Stream: Opthalmology
Topic: ig
Warren Oliver (May 17 2021 at 09:59):
The IG has been updated. There are some new examples and the base Observation profile now has guidance on what terminology to use for Observation.code
Alexander Gogol (May 17 2021 at 10:02):
Update Procedure for DiagnosticTest does not contain description for CPT code 92133
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve
Ashley Kras (May 17 2021 at 10:05):
The three CPT codes (92081, 92082, 92083) identify different levels of complexity and detail in perimetry testing. Depending on the nature of the disease, the physician will select a suitable testing method, since the HFA can test approp-riately at each code level. Be sure medical necessity for the scope of testing is documented.
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perimetry test CPT codes
Leah King (May 17 2021 at 10:10):
For presenting complaint (eg. redness), is it best to use an observation resource with reference to the patient as performer?
Ashley Kras (May 17 2021 at 10:14):
Leah King said:
For presenting complaint (eg. redness), is it best to use an observation resource with reference to the patient as performer?
While conditions are frequently a result of a clinician's assessment and assertion of a particular aspect of a patient's state of health, conditions can also be expressed by the patient, related person, or any care team member. A clinician may have a concern about a patient condition (e.g. anorexia) that the patient is not concerned about. Likewise, the patient may have a condition (e.g. hair loss) that does not rise to the level of importance such that it belongs on a practitioner’s Problem List.
--> Use Condition (there is probably a SNOMED code)
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Ashley Kras (May 17 2021 at 10:17):
There were no descriptions for CPT codes for Procedure resource of diagnostic tests. Now fixed and inserted
Leah King (May 17 2021 at 10:22):
We can't seem to find the list of units for VA, just methods. All of the examples have unit as logMar. Should we be converting all values to logMAR or should the IG have some guidance on how to specify other units for other methods? @Ashley Kras @Warren Oliver
Nigel Morlet (May 17 2021 at 10:23):
Hi Leah & Ash,
the issue is when we have a situation where the patient may state something (which maybe a 'condition') but that may be restated by the physician as a 'presenting complaint' (which is not a condition in a diagnostic sense, rather it is an Observation.patient.category - subjective response - history - presenting complaint - an extension.
N
Warren Oliver (May 17 2021 at 12:24):
Information @ Observation.code.coding[0] (line 29, col18) : Could not confirm that the codes provided are in the value set http://hl7.org/fhir/uv/ophthalmology/ValueSet/observable-entities, and a code is recommended to come from this value set
If the ValueSet was bound using "required" this validation would have failed.
Nigel Morlet (May 18 2021 at 02:10):
Leah a VA conversion chart can be found at this link - https://cran.r-project.org/web/packages/eye/vignettes/eye.html#va-conversion-chart
Nigel Morlet (May 18 2021 at 03:23):
There is a lot to the measurement of visual acuity, but all the test in use are roughly similar and reasonably robust if 150 years of use says something. Most believe the logMAR is the best, but the most commonly used test is variants of the Snellen chart.
The first letter of the 'fraction' notation represents the distance the chart is set (or calibrated to) and the second letter represents the line read - it is not a true fraction so the maths does not work as such.
The Monoyer chart is set up to represent steps in dioptres (the inverse of the focal length) and appears to be set at 3 metres (10 feet)- this gives the decimal notation - ie 6/6 (20/20 in feet) = 10/10 = 1.0, 6/60 (20/200) = 1/10 = 0.1. The Snellen lines are not exactly equivalent as seen in the conversion chart, but are close. The Monoyer lines follow 0.1 steps. logMAR steps are the inverse ie 6/60 = 1.0, 6/6 = 0, again the Snellen lines do not exactly replicate the logMAR lines which are in 0.1 steps. The link also includes code that might be useful.
Doug Phung (May 27 2021 at 16:51):
Leah King said:
We can't seem to find the list of units for VA, just methods. All of the examples have unit as logMar. Should we be converting all values to logMAR or should the IG have some guidance on how to specify other units for other methods? Ashley Kras Warren Oliver
I am also curious about this. I posted earlier in visual-acuity, but I would like to store additional fields (distance, near, intermediate) leading up to the logMAR calculation for completeness. If i wanted to store additional data, should I be making an accompanying observation for each Visual Acuity datum?
Elliot Silver (May 27 2021 at 16:54):
Separate Observations are typically used if the additional data could be used independently. Consider using components if the other values need to be understood together or in the context of the logMar calculation.
Brett Esler (Jul 14 2021 at 04:01):
hi all IG has been transferred across to HL7 Australia github org - so now CI build published at http://build.fhir.org/ig/hl7au/ophthal-collab-care-ig/branches/master/index.html and Github repo at https://github.com/hl7au/ophthal-collab-care-ig
Brett Esler (Jul 20 2021 at 14:41):
hi all IG repo has been moved again to its official destination - https://github.com/HL7/fhir-eyecare-ig - CI build will follow soon when issues with IG build (http://tx.fhir.org) have been rectified...
Brett Esler (Jul 21 2021 at 05:30):
CI build is now back in action - work on the IG can be viewed at: http://build.fhir.org/ig/HL7/fhir-eyecare-ig/branches/master/index.html
Last updated: Apr 12 2022 at 19:14 UTC
