Da Vinci Payer Data Exchange
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Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

US Core DiagnosticReport for Laboratory Results Reporting

Page standards status: Informative

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Where a Health Plan has access to Laboratory Results and other diagnostic information, they SHALL make the information available using the US Core DiagnosticReport for Laboratory Results Reporting resource. §pdex-22

The essential fields (Must Support or Cardinality greater than 0..*) to be provided in the US Core DiagnosticReport for Laboratory Results Reporting resource are:

R4 Element Name Cardinality Type
DiagnosticReport.status status 1..1 code
DiagnosticReport.category category 1..* (Slice Definition)
DiagnosticReport.category:LaboratorySlice category:LaboratorySlice 1..1 CodeableConcept
DiagnosticReport.category:LaboratorySlice.coding coding 1..* Coding
DiagnosticReport.category:LaboratorySlice.coding.system system 1..1 uri
DiagnosticReport.category:LaboratorySlice.coding.code code 1..1 code
DiagnosticReport.code code 1..1 CodeableConcept
DiagnosticReport.subject subject 1..1 Reference(US Core Patient Profile)
DiagnosticReport.effective[x] effective[x] 1..1  
DiagnosticReport.issued issued 1..1 instant
DiagnosticReport.performer performer 0..* Reference(US Core Practitioner Profile | US Core Organization Profile)
DiagnosticReport.result result 0..* Reference(US Core Laboratory Result Observation Profile)

Table Definition

HL7 V2 Mapping to Diagnostic Report

R4 Hierarchical Name R4 Name Cardinality Type HL7 V2 Source
DiagnosticReport.basedOn basedOn 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder| ServiceRequest) ORC
DiagnosticReport.status status 1..1 code OBX-11
DiagnosticReport.code code 1..1 CodeableConcept OBX-3
DiagnosticReport.subject subject 1..1 Reference(US Core Patient Profile) PID-3
DiagnosticReport.focus focus 0..* Reference(Resource) OBX-3
DiagnosticReport.encounter encounter 0..1 Reference(Encounter) PV1
DiagnosticReport.effective[x] effective[x] 0..1 dateTime, Period OBX-14
DiagnosticReport.issued issued 0..1 instant OBR-22
DiagnosticReport.performer performer 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) OBX-15
DiagnosticReport.value[x] value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period OBX-5
DiagnosticReport.dataAbsentReason dataAbsentReason 0..1 CodeableConcept N/A
DiagnosticReport.interpretation interpretation 0..* CodeableConcept OBX-8
DiagnosticReport.note note 0..* Annotation NTE
DiagnosticReport.bodySite bodySite 0..1 CodeableConcept OBX-20
DiagnosticReport.method method 0..1 CodeableConcept OBX-17
DiagnosticReport.specimen specimen 0..1 Reference(Specimen) SPM
DiagnosticReport.device device 0..1 Reference(Device | DeviceMetric) OBX-17
DiagnosticReport.referenceRange referenceRange 0..* BackboneElement OBX-7
DiagnosticReport.referenceRange.extension extension 0..* Extension OBX-7
DiagnosticReport.referenceRange.low low 0..1 SimpleQuantity OBX-7
DiagnosticReport.referenceRange.high high 0..1 SimpleQuantity OBX-7
DiagnosticReport.referenceRange.type type 0..1 CodeableConcept OBX-10
DiagnosticReport.referenceRange.appliesTo appliesTo 0..* CodeableConcept OBX-10
DiagnosticReport.referenceRange.text text 0..1 string OBX-7

