resourceType: CodeSystem id: cdex-temp extension: - url: >- http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status valueCode: trial-use - url: 'http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm' valueInteger: 1 url: http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp name: CDexTempCodes title: CDex Temporary Code System status: active experimental: false date: '2025-05-22' description: Codes temporarily defined as part of the CDex implementation guide. These will eventually migrate into an officially maintained terminology (likely HL7's [UTG](https://terminology.hl7.org/codesystems.html) code systems). caseSensitive: true content: complete concept: - code: claims-processing display: Claim Processing definition: Request for data necessary from payers to support claims for services. - code: preauth-processing display: Pre-authorization Processing definition: Request for data necessary from payers to support pre-authorization for services. - code: risk-adjustment display: Risk Adjustment definition: Request for data from payers to calculate differences in beneficiary-level risk factors that can affect quality outcomes or medical costs, regardless of the care provided. - code: quality-metrics display: Quality Metrics definition: Request for data used for aggregation, calculation and analysis, and ultimately reporting of quality measures. - code: referral display: Referral definition: Request for additional clinical information from referring provider to support performing the requested service. - code: social-care display: Social Care definition: Request for data from payers to support the non-medical social needs of individuals, especially the elderly, vulnerable or with special needs. - code: authorization-other display: Other Authorization definition: Request for data from payers for other authorization request not otherwise specified. - code: care-coordination display: Care Coordination definition: Request for data from payers to create a complete clinical record for each of their members to improve care coordination and provide optimum medical care. - code: documentation-general display: General Documentation definition: Request for data used from payers or providers for general documentation. - code: orders display: Orders definition: Request for additional clinical information from referring provider to support orders. - code: patient-status display: Patient Status definition: Requests for patient health record information from payers to support their payer member records. - code: signature display: Signature definition: Request for signatures from payers or providers on requested data. - code: care-planning display: Care Planning definition: Request for data from payers or providers to determine how to deliver care for a particular patient, group or community. - code: social-risk display: Social Risk definition: Request for data from payers or other providers to assess of social risk, establishing coded health concerns/problems, creating patient driven goals, managing interventions, and measuring outcomes. - code: operations-noe display: Operations Not Otherwise Enumerated definition: >- Existing concepts do not define a more detailed [Healthcare Operations as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code. - code: payment-noe display: Payment Not Otherwise Enumerated definition: >- [Existing concepts do not define a more detailed [Payment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code. - code: treatment-noe display: Treatment Not Otherwise Enumerated definition: >- Existing concepts do not define a more detailed [Treatment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code. - code: purpose-of-use display: Purpose Of Use definition: Purpose of use for the requested data. - code: signature-flag display: Signature Flag definition: Flag to indicate whether the requested data requires a signature. - code: tracking-id display: Tracking Id definition: A Payer-assigned claim/prior authorization identifier that ties the attachment(s) back to the claim or prior authorization. This value referred to as the “re-association tracking control numbers” or "attachment control number (ACN)". - code: admin-ref-number display: Administrative Reference Number definition: A Payer-assigned business identifier that ties the attachment(s) back to the prior authorization. This value is referred to as the "administrative reference number". - code: multiple-submits-flag display: Multiple Submits Flag definition: Flag to indicate whether the requested data can be submitted in multiple transactions. If true the data can be submitted in separate transactions. if false *all* the data should be submitted in a single transaction. # - code: payer-url # display: Payer URL # definition: $submit-attachment operation endpoint where the requested data can be # submitted - code: service-date display: Service Date definition: Date of service or starting date of the service for the claim or prior authorization. # - code: attachment-request-code # display: Coded Attachment Request # definition: A Task by a Payer requesting attachments for a Provider claim or prior-authorization # using LOINC attachment codes. - code: data-request-code display: Data Request Code definition: A Task requesting data using a code. - code: data-request-query display: Data Request Query definition: A Task requesting data using FHIR query syntax. - code: data-request-questionnaire display: Data Request Questionnaire definition: A Task requesting data using a data request questionnaire ([FHIR Questionnaire](http://hl7.org/fhir/questionnaire.html)). # - code: attachment-request-questionnaire # display: Attachment Request Questionnaire # definition: A Task by a Payer requesting attachments or additional data for a Provider claim or prior-authorization # using a data request questionnaire ([FHIR Questionnaire](http://hl7.org/fhir/questionnaire.html)).