/
submission_record_539_example.json
1374 lines (1374 loc) · 38.8 KB
/
submission_record_539_example.json
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{
"resourceType": "Bundle",
"id": "df9f4158-c63a-47f4-8ff8-f6bfef826433",
"meta": {
"profile": [
"http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-death-certificate-document"
]
},
"identifier": {
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/CertificateNumber",
"valueString": "539"
}
],
"system": "http://nchs.cdc.gov/vrdr_id",
"value": "2022MA000539"
},
"type": "document",
"timestamp": "2022-07-05T09:41:03.62943-04:00",
"entry": [
{
"fullUrl": "urn:uuid:5f16a154-e253-4def-8dfe-583a37bc72e2",
"resource": {
"resourceType": "Composition",
"id": "5f16a154-e253-4def-8dfe-583a37bc72e2",
"meta": {
"profile": [
"http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-death-certificate"
]
},
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/FilingFormat",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-filing-format-cs",
"code": "electronic",
"display": "Electronic"
}
]
}
}
],
"status": "final",
"type": {
"coding": [
{
"system": "http://loinc.org",
"code": "64297-5",
"display": "Death certificate"
}
]
},
"subject": {
"reference": "urn:uuid:64be7d42-d01d-4183-96b8-b9bc55eba6c4"
},
"author": [
{
"reference": "urn:uuid:727df59d-1dfa-4b71-bdb1-e919f6e4c631"
}
],
"title": "Death Certificate",
"attester": [
{
"mode": "legal",
"party": {
"reference": "urn:uuid:727df59d-1dfa-4b71-bdb1-e919f6e4c631"
}
}
],
"event": [
{
"code": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "103693007",
"display": "Diagnostic procedure (procedure)"
}
]
}
],
"detail": [
{
"reference": "urn:uuid:f81539e0-66eb-4e82-9b93-d38d403e05a0"
}
]
}
],
"section": [
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs",
"code": "DecedentDemographics"
}
]
},
"entry": [
{
"reference": "urn:uuid:64be7d42-d01d-4183-96b8-b9bc55eba6c4"
},
{
"reference": "urn:uuid:feba7edc-3af0-413c-9ce1-e47eabfa2d08"
},
{
"reference": "urn:uuid:e82e4667-faa2-4137-91c4-51479a024d67"
},
{
"reference": "urn:uuid:972f55ab-49cc-4cb0-ba84-feb25ce9dd54"
},
{
"reference": "urn:uuid:7a8a367f-624b-47fe-92c2-4a3827e9dc47"
},
{
"reference": "urn:uuid:82c06ccb-b6fb-4f8e-a350-a293e242c6ac"
},
{
"reference": "urn:uuid:7b9aa7ea-424d-4fb6-b35a-c038da0ee3df"
}
]
},
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs",
"code": "DeathCertification"
}
]
},
"entry": [
{
"reference": "urn:uuid:727df59d-1dfa-4b71-bdb1-e919f6e4c631"
},
{
"reference": "urn:uuid:f81539e0-66eb-4e82-9b93-d38d403e05a0"
},
{
"reference": "urn:uuid:33fe7675-7134-4c00-b326-63caeb9891f3"
},
{
"reference": "urn:uuid:6e60a955-4774-4307-bb69-cc2a740deb07"
}
]
},
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs",
"code": "DeathInvestigation"
}
]
},
"entry": [
{
"reference": "urn:uuid:8d9ed6b4-c23b-472a-8fb7-38c7d49a6d32"
},
{
"reference": "urn:uuid:304bf79d-d182-420d-83b0-92169412cea4"
},
{
"reference": "urn:uuid:d2a5dff9-dba5-4d69-a4a4-a751d442071d"
},
{
"reference": "urn:uuid:6b69fb15-a03c-48ce-b341-dcc61b81f7f2"
},
{
"reference": "urn:uuid:80f81acd-ce68-4e4e-91f4-a46d7ccaf65a"
}
]
},
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-document-section-cs",
"code": "DecedentDisposition"
}
]
},
"entry": [
{
"reference": "urn:uuid:61eaae77-e264-4d12-8c10-d3ab7359071b"
}
]
}
]
}
},
{
"fullUrl": "urn:uuid:64be7d42-d01d-4183-96b8-b9bc55eba6c4",
"resource": {
"resourceType": "Patient",
"id": "64be7d42-d01d-4183-96b8-b9bc55eba6c4",
"meta": {
"profile": [
"http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-decedent"
]
},
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/NVSS-SexAtDeath",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/administrative-gender",
"code": "male",
"display": "Male"
}
]
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/patient-birthPlace",
"valueAddress": {
"state": "CO",
"country": "US"
}
}
],
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "SB",
"display": "Social Beneficiary Identifier"
}
]
},
"system": "http://hl7.org/fhir/sid/us-ssn",
"value": "429471420"
}
],
"name": [
{
"use": "official",
"family": "Lineberry",
"given": [
"Davis"
],
"suffix": [
"Jr"
]
}
],
"_birthDate": {
"extension": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Date-Year",
"valueUnsignedInt": 2021
},
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Date-Month",
"valueUnsignedInt": 3
},
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Date-Day",
"valueUnsignedInt": 4
}
],
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/PartialDate"
