PRA - Practitioner Detail Segment

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 Segment

Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
PRA
1	Primary Key Value - PRA	CWE	C	0681	[0..1]	00685
2	Practitioner Group	CWE	O	0358 Practitioner Group	[0..*]	00686
3	Practitioner Category	CWE	O	0186 Practitioner Category	[0..*]	00687
4	Provider Billing	ID	O	0187(R) Provider Billing(Required)	[0..1]	00688	[1..1]
5	Specialty	SPD	O	0337(R) Certification Status(Required)	[0..*]	00689
6	Practitioner ID Numbers	PLN	B	0338(S) Practitioner ID Number Type(Suggested)	[0..*]	00690
7	Privileges	PIP	O		[0..*]	00691
8	Date Entered Practice	DT	O		[0..1]	01296
9	Institution	CWE	O	0537 Institution	[0..1]	01613
10	Date Left Practice	DT	O		[0..1]	01348
11	Government Reimbursement Billing Eligibility	CWE	O	0401 Government Reimbursement Program	[0..*]	01388
12	Set ID - PRA	SI	C		[0..1]	01616	[1..4]

PRA-1: Primary Key Value - PRA (CWE) 00685

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.

PRA-2: Practitioner Group (CWE) 00686

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.

PRA-3: Practitioner Category (CWE) 00687

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.

PRA-4: Provider Billing (ID) 00688

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.

PRA-5: Specialty (SPD) 00689

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.

PRA-6: Practitioner ID Numbers (PLN) 00690

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).

PRA-7: Privileges (PIP) 00691

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 (^).

PRA-8: Date Entered Practice (DT) 01296

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).

PRA-9: Institution (CWE) 01613

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.

PRA-10: Date Left Practice (DT) 01348

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).

PRA-11: Government Reimbursement Billing Eligibility (CWE) 01388

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.

PRA-12: Set ID - PRA (SI) 01616

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.