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Medical coding systems are common vocabularies that allow specific identification of different clinical concepts. There are a number of common and widely used medical coding systems, such as ICD-10-CM, SNOMED, and others. However, different healthcare IT systems use all kinds of coding systems - some standardized, some proprietary. Metriport enriches data with code system lookup, normalization, and cross-walks, so that the result is cohesive and more robust than it is at the source.

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Common Medical Coding Systems

Below is an overview of the most prevalent coding systems supported by Metriport and often found in the source documents:
Coding SystemPurposeMaintained byFHIR ResourcesExample
ICD-10-CM
(International Classification of Diseases, 10th Revision, Clinical Modification)		Encodes medical diagnoses and conditionsU.S. National Center for Health Statistics (NCHS)ConditionE11.9 → Type 2 diabetes mellitus without complications
CPT
(Current Procedural Terminology)		Encodes outpatient medical procedures and servicesAmerican Medical Association (AMA)Procedure0331T → Myocardial sympathetic innervation imaging, planar qualitative and quantitative assessment
CVX
(Vaccine Codes)		Identifies vaccines and vaccine groupsU.S. Centers for Disease Control and Prevention (CDC)Immunization125 → Novel Influenza-H1N1-09, live virus for nasal administration
SNOMED CT
(Systematized Nomenclature of Medicine – Clinical Terms)		Encodes comprehensive clinical terminology for conditions, findings, and proceduresSNOMED InternationalCondition, Procedure, and others44054006 → Diabetes mellitus type 2 (disorder)
LOINC
(Logical Observation Identifiers Names and Codes)		Encodes laboratory and clinical observationsRegenstrief InstituteObservation, Encounter, and others718-7 → Hemoglobin [Mass/volume] in Blood
NDC
(National Drug Code)		Identifies drug products marketed in the U.S.U.S. Food and Drug Administration (FDA)Medication0002-8215-01 → insulin human (Humulin R) 100 [iU]/mL Parenteral Injection, Solution, 1 VIAL, MULTI-DOSE in 1 CARTON (0002-8215-01) / 10 mL in 1 VIAL, MULTI-DOSE
RxNormNormalizes drug names and clinical drugsU.S. National Library of Medicine (NLM)Medication311036 → HumuLIN R 100 UNT/ML Injectable Solution

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Other Clinical Classification Systems

These systems are typically not provided in the source documents, but are added by Metriport:
Coding SystemPurposeMaintained byFHIR ResourcesExample
CCSR
(Clinical Classifications Software Refined)		Groups ICD-10-CM diagnosis codes into clinically meaningful categories across body systemsU.S. Agency for Healthcare Research and Quality (AHRQ)ConditionEND002 → Diabetes mellitus without complication
HCC
(Hierarchical Condition Categories)		Groups ICD-10-CM diagnosis codes into hierarchical categories used for risk adjustment and reimbursementU.S. Centers for Medicare & Medicaid Services (CMS)Condition18 → Diabetes with chronic complications
CCIR
(Chronic Condition Indicator Refined)		Classifies ICD-10-CM diagnosis codes as chronic or nonchronic across 18 clinical condition categoriesU.S. Agency for Healthcare Research and Quality (AHRQ)ConditionC → Chronic

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Representation in FHIR

Each of these coding systems appear in FHIR data as elements of coding arrays: 
{
  "coding": [
    {
      "system": "http://hl7.org/fhir/sid/icd-10-cm",
      "code": "E11.9",
      "display": "Type 2 diabetes mellitus without complications"
    }
  ]
}