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 and changes regularly. See the Directory of published versions

ValueSet: Claim Information Category


Defining URL:
Title:Claim Information Category

Claim Information Category - Used as the discriminator for supportingInfo

Publisher:HL7 Financial Management Working Group
Source Resource:XML / JSON / Turtle


This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)



This value set contains 23 concepts

Expansion based on Claim Information Category v0.3.1 (CodeSystem)

All codes from system

billingnetworkcontractingstatusbillingnetworkcontractingstatusIndicates the network status of the billing physician.
attendingnetworkcontractingstatusattendingnetworkcontractingstatusIndicates the network status of the attending physician.
sitenetworkcontractingstatussitenetworkcontractingstatusIndicates the network status of the site of service.
referringnetworkcontractingstatusreferringnetworkcontractingstatusIndicates the network status of the referring physician.
performingnetworkcontractingstatusperformingnetworkcontractingstatusIndicates the network status of the performing physician.
prescribingnetworkcontractingstatusprescribingnetworkcontractingstatusIndicates the network status of the prescribing physician.
supervisingnetworkcontractingstatussupervisingingnetworkcontractingstatusIndicates the network status of the supervising physician.
clmrecvddateclmrecvddateThe date the claim was received by the payer.
typeofservicetypeofserviceHigh level classification of services into logical grouping.
tob-typeoffacilitytob-typeoffacilityUB04 (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.
tob-billclassificationtob-billclassificationUB04 (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.
tob-frequencytob-frequencyUB04 (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.
admsrcadmsrcIdentifies 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).
admtypeadmtypePriority 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.
discharge-statusdischarge-statusPatient’s status as of the discharge date for a facility stay.
drgdrgDiagnosis Related Group
placeofserviceplaceofserviceCode indicating the location, such as inpatient, outpatient facility, office, or home health agency, where this service was performed.
dayssupplydayssupplyNumber of days supply of medication dispensed by the pharmacy.
dawcodedawcodePrescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.
refillnumrefillnumThe number fill of the current dispensed supply (0, 1, 2, etc.).
rxorigincoderxorigincodeWhether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy
brandgenericcodebrandgenericcodeWhether the plan adjudicated the claim as a brand or generic drug.
typeofbillType of BillType of Bill

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
Source The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code