LOINC Release Notes

June 2021

The LOINC twice-yearly release schedule is shifting to mid-February and mid-August. The first release per this new schedule will be in August 2021.

This is the first publication of combined released notes across all of the LOINC release artifacts. These combined notes are included in all primary and accessory files as a single, comprehensive source of information. Previously, each accessory file (Parts, Groups, Multiaxial hierarchy, etc.) included its own release notes.

For the time being, individual Readme notes, which contain the technical structure of each file, will continue to be published with each accessory file.

Table of contents:

LOINC table core, Version 2.70

There were no structural changes to the core table in this release, and no future changes to announce at this time. See the Readme included in the LOINC Table Core download file for information about its current file structure.

See the LOINC table notes below for information on content updates included in this release.

LOINC table, Version 2.70

Numbers

New terms and totals by type

Type New terms Total
Laboratory (type 1) 647 58,464
Clinical (type 2) 479 25,301
Attachments (type 3) 0 1,157
Survey (type 4) 214 11,313
Total 1,340 96,235

Totals by Status

Status Number of terms
Active 87,583
Deprecated 3,724
Discouraged 1,474
Trial 3,454

Term Status changes

Old Status New Status Number of terms Type
Active Discouraged 3 Lab
Active Deprecated 6 Lab
Trial Active 88 8 Lab, 80 Clinical

Edits by change type

Change type (field name CHNG_TYP) CHNG_TYP definition Number of terms
NAM Component update 229
MAJ Update to one of 5 other primary axes other than Component 113
MIN Update to a secondary field - see Updates file Readme for the full list 15,447* (see Term edit highlights below)
DEL Status changed to Deprecated 6
UND Status changed from Deprecated to Active 0
PANEL Change in the child elements or conditionality of one or more child elements in the panel or a sub-panel contained in the panel 29
Total 15,824

New content highlights

SARS-CoV-2/COVID-19

During this release cycle we continued to prioritize creating LOINC terms and other resources related to SARS-CoV-2/COVID-19 testing, clinical care, documentation, and reporting. We continued to work closely with the CDC, FDA, APHL, laboratories, IVD manufacturers, and other stakeholders to create LOINC content for SARS-CoV-2 laboratory tests. We also worked with the CDC Emergency Operations Center (CDC EOC) to create codes for reporting on mass vaccination.

LOINC terms related to SARS-CoV-2/COVID-19 testing, ask-at-order entry questions, case reporting, clinical documentation, and surveys can be found on a dedicated webpage that supports downloads of filtered subsets of these terms (https://loinc.org/sars-cov-2-and-covid-19/). This page includes both released and pre-release terms and is updated as soon as new terms or term edits are made.

A separate page provides guidance for choosing LOINCs for SARS-CoV-2 testing and general FAQs (https://loinc.org/sars-coronavirus-2).

New laboratory content

  • 190 new microbiology terms, 26 of which report on the pandemic virus, SARS-CoV-2 (COVID-19)
  • 142 new terms in the drug/toxicology class
  • 95 new terms in chemistry class
  • Over 75 new allergy terms, primarily created for allergy testing in Europe
  • Several new terms created for multigene analysis studies, including preconception/prenatal carrier screening and hereditary cancer screening
  • Many new terms in coagulation, serology, molecular pathology, hematology, HLA, and more

New clinical content

  • Nearly 170 new radiology terms
  • More than 90 new clinical document terms, including several new COVID-19 note terms
  • Over 60 new terms created for the Spine Tango Surgery forms (EUROSPINE) (panels 97782-7, 97029-3)
  • 20 new vaccine-related codes, primarily related to mass vaccination status reporting (96987-3), and individual case reporting for COVID-19
  • Several new clinical risk assessment and score terms, including for the Sequential Organ Failure Assessment (SOFA) (96789-3), LACE index (96569-9), Finnish diabetes risk (FINDRISC) (97055-8) and Barthel index (96762-0)
  • Two codes created for COVID-19 passports/certificates, including Proof of COVID-19 recovery certificate (97499-8) and Proof of COVID-19 immunization or negative status certificate (97500-3)
  • Several new administrative codes, including terms for reporting test result delivery method, shipping date & shipping tracking number

New survey content

  • Ten new survey panels for patient reported measures developed by R-Outcomes
  • Two panels, screen and assessment, for Tobacco, Alcohol, Prescription medications and other Substance use (TAPS) (96841-2, 96845-3)
  • Six COVID-19 related panels for assessments included in the Phenotypes and exposures (PhenX) COVID-19 protocol library
  • Two panels, screening tool and supplemental questions, for Accountable Health Communities Health-related Social Needs (AHCN-HRSN) (96777-8, 97023-6)
  • Core Outcome Measure Index (COMI) panels for the Back (97887-4) and Neck (97327-1)

