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18.8.124 PRA - Practitioner Detail Segment (15.4.6)

The Technical Steward for the PRA segment is PA and Personnel Management.

The PRA segment adds detailed medical practitioner information to the personnel identified by the STF segment. A PRA segment may optionally follow an STF segment. A PRA segment must always have been preceded by a corresponding STF segment. The PRA segment may also be used for staff who work in healthcare who are not practitioners but need to be certified, e.g., "medical records staff."

HL7 Attribute Table - PRA - Practitioner Detail

Base Framework
Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData Type
PRA

100685Primary Key Value - PRA
C

Condition defined for this element

MAY[0..1] PrimaryKeyValue-PRA (CD)
CWE

Coded with Exceptions

200686Practitioner Group MAY[0..*] PractitionerGroup (CD)
CWE

Coded with Exceptions

300687Practitioner Category MAY[0..*] PractitionerCategory (CD)
CWE

Coded with Exceptions

400688Provider Billing MAY[0..1][1..1]univ: ProviderBilling (CD) hl7VS-providerBilling (VS) providerBilling (CS)
ID

Coded Value for HL7 Defined Tables

500689Specialty MAY[0..*] univ: CertificationStatus (CD)
SPD

Specialty Description

600690Practitioner ID Numbers
B

backward compatible use only

SHOULD NOT  repr: PractitionerIdNumberType (CD)
PLN

Practitioner License or Other ID Number

700691Privileges MAY[0..*] 
PIP

Practitioner Institutional Privileges

801296Date Entered Practice MAY[0..1] 
DT

Date

901613Institution  MAY[0..1] Institution2 (CD)
CWE

Coded with Exceptions

1001348Date Left Practice MAY[0..1] 
DT

Date

1101388Government Reimbursement Billing Eligibility MAY[0..*] ex.:GovernmentReimbursementProgram (CD)
CWE

Coded with Exceptions

1201616Set ID - PRA
C

Condition defined for this element

MAY[0..1][1..4]
SI

Sequence ID

Conditions/Invariants

The root for the expression is on the segment.

Seq. Referenced Elements Introduction Invariant Comment
1 ?

Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData Type
PRA

100685Primary Key Value - PRA
C

Condition defined for this element

MAY[0..1] PrimaryKeyValue-PRA (CD)
CWE

Coded with Exceptions

200686Practitioner Group MAY[0..*] PractitionerGroup (CD)
CWE

Coded with Exceptions

300687Practitioner Category MAY[0..*] PractitionerCategory (CD)
CWE

Coded with Exceptions

400688Provider Billing MAY[0..1][1..1]univ: ProviderBilling (CD) hl7VS-providerBilling (VS) providerBilling (CS)
ID

Coded Value for HL7 Defined Tables

500689Specialty MAY[0..*] univ: CertificationStatus (CD) hl7VS-certificationStatus (VS) certificationStatus (CS)
SPD

Specialty Description

600690Practitioner ID Numbers
B

backward compatible use only

SHOULD NOT  repr: PractitionerIdNumberType (CD) hl7VS-practitionerIdNumberType (VS) identifierType (CS)
PLN

Practitioner License or Other ID Number

700691Privileges MAY[0..*] 
PIP

Practitioner Institutional Privileges

801296Date Entered Practice MAY[0..1] 
DT

Date

901613Institution  MAY[0..1] Institution2 (CD)
CWE

Coded with Exceptions

1001348Date Left Practice MAY[0..1] 
DT

Date

1101388Government Reimbursement Billing Eligibility MAY[0..*] ex.:GovernmentReimbursementProgram (CD)
CWE

Coded with Exceptions

1201616Set ID - PRA
C

Condition defined for this element

MAY[0..1][1..4]
SI

Sequence ID

Base FrameworkBase Standard Profile
Seq#Data ElementDescriptionFlagsImplementCardinalityLengthC.LENVocabularyData TypeImplementVocabulary
PRA 

100685Primary Key Value - PRA
C

Condition defined for this element

MAY[0..1] PrimaryKeyValue-PRA (CD)
CWE

Coded with Exceptions

MAY
200686Practitioner Group MAY[0..*] PractitionerGroup (CD)
CWE

Coded with Exceptions

MAY
300687Practitioner Category MAY[0..*] PractitionerCategory (CD)
CWE

Coded with Exceptions

MAY
400688Provider Billing MAY[0..1][1..1]univ: ProviderBilling (CD) hl7VS-providerBilling (VS) providerBilling (CS)
ID

