LOINC Version 2.83 Release Highlights

We are pleased to announce the release of LOINC® Version 2.83, now available for download from the LOINC website and via our Terminology Service using HL7® FHIR®. This release continues the evolution of LOINC with new and updated content across the Laboratory, Clinical, Surveys, and Document Ontology domains, supporting the growing needs of healthcare interoperability worldwide.

Release Highlights

• Approximately 1,260 new Drug/Toxicology concepts
• Discouraging Drug/Toxicology concepts that represent “screen” or “confirm” as a method in favor of actual analytical methods, such as immunoassay and mass spectrometry
• Approximately 1,050 new microbiology concepts supporting the European Health Data Space (EHDS) microbiology model
• Guidance and new terms to support post-coordination
• Approximately 315 new allergy concepts
• New and updated surveys and clinical assessment instruments
• CMS Post-Acute Care assessment updates
• New radiology, molecular genetics, and document ontology content
• New public health terms (approximately 20) supporting Hantavirus and Ebolavirus testing

Summary

LOINC v2.83 expands standardized terminology across multiple clinical domains while continuing to improve the quality, consistency, and interoperability of new and existing content. This release includes significant enhancements in laboratory testing, including expanded drug and toxicology content and a refined approach to representing drug toxicology testing methods that emphasizes the actual analytical methods, such as immunoassay or mass spectrometry, rather than “screen” and “confirm.” Additional enhancements include new microbiology, allergy, molecular genetics, surveys, clinical assessment instruments, and CMS Post-Acute Care assessment content. It also incorporates terminology developed to support emerging public health needs, including Hantavirus and Ebolavirus testing. In addition, the release advances international interoperability by expanding terminology that supports implementation of the European Health Data Space (EHDS).

Domain-by-domain highlights

Laboratory

To support global drug and toxicology reporting, we introduced approximately 1,260 new LOINC concepts in the Drug/Toxicology class. These additions expand support for commonly used analytical methods, including immunoassay and mass spectrometry, that laboratories use in drug testing. In addition, based on recommendations from the LOINC Laboratory Committee and subject matter experts, existing LOINC concepts that represented “screen” or “confirm” as the Method have been discouraged. The committee concluded that “screen” and “confirm” describe the intended use of a drug assay rather than the analytical method itself. This work improves the consistency and accuracy of Method representation by using the actual analytical methods (for example, immunoassay or mass spectrometry) instead of “screen” or “confirm.”

We added 1,050 new genetic microbiology concepts and modified approximately 50 existing concepts to allow post coordination of the specimen type and the method when testing for the presence of microbiology RNA and DNA. These concepts were added at the request of the HL7 Europe Lab Semantic WG which is standardizing the representation of these tests for data exchange in the European Health Data Space (EHDS). These concepts all have a System of “{Specimen}” and a      Method of “{Molgen}” to indicate the information about the tests (the specimen type and the kind of molecular genetic method) that is to be post coordinated in the results.

We also corrected the representation of targeted gene mutation analysis concepts. Previously, the concepts were modeled as

“X gene targeted mutation analysis:Prid:Pt:Bld/Tiss:Nom:Molgen”.

But “targeted mutation analysis” is the actual method, so the new representation is

“X gene targeted mutation:Prid:Pt:Bld/Tiss:Nom:targeted mutation analysis”.

We have also released approximately 315 new allergy tests done on SER or SER/PLAS, and with a Method of IA (Immunoassay). The method was explicitly added to these concepts to avoid any uncertainty about the method used.

Rapid response to emerging public health needs

Version 2.83 includes new terminology for Hantavirus and Ebolavirus testing that was rapidly developed through LOINC’s Special Use mechanism in response to emerging public health needs. The Special Use mechanism enables LOINC to develop and make urgently needed terminology available between regular releases, while maintaining LOINC’s standard quality assurance process.

With their inclusion in LOINC v2.83, these terms are now part of the official release, providing laboratories and public health organizations with standardized terminology to support timely response to emerging infectious disease needs.

Clinical

LOINC v2.83 expands Clinical LOINC with new content supporting radiology, clinical observations, and the continued development of the LOINC Ontology.

Radiology

This release includes new and revised radiology concepts supporting diagnostic imaging and image-guided procedures.

