Provisional Codes in Value Sets
In response to the COVID-19 pandemic, VSAC has adapted to our users' needs for provisional codes that several standard terminologies are currently producing and frequently updating.The following standard terminologies (CPT®, HCPCS, ICD-10-PCS, LOINC® and RxNorm) have added provisional, pre-release codes in response to the COVID-19 pandemic, based on the most up to date information available at the time of their creation:
|Code System||VSAC Code System Version*||Additional Information|
|CPT||Provisional_2020-11-25||CPT COVID-19 coding and guidance|
|HCPCS||Provisional_2020-06-30||COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing|
|ICD-10-PCS||Provisional_2020-10-19||2021 ICD-10-PCS COVID-19 UPDATE
In response to the COVID-19 public health emergency, the Centers for Medicare and Medicaid Services (CMS) is implementing 12 new procedure codes to describe the introduction or infusion of therapeutics into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective August 01, 2020.
|LOINC||Provisional_2020-11-30||LOINC Prerelease Terms, Special Use Codes Only
A new version of LOINC (2.68) was released by Regenstrief in June, 2020. Prerelease Terms up through June 17, 2020 are now included in LOINC 2.68. Any LOINC Prerelease Terms created by LOINC after June 17, 2020 will remain available in VSAC as Provisional Codes.
|RXNORM||Provisional_2020-11-25||Investigational Drugs in RxNorm
Bamlanivimab, a drug allowed under the U.S. Food & Drug Administration Emergency Use Authorization (EUA), was made available in the RxNorm November 12, 2020 weekly releases from the RxNorm Files page. Bamlanivimab will also be included in the RxNorm December 2020 Monthly releases.
*The “VSAC Code System Version” designation is a VSAC-created element based on the VSAC acquisition date of the provisional codes. Each provisional code system version contains all provisional codes, cumulatively, until the terminology incorporates their provisional codes into a formal release.
Be aware that downstream users may not be ready to handle prerelease codes until they are published in an official terminology release.
UPDATED July 2, 2020: How to Include Provisional Codes in Your Value Set
VSAC now includes provisional code system versions within the “Most Recent Code System Versions in VSAC” default expansion profile calculation. You no longer need to perform a special Expand/Publish step when you create value sets that include provisional codes.
We recommend you click Approve to produce your automatically updating “Latest” published value set expansion for your users.
The major benefit to this method is that you can use the value set’s “Latest” URL on web pages. This “Latest” URL will always be constant so you will not have to update the URL on your web pages when you update your value set.
Linking to the “Latest” expansion URL on your web pages will ensure that your users always connect to your correct value set expansion (code list) as the terminologies update and promote their provisional codes to official codes in official version releases. Here is an example of a “Latest” expansion URL: https://vsac.nlm.nih.gov/valueset/2.16.840.1.1137126.96.36.1994.9/expansion/Latest
Any questions? Please Contact Us!
Here are the steps you need to take in the Authoring Tool of VSAC (Authoring Permissions are a Prerequisite)
- Choose the provisional code system version to search for and select your desired codes.
- Read the provisional code disclaimer.
- Search, select, and add your desired codes to your value set.
- Save your value set, and then Submit and Approve it as well. It is critical that you Approve your value set for publication.
- Click the Expansion/Publication tab if you wish to keep a specific expanded code list in addition to your automatically updated "Latest" version.
- Choose Expansion Profile = "Most Recent Code System Versions in VSAC".
- Click the Expand/Publish button (if desired) to publish your value set into the public repository, "Search Value Sets".
Last Reviewed: November 30, 2020