2011 08 15 - Clinical LOINC Tutorial - Imaging

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2011 08 15 - Clinical LOINC Tutorial - Imaging

  1. 1. LOINC® Tutorial: Imaging Names and Codes<br />Pat Wilson, RT(R), CPC, PMP – 3M TCS/HDD Team<br />© 3M 2009 All rights reserved.<br />
  2. 2. Overview<br />Developed as header information for the narrative of a diagnostic imaging study<br />Clinical LOINC® terms are indicated by Class and Class Type<br />Imaging terms are Class Type 2<br />Class is primarily RAD, with some overlap in other classes such as OB.US<br />© 3M 2009. All rights reserved.<br />
  3. 3. Example of Class Other Than Rad<br />Class - OB.US <br />Code -12029-5<br />Study observation:Find:Pt:Abdomen^fetus:Nar:US<br />Class – Card.US<br />Code - 18141-2<br />Study observation:Find:Pt:Cardiovascular.central: Nar:US<br />© 3M 2009. All rights reserved.<br />
  4. 4. Radiology Terms<br />Approximately 4912 Radiology specific terms<br />Contributions from Indiana University, Intermountain, Partners and the DoD through 3M<br />Terms are imaging findings and measurements<br />Majority of terms are indicated as both observation and orderable<br />© 3M 2009. All rights reserved.<br />
  5. 5. Examples of Orderable Versus Observation<br />Observation<br />Code - 38261-4<br />Bone density:MAric:Pt:Hip:Qn:XR.DEXA<br />Orderable and Observation<br />Code - 26074-5<br />Views^W contrast intraarticular:Find:Pt:Knee.left:Nar:XR.fluor<br />© 3M 2009. All rights reserved.<br />
  6. 6. LOINC ® Six Axes for Imaging<br />Component: views, multisection, prone, ejection fraction, thickness, density, long axis<br />Property: finding, impression, length, mass area, volume rate, percentile<br />Timing: point in time, study, 15 minutes, 1 hour<br />System: heart, ^patient,elbow.left,^fetus, liver, aorta.thoracic<br />Scale: narrative, quantitative<br />Method: ultrasound.measured, CT.3D, fluoroscopy<br />© 3M 2009. All rights reserved.<br />
  7. 7. Component – View versus Film<br />Code - 37690-51<br />Views 2:Find:Pt:Femur.right:Nar:XR<br />Code - 37692-1<br />Views AP & lateral:Find:Pt:Femur.right:Nar:XR<br />Code - 42273-3<br />Views 6:Find:Pt:Ankle.bilateral:Nar:XR<br />Code - 42699-9<br />View 1:Find:Pt:Abdomen+Chest:Nar:XR<br />© 3M 2009. All rights reserved.<br />
  8. 8. Component – Position versus Patient Orientation<br />Code - 24637-1<br />View AP L-lateral-decubitus:Find:Pt:Chest:Nar:XR<br />Code - 24639-7<br />View L-lateral upright:Find:Pt:Chest:Nar:XR<br />Code - 37033-8<br />View transthoracic:Find:Pt:Humerus.left:Nar:XR<br />© 3M 2009. All rights reserved.<br />
  9. 9. Reprinted fromMerrill’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.<br />© 3M 2009. All rights reserved.<br />
  10. 10. © 3M 2009. All rights reserved.<br />
  11. 11. © 3M 2009. All rights reserved.<br />
  12. 12. Component – Limited versus Complete<br />Code - 46347-1<br />Views GE 3:Find:Pt:Ankle.right:Nar:XR<br />Code - 36089-1<br />Multisection limited:Find:Pt:Chest:Nar:CT<br />Code - 43470-4<br />Views LE 3:Find:Pt:Skull:Nar:XR<br />© 3M 2009. All rights reserved.<br />
  13. 13. Component – Guidance<br />Code – 35900-0<br />Guidance for biopsy:Find:Pt:Liver:Nar:XR.fluor<br />Code - 24623-1<br />Guidance for anesthetic block injection:Find:Pt:Celiac plexus:Nar:CT<br />Code - 44169-1<br />Guidance for abscess drainage:Find:Pt:Peritoneal space:Nar:US<br />© 3M 2009. All rights reserved.<br />