C-CDA Mapping to Diagnostic Report

R4 Hierarchical Name R4 Name Cardinality Type CCDA
DiagnosticReport.text text 0..1 Narrative Act.text (?)
DiagnosticReport.contained contained 0..* Resource N/A
DiagnosticReport.extension extension 0..* Extension N/A
DiagnosticReport.modifierExtension modifierExtension 0..* Extension N/A
DiagnosticReport.identifier identifier 0..* Identifier id
DiagnosticReport.basedOn basedOn 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder| ServiceRequest) .outboundRelationship[typeCode=FLFS].target
DiagnosticReport.category category 1..* CodeableConcept .outboundRelationship[typeCode="COMP].target[classCode="LIST", moodCode="EVN"].code
DiagnosticReport.code code 1..1 CodeableConcept code
DiagnosticReport.subject subject 1..1 Reference(US Core Patient Profile) participation[typeCode=SBJ]
DiagnosticReport.performer performer 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) participation[typeCode=PRF]
DiagnosticReport.value[x] value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period value
DiagnosticReport.dataAbsentReason dataAbsentReason 0..1 CodeableConcept value.nullFlavor
DiagnosticReport.interpretation interpretation 0..* CodeableConcept interpretationCode
DiagnosticReport.method method 0..1 CodeableConcept methodCode
DiagnosticReport.specimen specimen 0..1 Reference(Specimen) participation[typparticipation[typeCode=DEV]eCode=SPC].specimen
DiagnosticReport.device device 0..1 Reference(Device | DeviceMetric) participation[typeCode=DEV]
DiagnosticReport.referenceRange referenceRange 0..* BackboneElement outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]
DiagnosticReport.referenceRange.low low 0..1 SimpleQuantity value:IVL_PQ.low
DiagnosticReport.referenceRange.high high 0..1 SimpleQuantity value:IVL_PQ.high
DiagnosticReport.referenceRange.type type 0..1 CodeableConcept interpretationCode
DiagnosticReport.referenceRange.appliesTo appliesTo 0..* CodeableConcept N/A (?)
DiagnosticReport.referenceRange.age age 0..1 Range outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
DiagnosticReport.referenceRange.text text 0..1 string value:ST
DiagnosticReport.hasMember hasMember 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) outBoundRelationship
DiagnosticReport.derivedFrom derivedFrom 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) N/A (?)

Claim (837) to Diagnostic Report

R4 Hierarchical Name R4 Name Cardinality Type Claim(837) / Note
DiagnosticReport.implicitRules implicitRules 0..1 uri x
DiagnosticReport.language language 0..1 code x
DiagnosticReport.text text 0..1 Narrative x
DiagnosticReport.contained contained 0..* Resource x
DiagnosticReport.extension extension 0..* Extension x
DiagnosticReport.modifierExtension modifierExtension 0..* Extension x
DiagnosticReport.identifier identifier 0..* Identifier x
DiagnosticReport.partOf partOf 0..* Reference(MedicationAdministration| MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) x
DiagnosticReport.status status 1..1 code Default to "unknown"
DiagnosticReport.category category 1..* CodeableConcept x
DiagnosticReport.code code 1..1 CodeableConcept Procedure Code
DiagnosticReport.subject subject 1..1 Reference(US Core Patient Profile) Patient Demographics
DiagnosticReport.focus focus 0..* Reference(Resource) x
DiagnosticReport.effective[x] effective[x] 0..1 dateTime, Period Date of Service
DiagnosticReport.issued issued 0..1 instant Interchange Date/Time
DiagnosticReport.performer performer 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Billing/Rendering Provider
DiagnosticReport.value[x] value[x] 0..1 Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period x
DiagnosticReport.dataAbsentReason dataAbsentReason 0..1 CodeableConcept x
DiagnosticReport.interpretation interpretation 0..* CodeableConcept x
DiagnosticReport.note note 0..* Annotation Note Segment
DiagnosticReport.bodySite bodySite 0..1 CodeableConcept x
DiagnosticReport.method method 0..1 CodeableConcept x
DiagnosticReport.specimen specimen 0..1 Reference(Specimen) x
DiagnosticReport.device device 0..1 Reference(Device | DeviceMetric) x
DiagnosticReport.referenceRange referenceRange 0..* BackboneElement x
DiagnosticReport.referenceRange.id id 0..1 string x
DiagnosticReport.referenceRange.extension extension 0..* Extension x
DiagnosticReport.referenceRange.modifierExtension modifierExtension 0..* Extension x
DiagnosticReport.referenceRange.low low 0..1 SimpleQuantity x
DiagnosticReport.referenceRange.high high 0..1 SimpleQuantity x
DiagnosticReport.referenceRange.type type 0..1 CodeableConcept x
DiagnosticReport.referenceRange.appliesTo appliesTo 0..* CodeableConcept x
DiagnosticReport.referenceRange.age age 0..1 Range x
DiagnosticReport.referenceRange.text text 0..1 string x
DiagnosticReport.hasMember hasMember 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) x
DiagnosticReport.derivedFrom derivedFrom 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) x

