NHS North West Genomics
2.2.0 - ci-build
NHS North West Genomics
2.2.0 - ci-build
NHS North West Genomics - Local Development build (v2.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Official URL: https://fhir.nwgenomics.nhs.uk/Questionnaire/ChimerismTestAdditionalAskAtOrderQuestions | Version: 2.2.0 | ||||
| Draft as of 2026-09-20 | Computable Name: | ||||
Test Specific Additional Ask At Order Entry Questions used alongside the
common core order form for the
"Chimerism Testing Blood (PB)" order screen within Histocompatibility and
Immunogenetics orders (SNOMED CT 909871000000100) - the same "Test
Specific" tier pattern WGS Test Additional Ask At Order Entry
Questions follows
for WGS orders - see
Order Entry Questions and
Histocompatibility and Immunogenetics.
For the sibling HLA testing order screen, see
HLA Tests - Transplant Ask At Order Entry.
Extracted from the NTE segments of a live Histotrac ORM^O01 order for a Chimerism
Testing (Performable) test - see the worked
example
for the full message. Unlike HLA Tests - Transplant, this order carries only two NTE
segments, and in the reverse order (Specimen Source before Patient Test(s)). See also
Chimerism Testing Result Panel for the
(separate) structured result payload this order eventually produces.
Research summary: as with HLA Tests - Transplant,
no NHS England or NHSBT-published order-comms/interoperability standard was found
specifically for Chimerism testing order entry. NHSBT's INF136 "User Guide for
Histocompatibility and Immunogenetics Diagnostics Services" defines FRM1010 "H&I
Haematopoietic Stem Cell Transplantation (Recipients & Donors)" as the relevant national
request form for post-transplant chimerism monitoring, but does not publish a
FHIR/LOINC/SNOMED binding for the specific test-panel or specimen-source values Hive
uses. See each item below for candidate LOINC/SNOMED codes.
Histocompatibility and Immunogenetics
Used for these Digital Genomic Test Services tests:
| Code | Test |
|---|---|
GT1335 |
Chimerism by STR Testing - Post Solid Organ Transplant |
GT1336 |
Chimerism by XY FISH - Post Solid Organ Transplant |
| Question | LinkId | Cardinality | HL7 v2 OML_O21 Message | OBX-2 Value Type | Answer Options | FHIR Field |
|---|---|---|---|---|---|---|
| Specimen Source | ChimIG/specimen_source |
0..1 | SPM-4 | CWE | Blood (PB), Bone Marrow (BM) | Specimen.type |
| Patient Test(s) | ChimIG/patient_test |
0..* | OBR-46 | CWE | Chimerism Peripheral Blood, Chimerism CD3, Chimerism CD15, Chimerism CD19, Chimerism Lineage Other | ServiceRequest.orderDetail |
Specimen Source is asked before Patient Test(s) here, the reverse of HLA Tests -
Transplant - see Chimerism
Testing Ask At Order
Entry
for the worked example this Questionnaire was extracted from, and each item's own
design/reference notes below for why every answer option is coded locally against the
NWGMSA CodeSystem rather than a national code system.
