MII Implementierungsleitfaden Kerndatensatz-Modul Molekulargenetischer Befundbericht
2027.0.0-ballot.1 -
Germany
MII IG Kerndatensatz-Modul Molekulargenetischer Befundbericht - Downloaded Version 2027.0.0-ballot.1 See the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="mii-exa-befund-bundle-befund-2-nipbl-clinical"/>
<language value="de"/>
<type value="transaction"/>
<timestamp value="2022-11-21T14:44:00+01:00"/>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-patient-2"/>
<resource>
<Patient>
<id value="mii-exa-molgen-patient-2"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
</coding>
</type>
<system value="https://www.charite.de/fhir/sid/patienten"/>
<value value="146314909"/>
<assigner>
<identifier>
<system
value="https://www.medizininformatik-initiative.de/fhir/core/CodeSystem/core-location-identifier"/>
<value value="Charité"/>
</identifier>
<display value="Charité - Universitätsmedizin Berlin"/>
</assigner>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://fhir.de/CodeSystem/identifier-type-de-basis"/>
<code value="GKV"/>
</coding>
</type>
<system value="http://fhir.de/sid/gkv/kvid-10"/>
<value value="Z900211002"/>
<assigner>
<identifier>
<use value="official"/>
<system value="http://fhir.de/sid/arge-ik/iknr"/>
<value value="109519005"/>
</identifier>
</assigner>
</identifier>
<name>
<use value="official"/>
<family value="Müller">
<extension
url="http://hl7.org/fhir/StructureDefinition/humanname-own-name">
<valueString value="Müller"/>
</extension>
</family>
<given value="Melanie"/>
<given value="Marie"/>
</name>
<gender value="female"/>
<birthDate value="2021-09-19"/>
<deceasedBoolean value="false"/>
<address>
<type value="both"/>
<line value="Anna-Louisa-Karsch Str. 2"/>
<city value="Berlin"/>
<state value="DE-BE"/>
<postalCode value="10178"/>
<country value="DE"/>
</address>
</Patient>
</resource>
<request>
<method value="PUT"/>
<url value="Patient/mii-exa-molgen-patient-2"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-practitioner-lab"/>
<resource>
<Practitioner>
<id value="mii-exa-molgen-practitioner-lab"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<active value="true"/>
<name>
<use value="official"/>
<text value="Dr. Daniel Schmidt"/>
<family value="Schmidt"/>
<given value="Daniel"/>
<prefix value="Dr."/>
</name>
</Practitioner>
</resource>
<request>
<method value="PUT"/>
<url value="Practitioner/mii-exa-molgen-practitioner-lab"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-practitioner-physician"/>
<resource>
<Practitioner>
<id value="mii-exa-molgen-practitioner-physician"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<active value="true"/>
<name>
<use value="official"/>
<text value="Dr. Linda Rubens"/>
<family value="Rubens"/>
<given value="Linda"/>
<prefix value="Dr."/>
</name>
</Practitioner>
</resource>
<request>
<method value="PUT"/>
<url value="Practitioner/mii-exa-molgen-practitioner-physician"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-condition-nipbl-clinical"/>
<resource>
<Condition>
<id value="mii-exa-molgen-condition-nipbl-clinical"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/core/modul-diagnose/StructureDefinition/Diagnose"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
</coding>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
</coding>
</verificationStatus>
<code>
<coding>
<extension
url="http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit">
<valueCoding>
<system
value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_ICD_DIAGNOSESICHERHEIT"/>
<code value="G"/>
</valueCoding>
</extension>
<system value="http://fhir.de/CodeSystem/bfarm/icd-10-gm"/>
<version value="2021"/>
<code value="Q87.1"/>
<display
value="Angeborene Fehlbildungssyndrome, die vorwiegend mit Kleinwuchs einhergehen"/>
</coding>
<coding>
<system value="http://www.omim.org"/>
<code value="122470"/>
<display value="Cornelia de Lange syndrome 1"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<onsetPeriod>
<start value="2021-09-19">
<extension url="http://fhir.de/StructureDefinition/lebensphase">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="255407002"/>
<display value="Neonatal (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
</start>
</onsetPeriod>
<recordedDate value="2022-03-06T07:36:00+01:00"/>
<recorder>🔗
<reference
value="Practitioner/mii-exa-molgen-practitioner-physician"/>
</recorder>
<asserter>🔗
<reference
value="Practitioner/mii-exa-molgen-practitioner-physician"/>
</asserter>
<evidence>
<detail>🔗
<reference
value="DiagnosticReport/mii-exa-molgen-befundbericht-2"/>
</detail>
</evidence>
