Addressing the need for coding standards in occupational health

Jun 9, 2020 11:00:00 AM — by Enterprise Health

Standard terminology and codes in healthcare provide an important foundation for information exchange between health information systems. Every aspect of patient care requires the use of structured vocabularies, terminologies, code sets and classification systems so that senders and receivers of clinical health, disease, prescription and other types of information are speaking the same language. When it comes to occupational health, many domains in our industry, such as hearing conservation programs, lack coding standards. 

Enterprise Health is leading an effort to establish codes for some of the most frequently used occupational health tests and measurements that currently lack such standardization. Rich Hammel, MD, MPH, FACPM, FACOEM, chief product evangelist and Dave Carlson, director of standards and interoperability have identified gaps in current coding standards for noise-related health effects and exposure assessment, and they are working with LOINC, the organization that oversees a widely used international standard which provides a universal code system for identifying health measurements, observations and documents, to address the gaps.

Already, hearing threshold codes (Panel 89015-2) have been added for the right and left ears. This panel includes results for the individual measurements reported on an audiogram which usually provides independent measurements of the lowest intensity level at which a sound can be heard at a series of frequencies for each ear. Additionally, they have identified several LOINC hearing conservation program coding needs pertaining to hearing health effects. Examples include audiometer calibration information, threshold shift calculations and hearing health history information gleaned through questionnaires. 

Another need for LOINC codes exists to cover exposure to noise. This includes qualitative information about noise exposure history gathered via questionnaires and quantitative measurements devised for noise monitoring for both personal measurement with a noise dosimeter and area measurement through a sound level meter. Another opportunity pertains to codes for personal hearing protection devices (e.g. Personal Attenuation Rating (PAR) — measured via a hearing protection fit-testing device).

While Rich and Dave have worked closely with LOINC to address these needs, they are also looking to engage occupational health-related organizations such as NIOSH, CAOHC, ACOEM, AAOHN, AIHA and ACGIH to ensure a variety of coding needs is met. This effort exemplifies Enterprise Health’s commitment to excellence and our belief that occupational health is a critically important segment in the healthcare ecosystem. 

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