Smoking Status

N. Anthracite: e-mail 8-Oct-2012
I have made it through almost 50 pages of the 130 in the Federal Register version of the release of the Final Rule for MU Stage 2. There are certainly some interesting things that have come up and I will be mentioning them in some emails, hopefully separating threads to help us be able to look back on these things.

One is that two more categories for Smoking Status have been added with SNOMED codes to match. THEY CAN BE USED NOW if Matt, George and Sam want to tackle them. The list is in the attached screen capture so I there is not question of Typos as well as in the attached spreadsheet where I would appreciate it if typos are recognized that you let me know about them. As for SNOMED itself, both the JULY 2012 International and MARCH 2012 US Extensions are the SNOMED standard for the 2014 EHR Certification Criteria.

Note that the text of the document defines light and heavy tobacco smoker and cigars and pipes are there but not defined. Heavy is 10 or more cigarettes and Light is less than that. The mapping can be done internally to make these selections work for MU Stage I. It  is not required that the text of the description be what the provider picks, only that it be mapped internally to this, so 1 PPD might be selected and mapped to Heavy tobacco smoker &/or Current every day smoker and at least one of the latter both text and code must be used in transition of care documents to pass the certification criteria. This was apparently done to help make it easier to align the Meaningful Use and NQF standards.

BTW, there is a MU common dataset but it is not the only content needed in these documents that are needed for this stage, but Smoking Status is in the MU Common Dataset.

Description                                            SNOMED CT ID Current every day smoker                               449868002 Current some day smoker                                48041000124106 Former smoker                                          8517006 Never smoker                                           266919005 Smoker, current status unknown                         77176002 Unknown if ever smoked                                 266927001 Heavy tobacco Smoker                                   428071000124103 Light tobacco smoker                                   428061000124105

% less than 10 cigarettes or undefined cigars or pipes
 * > or = 10 cigarettes or ill defined cigars or pipes