Da Vinci - Coverage Requirements Discovery
2.1.0 - STU 2.1 United States of America flag

Da Vinci - Coverage Requirements Discovery, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-crd/ and changes regularly. See the Directory of published versions

ValueSet: CRD Coverage Information Additional Documentation Value Set

Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation Version: 2.1.0
Standards status: Trial-use Maturity Level: 1 Computable Name: CRDAdditionalDoc

Codes defining whether additional documentation needs to be captured

References

Logical Definition (CLD)

Generated Narrative: ValueSet AdditionalDocumentation

  • Include these codes as defined in http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp
    CodeDisplayDefinition
    clinicalClinical DocumentationDetails most likely to originate from a clinician are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by clinician. Indicates that the CRD client should expose the need to launch DTR to clinical users.
    adminAdministrative DocumentationAdministrative details not likely to require clinical expertise are needed to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by back-end staff. Indicates that while the CRD client might expose the ability to launch DTR as an option for clinical users, it should be clear that clinical input is not necessary and deferring the use of DTR to back-end staff is perfectly appropriate. Some CRD clients might be configured (based on provider preference) to not even show clinicians the option to launch.
    patientAdministrative & clinical docDetails most likely to originate from the patient or their personal representative (e.g. parent, spouse, etc.) are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. For example, information about household composition, accessibility considerations, etc. This should be used when the data needs to come from the patient themselves, rather than a clinician's assessment of the patient
    conditionalConditionalThere is the potential for information requirements from a participant type not listed. However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.)

 

Expansion

Generated Narrative: ValueSet

Expansion based on codesystem CRD Temporary Codes v2.1.0 (CodeSystem)

This value set contains 4 concepts

CodeSystemDisplayDefinition
  clinicalhttp://hl7.org/fhir/us/davinci-crd/CodeSystem/tempClinical Documentation

Details most likely to originate from a clinician are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by clinician. Indicates that the CRD client should expose the need to launch DTR to clinical users.

  adminhttp://hl7.org/fhir/us/davinci-crd/CodeSystem/tempAdministrative Documentation

Administrative details not likely to require clinical expertise are needed to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by back-end staff. Indicates that while the CRD client might expose the ability to launch DTR as an option for clinical users, it should be clear that clinical input is not necessary and deferring the use of DTR to back-end staff is perfectly appropriate. Some CRD clients might be configured (based on provider preference) to not even show clinicians the option to launch.

  patienthttp://hl7.org/fhir/us/davinci-crd/CodeSystem/tempAdministrative & clinical doc

Details most likely to originate from the patient or their personal representative (e.g. parent, spouse, etc.) are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. For example, information about household composition, accessibility considerations, etc. This should be used when the data needs to come from the patient themselves, rather than a clinician's assessment of the patient

  conditionalhttp://hl7.org/fhir/us/davinci-crd/CodeSystem/tempConditional

There is the potential for information requirements from a participant type not listed. However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.)


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
System 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