  14. 14. Component – Eponyms<br />Code - 37164-1<br />Views lateral & Caldwell & Waters:Find:Pt:Facial bones:Nar:XR<br />Code - 37035-3<br />View Grashey:Find:Pt:Shoulder.bilateral:Nar:XR<br />Code - 37625-1<br />View Ferguson:Find:Pt:Pelvis:Nar:XR<br />© 3M 2009. All rights reserved.<br />
  15. 15. © 3M 2009. All rights reserved.<br />
  16. 16. Component - Challenges<br />Code - 39410-6<br />View AP^W L-bending:Find:Pt:Spine.thoracic:Nar:XR<br />Code - 37486-8<br />Views Broden^W manual stress:Find:Pt:Ankle:Nar:XR<br />Code - 37579-0<br />Views^W & WO weight:Find:Pt:Acromioclavicular joint:Nar:XR<br />© 3M 2009. All rights reserved.<br />
  17. 17. © 3M 2009. All rights reserved.<br />
  18. 18. Component - Subparts<br />Code - 44108-9<br />Guidance for aspiration.fine needle:Find:Pt:Adrenal gland:Nar:CT<br />Code - 30711-6<br />Multisection^manipulation.infant view:Find:Pt:Hip:Nar:US<br />Code - 24632-2<br />Views AP portable:Find:Pt:Chest:Nar:XR<br />© 3M 2009. All rights reserved.<br />
  19. 19. System – Multiple Organs or Locations<br />Code - 24700-7<br />Views for leg length:Find:Pt:Femur+Tibia:Nar:XR<br />Code - 24819-5<br />Views^W Tc-99m calcium colloid IV: Find: Pt: Liver+Spleen:Nar:Radnuc<br />Code - 30861-9<br />Multisection:Find:Pt:Aortic arch+Neck vessels: Nar:MRI.angio<br />© 3M 2009. All rights reserved.<br />
  20. 20. © 3M 2009. All rights reserved.<br />
  21. 21. System - Laterality<br />Code - 26175-0<br />Views screening:Find:Pt:Breast.bilateral:Nar:Mam<br />Code - 26347-5<br />Views diagnostic:Find:Pt:Breast.left:Nar:Mam<br />Code - 24605-8<br />Views diagnostic:Find:Pt:Breast:Nar:Mam<br />Code - 46380-2<br />Views:Find:Pt:Breast implant.unilateral:Nar:Mam<br />© 3M 2009. All rights reserved.<br />
  22. 22. System - Subpart<br />Code - 24747-8<br />Multisection^W contrast IV:Find:Pt:Head.sagittal sinus:Nar:MRI.angio<br />Code - 36082-6<br />Multisection:Find:Pt:Vena cava.inferior: Nar: MRI.angio<br />Code - 24532-4 <br />Multisection:Find:Pt:Abdomen.RUQ:Nar:US<br />© 3M 2009. All rights reserved.<br />
  23. 23. Method – Modality Subpart<br />Code - 42174-3<br />Views screening:Find:Pt:Breast.bilateral:Nar:Mam.FFD<br />Code - 36782-1<br />Multisection:Find:Pt:Subclavian artery:Nar:MRI.angio<br />Code - 39432-0<br />Multisection:Find:Pt:Lower extremity vein.left: Nar:US.doppler<br />© 3M 2009. All rights reserved.<br />
  24. 24. Additional Issues and Development<br />Overlap with Document Types<br />Study Observation<br />Coordination with other Standards<br />SNOMED CT<br />RadLex<br />DICOM<br />Additional development:<br />Interventional Radiology<br />Combination of Modalities (e.g., PET/CT)<br />Surgical Component of Imaging<br />Therapeutic services<br />© 3M 2009. All rights reserved.<br />
  25. 25. Radiology Discussion - Issues<br />Additional views<br />Injection for<br />Multiple, non-adjacent anatomical sites<br />Multiple, non-compatible contrast media<br />Multiple modalities, or no modality at all<br />Including reason for exam<br />Not specific to radiology (surgical procedure)<br />Panels<br />© 3M 2009. All rights reserved.<br />
  26. 26. Questions?<br />© 3M 2009. All rights reserved.<br />

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