New concepts cover:

• Image-guided interventional radiology procedures for dialysis catheter insertion and gastric vein embolization.
• Diagnostic imaging for bilateral ankle and foot radiography, prostate nuclear medicine imaging, dental radiography, and CT imaging of the kidneys, ureters, and urinary bladder.
• Improved alignment with the LOINC/RSNA Radiology Playbook and the unified LOINC/RadLex modelincluding:
  • Standardization of radiology modality terminology (e.g., radiographic fluoroscopy (RF) and radiographic fluoroscopy angiography (angio).
  • Conversion of applicable image-guidance concepts from the Narrative (Nar) Scale to the Document (Doc) Scale to better align with CDA document modeling.
  • Refinements to anatomy modeling and region-imaged representation.
  • Updates to procedure components and body systems to improve semantic consistency.
  • Clarification of procedure names and contrast sequencing for selected image-guided procedures.

Collectively, these changes improve consistency across radiology terminology, strengthen interoperability with the LOINC/RSNA Radiology Playbook, and provide additional support for diagnostic imaging and interventional radiology workflows.

LOINC Ontology

To support continued development of the LOINC Ontology, this release adds the most frequently used clinical observations in the Clinical LOINC domain. These additions focus on a relatively small number of codes that represent a substantial share of clinical data volume:

• 14 codes account for approximately 90% of clinical observation data volume
• 65 codes account for approximately 99% of clinical data volume

The clinical items added are the ones you would expect: systolic and diastolic blood pressure, heart rate, body temperature, respiratory rate, smoking status, chief complaint, etc.

Document Ontology

LOINC v2.83 continues to enhance Document Ontology by expanding priority content while improving consistency and usability. This release includes approximately 40 new concepts supporting jurisdictional electronic health record (EHR) implementation, resuscitation orders, birth certification, and new clinical document types. In addition, numerous existing Document Ontology terms were updated to improve naming consistency and provide a more intuitive experience for implementers.

Surveys

With support from the Regenstrief Foundation and in collaboration with HL7® Gravity, LOINC v2.83 includes the following new and updated standardized health-related social needs assessment instruments.

• New assessments:
  • Perceived Nutrition Environment (NEMS-P)
  • Lubben Social Network Scale-6 (LSNS-6)
  • Neighborhood Scale Revision and New Subscale
  • Expanded Food Security Screener
• Updated assessments:
  • Medical Outcomes Study (MOS) Social Support Survey
  • Extended–Hurt, Insulted, Threaten, Scream (E-HITS)
  • Health Leads Screening Tool
  • US FSS-6 Screening Instrument
  • The Medical Expenditure Panel Survey (MEPS) Health Insurance (HX) Section Panel
  • Behavioral Risk Factor Surveillance System (BRFSS) ACE Module

LOINC v2.83 also broadens support for standardized clinical assessments beyond health-related social needs. This release includes the following additional assessment instruments:

1. Baecke Questionnaire of Habitual Physical Activity
2. Ask Suicide-Screening Questions (ASQ) Suicide Screening Tool
3. PROMIS Scale v1.2 – Global Physical Health 4a
4. Breast Cancer Risk Assessment Tool BCRAT
5. Modified Aldrete score system
6. Bishop Score Assessment

Updates Supporting the Centers for Medicare & Medicaid Services (CMS) Post-Acute Care (PAC) Assessment Program

LOINC v2.83 includes updates that support the ongoing evolution and standardization of CMS Post-Acute Care (PAC) assessment instruments. This release incorporates new versions of the following CMS assessments:

1. Inpatient Rehabilitation Facility–Patient Assessment Instrument (IRF-PAI) v4.4
2. Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) v5.3

In addition, this release includes terminology updates that support the CMS Standardization Maintenance Initiative, which promotes harmonization and consistency across PAC assessment instruments. Updates were completed for the following assessments:

1. Outcome and Assessment Information Set (OASIS-E2)
2. Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) v5.1
3. Inpatient Rehabilitation Facility–Patient Assessment Instrument (IRF-PAI) v4.2
4. Minimum Data Set (MDS) Resident Assessment Instrument (RAI) v1.20.1
5. Hospice Outcomes and Patient Evaluation (HOPE) v1.01
6. Functional Assessment Standardized Items (FASI) v1.2

Together, these updates ensure that LOINC remains aligned with current CMS assessment content, supporting standardized data collection, interoperability, and consistent implementation across post-acute care settings.