documentation:vocabulary:cpt4
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documentation:vocabulary:cpt4 [2015/07/20 01:58] cgreich [Ambiguous CPT4 Concepts] |
documentation:vocabulary:cpt4 [2015/10/06 16:37] (current) cgreich |
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| - | ===== CPT-4 ===== | + | ===== CPT4 ===== |
| + | CPT4 is a coding system for the reimbursement of ambulatory services in the US healthcare system. **Note**: CPT4 is called Common Procedural Terminology, but it does not just contain medical procedures. | ||
| - | Draft. Don't read on. | + | ==== Sources ==== |
| + | All CPT4 codes are sourced from the NLM, as are maps from MeSH and relationships to LOINC. Relationships to SNOMED and RxNorm (see below for Procedure Drugs) are provided by OHDSI. | ||
| - | Consults = Procedures | + | ==== Standard Concepts ==== |
| - | Disease guidelines = Observations | + | All valid CPT4 Concepts are Standard Concepts, with the exception of CPT4 section or subsection heading codes (CPT4 Hierarchy Concepts), which are Classification Concepts. |
| - | imaging tests = procdures | + | |
| - | all sorts of hearing tests = measurements | + | |
| - | ==== Procedure Drugs in CPT4 ==== | + | ==== Concept Classes ==== |
| + | Concepts are assigned Concept Class as following: | ||
| + | ^Source^Concept Class^ | ||
| + | |CPT4 codes|CPT4| | ||
| + | |CPT4 modifiers|CPT4 Modifier| | ||
| + | |CPT4 section and subsection headings|CPT4 Hierarchy| | ||
| + | ==== Domains ==== | ||
| + | Domains are manually assigned to CPT4 Hierarchy Concepts and propagated down to the CPT4 Concepts. | ||
| + | |||
| + | ==== Relationships, Hierarchy ==== | ||
| + | Relationships are defined within CPT4 and to the following other vocabularies: | ||
| + | |||
| + | === Internal CPT4 relationships === | ||
| + | - There are "Is a" relationships from CPT4 Concepts and CPT4 Modifier Concepts to CPT4 Hierarchy Concepts | ||
| + | - There are "Is a" relationships amongst CPT4 Hierarchy Concepts | ||
| + | - There are "Is a" relationships between CPT4 Concepts that refer to other CPT4 Concepts. These relationships are very few. | ||
| + | |||
| + | === CPT4 to LOINC relationships === | ||
| + | These relationships are defined as "CPT4 - LOINC eq". Note that these relationships are currently defined for drug (pharmaceutical ingredient, not illicit drug) testing procedures. | ||
| + | |||
| + | === CPT4 to SNOMED relationships === | ||
| + | These relationships are defined as "CPT4 - SNOMED cat" and "CPT4 - SNOMED eq" for categorical ("uphill") and equivalent relationships. These relationships embed the CPT4 system in a larger hierarchy for procedures, measurements, observations and devices. | ||
| + | |||
| + | === Hierarchy === | ||
| + | CPT4 contributes to the hierarchies of the Procedure, Measurement and Observation Domains. SNOMED provides the higher hierarchical concepts, while CPT4 are connected as descendents all the way down to leaf nodes. | ||
| + | |||
| + | === Maps === | ||
| + | All valid CPT4 codes are Standard Concepts and therefore map to themselves. In addition, there are mappings to RxNorm Drug concepts for Procedure Drugs. | ||
| + | |||
| + | === CPT4 to RxNorm map === | ||
| In CPT4, only vaccinations are recorded in sufficient detail that the administered drug can be inferred. Other Procedure Drugs, such as chemotherapies, are only mentioned as general Procedures, without mentioning any specific Drug Product. The Vaccine Concepts are between concept_code 90281 and 90749. They are also descendants of the CPT4 hierarchical term 1012602 "Vaccines, Toxoids". | In CPT4, only vaccinations are recorded in sufficient detail that the administered drug can be inferred. Other Procedure Drugs, such as chemotherapies, are only mentioned as general Procedures, without mentioning any specific Drug Product. The Vaccine Concepts are between concept_code 90281 and 90749. They are also descendants of the CPT4 hierarchical term 1012602 "Vaccines, Toxoids". | ||
| - | All vaccines are mapped to RxNorm entities in the following order of precedence: | + | Procedure Drugs are Standard Concepts of the domain_id = "Procedure". However, for each unambiguously mapped CPT4 Concept there is a record in the CONCEPT_RELATIONSHIP table mapping it to the corresponding RxNorm Concept. Depending on how precisely the CPT4 Concept describes the exact Drug Product, the mapping will attempt pick the most detailed RxNorm entity in the following order of precedence: |
| - | * Branded Drug | + | * Branded Drug |