</Condition>
</resource>
<request>
<method value="PUT"/>
<url value="Condition/mii-exa-molgen-condition-nipbl-clinical"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-phenotypic-feature-1"/>
<resource>
<Observation>
<id value="mii-exa-molgen-phenotypic-feature-1"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="exam"/>
</coding>
</category>
<code>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0000527"/>
<display value="Long eyelashes"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<effectiveDateTime value="2022-03-13T09:30:00+01:00"/>
<performer>🔗
<reference
value="Practitioner/mii-exa-molgen-practitioner-physician"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9633-4"/>
<display value="Present"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
<request>
<method value="PUT"/>
<url value="Observation/mii-exa-molgen-phenotypic-feature-1"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-phenotypic-feature-2"/>
<resource>
<Observation>
<id value="mii-exa-molgen-phenotypic-feature-2"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="exam"/>
</coding>
</category>
<code>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0001518"/>
<display value="Small for gestational age"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<effectiveDateTime value="2022-03-13T09:30:00+01:00"/>
<performer>🔗
<reference
value="Practitioner/mii-exa-molgen-practitioner-physician"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9633-4"/>
<display value="Present"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
<request>
<method value="PUT"/>
<url value="Observation/mii-exa-molgen-phenotypic-feature-2"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-phenotypic-feature-3"/>
<resource>
<Observation>
<id value="mii-exa-molgen-phenotypic-feature-3"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="exam"/>
</coding>
</category>
<code>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0000252"/>
<display value="Microcephaly"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<effectiveDateTime value="2022-03-13T09:30:00+01:00"/>
<performer>🔗
<reference
value="Practitioner/mii-exa-molgen-practitioner-physician"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9633-4"/>
<display value="Present"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
<request>
<method value="PUT"/>
<url value="Observation/mii-exa-molgen-phenotypic-feature-3"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-phenotypic-feature-4"/>
<resource>
<Observation>
<id value="mii-exa-molgen-phenotypic-feature-4"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="exam"/>
</coding>
</category>
<code>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0003560"/>
<display value="Muscular dystrophy"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<effectiveDateTime value="2022-03-13T09:30:00+01:00"/>
<performer>🔗
<reference
value="Practitioner/mii-exa-molgen-practitioner-physician"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9633-4"/>
<display value="Present"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
<request>
<method value="PUT"/>
<url value="Observation/mii-exa-molgen-phenotypic-feature-4"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-befundbericht-2"/>
<resource>
<DiagnosticReport>
<id value="mii-exa-molgen-befundbericht-2"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-molgen/StructureDefinition/molekulargenetischer-befundbericht|2027.0.0-ballot.1"/>
<profile
value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report|3.0.0"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
<valueRelatedArtifact>
<type value="citation"/>
<citation
value="Gillis LA, McCallum J, Kaur M, DeScipio C, Yaeger D, Mariani A, Kline AD, Li HH, Devoto M, Jackson LG, Krantz ID. NIPBL mutational analysis in 120 individuals with Cornelia de Lange syndrome and evaluation of genotype-phenotype correlations. Am J Hum Genet. 2004 Oct;75(4):610-23. doi: 10.1086/424698. Epub 2004 Aug 18. PMID: 15318302; PMCID: PMC1182048."/>
<url value="https://pubmed.ncbi.nlm.nih.gov/15318302/"/>
</valueRelatedArtifact>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
<valueRelatedArtifact>
<type value="citation"/>
<citation
value="Kawauchi S, Calof AL, Santos R, Lopez-Burks ME, Young CM, Hoang MP, Chua A, Lao T, Lechner MS, Daniel JA, Nussenzweig A, Kitzes L, Yokomori K, Hallgrimsson B, Lander AD. Multiple organ system defects and transcriptional dysregulation in the Nipbl(+/-) mouse, a model of Cornelia de Lange Syndrome. PLoS Genet. 2009 Sep;5(9):e1000650. doi: 10.1371/journal.pgen.1000650. Epub 2009 Sep 18. PMID: 19763162; PMCID: PMC2730539."/>
