England Pathology and Laboratory Medicine (PaLM) Technical Framework
0.1.0 - ci-build
England Pathology and Laboratory Medicine (PaLM) Technical Framework
0.1.0 - ci-build
England Pathology and Laboratory Medicine (PaLM) Technical Framework - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft as of 2026-11-04 |
<ConceptMap xmlns="http://hl7.org/fhir">
<id value="palm-procedure-to-loinc"/>
<language value="en"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ConceptMap palm-procedure-to-loinc</b></p><a name="palm-procedure-to-loinc"> </a><a name="hcpalm-procedure-to-loinc"> </a><p>Mapping from <a href="ValueSet-palm-procedure.html">PaLM Requestable Tests (SNOMED CT)</a> to <a href="http://hl7.eu/fhir/laboratory/2.1.0/ValueSet-lab-orderCodes-eu-lab.html">Laboratory Order</a></p><br/><p>Mapping from <code>http://snomed.info/sct|http://snomed.info/sct/83821000000107/version/20250702</code> to <a href="http://terminology.hl7.org/6.3.0/CodeSystem-v3-loinc.html">Logical Observation Identifiers, Names and Codes (LOINC)</a></p><table class="grid"><tr><td colspan="2"><b>Source Concept Details</b></td><td><b>Relationship</b></td><td colspan="2"><b>Target Concept Details</b></td><td><b>Comment</b></td></tr><tr><td colspan="2"><b>Codes</b> from http://snomed.info/sct|http://snomed.info/sct/83821000000107/version/20250702</td><td/><td colspan="2"><b>Codes</b> from <a href="http://terminology.hl7.org/6.3.0/CodeSystem-v3-loinc.html" title="http://loinc.org">Logical Observation Identifiers, Names and Codes (LOINC)</a></td><td/></tr><tr><td style="border-right-width: 0px">26604007</td><td style="border-left-width: 0px">Full blood count</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-inexact" title="inexact">maps loosely to</a></td><td style="border-right-width: 0px">57021-8</td><td style="border-left-width: 0px">CBC W Auto Differential panel - Blood</td><td>An England FBC usually includes the white cell differential. Without it, 58410-2 CBC panel - Blood by Automated count. The LOINC panel members are not the same as a laboratory's FBC.</td></tr><tr><td style="border-right-width: 0px">252167001</td><td style="border-left-width: 0px">Urea and electrolytes</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-inexact" title="inexact">maps loosely to</a></td><td style="border-right-width: 0px">24321-2</td><td style="border-left-width: 0px">Basic metabolic 2000 panel - Serum or Plasma</td><td>No LOINC panel matches U&E (sodium, potassium, urea, creatinine, eGFR). The basic metabolic panel also has glucose, calcium, chloride and bicarbonate, and no eGFR.</td></tr><tr><td style="border-right-width: 0px">26958001</td><td style="border-left-width: 0px">Hepatic function panel</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-inexact" title="inexact">maps loosely to</a></td><td style="border-right-width: 0px">24325-3</td><td style="border-left-width: 0px">Hepatic function 2000 panel - Serum or Plasma</td><td>Same test, different members: the LOINC panel has AST and direct bilirubin. An England LFT is usually bilirubin, ALT, ALP, albumin and total protein, with GGT at some laboratories.</td></tr><tr><td style="border-right-width: 0px">271244005</td><td style="border-left-width: 0px">Measurement of serum lipid level</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-inexact" title="inexact">maps loosely to</a></td><td style="border-right-width: 0px">24331-1</td><td style="border-left-width: 0px">Lipid 1996 panel - Serum or Plasma</td><td>The LOINC panel is cholesterol, HDL, calculated LDL and triglyceride. An England lipid profile usually adds non-HDL cholesterol and the cholesterol/HDL ratio.</td></tr><tr><td style="border-right-width: 0px">135842001</td><td style="border-left-width: 0px">Serum C reactive protein level</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-source-is-narrower-than-target" title="source-is-narrower-than-target">is narrower than</a></td><td style="border-right-width: 0px">1988-5</td><td style="border-left-width: 0px">C reactive protein [Mass/volume] in Serum or Plasma</td><td>The LOINC code is serum or plasma; the SNOMED CT concept is serum. High sensitivity CRP is a different code (30522-7).</td></tr><tr><td style="border-right-width: 0px">371981000000106</td><td style="border-left-width: 0px">Hb A1c (Haemoglobin A1c) measurement - IFCC (International Federation of Clinical Chemistry and Laboratory Medicine) standardised</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">59261-8</td><td style="border-left-width: 0px">Hemoglobin A1c/Hemoglobin.total standardized per IFCC-RMP for CDT in Blood</td><td>IFCC standardised HbA1c, reported in mmol/mol.