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

• Narrative Content
• XML
• JSON
• TTL

: CRD Coverage Information Documentation Reason Value Set - XML Representation

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="DocReason"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet DocReason</b></p><a name="DocReason"> </a><a name="hcDocReason"> </a><a name="DocReason-en-US"> </a><p>This value set includes codes based on the following rules:</p><ul><li>Include these codes as defined in <a href="CodeSystem-temp.html"><code>http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href="CodeSystem-temp.html#temp-withpa">withpa</a></td><td style="color: #cccccc">Include in prior authorization</td><td>The information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) a prior authorization for the associated request resource(s).</td></tr><tr><td><a href="CodeSystem-temp.html#temp-withclaim">withclaim</a></td><td style="color: #cccccc">Include with claim</td><td>The information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) the insurance claim for the services ordered by the associated request resource(s).</td></tr><tr><td><a href="CodeSystem-temp.html#temp-withorder">withorder</a></td><td style="color: #cccccc">Include with order</td><td>The information in this QuestionnaireResponse should be packaged into a Bundle and submitted along with (or referenced as supporting information to) the associated request resource(s) when transmitting the order to the fulfilling system.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-retain-doc">retain-doc</a></td><td style="color: #cccccc">Medical necessity</td><td>The information in this QuestionnaireResponse should be retained within the EHR as supporting evidence of the medical necessity of the associated request resource(s).</td></tr></table></li><li>Include these codes as defined in <a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-NullFlavor.html"><code>http://terminology.hl7.org/CodeSystem/v3-NullFlavor</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-NullFlavor.html#v3-NullFlavor-OTH">OTH</a></td><td style="color: #cccccc">other</td><td>**Description:**The actual value is not a member of the set of permitted data values in the constrained value domain of a variable. (e.g., concept not provided by required code system).<br/><br/>**Usage Notes**: This flavor and its specializations are most commonly used with the CD datatype and its flavors. However, it may apply to \*any\* datatype where the constraints of the type are tighter than can be conveyed. For example, a PQ that is for a true measured amount whose units are not supported in UCUM, a need to convey a REAL when the type has been constrained to INT, etc.<br/><br/>With coded datatypes, this null flavor may only be used if the vocabulary binding has a coding strength of CNE. By definition, all local codes and original text are part of the value set if the coding strength is CWE.</td></tr></table></li></ul></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"/>
      </extension>
    </valueCode>
  </extension>
  <url value="http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.40.18.48.3"/>
  </identifier>
  <version value="2.1.0"/>
  <name value="CRDDocReason"/>
  <title value="CRD Coverage Information Documentation Reason Value Set"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-12-11T01:38:49+00:00"/>
  <publisher value="HL7 International / Financial Management"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
  </contact>
  <description value="List of reasons for additional documentation"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <compose>
    <include>
      <system value="http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp"/>
      <concept>
        <code value="withpa"/>
      </concept>
      <concept>
        <code value="withclaim"/>
      </concept>
      <concept>
        <code value="withorder"/>
      </concept>
      <concept>
        <code value="retain-doc"/>
      </concept>
    </include>
    <include>
      <system value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
      <concept>
        <code value="OTH"/>
      </concept>
    </include>
  </compose>
</ValueSet>