Stream: Da Vinci/plan-net-connectathon
Topic: Questions for Future Session
Robert Little (Jan 14 2021 at 19:26):
Hey team, I am starting this thread to try and get all of our questions on a single thread. My immediate questions are:
Robert Little (Jan 14 2021 at 19:28):
Best Practice for: Durable ID's for Providers that can be used between Patient Access and Provider Directory | Search Parameters required for "Includes" vs "re-includes". How do I see what is required based on the capability statement?
Saul Kravitz (Jan 14 2021 at 19:55):
Somebody asked: Recommended approach, if any, to supporting specialties that don’t conform to the NUCC standard taxonomy?
Robert Little (Jan 14 2021 at 19:57):
@Saul Kravitz That was one my Maggie's questions. We have both NUCC and a Custom specialty list that some of our customers have required us to have in order to support their Provider Directories.
Robert Little (Jan 14 2021 at 19:58):
The question comes down to, can these specialties be included in the FHIR response or do we need to drop those and only support NUCC specialties?
Saul Kravitz (Jan 14 2021 at 20:25):
The NUCC-based Value-sets are specified as 'required'. So in the current IG substitution would lead to a non-conformant instance. I think this is a good topic of discussion (with @Gail Kocher ).
Robert Little (Jan 14 2021 at 20:35):
@Margret L Mellon Howdy Ma'am, Here's a good place for our conversation around including Custom specialties along with the NUCC specialties in the FHIR Provider Directory response.
Robert Little (Jan 14 2021 at 21:14):
Good afternoon @Gail Kocher , @Margret L Mellon and I would be very interested in any information or direction you could provide to us on the Specialties topic.
Margret L Mellon (Jan 14 2021 at 21:24):
Thanks @Robert Little . @Gail Kocher , many of our clients send specialty data that doesn't conform entirely to the NUCC standard. This may be due to a business need to support fellowship-specific certifications as specialties, reflect ASAM levels of care, meet state-specific Medicaid requirements for provider directories, or any of a number of other reasons. Are there plans for the specialty codeset for the Davinci PDEX Plan Net IG to be extensible beyond NUCC? If not, should we consider crosswalking our clients' non-NUCC specialties for exposure via
the HealthcareService profile instead? Is there perhaps an even better approach that we could explore?
Margret L Mellon (Jan 14 2021 at 21:29):
@Saul Kravitz and @Gail Kocher, also, the IG points to https://nucc.org/provider-taxonomy as the base source for the codeset, but as I believe you know, that link now returns a 404, and the new reference lives at https://taxonomy.nucc.org/. Can the IG be updated to reflect this?
Saul Kravitz (Jan 14 2021 at 21:59):
@Margret L Mellon -- there is a difference between the defining URL for a Codesystem/Valueset and the human readable access URL. The official reference (at the time the IG was published) was the https://nucc.org/provider-taxonomy URL. Many of the CS/VS are like this.
Gail Kocher (Jan 15 2021 at 16:06):
@Margret L Mellon @Robert Little speaking as the NUCC Code Set Subcommittee co-chair, the code set contains codes for specialties. Payers also recognize other credentials that are not specialties.. The NUCC does not support identifying these credentials as a specialty.
Speaking as someone who participated in the IG development, I know the FHIR IG is capable of capturing these other credentials through Practitioner qualifications. The value set in Healthcareservice.type is extensible and Healthcareserivce.characteristic is available for additional characteristics about the provider when not available elsewhere.
If the state Medicaids believe there are gaps in the code set, they should be working with the Medicaid representatives to the NUCC to submit requests for consideration. Specialties are not programs or services.
Speaking with my BCBSA payer hat on, we use taxonomy codes across our system and the current code set is sufficient for Blue Plan provider data.
Margret L Mellon (Jan 15 2021 at 16:42):
Hi @Gail Kocher, thanks for your response. We recognize the NUCC taxonomy as a mature codeset, and I am not trying to lobby here for its expansion. It sounds our best bet is to extend the HealthcareService elements as needed. Has there been any discussion among the IG authors regarding additional organization or standardization of HealthcareService categories or types? FYI, I plan to join the Working Group sessions in a couple of weeks if this is a better topic for that group.
Margret L Mellon (Jan 15 2021 at 16:45):
Hi @Saul Kravitz , would it not make sense even for the defining URL for a CS/VS to point to a target that is not broken? Is it a better route, perhaps, for us to reach out to NUCC to ask them to set up a redirect from nucc.org/provider-taxonomy (currently a 404) to taxonomy.nucc.org? cc: @Gail Kocher
Margret L Mellon (Jan 15 2021 at 16:46):
(deleted)
Saul Kravitz (Jan 15 2021 at 17:33):
@Margret L Mellon A URL is true to its name (Uniform Resource Locator). For FHIR resources they are just unique identifiers.
Take ICD10 for example its defining URL is http://www.cms.gov/Medicare/Coding/ICD10. There is a corresponding human readable page at https://terminology.hl7.org/2.0.0/CodeSystem-icd10PCS.html , but within FHIR resources, if you want to refer to it you use the former.
Last updated: Apr 12 2022 at 19:14 UTC
