CCN vs. PTAN

[Susan Mehle]

In my list of participating providers, about half of the numbers listed as CCNs included text. Upon investigating, I have found that these are actually PTANs. Exposing my absolute ignorance here, but has anyone else had this issue? I had to ask what a PTAN was, here is the response I received:

"PTAN = Provider Transaction Access Number.  It is the 'legacy' number on the Part B side of Medicare, just as the CCN is the legacy number for Part A of Medicare."

Is there some sort of cross reference for CCNs and PTANs? Will the PTANs work in the "1_user_specification.sas" program? Thank you for your assistance with this.

[Elizabeth Bailey]

Hi Susan,

We built the package around CCNs because we were informed by CMMI that the CCN would be the only unencrypted provider identifier included in the files, which is great for facility-specific analysis but trickier for physician group-specific analysis. Though we have not tested the package using PTANs, I am doubtful that they would work given that everything was built around CCN. 

If your goal is to perform an analysis for a group or groups of physicians, you could still use the CCNs of the facilities with which those particular physicians contract and then do a patient level validation to verify that the patients with episodes in the analysis are indeed the patients of those physicians. For instance, if you have a community ortho group and they want to review all of their cases for MS-DRGs 470 and 469 at Hospitals A, B, and C, you could limit the data run to A, B, and C's CCNs and identify the patients for inclusion by cross-referencing the Freeware outputs with medical record review.

--
Elizabeth (Siteman) Bailey

Program Implementation Leader

Central Region

Health Care Incentives Improvement Institute

(e): elizabet...@hci3.org

(o): 989.486.1428

(c): 757.630.4235

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[Susan Mehle]

Thanks, I will let the rest of my team know. I appreciate the help!