<url value="https://pubmed.ncbi.nlm.nih.gov/19763162/"/>
</valueRelatedArtifact>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
<valueRelatedArtifact>
<type value="citation"/>
<citation
value="Huisman SA, Redeker EJ, Maas SM, Mannens MM, Hennekam RC. High rate of mosaicism in individuals with Cornelia de Lange syndrome. J Med Genet. 2013 May;50(5):339-44. doi: 10.1136/jmedgenet-2012-101477. Epub 2013 Mar 15. PMID: 23505322."/>
<url value="https://pubmed.ncbi.nlm.nih.gov/23505322/"/>
</valueRelatedArtifact>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
<valueRelatedArtifact>
<type value="citation"/>
<citation
value="Kline AD, Moss JF, Selicorni A, Bisgaard AM, Deardorff MA, Gillett PM, Ishman SL, Kerr LM, Levin AV, Mulder PA, Ramos FJ, Wierzba J, Ajmone PF, Axtell D, Blagowidow N, Cereda A, Costantino A, Cormier-Daire V, FitzPatrick D, Grados M, Groves L, Guthrie W, Huisman S, Kaiser FJ, Koekkoek G, Levis M, Mariani M, McCleery JP, Menke LA, Metrena A, O'Connor J, Oliver C, Pie J, Piening S, Potter CJ, Quaglio AL, Redeker E, Richman D, Rigamonti C, Shi A, Tümer Z, Van Balkom IDC, Hennekam RC. Diagnosis and management of Cornelia de Lange syndrome: first international consensus statement. Nat Rev Genet. 2018 Oct;19(10):649-666. doi: 10.1038/s41576-018-0031-0. PMID: 29995837; PMCID: PMC7136165."/>
<url value="https://pubmed.ncbi.nlm.nih.gov/29995837/"/>
</valueRelatedArtifact>
</extension>
<extension
url="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report-note">
<valueAnnotation>
<extension
url="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/annotation-code">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="116148004"/>
<display value="Molecular genetics procedure (procedure)"/>
</coding>
</valueCodeableConcept>
</extension>
<text
value="Gen-Panel zusammengestellt nach den aktuellen Empfehlungen des Deutschen Konsortiums für erblichen Brust- und Eierstockkrebs sowie der ClinGen Breast/Ovarian Cancer Working Group (Lee et al. 2019, PMID: 30504931). Nach DNA-Extraktion wurden alle kodierenden Exons der zu untersuchenden Gene einschließlich flankierender intronischer Regionen (mindestens von -3 bis +8) angereichert (Custom Panel V02, IDT) und auf einem Illumina NextSeq 500-, NextSeq 550- oder NovaSeq 6000-Sequencer sequenziert. Zur Verifizierung der DNA-Probe wurden 14 SNPs (Single Nucleotide Polymorphism) mittels kompetitiver allelspezifischer PCR unter Verwendung fluoreszenzmarkierter Primer amplifiziert (StepOnePlus System, ThermoFisher Scientific) und analysiert (StepOnePlus software für Genotyping Experiments) und die Ergebnisse mit den Daten der NGS-Analyse verglichen (megSAP). Der Abgleich der ermittelten DNA-Sequenz erfolgte mit den in den Gendatenbanken niedergelegten Sequenzen: BRCA1 - NCBI Reference Sequence NM_007294.2, BRCA2 - ensembl ENST00000380152, ATM - NCBI Reference Sequence NM_000051.3, BARD1 - ENST00000260947.4, BRIP1 - NCBI Reference Sequence NM_032043.2, CDH1 - ensembl ENST00000261769, CHEK2 - NCBI Reference Sequence NM_007194.3, PALB2 - ensembl ENST00000261584, PTEN - NCBI Reference Sequence NM_000214.4, RAD51C - ensembl ENST00000337432, RAD51D - ensembl ENST00000345365, STK11 - ensembl ENST00000326873.7 und TP53 - ensembl ENST00000269305. Es wurden außerdem Varianten nachgewiesen, die nach heutigem Wissensstand als Normvarianten ohne pathologische Bedeutung zu werten sind."/>
</valueAnnotation>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo">
<valueReference>🔗
<reference value="ChargeItem/mii-exa-molgen-chargeitem-ebm-21"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo">
<valueReference>🔗
<reference value="ChargeItem/mii-exa-molgen-chargeitem-ebm-22"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo">
<valueReference>🔗
<reference value="ChargeItem/mii-exa-molgen-chargeitem-ebm-23"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo">
<valueReference>🔗
<reference value="ChargeItem/mii-exa-molgen-chargeitem-ebm-24"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo">
<valueReference>🔗
<reference
value="Condition/mii-exa-molgen-bundle-befund-2-nipbl-condition-lab"/>
</valueReference>
</extension>
<basedOn>🔗
<reference value="ServiceRequest/mii-exa-molgen-anforderung-2"/>
</basedOn>
<status value="final"/>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="GE"/>
<display value="Genetics"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="51969-4"/>
<display value="Genetic analysis report"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<performer>🔗
