Permissions Catalog: Recommendations for Reuse

Reusing the HL7 RBAC Permission Catalog Terminology
for Composite Privacy Consent Directive

Introduction

The current Permissions Catalog for Role-Based Access Control (RBAC) specifies a set of normative permissions that may grouped into functional roles for use in healthcare. The Security WG (jointly with CBCC) is currently working on a project intended to provide controlled terminology for the operations and objects referenced in the RBAC Permission Catalog (see TSC project list - item 118).

The permission catalog ad-hoc operation and object names is a normative specification and it is available for download.

• The most recently published permission catalog is 20071112_HL7_RBAC_Healthcare_Permission_Catalog_v3_37.pdf

The Community-based Collaborative Care (CBCC) work group is responsible for the maintenance and enhancement of the Data Consent standard (Release 1 approved in 2007). The Data Consent standard was enhanced and the update will continue through May 2009 (see Composite Privacy Directive Release 1, Draft for Comment).

The RBAC operations extend the typical database C(reate),R(ead),U(update),D(elete) operations and they refer specifically to the ability of healthcare users to:

• append,
• create,
• read,
• update,
• delete, and
• execute (?) "[...]results only in initiating performance of a single or set of programs."

specific healthcare "objects" identified in the RBAC Permission Catalog. The RBAC "objects" refer to a variety of healthcare information elements (e.g. Progress Notes, Summary Report) and functions (e.g. ADT). A permission specifies an operation and the object on it it is applied :

Permission
ID	Operation	Object	Effect
PAD-017	create, read	Administrative Ad Hoc Report	Create/Display/Print Administrative Ad Hoc Report {C, Administrative Ad Hoc Report} {R, Administrative Ad Hoc Report} A role that has this permission, allows the user that logs in with that role to create a new ad-hoc administrative report for any patient and read the contents of any administrative ad-hoc reports for any patient.
PRD-017	read	Progress Notes	Review Progress Notes {R, Progress Notes} A role that has this permission, allows the user that logs in with that role to review progress notes for any patient.

Sample Permission

HL7 Operations rather RBAC-only Operations

In order to reuse the RBAC operations for both RBAC and Composite Privacy Consent Directive (and perhaps other standards in the future), it would be preferable if the RBAC operations could be based on the HL7 trigger events specified in the HL7 RIM reference documentation and the HL7 RIM References included in this document. The healthcare work flow as specified in HL7, provides for "trigger events" that correspond to healthcare-specific operations. The following table is an example mapping of the HL7 trigger events to RBAC operations. As seen here, the HL7 triggers/operations are more closely related to the healthcare delivery workflow and thus they will promote the reuse of HL7 permissions.

• The current coded concept in HL7 Vocabulary is "HL7TriggerEventCode"

HL7 Operations (trigger event)	RBAC Operations	Data Consent Operation
create	create	NA - see "activate"
revise	update,append	revise
activate	update	activate
complete	update	NA
suspend	update	NA
resume	update	NA
abort	delete(?)	NA
hold	update	NA
release	update	NA
cancel	delete(?)	NA
obsolete	delete(?)	obsolete
nullify	delete(?)	nullify

Extensions to HL7 trigger events

The following operations are not currently specified in the HL7TriggerEventCodes and do not affect the state of a healthcare object but they are important to RBAC and Data Consent:

RBAC Operations	Data Consent Operation
read	read
NA	forward
NA	save
NA	print
NA	excerpt
execute	NA
NA	destroy
NA	archive

The following diagram shows the trigger events and the states that correspond to the healthcare work flow for healthcare object (e.g. Act). For example, an order may be created, activated, then canceled. Similarly an order may be created, activate, revised, and eventually completed.

