ER50 (ER1025)BLAISE NAME: CodeAllERSvc
Context Header:
[PERSON?S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER] [EVN-DT]
Question Text:
And ER-2.
Looking at this card, which of these services, if any, did [you/[PERSON]] have during this visit?
ENTER ALL THAT APPLY.
HELP: F1
Responses:
LABORATORY TESTS 1 ER60 (ER1035)
SONOGRAM OR ULTRASOUND 2 ER60 (ER1035)
X-RAYS 3 ER60 (ER1035)
MAMMOGRAM 4 ER60 (ER1035)
MRI OR CATSCAN 5 ER60 (ER1035)
EKG, ECG, OR EEG 6 ER60 (ER1035)
VACCINATION 7 ER60 (ER1035)
NONE OF THESE SERVICES RECEIVED 95 ER60 (ER1035)
REFUSED RF ER60 (ER1035)
DON'T KNOW DK ER60 (ER1035)
Programmer Instructions:
Soft Check:
If coded ?4? (MAMMOGRAM) and person being asked about is male or is female and less than or = 17 years of age (or age categories 1-3), display the following message: ?UNLIKELY RESPONSE FOR [MALES/CHILDREN 17 AND YOUNGER]. VERIFY AND RE-ENTER.?
Display ?MALE? in error message if person being asked about is a male greater than 17 years of age (or age categories 4 through 9). Display ?CHILDREN 17 AND YOUNGER? in the error message if person being asked about is male or female and less than or = 17 years of age (or age categories 1-3).
Allow code '95' (NONE OF THESE SERVICES RECEIVED) , 'RF' (REFUSED), and 'DK' (DON'T KNOW) alone only; these responses may not be selected with any other response.
Note: 'NONE OF THESE SERVICES RECEIVED' is not displayed on show card.
Hard check:
Edit: if coded ?95? (NONE OF THESE SERVICES RECEIVED), no other service categories can be coded.
If interviewer selects another code with NONE OF THESE SERVICES RECEIVED, display the following message: "NONE OF THESE SERVICES RECEIVED CANNOT BE SELECTED WITH OTHER OPTIONS. VERIFY AND RE- ENTER."
Display Instructions:
MV90 (MV1070)BLAISE NAME: MVSvcTp
Context Header:
(PERSON?S FIRST MIDDLE AND LAST NAME) (NAME OF MEDICAL CARE
PROVIDER) - (DOC OR DEPT (EVN-DT)
Question Text:
MV-2.
Looking at card MV-2, which of these services, if any, did (you/(PERSON)) have during this visit?
ENTER ALL THAT APPLY.
HELP: F1
Responses:
LABORATORY TESTS 1 MV100 (MV1075)
SONOGRAM OR ULTRASOUND 2 MV110 (MV1080)
X-RAYS 3 MV110 (MV1080)
MAMMOGRAM 4 MV110 (MV1080)
MRI OR CATSCAN 5 MV110 (MV1080)
EKG, ECG, OR EEG 6 MV110 (MV1080)
VACCINATION 7 MV110 (MV1080)
NONE OF THESE SERVICES RECEIVED 95 MV110 (MV1080)
REFUSED RF MV110 (MV1080)
DON'T KNOW DK MV110 (MV1080)
Programmer Instructions:
Soft check:
If MV90 (MVSvcTp) is coded '4' (MAMMOGRAM) and person being asked about is male or is female and less than or equal to 17 years of age (or age categories 1-3), display the following message: "UNLIKELY RESPONSE FOR (MALES/CHILDREN 17 AND YOUNGER). VERIFY AND RE-ENTER."
Display 'MALES' in error message if person being asked about is a male greater than 17 years of age (or age categories 4 through 9). Display 'CHILDREN 17 AND YOUNGER' in the error message if person being asked about is male or female and less than or equal to 17 years of age (or age categories 1-3).
Allow code '95' (NONE OF THESE SERVICES RECEIVED), 'RF' (REFUSED) and 'DK' (DON'T KNOW) alone only. These responses may not be selected with any other response.
'NONE OF THESE SERVICES RECEIVED' is not displayed on show card.
Hard check:
Edit: If MV90 (MVSvcTp) is coded '95' (NONE OF THESE SERVICES RECEIVED), no other treatment categories can be coded. If interviewer selects another code with 'NONE OF THESE SERVICES', display the following message: "NONE OF THESE SERVICES RECEIVED CANNOT BE SELECTED WITH OTHER OPTIONS. VERIFY AND RE-ENTER."
Display Instructions:
OP80 (OP1060)BLAISE NAME: CodeAllOPSvc
Context Header:
(PERSON?S FIRST MIDDLE AND LAST NAME) (NAME OF MEDICAL CARE PROVIDER)-(DOC OR DEPT) (EVN-DT)
Question Text:
OP-2.
Looking at card OP-2, which of these services, if any, did (you/ (PERSON)) have during this visit?
ENTER ALL THAT APPLY
HELP: F1
Responses:
LABORATORY TESTS 1 OP90 (OP1070)
SONOGRAM OR ULTRASOUND 2 OP90 (OP1070)
X-RAYS 3 OP90 (OP1070)
MAMMOGRAM 4 OP90 (OP1070)
MRI OR CATSCAN 5 OP90 (OP1070)
EKG, ECG, OR EEG 6 OP90 (OP1070)
VACCINATION 7 OP90 (OP1070)
NONE OF THESE SERVICES RECEIVED 95 OP90 (OP1070)
REFUSED RF OP90 (OP1070)
DON'T KNOW DK OP90 (OP1070)
Programmer Instructions:
Soft check:
If OP80 (CodeAllOPSvc) is coded '4' (MAMMOGRAM) and person being asked about is male or is female and less than or equal to 17 years of age (or age categories 1-3), display the following message: "UNLIKELY RESPONSE FOR (MALE/CHILDREN 17 AND YOUNGER). VERIFY AND RE-ENTER."
Display 'MALES' in error message if person being asked about is a male greater than 17 years of age (or age categories 4 through 9). Display 'CHILDREN 17 AND YOUNGER' in the error message if person being asked about is male or female and less than or equal to 17 years of age (or age categories 1-3).
Allow OP80 (CodeAllOPSvc) code '95' (NONE OF THESE SERVICES RECEIVED), 'RF' (REFUSED), and 'DK' (DON'T KNOW) alone only. These responses may not be selected with any other response.
'NONE OF THESE SERVICES RECEIVED' is not displayed on show card.
Hard check:
Edit: If OP80 (CodeAllOPSvc) is coded ?95? (NONE OF THESE SERVICES RECEIVED), no other treatment categories can be coded. If interviewer selects another code with 'NONE OF THESE SERVICES', display the following message: "NONE OF THESE SERVICES RECEIVED CANNOT BE SELECTED WITH OTHER OPTIONS. VERIFY AND RE- ENTER."
Display Instructions: