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LOINC® Tutorial – Feb 2012: Imaging Names and Codes

Pat Wilson, RT(R), CPC, PMP – 3M TCS/HDD Team

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Overview

Developed as header information for the narrative of a diagnostic imaging study

Clinical LOINC® terms are indicated by Class and Class Type Imaging terms are Class Type 2 Class is primarily RAD, with some overlap in other classes such as OB.US

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Example of Class Other Than Rad

Class - OB.US Code - 12029-5 Study observation:Find:Pt:Abdomen^fetus:Nar:US Class – Card.US Code - 18141-2 Study observation:Find:Pt:Cardiovascular.central: Nar:US

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Radiology Terms

Approximately 5198 Radiology specific terms, of which 5094 are active Contributions from Indiana University, Intermountain, Partners and the DoD

through 3M Terms are imaging findings and measurements Majority of terms are indicated as both observation and orderable

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Examples of Orderable Versus Observation

Observation Code - 38261-4 Bone density:MAric:Pt:Hip:Qn:XR.DEXA

Orderable and Observation Code - 26074-5 Views^W contrast intraarticular:Find:Pt:Knee.left:Nar:XR.fluor

Orderable Code – 38269-7 Study report:Find:Pt:Skeletal system:Doc:XR.DXA

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38269-7 Study report Skeletal system DXA

38261-4 Hip DXA Bone density 38264-8 Hip DXA Bone density T-score 24701-5 Femur DXA Bone density 38263-0 Femur DXA Bone density T-score 38262-2 Calcaneus DXA Bone density 24890-6 Radius and Ulna DXA Bone density 38265-5 Radius and Ulna DXA Bone density T-score 24966-4 Spine Lumbar DXA Bone density 38267-1 Spine Lumbar DXA Bone density T-score 38268-9 Skeletal system DXA Bone density

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LOINC ® Six Axes for Imaging

Component: views, multisection, prone, ejection fraction, thickness, density, long axis

Property: finding, impression, length, mass area, volume rate, percentile Timing: point in time, study, 15 minutes, 1 hour System: heart, ^patient,elbow.left,^fetus, liver, aorta.thoracic Scale: narrative, quantitative Method: ultrasound.measured, CT.3D, fluoroscopy

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Component – View versus Film

Code - 37690-51 Views 2:Find:Pt:Femur.right:Nar:XR Code - 37692-1 Views AP & lateral:Find:Pt:Femur.right:Nar:XR Code - 42273-3 Views 6:Find:Pt:Ankle.bilateral:Nar:XR Code - 42699-9 View 1:Find:Pt:Abdomen+Chest:Nar:XR

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Component – Position versus Patient Orientation

Code - 24637-1 View AP L-lateral-decubitus:Find:Pt:Chest:Nar:XR Code - 24639-7 View L-lateral upright:Find:Pt:Chest:Nar:XR Code - 37033-8 View transthoracic:Find:Pt:Humerus.left:Nar:XR

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Reprinted from Merrill’s Atlas of Radiographic Positions and Radiologic Procedures, 9th edition, Ballinger and Frank, page 548 (figure 10-68), copyright 1999 Mosby, with permission from Elsevier Science.

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Component – Limited versus Complete

Code - 46347-1 Views GE 3:Find:Pt:Ankle.right:Nar:XR Code - 36089-1 Multisection limited:Find:Pt:Chest:Nar:CT Code - 43470-4 Views LE 3:Find:Pt:Skull:Nar:XR

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Component – Guidance

Code – 35900-0 Guidance for biopsy:Find:Pt:Liver:Nar:XR.fluor Code - 24623-1 Guidance for anesthetic block injection:Find:Pt:Celiac plexus:Nar:CT Code - 44169-1 Guidance for abscess drainage:Find:Pt:Peritoneal space:Nar:US

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Component – Eponyms

Code - 37164-1 Views lateral & Caldwell & Waters:Find:Pt:Facial bones:Nar:XR Code - 37035-3 View Grashey:Find:Pt:Shoulder.bilateral:Nar:XR Code - 37625-1 View Ferguson:Find:Pt:Pelvis:Nar:XR

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Component - Challenges

Code - 39410-6 View AP^W L-bending:Find:Pt:Spine.thoracic:Nar:XR Code - 37486-8 Views Broden^W manual stress:Find:Pt:Ankle:Nar:XR Code - 37579-0 Views^W & WO weight:Find:Pt:Acromioclavicular joint:Nar:XR

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Component - Subparts

Code - 44108-9 Guidance for aspiration.fine needle:Find:Pt:Adrenal gland:Nar:CT Code - 30711-6 Multisection^developmental joint assessment:Find:Pt:Hip:Nar:US Code - 24632-2 Views AP portable:Find:Pt:Chest:Nar:XR

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System – Multiple Organs or Locations

Code - 24700-7 Views for leg length:Find:Pt:Femur+Tibia:Nar:XR Code - 24819-5 Views^W Tc-99m calcium colloid IV: Find: Pt: Liver+Spleen:Nar:Radnuc Code - 30861-9 Multisection:Find:Pt:Aortic arch+Neck vessels: Nar:MRI.angio

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System - Laterality

Code - 26175-0 Views screening:Find:Pt:Breast.bilateral:Nar:Mam Code - 26347-5 Views diagnostic:Find:Pt:Breast.left:Nar:Mam Code - 24605-8 Views diagnostic:Find:Pt:Breast:Nar:Mam Code - 46380-2 Views:Find:Pt:Breast implant.unilateral:Nar:Mam

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System - Subpart

Code - 24747-8 Multisection^W contrast IV:Find:Pt:Head.sagittal sinus:Nar:MRI.angio Code - 36082-6 Multisection:Find:Pt:Vena cava.inferior: Nar: MRI.angio Code - 24532-4 Multisection:Find:Pt:Abdomen.RUQ:Nar:US

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Method – Modality Subpart

Code - 42174-3 Views screening:Find:Pt:Breast.bilateral:Nar:Mam.FFD Code - 36782-1 Multisection:Find:Pt:Subclavian artery:Nar:MRI.angio Code - 39432-0 Multisection:Find:Pt:Lower extremity vein.left: Nar:US.doppler

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Additional Issues and Development

Overlap with Document Types Study Observation

Coordination with other Standards SNOMED CT RadLex DICOM

Additional development: Interventional Radiology Combination of Modalities (e.g., PET/CT) Surgical Component of Imaging Therapeutic services

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Radiology Discussion - Issues

Additional views (e.g., CPT nomenclature of ‘additional views’) Injection for (e.g., including the reason for the exam) Multiple, non-compatible contrast media (e.g., Intravenous and oral) Multiple modalities, or no modality at all Not specific to radiology (surgical procedure) Overlap with document names Panels

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Questions?