"The ProblemsDiagnoses domain describes information related to the client's problems - behavioral health as well as physical conditions. This class represents the typical set of diagnoses and repetitions typical of BH reports. The Problem data structure describes additional properties of Problems, including the standards-based code representing the problem, the provider who noted the problem/diagnosis, the date problem recorded (likely to be the assessment date), date of onset if known and date of resolution if problem is no longer active. Meaningful Use Stage 2 requires that problems included in a Problem List section of a CDA document must be exchanged using the SNOMED-CT code system, however behavioral health systems are required to support currently DSM-IV and migrate to DSM-5. The solution will require value sets and mappings to be created to facilitate adoption of MU standards by Behavioral Health providers." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses

Attributes
Problem	axis-II-problem	"Up to six diagnoses from the DSM-IV Axis II category may be reported in a single encounter. See definition for the primaryBehavioralHealthProblem data element. The primaryBehavioralHealthProblem is constrained to a value from either DSM-IV Axis I or Axis II." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.axis-II-problem
Problem	axis-I-problem	"Up to six diagnoses from the DSM-IV Axis I category may be reported in a single encounter. Note: The DSM-IV code will be replaced with a DSM-5 code." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.axis-I-problem
Problem	axis-IV-problem	"Up to two Axis IV conditions may be reported." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.axis-IV-problem
Problem	physicalProblem	"The problem may be encoded using SNOMED-CT, ICD-9-CM or ICD-10-CM, depending on the source system and the date of the diagnosis, pursuant to applicable regulations. This data element is used to represents problems typically exchanged in Axis III using a valid DSM-IV TR code. Axis III lists any medical or neurological problems that may be relevant to the client’s current or past psychiatric problems; for example, someone with severe asthma may experience respiratory symptoms that are easily confused with a panic attack, or indeed, which may precipitate a panic attack. Up to five Axis III conditions may be reported." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.physicalProblem
Problem	primaryBehavioralHealthProblem	"This data element is used to communicate the Principal diagnosis or first listed diagnosis (Primary diagnosis) for the behavioral health encounter. The PrincipalDiagnosis must be drawn from the AXIS I or AXIS II value sets which by definition consist of valid DSM-IV-TR or DSM 5 codes. DSM-IV codes are taken from International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) by reviewing the ICD-9-CM system to select the code that best corresponds to each DSM-IV-TR category to create a crosswalk between DSM-IV TR and ICD-9-CM. The Health Insurance Portability and Accountability Act (HIPAA) requirement for clinicians and hospitals to use ICD-9-CM codes for diagnostic purposes allows clinicians to use the DSM-IV-TR codes in any situation in which a valid ICD-9-CM code is required (e.g., on Medicare and other insurance forms) because each DSM-IV-TR diagnostic code is currently cross-walked to a valid ICD-9-CM code." DSM-IV TR has since been replaced by DSM-5, which can be used instead of DSM-IV. - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.primaryBehavioralHealthProblem

 axis-II-problem

Public Problem axis-II-problem

"Up to six diagnoses from the DSM-IV Axis II category may be reported in a single encounter. See definition for the primaryBehavioralHealthProblem data element. The primaryBehavioralHealthProblem is constrained to a value from either DSM-IV Axis I or Axis II." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.axis-II-problem

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ProblemsDiagnoses
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..6
Name	axis-II-problem
Name Expression
Namespace	ProblemsDiagnoses
Opposite
Owner	ProblemsDiagnoses
Owning Association
Owning Template Parameter
Qualified Name	FHIM::BehavioralHealth::ProblemsDiagnoses::axis-II-problem
Stereotype
Template Parameter
Type	Problem
Upper	1
Upper Value	(6)
Visibility	Public

 axis-I-problem

Public Problem axis-I-problem

"Up to six diagnoses from the DSM-IV Axis I category may be reported in a single encounter. Note: The DSM-IV code will be replaced with a DSM-5 code." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.axis-I-problem

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ProblemsDiagnoses
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..6
Name	axis-I-problem
Name Expression
Namespace	ProblemsDiagnoses
Opposite
Owner	ProblemsDiagnoses
Owning Association
Owning Template Parameter
Qualified Name	FHIM::BehavioralHealth::ProblemsDiagnoses::axis-I-problem
Stereotype
Template Parameter
Type	Problem
Upper	1
Upper Value	(6)
Visibility	Public

 axis-IV-problem

Public Problem axis-IV-problem

"Up to two Axis IV conditions may be reported." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.axis-IV-problem

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ProblemsDiagnoses
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..2
Name	axis-IV-problem
Name Expression
Namespace	ProblemsDiagnoses
Opposite
Owner	ProblemsDiagnoses
Owning Association
Owning Template Parameter
Qualified Name	FHIM::BehavioralHealth::ProblemsDiagnoses::axis-IV-problem
Stereotype
Template Parameter
Type	Problem
Upper	1
Upper Value	(2)
Visibility	Public

 physicalProblem

Public Problem physicalProblem

"The problem may be encoded using SNOMED-CT, ICD-9-CM or ICD-10-CM, depending on the source system and the date of the diagnosis, pursuant to applicable regulations. This data element is used to represents problems typically exchanged in Axis III using a valid DSM-IV TR code. Axis III lists any medical or neurological problems that may be relevant to the client’s current or past psychiatric problems; for example, someone with severe asthma may experience respiratory symptoms that are easily confused with a panic attack, or indeed, which may precipitate a panic attack. Up to five Axis III conditions may be reported." - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.physicalProblem

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ProblemsDiagnoses
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..5
Name	physicalProblem
Name Expression
Namespace	ProblemsDiagnoses
Opposite
Owner	ProblemsDiagnoses
Owning Association
Owning Template Parameter
Qualified Name	FHIM::BehavioralHealth::ProblemsDiagnoses::physicalProblem
Stereotype
Template Parameter
Type	Problem
Upper	1
Upper Value	(5)
Visibility	Public

 primaryBehavioralHealthProblem

Public Problem primaryBehavioralHealthProblem

"This data element is used to communicate the Principal diagnosis or first listed diagnosis (Primary diagnosis) for the behavioral health encounter. The PrincipalDiagnosis must be drawn from the AXIS I or AXIS II value sets which by definition consist of valid DSM-IV-TR or DSM 5 codes. DSM-IV codes are taken from International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) by reviewing the ICD-9-CM system to select the code that best corresponds to each DSM-IV-TR category to create a crosswalk between DSM-IV TR and ICD-9-CM. The Health Insurance Portability and Accountability Act (HIPAA) requirement for clinicians and hospitals to use ICD-9-CM codes for diagnostic purposes allows clinicians to use the DSM-IV-TR codes in any situation in which a valid ICD-9-CM code is required (e.g., on Medicare and other insurance forms) because each DSM-IV-TR diagnostic code is currently cross-walked to a valid ICD-9-CM code." DSM-IV TR has since been replaced by DSM-5, which can be used instead of DSM-IV. - HL7 Behavioral Health Record DAM R2, ProblemsDiagnoses.primaryBehavioralHealthProblem

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ProblemsDiagnoses
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1
Name	primaryBehavioralHealthProblem
Name Expression
Namespace	ProblemsDiagnoses
Opposite
Owner	ProblemsDiagnoses
Owning Association
Owning Template Parameter
Qualified Name	FHIM::BehavioralHealth::ProblemsDiagnoses::primaryBehavioralHealthProblem
Stereotype
Template Parameter
Type	Problem
Upper	1
Upper Value	(1)
Visibility	Public