US Veterans Health Administration FHIR Map Set Implementation Guide
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Resource Profile: LabObservationChemhemtoxriaserObservation - Mappings

Active as of 2025-06-20

Mappings for the LabObservationChemhemtoxriaserObservation resource profile.

Scroll down for the Raw FHIR, CDW & SDA mappings (if any).

Note that the CDW, SDA and VPR XML mappings are derived from a look-up based on the VistA source.

Mapping Sources

Use Case: Lab Observation: Chem, hem, tox, ria, ser (Source)Use Case: Lab Observation: Chem, hem, tox, ria, ser (Source)PATIENT (2)63LABORATORY REFERENCELABORATORY TEST (60)100SITE/SPECIMENCOLLECTION SAMPLE (62).01NAMELAB DATA (63).01LRDFNCHEM, HEM, TOX, RIA, SER, etc. (63.04).001IEN.01DATE/TIME SPECIMEN TAKEN.03ORDERED TEST.04VERIFY PERSON.06ACCESSION.112ACCESSIONING INSTITUTION.35ORDERED TEST.99COMMENT2+through+862testnamesORDERED TEST (63.07)3CPRS ORDER #9COLLECTION SAMPLE10DISPOSITION13LAB TEST ORDEREDCOMMENT (63.041).01COMMENTSITE/SPECIMEN (60.01)1REFERENCE LOW2REFERENCE HIGH6UNITS95.3LOINC CODELAB LOINC (95.3).01CODE1COMPONENT[not NULL]

Raw Mappings

key status direction source mapApproach mapCase FHIR Path subPath mapValue mapParameter mapComment FHIR URL | Ver
845 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - DATE/TIME SPECIMEN TAKEN (63.04-.01) source value Observation.effectiveDateTime http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
846 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - COMMENT > COMMENT - COMMENT (63.04-.99 > 63.041-.01) source value Observation.note http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
847 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ACCESSIONING INSTITUTION (63.04-.112) reference Observation.performer[va-at] /Organization http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
1676 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - VERIFY PERSON (63.04-.04) reference Observation.performer[va-by] /Practitioner http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
1656 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ACCESSION (63.04-.06) reference Observation.specimen Specimen http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
850 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ORDERED TEST > ORDERED TEST - LAB TEST ORDERED > LABORATORY TEST - SITE/SPECIMEN > SITE/SPECIMEN - REFERENCE HIGH (63.04-.35 > 63.07-13 > 60-100 > 60.01-2) source value Observation.referenceRange .high http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
854 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ORDERED TEST > ORDERED TEST - LAB TEST ORDERED > LABORATORY TEST - SITE/SPECIMEN > SITE/SPECIMEN - REFERENCE LOW (63.04-.35 > 63.07-13 > 60-100 > 60.01-1) source value Observation.referenceRange .low http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
851 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - IEN (63.04-.001) source value Observation.identifier .value .system = http://va.gov/identifiers/$Sta3n/63.04 Changed from .id to .identifier, added subPath, removed id_generator from mapValue, added .system, and changed from transform to source value http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
852 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - testnames (63.04-2+through+862) terminologyMaps Observation.interpretation VF_LabInterpretation Service compares value to reference and infers flag http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
853 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ORDERED TEST > ORDERED TEST - LAB TEST ORDERED > LABORATORY TEST - SITE/SPECIMEN > SITE/SPECIMEN - LOINC CODE > LAB LOINC (63.04-.35 > 63.07-13 > 60-100 > 60.01-95.3 > 95.3-) source value Observation.code.coding .system = "http://loinc.org"
.code = {CODE (.01)}
.display = {COMPONENT (1)}
http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
858 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - DATE REPORT COMPLETED (63.04-.03) source value Observation.issued http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
860 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ORDERED TEST > ORDERED TEST - DISPOSITION (63.04-.35 > 63.07-10) terminologyMaps not NULL Observation.status VF_LabObservationStatus Available in interface, use this first for status http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
2234 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ORDERED TEST (63.04-.03) fixed value not NULL and 63.07-10 is not available Observation.status #completed http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
2235 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ORDERED TEST (63.04-.03) fixed value NULL and 63.07-10 is not available Observation.status #preliminary http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
857 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - testnames (63.04-2+through+862) source value Observation.valueQuantity .value http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
864 for review V2F CHEM, HEM, TOX, RIA, SER, etc. - ORDERED TEST > ORDERED TEST - LAB TEST ORDERED > LABORATORY TEST - SITE/SPECIMEN > SITE/SPECIMEN - UNITS (63.04-.35 > 63.07-13 > 60-100 > 60.01-6) source value Observation.valueQuantity .unit Use CTTDM map "VistA Lab Chem Units to UCUM" to convert VistA text units to UCUM, where possible http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
843 for review V2F fixed value Observation.category[Laboratory] http://terminology.hl7.org/CodeSystem/observation-category#laboratory http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1
844 for review V2F PATIENT - LABORATORY REFERENCE > LAB DATA - LRDFN (2-63 > 63-.01) reference Observation.subject /Patient Pointer from PATIENT (2) http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab | 5.0.1

