Representing Alcohol Use

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Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Standard for observations
Rating 1
Standard for observation values
Feedback Requested
Limitations, Dependencies, and Preconditions for Consideration Applicable Value Set(s) and Starter Set(s)
  • The Alcohol Use Disorder Identification Test - Consumption [AUDIT-C] consists of the first 3 questions of the World Health Organization’s 10-question AUDIT alcohol screening that can help identify patients who are hazardous drinkers or have active alcohol use disorders (including alcohol abuse or dependence), is best suited for this interoperability need.
  • See LOINC projects in the Interoperability Proving Ground. 
  • For more information about observations and observation values, see Appendix III for an informational resource developed by the Health IT Standards Committee. 

AUDIT-C panel (LOINC® code 72109-2)

AUDIT-C member codes

   LOINC® code 68518-0 (with LOINC® answer list ID LL2179-1)

   LOINC® code 68519-8 (with LOINC® answer list ID LL2180-9)

   LOINC® code 68520-6 (with LOINC® answer list ID LL2181-7)

   AUDIT-C total score (LOINC® code 75626-2)

AUDIT panel (LOINC code 72110-0)

AUDIT panel total score (LOINC code 75624-7)


Consider adding additional screening tools

The Joint Commission currently has 3 chart-abstracted quality measures screening for alcohol use and treatment (SUB-1, SUB-2/2a, and SUB-3/3a) that are used by The Joint Commission and CMS in quality reporting programs.  We agree with inclusion of the Audit-C, as that is a validated screening tool for unhealthy alcohol use.  However, we also think that the AUDIT tool should be included as well.  This tool is also a validated survey instrument, and seems to be the most commonly used one for our chart-abstracted measures.  LOINC currently has 72110-0 Alcohol Use Disorder Identification Test [AUDIT] and 75624-7 Total Score [AUDIT].  In order for use, the rest of the questions from the survey instrument would need to be added in LOINC as well as the LOINC answer lists.

NCPDP - Comments

SNOMED – Not currently used in NCPDP MMA mandated standards. Future versions of the NCPDP SCRIPT standard support SNOMED.

AUDIT 10-question panel

Thank you for your comment.  We have added the full AUDIT panel code and the total score code.  This does not imply any requirement for an EHR or other health IT system to capture the AUDIT test questions or total score, but we recognize that this test may currently be in use.

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.

NCPDP Comment

  1. Alcohol Use reporting via SNOMED codes is available in the NCPDP SCRIPT Standard Version 2017071.

Type-Implementation Specification

Standard Implementation/Specification- NCPDP SCRIPT Standard, Implementation Guide, Version 2017071

Standards Process Maturity – Final

Implementation Maturity- Pilot

Adoption Level – 1

Federally Required – No

Cost – $

Test Tool Availability – Yes.