With an overwhelming number of healthcare terminology standards, how do industry professionals determine which ones they need to know? Terminology users can start by matching their purpose with the correct standard. Because different healthcare terminology standards fulfill distinct purposes, matching purpose to standard generally leads users to the right term for their goals. Terminology users can match their purpose with the correct standard by first identifying the standard’s purpose. Purposes encompass billing, clinical, laboratory, and pharmacy terminology standards: 1. Healthcare billing terminology. 2. Clinical terminology. 3. Clinical and laboratory terminology. 4. Pharmacy terminology.

1. Find the Right Term for Your Goals: How to
Choose Healthcare Terminology Standards
Cessily Johnson
Vice President of Terminology &
Master Data Management

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Find the Right Term for Your Goals
Healthcare has a lot of terminology
standards. The sheer number of
acronyms alone is often overwhelming,
leaving industry professionals to
wonder which ones they need to know.
The relevancy and importance of
healthcare terminology depend on
the user’s goals.

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Find the Right Term for Your Goals
Different healthcare terminology standards
fulfill distinct purposes, and each generally
does a good job meeting its purpose.
In other words, when users match their
purpose with the correct standard, they
generally find the right term.

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Healthcare Terminology Standards:
Matching Purpose and Standard
Matching a purpose with the correct
standard starts with identifying the
standard’s purpose. Basically, there
are billing, clinical, laboratory, and
pharmacy terminology standards:
 Healthcare Billing Terminology:
ICD, DRGs, and CPT Codes
 Clinical Terminology
 Clinical and Laboratory
Terminology: LOINC®
 Pharmacy Terminology

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Healthcare Terminology Standards:
Matching Purpose and Standard
Healthcare Billing Terminology: ICD, DRGs, and CPT Codes
Healthcare organizations use billing terminology
standards to support aspects of medical billing.
International Classifications of Diseases (ICD) is
a diagnosis code set.
As of 2021, the United States uses the version
ICD-10, with ICD-11 coming in the future.
Diagnosis-related groups (DRGs) are common
in the inpatient setting to bill for a patient’s
hospital stay. Current Procedural Terminology
(CPT) generally covers procedure billing.

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Healthcare Terminology Standards:
Matching Purpose and Standard
Clinical Terminology
Interoperability initiatives increasingly reference clinical terminology standards. Many
different standards exist and tend to have a specific clinical or workflow emphasis.
The following are examples of the most common clinical terminology standards:
Systematized Nomenclature of Medicine
Clinical Terms (SNOMED CT) primarily
encodes the clinical data in a patient record. It
is available for use in the U.S. via licensing by
the National Library of Medicine (NLM) and
managed globally under SNOMED
International. With SNOMED’s clinical focus,
it’s a useful standard for encoding clinical data
sent between systems or organizations.
Health Level 7 (HL7) is a healthcare standards
organization that produces a variety of
interoperability standards, including Fast
Healthcare. The organization produces and
maintains messaging and terminology
standards. HL7’s terminology contains a mix of
code sets that aren’t covered by other standard
terminologies. Many of these code sets are
necessary for HL7 V2 messaging or Fast
Healthcare Interoperability Resources (FHIR).

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Healthcare Terminology Standards:
Matching Purpose and Standard
Clinical and Laboratory Terminology: LOINC®
The Regenstrief Institute developed and
maintains the Logical Observation
Identifiers Names and Codes (LOINC®).
This terminology initially encoded lab
observations but has since expanded to
represent clinical observations.
LOINC is an open-source standard, which
the industry widely considers the definitive
lab standard. It is also the main standard
for clinical observations referenced by
measures.

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Healthcare Terminology Standards:
Matching Purpose and Standard
Pharmacy Terminology
Many commercially available solutions
represent the pharmacy terminology space,
including First Databank, Multum, Micromedex,
and Medi-Span.
The interoperability standard recommended for
pharmacy terminology is the open-source
RxNorm, available through the NLM.
RxNorm has some mappings to the proprietary
standards to facilitate interoperability.

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Healthcare Terminology Standards Simplified
There are other terminology standards
available for niche use cases, but the above
listing covers the most prominent options.
Terminology users will want to clarify their
objectives and do their research (i.e., match
purpose and standard) before embarking on
any terminology project.
When users simplify the terminology process
by matching purpose with standard, they’re
more likely to arrive at the appropriate term.

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For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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Link to original article for a more in-depth discussion.
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Cessily Johnson, VP of Terminology & Master Data Management; Michael Buck, SVP of Clinical Informatics

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Cessily Johnson joined Health Catalyst in January 2013 as Director of Terminology
Services. She started working in healthcare during college and graduated with a Bachelor’s
degree in Medical Laboratory Science from the University of Utah. She then worked in the
Lab for Intermountain Healthcare while earning an MBA with an emphasis in IT. During her
MBA program she moved to the Intermountain IT department working in Clinical Modeling
and Terminology, becoming the team lead and then the manager of that department. She then moved
on to work for Lantana Consulting Group doing terminology consulting for vendors and healthcare
provider organizations before joining Health Catalyst. The focus of her career has been application of
Standard Terminology in Healthcare Information Systems.
Other Clinical Quality Improvement Resources
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Cessily Johnson

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Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
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