Cytology

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This topic contains 7 replies, has 3 voices, and was last updated by  Pam Banning 2 months, 4 weeks ago.

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  • #16358

    bsberry
    Participant

    I’m finding Microscopic observation codes for most cytology specimens and a few Cytology reports codes for the same specimens. What is the significance of reports vs. observations? Would I need to use both if available?

    #23025

    I’m also looking for cytology (vaginal) finding codes (4 years later) but it seems there aren’t much codes about this, just a generic document code and a comment code for cytology.

    For instance: https://s.details.loinc.org/LOINC/33717-0.html?sections=Comprehensive

    But there is no associated coded result set.

    I did find some codes in SNOMED CT: http://browser.ihtsdotools.org/?perspective=full&conceptId1=416030007&edition=en-edition&release=v20180731&server=http://browser.ihtsdotools.org/api/v1/snomed&langRefset=900000000000509007

    #23027

    I couldn’t find cytology finding codes in LOINC but SNOMED has some.

    #23034

    Pam Banning
    Participant

    Hello Pablo,

    Please take a look at the outbound messaging format of your cytology reporting; this helps determine if the single document LOINC should be used, or if individual observations reside in separate OBX segments (pointing to individual LOINC observations).

    There are individual LOINCs under Microscopic Observation with methods of cyto stain, cyto stain.thin prep, or cytology.non-gyn . Other observations such as Clinical History, General Categories and Statements of Adequacy have LOINCs as well. There is also a Pathology Biopsy Report for cervix specimen.

    Please give a detail example of what you are looking for, and I’ll be glad to help.  All the best, Pam

    #23035

    Thanks Pam, tried to post examples and links but this forum did not recorded my message, maybe has an hidden rule that doesn’t allow to post links?

    #23036

    Pam Banning
    Participant

    Hi Pablo,

    If you’ll type in the display name of each field, we’ll go from there.

    Pam

    #23049

    Hi Pam

    My initial post with some links finally appeared.

    What I found in LOINC was the document type (scale=DOC) 33717-0 Cytology Cervical or vaginal smear or scraping study (PAP).

    But I couldn’t find a code related to findings/analytes for that type of study, nor the codes for the results associated with the study findings like “normal or negative”, “Low grade squamous intraepithelial lesion (LGSIL)”, “High grade squamous intraepithelial lesion or carcinoma (HGSIL)”, etc. (some of those can be found in SNOMED CT).

    As a reference, I would like to model:

    a. Cytology Cervical Report Document type (33717-0::LOINC)
    a.1. Cytology Cervical Report Findings (no code found in LOINC)
    a.1.1. Cytology Cervical Report Findings Response = NORMAL (no code found in LOINC)
    a.1.2. Cytology Cervical Report Findings Response = LGSIL (no code found in LOINC)
    a.1.3. Cytology Cervical Report Findings Response HGSIL (no code found in LOINC)
    a.1.4. …..

    The need of the code at a.1. is because other types of findings might be part of the Report Document, and need to know which one specifically is the PAP finding.

    Thanks a lot,
    Pablo.

    • This reply was modified 3 months ago by  Pablo Pazos Gutiérrez. Reason: forum doesnt handle pasting html correctly
    #23052

    Pam Banning
    Participant

    Hello Pablo,

    Thank you for your persistence in getting examples into the LOINC User’s Forum. Your statement notes that “because other types of findings might be part of the Report Document….specifically is the PAP finding”, we would probably not use a Doc scale for the LOINC. The statement infers to me that there may be other portions of the report describing items like clinical history statement of adequacy, follow up recommendation. There are LOINCs for all of these.

    For a.1 of your model, I would propose 19762-4 General categories [Interpretation] of Cervical or vaginal smear or scraping by Cyto stain. The answers of Normal, Low-Grade Squamous Intraepithelial Lesion, High-Grade Squamous Intraepithelial Lesion are all interpretations made by the cytology staff. Indeed, those answer values you found in SNOMED CT would be associated with the information system field mapped to 19762-4, identifying what is being reported. In the LOINC User’s Guide, there is a suggestion that LOINC maps to the field holding what is being reported and SNOMED CT identifiers map to the example answers in laboratory, cytology, and pathology reports.

    I hope this conversation is of help to you. Have a great day!

    Pam Banning

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