Term edit highlights

Changes based on internal review or as part of an ongoing project

  • *The only change to more than 15,000 of the 15,447 terms with a change type of MIN was emptying the value in one or more of the four fields that are scheduled to be deleted in the August 2022 release: EXAMPLE_SI_UCUM_UNITS, UnitsAndRange, SUBMITTED_UNITS, and CDISC_COMMON_TESTS (see Changes to the LOINC Table structure planned for August 2022 below for more details)
  • Updated System from “Rectum” to "Anorectal" for 7 microbiology terms and 1 microbiology panel to allow broader use and consistency across similar terms
  • Discouraged 3 panels that contained a single primary result because the LOINC for that result should be used as the order code. This change was approved by the Laboratory LOINC Committee in March 2021.
  • Began removing vendor-specific information from term descriptions as approved by the Laboratory LOINC Committee in October 2020. This is a work in progress.
  • Added "(Given)" and "(Family)" to First name and Last name terms, respectively, to broaden understanding
  • Removed Method from several survey terms that were previously limited to use in a specific panel. The terms represent generic concepts, such as number of drinks consumed, feeling sad, pain level, etc.
  • Updated Answer List binding from Normative to Example at the term level for newly Methodless terms, making the Answer List binding Normative at the panel level where appropriate
  • Continued work with updating the Timing representations in CMS post-acute care (PAC) assessments that have different assessment periods (e.g. 3 day, 7 day) so that the same LOINC term may be used across PAC assessments. In this release cycle, the focus was on updating the CMS Minimum Data Set (MDS) and Outcome and assessment information set (OASIS).

Changes based on community input

  • Updated inconsistencies and/or outdated information in several descriptions
  • Fixed the scoring for the USDA Food Security Survey answer lists
  • Corrected "C little w" and "C little x" in blood banking terms to "C super little w" and "C super little x", respectively, per current nomenclature
  • Corrected "D little u Ag" to "Weak D Ag", per current nomenclature
  • Corrected several minor typos in Components and display names
  • Removed R (required) from the Conditionality field for several panels to allow broader use
  • Corrected several synonym links to improve search results

Source organization

LOINC version 2.70 contains copyrighted content that is used with permission from the organizations documented in the SourceOrganization table. Users of this content must follow the copyright holders' terms of use.

Change to the LOINC Table structure in this release

None

Changes to the LOINC Table structure planned for August 2022

Field Name: EXAMPLE_SI_UCUM_UNITS

Formal Definition: The Unified Code for Units of Measure (UCUM) is a code system intended to include all units of measures being contemporarily used in international science, engineering, and business. (www.unitsofmeasure.org) This field contains example units of measures for this term expressed as SI UCUM units.

Action: DELETE

Discussion: The UCUM standard contains both SI and non-SI units, and a single unit is either one or the other. A single LOINC Property will match with a specific set of UCUM units, in some cases SI and in some cases non-SI. These units are already provided in the EXAMPLE_UCUM_UNITS field and do not require a separate field. For this release we have emptied the EXAMPLE_SI_UCUM_UNITS field. It will be deleted from the database on or after the August 2022 release.

Field Name: UnitsAndRange

Formal Definition: Units of measure (expressed using UCUM units) and normal ranges for physical quantities and survey scores. Intended as tailorable starter sets for applications that use LOINC forms as a way to capture data. Units are separated from normal ranges by a colon (:) and sets of unit:normal range pairs are separated by a semi-colon (;). Syntax for the normal range includes square brackets, which mean that the number adjacent to the bracket is included, and parentheses, which means that the number itself is not included. For example, [2,4] means “two to four”, while [2,4) means “two to less than four” and (2,4) means “between two and four but does not include two and four”.

Action: DELETE

Discussion: This field is sparsely populated and has not been maintained over time, primarily because reference ranges can vary between laboratories based on population characteristics and other factors. For this release we have emptied this field. It will be deleted from the database on or after the August 2022 release.

Field Name: SUBMITTED_UNITS

Formal Definition: Units as received from person who requested this LOINC term

Action: DELETE

Discussion: For the last several years we have included the submitted units in the EXAMPLE_UNITS field, and the SUBMITTED_UNITS field has not been consistently populated since 2012. For this release we have emptied this field. It will be deleted from the database on or after the August 2022 release.