<reference value="Practitioner/mii-exa-molgen-practitioner-lab"/>
</performer>
<specimen>🔗
<reference value="Specimen/mii-exa-molgen-specimen-2"/>
</specimen>
<result>🔗
<reference
value="Observation/mii-exa-molgen-diagnostische-implikation-2"/>
</result>
<result>🔗
<reference value="Observation/mii-exa-molgen-variante-2"/>
</result>
<conclusion
value="Nachweis der pathogenen Variante c.2207del p.(Pro736Glnfs*58) (heterozygot) im NIPBL-Gen."/>
</DiagnosticReport>
</resource>
<request>
<method value="PUT"/>
<url value="DiagnosticReport/mii-exa-molgen-befundbericht-2"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-anforderung-2"/>
<resource>
<ServiceRequest>
<id value="mii-exa-molgen-anforderung-2"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-molgen/StructureDefinition/anforderung-genetischer-test|2027.0.0-ballot.1"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<identifier>
<system value="https://www.charite.de/fhir/auftragsnummern"/>
<value value="gen_test_02"/>
</identifier>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="108252007"/>
<display value="Laboratory procedure (procedure)"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="405825005"/>
<display value="Molecular genetic test (procedure)"/>
</coding>
<coding>
<system value="http://loinc.org"/>
<code value="40428-5"/>
<display
value="NIPBL gene targeted mutation analysis in Blood or Tissue by Molecular genetics method"/>
</coding>
<coding>
<system value="http://www.genenames.org/geneId"/>
<code value="HGNC:28862"/>
<display value="NIPBL"/>
</coding>
<text
value="Molekulargenetische Diagnose eines Cornelia de Lange-Syndrom (MIM122470),autosomal dominanter Erbgang"/>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<authoredOn value="2022-03-16"/>
<requester>🔗
<reference
value="Practitioner/mii-exa-molgen-practitioner-physician"/>
</requester>
<reasonCode>
<coding>
<system value="http://snomed.info/sct"/>
<code value="395507008"/>
<display value="Premature infant (finding)"/>
</coding>
</reasonCode>
<reasonCode>
<coding>
<system value="http://snomed.info/sct"/>
<code value="276610007"/>
<display value="Low birth weight infant (disorder)"/>
</coding>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0001518"/>
<display value="Small for gestational age"/>
</coding>
</reasonCode>
<reasonCode>
<coding>
<system value="http://snomed.info/sct"/>
<code value="431265009"/>
<display value="Fetal microcephaly (disorder)"/>
</coding>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0000252"/>
<display value="Microcephaly"/>
</coding>
</reasonCode>
<reasonCode>
<coding>
<system value="http://snomed.info/sct"/>
<code value="137511000119103"/>
<display value="Carrier of muscular dystrophy (finding)"/>
</coding>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0003560"/>
<display value="Muscular dystrophy"/>
</coding>
</reasonCode>
<reasonCode>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0000527"/>
<display value="Long eyelashes"/>
</coding>
</reasonCode>
<reasonReference>🔗
<reference value="Observation/mii-exa-molgen-phenotypic-feature-1"/>
</reasonReference>
<reasonReference>🔗
<reference value="Observation/mii-exa-molgen-phenotypic-feature-2"/>
</reasonReference>
<reasonReference>🔗
<reference value="Observation/mii-exa-molgen-phenotypic-feature-3"/>
</reasonReference>
<reasonReference>🔗
<reference value="Observation/mii-exa-molgen-phenotypic-feature-4"/>
</reasonReference>
<specimen>🔗
<reference value="Specimen/mii-exa-molgen-specimen-2"/>
</specimen>
</ServiceRequest>
</resource>
<request>
<method value="PUT"/>
<url value="ServiceRequest/mii-exa-molgen-anforderung-2"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-chargeitem-ebm-21"/>
<resource>
<ChargeItem>
<id value="mii-exa-molgen-chargeitem-ebm-21"/>
<meta>
<profile
value="http://fhir.de/StructureDefinition/chargeitem-de-ebm"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="billable"/>
<code>
<coding>
<system value="https://fhir.kbv.de/NamingSystem/KBV_NS_Base_EBM"/>
<code value="11513"/>
<display
value="Postnatale Mutationssuche zum Nachweis oder Ausschluss einer krankheitsrelevanten oder krankheitsauslösenden konstitutionellen genomischen Mutation"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<quantity>
<value value="72"/>
</quantity>
</ChargeItem>
</resource>
<request>
<method value="PUT"/>
<url value="ChargeItem/mii-exa-molgen-chargeitem-ebm-21"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-chargeitem-ebm-22"/>
<resource>
<ChargeItem>
<id value="mii-exa-molgen-chargeitem-ebm-22"/>
<meta>
<profile
