Representing Provider Role in Team Care Settings

Comment

Use of the NUCC Provider Taxomony

I commented on how to properly reference the NUCC Provider Taxonomy code system and a value set that represents it in the Representing Health Care Providers section. The value set has an old name that perhaps should be changed to remove the "(HIPAA)". Noting that this element exists and is the proper use of the NUCC Provider Taxonomy, there can be confusion about how those concepts should also be used in the Representing Health Care Providers section. 

NCPDP - Comment

Taxonomy codes should be added as a standard. The pharmacy industry uses this value set to determine covered practice settings.

NUCC Taxonomy is challenging…

NUCC Taxonomy is challenging.  SNOMED CT is better for this purpose, as it references ONLY the singular aspect of provider role and does not merge three separate aspects (role, setting and specialty).

NUCC is too precise

NUCC is too precise, combining specialty and setting. Providers or care team members may have more than one role or more than one care setting. The precision of NUCC essentially decreases accuracy.  

NCPDP Comment

  1. NUCC does not represent all providers, such as Assistant Physician. NCPDP worked with the appropriate provider organizations to request a new taxonomy code for Assistant Physicians. However, the request was not supported by NUCC because it is a license type versus a provider type. While CMS does not allow Assistant Physicians to enroll, CMS agreed to research internal processes to determine if a distinct taxonomy identifier could improve the process.