx0007 "Procedure Urgency")

1 U BCID Cx0014 Procedure Urgency

5 >> HAS PROPERTIES

DATE EV (, DCM, "Date of Coronary Artery Bypass")

1 U

6 > CONTAINS CODE EV (TI-0314, DCM, "Death During This Admission")


7 >> HAS PROPERTIES

DATE EV ( , DCM, "Date of Death")

1 U

8 >> HAS PROPERTIES

CODE EV (TI-0316, DCM, "Primary Cause of Death")

1 U DCID (Cx1033, "Primary Cause of Death")

9 >> HAS PROPERTIES

CODE EV (TI-0317, DCM, Death During Catheterization ")


1550

1555


Add the following to PS3.16 Annex B:

Annex B DCMR Context Groups (Normative)

Context Group Cx0000 – Procedure Log Titles


Code Scheme Code Value Concept Name

DCM Vx0000 Cath Lab Procedure Log

Context Group Cx0001 – Types of Log Notes



DCM Vx0101 Tech NoteDCM Vx0102 Nursing NoteDCM Vx0103 Physician NoteDCM Vx0104 Note (general)

Context Group Cx0002 – Patient Events



DCM Vx0201 Patient called to procedure roomDCM Vx0202 Patient admitted to procedure roomDCM Vx0203 Patient given pre-procedure instruction DCM Vx0204 Patient informed consent givenDCM Vx0205 Patient advance directive givenDCM Vx0206 Patient assisted to tableDCM Vx0207 Patient prepped and drapedDCM Vx0221 Patient reports nauseaDCM Vx0222 Patient restlessDCM Vx0223 Patient sedatedDCM Vx0224 Patient has respiratory difficultyDCM Vx0225 Patient coughedDCM Vx0216 Patient transferred to holding areaDCM Vx0217 Patient transferred to surgeryDCM Vx0218 Patient transferred to CCU

165

1560

1565

1570


DCM Vx0219 Patient transferred to morgueDCM Vx0220 Patient discharged

Context Group Cx0002a – Percutaneous Entry


Code Scheme Code Scheme Version

Code Value Concept Name

NCDR 2.0b 74-1 Percutaneous entry made via femoral arteryNCDR 2.0b 74-2 Percutaneous entry made via brachial arteryNCDR 2.0b 74-3 Percutaneous entry made via radial arteryNCDR 2.0b 74-4 Percutaneous entry made via other arteryNCDR 2.0b 74-5 Percutaneous entry made via venous accessNCDR 2.0b 75-1 Percutaneous entry closed by sutureNCDR 2.0b 75-2 Percutaneous entry closed by sealantNCDR 2.0b 75-3 Percutaneous entry closed by other mechanism

Context Group Cx0002b – Laterality

Type: Enumerated


SNM3 G-A100 RightSNM3 G-A101 Left

Context Group Cx0004 - Staff Actions


Code Scheme Code Value Concept NameDCM Vx0401 Personnel ArrivedDCM Vx0402 Personnel DepartedDCM Vx0403 Page Sent ToDCM Vx0404 Consultation WithDCM Vx0405 Office called

1580

1585


Context Group Cx0004a – Equipment Events



DCM Vx0200 Procedure room ready for patientDCM Vx0410 Equipment failureDCM Vx0411 Equipment brought to procedure roomDCM Vx0412 Equipment readyDCM Vx0413 Equipment removed

Context Group Cx0005 – Procedure Action Values



Code Value

Concept Name

SNM3 3.5 P1-31604 Catheterization of left heartSNM3 3.5 P1-31602 Catheterization of right heartSRT V1 G-7295 Cardiac catheterization intervention phaseSRT V1 G-7299 Cardiac catheterization bailout phaseSRT V1 G-7293 Cardiac catheterization baseline phaseSRT V1 G-7294 Cardiac catheterization image acquisition phaseSRT V1 G-7295 Cardiac catheterization intervention phaseSRT V1 G-7298 Cardiac catheterization post-intervention phaseSRT V1 G-7296 Cardiac catheterization pre-intervention phaseSRT V1.1 G-929D Cardiac catheterization test/challenging phaseSRT V1 G-7297 Cardiac catheterization therapy phaseSNM3 3.5 P1-31612 Transseptal catheterizationSNM3 3.5 P1-30350 Atherectomy, NOSSNM3 3.5 P1-30350 Removal of atherosclerotic plaque from artery,

NOSSNM3 3.5 P1-30351 Atherectomy by rotary cutterSNM3 3.5 P1-30352 Atherectomy by laserSNM3 3.5 P1-30530 Selective embolization of arterySNM3 3.5 P5-31500 Percutaneous transluminal balloon angioplasty,

NOSSNM3 3.5 P5-39010 Transcatheter therapy for embolization, NOSSNM3 3.5 P5-39050 Percutaneous retrieval of intravascular foreign

body, NOSSNM3 3.5 P1-05550 Stent placementSNM3 3.5 P5-39015 Transcatheter deployment of detachable balloon

1590


SNM3 3.5 P5-39191 Percutaneous insertion of intravascular filterINCLUDE CID Cx0006 Non-Coronary Transcatheter Interventions

Context Group Cx0006 – Non-Coronary Transcatheter Interventions


Code Scheme Code Value

Concept Name

DCM Vx0503 Valvular InterventionDCM Vx0504 Aortic InterventionDCM Vx0505 Septal Defect InterventionDCM Vx0506 Vascular Intervention

Context Group Cx0007 – Purpose of Reference to Object


Code Scheme Code Value Concept NameDCM Vx0701 Patient History and Physical ReportDCM Vx0702 Pre-procedure logDCM Vx0703 Analysis or measurements for current procedureDCM Vx0704 Consultant reportDCM Vx0705 Prior report for current patient

Context Group Cx0008 – Actions with Consumables


Code Scheme Code Value Concept NameDCM Vx0801 Consumable taken from inventoryDCM Vx0802 Consumable returned to inventoryDCM Vx0803 Remaining consumable disposed

Context Group Cx0009 – Administration of Drugs/Contrast


Code Scheme Code Value Concept NameDCM Vx0901 Drug start

170

1600

1605


DCM Vx0902 Drug endDCM Vx0903 Drug administeredDCM Vx0904 contrast startDCM Vx0905 contrast endDCM Vx0906 contrast administeredDCM Vx0907 Infusate startDCM Vx0908 Infusate end

Context Group Cx0010 – Numeric Parameters of Drugs/Contrast


Code Scheme Code Value Concept NameDCM Vx0061 Volume administeredDCM Vx0062 Undiluted dose administeredDCM Vx0063 ConcentrationDCM Vx0064 Rate of administrationDCM Vx0065 Duration of administrationDCM Vx0066 Volume unadministered or discarded

Context Group Cx0011 – Intracoronary Devices


Code Scheme Code Value Concept NameSNM3 A-26912 Percutaneous Transluminal Angioplasty BalloonSNM3 A-25500 Stent

Directional Coronary Atherectomy (DCA) DeviceSNM3 A-25610 Rotational Atherectomy Device, Rotablator™

Saline Thrombectomy, AngioJet™Cutting Balloon Angioplasty (CBA) DeviceTransluminal Extraction Catheter (TEC)

SNM3 A-81080 LaserIntravascular Ultrasound (IVUS) DeviceIntracoronary Doppler guide wire, Flowire™Intracoronary pressure guide wireBrachytherapy DeviceRadiofrequency Ablation Device

1610


Context Group Cx0011a – Interventional Devices


Code Scheme Code Value Concept NameIntra-Aortic Balloon Pump (IABP)Fluid filled catheterFiberoptic catheterHall catheterThermistor catheterTip manometerSwann-Ganz catheterSheath

INCLUDE CID Cx0011 Intracoronary Devices

Context Group Cx0012 – Intervention Actions and Status


Code Scheme Code Value Concept NameDCM Vx1101 Guidewire crossing lesion unsuccessful DCM Vx1102 Guidewire crossing lesion successfulDCM Vx1103 Interventional device emplacedDCM Vx1104 Intervention performed DCM Vx1105 Interventional device withdrawnDCM Vx1106 Dissection in Segment observedDCM Vx1107 Acute Closure observedDCM Vx1108 Successful ReopeningDCM Vx1109 Perforation in Segment

Context Group Cx0013 – Complications


Code Scheme Code Value Concept NameDCM Vx1216 Death in LabINCLUDE CID Cx1054 Vascular ComplicationsINCLUDE CID Cx1055 Cath Complications

175

1620

1625


Context Group Cx0014 – Procedure Urgency



Coding Scheme Version

Code Value Code Meaning

NCDR 2.0b 78-I Elective ProcedureNCDR 2.0b 78-II Urgent ProcedureNCDR 2.0b 78-III Emergent ProcedureNCDR 2.0b 78-IV Salvage Procedure

Context Group Cx0015 – Cardiac Rhythms


Code Scheme Code Value Concept NameSCPECG D.3.2.6-SR sinus rhythmSCPECG D.3.2.6-NSR normal sinus rhythmSCPECG D.3.2.6-SARRH sinus arrhythmiaSCPECG D.3.2.6-MSAR marked sinus arrhythmiaSCPECG D.3.2.6-SVARR supraventricular arrhythmiaSCPECG D.3.2.6-STACH sinus tachycardiaSCPECG D.3.2.6-ETACH extreme tachycardiaSCPECG D.3.2.6-SBRAD sinus bradycardiaSCPECG D.3.2.6-EBRAD extreme bradycardiaSCPECG D.3.2.6-JTACH junctional tachycardiaSCPECG D.3.2.6-SVTAC supraventricular tachycardiaSCPECG D.3.2.6-JBRAD junctional bradycardiaSCPECG D.3.2.6-SVBRA supraventricular bradycardiaSCPECG D.3.2.6-WQTAC wide QRS tachycardiaSCPECG D.3.2.6-NQTAC narrow QRS tachycardiaSCPECG D.3.2.6-TACHO tachycardia, origin unknown or not specifiedSCPECG D.3.2.6-BRADO bradycardia, origin unknown or not specifiedSCPECG D.3.2.6-ARRHY arrhythmia, origin unknownSCPECG D.3.2.6-IRREG irregular rhythmSCPECG D.3.2.6-REGRH regular rhythmSCPECG D.3.2.6-JESCR junctional escape rhythmSCPECG D.3.2.6-VESCR ventricular escape rhythmSCPECG D.3.2.6-ACAR accelerated atrial rhythmSCPECG D.3.2.6-ACVR accelerated ventricular rhythmSCPECG D.3.2.6-ACJR accelerated junctional rhythmSCPECG D.3.2.6-AVJR AV-junctional rhythm

1630


SCPECG D.3.2.6-ARHYT atrial rhythmSCPECG D.3.2.6-SVRHY supraventricular rhythmSCPECG D.3.2.6-JRHYT junctional rhythmSCPECG D.3.2.6-VRHYT ventricular rhythmSCPECG D.3.2.6-UNRHY undetermined rhythmSCPECG D.3.2.6-EAR ectopic atrial rhythmSCPECG D.3.2.6-LAR left atrial rhythmSCPECG D.3.2.6-MAR multifocal atrial rhythmSCPECG D.3.2.6-NODRH nodal rhythmSCPECG D.3.2.6-RAR low right atrial rhythmSCPECG D.3.2.6-LGL Lown-Ganong-Levine syndrome SCPECG D.3.2.6-SHTPR Short PR-intervalSCPECG D.3.2.6-AFIB atrial fibrillationSCPECG D.3.2.6-AFLT atrial flutterSCPECG D.3.2.6-ATACH atrial tachycardiaSCPECG D.3.2.6-PSVT paroxysmal supraventricular tachycardiaSCPECG D.3.2.6-PAT paroxysmal atrial tachycardiaSCPECG D.3.2.6-MFAT multifocal atrial tachycardiaSCPECG D.3.2.6-RATAC run of atrial tachycardiaSCPECG D.3.2.6-RJTAC run of junctional tachycardiaSCPECG D.3.2.6-AVNRT atrioventricular nodal re-entrant tachycardiaSCPECG D.3.2.6-AVRT atrioventricular reciprocating tachycardiaSCPECG D.3.2.6-IDIOR idioventricular rhythmSCPECG D.3.2.6-VFIB ventricular fibrillationSCPECG D.3.2.6-VTACH ventricular tachycardiaSCPECG D.3.2.6-RVTAC run of ventricular tachycardiaSCPECG D.3.2.6-SVT sustained ventricular tachycardiaSCPECG D.3.2.6-NSVT non-sustained ventricular tachycardiaSCPECG D.3.2.6-TORSA torsade des pointes ventricular tachycardiaSCPECG D.3.2.6-MTACH multifocal tachycardia (multiform),

supraventricular or ventricularSCPECG D.3.2.6-VFLT ventricular flutterSCPECG D.3.2.6-ASYST asystole


Context Group Cx0018 – Lesion Risk




NCDR 2.0 2.0b 111-1 Low Risk LesionNCDR 2.0 2.0b 111-2 Moderate Risk LesionNCDR 2.0 2.0b 111-3 High Risk Lesion

Context Group Cx0019 – Findings Titles


Code Scheme Code Value Concept NameDCM 121071 FindingDCM 121073 ImpressionDCM 121075 Recommendation

Context Group Cx0021 – Procedure Action


Code Scheme Code Value Concept NameDCM Vx0020 Start Procedure ActionDCM Vx0021 End Procedure ActionDCM Vx0022 Suspend Procedure ActionDCM Vx0023 Resume Procedure Action

Context Group Cx0022 – Device Use Actions


Code Scheme Code Value Concept NameDevice inserted into sheathDevice at site of interestDevice withdrawn / removedDevice applied to patientDevice used

180

1640

1645

1650


Context Group Cx0023 – Device Characteristics


Code Scheme Code Value Concept NameSRT G-A22A LengthSNM3 M-02550 Diameter

Context Group Cx0025 – Intervention Parameters


Code Scheme Code Value Concept NameAngioplasty Inflation pressureAngioplasty Inflation durationRotational Atherectomy SpeedDelivered Radiation Dose

Context Group Cx0220 - Level of Significance


Code Scheme Code Value Concept Name Most significant Highly significant Moderately significant Minimally significant Not significant

Context Group Cx0221 - Measurement Range Concepts


Code Scheme Code Value Concept NameNormal Range Upper Limit90th Percentile95th Percentile1 Sigma Upper Limit2 Sigma Upper LimitNormal Range Lower Limit10th Percentile

1660

1665


5th Percentile1 Sigma Lower Limit2 Sigma Lower LimitPercentile RankingZ-Score

Context Group Cx0222 – Normality Codes


Code Scheme Code Value Concept NameNormalAbnormalAbnormally HighAbnormally LowNormality Undetermined

Context Group Cx0223 – Normal-Abnormal


Code Scheme Code Value Concept NameNormalAbnormalNormality Undetermined

Context Group Cx0225 – Measurement Uncertainty Concepts


Code Scheme Code Value Concept Name+/- , range of measurement uncertainty+ , range of upper measurement uncertainty- , range of lower measurement uncertainty

185

1670

1680


Context Group Cx0230 – Yes-No

Type: Enumerated Version: 2002

Code Scheme Code Value Concept NameYesNoUndetermined

Context Group Cx0500 – Pressure Units

Type: Enumerated

Code Scheme Code Value Concept NameUCUM mm[Hg] mmHgUCUM kPa kPa

Context Group Cx0502 – Hemodynamic Resistance Units

Type: Enumerated

Code Scheme Code Value Concept NameUCUM [PRU] Wood unitsUCUM dyn.s.cm-5 dyn.s.cm-5

Context Group Cx0503 – Indexed Hemodynamic Resistance Units

Type: Enumerated

Code Scheme Code Value Concept NameUCUM [PRU]/m2 Wood units / m2UCUM dyn.s.cm-5/m2 dyn.s.cm-5 / m2

Context Group Cx0510 – Catheter Size Units

Type: Enumerated

Code Scheme Code Value Concept NameUCUM [Ch] FrenchUCUM mm mm

1685

1690

1700


Context Group Cx0520 – Blood Source Type


Code Scheme Code Value Concept NameSystemic Artery BloodMixed Venous BloodPulmonary Artery BloodPulmonary Vein Blood

Context Group Cx0524 – Blood Gas Pressures


Code Scheme Code Value Concept NameLN 11557-6 Blood Carbon dioxide partial pressureLN 2019-8 Arterial Blood Carbon dioxide partial pressureLN 2021-4 Venous Blood Carbon dioxide partial pressureLN 11556-8 Blood Oxygen partial pressureLN 2703-7 Arterial Oxygen partial pressureLN 2705-2 Venous Oxygen partial pressureLN 19217-9 Oxygen partial pressure at 50% saturation (P50)LN 19214-6 Arterial Oxygen partial pressure at 50% saturation LN 19216-1 Venous Oxygen partial pressure at 50% saturation

Context Group Cx0525 – Blood Gas Content


Code Scheme Code Value Concept NameLN 20565-8 Blood Carbon dioxide contentLN 2026-3 Arterial Blood Carbon dioxide contentLN 2027-1 Venous Blood Carbon dioxide content

Blood Oxygen contentLN 19218-7 Arterial Oxygen contentLN 19220-3 Venous Oxygen contentLN 10232-7 Aortic Root Oxygen contentLN 10245-9 Pulmonary Artery Main Oxygen contentLN 10247-5 Pulmonary Wedge Oxygen content

1705

1710


Context Group Cx0526 – Blood Gas Saturation


Code Scheme Code Value Concept NameBlood Carbon dioxide saturation

LN 20564-1 Blood Oxygen saturationLN 2708-6 Arterial Oxygen saturationLN 2711-0 Venous Oxygen saturationLN 2709-4 Capillary Blood Oxygen Saturation LN 2710-2 Capillary Blood Oxygen Saturation, by Oximetry

Context Group Cx0527 – Blood Base Excess


Code Scheme Code Value Concept NameLN 11555-0 Blood Base ExcessLN 1925-7 Arterial Blood Base ExcessLN 1927-3 Venous Blood Base Excess

Context Group Cx0528 – Blood pH


Code Scheme Code Value Concept NameLN 11558-4 Blood Base ExcessLN 2744-1 Arterial Blood Base ExcessLN 2746-6 Venous Blood Base Excess

Context Group Cx0529 – Arterial / Venous Content


Code Scheme Code Value Concept NameArterial Content (FCa)Venous Content (FCv)Pulmonary Arterial Content (FCpa)Pulmonary Venous Content (FCpv)

190

1720

1725


Context Group Cx0530 – Oxygen Administration Actions


Code Scheme Code Value Concept NameDCM Vx05301 Begin oxygen administration

End oxygen administration

Context Group Cx0531 – Oxygen Administration


Code Scheme Code Value Concept Nameby nasal canulaby mask

Context Group Cx0550 – Circulatory Support Actions


Code Scheme Code Value Concept NameBegin Circulatory Support

End Circulatory Support

Context Group Cx0551 – Ventilation Actions


Code Scheme Code Value Concept NameBegin Ventilation

End Ventilation

Context Group Cx0552 – Pacing Actions


Code Scheme Code Value Concept NameBegin Pacing

End Pacing

1730

1740

1745


Context Group Cx0553 – Circulatory Support


Code Scheme Code Value Concept NameIntra-Aortic Balloon Pump

External Counter-Pulsation

Left Ventricular Assist Device

Context Group Cx0554 – Ventilation


Code Scheme Code Value Concept NameAmbue Bag

Pressure Support Ventilator

Volume Support Ventilator

Context Group Cx0555 – Pacing




SNM3 3.5 P2-35000 Pacing

DCM D-3262-002 pacing with magnet

DCM D-3262-003 atrial pacing

DCM D-3262-004 ventricular pacing

DCM D-3262-005 A-V sequential pacing

Context Group Cx0560 – Blood Pressure Measurement Techniques


Code Scheme Code Value Concept NameBlood pressure cuff method

Context Group Cx0600 – Relative time

195

1750

1755

1760

1765


Type: Enumerated

Code Scheme Code Value Concept NameBefore

During

After

Context Group Cx0602 – Hemodynamic Patient State




SRT V1 F-01602 Baseline state

SNM3 3.5 F-10340 Supine body position

SRT V1 F-01604 Resting state

SRT V1 F-01606 Exercise state

SRT V1 F-01608 Post-exercise state

DCM D-3262-007 Post-contrast state

Context Group Cx0606 – Arterial source locations


Code Scheme Code Value Concept NameSNM3 T-42500 Abdominal aortaSNM3 T-45530 anterior communicating arterySNM3 T-45530 anterior spinal arterySNM3 T-42000 AortaSNM3 T-42300 Aortic ArchSRT D3-81922 Aortic fistula SNM3 T-41000 Artery (NOS)SNM3 T-42100 Ascending aortaSNM3 T-47100 Axillary ArterySRT A-00203 BaffleSNM3 T-45800 basilar arterySNM3 T-47160 Brachial arterySNM3 T-46010 brachiocephalic trunkSNM3 T-45010 Carotid ArterySNM3 T-45510 cerebral arterySNM3 T-45100 Common carotid artery

1770


SNM3 T-43000 Coronary Artery (NOS)SNM3 T-42400 Descending aortaSNM3 T-45240 facial arterySNM3 T-47400 Femoral arterySRT D4-32504 Fistula coronary to left atriumSRT D4-32506 Fistula coronary to left ventricleSRT D4-32508 Fistula coronary to right atriumSRT D4-32510 Fistula coronary to right ventricleSRT T-47490 geniculate arterySNM3 T-46420 Hepatic arterySNM3 T-46700 Iliac arterySNM3 T-46010 Innominate arterySNM3 T-45300 internal carotid arterySNM3 T-46200 Internal mammary arterySNM3 T-46200 internal maxillary arterySNM3 T-45410 lactrimal arterySNM3 T-44400 Left pulmonary arterySNM3 T-45230 lingual arterySNM3 T-46960 lumbar arterySNM3 T-46500 mesenteric arterySNM3 T-F7001 Neo-aorta (primitive aorta)SNM3 T-F7040 Neonatal pulmonary artery (primitive PA)SNM3 T-45250 occipital arterySNM3 T-45400 ophthalmic arterySNM3 D4-32012 patent ductus arteriosusSNM3 T-47630 peroneal artery

plantar arterySNM3 T-47500 popliteal arterySNM3 T-45320 posterior communicating arterySNM3 D3-40208 Pulmonary arteriovenous fistulaSNM3 T-44000 Pulmonary arterySRT D4-33142 Pulmonary artery conduit

Pulmonary vein wedgeSNM3 T-47300 radial arterySNM3 T-46600 Renal arterySNM3 T-47410 Right femoral arterySNM3 T-44200 Right pulmonary artery

soleal arterySNM3 T-46100 Subclavian ArterySNM3 T-45270 superficial temporal artery


SNM3 T-45270 superior thyroid arterySNM3 T-44007 Systemic collateral Artery to lungSNM3 T-42070 Thoracic aorta

tibial arterySNM3 D4-31400 Truncus Arteriosus CommunisSNM3 T-88810 Umbilical arterySNM3 T-45700 Vertebral artery

Context Group Cx0607 – Venous Source locations


Code Scheme Code Value Concept NameSRT T-48503 Anomalous pulmonary veinSRT T-49215 Antecubital Vein (NOS)SNM3 T-49110 Axillary veinSNM3 T-48340 Azygos vein