value="http://fhir.de/StructureDefinition/chargeitem-de-ebm"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="billable"/>
<code>
<coding>
<system value="https://fhir.kbv.de/NamingSystem/KBV_NS_Base_EBM"/>
<code value="11512"/>
<display
value="Gezielter Nachweis oder Ausschluss von krankheitsrelevanten oder krankheitsauslösenden großen Deletionen und/oder Duplikationen"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<quantity>
<value value="6"/>
</quantity>
</ChargeItem>
</resource>
<request>
<method value="PUT"/>
<url value="ChargeItem/mii-exa-molgen-chargeitem-ebm-22"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-chargeitem-ebm-23"/>
<resource>
<ChargeItem>
<id value="mii-exa-molgen-chargeitem-ebm-23"/>
<meta>
<profile
value="http://fhir.de/StructureDefinition/chargeitem-de-ebm"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="billable"/>
<code>
<coding>
<system value="https://fhir.kbv.de/NamingSystem/KBV_NS_Base_EBM"/>
<code value="11302"/>
<display
value="Zuschlag für Gemeinkosten und die wissenschaftliche ärztliche Beurteilung und Befundung komplexer genetischer Analysen im individuellen klinischen Kontext bei seltenen Erkrankungen"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<quantity>
<value value="1"/>
</quantity>
</ChargeItem>
</resource>
<request>
<method value="PUT"/>
<url value="ChargeItem/mii-exa-molgen-chargeitem-ebm-23"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-chargeitem-ebm-24"/>
<resource>
<ChargeItem>
<id value="mii-exa-molgen-chargeitem-ebm-24"/>
<meta>
<profile
value="http://fhir.de/StructureDefinition/chargeitem-de-ebm"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="billable"/>
<code>
<coding>
<system value="https://fhir.kbv.de/NamingSystem/KBV_NS_Base_EBM"/>
<code value="11301"/>
<display
value="Grundpauschale humangenetische in-vitro-Diagnostik bei Probeneinsendung"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<quantity>
<value value="1"/>
</quantity>
</ChargeItem>
</resource>
<request>
<method value="PUT"/>
<url value="ChargeItem/mii-exa-molgen-chargeitem-ebm-24"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-specimen-2"/>
<resource>
<Specimen>
<id value="mii-exa-molgen-specimen-2"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-biobank/StructureDefinition/SpecimenCore"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<identifier>
<system value="https://www.charite.de/fhir/sid/bioproben"/>
<value value="specimen_02"/>
</identifier>
<status value="available"/>
<type>
<coding>
<system value="http://snomed.info/sct"/>
<code value="445295009"/>
<display value="Blood specimen with edetic acid (specimen)"/>
</coding>
</type>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<receivedTime value="2021-11-24"/>
<collection>
<collectedDateTime value="2021-11-23"/>
</collection>
</Specimen>
</resource>
<request>
<method value="PUT"/>
<url value="Specimen/mii-exa-molgen-specimen-2"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-device-sequencer-2"/>
<resource>
<Device>
<id value="mii-exa-molgen-device-sequencer-2"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="active"/>
<manufacturer value="Illumina"/>
<deviceName>
<name value="NovaSeq 6000-Sequencer"/>
<type value="manufacturer-name"/>
</deviceName>
</Device>
</resource>
<request>
<method value="PUT"/>
<url value="Device/mii-exa-molgen-device-sequencer-2"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-diagnostische-implikation-2"/>
<resource>
<Observation>
<id value="mii-exa-molgen-diagnostische-implikation-2"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-molgen/StructureDefinition/diagnostische-implikation|2027.0.0-ballot.1"/>
<profile
value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication|3.0.0"/>
</meta>
<language value="de"/>
<text>
<status value="extensions"/>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
<valueRelatedArtifact>
<type value="citation"/>
<citation value="Richards et al., Genet Med. 2015; 17:405-24"/>
<url value="https://doi.org/10.1038/gim.2015.30"/>
</valueRelatedArtifact>
</extension>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
<display value="Laboratory"/>
</coding>
</category>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="GE"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="diagnostic-implication"/>
<display value="Diagnostic Implication"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<effectiveDateTime value="2022-03-16"/>
<performer>🔗
<reference value="Practitioner/mii-exa-molgen-practitioner-lab"/>
</performer>
<derivedFrom>🔗
<reference value="Observation/mii-exa-molgen-variante-2"/>
