CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue ButtonĀ®)
1.2.0 - CI - STU2 Draft

CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue ButtonĀ®), published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 1.2.0). This version is based on the current content of https://github.com/HL7/carin-bb/ and changes regularly. See the Directory of published versions

Table of Contents

..0 Table of Contents
...1 Home
...2 Background
...3 Use Case
...4 General Guidance
...5 Common Payer Consumer Data Set (CPCDS)
...6 Terminology Licensure
...7 Artifacts Summary
....7.1 C4BB CapabilityStatement
....7.2 Coverage_Payor
....7.3 ExplanationOfBenefit_Careteam
....7.4 ExplanationOfBenefit_Coverage
....7.5 ExplanationOfBenefit_Identifier
....7.6 ExplanationOfBenefit_Insurer
....7.7 ExplanationOfBenefit_Patient
....7.8 ExplanationOfBenefit_Provider
....7.9 ExplanationOfBenefit_ServiceDate
....7.10 ExplanationOfBenefit_ServiceStartDate
....7.11 ExplanationOfBenefit_Type
....7.12 ExplanationOfBenefit_Organization
....7.13 ExplanationOfBenefit_Practitioner
....7.14 C4BB Explanation Of Benefit
....7.15 C4BB Coverage
....7.16 C4BB ExplanationOfBenefit Inpatient Institutional
....7.17 C4BB ExplanationOfBenefit Oral
....7.18 C4BB ExplanationOfBenefit Outpatient Institutional
....7.19 C4BB ExplanationOfBenefit Pharmacy
....7.20 C4BB ExplanationOfBenefit Professional NonClinician
....7.21 C4BB Organization
....7.22 C4BB Patient
....7.23 C4BB Practitioner
....7.24 ADA Code on Dental Procedures and Nomenclature
....7.25 American Dental Association Universal Numbering Value Set
....7.26 NUBC Patient Discharge Status Codes
....7.27 NUBC Point Of Origin
....7.28 NUBC Present On Admission Indicator Codes
....7.29 NUBC Priority (Type) of Admission or Visit
....7.30 NUBC Revenue Codes
....7.31 NUBC Type of Bill Codes
....7.32 Procedure Modifier Codes - AMA CPT - CMS HCPCS
....7.33 Procedure Codes - AMA CPT - CMS HCPCS
....7.34 C4BB Adjudication
....7.35 C4BB Adjudication Category Discriminator
....7.36 C4BB Claim Identifier Type
....7.37 C4BB Claim Inpatient Institutional Diagnosis Type
....7.38 C4BB Claim Institutional Care Team Role
....7.39 C4BB Claim Outpatient Institutional Diagnosis Type
....7.40 C4BB Claim Pharmacy CareTeam Roles
....7.41 C4BB Claim Procedure Type
....7.42 C4BB Claim Professional And Non Clinician Care Team Role
....7.43 C4BB Claim Professional And Non Clinician Diagnosis Type
....7.44 Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
....7.45 C4BB Institutional Claim SubType
....7.46 C4BB Organization Identifier Type
....7.47 C4BB Patient Identifier Type
....7.48 C4BB Payee Type
....7.49 C4BB Payer Benefit Payment Status
....7.50 C4BB Payer Claim Payment Status Code
....7.51 C4BB Payer Provider Contracting Status
....7.52 C4BB Practitioner Identifier Type
....7.53 C4BB Professional And Non Clinician Claim SubType
....7.54 C4BB Professional And Non Clinician Claim Type
....7.55 C4BB Related Claim Relationship Codes
....7.56 C4BB SupportingInfo Type
....7.57 US Surface Codes Set
....7.58 C4BB Total Category Discriminator
....7.59 Diagnosis Codes - International Classification of Diseases, Clinical Modification (ICD-9-CM, ICD-10-CM)
....7.60 Procedure Codes - International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) - ICD-10 Procedure Coding System
....7.61 MS-DRGs - AP-DRGs - APR-DRGs
....7.62 CMS Place of Service Codes (POS)
....7.63 NDC or Compound
....7.64 National Drug Code (NDC)
....7.65 NCPDP Brand Generic Indicator
....7.66 NCPDP Compound Code
....7.67 NCPDP Dispense As Written (DAW)/Product Selection Code
....7.68 NCPDP Prescription Origin Code
....7.69 NCPDP Reject Code
....7.70 Oral Body Site Value Set
....7.71 X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes
....7.72 American Dental Association Area of Oral Cavity System
....7.73 ADA Code on Dental Procedures and Nomenclature
....7.74 American Dental Association Universal Numbering System
....7.75 NUBC Patient Discharge Status Codes
....7.76 NUBC Point Of Origin for Newborn
....7.77 NUBC Point Of Origin for Non-newborn
....7.78 NUBC Present On Admission Indicator Codes
....7.79 NUBC Priority (Type) of Admission or Visit
....7.80 NUBC Revenue Codes
....7.81 NUBC Type Of Bill Codes
....7.82 C4BB Adjudication
....7.83 C4BB Adjudication Discriminator
....7.84 C4BB Claim Care Team Role
....7.85 C4BB Claim Diagnosis Type
....7.86 C4BB Claim Procedure Type
....7.87 C4BB Compound Literal
....7.88 C4BB Identifier Type
....7.89 C4BB Institutional Claim SubType
....7.90 C4BB Payee Type
....7.91 C4BB Payer Adjudication Status
....7.92 C4BB Related Claim Relationship Codes
....7.93 C4BB Supporting Info Type
....7.94 US Surface Codes System
....7.95 Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes
....7.96 Health Insurance Prospective Payment System (HIPPS)
....7.97 Medicare Severity Diagnosis Related Groups (MS-DRGs)
....7.98 CMS Place of Service Codes (POS)
....7.99 X12 Remittance Advice Remark Codes
....7.100 NCPDP Brand Generic Indicator
....7.101 NCPDP Compound Code
....7.102 NCPDP Dispense As Written (DAW)/Product Selection Code
....7.103 NCPDP Prescription Origin Code
....7.104 NCPDP Reject Code
....7.105 All Patient Diagnosis Related Groups (AP-DRGs)
....7.106 All Patient Refined Diagnosis Related Groups (APR-DRGs)
....7.107 X12 Claim Adjustment Reason Codes
....7.108 Coverage1
....7.109 CoverageDental1
....7.110 EOBInpatient1
....7.111 EOBOral1a
....7.112 EOBOral2
....7.113 EOBOutpatientInstitutional1
....7.114 EOBPharmacy1
....7.115 EOBProfessional1a
....7.116 OrganizationDentalPayer1
....7.117 OrganizationProvider1
....7.118 Patient1
....7.119 OrganizationPayer1
....7.120 PractitionerDentalProvider1
....7.121 Coverage Example 1
....7.122 Coverage Example 2
....7.123 EOB Inpatient Institutional - Example 1
....7.124 EOB Outpatient Institutional - Example 1
....7.125 EOB Professional - Example 1
....7.126 Payer Organization Example 1
....7.127 Provider Organization Example 1
....7.128 Provider Organization Example 3
....7.129 Provider Organization Example 4
....7.130 Provider Organization Example 5
....7.131 Provider Organization Example 6
....7.132 Patient Example 1
....7.133 Practitioner Example 1
....7.134 Practitioner Example 2
....7.135 Practitioner Example 3
...8 Search Parameters
...9 Security and Privacy Considerations
...10 Downloads
...11 Change Notes