Basilic veinSRT T-49424 Boyd perforating veinSNM3 T-49350 Brachial veinSNM3 T-48003 Central venous systemSNM3 T-49240 cephalic veinSNM3 T-49429 Dodd perforating veinSNM3 T-49410 Femoral veinSNM3 T-48820 gastric veinSNM3 T-48720 hepatic veinSRT T-4942A Hunterian perforating veinSNM3 T-48710 Inferior Vena cavaSNM3 T-48620 Innominate veinSRT T-4884A mesenteric veinSNM3 T-48810 portal veinSRT T-49535 posterior medial tributarySNM3 T-48500 Pulmonary veinSRT D4-33512 Pulmonary vein confluenceSNM3 T-48740 Renal veinSRT T-D930A Saphenofemoral junctionSNM3 T-49530 Saphenous veinSNM3 T-48890 splenic veinSNM3 T-48330 Subclavian vein

200


SNM3 T-48610 Superior vena cavaSNM3 T-48817 Umbilical veinSNM3 T-48000 Vein (NOS)

Vena anonymaSNM3 T-48710 Vena jugularis interna

Context Group Cx0608 – Atrial source locations


Code Scheme Code Value Concept NameSRT A-00203 BaffleSNM3 D4-31320 Common atriumSNM3 T-32320 Coronary sinusSRT D4-31052 Juxtaposed appendageSNM3 T-32300 Left atriumDCM D-608-001 Pulmonary artery wedgeDCM D-608-002 Pulmonary capillary wedgeSRT D4-33514 Pulmonary venous atriumSRT T-32190 Pulmonary chamber in cor triatriatumSNM3 T-32200 Right AtriumSRT D4-33516 Systemic venous atrium

Context Group Cx0609 – Ventricle source locations


Code Scheme Code Value Concept NameSNM3 T-32400 Common ventricleSNM3 T-32600 Left ventricle,SRT T-32602 left ventricle apexSNM3 T-32640 Left ventricle inflowSRT D4-31022 left ventricle outflow chamberSNM3 T-32650 Left ventricle outflow tractSNM3 T-32500 Right ventricleSRT T-32502 Right ventricle apexSNM3 T-32540 Right ventricle inflowSRT D4-31022 Right ventricle outflow chamberSNM3 T-32550 Right ventricle outflow tract

1785

1790


Context Group Cx0610 – Gradient Source Locations


Code Scheme Code Value Concept NameSNM3 T-35300 Mitral ValveSNM3 T-35400 Aortic ValveSNM3 T-35100 Tricuspid valveSNM3 T-35200 Pulmonary valveSNM3 T-44000 Pulmonary arterySNM3 T-32650 Left ventricle outflow tractSNM3 T-32550 Right ventricle outflow tract

Ventricular Septal defectAtrial Septal defectCoarctation of aorta

Context Group Cx0611 – Pressure Measurements


DCM 109016 a-wave pressureDCM c-wave pressureDCM Diastolic pressureDCM Diastolic pressure, meanDCM Diastolic pressure, nadirDCM End diastolic pressureDCM Gradient pressure, averageDCM Gradient pressure, peakDCM 109027 Mean pressureDCM Pressure at dp/dt maxDCM Systolic pressureDCM 109032 Systolic pressure, meanDCM 109033 Systolic pressure, peakDCM 109034 v-wave pressureDCM x-descent pressureDCM y-descent pressureDCM z-point pressure

205

1795


Context Group Cx0612 – Blood Velocity Measurements


DCM Diastolic blood velocity, meanDCM Diastolic blood velocity, peakDCM Systolic blood velocity, meanDCM Systolic blood velocity, peakDCM Blood velocity, meanDCM Blood velocity, minimumDCM Blood velocity, peak DCM 109073 Vmax

Context Group Cx0613 – Hemodynamic Time Measurements


DCM R-R intervalDCM 109072 TauDCM Left Ventricular ejection timeDCM Left Ventricular filling timeDCM Right Ventricular ejection timeDCM Right Ventricular filling timeDCM 109071 Indicator mean transit time

Context Group Cx0614 – Valve Areas


Vx702004 Aortic Valve AreaVx702044 Pulmonary Valve AreaVx702064 Tricuspid Valve AreaVx702006 Derived Area, Non-Valve

Context Group Cx0615 – Valve Area Indexes


Vx702002 Aortic Valve Area IndexVx702032 Mitral Valve Area IndexVx702042 Pulmonary Valve Area IndexVx702062 Tricuspid Valve Area Index

1800

1810


Vx702067 Derived Area Index, Non-Valve

Context Group Cx0616 – Hemodynamic Period Measurements


Aortic Systolic Ejection Period (SEPa)Pulmonary Systolic Ejection Period (SEPp)Mitral Diastolic Filling Period (DFPm)Tricuspid Diastolic Filling Period (DFPt)Derived Period, Non-Valve

Context Group Cx0617 – Valve Flows


Aortic Valve Flow Mitral Valve Flow Pulmonary Valve Flow Tricuspid Valve FlowDerived Flow, Non-Valve

Context Group Cx0619 – Indexed Hemodynamic Resistence Measurements


Pulmonary Vascular Resistance IndexSystemic Vascular Resistance IndexTotal Pulmonary Resistance IndexTotal Vacular Resistance Index

Context Group Cx0627 – Measurement Type


Code Scheme Code Value Concept NameBest valueMeanMedianModePoint source

1815

1820

1830


Peak to peakVisual estimation

Context Group Cx0628 – Cardiac Output Methods


Code Scheme Code Value Concept NameThermal BathThermal InlineDye Dilution

Context Group Cx0629 – Procedure Type


Code Scheme Code Value Concept NameDiagnosticTherapeuticCombined Diagnostic and Therapeutic

Context Group Cx0630 - Cardiovascular Anatomical locations


Code Scheme Code Value Concept NameINCLUDE CID Cx0606 Arterial source locationsINCLUDE CID Cx0607 Venous Source locationsINCLUDE CID Cx0608 Atrial source locationsINCLUDE CID Cx0609 Ventricle source locationsINCLUDE CID Cx0610 Gradient Source Locations

Context Group Cx0651 - Hemodynamic Measurement phase




SRT V1 G-7293 Cardiac catheterization baseline phaseSRT V1 G-729B Cardiac catheterization post contrast phaseSRT V1 G-7298 Cardiac catheterization post-intervention phase

210

1835

1840


SRT V1.1 G-929D Cardiac catheterization test/challenging phaseCardiac catheterization gradient assessment phaseDrugExercisePatient on Intra aortic balloon pump assistPatient on circulatory assistPatient on OxygenPatient pacedPatient ventilatedPost AngioPost PTCAPost VgramPullbackRest

Context Group Cx0702 - Fractional Flow Reserve


Code Scheme Code Value Concept NameDCM Vx702025 Fractional flow reserveDCM Vx702019 Fractional Flow Reserve using intracoronary bolusDCM Vx702020 Fractional FlowReserve using intravenous infusion

Context Group Cx0703 - Body Surface Area Equations


Code Scheme Code Value Concept NameDCM Vx703010 BSA = 0.003207*WT^(0.7285-0.0188 log (WT))*HT^0.3DCM Vx703010a BSA = 0.007184*WT^0.425*HT^0.725DCM Vx703010b BSA = 0.0235*WT^0.51456*HTcm^0.42246DCM Vx703010c BSA = 0.024265*WT^0.5378*HTcm^0.3964DCM Vx703010d BSA = (HT * WT/36)^0.5

Context Group Cx0704 - Oxygen Consumption Equations and Tables


Code Scheme Code Value Concept NameDCM Vx703037 VO2male = BSA (138.1 - 11.49 * loge(age) + 0.378*HRf)

1850

1855


DCM Vx703038 VO2female = BSA (138.1 - 17.04 * loge(age) + 0.378*HRf)DCM Vx703039 VO2 = VeSTPD * 10 * (FIO2 - FE02)DCM Vx703040 VO2 = 152 * BSADCM Vx703041 VO2 = 175 * BSADCM Vx703042 VO2 = 176 * BSADCM Vx703043 Robertson & Reid tableDCM Vx703044 Fleisch tableDCM Vx703045 Boothby table

Context Group Cx0706 - P50 Equations


Code Scheme Code Value Concept NameDCM Vx703046 if (prem age< 3days) P50= 19.9DCM Vx703047 if (age < 1day) P50= 21.6DCM Vx703048 if (age < 30day) P50= 24.6DCM Vx703049 if (age < 18y) P50= 27.2DCM Vx703050 if (age < 40y) P50= 27.4DCM Vx703051 if (age > 60y) P50= 29.3

Context Group Cx0707 - Framingham Scores


Code Scheme Code Value Concept NameDCM Vx702070 10 Year CHD Risk DCM Vx702071 Comparative Average 10 Year CHD RiskDCM Vx702072 Comparative Low 10 Year CHD Risk

Context Group Cx0708 - Framingham Tables


Code Scheme Code Value Concept NameDCM Vx702073 LDL Cholesterol Score Sheet for MenDCM Vx702074 LDL Cholesterol Score Sheet for WomenDCM Vx702075 Toral Cholesterol Score Sheet for MenDCM Vx702076 Toral Cholesterol Score Sheet for Women

215

1860

1870


Context Group Cx0900 - ECG Report Titles


CID Cx0900ECG Report Titles



Resting 12-Lead ECG Report15-Lead ECG Report

LN 28010-7 ECG Report

Context Group Cx0901 - Reason for Exam


CID Cx0901Reason for Exam



DCM EmergencyDCM Pre-SurgeryDCM OutpatientDCM CCUDCM EDDCM MurmurDCM Routine

Context Group Cx0902 - Pacemakers


CID Cx0902Pacemakers




SCPECG 1.3 PAVVI VVI pacemakerSCPECG 1.3 PAAAI AAI pacemakerSCPECG 1.3 PAVAT VAT pacemakerSCPECG 1.3 PAVDD VDD pacemakerSCPECG 1.3 PADVI DVI pacemaker

1875

1880

1885

1890


SCPECG 1.3 PADDD DDD pacemaker

Context Group Cx0903 Diagnosis


CID Cx0903Diagnosis




SCPECG 1.3 5.4.5-32-1 Apparently healthySCPECG 1.3 5.4.5-32-10 Acute myocardial infarctionSCPECG 1.3 5.4.5-32-11 Myocardial infarctionSCPECG 1.3 5.4.5-32-12 Previous myocardial infarctionSCPECG 1.3 5.4.5-32-15 Ischemic heart diseaseSCPECG 1.3 5.4.5-32-18 Peripheral vascular diseaseSCPECG 1.3 5.4.5-32-20 Cyanotic congenital heart diseaseSCPECG 1.3 5.4.5-32-21 Acyanotic congenital heart diseaseSCPECG 1.3 5.4.5-32-22 Valvular heart diseaseSCPECG 1.3 5.4.5-32-25 HypertensionSCPECG 1.3 5.4.5-32-27 Cerebrovascular accidentSCPECG 1.3 5.4.5-32-30 CardiomyopathySCPECG 1.3 5.4.5-32-35 PericarditisSCPECG 1.3 5.4.5-32-36 MyocarditisSCPECG 1.3 5.4.5-32-40 Post-operative cardiac surgerySCPECG 1.3 5.4.5-32-42 Implanted cardiac pacemakerSCPECG 1.3 5.4.5-32-45 Pulmonary embolismSCPECG 1.3 5.4.5-32-50 Respiratory diseaseSCPECG 1.3 5.4.5-32-55 Endocrine diseaseSCPECG 1.3 5.4.5-32-60 Neurological diseaseSCPECG 1.3 5.4.5-32-65 Alimentary diseaseSCPECG 1.3 5.4.5-32-70 Renal DiseaseSCPECG 1.3 5.4.5-32-80 Pre-operative general surgerySCPECG 1.3 5.4.5-32-81 Post-operative general surgerySCPECG 1.3 5.4.5-32-90 General medicalSCPECG 1.3 5.4.5-32-100 Other

Context Group Cx0905 - Other Filters


1895

1900


CID Cx0905Other Filters




SCPECG 1.3 5.4.5-299-0 60 Hertz notch filterSCPECG 1.3 5.4.5-299-1 50 Hertz notch filterSCPECG 1.3 5.4.5-299-2 Artifact filterSCPECG 1.3 5.4.5-299-3 Baseline filterSCPECG 1.3 5.4.5-299-4 Filter, other