Value Sets for "Object"

Currently, the Security work group is attempting to map the operations, "objects", and RBAC roles specified or referenced in the Permissions Catalog to SNOMED CT codes. However, several "objects" in the permission catalog are actually document types that have been codified for use with the CDA R2 standard. Additionally, sections of the CDA documents have been standardized by HL7. Since CDA R2 clinical documents are often used to exchange patient records between organizations, the ability to refer to specific types of documents or sections of a document may be useful both for RBAC and consent directive specifications.

HL7 Concept Domains and HL7 Coding Systems

The availability of HL7 concept domains and coding systems allows the reuse of RBAC object terminology by other standards such as Composite Privacy Consent Directive (aka Data Consent ). Concept domains may be bound to value sets that refer to external coding systems (e.g. SNOMED). Each concept domain and coded concepts in HL7, has unique identifier that allows that concept to be reused in a variety of HL7 specifications thus promoting the reuse of value sets, including value sets that refer to external codes.

Document Types

The permission catalog refers to specific document types as "objects". However, the CDA R2 document codes provide LOINC codes for most if not all the document "objects". For example, there are two codes for "Progress Note" in addition to "Procedure Note" and other types of reports:

28575-9	PROGRESS NOTE	{SETTING}	NURSE PRACTITIONER
28580-9	PROGRESS NOTE	{SETTING}	CHIROPRACTOR

Reference to CDA R2 Document Types corresponding to document types included in the permission catalog. The following is an excerpt from the table:

