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Multiple Modifier with Single Procedure


(Tarun Shah) #1

There are multiple modifiers mapped with single procedure. Do we have to insert row for each modifier in PROCEDURE_OCCURRENCE?

(Don Torok) #2

An example of what you are experiencing will help in answering your question.

(Melanie Philofsky) #3

You don’t have to and I would definitely assess the time cost versus the return before adding multiple modifiers to the CDM.
Many of the CPT4 modifiers are not related to the clinical aspect of a Procedure and are instead supplemental facts for billing purposes and/or additional information needed for healthcare workflow. See the list of modifiers. I would critically analyze the data and then make a decision on whether all the modifiers are necessary for your use cases.

(Tarun Shah) #4

Hi, @MPhilofsky
How can we differentiate Modifiers in clinical, supplemental and as additional information. Also what if there are two clinical modifiers are attached?

(Melanie Philofsky) #5

Hi @TMS,

Have a clinical informatician assess the data. I suggest writing some SQL to pull the data into a csv:

count (*)
FROM Your data source
4 desc

I think this will be a rare occurrence. But you can add another row in your Procedure table with procedure_concept_id = 0 (you don’t want to repeat the procedure_concept_id because your Person only got one Procedure) and then the modifier in the modifier_concept_id and link them using the Fact Relationship table. O