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
Page standards status: Trial-use | Maturity Level: 1 |
{
"resourceType" : "ValueSet",
"id" : "coverageAssertionReasons",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet coverageAssertionReasons</b></p><a name=\"coverageAssertionReasons\"> </a><a name=\"hccoverageAssertionReasons\"> </a><a name=\"coverageAssertionReasons-en-US\"> </a><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-gold-card\">gold-card</a></td><td style=\"color: #cccccc\">Gold card</td><td>Ordering Practitioner has been granted 'gold card' status with this payer/coverage type.</td></tr><tr><td><a href=\"CodeSystem-temp.html#temp-detail-code\">detail-code</a></td><td style=\"color: #cccccc\">Detail code</td><td>The ordered code is at too high a level of granularity to make decisions about coverage/pa/etc. Can only be present if something is 'conditional'</td></tr></table></li></ul></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 1
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "fm"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "trial-use",
"_valueCode" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical" : "http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"
}
]
}
}
],
"url" : "http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons",
"version" : "2.1.0",
"name" : "CRDCoverageAssertionReasons",
"title" : "CRD Coverage Assertion Reasons",
"status" : "active",
"experimental" : false,
"date" : "2024-11-20T17:59:38+00:00",
"publisher" : "HL7 International / Financial Management",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/fm"
}
]
}
],
"description" : "Reasons for a coverage assertion in the coverage-information extension",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"compose" : {
"include" : [
{
"system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
"concept" : [
{
"code" : "gold-card"
},
{
"code" : "detail-code"
}
]
}
]
}
}