Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

: PCT Total Value Set - JSON Representation

Page standards status: Trial-use

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{
  "resourceType" : "ValueSet",
  "id" : "PCTTotal",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This value set includes codes based on the following rules:</p><ul><li>Import all the codes that are contained in <a href=\"ValueSet-PCTAdjudication.html\">PCT Adjudication Value Set</a></li><li>Include these codes as defined in <a href=\"CodeSystem-PCTNetworkStatusCS.html\"><code>http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS</code></a><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=\"CodeSystem-PCTNetworkStatusCS.html#PCTNetworkStatusCS-innetwork\">innetwork</a></td><td>In Network</td><td>Indicates an in network status in relation to a patient's coverage</td></tr><tr><td><a href=\"CodeSystem-PCTNetworkStatusCS.html#PCTNetworkStatusCS-outofnetwork\">outofnetwork</a></td><td>Out Of Network</td><td>Indicates a not in network status in relation to a patient's coverage</td></tr><tr><td><a href=\"CodeSystem-PCTNetworkStatusCS.html#PCTNetworkStatusCS-negotiated\">negotiated</a></td><td>Negotiated Service or Product</td><td>Indicates a special negotiated status in relation to a patient's coverage</td></tr></table></li></ul></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTTotal",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.4.48.34"
    }
  ],
  "version" : "2.0.0-ballot",
  "name" : "PCTTotal",
  "title" : "PCT Total Value Set",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-04-08T16:35:46+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fmlists@lists.hl7.org"
        }
      ]
    }
  ],
  "description" : "Describes the various amount fields used when payers receive and adjudicate a claim.  It includes the values \ndefined in http://terminology.hl7.org/CodeSystem/adjudication, as well as those defined in the Network Status.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "copyright" : "This Valueset is not copyrighted.",
  "compose" : {
    "include" : [
      {
        "valueSet" : [
          🔗 "http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTAdjudication"
        ]
      },
      {
        "system" : "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS",
        "concept" : [
          {
            "code" : "innetwork",
            "display" : "In Network"
          },
          {
            "code" : "outofnetwork",
            "display" : "Out Of Network"
          },
          {
            "code" : "negotiated",
            "display" : "Negotiated Service or Product"
          }
        ]
      }
    ]
  }
}