Exam Name Mapping in the DIR is one of the most important, yet under-appreciated, duties for those managing their facility’s DIR program. It is important inter-exam mapping is maintained. By that I mean similar studies should be assigned to the same RPID. Sounds easy, but it isn’t for a variety of reasons. First and foremost, the DIR’s RPIDs are based on RadLex Playbook developed by RSNA to provide a standard system for naming radiology procedures. The RadLex Playbook is highly granular, which is necessary when naming exams. However, that level of granularity makes maintaining DIr exam name mapping consistency a challenge as nearly all RPIDs are presented as a mapping option to DIR users.
For example, below is a table of all Lower Extremity RPIDs available in RadLex, many including details such as Right or Left. This is necessary in a name, but not so much when assigning an exam to the DIR. Also, note that there are several possible RPIDs that could be assigned for a Tibia Fibula exam.
- RPIDs 25-30: CT LE with laterality and contrast choices (6);
- RPIDs 2042 – 2050; CT Tibia Fibula with laterality and contrast choices (9); and,
- RPIDs 3468-3470; CT Tibia Fibula with contrast choices (3);
- and that does no include the more generic RPIDS also included in the table.
Staff assigned mapping duties often find it difficult to determine to which RPIDs similar exams have been assigned, which can lead to inconsistent mappings. This means one person could assign TibFib exams to the RPIDs 25-30, another could choose the 2,xxx series RPIDS, yet someone else could select the 3,xxx series RPIDs or even some of the generic ones. In my experience, not only is this possible, it is fairly common.
I encourage all facilities using the DIR to pay particular attention to their Exam Name Mappings by
- Reviewing them for consistency; and,
- Developing a Mapping Table of codes in use at your facility for reference purposes when mapping any unmapped studies as they arise.
These two steps will go a long way towards ensuring higher levels of inter-exam naming consistency.
Here is an example of one of my Mapping Tables. The box on the left indicates which categories of RPIDs for which I developed specific Mapping Tables. The box on the right represents my Mapping Table for Multiphase body exams which I want people using when mapping any new unmapped exams in this category. Obviously, if a completely new and different exam arises, we’d look for a more appropriate RPID, but the reality is that most newly unmapped studies end up being a new version of a previously mapped exam. This helps ensure the new version is assigned to the RPID we want used.
I have made my basic set of tables available for purchase on my website for $24.99. This includes my recommended RPIDs for all Types shown above. It also allows you to modify them for your own purposes. Compared to the amount of time you’d spend developing your own, $25 is a bargain. However, there is no reason you can’t build it yourself, and I encourage you to do so. You’ll make the lives of those who perform your Exam Name Mapping so much easier, and have a much more consistent set of assigned RPIDs.