Field Name: CDISC_COMMON_TESTS

Formal Definition: "Y" in this field means that the term is a part of a subset of terms used by CDISC clinical trials.

Action: DELETE

Discussion: The CDISC_COMMON_TESTS field has not been maintained over time and has not been populated for any LOINC terms created since 2011. For this release we have emptied this field. It will be deleted from the database on or after the August 2022 release.

See Appendix A in the LOINC Users' Guide for the current LOINC table structure.

Answer lists, Version 2.70

See the Readme included in the LOINC Answer download file for information about its current file structure.

This release contains all of the answer lists associated with any LOINC term published in the current release. There have been no changes other than the addition of new content since the last release.

Change snapshot, Version 1.4

See the Readme included in the LOINC Change Snapshot download file for information about its current file structure.

The Change Snapshot file has been promoted to production status.

The LoincChangeSnapshot file contains all terms that had a change in Status between LOINC version 2.69 and version 2.70, such as from TRIAL to ACTIVE, or ACTIVE to DEPRECATED. It does not contain terms that were newly added in 2.70. In the future, this file will likely contain other types of term changes in addition to Status changes.

The PartChangeSnapshot file contains all of the Parts that had a change in Status between LOINC version 2.69 and version 2.70, such as from ACTIVE to DEPRECATED or ACTIVE to INACTIVE (see Readme for Status definitions). In the future, this file may contain other types of Part changes in addition to Status changes.

Consumer names, Version 1.4-Alpha

See the Readme included in the LOINC Consumer Name download file for information about its current file structure.

This release of the Consumer names file remains at Alpha pre-production status. It contains Consumer names for all Type 1 (Laboratory) and a subset of Type 2 (Clinical) terms in LOINC. The Consumer Names are created algorithmically based on the set of primary rules documented in the associated Readme notes.

We are in the process of removing title case from the Consumer Names, and you will see a mix of title case and non-title case in this release.

Consumer Names are intended for downstream display only and are not intended to be used at any point in the clinical workflow, or for the purpose of mapping local terms to LOINC. Their use case includes consumer-facing health and wellness applications that use LOINC to encode the underlying data.

We welcome user feedback about these names.

Document ontology, Version 2.70

See the Readme included in the LOINC Document Ontology download file for information about its current file structure.

During this release cycle, the Clinical LOINC Document Ontology Subcommittee approved a new Type of Service "Stroke prevention" under "Evaluation and Management". The Subcommittee discussed at length the historical usage of LOINC 34133-9 "Summary of Episode Note" for CCDA, and determined that "episode" should be clearly defined in the corresponding LOINC description as potentially spanning multiple encounters, allowing its continued use for this purpose.

Document ontology OWL, Version 1.4-Alpha

See the Readme included in the LOINC Document Ontology OWL download file for information about its current file structure.

Version 1.4 of the Document Ontology OWL file continues at Alpha status, meaning that it is part of a testing process, and the LOINC team continues to welcome comments regarding its usability and content.

Groups, Version 2.70-Beta

See the Readme included in the LOINC Group download file for information about its current file structure.

This release of the Group file remains at Beta pre-production status. We received no significant public comments about its contents, structure, or utility that we would have used as the basis for incrementing its maturity level or conceptualization. If you are using this file and have feedback (good or bad), please contact us at https://loinc.org/contact.

In this release, the group.STATUS field name was corrected to group.Status to be consistent with the other field names in this release artifact.

1. The LOINC Groups project is a work in progress. The contents of this file may change from release to release as we receive feedback from users and refine our processes. 2. The contents of the file and the groupings MUST be validated by the user prior to implementation in any aspect of clinical care. We have created Groups that may be useful in specific contexts, but these Groups have not been vetted for use in either patient care or research and should be used with caution.

Imaging document codes, Version 1.15

See the Readme included in the LOINC Imaging Document Codes download file for information about its current file structure.

The query that generates the set of LOINC imaging document codes was updated for the 2.70 release to include two new Methods (Colonoscopy + US and Flexible sigmoidoscopy + US) as well as a Method that was inadvertently excluded from the previous query (US && MG). Please see the Readme file for the actual query.

Linguistic variants, Version 3.3

See the Readme included in the LOINC Linguistic Variants download file for information about its current file structure.

Updated linguistic variants are generally based on the previous release version (i.e., LOINC version 2.69 is translated for inclusion in the 2.70 release).

