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Recommendation:
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EXAMPLE 1: Part of the Value set for Specimen Type. PHIN-VADS (CDC)
Value Set Code NHSNSpecimenTypeCode |
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Concept Code |
Preferred Concept Name |
Code System Name |
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258414004 |
Adipose tissue sample |
SNOMED-CT |
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309141004 |
Adrenal gland specimen |
SNOMED-CT |
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119373006 |
Amniotic fluid specimen |
SNOMED-CT |
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309479002 |
Artery sample |
SNOMED-CT |
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309493009 |
Bile duct biopsy sample |
SNOMED-CT |
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119341000 |
Bile specimen |
SNOMED-CT |
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309491006 |
Biliary tract tissue sample |
SNOMED-CT |
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119297000 |
Blood specimen |
SNOMED-CT |
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119359002 |
Bone marrow specimen |
SNOMED-CT |
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https://phinvads.cdc.gov/vads/ViewValueSet.action?id=6F61F377-E515-43D2-BFEB-4BF135244033# |
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EXAMPLE 2: Specimen type and specimen source site in NAHLN messaging
The Specimen Type (SPM.4) field describes the precise nature of the entity that will
be the source material for the observation. While every effort will be made to provide
coded values for specimen types being used in NAHLN agent testing, there may be cases
where a coded value specific to a particular specimen type is not immediately available.
In these instances, an alternative coded value and description of the specimen may
be sent in components 4-6 of the CWE data type. In some cases the precise term is
not available in the coded reference system. In these situations, it is allowable
to send the original text of the specimen description in the CWE.9 component
An example of coded value for SPM.4 is shown below:
<SPM.4>
<CWE.1>661000009100</CWE.1>
<CWE.2>Oropharyngeal swab</CWE.2>
<CWE.3>SCT</CWE.3>
<CWE.9>OP swabs</CWE.9>
</SPM.4>
The Specimen Source Site (SPM.8) contains an identifier for the source of the specimen
(i.e the anatomical location, organ or site from which the specimen originated). This
field is needed when the SNOMED specimen hierarchy does not contain a precoordinated
term that adequately describes the specimen. For example, in the case where tonsillar
tissue is obtained from a pig by scraping, the source would be 'Tonsillar structure
(palatine)' In general this field is only needed when additional information about
the region from where the specimen was collected is needed. For environmental specimens
this field may supply additional information on where the specimen originated. In
cases where the specimen and specimen source are identical, this field need not be
populated.
There is no one correct answer to precisely which detail should be provided by a pre-coordinated,
more specific specimen type and which with a less specific type plus a specimen source.
Many specimen/source combinations could be correctly expressed either way. The NAHLN
will try to provide guidance on specific testing protocols.
An example of SPM.8, used in conjunction with SPM.4 is shown below:
<SPM.4>
<CWE.1>128168004</CWE.1>
<CWE.2>Tissue specimen from liver</CWE.2>
<CWE.3>SCT</CWE.3>
</SPM.4>
<SPM.8>
<CWE.1>89255003</CWE.1>
<CWE.2>right lateral lobe of liver</CWE.2>
<CWE.3>SCT</CWE.3>
</SPM.8>