Table 147: LOINC document codes
LOINC_NUM	COMPONENT (Type of Service)	SYSTEM (Setting)	METHOD_TYPE (Subject Matter Domain and/or Training / Professional Level)
34862-3	ADMISSION EVALUATION NOTE	INPATIENT	ATTENDING PHYSICIAN.GENERAL MEDICINE
34744-3	ADMISSION EVALUATION NOTE	{SETTING}	NURSING
34873-0	ADMISSION EVALUATION NOTE	{SETTING}	SURGERY
34094-3	ADMISSION HISTORY AND PHYSICAL NOTE	HOSPITAL	CARDIOLOGY
34763-3	ADMISSION HISTORY AND PHYSICAL NOTE	{SETTING}	GENERAL MEDICINE
28615-3	AUDIOLOGY STUDY	{SETTING}
18743-5	AUTOPSY NOTE	{SETTING}	{PROVIDER}
33720-4	BLOOD BANK CONSULT	{SETTING}
34095-0	COMPREHENSIVE HISTORY & PHYSICAL NOTE	{SETTING}	{PROVIDER}
34096-8	COMPREHENSIVE HISTORY AND PHYSICAL	NURSING HOME
34098-4	CONFERENCE EVALUATION NOTE	{SETTING}	{PROVIDER}
34097-6	CONFERENCE EVALUATION NOTE	NURSING HOME	{PROVIDER}
24611-6	CONFIRMATORY CONSULTATION NOTE	OUTPATIENT	{PROVIDER}
34807-8	CONSULTATION NOTE	{SETTING}	OPHTHALMOLOGY
34100-8	CONSULTATION NOTE	CRITICAL CARE UNIT	{PROVIDER}
34810-2	CONSULTATION NOTE	{SETTING}	OPTOMETRY
34812-8	CONSULTATION NOTE	{SETTING}	OROMAXILLOFACIAL SURGERY
34814-4	CONSULTATION NOTE	{SETTING}	ORTHOPEDICS
34831-8	CONSULTATION NOTE	{SETTING}	RADIATION ONCOLOGY
34761-7	CONSULTATION NOTE	{SETTING}	GASTROENTEROLOGY
34099-2	CONSULTATION NOTE	{SETTING}	CARDIOLOGY
34833-4	CONSULTATION NOTE	{SETTING}	RECREATIONAL THERAPY
34820-1	CONSULTATION NOTE	{SETTING}	PHARMACY
34822-7	CONSULTATION NOTE	{SETTING}	PHYSICAL MEDICINE AND REHABILITATION
34835-9	CONSULTATION NOTE	{SETTING}	REHABILITATION
34824-3	CONSULTATION NOTE	{SETTING}	PHYSICAL THERAPY
34826-8	CONSULTATION NOTE	{SETTING}	PLASTIC SURGERY
34764-1	CONSULTATION NOTE	{SETTING}	GENERAL MEDICINE
34837-5	CONSULTATION NOTE	{SETTING}	RESPIRATORY THERAPY
34803-7	CONSULTATION NOTE	{SETTING}	OCCUPATIONAL HEALTH
34816-9	CONSULTATION NOTE	{SETTING}	OTORHINOLARYNGOLOGY
34783-1	CONSULTATION NOTE	{SETTING}	KINESIOTHERAPY
34756-7	CONSULTATION NOTE	{SETTING}	DENTISTRY
34788-0	CONSULTATION NOTE	{SETTING}	PSYCHIATRY
34102-4	CONSULTATION NOTE	HOSPITAL	PSYCHIATRY
34791-4	CONSULTATION NOTE	{SETTING}	PSYCHOLOGY
34103-2	CONSULTATION NOTE	{SETTING}	PULMONARY
34795-5	CONSULTATION NOTE	{SETTING}	NEPHROLOGY
34758-3	CONSULTATION NOTE	{SETTING}	DERMATOLOGY
34760-9	CONSULTATION NOTE	{SETTING}	DIABETOLOGY
34798-9	CONSULTATION NOTE	{SETTING}	NEUROSURGERY
34800-3	CONSULTATION NOTE	{SETTING}	NUTRITION+DIETETICS
34749-2	CONSULTATION NOTE	OUTPATIENT	ANESTHESIA
34781-5	CONSULTATION NOTE	{SETTING}	INFECTIOUS DISEASE
34828-4	CONSULTATION NOTE	{SETTING}	PODIATRY
