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Logical Observation Identifiers Names and Codes (LOINC®)

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The purpose of the LOINC® database is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research.

LOINC (Logical Observation Identifiers Names and Codes) was developed to provide a definitive standard for identifying clinical information in electronic reports. The LOINC database provides a set of universal names and ID codes for identifying laboratory and clinical test results in the context of existing HL7, ASTM E1238, and CEN TC251 observation report messages. One of the main goals of LOINC is to facilitate the exchange and pooling of results for clinical care, outcomes management, and research. LOINC codes are intended to identify the test result or clinical observation. Other fields in the message can transmit the identity of the source laboratory and special details about the sample.

Currently, most laboratories and other diagnostic services use HL7 to send their results electronically from their reporting systems to their care systems. However, most laboratories and other diagnostic care services identify tests in these messages by means of their internal and idiosyncratic code values. Thus, the care system cannot fully "understand" and properly file the results they receive unless they either adopt the producer's laboratory codes (which is impossible if they receive results from multiple sources), or invest in the work to map each result producer's code system to their internal code system. LOINC codes are universal identifiers for laboratory and other clinical observations that solve this problem.

The laboratory portion of the LOINC database contains the usual categories of chemistry, hematology, serology, microbiology (including parasitology and virology), and toxicology; as well as categories for drugs and the cell counts you would find reported on a complete blood count or a cerebrospinal fluid cell count. Antibiotic susceptibilities are a separate category. The clinical portion of the LOINC database includes entries for vital signs, hemodynamics, intake/output, EKG, obstetric ultrasound, cardiac echo, urologic imaging, gastroendoscopic procedures, pulmonary ventilator management, selected survey instruments, and other clinical observations.

LOINC codes are useful for both ordering and resulting of test results. LOINC has been widely recognized and recommended for transmitting laboratory and clinical observations in HL7 messages.

CPT codes may be used for ordering and billing purposes. Often, CPT codes are not as specific as LOINC codes. For example, one CPT code may have multiple LOINC codes associated with it. Many lab tests will not have specified CPT codes associated with the "parts" of a lab test-%basos as an example, though there is a CPT code for a differential (Blood count; automated differential WBC count).

SNOMED is a large, comprehensive computerized clinical terminology covering clinical data for diseases, clinical findings, and procedures. In HL7 ORU messages, LOINC provides codes for the question (OBR-4, OBX-3) while SNOMED provides codes for the answers (OBX-5).

LOINC codes have a fixed length field of 7 characters within the LOINC database. Current codes are from 3-7 characters long. If you are currently building a system to include LOINC codes, we advise allowing up to 10 characters (or at least 8 characters) to allow for further expansion. When the LOINC database contains 100,000 different LOINC records, the fixed length field will need to expand to 8 characters. The last digit of the LOINC code is a check digit and is always preceded by a hyphen(dash). The hyphen, as well as all the numbers, is part of the LOINC and must be included. The check digit is always a number form 0-9 and serves to help avoid errors in transcription of the code. Current licensing agreement for use of LOINC codes requires you to send the complete LOINC code. All LOINC names are case insensitive. Senders and receivers may use upper, lower, or mixed case. Meanings should NOT be sensitive to case conversion to avoid the possibility of confusion when the information is sent over networks that may apply case conversion. For the few names that ARE case sensitive by international convention, such as red blood cell antigens, we use the word 'LITTLE' in front of the the letter that is lower case. Superscripts are indicated by the word "SUPER'.

For further information about LOINC, please visit their website.


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