Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

US Core Encounter

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An example mapping of Health Plan data for Members to the US Core 3.1.1 Encounter or US Core 6.1.0 Encounter resource is shown below:

When populating the encounter resource period - if claim has period, populate period; if only a date, populate the end date in a period element.

Add warning text to alert the user that Claims consider the date of service to be the date when the service is completed therefore one generally cannot infer the start date of a diagnosis or the encounter to be the same as the service date of a line item.

The essential fields (Must Support or Cardinality greater than 0..*) to be provided in the US Core 3.1.1 Encounter or US Core 6.1.0 Encounter resource are:

Table Definition

Fields that can be mapped from the CARIN Blue Button IG CPCDS File are included in the table below:

Table Definition

Example Encounter Resource

An example mapping of an Encounter resource is shown here:

{
  "resourceType" : "Encounter",
  "id" : "example-1",
  "meta" : {
    "lastUpdated" : "2017-05-26T11:56:57.250-04:00",
    "profile" : [
      "http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">
Generated Narrative
id: example-1
meta: 
status: finished
class: <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>
type: <span title=\"Codes: {http://www.ama-assn.org/go/cpt 99201}\">Office Visit</span>
subject: <a href=\"Patient-example.html\">Generated Summary: id: example; Medical Record Number = 1032702 (USUAL); active; Amy V. Shaw , Amy V. Baxter ; ph: 555-555-5555(HOME), amy.shaw@example.com; gender: female; birthDate: 1987-02-20</a>
period: Nov 1, 2015, 10:00:14 PM --> Nov 1, 2015, 11:00:14 PM
</div>"
  },
  "status" : "finished",
  "class" : {
    "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
    "code" : "AMB",
    "display" : "ambulatory"
  },
  "type" : [
    {
      "coding" : [
        {
          "system" : "http://www.ama-assn.org/go/cpt",
          "code" : "99201"
        }
      ],
      "text" : "Office Visit"
    }
  ],
  "subject" : {
    "reference" : "Patient/example"
  },
  "period" : {
    "start" : "2015-11-01T17:00:14-05:00",
    "end" : "2015-11-01T18:00:14-05:00"
  }
}

Refer to the US Core Additional examples of the US Core 3.1.1 Implementation Guide or US Core 6.1.0 Implementation Guide for further examples of completed Encounter Profiles.

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