34101-6	CONSULTATION NOTE	OUTPATIENT	GENERAL MEDICINE
34104-0	CONSULTATION NOTE	HOSPITAL	{PROVIDER}
34785-6	CONSULTATION NOTE	{SETTING}	MENTAL HEALTH
34805-2	CONSULTATION NOTE	{SETTING}	ONCOLOGY
34797-1	CONSULTATION NOTE	{SETTING}	NEUROLOGY
34879-7	CONSULTATION NOTE	{SETTING}	ENDOCRINOLOGY
34839-1	CONSULTATION NOTE	{SETTING}	RHEUMATOLOGY
34779-9	CONSULTATION NOTE	{SETTING}	HEMATOLOGY+ONCOLOGY
34777-3	CONSULTATION NOTE	{SETTING}	GYNECOLOGY
34776-5	CONSULTATION NOTE	{SETTING}	GERONTOLOGY
34855-7	CONSULTATION NOTE	{SETTING}	OCCUPATIONAL THERAPY
34853-2	CONSULTATION NOTE	{SETTING}	VASCULAR SURGERY
34771-6	CONSULTATION NOTE	{SETTING}	GENERAL SURGERY
34841-7	CONSULTATION NOTE	{SETTING}	SOCIAL WORK
34845-8	CONSULTATION NOTE	{SETTING}	SPEECH THERAPY+AUDIOLOGY
11488-4	CONSULTATION NOTE	{SETTING}	{PROVIDER}
34847-4	CONSULTATION NOTE	{SETTING}	SURGERY
34851-6	CONSULTATION NOTE	{SETTING}	UROLOGY
34849-0	CONSULTATION NOTE	{SETTING}	THORACIC SURGERY
34865-6	COUNSELING NOTE	{SETTING}	PSYCHIATRY
34866-4	COUNSELING NOTE	{SETTING}	PSYCHOLOGY
34872-2	COUNSELING NOTE	{SETTING}	SOCIAL WORK
34869-8	COUNSELING NOTE	{SETTING}	PHARMACY
34864-9	COUNSELING NOTE	{SETTING}	MENTAL HEALTH
28622-9	DISCHARGE ASSESSMENT NOTE	{SETTING}	NURSING
28574-2	DISCHARGE NOTE	{SETTING}	{PROVIDER}
11490-0	DISCHARGE SUMMARIZATION NOTE	{SETTING}	PHYSICIAN
28655-9	DISCHARGE SUMMARIZATION NOTE	{SETTING}	ATTENDING PHYSICIAN
18842-5	DISCHARGE SUMMARIZATION NOTE	{SETTING}	{PROVIDER}
34105-7	DISCHARGE SUMMARIZATION NOTE	HOSPITAL	{PROVIDER}
29761-4	DISCHARGE SUMMARIZATION NOTE	{SETTING}	DENTISTRY
34745-0	DISCHARGE SUMMARIZATION NOTE	{SETTING}	NURSING
34106-5	DISCHARGE SUMMARIZATION NOTE	HOSPITAL	PHYSICIAN
34902-7	EDUCATION NOTE	OUTPATIENT	GERONTOLOGY
34897-9	EDUCATION NOTE	{SETTING}	DIABETOLOGY
34895-3	EDUCATION NOTE	{SETTING}	{PROVIDER}
34107-3	EDUCATION PROCEDURE NOTE	HOME HEALTH	{PROVIDER}
34108-1	EVALUATION AND MANAGEMENT	OUTPATIENT	{PROVIDER}
34836-7	EVALUATION AND MANAGEMENT NOTE	{SETTING}	REHABILITATION
34111-5	EVALUATION AND MANAGEMENT NOTE	EMERGENCY DEPARTMENT	{PROVIDER}
34834-2	EVALUATION AND MANAGEMENT NOTE	{SETTING}	RECREATIONAL THERAPY
34759-1	EVALUATION AND MANAGEMENT NOTE	{SETTING}	DERMATOLOGY
34842-5	EVALUATION AND MANAGEMENT NOTE	{SETTING}	SOCIAL WORK
34113-1	EVALUATION AND MANAGEMENT NOTE	NURSING HOME	{PROVIDER}
34762-5	EVALUATION AND MANAGEMENT NOTE	{SETTING}	GASTROENTEROLOGY
34840-9	EVALUATION AND MANAGEMENT NOTE	{SETTING}	RHEUMATOLOGY
34757-5	EVALUATION AND MANAGEMENT NOTE	{SETTING}	DENTISTRY
34112-3	EVALUATION AND MANAGEMENT NOTE	INPATIENT	{PROVIDER}