Context Group Cx0906 - Lead Measurement Technique


CID Cx0906Lead Measurement Technique



DCM AveragedDCM RoutineDCM MedianDCM RepresentativeDCM Single Beats

Context Group Cx0907 - Summary Codes ECG


CID Cx0907Summary Codes ECG



DCM NormalDCM AbnormalDCM Borderline NormalDCM Otherwise Normal

Context Group Cx0908 - QT Correction Algorithms


220

1905

1910

1915


CID Cx0908QT Correction Algorithms




SCPECG 1.3 5.10.2.5-1 BazettSCPECG 1.3 5.10.2.5-2 HodgesSCPECG 1.3 5.10.2.5-3 Other

Context Group Cx0909 - ECG Morphology Descriptions


CID Cx0909ECG Morphology Descriptions




SCPECG 1.3 5.13.5.1-0 UnknownSCPECG 1.3 5.13.5.1-1 PositiveSCPECG 1.3 5.13.5.1-2 NegativeSCPECG 1.3 5.13.5.1-3 positive/negativeSCPECG 1.3 5.13.5.1-4 negative/positiveSCPECG 1.3 5.13.5.1-5 positive/negative/positiveSCPECG 1.3 5.13.5.1-6 negative/positive/negativeSCPECG 1.3 5.13.5.1-7 notched M-shapedSCPECG 1.3 5.13.5.1-8 notched W-shaped

Context Group Cx0910 - ECG Lead Noise Descriptions


CID Cx0910ECG Lead Noise Descriptions




SCPECG 1.3 Noise-1 AC (mains) noiseSCPECG 1.3 Noise-2 overrangeSCPECG 1.3 Noise-3 wanderSCPECG 1.3 Noise-4 tremor or muscle artifactSCPECG 1.3 Noise-5 spikes or sudden jumpsSCPECG 1.3 Noise-6 electrode loose or offSCPECG 1.3 Noise-7 pacemakerSCPECG 1.3 Noise-8 interchanged lead

1920

1925

1930


Context Group Cx0911 - ECG Lead Noise Modifiers


CID Cx0911ECG Lead Noise Modifiers




SCPECG 1.3 5-13-5-2-0 NoneSCPECG 1.3 5-13-5-2-1 ModerateSCPECG 1.3 5-13-5-2-2 SevereSCPECG 1.3 5-13-5-2-3 Unknown

Context Group Cx0912 - Probability


CID Cx0912Probability




SCPECG 1.3 D.2.2-DE definiteSCPECG 1.3 D.2.2-PR probableSCPECG 1.3 D.2.2-PS possibleSCPECG 1.3 D.2.2-CE rule out/cannot excludeSCPECG 1.3 D.2.2-CO considerSCPECG 1.3 D.2.2-SS strongly suggestiveSCPECG 1.3 D.2.2-CW consistent withSCPECG 1.3 D.2.2-UN unknown

Context Group Cx0913 - Modifiers


CID Cx0913Modifiers




SCPECG 1.3 D.2.3-AB abnormal

225

1935

1940

1945

1950


SCPECG 1.3 D.2.3-AC acuteSCPECG 1.3 D.2.3-AF antero-inferiorSCPECG 1.3 D.2.3-AI age indeterminateSCPECG 1.3 D.2.3-AL anterolateralSCPECG 1.3 D.2.3-AN anteriorSCPECG 1.3 D.2.3-AS anteroseptalSCPECG 1.3 D.2.3-AT atrialSCPECG 1.3 D.2.3-AU age undeterminedSCPECG 1.3 D.2.3-BA basalSCPECG 1.3 D.2.3-BA borderline abnormalSCPECG 1.3 D.2.3-BN borderline normalSCPECG 1.3 D.2.3-BO borderlineSCPECG 1.3 D.2.3-CP completeSCPECG 1.3 D.2.3-DI diffuseSCPECG 1.3 D.2.3-EL compatible with electrolyte abnormalitiesSCPECG 1.3 D.2.3-EV evolvingSCPECG 1.3 D.2.3-EX extensiveSCPECG 1.3 D.2.3-HL high lateralSCPECG 1.3 D.2.3-IC incompleteSCPECG 1.3 D.2.3-IL inferolateralSCPECG 1.3 D.2.3-IN inferiorSCPECG 1.3 D.2.3-IP inferoposteriorSCPECG 1.3 D.2.3-LA lateralSCPECG 1.3 D.2.3-LV compatible with left ventricular strainSCPECG 1.3 D.2.3-MA majorSCPECG 1.3 D.2.3-MD compatible with myocardial ischemic damageSCPECG 1.3 D.2.3-MI minorSCPECG 1.3 D.2.3-MO moderateSCPECG 1.3 D.2.3-ND nodalSCPECG 1.3 D.2.3-NO within normal limitsSCPECG 1.3 D.2.3-NX may be normal variantSCPECG 1.3 D.2.3-OL oldSCPECG 1.3 D.2.3-PE compatible with pericarditisSCPECG 1.3 D.2.3-PL posterolateralSCPECG 1.3 D.2.3-PO posteriorSCPECG 1.3 D.2.3-RE recentSCPECG 1.3 D.2.3-SE septalSCPECG 1.3 D.2.3-SI sinusSCPECG 1.3 D.2.3-SN subendocardialSCPECG 1.3 D.2.3-SP subepicardial


SCPECG 1.3 D.2.3-SU subacuteSCPECG 1.3 D.2.3-SV supraventricularSCPECG 1.3 D.2.3-TY typicalSCPECG 1.3 D.2.3-VE ventricularSCPECG 1.3 D.2.3-WI widespreadSCPECG 1.3 D.2.3-XA probably acute (recent)SCPECG 1.3 D.2.3-XO probably oldSCPECG 1.3 D.2.3-YA possibly acute (recent)SCPECG 1.3 D.2.3-YO possibly oldSCPECG 1.3 D.2.3-YT atypical

Context Group Cx0914 - Trend


CID Cx0914Trend




SCPECG 1.3 D.2.3-4-SE serial changes consistent with...SCPECG 1.3 D.2. 3-4-CC continuing changes of...SCPECG 1.3 D.2. 3-4-OC occasionalSCPECG 1.3 D.2. 3-4-IM intermittentSCPECG 1.3 D.2. 3-4-TE temporarySCPECG 1.3 D.2. 3-4-EV evolvingSCPECG 1.3 D.2. 3-4-NE newSCPECG 1.3 D.2. 3-4-MU multipleSCPECG 1.3 D.2. 3-4-TR transientSCPECG 1.3 D.2. 3-4-UF unifocalSCPECG 1.3 D.2. 3-4-MF multifocalSCPECG 1.3 D.2. 3-4-FR frequent

Context Group Cx0915 - Conjunctive Terms


CID Cx0915Conjunctive Terms




SCPECG 1.3 D.2.5-2-AND and

1955

1960


SCPECG 1.3 D.2.5-2-OR orSCPECG 1.3 D.2.5-2-NOT notSCPECG 1.3 D.2.5-2-XOR exclusive orSCPECG 1.3 D.2.5-3-SER serial changes ofSCPECG 1.3 D.2.5-3-DEC decreased (in comparison to the previous

recordingSCPECG 1.3 D.2.5-3-INC increased (in comparison to the previous

recordingSCPECG 1.3 D.2.5-3-UNC unchanged/has not changed (in comparison to the

prSCPECG 1.3 D.2.5-3-CHG changed/has changed (in comparison to the

previousSCPECG 1.3 D.2.5-3-DIS (now) disappeared (in comparison to the previous

rSCPECG 1.3 D.2.5-3-REP (now) replaced ((statement) reported previously )SCPECG 1.3 D.2.5-3-IMP improved (compared to)SCPECG 1.3 D.2.5-3-WRS worse (compared to)SCPECG 1.3 D.2.5-4-RES to indicate that the leading statement "results" in

or "causes" the second statementSCPECG 1.3 D.2.5-4-SEC to indicate that the leading statement is

"secondary to" the subsequent statementSCPECG 1.3 D.2.5-4-ASS is associated withSCPECG 1.3 D.2.5-4-EXC exclude, rule out, or consider also the next stateSCPECG 1.3 D.2.5-4-WTH withSCPECG 1.3 D.2.5-4-ALT alternating with

Context Group Cx0916 ECG Interpretive Statements


CID Cx0916ECG Interpretive Statements




SCPECG 1.3 D.3-NORM normal ECGSCPECG 1.3 D.3-NLQRS normal QRSSCPECG 1.3 D.3-NLP normal P waveSCPECG 1.3 D.3-NLSTT normal ST-TSCPECG 1.3 D.3-WHNOR ECG within normal limits for age and sexSCPECG 1.3 D.3-POSNL possibly normal ECGSCPECG 1.3 D.3-BOECG borderline ECGSCPECG 1.3 D.3-ABECG abnormal ECGSCPECG 1.3 D.3-POSAB possibly abnormal ECG

230

1965


SCPECG 1.3 D.3-ABQRS abnormal QRSSCPECG 1.3 D.3-ABSTT abnormal ST-TSCPECG 1.3 D.3-NFA normal for ageSCPECG 1.3 D.3-NFB normal for buildSCPECG 1.3 D.3-ABFA abnormal for ageSCPECG 1.3 D.3-ABFB abnormal for buildSCPECG 1.3 D.3-UFB unusual for buildSCPECG 1.3 D.3-LVH left ventricular hypertrophySCPECG 1.3 D.3-VCLVH voltage criteria (QRS) for left ventricular hypertSCPECG 1.3 D.3-RVH right ventricular hypertrophySCPECG 1.3 D.3-VCRVH voltage criteria (QRS) for right ventricular hyperSCPECG 1.3 D.3-BVH biventricular hypertrophySCPECG 1.3 D.3-SEHYP septal hypertrophySCPECG 1.3 D.3-PRANT prominent anterior forcesSCPECG 1.3 D.3-MI myocardial infarctionSCPECG 1.3 D.3-AMI anterior myocardial infarctionSCPECG 1.3 D.3-ASMI anteroseptal myocardial infarctionSCPECG 1.3 D.3-ALMI anterolateral myocardial infarctionSCPECG 1.3 D.3-LMI lateral myocardial infarctionSCPECG 1.3 D.3-HLMI high-lateral myocardial infarctionSCPECG 1.3 D.3-APMI apical myocardial infarctionSCPECG 1.3 D.3-IMI inferior myocardial infarctionSCPECG 1.3 D.3-ILMI inferolateral myocardial infarctionSCPECG 1.3 D.3-IPMI inferoposterior myocardial infarctionSCPECG 1.3 D.3-IPLMI inferoposterolateral myocardial infarctionSCPECG 1.3 D.3-PMI posterior myocardial infarctionSCPECG 1.3 D.3-BBB unspecified bundle branch blockSCPECG 1.3 D.3-CLBBB complete left bundle branch blockSCPECG 1.3 D.3-ILBBB incomplete left bundle branch blockSCPECG 1.3 D.3-ALBBB atypical left bundle branch blockSCPECG 1.3 D.3-CRBBB complete right bundle branch blockSCPECG 1.3 D.3-IRBBB incomplete right bundle branch blockSCPECG 1.3 D.3-IVCD non-specific intraventricular conduction disturbanSCPECG 1.3 D.3-IVCD> intraventricular conduction disturbance (QRS>120

mSCPECG 1.3 D.3-IVCD< minor intraventricular conduction disturbance

(QRSSCPECG 1.3 D.3-WPW Wolf-Parkinson-White syndromeSCPECG 1.3 D.3-WPWA Wolf-Parkinson type ASCPECG 1.3 D.3-WPWB Wolf-Parkinson type B