Example DiagnosticReport for Laboratory Results Reporting Resource

An example mapping of a DiagnosticReport for urinalysis is shown below:

{
  "resourceType" : "DiagnosticReport",
  "id" : "urinalysis",
  "meta" : {
    "versionId" : "209563",
    "lastUpdated" : "2016-04-19T17:28:11.308+00:00",
    "profile" : [
      "http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">
Generated Narrative with Details
id: urinalysis
meta: 
status: final
category: Laboratory <span style=\"background: LightGoldenRodYellow\">(Details : {http://terminology.hl7.org/CodeSystem/v2-0074 code 'LAB' = 'Laboratory', given as 'Laboratory'})</span>
code: Complete Urinalysis <span style=\"background: LightGoldenRodYellow\">(Details : {LOINC code '24356-8' = 'Urinalysis complete panel - Urine', given as 'Urinalysis complete panel - Urine'})</span>
subject: <a href=\"Patient-example.html\">Amy Shaw. Generated Summary: id: example; Medical Record Number = 1032702 (USUAL); active; Amy V. Shaw ; ph: 555-555-5555(HOME), amy.shaw@example.com; gender: female; birthDate: Feb 20, 2007</a>
effective: Jul 5, 2005, 12:00:00 AM
issued: Jul 6, 2005, 12:45:33 AM
performer: <a href=\"Organization-acme-lab.html\">Acme Laboratory, Inc. Generated Summary: id: acme-lab; 1144221847, 2523423456; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: Acme Labs; ph: (+1) 734-677-7777, hq@acme.org</a>
result: 
  • <a href=\"Observation-urine-color.html\">COLOR=Yellow. Generated Summary: id: urine-color; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5778-6}\">COLOR</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.inbnm,fo/sct 371244009}\">Yellow</span></a>
  • <a href=\"Observation-urine-clarity.html\">APPEARANCE=Hazy. Generated Summary: id: urine-clarity; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 32167-9}\">APPEARANCE</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 81858005}\">Hazy</span></a>
  • <a href=\"Observation-urine-glucose.html\">GLUCOSE=Negative. Generated Summary: id: urine-glucose; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 25428-4}\">GLUCOSE</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 260385009}\">Negative</span></a>
  • <a href=\"Observation-urine-bilirubin.html\">BILIRUBIN=Negative. Generated Summary: id: urine-bilirubin; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5770-3}\">BILIRUBIN</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 260385009}\">Negative</span></a>
  • <a href=\"Observation-urine-ketone.html\">KETONE=Negative. Generated Summary: id: urine-ketone; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 2514-8}\">KETONE</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 260385009}\">Negative</span></a>
  • <a href=\"Observation-usg.html\">SPEC GRAV=1.017. Generated Summary: id: usg; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5811-5}\">SPEC GRAV</span>; effective: Jul 5, 2005, 12:00:00 AM; 1.017 {urine specific gravity}</a>
  • <a href=\"Observation-urine-ph.html\">PH=6 (pH). Generated Summary: id: urine-ph; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5803-2}\">PH</span>; effective: Jul 5, 2005, 12:00:00 AM; 6.0 (pH)</a>
  • <a href=\"Observation-urine-protein.html\">PROTEIN=Negative. Generated Summary: id: urine-protein; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 20454-5}\">PROTEIN</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 260385009}\">Negative</span></a>
  • <a href=\"Observation-urobilinogen.html\">UROBILINOGEN=0.3 mg/dL. Generated Summary: id: urobilinogen; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 20405-7}\">UROBILINOGEN</span>; effective: Jul 5, 2005, 12:00:00 AM; 0.3 mg/dL</a>
  • <a href=\"Observation-urine-nitrite.html\">NITRITE=Positive. Generated Summary: id: urine-nitrite; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5802-4}\">NITRITE</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 10828004}\">Positive</span></a>
  • <a href=\"Observation-urine-hemoglobin.html\">BLOOD=Trace. Generated Summary: id: urine-hemoglobin; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5794-3}\">BLOOD</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 260405006}\">Trace</span></a>
