Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.0-snapshot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions
: Claim Types
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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:ValueSet ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "ClaimTypes"] ; #
fhir:language [ fhir:v "en"] ; #
fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet ClaimTypes</b></p><a name=\"ClaimTypes\"> </a><a name=\"hcClaimTypes\"> </a><ul><li>Include these codes as defined in <a href=\"http://terminology.hl7.org/7.0.1/CodeSystem-claim-type.html\"><code>http://terminology.hl7.org/CodeSystem/claim-type</code></a><span title=\"Version is not explicitly stated, which means it is fixed to 1.0.1, the version found through the package references\"> version ?1.0.1</span><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"http://terminology.hl7.org/7.0.1/CodeSystem-claim-type.html#claim-type-institutional\">institutional</a></td><td style=\"color: #cccccc\">Institutional</td><td>Hospital, clinic and typically inpatient claims.</td></tr><tr><td><a href=\"http://terminology.hl7.org/7.0.1/CodeSystem-claim-type.html#claim-type-professional\">professional</a></td><td style=\"color: #cccccc\">Professional</td><td>Typically, outpatient claims from Physician, Psychological, Chiropractor, Physiotherapy, Speech Pathology, rehabilitative, consulting.</td></tr><tr><td><a href=\"http://terminology.hl7.org/7.0.1/CodeSystem-claim-type.html#claim-type-oral\">oral</a></td><td style=\"color: #cccccc\">Oral</td><td>Dental, Denture and Hygiene claims.</td></tr></table></li></ul></div>"^^rdf:XMLLiteral ]
] ; #
fhir:extension ( [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-wg> ] ;
fhir:value [
a fhir:Code ;
fhir:v "fm" ]
] [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm> ] ;
fhir:value [
a fhir:Integer ;
fhir:v 4 ;
( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom> ] ;
fhir:value [
a fhir:Canonical ;
fhir:v "http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas> ] ] ) ]
] [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status> ] ;
fhir:value [
a fhir:Code ;
fhir:v "trial-use" ;
( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom> ] ;
fhir:value [
a fhir:Canonical ;
fhir:v "http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas> ] ] ) ]
] ) ; #
fhir:url [
fhir:v "http://hl7.org/fhir/us/davinci-pas/ValueSet/ClaimTypes"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/davinci-pas/ValueSet/ClaimTypes>
] ; #
fhir:identifier ( [
fhir:system [
fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ;
fhir:l <urn:ietf:rfc:3986> ] ;
fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.40.24.48.21" ]
] ) ; #
fhir:version [ fhir:v "2.2.0-snapshot"] ; #
fhir:name [ fhir:v "ClaimTypes"] ; #
fhir:title [ fhir:v "Claim Types"] ; #
fhir:status [ fhir:v "active"] ; #
fhir:experimental [ fhir:v false] ; #
fhir:date [ fhir:v "2026-01-30T23:58:09+00:00"^^xsd:dateTime] ; #
fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; #
fhir:contact ( [
fhir:name [ fhir:v "HL7 International / Financial Management" ] ;
( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://hl7.org/Special/committees/fm" ] ] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "fmlists@lists.hl7.org" ] ] )
] [
fhir:name [ fhir:v "Jean Duteau" ] ;
( fhir:telecom [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "mailto:jean@duteaudesign.com" ] ] )
] [
fhir:name [ fhir:v "HL7 International / Financial Management" ] ;
( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ] ] )
] ) ; #
fhir:description [ fhir:v "This set of codes restricts the claim type."] ; #
fhir:jurisdiction ( [
( fhir:coding [
fhir:system [
fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ;
fhir:l <urn:iso:std:iso:3166> ] ;
fhir:code [ fhir:v "US" ] ;
fhir:display [ fhir:v "United States of America" ] ] )
] ) ; #
fhir:compose [
( fhir:include [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/claim-type> ] ;
( fhir:concept [
fhir:code [ fhir:v "institutional" ] ] [
fhir:code [ fhir:v "professional" ] ] [
fhir:code [ fhir:v "oral" ] ] ) ] )
] . #
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