Mappings to Structures in this Implementation Guide

No Mappings Found

Mappings to other Structures

No Mappings Found

Other Mappings

NameWorkflow PatternSNOMED CT Concept Domain BindingHL7 v2 MappingRIM MappingFiveWs Pattern MappingSNOMED CT Attribute Bindingdoco
.. Observation
Event
< 363787002 |Observable entity|
OBX
  • Observation[classCode=OBS
  • moodCode=EVN]
... id
... meta
... implicitRules
... language
... text
Act.text?
... contained
N/A
... extension
N/A
... modifierExtension
N/A
... identifier
Event.identifier
1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.
id
FiveWs.identifier
.... id
n/a
.... extension
n/a
.... use
N/A
Role.code or implied by context
.... type
CX.5
Role.code or implied by context
.... system
CX.4 / EI-2-4
II.root or Role.id.root
.... value
CX.1 / EI.1
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
.... period
CX.7 + CX.8
Role.effectiveTime or implied by context
.... assigner
  • CX.4 / (CX.4
  • CX.9
  • CX.10)
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
... basedOn
Event.basedOn
ORC
.inboundRelationship[typeCode=COMP].source[moodCode=EVN]
... partOf
Event.partOf
Varies by domain
.outboundRelationship[typeCode=FLFS].target
... status
Event.status
< 445584004 |Report by finality status|
OBX-11
status Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"
FiveWs.status
... Slices for category
  • .outboundRelationship[typeCode="COMP].target[classCode="LIST"
  • moodCode="EVN"].code
FiveWs.class
.... category:Laboratory
  • .outboundRelationship[typeCode="COMP].target[classCode="LIST"
  • moodCode="EVN"].code
FiveWs.class
... code
Event.code
< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
OBX-3
code
FiveWs.what[x]
116680003 |Is a|
.... id
n/a
.... extension
n/a
.... coding
  • C*E.1-8
  • C*E.10-22
  • union(.
  • ./translation)
..... id
n/a
..... extension
n/a
..... system
C*E.3
./codeSystem
..... version
C*E.7
./codeSystemVersion
..... code
C*E.1
./code
..... display
C*E.2 - but note this is not well followed
CV.displayName
..... userSelected
Sometimes implied by being first
CD.codingRationale
.... text
C*E.9. But note many systems use C*E.2 for this
./originalText[mediaType/code="text/plain"]/data
... subject
Event.subject
PID-3
participation[typeCode=RTGT]
FiveWs.subject
... focus
OBX-3
participation[typeCode=SBJ]
FiveWs.subject
... encounter
Event.context
PV1
  • inboundRelationship[typeCode=COMP].source[classCode=ENC
  • moodCode=EVN]
FiveWs.context
... Slices for effective[x]
Event.occurrence[x]
  • OBX-14
  • and/or OBX-19 after v2.4 (depends on who observation made)
effectiveTime
FiveWs.done[x]
.... effective[x]:effectiveDateTime
Event.occurrence[x]
  • OBX-14
  • and/or OBX-19 after v2.4 (depends on who observation made)
effectiveTime
FiveWs.done[x]
... issued
  • OBR.22 (or MSH.7)
  • or perhaps OBX-19 (depends on who observation made)
participation[typeCode=AUT].time
FiveWs.recorded
... Slices for performer
Event.performer.actor
  • OBX.15 / (Practitioner) OBX-16
  • PRT-4='RO' / (Device) OBX-18
  • PRT-4='EQUIP' / (Organization) OBX-23
  • PRT-4='PO'
participation[typeCode=PRF]
FiveWs.actor
.... performer:va-at
