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

## : Deprecated CRD Coverage Detail Codes Value Set

Page standards status: Deprecated | Maturity Level: 4

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    <ValueSet xmlns="http://hl7.org/fhir">
      <id value="coverageDetail"/>
      <language value="en"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet coverageDetail</b></p><a name="coverageDetail"> </a><a name="hccoverageDetail"> </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><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-temp.html#temp-allowed-quantity">allowed-quantity</a></td><td style="color: #cccccc">Maximum quantity</td><td>Indicates limitations on the number of services/products allowed (possibly per time period).  Value should be a Quantity</td></tr><tr><td><a href="CodeSystem-temp.html#temp-allowed-period">allowed-period</a></td><td style="color: #cccccc">Maximum allowed period</td><td>Indicates the maximum period of time that can be covered in a single order.  Value should be a Period</td></tr><tr><td><a href="CodeSystem-temp.html#temp-in-network-copay">in-network-copay</a></td><td style="color: #cccccc">Copay for in-network</td><td>Indicates a percentage co-pay to expect if delivered in-network.  Value should be a Quantity.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-out-network-copay">out-network-copay</a></td><td style="color: #cccccc">Copay for out-of-network</td><td>Indicates a percentage co-pay to expect if delivered out-of-network.  Value should be a Quantity.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-concurrent-review">concurrent-review</a></td><td style="color: #cccccc">Concurrent review</td><td>Additional payer-defined documentation will be required prior to claim payment.  Value should be a boolean.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-appropriate-use-needed">appropriate-use-needed</a></td><td style="color: #cccccc">Appropriate use</td><td>Payer-defined appropriate use process must be invoked to determine coverage.  Value should be a boolean.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-policy-link">policy-link</a></td><td style="color: #cccccc">Policy Link</td><td>A URL pointing to the specific portion of a payer policy, coverage agreement or similar authoritative document that provides a portion of the basis for the decision documented in the coverage-information.  Value should be a url.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-instructions">instructions</a></td><td style="color: #cccccc">Instructions</td><td>Information to display to the user that gives guidance about what steps to take in achieving the recommended actions identified by this coverage-information (e.g. special instructions about requesting authorization, details about information needed, details about data retention, etc.).  Value should be a string.  (Category may vary.)</td></tr></table></li></ul></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="deprecated"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="fm"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="4">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"/>
          </extension>
        </valueInteger>
      </extension>
      <url value="http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetail"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:2.16.840.1.113883.4.642.40.18.48.12"/>
      </identifier>
      <version value="2.2.1"/>
      <name value="CRDCoverageDetailCodes"/>
      <title value="Deprecated CRD Coverage Detail Codes Value Set"/>
      <status value="retired"/>
      <experimental value="false"/>
      <date value="2026-03-26T15:54:25+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="Codes for name-value-pair details on a coverage assertion - replaced by the coverageDetailNew value set.  Support for this ValueSet will be dropped in a future version."/>
      <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="allowed-quantity"/>
          </concept>
          <concept>
            <code value="allowed-period"/>
          </concept>
          <concept>
            <code value="in-network-copay"/>
          </concept>
          <concept>
            <code value="out-network-copay"/>
          </concept>
          <concept>
            <code value="concurrent-review"/>
          </concept>
          <concept>
            <code value="appropriate-use-needed"/>
          </concept>
          <concept>
            <code value="policy-link"/>
          </concept>
          <concept>
            <code value="instructions"/>
          </concept>
        </include>
      </compose>
    </ValueSet>