Coded Value for HL7 Defined Tables

MAY 
500689Specialty MAY[0..*] univ: CertificationStatus (CD)
SPD

Specialty Description

MAYhl7VS-certificationStatus (VS) certificationStatus (CS)
600690Practitioner ID Numbers
B

backward compatible use only

SHOULD NOT  repr: PractitionerIdNumberType (CD)
PLN

Practitioner License or Other ID Number

SHOULD NOThl7VS-practitionerIdNumberType (VS) identifierType (CS)
700691Privileges MAY[0..*] 
PIP

Practitioner Institutional Privileges

MAY
801296Date Entered Practice MAY[0..1] 
DT

Date

MAY
901613Institution  MAY[0..1] Institution2 (CD)
CWE

Coded with Exceptions

MAY
1001348Date Left Practice MAY[0..1] 
DT

Date

MAY
1101388Government Reimbursement Billing Eligibility MAY[0..*] ex.:GovernmentReimbursementProgram (CD)
CWE

Coded with Exceptions

MAY
1201616Set ID - PRA
C

Condition defined for this element

MAY[0..1][1..4]
SI

Sequence ID

MAY
Base Framework Base Standard Profile
Seq# Data Element Description Flags Optionality Repetition Length C.LEN Table Data Type Optionality Table
PRA  

1 00685 Primary Key Value - PRA
C

Condition defined for this element

O      
CWE

Coded with Exceptions

  (0681)
2 00686 Practitioner Group   O Y    
CWE

Coded with Exceptions

  (0358)
3 00687 Practitioner Category   O Y    
CWE

Coded with Exceptions

  (0186)
4 00688 Provider Billing   O   [1..1]  
ID

Coded Value for HL7 Defined Tables

  (0187)
5 00689 Specialty   O Y    
SPD

Specialty Description

  (0337)
6 00690 Practitioner ID Numbers   B Y    
PLN

Practitioner License or Other ID Number

  (0338)
7 00691 Privileges   O Y    
PIP

Practitioner Institutional Privileges

   
8 01296 Date Entered Practice   O      
DT

Date

   
9 01613 Institution   O      
CWE

Coded with Exceptions

  (0537)
10 01348 Date Left Practice   O      
DT

Date

   
11 01388 Government Reimbursement Billing Eligibility   O Y    
CWE

Coded with Exceptions

  (0401)
12 01616 Set ID - PRA
C

Condition defined for this element

O   [1..4]  
SI

Sequence ID

   
Seq# Data Element Description Optionality Repetition Length C.LEN Table Data Type
PRA
1 00685 Primary Key Value - PRA C     (0681)
CWE

Coded with Exceptions

2 00686 Practitioner Group O Y   (0358)
CWE

Coded with Exceptions

3 00687 Practitioner Category O Y   (0186)
CWE

Coded with Exceptions

4 00688 Provider Billing O   [1..1] (0187)
ID

Coded Value for HL7 Defined Tables

5 00689 Specialty O Y   (0337)
SPD

Specialty Description

6 00690 Practitioner ID Numbers B Y   (0338)
PLN

Practitioner License or Other ID Number

7 00691 Privileges O Y    
PIP

Practitioner Institutional Privileges

8 01296 Date Entered Practice O      
DT

Date

9 01613 Institution O     (0537)
CWE

Coded with Exceptions

10 01348 Date Left Practice O      
DT

Date

11 01388 Government Reimbursement Billing Eligibility O Y   (0401)
CWE

Coded with Exceptions

12 01616 Set ID - PRA C   [1..4]  
SI

Sequence ID

18.8.124.1 PRA Field Definitions (15.4.6.0)

18.8.124.2 PRA-1 Primary Key Value - PRA (CWE) 00685 (15.4.6.1)

Definition: For MFN Master File Notification, this field is required and must match MFE-4 Primary Key Value to identify which entry is being referenced. For all other messages, this field should not be used. Refer to Table 0681 - Primary Key Value - PRA in Chapter 2C for valid values.

18.8.124.3 PRA-2 Practitioner Group (CWE) 00686 (15.4.6.2)

Definition: This field contains the name and/or code of a group of practitioners to which this practitioner belongs. Refer to User-defined Table 0358 Practitioner Group for suggested values.

Refer to User.defined Table 0358 - Practitioner Group in Chapter 2C, Code Tables, for valid values. This table contains no suggested values.

