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

## Extension: Billing Options

Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options | Version: 2.2.1 | Highlight text changes?
Standards status: Trial-use Active as of 2026-03-26 | Maturity Level: 1 | Computable Name: CRDBillingOptions
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.42.24

Identifies billing codes that could potentially be used for this clinical code

Context of Use

This extension may be used on the following element(s)

- Element ID: `Appointment.serviceType`
- Path CommunicationRequest.payload.content.extension('http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content')
- Element ID: `Device`
- Path DeviceRequest.code.ofType(CodeableConcept)
- Element ID: `Encounter.serviceType`
- Element ID: `Medication.code`
- Path MedicationRequest.medication.ofType(CodeableConcept)
- Element ID: `NutritionOrder`
- Element ID: `ServiceRequest.code`
- Element ID: `VisionPrescription.lensSpecification.product`

### Introduction

CRD clients SHALL use the billing-options extension to convey likely billing codes if they are known, but are not required to know billing codes (e.g. if ordering and performing systems will differ). §billopt-1 CRD servers SHALL NOT depend on the billing-options extension being present in order to provide a response. §billopt-2 If codes are provided with the billing-options extension, CRD servers SHALL consider any codes provided and MAY consider additional codes determined by their own mapping when returning coverage information responses. §billopt-3

Usage info

Usages:

- Use this Extension: CRD Appointment without Order, CRD Communication Request, CRD Device, CRD Device Request... Show 5 more, CRD Encounter, CRD Medication, CRD Medication Request, CRD Service Request and CRD Vision Prescription
- Examples for this Extension: ServiceRequest/example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description Differentials, Snapshots, and other representations.

- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Billing Options
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: CRD Billing Codes Value Set (extensible)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Extension.value[x] | Base | extensible | CRD Billing Codes Value Set | 📦2.2.1 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Billing Options
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: CRD Billing Codes Value Set (extensible)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.value[x] | Base | extensible | CRD Billing Codes Value Set | 📦2.2.1 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Simple Extension with the type CodeableConcept: Identifies billing codes that could potentially be used for this clinical code

Maturity: 1

Differential ViewDifferential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Billing Options
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: CRD Billing Codes Value Set (extensible)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Extension.value[x] | Base | extensible | CRD Billing Codes Value Set | 📦2.2.1 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Billing Options
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: CRD Billing Codes Value Set (extensible)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.value[x] | Base | extensible | CRD Billing Codes Value Set | 📦2.2.1 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Simple Extension with the type CodeableConcept: Identifies billing codes that could potentially be used for this clinical code

Maturity: 1

Other representations of profile: CSV, Excel, Schematron