34746-8	EVALUATION AND MANAGEMENT NOTE	{SETTING}	NURSING
34754-2	EVALUATION AND MANAGEMENT NOTE	{SETTING}	CRITICAL CARE
34772-4	EVALUATION AND MANAGEMENT NOTE	{SETTING}	GENERAL SURGERY
34753-4	EVALUATION AND MANAGEMENT NOTE	OUTPATIENT	CARDIOLOGY
34752-6	EVALUATION AND MANAGEMENT NOTE	{SETTING}	CARDIOLOGY
34832-6	EVALUATION AND MANAGEMENT NOTE	{SETTING}	RADIATION ONCOLOGY
34750-0	EVALUATION AND MANAGEMENT NOTE	{SETTING}	ANESTHESIA
34773-2	EVALUATION AND MANAGEMENT NOTE	{SETTING}	ATTENDING PHYSICIAN.GENERAL SURGERY
34830-0	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PULMONARY
34778-1	EVALUATION AND MANAGEMENT NOTE	{SETTING}	GYNECOLOGY
34838-3	EVALUATION AND MANAGEMENT NOTE	{SETTING}	RESPIRATORY THERAPY
34780-7	EVALUATION AND MANAGEMENT NOTE	{SETTING}	HEMATOLOGY+ONCOLOGY
34109-9	EVALUATION AND MANAGEMENT NOTE	{SETTING}	{PROVIDER}
34854-0	EVALUATION AND MANAGEMENT NOTE	OUTPATIENT	VASCULAR SURGERY
34765-8	EVALUATION AND MANAGEMENT NOTE	{SETTING}	GENERAL MEDICINE
34819-3	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PATHOLOGY
34801-1	EVALUATION AND MANAGEMENT NOTE	{SETTING}	NUTRITION+DIETETICS
34823-5	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PHYSICAL MEDICINE AND REHABILITATION
34825-0	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PHYSICAL THERAPY
34827-6	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PLASTIC SURGERY
34829-2	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PODIATRY
34846-6	EVALUATION AND MANAGEMENT NOTE	{SETTING}	SPEECH THERAPY+AUDIOLOGY
34848-2	EVALUATION AND MANAGEMENT NOTE	{SETTING}	SURGERY
34815-1	EVALUATION AND MANAGEMENT NOTE	{SETTING}	ORTHOPEDICS
34852-4	EVALUATION AND MANAGEMENT NOTE	{SETTING}	UROLOGY
34817-7	EVALUATION AND MANAGEMENT NOTE	{SETTING}	OTORHINOLARYNGOLOGY
34856-5	EVALUATION AND MANAGEMENT NOTE	{SETTING}	ANTICOAGULATION
34857-3	EVALUATION AND MANAGEMENT NOTE	{SETTING}	SUBSTANCE ABUSE
34858-1	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PAIN MANAGEMENT
34859-9	EVALUATION AND MANAGEMENT NOTE	{SETTING}	HYPERLIPIDEMIA
34860-7	EVALUATION AND MANAGEMENT NOTE	{SETTING}	HYPERTENSION
34861-5	EVALUATION AND MANAGEMENT NOTE	{SETTING}	DIABETOLOGY
34878-9	EVALUATION AND MANAGEMENT NOTE	{SETTING}	EMERGENCY MEDICINE
34898-7	EVALUATION AND MANAGEMENT NOTE	{SETTING}	ENDOCRINOLOGY
34905-0	EVALUATION AND MANAGEMENT NOTE	{SETTING}	NEUROLOGY
34850-8	EVALUATION AND MANAGEMENT NOTE	OUTPATIENT	THORACIC SURGERY
34792-2	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PSYCHOLOGY
34766-6	EVALUATION AND MANAGEMENT NOTE	OUTPATIENT	GENERAL MEDICINE
