LOINC helps providers and payers speak the same language
The HIPAA Administrative Simplification provision mandates the adoption of standards for electronic claims attachments. A claims attachment includes the clinical and administrative information often necessary to adjudicate claims such as those for ambulance, rehabilitation, or emergency room services. Regenstrief has worked closely with the HL7 Payer/Provider Information Exchange (PIE) Work Group (formerly called the "Attachments" Work Group) to support the use of LOINC codes in the electronic exchanges of attachments between payers and providers.
The current proposed specifications for attachments use LOINC codes for three main purposes:
- To identify the specific kind of information being communicated in both a request and response (e.g., a discharge summary or diagnostic imaging report).
- To specify certain optional modifier variables for fulfilling the request for information (e.g. variables that indicate a modification to the default time period).
- In structured attachment responses using HL7 CDA, LOINC codes identify the attachment (document) type, sections, and sometimes the individual entries (tests or observations).
There are 4 ways to identify LOINC codes for valid attachment requests and responses:
1 In the LOINC Table
2 Searching in RELMA or the online searchLOINC application
3 Using the LOINC FHIR terminology services
4 The RELMA HIPAA tab
The following table shows you how to find the codes you need using 1, 2, and 3.
(See the RELMA HIPAA tab page for more information about 4.)
For Attachment Requestors (e.g., Payers) |
For Attachment Responders (e.g., Providers) |
|
| LOINC table | Filter ValidHL7AttachmentRequest column for value "Y" |
1. LOINC codes that are valid attachment responses
2. Subset of response terms that have associated U.S. Realm C-CDA implementation guides
3. Subset of response terms that do NOT have associated C-CDA implementation guides
|
| searchLOINC or RELMA search | Search string: ValidHL7AttachmentRequest:Y |
1. LOINC codes that are valid attachment responses
2. Subset of response terms that have associated U.S. Realm C-CDA implementation guides
3. Subset of response terms that do NOT have associated C-CDA implementation guides
|
| FHIR terminology services |
|
1. LOINC codes that are valid attachment responses
2. Subset of response terms that have associated U.S. Realm C-CDA implementation guides
3. Subset of response terms that do NOT have associated C-CDA implementation guides |