Platelet count lab test (2.16.840.1.113762.1.4.1045.127) includes 10 LOINC codes; however they represent different LOINC properties. 6 codes are Number Concentrations (count/vol), 1 code is panel of child codes, 1 code is a numeric fraction, 1 code is a threshold, and 1 code is an entitic volume.

The code representing the panel will likely not be an issue since there would not be a result associated with the panel. The other three codes are ambiguous about what should be sent, how it should be represented, and how it will be used for risk adjustment. 

• The numeric fraction will be unitless. The recommended UCUM units in the CMS-844 specification and CMS Implementation Guides do not align with this unitless value.
• The threshold code may be a string result of 'Yes' or 'No'. There is no numeric value that could be sent.
• The entitic volume has a LOINC-suggested unit of fL (femtoliter). This does not align with the recommended UCUM units in the CMS-844 specification or the CMS Implementation Guide. Comparison against a "count/vol" doesn't seem appropriate. Additionally, "Mean Platelet Volume" and "Platelets #/vol" exist in the same lab panel and are frequently resulted at the same time. Since only one result for "Platelet count lab test" should be sent per encounter, it is system dependent on which value would be sent. 

Is the value set name informative, and should only Number Concentrations be sent? If it is possible by implementing vendors, should any value within the value set be prioritized so that we could provide more meaningful values to CMS? Or should any value for any of the 10 codes be allowable?

If all 10 codes should remain in the value set, we'd recommend minor adjustments to the CMS Implementation Guide and future CMS-844 specifications to adjust the recommended units.