Stream: CARIN IG for Blue Button®
Topic: EOB Search Parameter
Bapi Behera (Aug 31 2020 at 18:48):
In EOB IG, Search parameter - EOB.identifier, CPCDS element is mapped to Rx Number. My question is, this parameter should be searched along with Patient demographics details. Agree??
Because the Rx Number is not unique across. Please suggest.
https://build.fhir.org/ig/HL7/carin-bb/search.html
Karl M. Davis (Aug 31 2020 at 18:53):
Your organization really doesn't have a unique ID for pharmacy claims/events?
Karl M. Davis (Aug 31 2020 at 18:55):
(As an aside: you can always construct a synthetic one by concatenating patient ID with the prescription ID, if those two fields are what you use internally as primary keys, e.g. "patient123-rx456".)
Bapi Behera (Aug 31 2020 at 19:12):
Karl M. Davis said:
Your organization really doesn't have a unique ID for pharmacy claims/events?
Karl,
Per CPCDS, the mapping element is RxNum from pharmacy. Not the claim# in receiving system. The same RxNum can be generated form different pharmacies. So its not unique. Again that's a search parameter. If the rxNum +Patient demographics included in the search criteria it can return the Unique EOB record.
Karl M. Davis (Aug 31 2020 at 19:13):
If it's not unique by pharmacy, then I'd guess that even patient+rx isn't always unique. You'll likely have to add in pharmacy ID, as well.
Karl M. Davis (Aug 31 2020 at 19:16):
Re: the wider question with CPCDS, as I recall (though hopefully @Amol Vyas or @Pat Taylor will chime in), the CPCDS' mappings aren't normative -- they're there to be helpful if they happen to work for you.
You should probably submit a formal request to have that updated in the mapping, though, since I'm sure you're not the only org it's true for, so it'd be good to get it fixed.
Josh Mandel (Aug 31 2020 at 21:01):
CPCDS' mappings aren't normative -- they're there to be helpful if they happen to work for you.
Agree strongly with this reminder. The latest spec draft should make this clear -- from the change log:
Eliminated CPCDS mapping table in Coverage intro. CPCDS information is to be moved to an external reference only based on FW WG direction.
Josh Mandel (Aug 31 2020 at 21:02):
I guess that's just for Coverage though? http://build.fhir.org/ig/HL7/carin-bb/Common_Payer_Consumer_Data_Set.html doesn't make this point crystal clear.
Pat Taylor (Sep 08 2020 at 16:17):
The CPCDS data element, RX service reference number, is mapped to identifier. It is equivalent to a claim number on a medical claims. For search purposes, the member / patient has already been identified. So the identifier search would be the RX service reference number for that patient.
Mona O (Sep 16 2020 at 01:56):
Pat Taylor said:
The CPCDS data element, RX service reference number, is mapped to identifier. It is equivalent to a claim number on a medical claims. For search purposes, the member / patient has already been identified. So the identifier search would be the RX service reference number for that patient.
Please disregard.
@Pat Taylor , based on your comment that Rx service reference number is the equivalent to a claim number on a medical claim then is "MR" the appropriate identifier type code that should be used for pharmacy claims?
Last updated: Apr 12 2022 at 19:14 UTC
