D - Procedure for Submitting Additions or Changes to LOINC
Last Updated: 2020-05-19 (2 months ago)
Since its inception, LOINC has been developed as an open standard. We welcome requests for new terms! Submissions from LOINC users have helped us grow and adapt quickly. Likewise, we welcome suggestions for changes to existing terms or other enhancements like additional synonyms or term descriptions.
Regenstrief balances the desire to respond quickly to new term submissions with the review processes necessary for a high quality standard. We can only be quick if the requesters provide clearand comprehensive information about the terms they are submitting. A list of information required for a submission is provided below.
New requests are often for variations on observations we already have in the database. For example, there may be an existing term for a particular test result with serum as the specimen (system) and a user requests an identical term for a specimen of gastric contents. With the supporting information, these kinds of requests are usually straightforward.
Prior to submitting your request, please check the online LOINC Submissions Queue to see if a similar or equivalent term has already been requested.
Even when requesters provide complete information with their submission, some requests require discussion and decision by the LOINC Committee before Regenstrief completes them. These kinds of requests are for things like:
- an entirely novel kind of measurement
- use of LOINC codes in ways not previously agreed upon by the LOINC Committee
Before you submit
Please note that we tend to avoid the use of methods for chemistry tests. We will not routinely accept requests for method-specific chemistry tests. Only in very special circumstances will we distinguish among analytic methods in chemistry. We do distinguish microbiology, serology, and coagulation tests by method type. Even here, however, we do not distinguish every variation in method. Look in the body of this User’s guide for information about the kinds of distinctions that we make.
Note that our policy is to allow both method-vague (no method) as well as method-specific measures in serology (measures of Ab and Ag), and in antibiotic susceptibility testing.
Please pay special attention to submissions that include the system of serum or plasma alone. For most chemical analyses there is no important clinical difference between the values obtained from serum and those obtained from plasma, and we would like to represent them in the database as Ser/Plas to indicate our indifference to the distinction. Unfortunately, many requesters of new terms define their request in terms of the one that they happen to use (e.g., serum or plasma) without telling us that the measure can really be done on either serum or plasma. Most such requests should be for Ser/Plas as the system (sample). If the measurement MUST be done on either serum or plasma, please scientifically justify your request and send documentation; otherwise you will greatly delay our response to your submission.
Survey instrument content has some additional complexity. If the instrument is copyrighted by a third party, Regenstrief will need to obtain permission prior to being able to model it in LOINC. In general, new LOINC terms are required for questions or variables that have different enumerated answer lists.
How to submit
First things first
The information you provide about your local test/measurement and how it is used is more important than the proposed LOINC name you come up with. Having complete information on what your local test is makes the review process much smoother and helps us create clear term definitions as well as verifying and enhancing other accessory content, which benefits everyone. The kinds of information we need does vary a bit depending on the type of content (lab, radiology, document titles, survey questionnaires, etc.), so not all items are applicable all of the time.
Format for submissions
For most users, we recommend using the online request form. Regardless of format, we ask that users submit no more than 50 proposed terms at a time.
The set of information required for a particular submission depends on the content of the request. In order for us to process your request, we need:
- Local test/observation name
- Local order (panel) name
- Name of send out lab (if applicable)
- Name of healthcare organization that stimulated the request for this term (if you are submitting on behalf of someone else)
- Description of the test
- For laboratory tests and clinical measurements, the description should indicate what is measured, how it is performed, and how it is used clinically (e.g., what conditions does it diagnose, monitor, screen for, etc.).
- For other kinds of clinical terms, such as clinical documents, the description should indicate the expected information content that would be sent as the result value (i.e., what kinds of information this document or report contains).
- Units of measure (for quantitative observations)
- Answer lists (for qualitative observations) (both normal and abnormal answers)
- Sample results, reports (if applicable)
- If the request is for a panel, the request should include the tests that comprise the panel. Whether or not each test already has a LOINC code should be included, and for any tests that do not already have a code, all of the above information for each individual test should be provided.