Profile: Questionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  |
**Test Specific Additional Ask At Order Entry Questions** used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) for the "Chimerism Testing Blood (PB)" order screen within Histocompatibility and Immunogenetics orders (SNOMED CT `909871000000100`) - the same "Test Specific" tier pattern [WGS Test Additional Ask At Order Entry Questions](Questionnaire-WGSTestAdditionalAskAtOrderQuestions.html) follows for WGS orders - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions) and [Histocompatibility and Immunogenetics](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions). For the sibling HLA testing order screen, see [HLA Tests - Transplant Ask At Order Entry](Questionnaire-HLATestsTransplantAskAtOrderEntry.html). Extracted from the `NTE` segments of a live Histotrac `ORM^O01` order for a Chimerism Testing (Performable) test - see the worked [example](HistocompatibilityAndImmunogenetics.html#chimerism-testing-ask-at-order-entry) for the full message. Unlike HLA Tests - Transplant, this order carries only two `NTE` segments, and in the reverse order (Specimen Source before Patient Test(s)). See also [Chimerism Testing Result Panel](Questionnaire-ChimerismResultPanel.html) for the (separate) structured *result* payload this order eventually produces. **Research summary**: as with [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html), no NHS England or NHSBT-published order-comms/interoperability standard was found specifically for Chimerism testing order entry. NHSBT's INF136 "User Guide for Histocompatibility and Immunogenetics Diagnostics Services" defines `FRM1010` "H&I Haematopoietic Stem Cell Transplantation (Recipients & Donors)" as the relevant national request form for post-transplant chimerism monitoring, but does not publish a FHIR/LOINC/SNOMED binding for the specific test-panel or specimen-source values Hive uses. See each item below for candidate LOINC/SNOMED codes. | Questionnaire | https://fhir.nwgenomics.nhs.uk/Questionnaire/ChimerismTestAdditionalAskAtOrderQuestions#2.2.0 | |
  AskAtOrderEntry |
Ask At Order Entry Questions | 0..1 | group | Value Set: |
   ChimIG/specimen_source |
Specimen Source | 0..1 | choice | Definition: Specimen.type.coding.code Value Set: Options: 2 options |
  ChimIG/specimen_source-designNote |
Confirmed as this 2-value list (Blood (PB), Bone Marrow (BM)) from the Hive/Histotrac order-entry UI's Chimerism panel - a different list from the Blood/Buccal/Other list [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html) uses for the same underlying `code` (LOINC `66746-9`), since the two order screens offer different specimen-source options in Hive. Coded locally against the `NWGMSA` CodeSystem rather than the EU/UK/NW-compatible [Specimen Type](ValueSet-specimen-type.html) value set, to match what Hive actually offers for this exchange. Deliberately given its own `ChimIG/specimen_source` linkId rather than reusing the base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own `LN/66746-9` Specimen Type item - the IG Publisher's Questionnaire derivation validator does not support a `derivedFrom`/`extends` item reusing a base item's linkId while also declaring more than one `answerOption`. Ordered first (before Patient Test(s)) to match `NTE|1` in the live Histotrac order - the reverse of HLA Tests - Transplant, where Patient Test(s) comes first. | 0..1 | display | Value Set: |
| ChimIG/specimen_source-reference |
Post-transplant chimerism monitoring conventionally uses peripheral blood, with bone marrow used for deeper/marrow-level engraftment assessment - consistent with this 2-value list. If a coded alternative to the local `NWGMSA` codes is wanted, the [Specimen Type](ValueSet-specimen-type.html) value set remains a candidate binding (e.g. whole blood specimen for Blood (PB); bone marrow specimen for Bone Marrow (BM)). No dedicated NHS-published specimen-type binding specific to H&I chimerism testing was found. | 0..1 | display | Value Set: |
| ChimIG/patient_test |
Patient Test(s) | 0..* | choice | Definition: ServiceRequest.orderDetail Value Set: Options: 5 options |
| ChimIG/patient_test-designNote |
Which chimerism panel/lineage is being tested - the same Ask At Order Entry pattern as `HistoIG/patient_test` on [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html) (`repeats = true`, since the Hive UI presents them as checkboxes - more than one may be selected per order). Confirmed as this fixed 5-value checklist from the Hive/Histotrac order-entry UI - coded locally against the `NWGMSA` CodeSystem, as no NHSBT/NHS England-published FHIR/LOINC/SNOMED binding exists. Ordered second (after Specimen Source) to match `NTE|2` in the live Histotrac order, whose NTE-3 value carries a `(PB)` suffix ("Chimerism Peripheral Blood (PB)") the Hive checkbox label itself doesn't show - the same OBR-4-restatement behaviour as HLA Tests - Transplant's Patient Test(s) item. Mapped to `ServiceRequest.orderDetail` rather than `ServiceRequest.code` - the same reasoning as that item: `ServiceRequest.code` is single-cardinality and already targeted by the base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own Test Code item, with no `enableWhen` to say which wins, while `orderDetail` is repeating and intended for exactly this kind of further order qualifier. | 0..1 | display | Value Set: |
