We want to distinguish between principal and secondary procedures. We are considering two possible fields in procedure_occurrence table, but neither seems to have an existing proper mapping.
One potential option is to use modifier field, but we did not find a proper modifier value that we could use to denote principal procedure or secondary procedure.
Another potential option is to use procedure_concept_type_id. We see some valuable options such as 44786630 and 44786631 concept_ids, but these are non-standard codes, and they don’t have an equivalent standard value. They also don’t distinguish the source of the procedure code (e.g. hospital billing vs physician billing).
Can someone recommend how to distinguish between principal and secondary procedures?
There is no “standard” way to distinguish between principal and secondary procedures. As always, do you have a “use case” for keeping this information? Assuming you do, do not override the meaning of an existing CDM column. Since your “use case” is specific to you CDM instance add a column to your Procedure Occurrence table to hold a value that will distinguish between principal and secondary procedures.
As for hospital billing vs physician billing, there are the types 32844 [Facility claim] and 32871 [Professional claim].