Thanks Cecil!
Keith
Text | SNOMED Code | SNOMED Text |
Current every day smoker | 449868002 | Smokes tobacco daily (finding) |
Current some day smoker | 230059006 | Occasional cigarette smoker (finding) |
Former smoker | 8517006 | Ex-smoker (finding) |
Never smoker | 266919005 | Never smoked tobacco (finding) |
Smoker, current status unknown | 266927001 | Tobacco smoking consumption unknown (finding) |
Unknown if ever smoked | 405746006 | current non smoker but past smoking history unknown (finding) |
How about that! Very timely. Thanks, Keith.
ReplyDeletewe had discussions about tobacco usage vs smoking status (e.g. tobacco chewers)... NQF if I recall, counts this in some of their measures. Any thoughts? What about level of smoking (3 packs a day). How is this represented in CCD?
ReplyDeleteThe best code I can find to use for a measure of level is SNOMED CT 365982000 (tobacco smoking consumption - finding).
ReplyDeleteRepresenting level of smoking across methods is difficult because there are no standard units that you can associate with it. Smoking includes pipes (without a standard bowl size), cigarettes (also without a standard size), cigars (also no standard size), and packs also don't have a standard size (some have 10, others 15, most commonly have 20, yet others have 25).
So, what do you count? Under the SNOMED CT code above are degrees for cigarette smokers: (light, moderate, heavy and others in between) measured by number of cigarettes per day, but nothing for other methods of consumption. Using a scale like that is probably better than other methods of "counting".
In terms of tobacco usage (e.g., chew, snuff or other uses), there are other codes in SNOMED to support those kinds of findings of use, but not degree of use.
I just came across this while looking for information on mapping the CDC smoking status recodes. For the record, I am a total SNOMED novice.
ReplyDeleteI see that 405746006, "current non smoker but past smoking history unknown (finding)", is proposed. This talks specifically about smoking which is appropriate, but the finding is explicit in that the patient is currently not a smoker, unlike the CDC value which is "Unknown if ever smoked."
SNOMED 160614008, "Tobacco consumption unknown (finding)", which addresses all forms of tobacco consumption, does state that consumption is unknown, seemingly for smoking or smokeless, over all time.
Might this not be a valid proposal?
Update: C-CDA requires a slightly different set of codes for these same six meanings:
ReplyDeleteTwo changes from what's listed above:
230059006 --> 428041000124106
Current some day smoker
Occasional cigarette smoker (finding)
405746006 --> 266927001
Unknown if ever smoked
current non smoker but past smoking history unknown (finding)
---
Complete value set:
Value Set: Smoking Status 2.16.840.1.113883.11.20.9.38 STATIC 2012-07-01
Code System(s):
SNOMED CT 2.16.840.1.113883.6.96
Description:
This value set indicates the current smoking status of a patient
Code Code System Print Name
449868002 SNOMED CT Current every day smoker
428041000124106 SNOMED CT Current some day smoker
8517006 SNOMED CT Former smoker
266919005 SNOMED CT Never smoker (Never Smoked)
77176002 SNOMED CT Smoker, current status unknown
266927001 SNOMED CT Unknown if ever smoked
What if you dont know? as in, value is NULL in my _* database?
ReplyDeleteand yet we have to spit out the section?
as near as I can tell these numeric codes do not exist in SNOMED CT. what am I missing?
ReplyDeleteHeavy tobacco smoker 428071000124103
Light tobacco smoker 428061000124105
Current some day smoker 428041000124106
Anyone has Smokeless Status Snomed Codes ??
ReplyDeleteDoes anyone know what consitutes a Heavy smoker and what constitutes a Light smaoker? Is there a certain number of cigarettes per day or pack years used for the definition?
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ReplyDeletehi i am John
ReplyDeletei find this just information
thank
How would you document e-cigarets
ReplyDeleteI would not document e-cigs, as they contain no tobacco or smoke, and are an evidence-based tool for smoking cessation. They do not meet the criteria for addiction.
DeleteWhat does cigarette smoking snomed code 266927001 mean? Because I don't smoke
ReplyDelete