SCPECG 1.3 D.3-PREEX pre-excitationSCPECG 1.3 D.3-LAFB left anterior fascicular blockSCPECG 1.3 D.3-LPFB left posterior fascicular blockSCPECG 1.3 D.3-BIFAS bifascicular blockSCPECG 1.3 D.3-TRFAS trifascicular blockSCPECG 1.3 D.3-COPD ECG consistent with chronic obstructive

pulmonary SCPECG 1.3 D.3-PE pulmonary emphysemaSCPECG 1.3 D.3-QWAVE Q waves presentSCPECG 1.3 D.3-POORR poor R-wave progression in precordial leadsSCPECG 1.3 D.3-ABRPR abnormal R-wave progressionSCPECG 1.3 D.3-PROMR prominent R waves in right precordial leadsSCPECG 1.3 D.3-DXTRO dextrocardiaSCPECG 1.3 D.3-LVOLT low QRS voltages in the frontal and horizontal leaSCPECG 1.3 D.3-HVOLT high QRS voltageSCPECG 1.3 D.3-LVOLF low voltage in frontal leadsSCPECG 1.3 D.3-LVOLH low QRS voltages in the horizontal leadsSCPECG 1.3 D.3-HVOLF high QRS voltages in the frontal leadsSCPECG 1.3 D.3-HVOLH high QRS voltage in the horizontal leads.SCPECG 1.3 D.3-S1S23 S1 S2 S3 type QRS patternSCPECG 1.3 D.3-RSR1 rSr' type in V1 or V2SCPECG 1.3 D.3-TRNZL Transition zone in precordial leads displaced to tSCPECG 1.3 D.3-TRNZR Transition zone in precordial leads displaced to tSCPECG 1.3 D.3-MYOPA compatible with cardiomyopathySCPECG 1.3 D.3-MYOCA compatible with myocarditisSCPECG 1.3 D.3-CRIMA criteria forSCPECG 1.3 D.3-CRIMO moderate criteria forSCPECG 1.3 D.3-CRIMI minimal criteria forSCPECG 1.3 D.3-SR sinus rhythmSCPECG 1.3 D.3-NSR normal sinus rhythmSCPECG 1.3 D.3-SARRH sinus arrhythmiaSCPECG 1.3 D.3-MSAR marked sinus arrhythmiaSCPECG 1.3 D.3-SVARR supraventricular arrhythmiaSCPECG 1.3 D.3-STACH sinus tachycardiaSCPECG 1.3 D.3-ETACH extreme tachycardiaSCPECG 1.3 D.3-SBRAD sinus bradycardiaSCPECG 1.3 D.3-EBRAD extreme bradycardiaSCPECG 1.3 D.3-JTACH junctional tachycardiaSCPECG 1.3 D.3-SVTAC supraventricular tachycardiaSCPECG 1.3 D.3-JBRAD junctional bradycardiaSCPECG 1.3 D.3-SVBRA supraventricular bradycardia

235


SCPECG 1.3 D.3-WQTAC wide QRS tachycardiaSCPECG 1.3 D.3-NQTAC narrow QRS tachycardiaSCPECG 1.3 D.3-TACHO tachycardia, origin unknown or not specifiedSCPECG 1.3 D.3-BRADO bradycardia, origin unknown or not specifiedSCPECG 1.3 D.3-ARRHY arrhythmia, origin unknownSCPECG 1.3 D.3-IRREG irregular rhythmSCPECG 1.3 D.3-REGRH regular rhythmSCPECG 1.3 D.3-JESCR junctional escape rhythmSCPECG 1.3 D.3-VESCR ventricular escape rhythmSCPECG 1.3 D.3-ACAR accelerated atrial rhythmSCPECG 1.3 D.3-ACVR accelerated ventricular rhythmSCPECG 1.3 D.3-ACJR accelerated junctional rhythmSCPECG 1.3 D.3-ARHYT atrial rhythmSCPECG 1.3 D.3-SVRHY supraventricular rhythmSCPECG 1.3 D.3-JRHYT junctional rhythmSCPECG 1.3 D.3-VRHYT ventricular rhythmSCPECG 1.3 D.3-UNRHY undetermined rhythmSCPECG 1.3 D.3-EAR ectopic atrial rhythmSCPECG 1.3 D.3-LAR left atrial rhythmSCPECG 1.3 D.3-MAR multifocal atrial rhythmSCPECG 1.3 D.3-NODRH nodal rhythmSCPECG 1.3 D.3-RAR low right atrial rhythmSCPECG 1.3 D.3-LGL Lown-Ganong-Levine syndromeSCPECG 1.3 D.3-SHTPR Short PR-interval.SCPECG 1.3 D.3-AFIB atrial fibrillationSCPECG 1.3 D.3-AFLT atrial flutterSCPECG 1.3 D.3-ATACH atrial tachycardiaSCPECG 1.3 D.3-PSVT paroxysmal supraventricular tachycardiaSCPECG 1.3 D.3-PAT paroxysmal atrial tachycardiaSCPECG 1.3 D.3-MFAT multifocal atrial tachycardiaSCPECG 1.3 D.3-RATAC run of atrial tachycardiaSCPECG 1.3 D.3-RJTAC run of junctional tachycardiaSCPECG 1.3 D.3-AVNRT atrioventricular nodal re-entrant tachycardiaSCPECG 1.3 D.3-AVRT atrioventricular reciprocating tachycardiaSCPECG 1.3 D.3-IDIOR idioventricular rhythmSCPECG 1.3 D.3-VFIB ventricular fibrillationSCPECG 1.3 D.3-VTACH ventricular tachycardiaSCPECG 1.3 D.3-RVTAC run of ventricular tachycardiaSCPECG 1.3 D.3-SVT sustained ventricular tachycardia


SCPECG 1.3 D.3-NSVT non-sustained ventricular tachycardiaSCPECG 1.3 D.3-TORSA torsade des pointes ventricular tachycardiaSCPECG 1.3 D.3-MTACH multifocal tachycardia (multiform), supraventr. orSCPECG 1.3 D.3-VFLT ventricular flutterSCPECG 1.3 D.3-ASYST asystoleSCPECG 1.3 D.3-1AVB first degree AV blockSCPECG 1.3 D.3-2AVB second degree AV blockSCPECG 1.3 D.3-3AVB third degree AV blockSCPECG 1.3 D.3-I2AVB intermittent second degree AV blockSCPECG 1.3 D.3-A2AVB alternating second degree AV blockSCPECG 1.3 D.3-AVDIS AV-dissociationSCPECG 1.3 D.3-WENCK Wenckebach phenomenonSCPECG 1.3 D.3-MOBI2 Mobitz type 2 second degree AV blockSCPECG 1.3 D.3-SAR sinus arrestSCPECG 1.3 D.3-SARA sinus arrest with atrial escapeSCPECG 1.3 D.3-SARSV sinus arrest with supraventricular escapeSCPECG 1.3 D.3-SARJ sinus arrest with junctional escapeSCPECG 1.3 D.3-SARV sinus arrest with ventricular escapeSCPECG 1.3 D.3-SABLK sino-atrial blockSCPECG 1.3 D.3-SPAUS sinus pauseSCPECG 1.3 D.3-WANDP wandering pacemakerSCPECG 1.3 D.3-LRR long R-R interval measuredSCPECG 1.3 D.3-OCAP occasional captureSCPECG 1.3 D.3-PRC premature complex(es)SCPECG 1.3 D.3-APC atrial premature complexSCPECG 1.3 D.3-PAC atrial premature complexSCPECG 1.3 D.3-BPAC BPAC blocked premature atrial contractionSCPECG 1.3 D.3-MAPCS MAPCS multiple atrial premature complexesSCPECG 1.3 D.3-VPC ventricular premature complexSCPECG 1.3 D.3-PVC ventricular premature complexSCPECG 1.3 D.3-MVPCS multiple premature ventricular complexesSCPECG 1.3 D.3-RPVCS run of ventricular premature complexesSCPECG 1.3 D.3-RVPCS run of ventricular premature complexesSCPECG 1.3 D.3-RAPCS run of atrial premature complexesSCPECG 1.3 D.3-RJPCS run of junctional premature complexesSCPECG 1.3 D.3-VIC ventricular interpolated complexes.SCPECG 1.3 D.3-MVICS multiple ventricular interpolated complexesSCPECG 1.3 D.3-MICS multiple interpolated complexesSCPECG 1.3 D.3-SVPC supraventricular premature complexSCPECG 1.3 D.3-SVPCS (multiple) supraventricular premature complexes


SCPECG 1.3 D.3-SVIC supraventricular interpolated complex(es)SCPECG 1.3 D.3-ABER aberrantly conducted complex(es)SCPECG 1.3 D.3-ABPCS aberrant premature complexes, origin unknownSCPECG 1.3 D.3-ABSVC aberrant complex, possibly supraventricular originSCPECG 1.3 D.3-ABSVS aberrant complexes, possibly supraventricular origSCPECG 1.3 D.3-ABASH aberrant supraventricular complexes of the

Ashman SCPECG 1.3 D.3-JPC junctional premature complex(es)SCPECG 1.3 D.3-MJPCS multiple junctional premature complexesSCPECG 1.3 D.3-PPVCS paired ventricular premature complexesSCPECG 1.3 D.3-PVPCS paired ventricular premature complexesSCPECG 1.3 D.3-PAPCS paired atrial premature complexesSCPECG 1.3 D.3-PJPCS paired junctional premature complexesSCPECG 1.3 D.3-OVPAC occasional ventricular paced complexesSCPECG 1.3 D.3-ONPAC occasional non-paced complexesSCPECG 1.3 D.3-VBIG ventricular bigeminySCPECG 1.3 D.3-ABIG atrial bigeminySCPECG 1.3 D.3-SVBIG supraventricular bigeminySCPECG 1.3 D.3-BIGU bigeminal pattern (unknown origin, SV or VentriculSCPECG 1.3 D.3-FUSC fusion complex(es)SCPECG 1.3 D.3-CAPT capture complex(es)SCPECG 1.3 D.3-VEC ventricular escape complex(es)SCPECG 1.3 D.3-AEC atrial escape complex(es)SCPECG 1.3 D.3-SVEC supraventricular escape complex(es)SCPECG 1.3 D.3-JEC junctional escape complex(es)SCPECG 1.3 D.3-ESCUN escape complex, origin unknownSCPECG 1.3 D.3-VPARA ventricular parasystoleSCPECG 1.3 D.3-APARA atrial parasystoleSCPECG 1.3 D.3-VTRIG ventricular trigeminySCPECG 1.3 D.3-ATRIG atrial trigeminySCPECG 1.3 D.3-SVTRI supraventricular trigeminySCPECG 1.3 D.3-TRIGU trigeminal pattern (unknown origin, SV or VentricuSCPECG 1.3 D.3-VQUAG ventricular quadrigeminySCPECG 1.3 D.3-RECIP reciprocal or re-entrant impulseSCPECG 1.3 D.3-B2T1 (predominant) 2:1 blockSCPECG 1.3 D.3-B351 (predominant) 3:1 blockSCPECG 1.3 D.3-B4T1 (predominant) 4:1 blockSCPECG 1.3 D.3-B5T1 (predominant) 5:1 blockSCPECG 1.3 D.3-VARBL variable blockSCPECG 1.3 D.3-EXIBL exit blockSCPECG 1.3 D.3-ENTBL entrance block

