Dear Bonnie,

Thank you for your question. It is very important to us that we understand the needs of our implementers as it helps us make better decisions for the maintenance of pCLOCD to be based on usage and requirements.

In reviewing LOINC Code 3636-8, Fentanyl we noted it is an active LOINC Code and only inactive in pCLOCD. This decision was made sometime in 2015 when we collaborated with the Canadian Society of Clinical Chemists that provided us with a large number of recommended SI units and where there were codes that had a similar LOINC code but in mass concentration, they were made inactive in pCLOCD. These recommendations were mostly based on the Canadian preferred reporting of lab test in SI units.

However, we recognize that some tests may be performed in US labs that are reported back in Canadian labs in mass units, e.g. mg/dL, rather than molar units, e.g. mmol/L. In this situation, some labs can convert those test results to SI. It is important that if the preferred pCLOCD code is being used that the conversion to SI units (molar units) be completed for accuracy in reporting. That being said, not every facility has this type of conversion capability and in this case we see that there is a need to use the 'Inactive' code, as is the case with 3636-8 Fentanyl.

We work to support and be responsive to the needs of implementers. For this reason we will work to activate LOINC code 3636-8 in pCLOCD in the impending release - January 2020.

We hope this helps answer your question and provides the guidance necessary. If you have any questions or comments, please let us know. Send us an email at standards@infoway-inforoute.ca

Thanks kindly,
Linda Monico
Senior Specialist, Standards and InfoCentral
lmonico@infoway-inforoute.ca

Good afternoon,

I am in the process of providing pCLOCD codes to one of our RHAs for the implementation of a new panel. While referencing the July 2019 release, I found a change that I would like clarified. The test in question is Fentanyl, reporting units of ng/mL, performed at the Mayo Clinic using code 3636-8. In the new pCLOCD release, this code is now inactive with a note “Map to 55537-5”. When I checked 55537-5, this code has recommended units nmol/L. As the Mayo Clinic is reporting in units ng/mL, I am left wondering how to proceed.

Any help and clarification would be greatly appreciated.

Kindest regards,

Bonnie Chipman
EHR Informatics Consultant
NL Centre for Health Information, 70 O'Leary Ave, St. John's NL, A1B 2C7