18.8.124.4 PRA-3 Practitioner Category (CWE) 00687 (15.4.6.3)

Definition: This field contains the category of practitioner. Refer to User-defined Table 0186 - Practitioner Category for suggested values. Values may include codes for staff physician, courtesy physician, resident, physician assistant, physical therapist, psychiatrist, psychologist, pharmacist, registered nurse, licensed practical nurse, licensed vocational nurse, nurse practitioner, etc. If the provider works in different Practitioner Categories in different organization units, then this information should be recorded separately in ORG-6,7,8.

Refer to User.defined Table 0186 - Practitioner Category in Chapter 2C, Code Tables, for valid values. This table contains no suggested values.

18.8.124.5 PRA-4 Provider Billing (ID) 00688 (15.4.6.4)

Definition: This field indicates how provider services are billed. Refer to HL7 Table 0187 - Provider Billing for valid values.

Refer to HL7 Table 0187 - Provider Billing for valid values. This table contains values for provider or institutional billing.

18.8.124.6 PRA-5 Specialty (SPD) 00689 (15.4.6.5)

Definition: This repeating field is made up of multiple components to record the practitioner's specialties. The multiple components of each specialty are: (1) specialty name or abbreviation, identifies provider's specialty, (2) name of specialty governing board, (3) Certification Status, (4) certified date contains the date of certification, if certified. Refer to HL7 Table 0337 - Certification Status for valid values.

Refer to HL7 Table 0337 - Certification Status in Chapter 2C, Code Tables, for valid values. This table contains values for certified or eligible.

18.8.124.7 PRA-6 Practitioner ID Numbers (PLN) 00690 (15.4.6.6)

Definition: As of version 2.5, this field has been retained for backward compatibility only. Practitioner ID numbers should be contained in STF-2 Staff Identifier List. This repeating field contains this practitioner's license numbers and other ID numbers. This is a field made up of the following components: (1) the ID number, and (2) the type of number, and optionally (3) the state or province in which it is valid, if relevant, or other qualifying information. It is recommended that state qualifications use the abbreviations from the postal service of the country. The practitioner ID number type (component 2) is a user-defined table (User-defined Table 0338 - Practitioner ID Number in Chapter 2C, Code Tables).

18.8.124.8 PRA-7 Privileges (PIP) 00691 (15.4.6.7)

Definition: This field contains the institutional privileges which this provider may exercise. Depends upon institutional needs. For example, admit, transfer, discharge, place orders, verify orders, review results, etc. Can also be used for privileges other than patient services. This is a repeating field, with each privilege made up of the following components: (1) privilege; (2) privilege class; (3) privilege expiration date, if any; (4) privilege activation date, if any, and (5) facility. Note that the privilege and privilege class components are CWE data types, and thus they are encoded with the subcomponent delimiter (&) rather than the component delimiter (^). The facility component is an EI data type specifying the facility to which the privilege applies and is encoded with the subcomponent delimiter (&) rather than the component delimiter (^). The facility component is an EI data type specifying the facility to which the privilege applies and is encoded with the subcomponent delimiter (&) rather than the component delimiter (^).

18.8.124.9 PRA-8 Date Entered Practice (DT) 01296 (15.4.6.8)

Definition: This field contains the date the practitioner began practicing at the present institution (e.g., at hospital, at physician organization, at managed care network).

18.8.124.10 PRA-9 Institution (CWE) 01613 (15.4.6.9)

Definition: This field contains the institution the practitioner began or intends to begin practicing at (e.g., at hospital, at physician organization, at managed care network). Refer to User-defined Table 0537 - Institution for valid values.

Refer to User-defined Table 0537 - Institution in Chapter 2C, Code Tables, for valid values. This table contains no suggested values.

18.8.124.11 PRA-10 Date Left Practice (DT) 01348 (15.4.6.10)

Definition: This field contains the date the practitioner ended or intends to end practicing at the given institution (e.g., at hospital, at physician organization, at managed care network).

18.8.124.12 PRA-11 Government Reimbursement Billing Eligibility (CWE) 01388 (15.4.6.11)

Definition: This field contains a code that indicates the agency that the practitioner is authorized to bill for medical services. Refer to User-defined Table 0401 - Government Reimbursement Program in Chapter 2C, Code Tables,for valid values. This table contains the associated code values for medicaid and medical. This is a repeating field.

18.8.124.13 PRA-12 Set ID - PRA (SI) 01616 (15.4.6.12)

Definition: For all messages except the Staff/Practitioner Master File Notification, this field is required and contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one; for the second occurrence, the sequence number shall be two; etc. For the Staff/Practitioner Master File Notification message, this field should not be used.