240


SCPECG 1.3 D.3-VABL ventriculo-atrial blockSCPECG 1.3 D.3-BLOCK unspecified delay or failure of impulse propagatioSCPECG 1.3 D.3-C2T1 (predominant) 2:1 conductionSCPECG 1.3 D.3-C3T1 (predominant) 3:1 conductionSCPECG 1.3 D.3-C4T1 (predominant) 4:1 conductionSCPECG 1.3 D.3-C5T1 (predominant) 5:1 conductionSCPECG 1.3 D.3-VARCO variable conductionSCPECG 1.3 D.3-SVR slow ventricular responseSCPECG 1.3 D.3-IVR irregular ventricular responseSCPECG 1.3 D.3-RVR rapid ventricular responseSCPECG 1.3 D.3-WRV wide rate variationSCPECG 1.3 D.3-AAVCO accelerated AV conductionSCPECG 1.3 D.3-RETCO retrograde conductionSCPECG 1.3 D.3-ANTCO anterograde conductionSCPECG 1.3 D.3-ORTCO orthograde conductionSCPECG 1.3 D.3-ABBCO aberrant conductionSCPECG 1.3 D.3-CONCO concealed conductionSCPECG 1.3 D.3-AVREN AV nodal re-entrySCPECG 1.3 D.3-CONRE concealed re-entrySCPECG 1.3 D.3-RENTR re-entry phenomenonSCPECG 1.3 D.3-AECHO return of impulse to its chamber of origin: the atSCPECG 1.3 D.3-VECHO return of impulse to its chamber of origin: the veSCPECG 1.3 D.3-FCOUP fixed coupling intervalSCPECG 1.3 D.3-VCOUP variable coupling intervalSCPECG 1.3 D.3-PACE normal functioning artificial pacemakerSCPECG 1.3 D.3-PACEA artificial pacemaker rhythm with 100% captureSCPECG 1.3 D.3-PACEP PACEP artificial pacemaker rhythm with partial

capSCPECG 1.3 D.3-PACEF artificial pacemaker rhythm with underlying Cx16SCPECG 1.3 D.3-PACED demand pacemaker rhythmSCPECG 1.3 D.3-PACEM malfunctioning artificial pacemakerSCPECG 1.3 D.3-EPAVS electronic pacemaker AV sequential, normal

captureSCPECG 1.3 D.3-EPVC electronic pacemaker, ventricular captureSCPECG 1.3 D.3-EPDM electronic pacemaker, demand modeSCPECG 1.3 D.3-EPFC electronic pacemaker, failure to captureSCPECG 1.3 D.3-EPFS electronic pacemaker, failure to senseSCPECG 1.3 D.3-EPARV bipolar electronic pacemaker at the apex of the riSCPECG 1.3 D.3-EPU unipolar electronic pacemakerSCPECG 1.3 D.3-EPURV unipolar electronic pacemaker at the apex of the r


SCPECG 1.3 D.3-PAA electronic atrial pacingSCPECG 1.3 D.3-PAD dual chamber electronic pacingSCPECG 1.3 D.3-PAVA electronic ventricular pacing with atrial sensingSCPECG 1.3 D.3-PADEM demand pacing, analysis based upon intrinsic

complSCPECG 1.3 D.3-OVPAC occasional ventricular paced complexesSCPECG 1.3 D.3-ONPAC occasional non-paced complexesSCPECG 1.3 D.3-PAVVI VVI pacemakerSCPECG 1.3 D.3-PAAAI AAI pacemakerSCPECG 1.3 D.3-PAVAT VAT pacemakerSCPECG 1.3 D.3-PAVDD VDD pacemakerSCPECG 1.3 D.3-PADVI DVI pacemakerSCPECG 1.3 D.3-PADDD DDD pacemakerSCPECG 1.3 D.3-ARATE atrial rateSCPECG 1.3 D.3-VRATE ventricular rateSCPECG 1.3 D.3-RATE rate, not specified ventricular or atrial (but mosSCPECG 1.3 D.3-RHY rhythmSCPECG 1.3 D.3-LAD left axis deviation of QRS in frontal plane (< -30SCPECG 1.3 D.3-RAD right axis deviation of QRS in frontal plane (> +9SCPECG 1.3 D.3-AXL leftward axis (i.e. not severe enough to be calledSCPECG 1.3 D.3-AXR rightward axis (i.e. not severe enough to be calleSCPECG 1.3 D.3-AXIND QRS axis indeterminateSCPECG 1.3 D.3-AXSUP axis shifted superiorlySCPECG 1.3 D.3-AXPOS axis shifted posteriorlySCPECG 1.3 D.3-AXVER axis vertical in frontal planeSCPECG 1.3 D.3-AXHOR horizontal axis in frontal planeSCPECG 1.3 D.3-TRSLT transition in horizontal leads shifted leftwardSCPECG 1.3 D.3-TRSRT transition in horizontal leads shifted rightwardSCPECG 1.3 D.3-CCWRT counterclockwise rotationSCPECG 1.3 D.3-CWRT clockwise rotationSCPECG 1.3 D.3-ISC IschemicSCPECG 1.3 D.3-INJ subendocardial injurySCPECG 1.3 D.3-EPI epicardial injurySCPECG 1.3 D.3-STT ST-T changeSCPECG 1.3 D.3-NST non-specific ST changesSCPECG 1.3 D.3-STE non-specific ST elevationSCPECG 1.3 D.3-STD non-specific ST depressionSCPECG 1.3 D.3-RST reciprocal ST-T changesSCPECG 1.3 D.3-TAB T-wave abnormalitySCPECG 1.3 D.3-NT non-specific T-wave changesSCPECG 1.3 D.3-NDT non-diagnostic T abnormalities

245


SCPECG 1.3 D.3-TNOR normal T-wave variationsSCPECG 1.3 D.3-DIG digitalis-effectSCPECG 1.3 D.3-HTVOL high T-voltagesSCPECG 1.3 D.3-QUIN ST-T changes due to quinidine-effectSCPECG 1.3 D.3-PERIC ST-T changes compatible with pericarditisSCPECG 1.3 D.3-STVAG ST-elevation V1-V3 possibly due to enhanced

vagal SCPECG 1.3 D.3-LNGQT long QT-intervalSCPECG 1.3 D.3-SHTQT short QT-intervalSCPECG 1.3 D.3-HIGHT high amplitude T-wavesSCPECG 1.3 D.3-LOWT low amplitude T-wavesSCPECG 1.3 D.3-INVT inverted T-wavesSCPECG 1.3 D.3-HPOCA consider hypocalcemiaSCPECG 1.3 D.3-HPOK consider hypokalemiaSCPECG 1.3 D.3-HPRCA consider hypercalcemiaSCPECG 1.3 D.3-HPRK consider hyperkalemiaSCPECG 1.3 D.3-STDJ junctional ST depressionSCPECG 1.3 D.3-REPOL ST-T changes compatible with early repolarizationSCPECG 1.3 D.3-ANEUR ST-T changes compatible with ventricular

aneurysmSCPECG 1.3 D.3-POSTO post-operative changesSCPECG 1.3 D.3-PULM compatible with pulmonary embolismSCPECG 1.3 D.3-ACET related to pacemaker activitySCPECG 1.3 D.3-NDOC compatible with endocrine diseaseSCPECG 1.3 D.3-METAB possibly due to metabolic changesSCPECG 1.3 D.3-IBP compatible with hypertensionSCPECG 1.3 D.3-CONG secondary to congenital heart diseaseSCPECG 1.3 D.3-VALV secondary to valvular heart diseaseSCPECG 1.3 D.3-RESP secondary to respiratory diseaseSCPECG 1.3 D.3-JUV juvenile T wavesSCPECG 1.3 D.3-CLIN interpret with clinical dataSCPECG 1.3 D.3-MYOIN suggests myocardial infarction (no location specifSCPECG 1.3 D.3-ISDIG compatible with ischemia / digitalis effectSCPECG 1.3 D.3-STNOR normal variantSCPECG 1.3 D.3-STPAC review ST-T analysis for the effects of pacingSCPECG 1.3 D.3-STPVC post-extrasystolic T-wave changesSCPECG 1.3 D.3-LAO left atrial overloadSCPECG 1.3 D.3-LAE left atrial enlargementSCPECG 1.3 D.3-RAO right atrial overloadSCPECG 1.3 D.3-RAE right atrial enlargement


SCPECG 1.3 D.3-BAO bi-atrial overloadSCPECG 1.3 D.3-BAE bi-atrial enlargementSCPECG 1.3 D.3-IACD intra-atrial conduction delaySCPECG 1.3 D.3-HPVOL high P-voltagesSCPECG 1.3 D.3-NSPEP non-specific P wave abnormalitiesSCPECG 1.3 D.3-ABPAX abnormal P-axisSCPECG 1.3 D.3-UNPAX unusual P-axisSCPECG 1.3 D.3-PED pediatric interpretationSCPECG 1.3 D.3-RVD right ventricular dominanceSCPECG 1.3 D.3-ASD changes compatible with atrial septal defect (ostiSCPECG 1.3 D.3-ECD compatible endocardial cushion defect (ASD

ostium SCPECG 1.3 D.3-EBSTA compatible with Ebstein's anomalySCPECG 1.3 D.3-TCA compatible with tricuspid atresiaSCPECG 1.3 D.3-ACA compatible with anomalous location of the

coronarySCPECG 1.3 D.3-HSCAL all leads half standard calibration (i.e. 5 mm/mV)SCPECG 1.3 D.3-HSPRE precordial leads half standard calibrationSCPECG 1.3 D.3-HSLIM limb leads half standard calibrationSCPECG 1.3 D.3-DSCAL all leads double standard calibration (i.e. 20 mm/SCPECG 1.3 D.3-DSPRE precordial leads double standard calibrationSCPECG 1.3 D.3-DSLIM limb leads double standard calibrationSCPECG 1.3 D.3-NSCAL non-standard calibrationSCPECG 1.3 D.3-ARMRE suspect arm leads reversedSCPECG 1.3 D.3-LMISP lead misplacementSCPECG 1.3 D.3-QCERR poor data quality, interpretation may be adverselySCPECG 1.3 D.3-AHERR acquisition/hardware errorSCPECG 1.3 D.3-MEASE possibly measurement errorSCPECG 1.3 D.3-NOISE noisy recordingSCPECG 1.3 D.3-WANDR baseline wanderSCPECG 1.3 D.3-FAULT faulty leadSCPECG 1.3 D.3-ARTEF artifactsSCPECG 1.3 D.3-SIMUL input is from simulator or test patternSCPECG 1.3 D.3-PINFO inconsistent or erroneous patient demographic

dataSCPECG 1.3 D.3-INCAN incomplete or no analysis (by the program)SCPECG 1.3 D.3-NODAT missing or no dataSCPECG 1.3 D.3-AVJR AV-junctional rhythm


Context Group Cx0917 - Electrophysiology Waveform Durations


CID Cx0917Electrophysiology Waveform Durations



DCM P DurationDCM PR IntervalDCM QRS DurationDCM QT IntervalDCM Q DurationDCM R DurationDCM S DurationDCM R' DurationDCM S' DurationDCM Intrisicoid Deflection

Context Group Cx0918 Electrophysiology Waveform Voltages


CID Cx0918Electrophysiology Waveform Voltages



DCM Q AmplitudeDCM R AmplitudeDCM S AmplitudeDCM R' AmplitudeDCM S' AmplitudeDCM J Point AmplitudeDCM P(+) AmplitudeDCM P(-) AmplitudeDCM T(+) AmplitudeDCM T(-) AmplitudeDCM Isoelectric Segment at the onset of QRSDCM Isoelectric Segment at the end of QRSDCM ST Amplitude at the J-Point plus 20 msDCM ST Amplitude at the J-Point plus 60 msDCM ST Amplitude at the J-Point plus 80 ms

250

1970

1975

1980


DCM Amplitude at the J-Point plus 1/16 average R-RDCM Amplitude at the J-Point plus 1/8 average R-R

Context Group Cx1002 Cath Diagnosis


CID Cx1002Cath Diagnosis




DCM Vx100201 Coronary artery diseaseDCM Vx100202 Acute myocardial infarctionDCM Vx100203 s/p Thrombolytic therapyDCM Vx100204 Atypical chest painDCM Vx100205 Stable AnginaDCM Vx100206 Variant AnginaDCM Vx100207 Unstable AnginaDCM Vx100208 Progressive AnginaDCM Vx100209 Atypical AnginaDCM Vx100210 Post-infarction anginaDCM Vx100211 Recurrent angina s/p PTCADCM Vx100212 Recurrent angina s/p DCADCM Vx100213 Recurrent angina s/p RotoDCM Vx100214 Recurrent angina s/p StentDCM Vx100215 Recurrent angina s/p CABGDCM Vx100216 Congestive heart failureDCM Vx100217 Pulmonary edemaNCDR 2.0b 79 cardiogenic shockDCM Vx100219 Acute ventricular septal ruptureNCDR 2.0b 86 Mitral valve diseaseDCM Vx102815 Mitral stenosisDCM Vx102816 Mitral regurgitationDCM Vx100223 Acute mitral regurgitationDCM Vx100224 Silent ischemiaDCM Vx100225 s/p MI positive stress for ischemiaDCM Vx100226 MyocarditisDCM Vx100227 Subacute bacterial endocarditisDCM Vx100228 Idiopathic hypertrophic subaortic sten.NCDR 2.0b 85 Pulmonary hypertension

