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New Comprehensive Hierarchy for Providers, Visits (and Place of Service, Specialty, Care Site)


(Christian Reich) #43

All good now. Check it out.

NOOOOOO!!! They are all there, standard and happy. But:

  • They now roll up in the hierarchy to the top 12
  • They are deduped, so if CMS Place of Service and NUCC have the same concept one of them became standard, and the other one become source, with a Maps to relationship. Like everywhere else.

All there. I think it works, but you guys need to make it fly.


Place of service, no standard concept equal S
(Adam Black) #44

Thanks for everyone’s work on this. It is very helpful. In using this hierarchy I have a couple questions. It looks like the “Telehealth” place of service code (concept_id = 5083) does not roll up into a visit type. Is this because telehealth encounters are not considered visits since they do not involve a patient going to a care site?

Another issue is the “Other Place of Service” code (concept_id = 8844) which seems to be used heavily. It has no standard concept. Maybe this is an ETL question but I’m wondering how people handle this code when creating visits.


(Christian Reich) #45

Correct. It’s a “top dog”. Like Inpatient and Outpatient.

It does. It’s concept_id=0. So-called Flavor of Null. We don’t know what it is.


(Adam Black) #46

Thanks @Christian_Reich. So would you create a record for a telehealth encounter in the visit_occurrence table and if so what would the visit_concept_id be? According to the CDM documentation the visit_concept_id must be in the visit vocabulary. Would it be incorrect to put the Telehealth concept_id (5083) in the visit_concept_id field?


(Christian Reich) #47

Almost. It must be in the Visit Domain. So, 5083 “Telehealth” is just fine.


(Christian Reich) #48

And fixed the documentation.


(Adam Black) #49

I have another question and I think it belongs on this thread. Suppose I am creating a CARE_SITE record for a hospital with an associated taxonomy code from the NUCC vocabulary of 282N00000X (General Acute Care Hospital). What should go in the place_of_service_concept_id field? Does place_of_service_concept_id need to be a standard concept in the place_of_service domain?

General Acute Care Hospital is a standard concept which rolls up to Inpatient Hospital but both are in the visit domain so I’m not sure if it they belong in the CARE_SITE.place_of_service_concept_id field.


(Christian Reich) #50

Oh. You found an lapse. The VISIT_OCCURRENCE table defines the care constellation, not the CARE_SITE table. In other words - a Care Site is not limited to a single way the care is provided. The same Care Site can have an office and an ambulatory surgery in the same instance. Put an issue in. Thanks, @Adam_Black


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