Other Provider vs Other Operating Provider

[Stanley Zhu]

Hi BCDA team,

I am asking for a clarification with the mapping of CCLF1 field OTHR_PRVDR_NPI_NUM which codes as "otheroperating". The CCLF specifications do not refer to this field as "Other operating provider", just "Other provider" so I'm wondering which one is it really?

Best,

Stanley

[Beneficiary Claims Data API (BCDA) Community]

Hi Stanley,

Thanks for the question. The mapping of this field to CCLF1's OTHR_PRVDR_NPI_NUM is correct, it is populated with the NPI of "other" providers, and is not restricted to "other operating" providers.

The code otheroperating was selected for this field to conform with the CARIN IG For Blue Button's Care Team Role Code System. We can include a note in the BCDA Data Dictionary to make it clear that this value is not restricted to operating providers, and we'll re-evaluate the mapping to this code system ahead of the upcoming BCDA v3.

Thanks,
The BCDA team