Hi everyone,
I am having trouble finding codes that identify specific bacterial cultures in CSF and Urine. I saw that there were codes such as “630-4- Bacteria Identified in Urine by Culture”, but I am unsure if there are codes where the specific identity of the bacteria is stated from a culture sample.
Any guidance/support is appreciated! Thank you.
Good morning,
Most laboratories structure/model cultures as a Urine Culture Order which would be mapped to 630-4 as you have identified. If nothing is grown, there is a culture result term and it’s value such as a “no growth” text response reported. The culture result term may vary and is typically mapped to 630-4 as well. If you scroll down on the code details page to Basic Attributes, you’ll seee Order/Observation is both indicating the LOINC can be used for both orders and results.
That said, Cultures are reflex orders, whereby additional orders and their results are added on depending on previous results and values. If somethign grows, an “organization identification” result term may be added on and the value is the name of the organism. The organism name would be mapped to a SNOMED CT organism code corresponding to it. So LOINC would not be used for the actual organism as it seems like your question is about.
Here’s an APHL best practice document that has nice figures about culture workflows, testing, etc. for Campylobacter species. It shows reflex tests that may be added at each step. This varies by what labs offer and by organism/culture needs.
In short, each add on order and result should be LOINC encoded. Encoding of result values will differ depending on if qualitative (pos, detected, etc.) which may be used for testing identifying organisms or characteristics of orgs (catalase result: positive value) whether serology/manual, kit based, or molecular micro/pcr based. Some LISs may not have full LOINC mapping functionality for these items too.
You didn’t ask about antimicrobial sensitivity testing. These are added on too and LOINCs are available for antibiotic order panels and results. SNOMED CT qualifier codes are used for result values such as Sensitive, Resistant, etc.
You may wish to review the HL7 ELR Implementation Guide and the LOINC Mapping Guides (Micro, serology, etc.) for further info too Given many organisms are reportable conditions for ELR if you are exchanging data, you’ll want to ensure you are meeting requirements for each public health jurisdiction. I see you are from Canada so you may have other requirements too.