- Package inserts, test kit documentation (if applicable)
- Vendor, instrument, and/or reagent kit used to perform this test (if applicable)
- Description of the project or activity that stimulated the request for this term (e.g., IHE Antepartum Record Profile, Indiana Network for Patient Care health information exchange project, etc.)
- Implementation guide (for terms designed for use in the context of a specific messaging implementation guide)
- Original survey form (for questionnaires or survey content)
- If you are requesting survey terms, we recommend that you find out whether the terms are copyrighted and let us know this information when you submit your request. It would be especially helpful and would facilitate processing for you to contact the copyright-holder prior to submission to find out whether they would be willing to give permission to represent the copyrighted content in LOINC, and then include their contact information with your submission so that we can follow up directly with them.
- Occasionally copyright-holders are only willing to grant time-limited permission or grant permission but at a cost, and in such cases, we will not create the requested content because we cannot agree to these terms.
- Any other documentation that may assist us in creating the requested codes
Online request form
New LOINC terms can be requested directly from the LOINC website using the online request form. The request form can build a set of requested terms by entering the required information for each term and/or by uploading a spreadsheet file with the required fields. Requested terms and supporting information are sent to Regenstrief, and users can review the status of their submissions from the My Submissions section of the LOINC website.
The RELMA program can aid you in creating submissions by allowing you to create, manage and store submission terms in a way that is similar to how the program creates, manages and stores local working sets. With RELMA, you can create terms for submission over time and submit groups of terms in batches. The program will track when the term was created and the date when you submitted the term. The program will help you organize the terms that you create and it will automate the process of creating the submission files.
For detailed instructions on how to use the RELMA propose a term feature, please see Appendix A of the RELMA manual. You can download the RELMA Manual from the LOINC website.
Excel file submission
If you are not using RELMA for submission, please use one of the templates provided on our website.
Other formats (e.g., distributed database fields, exported internal/local formats) will not be accepted.
Please email your submission template and related documents to firstname.lastname@example.org.
Communication with Regenstrief Institute
Within a day or two of receipt of your file, you will receive a confirmation email and the submission process will be underway. You may receive additional communication from Regenstrief with requests for further information if required.
You can follow the progress of your requested terms as it progresses through the review process by visiting the LOINC Submissions Queue.
Once the submission process has completed, you will receive files containing your requested codes.
- 1 – Introduction
- 2 – Major Parts of a LOINC term
- 3 – Special cases
- 4 – Clinical observations and measures
- 5 – Claims attachments
- 6 – Document Ontology
- 7 – Panels (Batteries)
- 8 – Evolving principles for naming collections
- 9 – Additional content in the LOINC distribution
- 10 – Standardized assessment measures
- 11 – Editorial policies and procedures
- 12 – Recommendations for best practices in using and mapping to LOINC
- A – LOINC Database Structure
- B – Classes
- C – Calculating Mod 10 Check Digits
- D – Procedure for Submitting Additions or Changes to LOINC
- E – Examples for LOINC Property Matching
- F – Example Acronyms used in LOINC
- G – LOINC Technical Briefs
- D-Dimer Revisions in LOINC
- Cockcroft-Gault formula, Schwartz equation
- Inducible Clindamycin Resistance in Staphylococcus and Streptococcus
- KIR Gene Family
- Oxygen Saturation and LOINC
- Nomenclature of Salmonella Species, Subspecies, and Serovars
- Segmented Neutrophils Versus Polymorphonuclear WBC
- Vitamin D
- Free Thyroxine Index Variants
- Streptococcus pneumoniae serotype nomenclature
- H – LOINC Committee
- LOINC/RSNA Radiology Playbook User Guide
- User Preferences
- Searching in RELMA
- Keyword Spell Check
- Term File Operations
- Import Local Terms
- Mapping Local Terms to LOINC
- Panels, Forms & Surveys
- HIPAA Claims Attachments
- Lab Auto Mapper
- Community Mapping Repository