5.17 ED CLINICAL FINDING PRACTITIONER ID

PART OF THE MULTIPURPOSE CLINICAL FINDING GROUP (5.14 - 5.19)

Definition

Identifier for practitioner who obtains clinical finding.

Uses

The identification of the practitioner is needed for direct patient care, continuity of care, quality-of-care monitoring, health care administration, reimbursement, and research.

Discussion

In 1998, the Health Care Financing Administration (HCFA) plans to begin issuing a National Provider Identifier (NPI) to all individual practitioners and organizations that provide health care. The NPI consists of two parts: a 7-position alphanumeric identifier and a 1-position numeric check digit. A locally assigned identifier may be entered until the NPI is issued. To protect confidentiality, disclosure of practitioner- or organization-specific data must be limited to authorized personnel.

Data Type (and Field Length)

XCN - extended composite ID number and name for persons (80).

Repetition

Yes; the Multipurpose Clinical Finding Group repeats to record each clinical finding.

Field Values

Component 1 is the practitioner identifier.
Component 11 is the check digit.
Component 12 is the code indicating the check digit scheme.
Component 13 is the code indicating the identifier type.
Components 2 - 10 and 14 are not used unless needed for local purposes.

Example:

Component 1 = 4672093
Component 11 = 5
Component 12 = IBM Check
Component 13 = NPI

Enter " " in Component 1 if the practitioner has no identifier, and enter Unknown if it is not known whether the practitioner has an identifier. Entries in all other components can be " " (none) or Unknown when appropriate, and entries in Components 2 - 10 and 14 need not be made when they are not necessary.

Data Standards or Guidelines

National Provider Identifier/National Provider File (HCFA, 1995) and Establishing and Maintaining the National Provider Identifier (NPI) Effort in Carrier Operations (HCFA, 1996).

Other References

None.