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BCDA-8126: Add NDC and ADM_TYP_CD to PAC Data Dictionary #210

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merged 5 commits into from
Aug 9, 2024

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greg-pf
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@greg-pf greg-pf commented Aug 6, 2024

🎫 Ticket

https://jira.cms.gov/browse/BCDA-8126

🛠 Changes

  1. Uploaded a new version of the Partially Adjudicated Claims Data Dictionary with the following changes:

a) Added the following rows to the Institutional-FISS tab

FISS Business Name Field Name Field Description Additional Information CCLF File CCLF FIeld CMS Code List, if any FHIR Resource (C= claim, CR = claim response) FHIR R4 Element FHIRPath Hard-coded Values for Sandbox Data
National Drug Code (NDC) NDC This field identifies the NDC assigned to each medication.   No direct equivalent No direct equivalent None C item[N].detail[N].productOrService.coding[N].code item[%n].productOrService.extension.where(url='http://hl7.org/fhir/sid/ndc').valueCoding.code  
National Drug Code (NDC) Quantity NDC-QTY This field identifies the quantity of the NDC medication administered.   No direct equivalent No direct equivalent None C item[N].detail[N].quantity.value item[%n].quantity.value  
National Drug Code (NDC) Quantity Qualifier NDC-QTY-QUAL This field identifies the measurement qualifier for the quantity of the NDC medication administered   No direct equivalent No direct equivalent None C item[N].detail[N].quantity.unit item[%n].modifier.coding.where(system='http://unitsofmeasure.org').code  
Admission Type Code ADM-TYP-CD Indicates the type and priority of inpatient services.   CCLF1 CLM_ADMSN_TYPE _CD Claim Admission Type Code include: 0 = Blank 1 = Emergency 2 = Urgent 3 = Elective 4 = Newborn 5 = Trauma Center 6-8 = Reserved 9 = Unknown C supportingInfo[N].coding[N].code supportingInfo.where(code.coding.where(system='https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit')).code.coding.code

b) Added the following rows to the Professional-MCS tab

MCS Business Name Field Name Field Description Additional Information CCLF File CCLF Field CMS Code List, if any FHIR Resource FHIR R4 Element FHIRPath Hard-coded Values for Sandbox Data
Detail level NDC (National Drug Code) DTL-NDC This field holds the data from segment 2410-LIN03 of claims submitted in 5010A1 format.   No direct equivalent No direct equivalent None C item[N].detail[N].productOrService.coding[N].code item[%n].productOrService.extension.where(url='http://hl7.org/fhir/sid/ndc').valueCoding.code  
Detail level NDC (National Drug Code) Units NDC-UNIT-COUNT This field holds the data from 5010A format 2410 CTP04 claims.   No direct equivalent No direct equivalent None C item[N].detail[N].quantity.value item[%n].quantity.value

c) Updated the Change Log tab
d) Incremented the version # to 1.1.0 in the Overview tab
2. Reference new PAC data dictionary following the pattern established in #191
3. Remove the old PAC data dictionary

ℹ️ Context

This change updates the data dictionary for partially adjudicated claims to reflect new fields added to partially adjudicated claims in May 2024.

🧪 Validation

Deployed to staging and confirmed both file download links work as expected in the PAC Data Dictionary & PAC FAQ sections

greg-pf and others added 5 commits August 6, 2024 14:41
This version (1.1.0) includes the following changes:

Tab	Impacted Field Name	Document Change Date	Document Change Description
Institutional-FISS	National Drug Code (NDC)	8/6/2024	Added data element
Institutional-FISS	National Drug Code (NDC) Quantity	8/6/2024	Added data element
Institutional-FISS	National Drug Code (NDC) Quantity Qualifier	8/6/2024	Added data element
Institutional-FISS	Admission Type Code	8/6/2024	Added data element
Professional-MCS	Detail level NDC (National Drug Code)	8/6/2024	Added data element
Professional-MCS	Detail level NDC (National Drug Code) Units	8/6/2024	Added data element
@greg-pf greg-pf marked this pull request as ready for review August 6, 2024 19:48
@alex-dzeda
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Looks good, I've put out a clarifier to BFD on a change to an existing field as a result of new learnings that may want to be put in the same change (related to amount billed vs. amount covered)

@greg-pf greg-pf requested a review from alex-dzeda August 9, 2024 15:18
@greg-pf greg-pf merged commit e6ba611 into main Aug 9, 2024
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@greg-pf greg-pf deleted the greg-pf/BCDA-8126 branch August 9, 2024 19:56
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2 participants