34767-4	EVALUATION AND MANAGEMENT NOTE	{SETTING}	MEDICAL STUDENT.GENERAL MEDICINE
34768-2	EVALUATION AND MANAGEMENT NOTE	{SETTING}	NURSE.GENERAL MEDICINE
34769-0	EVALUATION AND MANAGEMENT NOTE	{SETTING}	ATTENDING PHYSICIAN.GENERAL MEDICINE
34782-3	EVALUATION AND MANAGEMENT NOTE	{SETTING}	INFECTIOUS DISEASE
34784-9	EVALUATION AND MANAGEMENT NOTE	{SETTING}	KINESIOTHERAPY
34786-4	EVALUATION AND MANAGEMENT NOTE	{SETTING}	MENTAL HEALTH
34821-9	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PHARMACY
34789-8	EVALUATION AND MANAGEMENT NOTE	{SETTING}	PSYCHIATRY
34813-6	EVALUATION AND MANAGEMENT NOTE	{SETTING}	OROMAXILLOFACIAL SURGERY
34802-9	EVALUATION AND MANAGEMENT NOTE	{SETTING}	OCCUPATIONAL HEALTH
34811-0	EVALUATION AND MANAGEMENT NOTE	{SETTING}	OPTOMETRY
34808-6	EVALUATION AND MANAGEMENT NOTE	{SETTING}	OPHTHALMOLOGY
34806-0	EVALUATION AND MANAGEMENT NOTE	{SETTING}	ONCOLOGY
34804-5	EVALUATION AND MANAGEMENT NOTE	{SETTING}	OCCUPATIONAL THERAPY
34794-8	EVALUATION AND MANAGEMENT NOTE	{SETTING}	MULTIDISCIPLINARY
34110-7	EVALUATION AND MANAGEMENT NOTE	OUTPATIENT	DIABETOLOGY
34799-7	EVALUATION AND MANAGEMENT NOTE	{SETTING}	NEUROSURGERY
34796-3	EVALUATION AND MANAGEMENT NOTE	{SETTING}	NEPHROLOGY
34787-2	GROUP COUNSELING NOTE	{SETTING}	MENTAL HEALTH
34790-6	GROUP COUNSELING NOTE	{SETTING}	PSYCHIATRY
34843-3	GROUP COUNSELING NOTE	{SETTING}	SOCIAL WORK
34114-9	GROUP COUNSELING NOTE	HOSPITAL	{PROVIDER}
34793-0	GROUP COUNSELING NOTE	{SETTING}	PSYCHOLOGY
34774-0	HISTORY & PHYSICAL NOTE	{SETTING}	GENERAL SURGERY
28626-0	HISTORY & PHYSICAL NOTE	{SETTING}	PHYSICIAN
11492-6	HISTORY & PHYSICAL NOTE	HOSPITAL	{PROVIDER}
34116-4	HISTORY & PHYSICAL NOTE	NURSING HOME	PHYSICIAN
34115-6	HISTORY & PHYSICAL NOTE	HOSPITAL	MEDICAL STUDENT
34117-2	HISTORY AND PHYSICAL NOTE	{SETTING}	{PROVIDER}
18841-7	HOSPITAL CONSULTATIONS	{SETTING}
28572-6	INITIAL EVALUATION NOTE	{SETTING}	DENTISTRY
28654-2	INITIAL EVALUATION NOTE	{SETTING}	ATTENDING PHYSICIAN
18735-1	INITIAL EVALUATION NOTE	{SETTING}	PHYSICAL THERAPY
18736-9	INITIAL EVALUATION NOTE	{SETTING}	PHYSICIAN
18737-7	INITIAL EVALUATION NOTE	{SETTING}	PODIATRY
18738-5	INITIAL EVALUATION NOTE	{SETTING}	PSYCHOLOGY
18739-3	INITIAL EVALUATION NOTE	{SETTING}	SOCIAL SERVICE
18734-4	INITIAL EVALUATION NOTE	{SETTING}	OCCUPATIONAL THERAPY
28581-7	INITIAL EVALUATION NOTE	{SETTING}	CHIROPRACTOR
29753-1	INITIAL EVALUATION NOTE	{SETTING}	NURSING
28636-9	INITIAL EVALUATION NOTE	{SETTING}	{PROVIDER}
28635-1	INITIAL EVALUATION NOTE	{SETTING}	PSYCHIATRY
28621-1	INITIAL EVALUATION NOTE	{SETTING}	NURSE PRACTITIONER
