Da Vinci - Coverage Requirements Discovery
2.2.1 - STU 2.2

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 2.2.1 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

## : CRD Coverage Information Additional Documentation Value Set

Page standards status: Trial-use | Maturity Level: 1

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      "id" : "AdditionalDocumentation",
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        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet AdditionalDocumentation</b></p><a name=\"AdditionalDocumentation\"> </a><a name=\"hcAdditionalDocumentation\"> </a><ul><li>Include these codes as defined in <a href=\"CodeSystem-coverage-information-codes.html\"><code>http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes</code></a><span title=\"Version is not explicitly stated, which means it is fixed to the version provided in this specification\"> version &#x1F4E6;2.2.1</span><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-coverage-information-codes.html#coverage-information-codes-clinical\">clinical</a></td><td style=\"color: #cccccc\">Clinical Documentation</td><td>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.</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-admin\">admin</a></td><td style=\"color: #cccccc\">Administrative Documentation</td><td>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.</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-patient\">patient</a></td><td style=\"color: #cccccc\">Patient-sourced Information</td><td>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</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-conditional\">conditional</a></td><td style=\"color: #cccccc\">Conditional</td><td>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.)</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-indeterminate\">indeterminate</a></td><td style=\"color: #cccccc\">Indeterminate</td><td>Indicates that, due to technical issues on the part of the client and/or server, consent restrictions by the patient, or similar atypical limitations or constraints, the payer is unable to evaluate coverage requirements</td></tr></table></li></ul></div>"
      },
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        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
          "valueCode" : "fm"
        },
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          "_valueCode" : {
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              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
                "valueCanonical" : "http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"
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      ],
      "url" : "http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation",
      "identifier" : [
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          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:oid:2.16.840.1.113883.4.642.40.18.48.1"
        }
      ],
      "version" : "2.2.1",
      "name" : "CRDAdditionalDoc",
      "title" : "CRD Coverage Information Additional Documentation Value Set",
      "status" : "active",
      "experimental" : false,
      "date" : "2026-03-26T15:54:25+00:00",
      "publisher" : "HL7 International / Financial Management",
      "contact" : [
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          "telecom" : [
            {
              "system" : "url",
              "value" : "http://www.hl7.org/Special/committees/fm"
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          ]
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      ],
      "description" : "Codes defining whether additional documentation needs to be captured",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "US"
            }
          ]
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      ],
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              {
                "code" : "clinical"
              },
              {
                "code" : "admin"
              },
              {
                "code" : "patient"
              },
              {
                "code" : "conditional"
              },
              {
                "code" : "indeterminate"
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            ]
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