Outpatient Department (OP) Section

BOX_00

CONTEXT HEADER DISPLAY INSTRUCTIONS:
DISPLAY PERS.FULLNAME, PROV.LORPNAME,
EVNT.EVNTBEGM, EVNT.EVNTBEGD, EVNT.EVNTBEGY

OP01

OMITTED.

OP02

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

Did {you/(PERSON}} visit the outpatient department at {PROVIDER}
on {VISIT DATE} in person or was this a telephone call?

SAW PROVIDER ........................... 1 {OP04}
TELEPHONE CALL ......................... 2 {OP04}
REF ................................... -7 {OP04}
DK .................................... -8 {OP04}

[Code One]

IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS
‘OP-IN-PERSON’.

IF OP02 IS CODED '2' (TELEPHONE CALL), ‘-7’
(REFUSED), OR ‘-8’ (DON’T KNOW) FLAG EVENT AS
‘OP-TELEPHONE’. (THIS EVENT IS FLAGGED IN SUCH A
WAY FOR PURPOSES OF SKIPS IN THE C/P SECTION.
HOWEVER, ‘RF’ AND ‘DK’ WILL USE THE SAME QUESTION
WORDING AS ‘OP-IN-PERSON’ EVENTS DURING THE
ADMINISTRATION OF THE OP SECTION.

OP03

OMITTED.

OP04

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

{Did {you/{PERSON}} see a medical doctor during this particular
visit?/Was this telephone call about {your/{PERSON}’s} health with a
medical doctor?}

YES .................................... 1 {OP04A}
NO ..................................... 2 {OP05}
REF ................................... -7 {OP05}
DK .................................... -8 {OP05}

HELP AVAILABLE FOR DEFINITION OF MEDICAL DOCTOR.

DISPLAY ‘Did {you/{PERSON}} see a medical doctor
during this particular visit?’ IF OP02 IS CODED
‘1’ (SAW PROVIDER), ‘-7’ (REFUSED), OR ‘-8’ (DON’T
KNOW) FOR THIS EVENT.

DISPLAY ‘Was this telephone call about {your/
{PERSON}’s} health with a medical doctor?’ IF OP02
IS CODED ‘2’ (TELEPHONE CALL) FOR THIS EVENT.

OP04A

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

What was the doctor’s specialty?

IF TALKED TO MORE THAN ONE DOCTOR, PROBE FOR MAIN PROVIDER.

ALLERGY/IMMUNOLOGY .................... 1 {BOX_01}
ANESTHESIOLOGY ........................ 2 {BOX_01}
CARDIOLOGY (HEART) .................... 3 {BOX_01}
DERMATOLOGY (SKIN) .................... 4 {BOX_01}
ENDOCRINOLOGY/METABOLISM
(DIABETES, THYROID) ................. 5 {BOX_01}
FAMILY PRACTICE ....................... 6 {BOX_01}
GASTROENTEROLOGY ...................... 7 {BOX_01}
GENERAL PRACTICE ...................... 8 {BOX_01}
GENERAL SURGERY ....................... 9 {BOX_01}
GERIATRICS (ELDERLY) .................. 10 {BOX_01}
GYNECOLOGY/OBSTETRICS ................. 11 {BOX_01}
HEMATOLOGY (BLOOD) .................... 12 {BOX_01}
HOSPITAL RESIDENCE .................... 13 {BOX_01}
INTERNAL MEDICINE
(INTERNIST) ......................... 14 {BOX_01}
NEPHROLOGY (KIDNEYS) .................. 15 {BOX_01}
NEUROLOGY ............................. 16 {BOX_01}
NUCLEAR MEDICINE ...................... 17 {BOX_01}
ONCOLOGY (TUMORS, CANCER) ............. 18 {BOX_01}
OPHTHALMOLOGY (EYES) .................. 19 {BOX_01}
ORTHOPEDICS ........................... 20 {BOX_01}
OSTEOPATHY (DO) ....................... 21 {BOX_01}
OTORHINOLARYNGOLOGY
(EAR, NOSE, THROAT) ................. 22 {BOX_01}
PATHOLOGY ............................. 23 {BOX_01}
PEDIATRICIAN .......................... 24 {BOX_01}
PHYSICAL MEDICINE/REHAB ............... 25 {BOX_01}
PLASTIC SURGERY ....................... 26 {BOX_01}
PROCTOLOGY ............................ 27 {BOX_01}
PSYCHIATRY/PSYCHIATRIST ............... 28 {BOX_01}
PULMONARY ............................. 29 {BOX_01}
RADIOLOGY ............................. 30 {BOX_01}
RHEUMATOLOGY (ARTHRITIS) .............. 31 {BOX_01}
THORACIC SURGERY (CHEST) .............. 32 {BOX_01}
UROLOGY ............................... 33 {BOX_01}
OTHER DR SPECIALTY .................... 91 {BOX_01}
REF ................................... -7 {BOX_01}
DK .................................... -8 {BOX_01}

