Computer Codes for MTM Proposed to National Library of Medicine

May 17, 2011

Collaborating organizations take the next step toward enabling pharmacists to document MTM services into patients' electronic records.

Earlier this month, 341 computer-friendly definitions for various aspects of medication therapy management (MTM) were submitted to the National Library of Medicine (NLM), marking a significant step toward the long-term goal of enabling pharmacists to document MTM services in their patients’ electronic health records.

In March, the Pharmacist Services Technical Advisory Coalition (PSTAC) and the Pharmacy e-Health Information Technology (HIT) Collaborative submitted the MTM-related definitions for proposed Systematized Nomenclature of Medicine—Clinical Terms (SNOMED CT) codes to NLM, part of the US Department of Health and Human Services and the US member of the International Health Terminology Standards Development Organization (IHTSDO).

SNOMED CT, a library of clinical terminology codes, has been adopted as the standard for HIT by NLM. The development of codes is one moving part in the process of computerization of medical records. Pharmacy organizations are working on coding for pharmacist-provided services to ensure pharmacists can document and exchange clinical information.

Some of the 341 MTM definitions match current SNOMED CT codes and will be submitted by NLM to IHTSDO for the international organization’s biennial release of updated SNOMED CT codes in July. The remaining MTM definitions will be whittled down by NLM to produce a final set of MTM definitions by July that will be submitted to IHTSDO in September; in January 2012, IHTSDO will accept some and reject other MTM definitions, and NLM will develop the rejected ones into SNOMED CT codes for use only in the United States. The entire set of SNOMED CT codes for MTM will be complete by the end of March 2012, according to the American Pharmacists Association (APhA).

By way of example, one MTM definition that doesn’t yet have a SNOMED CT code is “hypertension medication review for a new patient,” according Rachelle F. Spiro, BPharm, FASCP, Director of the Pharmacy e-HIT Collaborative.The closest existing SNOMED CT code to the “hypertension medication review for a new patient” definition is a code simply for medication review, which is too general to accurately document a very specific MTM service. So PSTAC and the collaborative submitted the “hypertension medication review for a new patient” definition for a proposed new SNOMED CT code, making the broad concept of medication review more fine-grained. NLM could change this definition if, say, the part of the definition that specifies a new patient will be documented elsewhere in the EHR. Such changes will lead to the final set of MTM definitions this July.

Once the SNOMED CT codes for MTM are published, the collaborative and its individual member pharmacy organizations, including APhA, can educate pharmacists on how to use the codes, and promote adoption within pharmacy practice management systems, according to a document from the collaborative.

“APhA remains committed to ensuring pharmacists have access to and are able to contribute to the electronic health record to move MTM forward,” said James Owen, PharmD, Senior Director of Professional Practice at APhA, in a statement. “APhA’s involvement in these initiatives reinforces the Association’s commitment to address pharmacists’ needs in the HIT environment.”