</derivedFrom>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="conclusion-string"/>
</coding>
</code>
<valueString
value="Nachweis einer pathogenen Variante im NIPBL-Gen in heterozygoter Form."/>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="53037-8"/>
<display value="Genetic variation clinical significance [Imp]"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6668-3"/>
<display value="Pathogenic"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
<code value="condition-inheritance"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://human-phenotype-ontology.org"/>
<code value="HP:0000006"/>
<display value="Autosomal dominant inheritance"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81259-4"/>
<display value="Associated phenotype"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="40354009"/>
<display value="De Lange syndrome (disorder)"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
<request>
<method value="PUT"/>
<url value="Observation/mii-exa-molgen-diagnostische-implikation-2"/>
</request>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/mii-exa-molgen-variante-2"/>
<resource>
<Observation>
<id value="mii-exa-molgen-variante-2"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-molgen/StructureDefinition/variante|2027.0.0-ballot.1"/>
<profile
value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant|3.0.0"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<basedOn>🔗
<reference value="ServiceRequest/mii-exa-molgen-anforderung-2"/>
</basedOn>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
<display value="Laboratory"/>
</coding>
</category>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="GE"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="69548-6"/>
<display value="Genetic variant assessment"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-molgen-patient-2"/>
</subject>
<effectiveDateTime value="2022-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9633-4"/>
<display value="Present"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://loinc.org"/>
<code value="LA26398-0"/>
<display value="Sequencing"/>
</coding>
<coding>
<system value="http://loinc.org"/>
<code value="86206-0"/>
<display
value="Whole genome sequence analysis in Blood or Tissue by Molecular genetics method"/>
</coding>
</method>
<specimen>🔗
<reference value="Specimen/mii-exa-molgen-specimen-2"/>
</specimen>
<device>🔗
<reference value="Device/mii-exa-molgen-device-sequencer-2"/>
</device>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48018-6"/>
<display value="Gene studied [ID]"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.genenames.org/geneId"/>
<code value="HGNC:28862"/>
<display value="NIPBL"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="51958-7"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.ncbi.nlm.nih.gov/refseq"/>
<code value="NM_133433.4"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="47999-8"/>
<display value="DNA region name [Identifier]"/>
</coding>
</code>
<valueString value="Exon #10"/>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48004-6"/>
<display value="DNA change (c.HGVS)"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://varnomen.hgvs.org"/>
<code value="NM_133433.4:c.2207del"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48005-3"/>
<display value="Amino acid change (pHGVS)"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://varnomen.hgvs.org"/>
<code value="p.(Pro736Glnfs*58)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="53034-5"/>
<display value="Allelic state"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6706-1"/>
<display value="Heterozygous"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48019-4"/>
<display value="DNA change type"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://sequenceontology.org"/>
<code value="SO:0000159"/>
<display value="Deletion"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48001-2"/>
<display value="Cytogenetic (chromosome) location"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="urn:oid:2.16.840.1.113883.6.335"/>
<code value="5p13.2"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81252-9"/>
<display value="Discrete genetic variant"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.ncbi.nlm.nih.gov/clinvar"/>
<code value="1076298"/>
</coding>
<coding>
<system value="http://www.ncbi.nlm.nih.gov/clinvar"/>
<code value="VCV001076298.1"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
<request>
<method value="PUT"/>
<url value="Observation/mii-exa-molgen-variante-2"/>
</request>
</entry>
</Bundle>