Event.performer.actor
  • OBX.15 / (Practitioner) OBX-16
  • PRT-4='RO' / (Device) OBX-18
  • PRT-4='EQUIP' / (Organization) OBX-23
  • PRT-4='PO'
participation[typeCode=PRF]
FiveWs.actor
.... performer:va-by
Event.performer.actor
  • OBX.15 / (Practitioner) OBX-16
  • PRT-4='RO' / (Device) OBX-18
  • PRT-4='EQUIP' / (Organization) OBX-23
  • PRT-4='PO'
participation[typeCode=PRF]
FiveWs.actor
... Slices for value[x]
< 441742003 |Evaluation finding|
  • OBX.2
  • OBX.5
  • OBX.6
value
363714003 |Interprets|
.... value[x]:valueQuantity
< 441742003 |Evaluation finding|
  • OBX.2
  • OBX.5
  • OBX.6
value
363714003 |Interprets|
..... id
n/a
..... extension
n/a
..... value
SN.2 / CQ - N/A
  • PQ.value
  • CO.value
  • MO.value
  • IVL.high or IVL.low depending on the value
..... comparator
SN.1 / CQ.1
IVL properties
..... unit
(see OBX.6 etc.) / CQ.2
PQ.unit
..... system
(see OBX.6 etc.) / CQ.2
  • CO.codeSystem
  • PQ.translation.codeSystem
..... code
(see OBX.6 etc.) / CQ.2
  • PQ.code
  • MO.currency
  • PQ.translation.code
... dataAbsentReason
N/A
value.nullFlavor
... interpretation
< 260245000 |Findings values|
OBX-8
interpretationCode
363713009 |Has interpretation|
... note
  • NTE.3 (partner NTE to OBX
  • or sometimes another (child?) OBX)
subjectOf.observationEvent[code="annotation"].value
... bodySite
< 123037004 |Body structure|
OBX-20
targetSiteCode
718497002 |Inherent location|
... method
OBX-17
methodCode
... specimen
< 123038009 |Specimen|
SPM segment
participation[typeCode=SPC].specimen
704319004 |Inherent in|
... device
< 49062001 |Device|
OBX-17 / PRT -10
participation[typeCode=DEV]
424226004 |Using device|
... referenceRange
OBX.7
  • outboundRelationship[typeCode=REFV]/target[classCode=OBS
  • moodCode=EVN]
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... low
OBX-7
IVL_PQ.low
.... high
OBX-7
IVL_PQ.high
.... type
< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
OBX-10
interpretationCode
.... appliesTo
< 260245000 |Findings values| OR < 365860008 |General clinical state finding| OR < 250171008 |Clinical history or observation findings| OR < 415229000 |Racial group| OR < 365400002 |Finding of puberty stage| OR < 443938003 |Procedure carried out on subject|
OBX-10
interpretationCode
.... age
outboundRelationship[typeCode=PRCN].targetObservationCriterion[code="age"].value
.... text
OBX-7
ST
... hasMember
Relationships established by OBX-4 usage
outBoundRelationship
... derivedFrom
Relationships established by OBX-4 usage
.targetObservation
... component
containment by OBX-4?
outBoundRelationship[typeCode=COMP]
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... code
< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|
OBX-3
code
FiveWs.what[x]
.... value[x]
363714003 |Interprets| < 441742003 |Evaluation finding|
  • OBX.2
  • OBX.5
  • OBX.6
value
363714003 |Interprets|
.... dataAbsentReason
N/A
value.nullFlavor
.... interpretation
< 260245000 |Findings values|
OBX-8
interpretationCode
363713009 |Has interpretation|
.... referenceRange
OBX.7
  • outboundRelationship[typeCode=REFV]/target[classCode=OBS
  • moodCode=EVN]

doco Documentation for this format