1985


NCDR 2.0b 87 Tricuspid valve diseaseDCM Vx100230 Tricuspid regurgitationDCM Vx102822 Mitral valve prolapseDCM Vx100232 Ventricular tachycardiaDCM Vx100233 Ventricular fibrillationDCM Vx102823 Congestive cardiomyopathyDCM Vx102826 Hypertensive heart diseaseDCM Vx102827 Restrictive cardiomyopathyDCM Vx100237 Pericardial diseaseDCM Vx102828 Pericardial tamponadeNCDR 2.0b 88 Aortic valve diseaseDCM Vx102813 Aortic stenosisDCM Vx102814 Aortic insufficiencyDCM Vx102831 Atrial septal defectDCM Vx100243 Aortic dissectionNCDR 2.0b 89 Pulmonic valve diseaseDCM Vx102832 Ventricular septal defectDCM Vx100245 Aortic aneurysmDCM Vx100246 Arhythmia EvaluationDCM Vx100247 Atrial fibrillationNCDR 2.0b 84.2 heart disease - congenitalDCM Vx102829 Constrictive pericarditis

Context Group Cx1003 Cardiac Valves and Tracts


CID Cx1003Cardiac Valves and Tracts



SNM3 T-35300 Mitral ValveSNM3 T-35400 Aortic ValveSNM3 T-35100 Tricuspid valveSNM3 T-35200 Pulmonary valveSNM3 T-32650 Left ventricle outflow tract

255

1990

1995


Context Group Cx1004 Wall Motion


CID Cx1004Wall Motion




DCM 1.0 CATH04-1 Not Done

DCM 1.0 CATH04-2 Unknown

DCM 1.0 CATH04-3 Normal

DCM 1.0 CATH04-4 Hyperkinesis

DCM 1.0 CATH04-5 Mild Hypokinesis

DCM 1.0 CATH04-6 Moderate Hypokinesis

DCM 1.0 CATH04-7 Severe Hypokinesis

DCM 1.0 CATH04-8 Akinesis

DCM 1.0 CATH04-9 Dyskinesis

Context Group Cx1005 Chamber Size


CID Cx1005Chamber Size





DCM 1.0 CATH05-2 Small

DCM 1.0 CATH05-3 Mildly Enlarged

DCM 1.0 CATH05-4 Moderately Enlarged

DCM 1.0 CATH05-5 Markedly Enlarged

Context Group Cx1006 Overall Contractility


CID Cx1006Overall Contractility





DCM 1.0 CATH06-2 Hyperkinetic

DCM 1.0 CATH06-3 Hypokinetic

2000

2005

2010


DCM 1.0 CATH06-4 Akinetic

Context Group Cx1007 VSD Description


CID Cx1007VSD Description




DCM 1.0 CATH07-1 Membranous

DCM 1.0 CATH07-2 Non-restrictive

DCM 1.0 CATH07-3 Restrictive

DCM 1.0 CATH07-4 None

Context Group Cx1008 Valve Stenosis and Regurgitation


CID Cx1008Valve Stenosis and Regurgitation




DCM 1.0 CATH08-1 None

DCM 1.0 CATH08-2 1+

DCM 1.0 CATH08-3 2+

DCM 1.0 CATH08-4 3+

DCM 1.0 CATH08-5 4+

DCM 1.0 CATH08-6 Mild

DCM 1.0 CATH08-7 Moderate

DCM 1.0 CATH08-8 Severe

Context Group Cx1009 Aortic Root Description


CID Cx1009Aortic Root Description

2015

2020

2025

2030






DCM 1.0 CATH09-2 Enlarged

DCM 1.0 CATH09-3 Aneurysm

DCM 1.0 CATH09-4 Annular Abscess

DCM 1.0 CATH09-5 Post Stenotic Dilation

DCM 1.0 CATH09-6 Ruptured Sinus of Valsalva

Context Group Cx1010 Coronary Dominance


CID Cx1010Coronary Dominance




NCDR 2.0b 68-1 Left Coronary DominanceNCDR 2.0b 68-2 Right Coronary DominanceNCDR 2.0b 68-3 Mixed Coronary Dominance

Context Group Cx1011 Valvular Abnormalities


CID Cx1011Valvular Abnormalities




DCM 1.0 VX1011-1 Stenosis

DCM 1.0 VX1011-2 Regurgitation

DCM 1.0 VX1011-3 Calcified

DCM 1.0 VX1011-4 Immobile

DCM 1.0 VX1011-5 Flail

Context Group Cx1012 Coronary Lesion Descriptors


260

2035

2040

2045


CID Cx1012Coronary Lesion Descriptors




DCM 1.0 VX1012-1 Ulcerated

DCM 1.0 VX1012-2 Restenotic

DCM 1.0 VX1012-3 Bifurcation

DCM 1.0 VX1012-4 Culprit

DCM 1.0 VX1012-5 Aneurysmal

DCM 1.0 VX1012-6 Diffuse Disease

DCM 1.0 VX1012-7 Luminal Irregularities

Context Group Cx38013 TIMI Flow Characteristics


CID Cx38013TIMI Flow Characteristics




DCM 1.0 Vx1013-0 0: No Perfusion

DCM 1.0 Vx1013-1 1: Penetration w/o Perfusion

DCM 1.0 Vx1013-2 2: Partial Perfusion

DCM 1.0 Vx1013-3 3: Complete Perfusion

Context Group Cx1014 Thrombus


CID Cx1014Thrombus




DCM 1.0 Vx1014-1 None

DCM 1.0 Vx1014-2 Possible

DCM 1.0 Vx1014-3 Definite

DCM 1.0 Vx1014-4 Severe

2050

2055

2060

2065


Context Group Cx1015 MorphologyCID Cx1015Morphology




DCM 1.0 Vx1015-1 Smooth

DCM 1.0 Vx1015-2 Irregular

DCM 1.0 Vx1015-3 Multiple Irregularities

Context Group Cx1016 Severity


CID Cx1016Severity



DCM Vx101601 NoneDCM Vx101602 MildDCM Vx101603 Mild to ModerateDCM Vx101604 ModerateDCM Vx101605 Moderate to SevereDCM Vx101606 Severe

Context Group Cx1017 Ventriculography Wall SegmentsThis 17-segment model of wall segments uses the terminology specified in Manuel D. Cerqueira, et al., "Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart", 2001


CID Cx1017Ventriculography Wall Segments



1 basal anterior segment2 basal anteroseptal segment3 basal inferoseptal segment4 basal inferior segment5 basal inferolateral segment6 basal anterolateral segment7 mid anterior segment8 mid anteroseptal segment

265

2070

2075

2080


9 mid inferoseptal segment10 mid inferior segment11 mid inferolateral segment12 mid anterolateral segment13 apical anterior segment14 apical septal segment15 apical inferior segment16 apical lateral segment17 apex

Context Group Cx1019 Canadian Clinical Classification


CID Cx1019Canadian Clinical Classification




NCDR 2.0b 50-0 Class 0

NCDR 2.0b 50-I Class I

NCDR 2.0b 50-II Class II

NCDR 2.0b 50-IIII Class III

NCDR 2.0b 50-IV Class IV

Context Group Cx1020 Cardiac History Dates


CID Cx1020Cardiac History Dates



Code Value

Code Meaning

NCDR 2.0b 41 Date of Previous Percutaneous Coronary Intervention NCDR 2.0b 43 Date of Previous Coronary Artery Bypass GraftNCDR 2.0b 45 Date of Previous Valvular Surgery

2085

2090

2095


Context Group Cx1021 Cath Patient History / Risk Factors


CID Cx1021Cath Patient History / Risk Factors




NCDR 2.0b 40 previous precutaneous coronary interventionNCDR 2.0b 42 previous cardiovascular surgeryNCDR 2.0b 44 previous valvular surgeryNCDR 2.0b 29 family history of coronary artery diseaseNCDR 2.0b 30 congestive heart failureNCDR 2.0b 31 DiabetesNCDR 2.0b 32 renal failureNCDR 2.0b 33 chronic obstructive lung diseaseNCDR 2.0b 34 cerebrovascular diseaseNCDR 2.0b 35 peripheral vascular diseaseNCDR 2.0b 37 HypertensionNCDR 2.0b 39 hypercholesterolemia

Context Group Cx1022 Diabetic Therapy


CID Cx1022Diabetic Therapy




NCDR 2.0b 31-1 DietNCDR 2.0b 31-2 Oral Agent TreatmentNCDR 2.0b 31-3 Insulin

Context Group Cx1023 MI Types


CID Cx1023MI Types




2100

2105

2110

2115


NCDR 2.0b 94-1 Non ST Elevation Myocardial InfarctionNCDR 2.0b 94-2 ST Elevation Myocardial InfarctionNCDR 2.0b 94-0 No documented MI

Context Group Cx1024 Smoking History


CID Cx1024Smoking History




NCDR 2.0b 38-0 No History of SmokingNCDR 2.0b 38-1 Current SmokerNCDR 2.0b 38-2 Former Smoker

Context Group Cx1027 Indications for Catheterization


CID Cx1027Indications for Catheterization




NCDR 2.0b 79 cardiogenic shockNCDR 2.0b 80 valvular heart diseaseNCDR 2.0b 81 ArrhythmiaNCDR 2.0b 82 ischemic heart diseaseNCDR 2.0b 83 positive functional testsNCDR 2.0b 84.1 heart disease - transplantNCDR 2.0b 84.2 heart disease - congenitalNCDR 2.0b 84.3 heart disease - cardiomyopathyNCDR 2.0b 84.4 heart disease of other etiology

Context Group Cx1028 Cath Findings


CID Cx1028Cath Findings

270

2120

2125

2130




DCM Cx102801 Normal left heart hemodynamicsDCM Cx102802 Normal right heart hemodynamicsDCM Cx102803 Normal left and right heart hemodynamicsDCM Cx102804 Normal left ventricular systolic function and wall

motionDCM Cx102805 Normal coronary arteriesDCM Cx102806 Mild intimal coronary irregularities w/o significant

stenoses.DCM Cx102807 Single vessel coronary artery disease.DCM Cx102808 Double vessel coronary artery disease.DCM Cx102809 Triple vessel coronary artery disease.DCM Cx102810 Multi vessel coronary artery disease.DCM Cx102811 Left main coronary artery diseaseDCM Cx102812 Significant coronary bypass graft diseaseDCM Cx102813 Aortic stenosisDCM Cx102814 Aortic insufficiencyDCM Cx102815 Mitral stenosisDCM Cx102816 Mitral regurgitationDCM Cx102817 Depression of left ventricular systolic functionDCM Cx102818 Acute mitral regurgitation from chordal ruptureDCM Cx102819 Acute mitral regurgitation from chordal dysfunctionDCM Cx102820 Acute mitral regurgitation from papillary muscle

ruptureDCM Cx102821 Acute mitral regurgitation from papillary muscle

dysfunctionDCM Cx102822 Mitral valve prolapseDCM Cx102823 Congestive cardiomyopathyDCM Cx102824 Hypertrophic cardiomyopathy with obstructionDCM Cx102825 Hypertrophic cardiomyopathy without obstructionDCM Cx102826 Hypertensive heart diseaseDCM Cx102827 Restrictive cardiomyopathyDCM Cx102828 Pericardial tamponadeDCM Cx102829 Constrictive pericarditisNCDR 2.0b 85 Pulmonary hypertensionDCM Cx102831 Atrial septal defectDCM Cx102832 Ventricular septal defectDCM Cx102833 Acute ventricular septal ruptureNCDR 2.0b 84.2 heart disease - congenital