</td></tr><tr><td style="border-right-width: 0px">47758006</td><td style="border-left-width: 0px">Hepatitis B surface antigen measurement</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-source-is-broader-than-target" title="source-is-broader-than-target">is broader than</a></td><td style="border-right-width: 0px">5195-3</td><td style="border-left-width: 0px">Hepatitis B virus surface Ag [Presence] in Serum</td><td>The LOINC code is a qualitative (presence) test in serum; the SNOMED CT concept does not give the scale or specimen.</td></tr><tr><td style="border-right-width: 0px">700152009</td><td style="border-left-width: 0px">Human papilloma virus screening</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-source-is-broader-than-target" title="source-is-broader-than-target">is broader than</a></td><td style="border-right-width: 0px">82675-0</td><td style="border-left-width: 0px">Human papilloma virus 16+18+31+33+35+39+45+51+52+56+58+59+66+68 DNA [Presence] in Cervix by NAA with probe detection</td><td>High risk HPV as tested in NHS cervical screening. The LOINC code names the HPV types, specimen and method, so the right code depends on the assay.</td></tr><tr><td style="border-right-width: 0px">113076002</td><td style="border-left-width: 0px">Glucose tolerance test</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-source-is-broader-than-target" title="source-is-broader-than-target">is broader than</a></td><td style="border-right-width: 0px">72171-2</td><td style="border-left-width: 0px">Glucose tolerance 2 hours panel - Serum or Plasma</td><td>The 2 hour (75 g) oral glucose tolerance test. Gestational and other protocols have other LOINC panels.</td></tr><tr><td style="border-right-width: 0px; border-bottom-style: none">401324008</td><td style="border-left-width: 0px; border-bottom-style: none">Urinary microscopy, culture and sensitivities</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-source-is-broader-than-target" title="source-is-broader-than-target">is broader than</a></td><td style="border-right-width: 0px">50554-5</td><td style="border-left-width: 0px">Urinalysis microscopic panel [#/volume] - Urine by Automated count</td><td>No single LOINC order code for urine MC&S: it maps to microscopy, culture and susceptibility. Manual microscopy has other LOINC panels.</td></tr><tr><td style="border-right-width: 0px; border-top-style: none; border-bottom-style: none"/><td style="border-left-width: 0px; border-top-style: none; border-bottom-style: none"/><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-source-is-broader-than-target" title="source-is-broader-than-target">is broader than</a></td><td style="border-right-width: 0px">630-4</td><td style="border-left-width: 0px">Bacteria identified in Urine by Culture</td><td>The culture part of urine MC&S.</td></tr><tr><td style="border-right-width: 0px; border-top-style: none"/><td style="border-top-style: none; border-left-width: 0px"/><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#concept-map-equivalence-source-is-broader-than-target" title="source-is-broader-than-target">is broader than</a></td><td style="border-right-width: 0px">29576-6</td><td style="border-left-width: 0px">Bacterial susceptibility panel</td><td>The sensitivities part of urine MC&S.</td></tr></table></div>
</text>
<url value="https://examplesihe.org.uk/ConceptMap/palm-procedure-to-loinc"/>
<version value="0.1.0"/>
<name value="PaLMProcedureToLOINC"/>
<title value="PaLM Requestable Tests to LOINC Order Codes (illustrative)"/>
<status value="draft"/>
<experimental value="true"/>
<date value="2026-11-04"/>
<publisher value="Kevin Mayfield"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://github.com/KevinMayfield/PathologyAndLaboratory"/>
</telecom>
</contact>
<description
value="**Illustrative only.** Shows how the [PaLM Requestable Tests](ValueSet-palm-procedure.html) (SNOMED CT
UK, refset `1853561000000109`) could be mapped to LOINC order codes in the HL7 Europe Laboratory
`lab-orderCodes-eu-lab` value set (LOINC `ORDER_OBS` = Order or Both), the preferred binding for
`ServiceRequest.code` in HL7 Europe Laboratory. It covers only the tests in the NHS England examples.
It is not a national map: NHS England is understood to be producing one (**To confirm**).