[Code One]

OP05

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

What type of medical person did {you/{PERSON}} talk to on {VISIT
DATE}?

IF TALKED TO MORE THAN ONE MEDICAL PERSON, PROBE FOR MAIN
PROVIDER.

CHIROPRACTOR .......................... 1 {BOX_01}
DENTIST/DENTAL CARE PERSON ............ 2 {BOX_01}
MIDWIFE ............................... 3 {BOX_01}
NURSE/NURSE PRACTITIONER .............. 4 {BOX_01}
OPTOMETRIST ........................... 5 {BOX_01}
PODIATRIST ............................ 6 {BOX_01}
PHYSICIAN’S ASSISTANT ................. 7 {BOX_01}
PHYSICAL THERAPIST .................... 8 {BOX_01}
OCCUPATIONAL THERAPIST ................ 9 {BOX_01}
PSYCHOLOGIST .......................... 10 {BOX_01}
SOCIAL WORKER ......................... 11 {BOX_01}
TECHNICIAN ............................ 12 {BOX_01}
ACUPUNCTURIST ......................... 14 {BOX_01}
MASSAGE THERAPIST ..................... 15 {BOX_01}
HOMEOPATHIC/NATUROPATHIC/HERBALIST .... 16 {BOX_01}
OTHER ALTERNATIVE/COMPLEMENTARY
CARE PROVIDER ....................... 17 {BOX_01}
OTHER ................................. 91 {BOX_01}
REF ................................... -7 {BOX_01}
DK .................................... -8 {BOX_01}

[Code One]

HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.

OP06

OMITTED.

BOX_01

IF OP02 IS CODED '2' (TELEPHONE CALL), '-7'
(REFUSED), OR '-8' (DON'T KNOW), GO TO OP08

IF OP02 IS CODED '1' (SAW PROVIDER), CONTINUE WITH
OP07

OP07

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

SHOW CARD OP-1.

Please look at this card and tell me which category best
describes the care {you/{PERSON}} received during the visit to
the outpatient department at {PROVIDER} on {VISIT DATE}.

GENERAL CHECKUP ........................ 1 {OP08}
DIAGNOSIS OR TREATMENT ................. 2 {OP08}
EMERGENCY (E.G., ACCIDENT OR INJURY) ... 3 {OP08}
PSYCHOTHERAPY OR MENTAL HEALTH
COUNSELING ............................. 4 {OP08}
FOLLOW-UP OR POST-OPERATIVE VISIT ...... 5 {OP08}
IMMUNIZATIONS OR SHOTS ................. 6 {OP08}
VISION EXAM ............................ 7 {OP08}
PREGNANCY-RELATED (INCLUDING PRENATAL
CARE AND DELIVERY) ................... 8 {OP08}
WELL CHILD EXAM ........................ 9 {OP08}
LASER EYE SURGERY ..................... 10 {OP08}
OTHER ................................. 91 {OP08}
REF ................................... -7 {OP08}
DK .................................... -8 {OP08}

[Code One]

HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.

IF CODED ‘8’ (PREGNANCY-RELATED (INCLUDING
PRENATAL CARE AND DELIVERY)), CHECK THAT PERSON
IS FEMALE. IF NOT, DISPLAY THE FOLLOWING MESSAGE:
"CODE UNAVAILABLE FOR MALES. VERIFY AND RE-ENTER."

IF CODED ‘9’ (WELL CHILD EXAM), CHECK THAT PERSON
IS <7 YEARS OLD (OR AGE CATEGORIES 1 TO 3). IF
NOT, DISPLAY THE FOLLOWING MESSAGE: "CODE
UNAVAILABLE FOR PERSONS 7 AND OLDER. VERIFY AND
RE-ENTER."

