The prom has to stay with the truck. It contains all the info the ECM needs for your particular engine, transmission, etc.
ECM's rarely fail. Not saying it can't be, but I'd bet 90% of the ones replaced didn't need to be. Something else was the problem. If the numbers don't match at O'reillys don't be too concerned as long as the electrical connectors are exactly the same and the Prom will switch. In that era GM used different part numbers on ECMs that were basically the same. Usually, if a newer faster or better computer was introduced during a model year they would just change to it. In later years they only did it when the MY changed. And then they changed almost every year.