OP07
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[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
SHOW CARD OP-1.
Please look at this card and tell me which category best describes the care (PERSON) received during the visit to (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE)?
GENERAL CHECKUP ........................ 1
DIAGNOSIS OR TREATMENT ................. 2
EMERGENCY (E.G., ACCIDENT OR INJURY) ... 3
PSYCHOTHERAPY OR MENTAL HEALTH COUNSELING ............................. 4
FOLLOW-UP OR POST-OPERATIVE VISIT ...... 5
IMMUNIZATIONS OR SHOTS ................. 6
VISION EXAM ............................ 7
MATERNITY CARE (PRE/POSTNATAL) ......... 8
WELL CHILD EXAM ........................ 9
OTHER ................................. 91
REF ................................... -7
DK .................................... -8
[Code One]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
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DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
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IF CODED '8' (MATERNITY CARE (PRE/POSTNATAL)), CHECK THAT PERSON IS FEMALE. IF NOT, DISPLAY THE FOLLOWING MESSAGE: 'CODE UNAVAILABLE FOR MALES.
VERIFY AND RE-ENTER.'
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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.'
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MV07
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[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
SHOW CARD MV-1.
Please look at this card and tell me which category best describes the care (PERSON) received during the visit to (PROVIDER) on (VISIT DATE)?
GENERAL CHECKUP ........................ 1
DIAGNOSIS OR TREATMENT ................. 2
EMERGENCY (E.G., ACCIDENT OR INJURY) ... 3
PSYCHOTHERAPY OR MENTAL HEALTH COUNSELING ............................. 4
FOLLOW-UP OR POST-OPERATIVE VISIT ...... 5
IMMUNIZATIONS OR SHOTS ................. 6
VISION EXAM ............................ 7
MATERNITY CARE (PRE/POSTNATAL) ......... 8
WELL CHILD EXAM ........................ 9
OTHER ................................. 91
REF ................................... -7
DK .................................... -8
[Code One]
PRESS F1 FOR DEFINITIONS OF ANSWER CATEGORIES.
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EDITS: IF MVO7 IS CODED '8' (MATERNITY CARE (PRE/POSTNATAL)), CHECK THAT PERSON IS FEMALE.
IF NOT, DISPLAY THE FOLLOWING MESSAGE: CODE UNAVAILABLE FOR MALES. VERIFY AND RE-ENTER.
IF MV07 IS CODED '9' (WELL CHILD EXAM), CHECK THAT PERSON IS ( 7 YEARS OLD (OR AGE CATEGORIES 1 THROUGH 3). IF NOT, DISPLAY THE FOLLOWING MESSAGE: CODE UNAVAILABLE FOR PERSONS 7 AND OLDER. VERIFY AND RE-ENTER.
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