OP08

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

Was this {visit/telephone call} related to any specific health
condition or were any conditions discovered during this {visit/
telephone call}?

YES .................................... 1 {OP09}
NO ..................................... 2 {BOX_02}
REF ................................... -7 {BOX_02}
DK .................................... -8 {BOX_02}

DISPLAY ‘visit’ IF OP02 IS CODED ‘1’ (SAW
PROVIDER), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW)
FOR THIS EVENT. DISPLAY ‘telephone call’ IF OP02
IS CODED ‘2’(TELEPHONE CALL) FOR THIS EVENT.

OP09

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

What conditions were discovered or led {you/{PERSON}} to make this
{visit/telephone call}?

PROBE: Any other condition?

IF CONDITION IS ALREADY LISTED, SELECT ENTRY ON ROSTER.

[1. Medical Condition]
[2. Medical Condition]
[3. Medical Condition]

DISPLAY ‘ADD CONDITION’ AS AN OPTION ON THIS
SCREEN.

GO TO BOX_02

ROSTER DETAILS:
Title: PERS_COND_1

COL #1 HEADER: MEDICAL CONDITION
INSTRUCTIONS: DISPLAY NAME OF MEDICAL CONDITION
(COND.CONDNAM)

ROSTER DEFINITION:
DISPLAY THE PERSON-MEDICAL-CONDITIONS-ROSTER FOR
SELECTION AND ADDITION OF ONE OR MANY MEDICAL
CONDITION(S) ASSOCIATED WITH THIS EVENT.

ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. MULTIPLE ADD ALLOWED.

3. LIMITED DELETE ALLOWED. INTERVIEWER MAY DELETE
A CONDITION ADDED ON THIS SCREEN AS LONG AS
CAPI HAS NOT YET CREATED THE LINK BETWEEN THIS
CONDITION AND THE EVENT.
4. LIMITED EDIT ALLOWED. INTERVIEWER MAY EDIT A
CONDITION NAME NEWLY ADDED ON THIS SCREEN AS
LONG AS CAPI HAS NOT YET CREATED THE LINK
BETWEEN THIS CONDITION AND THE EVENT.

ROSTER FILTER:
DISPLAY ALL CONDITIONS ON PERSON’S ROSTER; NO
FILTER.

BOX_02

IF OP02 IS CODED '2' (TELEPHONE CALL), '-7'
(REFUSED), OR '-8' (DON'T KNOW), GO TO OP14

IF OP02 IS CODED '1' (SAW PROVIDER), CONTINUE WITH
BOX_03

BOX_03

IF OP05 IS CODED ‘2’ (DENTIST/DENTAL CARE PERSON),
‘3’ (MIDWIFE), OR ‘5’ (OPTOMETRIST), GO TO OP11

OTHERWISE, CONTINUE WITH OP10

OP10

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

SHOW CARD OP-2.

Looking at this card, which of these treatments, if any, did
{you/{PERSON}} receive during this visit?

CHECK ALL THAT APPLY.

PHYSICAL THERAPY ....................... 1 {OP11}
OCCUPATIONAL THERAPY ................... 2 {OP11}
SPEECH THERAPY ......................... 3 {OP11}
CHEMOTHERAPY ........................... 4 {OP11}
RADIATION THERAPY ...................... 5 {OP11}
KIDNEY DIALYSIS ........................ 6 {OP11}
IV THERAPY ............................. 7 {OP11}
DRUG OR ALCOHOL TREATMENT .............. 8 {OP11}
ALLERGY SHOT ........................... 9 {OP11}
PSYCHOTHERAPY/COUNSELING .............. 10 {OP11}
SHOTS, OTHER THAN ALLERGY ............. 11 {OP11}
NO TREATMENTS RECEIVED ................ 95 {OP11}
REF ................................... -7 {OP11}
DK .................................... -8 {OP11}

[Code All That Apply]

HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.

ALLOW CODE ‘95’ (NO TREATMENTS RECEIVED), ‘-7’
(REFUSED), AND ‘-8’ (DON’T KNOW) ALONE ONLY.
THESE RESPONSES MAY NOT BE SELECTED WITH ANY OTHER
RESPONSE.

‘NO TREATMENTS RECEIVED’ IS NOT DISPLAYED ON SHOW
CARD.

HARD CHECK:
EDIT: IF CODED ‘95’ (NO TREATMENTS RECEIVED),
NO OTHER TREATMENT CATEGORIES CAN BE CODED. IF
INTERVIEWER SELECTS ANOTHER CODE WITH ‘NO
TREATMENTS’, DISPLAY THE FOLLOWING MESSAGE: "NO
TREATMENTS RECEIVED CANNOT BE SELECTED WITH OTHER
OPTIONS. VERIFY AND RE-ENTER."

OP11

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

SHOW CARD OP-3.

Looking at this card, which of these services, if any, did
{you/{PERSON}} have during this visit?

CHECK ALL THAT APPLY.

LABORATORY TESTS ....................... 1 {OP12}
SONOGRAM OR ULTRASOUND ................. 2 {OP12}
X-RAYS ................................. 3 {OP12}
MAMMOGRAM .............................. 4 {OP12}
MRI OR CATSCAN ......................... 5 {OP12}
EKG OR ECG ............................. 6 {OP12}
EEG .................................... 7 {OP12}
VACCINATION ............................ 8 {OP12}
ANESTHESIA ............................. 9 {OP12}
OTHER DIAGNOSTIC TEST ................. 10 {OP12}
THROAT SWAB ........................... 11 {OP12}
NO SERVICES RECEIVED .................. 95 {OP12}
REF ................................... -7 {OP12}
DK .................................... -8 {OP12}

[Code All That Apply]

HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.

ALLOW CODE ‘4’ (MAMMOGRAM) ONLY IF PERSON IS
FEMALE AND AGE IS > 17 YEARS (OR AGE CATEGORIES 4
THROUGH 9).

ALLOW CODE ‘95’ (NO SERVICES RECEIVED), ‘-7’
(REFUSED), AND ‘-8’ (DON’T KNOW) ALONE ONLY.
THESE RESPONSES MAY NOT BE SELECTED WITH ANY OTHER
RESPONSE.

‘OTHER DIAGNOSTIC TEST’ AND ‘NO SERVICES RECEIVED’
ARE NOT DISPLAYED ON SHOW CARD.

HARD CHECK:
EDIT: IF CODED ‘95’ (NO SERVICES RECEIVED),
NO OTHER TREATMENT CATEGORIES CAN BE CODED. IF
INTERVIEWER SELECTS ANOTHER CODE WITH ‘NO
SERVICES’, DISPLAY THE FOLLOWING MESSAGE: "NO
SERVICES RECEIVED CANNOT BE SELECTED WITH OTHER
OPTIONS. VERIFY AND RE-ENTER."

NOTE: CODE ‘11’ (THROAT SWAB) IS DISPLAYED ON THE
SCREEN AND ON THE SHOW CARD BETWEEN CODES ‘1’
(LABORATORY TESTS) AND ‘2’ (SONOGRAM OR
ULTRASOUND).

OP12

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

Was a surgical procedure performed on {you/{PERSON}} during this
visit?

YES .................................... 1 {OP14}
NO ..................................... 2 {OP14}
REF ................................... -7 {OP14}
DK .................................... -8 {OP14}

HELP AVAILABLE FOR DEFINITION OF SURGICAL PROCEDURE.

OP13

OMITTED.

OP14

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

During this {visit/telephone call}, were any medicines
prescribed for {you/{PERSON}}? Please include only prescriptions
which were filled.

YES .................................... 1 {OP15}
NO ..................................... 2 {BOX_04}
REF ................................... -7 {BOX_04}
DK .................................... -8 {BOX_04}

HELP AVAILABLE FOR DEFINITION OF PRESCRIBED MEDICINE.

OP15

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

Please tell me the names of the prescriptions from this {visit/
telephone call} that were filled.

PROBE: Any other prescribed medicines from this {visit/telephone
call} that were filled?

[1. Prescribed Medicine]
[2. Prescribed Medicine]
[3. Prescribed Medicine]

DISPLAY ‘ADD MEDICINE’ AS AN OPTION ON THIS
SCREEN.

GO TO BOX_04

ROSTER DETAILS:
TITLE: PERSON'S_PRESCRIBED_MEDICINES_1

COL # 1 HEADER: PRESCRIBED MEDICINE
INSTRUCTIONS: DISPLAY NAME OF PRESCRIBED MEDICINE
(DRUG.DRUGNAME)

ROSTER DEFINITION:
THIS ITEM DISPLAYS THE PERSON'S-PRESCRIPTION-
MEDICINES-ROSTER FOR SELECTION AND ADDITION OF
PRESCRIBED MEDICINES.

ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED AND ADD ALLOWED.

2. LIMITED DELETE ALLOWED. INTERVIEWER MAY DELETE
A PMED ADDED ON THIS SCREEN AS LONG AS CAPI HAS
NOT YET CREATED THE LINK BETWEEN THIS PMED AND
THE EVENT.

3. EDIT DISALLOWED.

ROSTER FILTER:
DISPLAY ALL MEDICINES ON PERSON’S’ ROSTER; NO
FILTER.

BOX_04

IF OP02 IS CODED '2' (TELEPHONE CALL), '-7'
(REFUSED), OR '-8' (DON'T KNOW), GO TO BOX_10

IF OP02 IS CODED '1' (SAW PROVIDER), GO TO BOX_07

OP16

OMITTED.

OP17

OMITTED.

LOOP_01

OMITTED.

BOX_05

OMITTED.

BOX_06

OMITTED.

OP18

OMITTED.

END_LP01

OMITTED.

BOX_07

IF NO CONDITION IS ASSOCIATED WITH THIS VISIT TO
THIS PROVIDER FOR THIS PERSON, GO TO BOX_10

OTHERWISE, CONTINUE WITH BOX_08

BOX_08

IF 2 OR MORE VISITS TO THIS PROVIDER FOR THIS
PERSON HAVE NOT COMPLETED THE OUTPATIENT
DEPARTMENT (OP) UTILIZATION SECTION, CONTINUE
WITH BOX_09

OTHERWISE, GO TO BOX_10

BOX_09

IF THIS EVENT IS NOT PART OF A FLAT FEE GROUP,
CONTINUE WITH OP19

OTHERWISE, GO TO BOX_10

OP19

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

Earlier I recorded that {you/{PERSON}} had some other visits to an
outpatient department at {PROVIDER}. Were any of these visits
related to any condition associated with {your/his/her} visit on
{VISIT DATE}? That is, were any of the other visits for the
(READ CONDITIONS BELOW) and did {you/PERSON}} receive {(READ
SERVICES BELOW)/the same services}?

CONDITIONS SERVICES
{Person's OP Medical Condition} {Services Received}
{Person's OP Medical Condition} {Services Received}
{Person's OP Medical Condition} {Services Received}

YES .................................... 1 {OP20}
NO ..................................... 2 {BOX_10}
REF ................................... -7 {BOX_10}
DK .................................... -8 {BOX_10}

HELP AVAILABLE FOR DEFINITION OF REPEAT VISITS.

DISPLAY ‘(READ SERVICES BELOW)’ IF OP11 IS NOT
CODED ‘95’ (NO SERVICES RECEIVED), ‘-7’ (REFUSED),
OR ‘-8’ (DON’T KNOW). IF OP11 IS CODED ‘95’ (NO
SERVICES RECEIVED), ‘-7’ (REFUSED), OR ‘-8’ (DON’T
KNOW), DISPLAY ‘the same services’.

FOR ‘PERSON’S OP MEDICAL CONDITION’, DISPLAY ALL
CONDITIONS SELECTED FROM OR ADDED TO PERSON’S-
MEDICAL-CONDITIONS-ROSTER AT OP09.

FOR ‘SERVICES RECEIVED’, DISPLAY THE FOLLOWING
TEXT FOR EACH CODE ENTERED AT OP11:

CODE ‘1’ = LABORATORY TESTS
CODE ‘2’ = SONOGRAM/ULTRASOUND
CODE ‘3’ = X-RAYS
CODE ‘4’ = MAMMOGRAM
CODE ‘5’ = MRI/CATSCAN
CODE ‘6’ = EKG/ECG
CODE ‘7’ = EEG
CODE ‘8’ = VACCINATION
CODE ‘9’ = ANESTHESIA
CODE ‘10’ = OTHER SERVICES
CODE ‘11’ = THROAT SWAB

OP20

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

Did any of these visits or calls cost the same amount as
{your/{PERSON}'s} visit on {VISIT DATE}?