18763-3	INITIAL EVALUATION NOTE	{SETTING}	CONSULTING PHYSICIAN
18740-1	INITIAL EVALUATION NOTE	{SETTING}	SPEECH THERAPY
34120-6	INITIAL EVALUATION NOTE	OUTPATIENT	{PROVIDER}
34119-8	INITIAL EVALUATION NOTE	NURSING HOME	{PROVIDER}
34118-0	INITIAL EVALUATION NOTE	HOME HEALTH	{PROVIDER}
34121-4	INTERVENTIONAL PROCEDURE NOTE	{SETTING}
34896-1	INTERVENTIONAL PROCEDURE NOTE	{SETTING}	CARDIOLOGY
34899-5	INTERVENTIONAL PROCEDURE NOTE	{SETTING}	GASTROENTEROLOGY
34903-5	NOTE	{SETTING}	MENTAL HEALTH
34906-8	NOTE	{SETTING}	PASTORAL CARE
11536-0	NOTES	{SETTING}	NURSING
34871-4	OPERATIVE NOTE	{SETTING}	PODIATRY
34874-8	OPERATIVE NOTE	{SETTING}	SURGERY
34877-1	OPERATIVE NOTE	{SETTING}	UROLOGY
34870-6	OPERATIVE NOTE	{SETTING}	PLASTIC SURGERY
34868-0	OPERATIVE NOTE	{SETTING}	ORTHOPEDICS
34818-5	OPERATIVE NOTE	{SETTING}	OTORHINOLARYNGOLOGY
34122-2	PATHOLOGY PROCEDURE NOTE	{SETTING}	PATHOLOGY
34880-5	POST-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	NURSE.SURGERY
34875-5	POST-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	SURGERY
34863-1	POST-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	GENERAL SURGERY
34867-2	POST-OPERATIVE EVALUATION AND MANAGEMENT NOTE	OUTPATIENT	OPHTHALMOLOGY
34881-3	PRE-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	NURSE.SURGERY
34123-0	PRE-OPERATIVE EVALUATION AND MANAGEMENT NOTE	HOSPITAL	ANESTHESIA
34775-7	PRE-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	GENERAL SURGERY
34876-3	PRE-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	SURGERY
34751-8	PRE-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	ANESTHESIA
34809-4	PRE-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	OPHTHALMOLOGY
34747-6	PRE-OPERATIVE EVALUATION AND MANAGEMENT NOTE	{SETTING}	NURSING
28570-0	PROCEDURE NOTE	{SETTING}	{PROVIDER}
28625-2	PROCEDURE NOTE	{SETTING}	PODIATRY
28577-5	PROCEDURE NOTE	{SETTING}	DENTISTRY
11505-5	PROCEDURE NOTE	{SETTING}	PHYSICIAN
28575-9	PROGRESS NOTE	{SETTING}	NURSE PRACTITIONER
28580-9	PROGRESS NOTE	{SETTING}	CHIROPRACTOR
18744-3	STUDY REPORT	RESPIRATORY SYSTEM	BRONCHOSCOPY
11510-5	SUBSEQUENT EVALUATION NOTE	{SETTING}	PSYCHOLOGY
11508-9	SUBSEQUENT EVALUATION NOTE	{SETTING}	PHYSICAL THERAPY
11509-7	SUBSEQUENT EVALUATION NOTE	{SETTING}	PODIATRY
11506-3	SUBSEQUENT EVALUATION NOTE	{SETTING}	{PROVIDER}
11507-1	SUBSEQUENT EVALUATION NOTE	{SETTING}	OCCUPATIONAL THERAPY
11512-1	SUBSEQUENT EVALUATION NOTE	{SETTING}	SPEECH THERAPY
15507-7	SUBSEQUENT EVALUATION NOTE	EMERGENCY DEPARTMENT	{PROVIDER}
18733-6	SUBSEQUENT EVALUATION NOTE	{SETTING}	ATTENDING PHYSICIAN