| - | * Branded Drug Form or Branded Drug Component | + | * Branded Drug Form or Branded Drug Component |
| - | * Clinical Drug | + | * Clinical Drug |
| - | * Clinical Drug Form | + | * Clinical Drug Form |
| - | * List of ingredients. Note that the OMOP Standard Vocabularies currently do not support the notion of ingredient combinations. Therefore, a single CPT4 Concept will be mapped to all Ingredients. The consequence of that is that for each CPT4 record there are as many DRUG_EXPOSURE records as there are Ingredients. | + | * List of Ingredients. Note that the OMOP Standard Vocabularies currently do not support the notion of Ingredient combinations. Therefore, a single CPT4 Concept will be mapped to all individual Ingredients. The consequence of that is that for each CPT4 record there are as many DRUG_EXPOSURE records as there are Ingredients. |
| - | ==== Ambiguous CPT4 Concepts ==== | + | ** Ambiguous CPT4 Procedure Drug Concepts ** |
| The following CPT4 Concepts cannot be unambiguously assigned to RxNorm. The reason is that there is more than one type of Vaccine availabe to immunize against a certain infectious disease, but CPT4 does not distinguish between them. For exampe, for Botulinum Antitoxin, there are human and equine antibodies or sera against the Botulinum Toxin variants A to F, and different combinations of antitoxins are on the market against these variants. | The following CPT4 Concepts cannot be unambiguously assigned to RxNorm. The reason is that there is more than one type of Vaccine availabe to immunize against a certain infectious disease, but CPT4 does not distinguish between them. For exampe, for Botulinum Antitoxin, there are human and equine antibodies or sera against the Botulinum Toxin variants A to F, and different combinations of antitoxins are on the market against these variants. | ||
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| |2213450|90676|Rabies vaccine, for intradermal use| | |2213450|90676|Rabies vaccine, for intradermal use| | ||
| - | ==== Influenza Vaccines ==== | + | ** Influenza Vaccines ** |
| - | Influenza A virusses are very volatile and every year a new vaccine is used for vaccination. That means that the same CPT4 Concept will be mapped to different Drugs dependent on the year. The following table contains all Influenza virus vaccines. At a later point, a mechanism for the correct mapping will be provided here. | + | Influenza A virusses are very volatile and each year a new product is developed by the pharmaceutical industry for use during the flu season. That means that the same CPT4 Concept will be mapped to different Drugs dependent on the year. The following table contains all Influenza virus vaccines. At a later point, a mechanism for the correct mapping will be provided here that takes the administration date into account. |
| ^Concept ID^CPT4 Code^Concept Name^ | ^Concept ID^CPT4 Code^Concept Name^ | ||
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| |44816518|90688|Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use| | |44816518|90688|Influenza virus vaccine, quadrivalent, split virus, when administered to individuals 3 years of age and older, for intramuscular use| | ||
| - | ==== CPT4 vaccines that have no marketed Drug Product ==== | + | ** CPT4 vaccines that do not correspond to a marketed Drug Product ** |
| Certain CPT4 Concepts describe vaccination using a Drug that is not or no longer approved by the FDA and marketed by a manufacturer for general use. Some of them are strictly for military use, some of them have been out of circulation before RxNorm started: | Certain CPT4 Concepts describe vaccination using a Drug that is not or no longer approved by the FDA and marketed by a manufacturer for general use. Some of them are strictly for military use, some of them have been out of circulation before RxNorm started: | ||
| ^Concept ID^CPT4 Code^Concept Name^ | ^Concept ID^CPT4 Code^Concept Name^ | ||
| - | |2213399|90288|Botulinum human antitoxin for infusion into vein| | ||
| |2213455|90692|Typhoid vaccine, heat- and phenol-inactivated (H-P), for subcutaneous or intradermal use| | |2213455|90692|Typhoid vaccine, heat- and phenol-inactivated (H-P), for subcutaneous or intradermal use| | ||
| |2213456|90693|Typhoid vaccine, acetone-killed, dried (AKD), for subcutaneous use (U.S. military)| | |2213456|90693|Typhoid vaccine, acetone-killed, dried (AKD), for subcutaneous use (U.S. military)| | ||
documentation/vocabulary/cpt4.1437357504.txt.gz · Last modified: 2015/07/20 01:58 by cgreich
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