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 - XML Representation

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="ClaimInformationCategoryCS"/>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <url
       value="http://hl7.org/fhir/us/carin-bb/CodeSystem/ClaimInformationCategoryCS"/>
  <version value="0.3.1"/>
  <name value="ClaimInformationCategoryCS"/>
  <title value="Claim Information Category"/>
  <status value="active"/>
  <date value="2020-08-04T02:04:45+00:00"/>
  <publisher value="HL7 Financial Management Working Group"/>
  <contact>
    <name value="HL7 Financial Management Working Group"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm/index.cfm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fm@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               value="Claim Information Category - Used as the discriminator for supportingInfo"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <content value="complete"/>
  <count value="23"/>
  <concept>
    <code value="billingnetworkcontractingstatus"/>
    <display value="billingnetworkcontractingstatus"/>
    <definition value="Indicates the network  status of the billing physician."/>
  </concept>
  <concept>
    <code value="attendingnetworkcontractingstatus"/>
    <display value="attendingnetworkcontractingstatus"/>
    <definition
                value="Indicates the network  status of the attending physician."/>
  </concept>
  <concept>
    <code value="sitenetworkcontractingstatus"/>
    <display value="sitenetworkcontractingstatus"/>
    <definition value="Indicates the network  status of the site of service."/>
  </concept>
  <concept>
    <code value="referringnetworkcontractingstatus"/>
    <display value="referringnetworkcontractingstatus"/>
    <definition
                value="Indicates the network  status of the referring physician."/>
  </concept>
  <concept>
    <code value="performingnetworkcontractingstatus"/>
    <display value="performingnetworkcontractingstatus"/>
    <definition
                value="Indicates the network  status of the performing physician."/>
  </concept>
  <concept>
    <code value="prescribingnetworkcontractingstatus"/>
    <display value="prescribingnetworkcontractingstatus"/>
    <definition
                value="Indicates the network  status of the prescribing physician."/>
  </concept>
  <concept>
    <code value="supervisingnetworkcontractingstatus"/>
    <display value="supervisingingnetworkcontractingstatus"/>
    <definition
                value="Indicates the network  status of the supervising physician."/>
  </concept>
  <concept>
    <code value="clmrecvddate"/>
    <display value="clmrecvddate"/>
    <definition value="The date the claim was received by the payer."/>
  </concept>
  <concept>
    <code value="typeofservice"/>
    <display value="typeofservice"/>
    <definition
                value="High level classification of services into logical grouping."/>
  </concept>
  <concept>
    <code value="tob-typeoffacility"/>
    <display value="tob-typeoffacility"/>
    <definition
                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."/>
  </concept>
  <concept>
    <code value="tob-billclassification"/>
    <display value="tob-billclassification"/>
    <definition
                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."/>
  </concept>
  <concept>
    <code value="tob-frequency"/>
    <display value="tob-frequency"/>
    <definition
                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."/>
  </concept>
  <concept>
    <code value="admsrc"/>
    <display value="admsrc"/>
    <definition
                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)."/>
  </concept>
  <concept>
    <code value="admtype"/>
    <display value="admtype"/>
    <definition
                value="Priority of the admission. Information located on (UB04 Form Locator 14). For example, an admission type of elective indicates that the patient&#39;s condition permitted time for medical services to be scheduled."/>
  </concept>
  <concept>
    <code value="discharge-status"/>
    <display value="discharge-status"/>
    <definition
                value="Patient’s status as of the discharge date for a facility stay."/>
  </concept>
  <concept>
    <code value="drg"/>
    <display value="drg"/>
    <definition value="Diagnosis Related Group"/>
  </concept>
  <concept>
    <code value="placeofservice"/>
    <display value="placeofservice"/>
    <definition
                value="Code indicating the location, such as inpatient, outpatient facility, office, or home health agency, where this service was performed."/>
  </concept>
  <concept>
    <code value="dayssupply"/>
    <display value="dayssupply"/>
    <definition
                value="Number of days supply of medication dispensed by the pharmacy."/>
  </concept>
  <concept>
    <code value="dawcode"/>
    <display value="dawcode"/>
    <definition
                value="Prescriber&#39;s instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication."/>
  </concept>
  <concept>
    <code value="refillnum"/>
    <display value="refillnum"/>
    <definition
                value="The number fill of the current dispensed supply (0, 1, 2, etc.)."/>
  </concept>
  <concept>
    <code value="rxorigincode"/>
    <display value="rxorigincode"/>
    <definition
                value="Whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy"/>
  </concept>
  <concept>
    <code value="brandgenericcode"/>
    <display value="brandgenericcode"/>
    <definition
                value="Whether the plan adjudicated the claim as a brand or generic drug."/>
  </concept>
  <concept>
    <code value="typeofbill"/>
    <display value="Type of Bill"/>
    <definition value="Type of Bill"/>
  </concept>
</CodeSystem>