Representing Intimate Partner Violence

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Federally required	Cost	Test Tool Availability
Standard	LOINC®	Final	Production	Yes	Free	N/A
Standard	SNOMED CT® U.S. Edition	Final	Production	No	Free	No
Standard	ICD-10-CM	Final	Production	No	Free	No
Standard	CPT®	Final	Production	No	$	N/A
Standard	Unified Code for Units of Measure	Final	Production	Yes	Free	N/A

Limitations, Dependencies, and Preconditions for Consideration	Applicable Value Set(s) and Starter Set(s)
The optional 2015 Edition Cures Act Social, psychological, and behavioral data criterion (170.315(a)(15)) specifies LOINC codes for exchanging information about exposure to violence (intimate partner violence). This criterion was not changed in HTI-1. Intimate partner violence is defined by the HL7 Gravity Project as physical violence, sexual violence, or psychological harm by a current or former partner or spouse. Often including a pattern of methods and tactics to gain and maintain power and control over the other person. The scope of the HL7 Gravity Project Intimate Partner Violence domain is more broad than the certification criterion and includes information about related conditions and interventions. LOINC is used for Social Determinants of Health (SDOH) observations (assessment instrument panels, questions, and answers.) SNOMED CT U.S. Edition is used for SDOH observations, conditions, goals, and interventions. ICD-10-CM is used for SDOH diagnoses. CPT is used for SDOH procedures and interventions. Units of measure for quantitative result values must be represented using UCUM, see Representing Units of Measure. Implementation information for Intimate Partner Violence exchange can be found in Structure and Exchange of Social Determinants of Health Information. For more information about observations and observation values, see Appendix III for an informational resource developed by the Health IT Standards Committee.	Intimate Partner Violence Screening Assessments (LOINC) Intimate Partner Violence Screening Assessments Questions (LOINC) Intimate Partner Violence Screening Assessments Answers (LOINC) Intimate Partner Violence Diagnoses (ICD-10-CM, SNOMED CT) Intimate Partner Violence Goals (SNOMED CT) Intimate Partner Violence Procedures (CPT, SNOMED CT) Intimate Partner Violence Service Requests (CPT, SNOMED CT) HTI-1 Requirements

Limitations, Dependencies, and Preconditions for Consideration

Applicable Value Set(s) and Starter Set(s)

The optional 2015 Edition Cures Act Social, psychological, and behavioral data criterion (170.315(a)(15)) specifies LOINC codes for exchanging information about exposure to violence (intimate partner violence). This criterion was not changed in HTI-1.
Intimate partner violence is defined by the HL7 Gravity Project as physical violence, sexual violence, or psychological harm by a current or former partner or spouse. Often including a pattern of methods and tactics to gain and maintain power and control over the other person.
The scope of the HL7 Gravity Project Intimate Partner Violence domain is more broad than the certification criterion and includes information about related conditions and interventions.
LOINC is used for Social Determinants of Health (SDOH) observations (assessment instrument panels, questions, and answers.)
SNOMED CT U.S. Edition is used for SDOH observations, conditions, goals, and interventions.
ICD-10-CM is used for SDOH diagnoses.
CPT is used for SDOH procedures and interventions.
Units of measure for quantitative result values must be represented using UCUM, see Representing Units of Measure.
Implementation information for Intimate Partner Violence exchange can be found in Structure and Exchange of Social Determinants of Health Information.
For more information about observations and observation values, see Appendix III for an informational resource developed by the Health IT Standards Committee.

Intimate Partner Violence Screening Assessments (LOINC)
Intimate Partner Violence Screening Assessments Questions (LOINC)
Intimate Partner Violence Screening Assessments Answers (LOINC)
Intimate Partner Violence Diagnoses (ICD-10-CM, SNOMED CT)
Intimate Partner Violence Goals (SNOMED CT)
Intimate Partner Violence Procedures (CPT, SNOMED CT)
Intimate Partner Violence Service Requests (CPT, SNOMED CT)
HTI-1 Requirements

Comment

Submitted by mattreid on 2020-03-26

The AMA requests that the…

The AMA requests that the Current Procedural Terminology (CPT) code set be added to the standards listed in Section I: Representing Exposure to Violence (Intimate Partner Violence). The CPT Evaluation and Maintenance services include assessing a patient’s risk and exposure to violence.

CPT is a comprehensive and regularly curated uniform language that accurately describes medical, surgical, and diagnostic services and provides for reliable communication among users. It has an extremely robust and mature development process with open and transparent meetings and clinical input from national medical specialties and relevant stakeholders. It is the most widely adopted outpatient procedure code set. Use of the CPT code set is federally required under HIPAA.

Submitted by cmcdonald on 2018-10-01

Since this LOINC code and…

Since this LOINC code and answer set has been developed (30 behavior and functional status variables suggested by the IOM report and adopted for requirement in the last MU NPRM), the adoption level could now be very high.

Submitted by gdixon on 2018-09-12

Additional questions needed

Exposure to firearms, I do not see a viable code set for this. It should be a single question and answer

Has the patient or significant other been incarcerated?

We applaud adding Social Determinates being added to ISA.

Submitted by cmcdonald on 2018-10-01

Re: patient/significant…

Re: patient/significant other been incarcerated: may be a privacy concern about this one, though, would likely have predictive value.