Mapping CPT To LOINC Codes For Accurate Quality Reporting

Increasingly, payers are relying on laboratory data to support quality and reporting initiatives, analytics, and population health strategies. For instance, the HEDIS ® and CMS Stars ratings rely on LOINC ® , the standard for codifying lab tests, within the underlying quality measures. If lab results aren’t accurately represented within the measures, this could directly impact your HEDIS scores and Stars ratings.

To ensure all your lab results are included, maps between lab orders and lab results can assist health plans to identify and close gaps between claims from providers and lab results received from a variety of sources, including hospitals, national lab providers, and HL7 messages. With Health Language’s CPT ® to LOINC maps, your team will be equipped to answer key questions:

• Was the test actually completed?
• Was the right test performed?
• Are all the test results accounted for based on the corresponding claim?
• Are follow-up activities required with a particular patient cohort?