The producers of the translation have provided updated content to include in the LOINC 2.70 release for the following linguistic variants:

  • es_ES_12 - Spanish (SPAIN)
  • fr_CA_8 - French (CANADA)
  • fr_FR_18 - French (FRANCE)
  • it_IT_16 - Italian (ITALY)
  • nl_NL_22 - Dutch (NETHERLANDS)
  • zh_CN_5 - Chinese (CHINA)

The table below shows the LOINC version when each linguistic variant included in this release was last updated.

Linguistic variant Version last updated
Chinese (CHINA) 2.70
Dutch (NETHERLANDS) 2.70
Estonian (ESTONIA) 2.23
French (BELGIUM) 2.47
French (CANADA) 2.70
French (FRANCE) 2.70
German (AUSTRIA) 2.67
German (GERMANY) 2.68
Greek (GREECE) 2.34
Italian (ITALY) 2.70
Korean (KOREA, REPUBLIC OF) 2.27
Portuguese (BRAZIL) 2.51
Russian (RUSSIAN FEDERATION) 2.65
Spanish (ARGENTINA) 2.15
Spanish (SPAIN) 2.70
Turkish (TURKEY) 2.56

Please note that some term translations are based on the translation of Parts. For such translations, even if no additional Part translations were provided by the producer, the number of translated terms may vary from release to release because new LOINC terms using previously translated Parts will also be included, and old LOINC terms that have been updated to use untranslated Parts will be excluded.

LOINC/IEEE Medical Device Code Mapping Table, Version 3.2

See the Readme included in the LOINC/IEEE Medical Device Code Mapping Table download file for information about its current file structure.

There have been no changes to the structure or contents of this file since the LOINC 2.67 release in December 2019.

LOINC/RSNA Radiology Playbook, Version 2.70

See the Readme included in the LOINC/RSNA Radiology Playbook download file for information about its current file structure.

The mappings to and content from the RSNA Playbook are based on version 2.4 of that terminology, and Radiology Part mappings are based on RadLex version 4.1 and pre-release 4.2.

We are still seeking feedback on the usefulness of the PartSequenceOrder field from anybody who is utilizing this file to help inform our future efforts, e.g., whether we should remove this field.

Known issues: Parsing issue for terms with multiple Aggregation or View type values in which one or more values is not being assigned the correct PartSequenceOrder value. We plan to address the parsing procedure in a future release if necessary, depending on whether users find this field useful (see request for feedback above).

A few outstanding cases for LOINC Radiology Parts without mappings to RadLex RIDs exists. We plan to review these with RSNA and add mappings, as appropriate, in a future release.

Terms with XXX (meaning Unspecified) as the Region Imaged without an Imaging focus do not have an Anatomy attribute (Region imaged or Imaging focus) represented in the file. The LOINC/RSNA Committee is reviewing the representation of XXX without a specified imaging focus in the LOINC/RSNA model to determine how the Anatomy should be represented.

LOINC Universal Lab Orders Value Set, Version 2.2

See the Readme included in the LOINC Universal Lab Orders Value Set download file for information about its current file structure.

In this release, the Long Common Names were updated for a few terms for which the Long Common Name changed since the 2.69 release. Additionally, LOINC 7799-0 was removed from this file because it was deprecated based on review and approval by the Lab LOINC Committee. We are not aware of results for D-dimer being reported as an arbitrary concentration (ACnc). Rather, results are commonly reported in mass concentrations and distinguished between fibrinogen equivalent units (FEU) and D-dimer units (DDU). LOINC 7799-0 also does not distinguish FEU from DDU.

Multiaxial Hierarchy, Version 3.4

See the Readme included in the LOINC Multiaxial Hierarchy download file for information about its current file structure.

This file has been promoted to production status. No other changes were made other than the addition of new content.

Panels and Forms, Version 3.5

See the Readme included in the LOINC Panels and Forms download file for information about its current file structure.

There have been no changes to this file other than the addition of new content since the last release.

Parts, Version 5.2

See the Readme included in the LOINC Part download file for information about its current file structure.

The Parts file has been promoted to production status.

This file contains all of the parts associated with any LOINC term published in the current release.

The previously reported issue of deprecated Parts being linked to active LOINC terms with a link type of Search in the LoincPartLink_Supplementary file has been fixed for this release. The LoincPartLink_Supplementary file still correctly contains deprecated Parts linked to deprecated Terms.

The LoincPartLink_Supplementary file exceeds the row capacity of Excel and LibreOfficeOne.

Updates, Version 2.70

See the Readme included in the LOINC Updates download file for information about its current file structure.

There were no changes made to this file other than the addition of new content.

Knowledge Base

Users’ Guide

Search Syntax

RELMA

FAQ