Context Group Cx1029 Admission Status


CID Cx1029Admission Status




NCDR 2.0b 17-1 Referral / ElectiveNCDR 2.0b 17-2 Emergency DepartmentNCDR 2.0b 17-3 TransferNCDR 2.0b 17-4 Other

Context Group Cx1030 Insurance Payor


CID Cx1030Insurance Payor




NCDR 2.0b 18-1 GovernmentNCDR 2.0b 18-2 CommercialNCDR 2.0b 18-3 HMONCDR 2.0b 18-4 None

Context Group Cx1031 CAB Status This Admission


CID Cx1031CAB Status This Admission




NCDR 2.0b 21-1 Elective

NCDR 2.0b 21-2 Urgent

NCDR 2.0b 21-3 Emergency

NCDR 2.0b 21-4 Salvage

Context Group Cx1032 Discharge Status

275

2135

2140

2145

2150



CID Cx1032Discharge Status




DCM 1.0 Cath32-1 Alive

DCM 1.0 Cath32-2 Dead

Context Group Cx1033 Primary Cause of Death


CID Cx1033Primary Cause of Death




NCDR 2.0b 25-1 Cardiac

NCDR 2.0b 25-2 Neurologic

NCDR 2.0b 25-3 Renal

NCDR 2.0b 25-4 Vascular

NCDR 2.0b 25-5 Infection

NCDR 2.0b 25-6 Pulmonary

NCDR 2.0b 25-7 Valvular

NCDR 2.0b 25-8 Other

Context Group Cx1034 Location of Death


CID Cx1034Location of Death




NCDR 2.0b 26-1 During cath visit

NCDR 2.0b 26-2 After cath visit

Context Group Cx1035 Acute Coronary Syndrome Time Period


2155

2160

2165

2170


CID Cx1035Acute Coronary Syndrome Time Period




NCDR 2.0b 51-1 <= 6 hours

NCDR 2.0b 51-2 between 6 hours and 24 hours

NCDR 2.0b 51-3 between 24 hours and 7 days

Context Group Cx1036 NYHA Classification


CID Cx1036NYHA Classification




NCDR 2.0b 47-I NYHA Class I

NCDR 2.0b 47-II NYHA Class II

NCDR 2.0b 47-III NYHA Class III

NCDR 2.0b 47-IV NYHA Class IV

Context Group Cx1037 Non-Invasive Test - Ischemia


CID Cx1037Non-Invasive Test - Ischemia




NCDR 2.0b 48-1 Not Done

NCDR 2.0b 48-2 Positive

NCDR 2.0b 48-3 Negative

NCDR 2.0b 48-4 Equivocal

NCDR 2.0b 48-5 Arrhythmia

Context Group Cx1038 Pre-Cath Angina Type


CID Cx1038Pre-Cath Angina Type

2175

2180

2185

2190





NCDR 2.0b 49-I Atypical Chest Pain

NCDR 2.0b 49-II Stable Angina

NCDR 2.0b 49-IIIa Acute Coronary Syndrome: Unstable Angina

NCDR 2.0b 49-IIIb Acute Coronary Syndrome: Non ST-Elevation Myocardial Infarction

NCDR 2.0b 49-IIIc Acute Coronary Syndrome: ST-Elevation Myocardial Infarction

Context Group Cx1039 Cath Procedure Type


CID Cx1039Cath Procedure Type




NCDR 2.0b 54-1 Right Heart Cath

NCDR 2.0b 54-2 Left Heart Cath

NCDR 2.0b 54-3 Percutaneous Coronary Intervention

SNM3 3.5 P1-31602 Catheterization of right heartSNM3 3.5 P1-31604 Catheterization of left heart

Context Group Cx1040 Thrombolytic Administration


CID Cx1040Thrombolytic Administration



Cx104001 ContraindicatedCx104003 Administered less than 3 hours before PCICx104004 Administered between 3 and 6 hours before PCICx104005 Administered between 6 hours and 7 days before PCI

Context Group Cx1041 Medication Administration, Lab Visit


280

2195

2200

2205

2210


CID Cx1041Medication Administration, Lab Visit



Cx104001 ContraindicatedCx104010 Administered before lab visitCx104011 Administered during lab visitCx104012 Administered after lab visit

Context Group Cx1042 Medication Administration, PCI


CID Cx1042Medication Administration, PCI



Cx104000 Not AdministeredCx104001 ContraindicatedCx104002 Administered Prior to Percutaneous Coronary InterventionCx104007 Administered During Percutaneous Coronary InterventionCx104008 Administered After Percutaneous Coronary Intervention

Context Group Cx1043 Clopidogrel/Ticlopidine Administration


CID Cx1043Clopidogrel/Ticlopidine Administration



Cx104000 Not AdministeredCx104001 ContraindicatedCx104006 Administered Less than 72 Hours before PCICx104008 Administered After Percutaneous Coronary Intervention

Context Group Cx1044 EF Testing Method


2215

2220

2225

2230


CID Cx1044EF Testing Method




NCDR 2.0b 66-1 obtained by contrast

NCDR 2.0b 66-2 obtained by non-invasive testing

Context Group Cx1045 EF Testing Calculation Method


CID Cx1045EF Testing Calculation Method




NCDR 2.0b 66-3 EF estimated

NCDR 2.0b 66-4 EF calculated

Context Group Cx1046 Percutaneous Entry Site


CID Cx1046Percutaneous Entry Site




NCDR 2.0b 74-1 Femoral

NCDR 2.0b 74-2 Brachial

NCDR 2.0b 74-3 Radial

NCDR 2.0b 74-4 Other

Context Group Cx1047 Closure Device


ID Cx1047Closure Device




NCDR 2.0b 75-0 No closure device

NCDR 2.0b 75-1 suture

NCDR 2.0b 75-2 sealant

285

2235

2240

2245

2250


NCDR 2.0b 75-3 other

Context Group Cx1049 PCI Procedure Result


CID Cx1049PCI Procedure Result




NCDR 2.0b 100-1 Successful

NCDR 2.0b 100-2 Partially successful

NCDR 2.0b 100-3 Unsuccessful

Context Group Cx1050 Previously Dilated Lesion


CID Cx1050Previously Dilated Lesion




NCDR 2.0b 108-0 not previously treated

NCDR 2.0b 108-1 balloon only

NCDR 2.0b 108-2 stent only

NCDR 2.0b 108-3 other/any combination

Context Group Cx1051 Location in Graft


CID Cx1051Location in Graft




NCDR 2.0b 110-1 graft-aortic anastomosis

NCDR 2.0b 110-2 body of graft

NCDR 2.0b 110-3 graft distal anastomosis

2255

2260

2265

2270


Context Group Cx1053 Coronary Intervention Devices


CID Cx1053Coronary Intervention Devices




NCDR 2.0b 113-1 Balloon

NCDR 2.0b 113-2 Cutting Balloon

NCDR 2.0b 113-3 Stent

NCDR 2.0b 113-4 Directional Coronary Atherectomy

NCDR 2.0b 113-5 Rotablator

NCDR 2.0b 113-6 Angiojet

NCDR 2.0b 113-7 Transluminal Extraction Catheter

NCDR 2.0b 113-8 Laser

NCDR 2.0b 113-9 Intravascular Ultrasound

NCDR 2.0b 113-10 Flowire

NCDR 2.0b 113-11 Pressure wire

NCDR 2.0b 113-12 other device

Context Group Cx1054 Vascular Complications


CID Cx1054Vascular Complications




NCDR 2.0b 127 BleedingNCDR 2.0b 128 OcclusionNCDR 2.0b 129 Loss of distal pulseNCDR 2.0b 130 DissectionNCDR 2.0b 131 PseudoaneurysmNCDR 2.0b 132 AV Fistula

Context Group Cx1055 Cath Complications


CID Cx1055Cath Complications

2275

2280

2285





NCDR 2.0b 123 cardiogenic shockNCDR 2.0b 124 arrhythmiaNCDR 2.0b 125 Cerebrovascular Accident or StrokeNCDR 2.0b 126 tamponadeNCDR 2.0b 133 contrast reactionNCDR 2.0b 134 congestive heart failureNCDR 2.0b 135 renal failureNCDR 2.0b 136 Emergency Percutaneous Coronary InterventionNCDR 2.0b 137 Unplanned Coronary Artery Bypass

Context Group Cx1058 Catheterization Hemodynamic Support


CID Cx1058Catheterization Hemodynamic Support




NCDR 2.0b 62 Intraaortic Balloon Pump

NCDR 2.0b 63 cardiopulmonary bypass

290

2290

2295


Add the following to PS3.16 Annex D:

Annex D DICOM Controlled Terminology Definitions (Normative)

Note: Need to consolidate all proposed DCM code values from all templates and context groups.

Vx0001 Cath Lab Procedure LogVx0005 Room identificationVx0006 Equipment identificationVx0007 Procedure UrgencyVx0008 Vital SignsVx0010 Patient EventVx0011 CommentVx0012 ComplicationVx0013 Procedure Action Item IDVx0014 DateTime of Recording of Log EntryVx0015 Performed Procedure Step SOP Instance UIDVx0016 Performed Procedure Step SOP Class UIDVx0017 Procedure Step or Action DurationVx0020 Start Procedure Action ItemVx0021 End Procedure Action ItemVx0022 Suspend Procedure Action ItemVx0023 Resume Procedure Action ItemVx0030 Image AcquiredVx0031 ModalityVx0032 Number of FramesVx0033 Image TypeVx0034 Positioner Primary AngleVx0035 Positioner Secondary AngleVx0036 Image Area Dose ProductVx0037 Cine RateVx0038 Waveform AcquiredVx0039 Document TitleVx0040 Peak X-ray Generator VoltageVx0041 X-ray Generator CurrentVx0042 Description of MaterialVx0043 Quantity of MaterialVx0044 Billing CodeVx0050 Lesion IdentifierVx0051 Anatomic siteVx0052 Anatomic site modifier


Vx0053 Stenosis measurement coordinate code with QCA/QVAVx0054 TIMI flow coordinate code with QCA/QVAVx0055 Lesion RiskVx0056 Intervention StatusVx0060 Route of administration Vx0061 Device CodeVx0064 Percutaneous Entry ActionVx0065 LateralityVx0099 Table of ValuesVx0100 Equation

295


Vx640001 Hemodynamics Report

Vx640002 Procedure Name

Vx640003 Procedure Type

Vx640005 Measurement Group

Vx640006 Catheterization Procedure Phase

Vx640009 Proximal Anatomic Location

Vx640010 Distal Anatomic Location

Vx640011 Hemodynamic Measurement Technique

Vx640012 Measurement Type

Vx640013 equation

Vx640014 Complication

Vx640015 Medication

Vx640016 Invocation

Vx640017 Thermal Cardiac Output Technique Properties

Vx640018 Thermal Cardiac Output Method

Vx640019 Thermal Cardiac output Catheter Size

Vx640020 Injectate Temperature

Vx640021 Injectate Volume

Vx640022 Calibration Factor

Vx640023 Patient Characteristics

Vx640024 Patient Age

Vx640025 Patient Gender

Vx640026 Patient Height

Vx640027 Patient Weight

Vx640028 Thorax diameter, sagittal

Vx640029 Smoking duration

Vx640030 Smoking consumption

Vx640031 Procedure Environmental Characteristics

Vx640032 Room oxygen concentration

Vx640033 Room temperature

Vx640034 Room Barometric pressure

Vx640035 Normality

Vx640036 Normal Range upper limit

Vx640037 Normal Range lower limit

Vx640038 Normal Range Authority

Vx640039 Level of Significance

Vx640040 Patient State

Vx640041 component

Vx640042 Normal

Vx640043 Abnormal

Vx640044 Undetermined

Vx640502 Blood oxygen measurements

Vx640503 Blood Source Type

2300

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