YES .................................... 1 {OP21}
NO ..................................... 2 {BOX_10}
REF ................................... -7 {BOX_10}
DK .................................... -8 {BOX_10}

HELP AVAILABLE FOR DEFINITION OF COST THE SAME AMOUNT.

NOTE: THE ISSUE OF COST WHEN THE PERSON HAS A
COPAY AND DOES NOT KNOW THE TOTAL CHARGE WILL BE
HANDLED IN THE HELP FILE DEFINITION.

OP21

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

Which of the following visits were related to the (READ
CONDITIONS BELOW) and {(READ SERVICES BELOW)/the same services}
and cost the same amount as the {VISIT DATE} visit we’ve just
talked about?

PROBE: Any other visits related to this condition and cost
the same amount?

CONDITIONS SERVICES
{PERSON'S OP MEDICAL CONDITION} {SERVICES RECEIVED}
{PERSON'S OP MEDICAL CONDITION} {SERVICES RECEIVED}
{PERSON'S OP MEDICAL CONDITION} {SERVICES RECEIVED}

[1. Month,Day,Year-4]
[2. Month,Day,Year-4]
[3. Month,Day,Year-4]

FOR ‘PERSON’S OP MEDICAL CONDITION’, DISPLAY ALL
CONDITIONS SELECTED FROM OR ADDED TO PERSON’S-
MEDICAL-CONDITIONS-ROSTER AT OP09.

FOR ‘SERVICES RECEIVED’, DISPLAY THE FOLLOWING
TEXT FOR EACH SERVICE ENTERED AT OP11:

CODE ‘1’ = LABORATORY TESTS
CODE ‘2’ = SONOGRAM/ULTRASOUND
CODE ‘3’ = X-RAY
CODE ‘4’ = MAMMOGRAM
CODE ‘5’ = MRI/CATSCAN
CODE ‘6’ = EKG/ECG
CODE ‘7’ = EEG
CODE ‘8’ = VACCINATION
CODE ‘9’ = ANESTHESIA
CODE ‘10’ = OTHER SERVICES
CODE ‘11’ = THROAT SWAB

FLAG EACH VISIT SELECTED AT OP21 AS A REPEAT VISIT
RELATED TO THE EVENT BEING ASKED ABOUT.

FLAG THE CHARGE PAYMENT (CP) STATUS OF EACH REPEAT
VISIT AS 'PROCESSED'.

LINK CONDITION(S) AND SERVICE(S) ASSOCIATED WITH
THE EVENT BEING ASKED ABOUT WITH EACH REPEAT
VISIT.

THE EVENT DRIVER WILL NOT SERVE THESE REPEAT
VISITS FOR THE OP SECTION.

GO TO OP22

ROSTER DETAILS:
TITLE: PERS_EVNT_1

COL # 1 HEADER: MONTH/DAY/YEAR
INSTRUCTIONS: DISPLAY EVENT BEGIN DATE
(EVNT.EVNTBEGM, EVNT.EVNTBEGD, EVNT.EVNTBEGY)

ROSTER DEFINITION:
THIS ITEM DISPLAYS ALL MEDICAL EVENTS (DATES) ON
PERSON’S-MEDICAL-EVENTS-ROSTER FOR SELECTION.

ROSTER BEHAVIOR:
1. MULTIPLE SELECT ALLOWED.

2. ADD, DELETE, AND EDIT DISALLOWED.

ROSTER FILTER:
DISPLAY ONLY THOSE EVENTS WITH THE FOLLOWING
CHARACTERISTICS:
1. EVENT WAS CREATED THIS ROUND.
2. EVENT HAS NOT BEEN PROCESSED IN UTILIZATION.
3. EVENT HAS EVENT TYPE ‘OP’.
4. EVENT IS ASSOCIATED WITH THE SAME PROVIDER AS
THE EVENT BEING ASKED ABOUT.

OP22

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER} {EVN-DT}

INTERVIEWER: RECORD 'NAME OF REPEAT VISIT GROUP' FOR EVENTS
SELECTED IN PREVIOUS QUESTION:

[Enter Repeat Visit Group] ............ {BOX_10}

BOX_10

IF CHARGE/PAYMENT (CP) SECTION IS NOT COMPLETED
FOR THIS OUTPATIENT EVENT, ASK THE CHARGE/PAYMENT
(CP) SECTION

OTHERWISE, GO TO EVENT DRIVER (ED) SECTION

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