| ChimIG/patient_test-reference |
No MFT/NHS England code set was found for these five specific test names. LOINC has short tandem repeat (STR)/chimerism-adjacent panels (e.g. `48018-6` Gene studied, engraftment-monitoring local codes used elsewhere in genetics laboratories) but no exact match for a CD3/CD15/CD19 lineage-specific chimerism checklist was confirmed - a candidate future binding if a coded alternative to the local `NWGMSA` codes is wanted. See also this IG's existing [Chimerism](CodeSystem-Chimerism.html) CodeSystem, which covers the *result* payload's OBX-3 sub-identifiers (STR/IM/RANGE/CV/EXT/PURE/POST/DTP/DID) rather than these order-entry test-selection values. | 0..1 | display | Value Set: |
| Documentation for this format | ||||
Options Sets
Answer options for ChimIG/specimen_source
Answer options for ChimIG/patient_test
Profile: Questionnaire
Ask At Order Entry Questions
Specimen Source
Confirmed as this 2-value list (Blood (PB), Bone Marrow (BM)) from the Hive/Histotrac order-entry UI's Chimerism panel - a different list from the Blood/Buccal/Other list [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html) uses for the same underlying `code` (LOINC `66746-9`), since the two order screens offer different specimen-source options in Hive. Coded locally against the `NWGMSA` CodeSystem rather than the EU/UK/NW-compatible [Specimen Type](ValueSet-specimen-type.html) value set, to match what Hive actually offers for this exchange. Deliberately given its own `ChimIG/specimen_source` linkId rather than reusing the base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own `LN/66746-9` Specimen Type item - the IG Publisher's Questionnaire derivation validator does not support a `derivedFrom`/`extends` item reusing a base item's linkId while also declaring more than one `answerOption`. Ordered first (before Patient Test(s)) to match `NTE|1` in the live Histotrac order - the reverse of HLA Tests - Transplant, where Patient Test(s) comes first.
Post-transplant chimerism monitoring conventionally uses peripheral blood, with bone marrow used for deeper/marrow-level engraftment assessment - consistent with this 2-value list. If a coded alternative to the local `NWGMSA` codes is wanted, the [Specimen Type](ValueSet-specimen-type.html) value set remains a candidate binding (e.g. whole blood specimen for Blood (PB); bone marrow specimen for Bone Marrow (BM)). No dedicated NHS-published specimen-type binding specific to H&I chimerism testing was found.
Patient Test(s)
Which chimerism panel/lineage is being tested - the same Ask At Order Entry pattern as `HistoIG/patient_test` on [HLA Tests - Transplant](Questionnaire-HLATestsTransplantAskAtOrderEntry.html) (`repeats = true`, since the Hive UI presents them as checkboxes - more than one may be selected per order). Confirmed as this fixed 5-value checklist from the Hive/Histotrac order-entry UI - coded locally against the `NWGMSA` CodeSystem, as no NHSBT/NHS England-published FHIR/LOINC/SNOMED binding exists. Ordered second (after Specimen Source) to match `NTE|2` in the live Histotrac order, whose NTE-3 value carries a `(PB)` suffix ("Chimerism Peripheral Blood (PB)") the Hive checkbox label itself doesn't show - the same OBR-4-restatement behaviour as HLA Tests - Transplant's Patient Test(s) item. Mapped to `ServiceRequest.orderDetail` rather than `ServiceRequest.code` - the same reasoning as that item: `ServiceRequest.code` is single-cardinality and already targeted by the base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own Test Code item, with no `enableWhen` to say which wins, while `orderDetail` is repeating and intended for exactly this kind of further order qualifier.
No MFT/NHS England code set was found for these five specific test names. LOINC has short tandem repeat (STR)/chimerism-adjacent panels (e.g. `48018-6` Gene studied, engraftment-monitoring local codes used elsewhere in genetics laboratories) but no exact match for a CD3/CD15/CD19 lineage-specific chimerism checklist was confirmed - a candidate future binding if a coded alternative to the local `NWGMSA` codes is wanted. See also this IG's existing [Chimerism](CodeSystem-Chimerism.html) CodeSystem, which covers the *result* payload's OBX-3 sub-identifiers (STR/IM/RANGE/CV/EXT/PURE/POST/DTP/DID) rather than these order-entry test-selection values.
Profile: Questionnaire
| LinkID | Description & Constraints |
|---|---|
| AskAtOrderEntry |
Value Set: |
| ChimIG/specimen_source |
Definition: Specimen.type.coding.code Value Set: Options: 2 options |
| ChimIG/specimen_source-designNote |
Value Set: |
| ChimIG/specimen_source-reference |
Value Set: |
| ChimIG/patient_test |
Definition: ServiceRequest.orderDetail Value Set: Options: 5 options |
| ChimIG/patient_test-designNote |
Value Set: |
| ChimIG/patient_test-reference |
Value Set: |
| Documentation for this format | |
Try this questionnaire out: