CARIN Consumer Directed Payer Data Exchange
0.3.1 - STU1

CARIN Consumer Directed Payer Data Exchange, published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 0.3.1). This version is based on the current content of https://github.com/HL7/carin-bb/ and changes regularly. See the Directory of published versions

: Claim Information Category - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@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:Resource.id [ fhir:value "ClaimInformationCategoryCS"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategoryCS defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">billingnetworkcontractingstatus<a name=\"ClaimInformationCategoryCS-billingnetworkcontractingstatus\"> </a></td><td>billingnetworkcontractingstatus</td><td>Indicates the network  status of the billing physician.</td></tr><tr><td style=\"white-space:nowrap\">attendingnetworkcontractingstatus<a name=\"ClaimInformationCategoryCS-attendingnetworkcontractingstatus\"> </a></td><td>attendingnetworkcontractingstatus</td><td>Indicates the network  status of the attending physician.</td></tr><tr><td style=\"white-space:nowrap\">sitenetworkcontractingstatus<a name=\"ClaimInformationCategoryCS-sitenetworkcontractingstatus\"> </a></td><td>sitenetworkcontractingstatus</td><td>Indicates the network  status of the site of service.</td></tr><tr><td style=\"white-space:nowrap\">referringnetworkcontractingstatus<a name=\"ClaimInformationCategoryCS-referringnetworkcontractingstatus\"> </a></td><td>referringnetworkcontractingstatus</td><td>Indicates the network  status of the referring physician.</td></tr><tr><td style=\"white-space:nowrap\">performingnetworkcontractingstatus<a name=\"ClaimInformationCategoryCS-performingnetworkcontractingstatus\"> </a></td><td>performingnetworkcontractingstatus</td><td>Indicates the network  status of the performing physician.</td></tr><tr><td style=\"white-space:nowrap\">prescribingnetworkcontractingstatus<a name=\"ClaimInformationCategoryCS-prescribingnetworkcontractingstatus\"> </a></td><td>prescribingnetworkcontractingstatus</td><td>Indicates the network  status of the prescribing physician.</td></tr><tr><td style=\"white-space:nowrap\">supervisingnetworkcontractingstatus<a name=\"ClaimInformationCategoryCS-supervisingnetworkcontractingstatus\"> </a></td><td>supervisingingnetworkcontractingstatus</td><td>Indicates the network  status of the supervising physician.</td></tr><tr><td style=\"white-space:nowrap\">clmrecvddate<a name=\"ClaimInformationCategoryCS-clmrecvddate\"> </a></td><td>clmrecvddate</td><td>The date the claim was received by the payer.</td></tr><tr><td style=\"white-space:nowrap\">typeofservice<a name=\"ClaimInformationCategoryCS-typeofservice\"> </a></td><td>typeofservice</td><td>High level classification of services into logical grouping.</td></tr><tr><td style=\"white-space:nowrap\">tob-typeoffacility<a name=\"ClaimInformationCategoryCS-tob-typeoffacility\"> </a></td><td>tob-typeoffacility</td><td>UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of facility.</td></tr><tr><td style=\"white-space:nowrap\">tob-billclassification<a name=\"ClaimInformationCategoryCS-tob-billclassification\"> </a></td><td>tob-billclassification</td><td>UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The second digit classifies the type of care (service classification) being billed.</td></tr><tr><td style=\"white-space:nowrap\">tob-frequency<a name=\"ClaimInformationCategoryCS-tob-frequency\"> </a></td><td>tob-frequency</td><td>UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The third digit identifies the frequency of the bill for a specific course of treatment or inpatient confinement.</td></tr><tr><td style=\"white-space:nowrap\">admsrc<a name=\"ClaimInformationCategoryCS-admsrc\"> </a></td><td>admsrc</td><td>Identifies the place where the patient was identified as needing admission to a facility. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15).</td></tr><tr><td style=\"white-space:nowrap\">admtype<a name=\"ClaimInformationCategoryCS-admtype\"> </a></td><td>admtype</td><td>Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled.</td></tr><tr><td style=\"white-space:nowrap\">discharge-status<a name=\"ClaimInformationCategoryCS-discharge-status\"> </a></td><td>discharge-status</td><td>Patient’s status as of the discharge date for a facility stay.</td></tr><tr><td style=\"white-space:nowrap\">drg<a name=\"ClaimInformationCategoryCS-drg\"> </a></td><td>drg</td><td>Diagnosis Related Group</td></tr><tr><td style=\"white-space:nowrap\">placeofservice<a name=\"ClaimInformationCategoryCS-placeofservice\"> </a></td><td>placeofservice</td><td>Code indicating the location, such as inpatient, outpatient facility, office, or home health agency, where this service was performed.</td></tr><tr><td style=\"white-space:nowrap\">dayssupply<a name=\"ClaimInformationCategoryCS-dayssupply\"> </a></td><td>dayssupply</td><td>Number of days supply of medication dispensed by the pharmacy.</td></tr><tr><td style=\"white-space:nowrap\">dawcode<a name=\"ClaimInformationCategoryCS-dawcode\"> </a></td><td>dawcode</td><td>Prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.</td></tr><tr><td style=\"white-space:nowrap\">refillnum<a name=\"ClaimInformationCategoryCS-refillnum\"> </a></td><td>refillnum</td><td>The number fill of the current dispensed supply (0, 1, 2, etc.).</td></tr><tr><td style=\"white-space:nowrap\">rxorigincode<a name=\"ClaimInformationCategoryCS-rxorigincode\"> </a></td><td>rxorigincode</td><td>Whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy</td></tr><tr><td style=\"white-space:nowrap\">brandgenericcode<a name=\"ClaimInformationCategoryCS-brandgenericcode\"> </a></td><td>brandgenericcode</td><td>Whether the plan adjudicated the claim as a brand or generic drug.</td></tr><tr><td style=\"white-space:nowrap\">typeofbill<a name=\"ClaimInformationCategoryCS-typeofbill\"> </a></td><td>Type of Bill</td><td>Type of Bill</td></tr></table></div>"
  ];
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategoryCS"];
  fhir:CodeSystem.version [ fhir:value "0.3.1"];
  fhir:CodeSystem.name [ fhir:value "ClaimInformationCategoryCS"];
  fhir:CodeSystem.title [ fhir:value "Claim Information Category"];
  fhir:CodeSystem.status [ fhir:value "active"];
  fhir:CodeSystem.date [ fhir:value "2020-08-04T02:04:45+00:00"^^xsd:dateTime];
  fhir:CodeSystem.publisher [ fhir:value "HL7 Financial Management Working Group"];
  fhir:CodeSystem.contact [
     fhir:index 0;
     fhir:ContactDetail.name [ fhir:value "HL7 Financial Management Working Group" ];
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/fm/index.cfm" ]     ], [
       fhir:index 1;
       fhir:ContactPoint.system [ fhir:value "email" ];
       fhir:ContactPoint.value [ fhir:value "fm@lists.HL7.org" ]     ]
  ];
  fhir:CodeSystem.description [ fhir:value "Claim Information Category - Used as the discriminator for supportingInfo"];
  fhir:CodeSystem.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
       fhir:Coding.code [ fhir:value "US" ]     ]
  ];
  fhir:CodeSystem.content [ fhir:value "complete"];
  fhir:CodeSystem.count [ fhir:value "23"^^xsd:nonNegativeInteger];
  fhir:CodeSystem.concept [
     fhir:index 0;
     fhir:CodeSystem.concept.code [ fhir:value "billingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "billingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates the network  status of the billing physician." ]
  ], [
     fhir:index 1;
     fhir:CodeSystem.concept.code [ fhir:value "attendingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "attendingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates the network  status of the attending physician." ]
  ], [
     fhir:index 2;
     fhir:CodeSystem.concept.code [ fhir:value "sitenetworkcontractingstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "sitenetworkcontractingstatus" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates the network  status of the site of service." ]
  ], [
     fhir:index 3;
     fhir:CodeSystem.concept.code [ fhir:value "referringnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "referringnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates the network  status of the referring physician." ]
  ], [
     fhir:index 4;
     fhir:CodeSystem.concept.code [ fhir:value "performingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "performingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates the network  status of the performing physician." ]
  ], [
     fhir:index 5;
     fhir:CodeSystem.concept.code [ fhir:value "prescribingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "prescribingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates the network  status of the prescribing physician." ]
  ], [
     fhir:index 6;
     fhir:CodeSystem.concept.code [ fhir:value "supervisingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "supervisingingnetworkcontractingstatus" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates the network  status of the supervising physician." ]
  ], [
     fhir:index 7;
     fhir:CodeSystem.concept.code [ fhir:value "clmrecvddate" ];
     fhir:CodeSystem.concept.display [ fhir:value "clmrecvddate" ];
     fhir:CodeSystem.concept.definition [ fhir:value "The date the claim was received by the payer." ]
  ], [
     fhir:index 8;
     fhir:CodeSystem.concept.code [ fhir:value "typeofservice" ];
     fhir:CodeSystem.concept.display [ fhir:value "typeofservice" ];
     fhir:CodeSystem.concept.definition [ fhir:value "High level classification of services into logical grouping." ]
  ], [
     fhir:index 9;
     fhir:CodeSystem.concept.code [ fhir:value "tob-typeoffacility" ];
     fhir:CodeSystem.concept.display [ fhir:value "tob-typeoffacility" ];
     fhir:CodeSystem.concept.definition [ fhir:value "UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of facility." ]
  ], [
     fhir:index 10;
     fhir:CodeSystem.concept.code [ fhir:value "tob-billclassification" ];
     fhir:CodeSystem.concept.display [ fhir:value "tob-billclassification" ];
     fhir:CodeSystem.concept.definition [ fhir:value "UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The second digit classifies the type of care (service classification) being billed." ]
  ], [
     fhir:index 11;
     fhir:CodeSystem.concept.code [ fhir:value "tob-frequency" ];
     fhir:CodeSystem.concept.display [ fhir:value "tob-frequency" ];
     fhir:CodeSystem.concept.definition [ fhir:value "UB04 (Form Locator 4) type of bill code provides specific information for payer purposes. The third digit identifies the frequency of the bill for a specific course of treatment or inpatient confinement." ]
  ], [
     fhir:index 12;
     fhir:CodeSystem.concept.code [ fhir:value "admsrc" ];
     fhir:CodeSystem.concept.display [ fhir:value "admsrc" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Identifies the place where the patient was identified as needing admission to a facility. This is a two position code mapped from the standard values for the UB-04 Source of Admission code (FL-15)." ]
  ], [
     fhir:index 13;
     fhir:CodeSystem.concept.code [ fhir:value "admtype" ];
     fhir:CodeSystem.concept.display [ fhir:value "admtype" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled." ]
  ], [
     fhir:index 14;
     fhir:CodeSystem.concept.code [ fhir:value "discharge-status" ];
     fhir:CodeSystem.concept.display [ fhir:value "discharge-status" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Patient’s status as of the discharge date for a facility stay." ]
  ], [
     fhir:index 15;
     fhir:CodeSystem.concept.code [ fhir:value "drg" ];
     fhir:CodeSystem.concept.display [ fhir:value "drg" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Diagnosis Related Group" ]
  ], [
     fhir:index 16;
     fhir:CodeSystem.concept.code [ fhir:value "placeofservice" ];
     fhir:CodeSystem.concept.display [ fhir:value "placeofservice" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Code indicating the location, such as inpatient, outpatient facility, office, or home health agency, where this service was performed." ]
  ], [
     fhir:index 17;
     fhir:CodeSystem.concept.code [ fhir:value "dayssupply" ];
     fhir:CodeSystem.concept.display [ fhir:value "dayssupply" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Number of days supply of medication dispensed by the pharmacy." ]
  ], [
     fhir:index 18;
     fhir:CodeSystem.concept.code [ fhir:value "dawcode" ];
     fhir:CodeSystem.concept.display [ fhir:value "dawcode" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication." ]
  ], [
     fhir:index 19;
     fhir:CodeSystem.concept.code [ fhir:value "refillnum" ];
     fhir:CodeSystem.concept.display [ fhir:value "refillnum" ];
     fhir:CodeSystem.concept.definition [ fhir:value "The number fill of the current dispensed supply (0, 1, 2, etc.)." ]
  ], [
     fhir:index 20;
     fhir:CodeSystem.concept.code [ fhir:value "rxorigincode" ];
     fhir:CodeSystem.concept.display [ fhir:value "rxorigincode" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy" ]
  ], [
     fhir:index 21;
     fhir:CodeSystem.concept.code [ fhir:value "brandgenericcode" ];
     fhir:CodeSystem.concept.display [ fhir:value "brandgenericcode" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Whether the plan adjudicated the claim as a brand or generic drug." ]
  ], [
     fhir:index 22;
     fhir:CodeSystem.concept.code [ fhir:value "typeofbill" ];
     fhir:CodeSystem.concept.display [ fhir:value "Type of Bill" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Type of Bill" ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.