34904-3	SUBSEQUENT EVALUATION NOTE	{SETTING}	MENTAL HEALTH
34901-9	SUBSEQUENT EVALUATION NOTE	OUTPATIENT	GENERAL MEDICINE
18764-1	SUBSEQUENT EVALUATION NOTE	{SETTING}	NURSE PRACTITIONER
34129-7	SUBSEQUENT EVALUATION NOTE	HOME HEALTH	{PROVIDER}
34132-1	SUBSEQUENT EVALUATION NOTE	OUTPATIENT	PHARMACY
34131-3	SUBSEQUENT EVALUATION NOTE	OUTPATIENT	{PROVIDER}
28656-7	SUBSEQUENT EVALUATION NOTE	{SETTING}	SOCIAL SERVICE
34130-5	SUBSEQUENT EVALUATION NOTE	HOSPITAL	{PROVIDER}
28617-9	SUBSEQUENT EVALUATION NOTE	{SETTING}	DENTISTRY
34128-9	SUBSEQUENT EVALUATION NOTE	OUTPATIENT	DENTISTRY
34127-1	SUBSEQUENT EVALUATION NOTE	OUTPATIENT	DENTAL HYGIENIST
34126-3	SUBSEQUENT EVALUATION NOTE	CRITICAL CARE UNIT	{PROVIDER}
34900-1	SUBSEQUENT EVALUATION NOTE	{SETTING}	GENERAL MEDICINE
34125-5	SUBSEQUENT EVALUATION NOTE	HOME HEALTH CARE	CASE MANAGER
28569-2	SUBSEQUENT EVALUATION NOTE	{SETTING}	CONSULTING PHYSICIAN
18762-5	SUBSEQUENT EVALUATION NOTE	{SETTING}	CHIROPRACTOR
34124-8	SUBSEQUENT EVALUATION NOTE	OUTPATIENT	CARDIOLOGY
28627-8	SUBSEQUENT EVALUATION NOTE	{SETTING}	PSYCHIATRY
28623-7	SUBSEQUENT EVALUATION NOTE	{SETTING}	NURSING
34133-9	SUMMARIZATION OF EPISODE NOTE	{SETTING}	{PROVIDER}
34134-7	SUPERVISORY NOTE	OUTPATIENT	ATTENDING PHYSICIAN
34135-4	SUPERVISORY NOTE	OUTPATIENT	ATTENDING PHYSICIAN.CARDIOLOGY
34136-2	SUPERVISORY NOTE	OUTPATIENT	ATTENDING PHYSICIAN.GASTROENTEROLOGY
28624-5	SURGICAL OPERATION NOTE	{SETTING}	PODIATRY
28573-4	SURGICAL OPERATION NOTE	{SETTING}	PHYSICIAN
11504-8	SURGICAL OPERATION NOTE	{SETTING}	{PROVIDER}
28583-3	SURGICAL OPERATION NOTE	{SETTING}	DENTISTRY
34137-0	SURGICAL OPERATION NOTE	OUTPATIENT	{PROVIDER}
34138-8	TARGETED HISTORY AND PHYSICAL NOTE	{SETTING}	{PROVIDER}
34139-6	TELEPHONE ENCOUNTER NOTE	{SETTING}	NURSING
34844-1	TELEPHONE ENCOUNTER NOTE	OUTPATIENT	SOCIAL WORK
34748-4	TELEPHONE ENCOUNTER NOTE	{SETTING}	{PROVIDER}
34140-4	TRANSFER OF CARE REFERRAL NOTE	{SETTING}	{PROVIDER}
34770-8	TRANSFER SUMMARIZATION NOTE	{SETTING}	GENERAL MEDICINE
18761-7	TRANSFER SUMMARIZATION NOTE	{SETTING}	{PROVIDER}
28651-8	TRANSFER SUMMARIZATION NOTE	{SETTING}	NURSING
28616-1	TRANSFER SUMMARIZATION NOTE	{SETTING}	PHYSICIAN
34755-9	TRANSFER SUMMARIZATION NOTE	{SETTING}	CRITICAL CARE
28568-4	VISIT NOTE	EMERGENCY DEPARTMENT	PHYSICIAN
28653-4	VISIT NOTE	{SETTING}	SOCIAL SERVICE
28618-7	VISIT NOTE	{SETTING}	DENTISTRY
28579-1	VISIT NOTE	{SETTING}	PHYSICAL THERAPY
28578-3	VISIT NOTE	{SETTING}	OCCUPATIONAL THERAPY
28571-8	VISIT NOTE	{SETTING}	SPEECH THERAPY
28628-6	VISIT NOTE	{SETTING}	PSYCHIATRY