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. The original order carried two NTE segments (Specimen Source, then Patient Test(s)); only Specimen Source is asked here - Specimen Identifier (a speculative future SPM-2 addition) and Patient Test(s) have both since been dropped as Ask At Order Entry questions. 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.

Questions Summary

Histocompatibility and Immunogenetics

Used for these Digital Genomic Test Services tests:

Specimen Source is now the only Ask At Order Entry question this Questionnaire asks - Specimen Identifier (a speculative future SPM-2 addition) and Patient Test(s) have both since been dropped. See Chimerism Testing Ask At Order Entry for the worked example this Questionnaire was extracted from (including the OML_O21 version showing SPM in place of the original order's free-text NTE segments), and the item's own design/reference notes below for the reasoning behind its coding. Specimen Source is coded against SNOMED CT (the Specimen Type value set's own generic codes).

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Structure

LinkID	Text	Cardinality	Type	Description & Constraints
	**Test Specific Additional Ask At Order Entry Questions** used alongside the [common core order form](StructureDefinition-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](StructureDefinition-GenomicTestOrder.html#order-entry-questions) and [Histocompatibility and Immunogenetics](https://github.com/nw-gmsa/nw-gmsa-use-cases/blob/main/HistocompatibilityAndImmunogenetics.md#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](https://github.com/nw-gmsa/nw-gmsa-use-cases/blob/main/HistocompatibilityAndImmunogenetics.md#chimerism-testing-ask-at-order-entry) for the full message. The original order carried two `NTE` segments (Specimen Source, then Patient Test(s)); only Specimen Source is asked here - Specimen Identifier (a speculative future `SPM-2` addition) and Patient Test(s) have both since been dropped as Ask At Order Entry questions. 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#2.2.5
AskAtOrderEntry	Ask At Order Entry Questions	0..1	group	Value Set:
AskAtOrderEntry / ChimIG/specimen_source	Specimen Source	0..1	choice	Definition: Specimen.type.coding.code Value Set: Options: 2 options
AskAtOrderEntry / ChimIG/specimen_source / ChimIG/specimen_source-designNote	Confirmed as this 2-value list (Blood, Bone marrow) 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 against SNOMED CT (the EU/UK/NW-compatible [Specimen Type](ValueSet-specimen-type.html) value set's own generic codes - `119297000` "Blood specimen" for Blood (PB), `119359002` "Bone marrow specimen" for Bone Marrow (BM)) rather than a local `NWGMSA` code, once converted onto `SPM-4` (`Specimen.type`) - see [Chimerism Testing Ask At Order Entry](https://github.com/nw-gmsa/nw-gmsa-use-cases/blob/main/HistocompatibilityAndImmunogenetics.md#chimerism-testing-ask-at-order-entry). Deliberately given its own `ChimIG/specimen_source` linkId rather than reusing the base [Genomic Test Order](StructureDefinition-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`. Matches `NTE|1` in the live Histotrac order. Specimen Identifier (a speculative future `SPM-2` addition) and Patient Test(s) (`NTE|2`) have since been dropped, leaving Specimen Source as this Questionnaire's only Ask At Order Entry question.	0..1	display	Value Set:
AskAtOrderEntry / ChimIG/specimen_source / 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. No dedicated NHS-published specimen-type binding specific to H&I chimerism testing was found; the generic [Specimen Type](ValueSet-specimen-type.html) SNOMED CT codes above are used instead.	0..1	display	Value Set:
Documentation for this format

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Options Sets

Answer options for ChimIG/specimen_source

• http://snomed.info/sct#119297000 ("Blood specimen")
• http://snomed.info/sct#119359002 ("Bone marrow specimen")

Profile: Questionnaire

LinkID	Description & Constraints
AskAtOrderEntry	Value Set:
AskAtOrderEntry / ChimIG/specimen_source	Definition: Specimen.type.coding.code Value Set: Options: 2 options
AskAtOrderEntry / ChimIG/specimen_source / ChimIG/specimen_source-designNote	Value Set:
AskAtOrderEntry / ChimIG/specimen_source / ChimIG/specimen_source-reference	Value Set:
Documentation for this format

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