P04 KE-P04 · outpatient visit

One row per condition family: what the record supports under the published definition, what the note states, the visit's diagnosis entries, and an assessment. Codes are coded from the signed documentation; the software never assigns one.

Library check LRUN-00004 · library_default_set@1.0 · library-engine 1.0 · replay c5f6663f69e18f08… · Data (JSON)

Draft query: Osteoporosis / osteopenia (bone density)

Blocked by the query linter

A non-leading clarification request: clinical indicators with their sources, an open question, several options plus "other" and "unable to determine". No code and no payment word; the same indicators cannot be queried twice.

DOCUMENTATION QUERY (draft) for KE-P04 · bone_density
Title: Clarification request: bone density results
Encounter: KE-P04   Patient: P04   To: author of the draft note
From: (no named sender: sign in to send)
Date: 2026-11-13   Rule versions: who1994_osteoporosis@1.0, library_default_set@1.0   Check run: LRUN-00004

Clinical indicators from the health record:
- Documented in the record: "Osteopenia" [draft note KN-P04-1, characters 110-120]
- T-score -2.7 (2026-10-11 09:00) [measurement LM-P04-01]

Question:
Based on your independent clinical judgement, can the documentation be further specified in light of the bone density results listed above?

Response options (select one or write your own):
( ) Age-related osteoporosis without current pathological fracture
( ) Osteopenia (low bone mass)
( ) Not clinically significant for this encounter
( ) Other (please specify): ____________
( ) Unable to determine

Please respond based on your independent clinical judgement. Any response, including "unable to determine", is acceptable. This query and your response are kept as part of the health record.

error · no_sender: A query needs a named human sender (sign in).

Condition families for this encounter (1)
Condition family	What the record supports	What the note states	Visit diagnosis entries	Assessment
Osteoporosis / osteopenia (bone density) measured	`who1994_osteoporosis@1.0` Draft · pending review Osteoporosis: 2.5 SD or more below the young adult mean bmd t score -2.7 SD 2026-10-11 09:00 · LM-P04-01 Window: 1095 days before the check. Citation Osteoporosis and osteopenia by BMD T-score (WHO 1994) who1994_osteoporosis@1.0 Normal. A value for BMD or BMC within 1 SD of the young adult reference mean. Low bone mass (osteopenia). ... more than 1 SD below the young adult mean but less than 2.5 SD below this value. Osteoporosis. ... 2.5 SD or more below the young adult mean. World Health Organization, Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO Study Group (WHO Technical Report Series 843) (1994) · Section 2.1 Definitions, printed pages 5-6 (PDF pages 11-12) · source Contested: T-score categories were defined for postmenopausal (white) women; their use in men and other populations relies on later bodies (e.g. ISCD), which were not opened; the report itself calls cut-off values 'somewhat arbitrary'. Not encoded: Men, premenopausal women and children: the report states the categories for women; not assessable. The site, technique, equipment and reference population (the report notes individuals 'will be categorized differently according to the site and technique') are not checked; the lowest T-score passed is used. Fracture risk (e.g. FRAX) is not assessed.	Osteopenia	None entered	Supported, but entered or stated less specifically than the record supports the category written in the note differs from the one the values meet Draft a query
Code-family reference: Osteoporosis / osteopenia (bone density) Coders only reference for coders — the clinician's documented statement governs; the software does not assign codes `M81` Osteoporosis without current pathological fracture: distinguishes osteoporosis without current pathological fracture: age-related, localized, other (3 codes in the category). `M81.0` Age-related osteoporosis without current pathological fracture `M81.6` Localized osteoporosis [Lequesne] `M81.8` Other osteoporosis without current pathological fracture `M80` Osteoporosis with current pathological fracture: distinguishes osteoporosis with current pathological fracture, by type, site and laterality, with encounter and healing 7th characters (324 codes in the category). 324 codes; see the official files `M85` Other disorders of bone density and structure: distinguishes M85.8- other specified disorders of bone density and structure (used for osteopenia), by site and laterality (169 codes in the category). 169 codes; see the official files Codes in this family for the category the record supports: `M81.0` Age-related osteoporosis without current pathological fracture; `M81.6` Localized osteoporosis [Lequesne]; `M81.8` Other osteoporosis without current pathological fracture. Source: official ICD-10-CM FY2027 code descriptions (extract in library/data/code_reference_fy2027.json).