We are trying to decide what to do with procedure modifiers in our data.
The problem (as usual) is that the corresponding procedure codes map to different domains, but only Procedure_occurrence table has the place for a modifier (modifier_concept_id).
Usually we solve this problem by mapping modifiers separately from procedure codes and then linking them in fact_relationship. But it looks really complicated for the end-user of data. Most likely no one will use fact_relationship to look for the related records.
Now we would like to go another way.
We looked at the pairs (procedure code - modifier) with top counts for each of the domain and we would like to do the following solutions:
Procedure - map all modifiers to modifier_concept_id field
Observation - ignore modifier data
- Hospital outpatient clinic visit for assessment and management of a patient - Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
- Ground mileage, per statute mile - Bachelors degree level
- Ambulance service, basic life support, non-emergency transport, (bls) - Bachelors degree level
- Mobility: walking & moving around functional limitation … - Services delivered under an outpatient physical therapy plan of care
- Travel allowance one way in connection with medically necessary … - Laboratory round trip
- Ground mileage, per statute mile - Integrated mental health/substance abuse program
Measurement - ignore modifier data
- Prothrombin time - Clia waived test
- Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) … - Professional Component
- Thyroid stimulating hormone (TSH) - Reference (Outside) Laboratory
- Lipoprotein, direct measurement; LDL cholesterol - Distinct Procedural Service
- Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin … - Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps
Drug - map modifiers meaning route of administration to route_concept_id and ignore other modifiers
- Injection, epoetin alfa, 100 units (for esrd on dialysis) - Administered intravenously
- Injection, epoetin alfa, (for non-esrd use), 1000 units - Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy
- Albuterol, inhalation solution, fda-approved final product … - Single drug unit dose formulation
- Injection, epoetin alfa, 100 units (for esrd on dialysis) - Administered subcutaneously
Device - ignore modifier data
- Oxygen concentrator, single delivery port, capable of… - Rental (use the ‘rr’ modifier when dme is to be rented)
- Filter, disposable, used with positive airway pressure device - New equipment
Is it a good idea? What do you think?