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.

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

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 "objects" specified 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 ).

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	{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: <thead> </thead> 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