  • <a href=\"Observation-urine-leukocyte-esterase.html\">LEUK ESTERASE=2+e. Generated Summary: id: urine-leukocyte-esterase; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5799-2}\">LEUK ESTERASE</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 260348001}\">2+</span></a>
  • <a href=\"Observation-urine-sediment.html\">COMMENT=Recommend Urine Culture. Generated Summary: id: urine-sediment; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 11279-7}\">COMMENT</span>; effective: Jul 5, 2005, 12:00:00 AM; value: Recommend Urine Culture</a>
  • <a href=\"Observation-urine-bacteria.html\">BACTERIA=4+. Generated Summary: id: urine-bacteria; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 25145-4}\">BACTERIA</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 260350009}\">4+</span></a>
  • <a href=\"Observation-urine-epi-cells.html\">EPITHELIAL CELLS=1-5 cells/HPF. Generated Summary: id: urine-epi-cells; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5787-7}\">EPITHELIAL CELLS</span>; effective: Jul 5, 2005, 12:00:00 AM; </a>
  • <a href=\"Observation-urine-wbcs.html\">WBC=20-30 cells/HPF. Generated Summary: id: urine-wbcs; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 5821-4}\">WBC</span>; effective: Jul 5, 2005, 12:00:00 AM; </a>
  • <a href=\"Observation-urine-rbcs.html\">RBC=Occasional cells/HPF. Generated Summary: id: urine-rbcs; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 13945-1}\">RBC</span>; effective: Jul 5, 2005, 12:00:00 AM; <span title=\"Codes: {http://snomed.info/sct 84638005}\">Occasional</span></a>
</div>"
  },
  "status" : "final",
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
          "code" : "LAB",
          "display" : "Laboratory"
        }
      ]
    }
  ],
  "code" : {
    "coding" : [
      {
        "system" : "http://loinc.org",
        "code" : "24356-8",
        "display" : "Urinalysis complete panel - Urine"
      }
    ],
    "text" : "Complete Urinalysis"
  },
  "subject" : {
    "reference" : "Patient/example",
    "display" : "Amy Shaw"
  },
  "effectiveDateTime" : "2005-07-05",
  "issued" : "2005-07-06T11:45:33+11:00",
  "performer" : [
    {
      "reference" : "Organization/acme-lab",
      "display" : "Acme Laboratory, Inc"
    }
  ],
  "result" : [
    {
      "reference" : "Observation/urine-color",
      "display" : "COLOR=Yellow"
    },
    {
      "reference" : "Observation/urine-clarity",
      "display" : "APPEARANCE=Hazy"
    },
    {
      "reference" : "Observation/urine-glucose",
      "display" : "GLUCOSE=Negative"
    },
    {
      "reference" : "Observation/urine-bilirubin",
      "display" : "BILIRUBIN=Negative"
    },
    {
      "reference" : "Observation/urine-ketone",
      "display" : "KETONE=Negative"
    },
    {
      "reference" : "Observation/usg",
      "display" : "SPEC GRAV=1.017"
    },
    {
      "reference" : "Observation/urine-ph",
      "display" : "PH=6 (pH)"
    },
    {
      "reference" : "Observation/urine-protein",
      "display" : "PROTEIN=Negative"
    },
    {
      "reference" : "Observation/urobilinogen",
      "display" : "UROBILINOGEN=0.3 mg/dL"
    },
    {
      "reference" : "Observation/urine-nitrite",
      "display" : "NITRITE=Positive"
    },
    {
      "reference" : "Observation/urine-hemoglobin",
      "display" : "BLOOD=Trace"
    },
    {
      "reference" : "Observation/urine-leukocyte-esterase",
      "display" : "LEUK ESTERASE=2+e"
    },
    {
      "reference" : "Observation/urine-sediment",
      "display" : "COMMENT=Recommend Urine Culture"
    },
    {
      "reference" : "Observation/urine-bacteria",
      "display" : "BACTERIA=4+"
    },
    {
      "reference" : "Observation/urine-epi-cells",
      "display" : "EPITHELIAL CELLS=1-5 cells/HPF"
    },
    {
      "reference" : "Observation/urine-wbcs",
      "display" : "WBC=20-30 cells/HPF"
    },
    {
      "reference" : "Observation/urine-rbcs",
      "display" : "RBC=Occasional cells/HPF"
    }
  ]
}

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