HL7 Terminology (THO)
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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

: CDS Hooks Card Types - TTL Representation

Active as of 2025-10-16 Maturity Level: 1

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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:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "cdshooks-card-type"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<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\">  unsolicited-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>"^^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 1     ]
  ] ) ; # 
  fhir:url [
fhir:v "http://terminology.hl7.org/CodeSystem/cdshooks-card-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/cdshooks-card-type>
  ] ; # 
  fhir:identifier ( [
fhir:system [
fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ;
fhir:l <urn:ietf:rfc:3986>     ] ;
fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.5.176" ]
  ] ) ; # 
  fhir:version [ fhir:v "1.0.0"] ; # 
  fhir:name [ fhir:v "CDSHooksCardType"] ; # 
  fhir:title [ fhir:v "CDS Hooks Card Types"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v false] ; # 
  fhir:date [ fhir:v "2025-10-16T00:00:00+00:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "Health Level Seven International"] ; # 
  fhir:contact ( [
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://hl7.org" ]     ] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "hq@HL7.org" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "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."] ; # 
  fhir:copyright [ fhir:v "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"] ; # 
  fhir:caseSensitive [ fhir:v true] ; # 
  fhir:hierarchyMeaning [ fhir:v "is-a"] ; # 
  fhir:content [ fhir:v "complete"] ; # 
  fhir:concept ( [
fhir:code [ fhir:v "coverage-info" ] ;
fhir:display [ fhir:v "Coverage Information" ] ;
fhir:definition [ fhir:v "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" ] ;
    ( fhir:concept [
fhir:code [ fhir:v "unsolicited-determ" ] ;
fhir:display [ fhir:v "Unsolicited Determination" ] ;
fhir:definition [ fhir:v "An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request" ]     ] )
  ] [
fhir:code [ fhir:v "claim" ] ;
fhir:display [ fhir:v "Claim" ] ;
fhir:definition [ fhir:v "Information about what steps need to be taken to submit a claim for the service" ]
  ] [
fhir:code [ fhir:v "insurance" ] ;
fhir:display [ fhir:v "Insurance" ] ;
fhir:definition [ fhir:v "Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)" ]
  ] [
fhir:code [ fhir:v "limits" ] ;
fhir:display [ fhir:v "Limits" ] ;
fhir:definition [ fhir:v "Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general" ]
  ] [
fhir:code [ fhir:v "network" ] ;
fhir:display [ fhir:v "Network" ] ;
fhir:definition [ fhir:v "Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)" ]
  ] [
fhir:code [ fhir:v "appropriate-use" ] ;
fhir:display [ fhir:v "Appropriate Use" ] ;
fhir:definition [ fhir:v "Guidance on whether appropriate-use documentation is needed" ]
  ] [
fhir:code [ fhir:v "cost" ] ;
fhir:display [ fhir:v "Cost" ] ;
fhir:definition [ fhir:v "What is the anticipated cost to the patient based on their coverage" ]
  ] [
fhir:code [ fhir:v "therapy-alternatives-opt" ] ;
fhir:display [ fhir:v "Optional Therapy Alternatives" ] ;
fhir:definition [ fhir:v "Are there alternative therapies that have better coverage and/or are lower-cost for the patient" ]
  ] [
fhir:code [ fhir:v "therapy-alternatives-req" ] ;
fhir:display [ fhir:v "Required Therapy Alternatives" ] ;
fhir:definition [ fhir:v "Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy" ]
  ] [
fhir:code [ fhir:v "clinical-reminder" ] ;
fhir:display [ fhir:v "Clinical Reminder" ] ;
fhir:definition [ fhir:v "Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)" ]
  ] [
fhir:code [ fhir:v "duplicate-therapy" ] ;
fhir:display [ fhir:v "Duplicate Therapy" ] ;
fhir:definition [ fhir:v "Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system" ]
  ] [
fhir:code [ fhir:v "contraindication" ] ;
fhir:display [ fhir:v "Contraindication" ] ;
fhir:definition [ fhir:v "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" ]
  ] [
fhir:code [ fhir:v "guideline" ] ;
fhir:display [ fhir:v "Guideline" ] ;
fhir:definition [ fhir:v "Indication that there is a guideline available for the proposed therapy (with an option to view)" ]
  ] [
fhir:code [ fhir:v "off-guideline" ] ;
fhir:display [ fhir:v "Off Guideline" ] ;
fhir:definition [ fhir:v "Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline" ]
  ] ) . #