}
]
},
"address": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/StreetNumber",
"valueString": "2722"
},
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/PreDirectional",
"valueString": "N"
},
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/StreetName",
"valueString": "Pin Oak"
},
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/StreetDesignator",
"valueString": "Dr"
}
],
"line": [
"2722 N Pin Oak Dr"
],
"city": "Laramie",
"_city": {
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/CityCode",
"valuePositiveInt": 45050
}
]
},
"district": "Albany",
"_district": {
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/DistrictCode",
"valuePositiveInt": 1
}
]
},
"state": "WY",
"_state": {
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Location-Jurisdiction-Id",
"valueString": "WY"
}
]
},
"postalCode": "82070",
"country": "US"
}
],
"maritalStatus": {
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/BypassEditFlag",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-bypass-edit-flag-cs",
"code": "0",
"display": "Edit Passed"
}
]
}
}
],
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
"code": "S",
"display": "Never Married"
}
]
}
}
},
{
"fullUrl": "urn:uuid:727df59d-1dfa-4b71-bdb1-e919f6e4c631",
"resource": {
"resourceType": "Practitioner",
"id": "727df59d-1dfa-4b71-bdb1-e919f6e4c631",
"meta": {
"profile": [
"http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-certifier"
]
}
}
},
{
"fullUrl": "urn:uuid:f81539e0-66eb-4e82-9b93-d38d403e05a0",
"resource": {
"resourceType": "Procedure",
"id": "f81539e0-66eb-4e82-9b93-d38d403e05a0",
"meta": {
"profile": [
"http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-death-certification"
]
},
"status": "completed",
"category": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "103693007",
"display": "Diagnostic procedure"
}
]
},
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "308646001",
"display": "Death certification"
}
]
},
"subject": {
"reference": "urn:uuid:64be7d42-d01d-4183-96b8-b9bc55eba6c4"
}
}
},
{
"fullUrl": "urn:uuid:8d9ed6b4-c23b-472a-8fb7-38c7d49a6d32",
"resource": {
"resourceType": "Observation",
"id": "8d9ed6b4-c23b-472a-8fb7-38c7d49a6d32",
"meta": {
"profile": [
"http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-death-date"
]
},
"status": "final",
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "81956-5",
"display": "Date+time of death"
}
]
},
"subject": {
"reference": "urn:uuid:64be7d42-d01d-4183-96b8-b9bc55eba6c4"
},
"_valueDateTime": {
"extension": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Date-Year",
"valueUnsignedInt": 2022
},
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Date-Month",
"valueUnsignedInt": 1
},
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Date-Day",
"valueUnsignedInt": 17
},
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Date-Time",
"valueTime": "18:23"
}
],
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/PartialDateTime"
}
]
},
"component": [
{
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "58332-8",
"display": "Place of death"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "16983000",
"display": "Death in hospital"
}
]
}
}
]
}
},
{
"fullUrl": "urn:uuid:304bf79d-d182-420d-83b0-92169412cea4",
"resource": {
"resourceType": "Location",
"id": "304bf79d-d182-420d-83b0-92169412cea4",
"meta": {
"profile": [
"http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-death-location"
]
},
"name": "BLANK",
"type": [
{
"coding": [
{
"system": "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-location-type-cs",
"code": "death",
"display": "death location"
}
]
}
],
"address": {
"_district": {
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/DistrictCode",
"valuePositiveInt": 1
}
]
},
"state": "MA",
"_state": {
"extension": [
{
"url": "http://hl7.org/fhir/us/vrdr/StructureDefinition/Location-Jurisdiction-Id",
"valueString": "MA"
}
]
}
}
}
},
{
"fullUrl": "urn:uuid:feba7edc-3af0-413c-9ce1-e47eabfa2d08",
"resource": {
"resourceType": "RelatedPerson",
"id": "feba7edc-3af0-413c-9ce1-e47eabfa2d08",
"meta": {
"profile": [
"http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-decedent-father"
]
},
"patient": {
"reference": "urn:uuid:64be7d42-d01d-4183-96b8-b9bc55eba6c4"
},
"relationship": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "FTH",
"display": "father"
}
]
}
],
"name": [
{
"use": "official",
"family": "Lineberry"
}
]
}
},
{
"fullUrl": "urn:uuid:e82e4667-faa2-4137-91c4-51479a024d67",
"resource": {
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