HL7 Terminology (THO)
7.0.0 - Continuous Process Integration (ci build)
HL7 Terminology (THO)
7.0.0 - Continuous Process Integration (ci build)
HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This guide is not an authorized publication; it is the continuous build for version 7.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions
| Active as of 2025-10-16 | Maturity Level: 1 |
{
"resourceType" : "CodeSystem",
"id" : "cdshooks-card-type",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem cdshooks-card-type</b></p><a name=\"cdshooks-card-type\"> </a><a name=\"hccdshooks-card-type\"> </a><p>This case-sensitive code system <code>http://terminology.hl7.org/CodeSystem/cdshooks-card-type</code> defines the following codes in a Is-A hierarchy:</p><table class=\"codes\"><tr><td><b>Lvl</b></td><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>1</td><td style=\"white-space:nowrap\">coverage-info<a name=\"cdshooks-card-type-coverage-info\"> </a></td><td>Coverage Information</td><td>Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection</td></tr><tr><td>2</td><td style=\"white-space:nowrap\">\u00a0\u00a0unsolicited-determ<a name=\"cdshooks-card-type-unsolicited-determ\"> </a></td><td>Unsolicited Determination</td><td>An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">claim<a name=\"cdshooks-card-type-claim\"> </a></td><td>Claim</td><td>Information about what steps need to be taken to submit a claim for the service</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">insurance<a name=\"cdshooks-card-type-insurance\"> </a></td><td>Insurance</td><td>Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">limits<a name=\"cdshooks-card-type-limits\"> </a></td><td>Limits</td><td>Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">network<a name=\"cdshooks-card-type-network\"> </a></td><td>Network</td><td>Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">appropriate-use<a name=\"cdshooks-card-type-appropriate-use\"> </a></td><td>Appropriate Use</td><td>Guidance on whether appropriate-use documentation is needed</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">cost<a name=\"cdshooks-card-type-cost\"> </a></td><td>Cost</td><td>What is the anticipated cost to the patient based on their coverage</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">therapy-alternatives-opt<a name=\"cdshooks-card-type-therapy-alternatives-opt\"> </a></td><td>Optional Therapy Alternatives</td><td>Are there alternative therapies that have better coverage and/or are lower-cost for the patient</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">therapy-alternatives-req<a name=\"cdshooks-card-type-therapy-alternatives-req\"> </a></td><td>Required Therapy Alternatives</td><td>Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">clinical-reminder<a name=\"cdshooks-card-type-clinical-reminder\"> </a></td><td>Clinical Reminder</td><td>Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">duplicate-therapy<a name=\"cdshooks-card-type-duplicate-therapy\"> </a></td><td>Duplicate Therapy</td><td>Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">contraindication<a name=\"cdshooks-card-type-contraindication\"> </a></td><td>Contraindication</td><td>Notice that the proposed intervention may be contraindicated based on information the payer has in their record that the provider doesn't have in theirs</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">guideline<a name=\"cdshooks-card-type-guideline\"> </a></td><td>Guideline</td><td>Indication that there is a guideline available for the proposed therapy (with an option to view)</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">off-guideline<a name=\"cdshooks-card-type-off-guideline\"> </a></td><td>Off Guideline</td><td>Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline</td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "fm"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 1
}
],
"url" : "http://terminology.hl7.org/CodeSystem/cdshooks-card-type",
"identifier" : [
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.5.176"
}
],
"version" : "1.0.0",
"name" : "CDSHooksCardType",
"title" : "CDS Hooks Card Types",
"status" : "active",
"experimental" : false,
"date" : "2025-10-16T00:00:00+00:00",
"publisher" : "Health Level Seven International",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://hl7.org"
},
{
"system" : "email",
"value" : "hq@HL7.org"
}
]
}
],
"description" : "Codes defining types of cards that can potentially be returned by a decision support service. The initial set of codes is biased towards those related to insurance coverage, but all types of response types are acceptable in the code system.",
"copyright" : "This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license",
"caseSensitive" : true,
"hierarchyMeaning" : "is-a",
"content" : "complete",
"concept" : [
{
"code" : "coverage-info",
"display" : "Coverage Information",
"definition" : "Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection",
"concept" : [
{
"code" : "unsolicited-determ",
"display" : "Unsolicited Determination",
"definition" : "An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request"
}
]
},
{
"code" : "claim",
"display" : "Claim",
"definition" : "Information about what steps need to be taken to submit a claim for the service"
},
{
"code" : "insurance",
"display" : "Insurance",
"definition" : "Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)"
},
{
"code" : "limits",
"display" : "Limits",
"definition" : "Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general"
},
{
"code" : "network",
"display" : "Network",
"definition" : "Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)"
},
{
"code" : "appropriate-use",
"display" : "Appropriate Use",
"definition" : "Guidance on whether appropriate-use documentation is needed"
},
{
"code" : "cost",
"display" : "Cost",
"definition" : "What is the anticipated cost to the patient based on their coverage"
},
{
"code" : "therapy-alternatives-opt",
"display" : "Optional Therapy Alternatives",
"definition" : "Are there alternative therapies that have better coverage and/or are lower-cost for the patient"
},
{
"code" : "therapy-alternatives-req",
"display" : "Required Therapy Alternatives",
"definition" : "Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy"
},
{
"code" : "clinical-reminder",
"display" : "Clinical Reminder",
"definition" : "Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)"
},
{
"code" : "duplicate-therapy",
"display" : "Duplicate Therapy",
"definition" : "Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system"
},
{
"code" : "contraindication",
"display" : "Contraindication",
"definition" : "Notice that the proposed intervention may be contraindicated based on information the payer has in their record that the provider doesn't have in theirs"
},
{
"code" : "guideline",
"display" : "Guideline",
"definition" : "Indication that there is a guideline available for the proposed therapy (with an option to view)"
},
{
"code" : "off-guideline",
"display" : "Off Guideline",
"definition" : "Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline"
}
]
}
IG © 2020+ HL7 International - Vocabulary Work Group. Package hl7.terminology#7.0.0 based on FHIR 5.0.0. Generated 2025-11-26
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