1. LOINC® Tutorial: Imaging Names and Codes Pat Wilson, RT(R), CPC, PMP – 3M TCS/HDD Team © 3M 2009 All rights reserved.

2. 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 © 3M 2009. All rights reserved.

3. 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 © 3M 2009. All rights reserved.

4. Radiology Terms Approximately 4912 Radiology specific terms 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 © 3M 2009. All rights reserved.

5. 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 © 3M 2009. All rights reserved.

6. 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 © 3M 2009. All rights reserved.

7. 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 © 3M 2009. All rights reserved.

8. 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 © 3M 2009. All rights reserved.

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. © 3M 2009. All rights reserved.

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12. 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 © 3M 2009. All rights reserved.

13. 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 © 3M 2009. All rights reserved.

14. 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 © 3M 2009. All rights reserved.

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16. 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 © 3M 2009. All rights reserved.

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18. Component - Subparts Code - 44108-9 Guidance for aspiration.fine needle:Find:Pt:Adrenal gland:Nar:CT Code - 30711-6 Multisection^manipulation.infant view:Find:Pt:Hip:Nar:US Code - 24632-2 Views AP portable:Find:Pt:Chest:Nar:XR © 3M 2009. All rights reserved.

19. 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 © 3M 2009. All rights reserved.

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21. 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 © 3M 2009. All rights reserved.

22. 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 © 3M 2009. All rights reserved.

23. 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 © 3M 2009. All rights reserved.

24. 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 © 3M 2009. All rights reserved.

25. Radiology Discussion - Issues Additional views Injection for Multiple, non-adjacent anatomical sites Multiple, non-compatible contrast media Multiple modalities, or no modality at all Including reason for exam Not specific to radiology (surgical procedure) Panels © 3M 2009. All rights reserved.

26. Questions? © 3M 2009. All rights reserved.