LOINC panels follow US practice and their members are not the same as an England test profile (for
example an FBC or U&E), so most panel maps are `inexact`. Each laboratory decides the content of its
own profiles."/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="GB"/>
<display value="United Kingdom of Great Britain and Northern Ireland"/>
</coding>
</jurisdiction>
<sourceCanonical
value="https://examplesihe.org.uk/ValueSet/palm-procedure"/>
<targetCanonical
value="http://hl7.eu/fhir/laboratory/ValueSet/lab-orderCodes-eu-lab"/>
<group>
<source value="http://snomed.info/sct"/>
<sourceVersion
value="http://snomed.info/sct/83821000000107/version/20250702"/>
<target value="http://loinc.org"/>
<element>
<code value="26604007"/>
<display value="Full blood count"/>
<target>
<code value="57021-8"/>
<display value="CBC W Auto Differential panel - Blood"/>
<equivalence value="inexact"/>
<comment
value="An England FBC usually includes the white cell differential. Without it, 58410-2 CBC panel - Blood by Automated count. The LOINC panel members are not the same as a laboratory's FBC."/>
</target>
</element>
<element>
<code value="252167001"/>
<display value="Urea and electrolytes"/>
<target>
<code value="24321-2"/>
<display value="Basic metabolic 2000 panel - Serum or Plasma"/>
<equivalence value="inexact"/>
<comment
value="No LOINC panel matches U&E (sodium, potassium, urea, creatinine, eGFR). The basic metabolic panel also has glucose, calcium, chloride and bicarbonate, and no eGFR."/>
</target>
</element>
<element>
<code value="26958001"/>
<display value="Hepatic function panel"/>
<target>
<code value="24325-3"/>
<display value="Hepatic function 2000 panel - Serum or Plasma"/>
<equivalence value="inexact"/>
<comment
value="Same test, different members: the LOINC panel has AST and direct bilirubin. An England LFT is usually bilirubin, ALT, ALP, albumin and total protein, with GGT at some laboratories."/>
</target>
</element>
<element>
<code value="271244005"/>
<display value="Measurement of serum lipid level"/>
<target>
<code value="24331-1"/>
<display value="Lipid 1996 panel - Serum or Plasma"/>
<equivalence value="inexact"/>
<comment
value="The LOINC panel is cholesterol, HDL, calculated LDL and triglyceride. An England lipid profile usually adds non-HDL cholesterol and the cholesterol/HDL ratio."/>
</target>
</element>
<element>
<code value="135842001"/>
<display value="Serum C reactive protein level"/>
<target>
<code value="1988-5"/>
<display value="C reactive protein [Mass/volume] in Serum or Plasma"/>
<equivalence value="wider"/>
<comment
value="The LOINC code is serum or plasma; the SNOMED CT concept is serum. High sensitivity CRP is a different code (30522-7)."/>
</target>
</element>
<element>
<code value="371981000000106"/>
<display
value="Hb A1c (Haemoglobin A1c) measurement - IFCC (International Federation of Clinical Chemistry and Laboratory Medicine) standardised"/>
<target>
<code value="59261-8"/>
<display
value="Hemoglobin A1c/Hemoglobin.total standardized per IFCC-RMP for CDT in Blood"/>
<equivalence value="equivalent"/>
<comment value="IFCC standardised HbA1c, reported in mmol/mol."/>
</target>
</element>
<element>
<code value="47758006"/>
<display value="Hepatitis B surface antigen measurement"/>
<target>
<code value="5195-3"/>
<display value="Hepatitis B virus surface Ag [Presence] in Serum"/>
<equivalence value="narrower"/>
<comment
value="The LOINC code is a qualitative (presence) test in serum; the SNOMED CT concept does not give the scale or specimen."/>
</target>
</element>
<element>
<code value="700152009"/>
<display value="Human papilloma virus screening"/>
<target>
<code value="82675-0"/>
<display
value="Human papilloma virus 16+18+31+33+35+39+45+51+52+56+58+59+66+68 DNA [Presence] in Cervix by NAA with probe detection"/>
<equivalence value="narrower"/>
<comment
value="High risk HPV as tested in NHS cervical screening. The LOINC code names the HPV types, specimen and method, so the right code depends on the assay."/>
</target>
</element>
<element>
<code value="113076002"/>
<display value="Glucose tolerance test"/>
<target>
<code value="72171-2"/>
<display value="Glucose tolerance 2 hours panel - Serum or Plasma"/>
<equivalence value="narrower"/>
<comment
value="The 2 hour (75 g) oral glucose tolerance test. Gestational and other protocols have other LOINC panels."/>
</target>
</element>
<element>
<code value="401324008"/>
<display value="Urinary microscopy, culture and sensitivities"/>
<target>
<code value="50554-5"/>
<display
value="Urinalysis microscopic panel [#/volume] - Urine by Automated count"/>
<equivalence value="narrower"/>
<comment
value="No single LOINC order code for urine MC&S: it maps to microscopy, culture and susceptibility. Manual microscopy has other LOINC panels."/>
</target>
<target>
<code value="630-4"/>
<display value="Bacteria identified in Urine by Culture"/>
<equivalence value="narrower"/>
<comment value="The culture part of urine MC&S."/>
</target>
<target>
<code value="29576-6"/>
<display value="Bacterial susceptibility panel"/>
<equivalence value="narrower"/>
<comment value="The sensitivities part of urine MC&S."/>
</target>
</element>
</group>
</ConceptMap>