Da Vinci - Coverage Requirements Discovery
2.2.0-snapshot - STU 2.2 Peer Review

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 2.2.0-snapshot 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

## ValueSet: CRD Coverage Assertion Reasons Value Set

Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons | Version: 2.2.0-snapshot | Highlight text changes?
Standards status: Trial-use Active as of 2026-02-19 | Maturity Level: 1 | Computable Name: CRDCoverageAssertionReasons
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.10

Reasons for a coverage assertion in the coverage-information extension

References

- Coverage Information

> This value set uses codes slated to be moved from the temporary code system to a more permanent URL.

### Logical Definition (CLD)

- Include these codes as defined in `http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp` version 📦2.2.0-snapshot

  Code | Display | Definition
  gold-card | Gold card | Ordering Practitioner has been granted 'gold card' status with this payer/coverage type.
  no-member-found | Member not found | The CRD server was unable to find a matching member, so no coverage information can be provided
  no-active-coverage | Coverage not active | The referenced insurance coverage for the member is not active, so no coverage information can be provided
  auth-out-network | Authorization needed out-of-network | Authorization is necessary if out-of-network.

### Expansion

Expansion performed internally based on codesystem CRD Temporary Codes v2.2.0-snapshot (CodeSystem)

This value set contains 4 concepts

System | Code | Display (en) | Definition | JSON | XML
`http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp` | gold-card | Gold card | Ordering Practitioner has been granted 'gold card' status with this payer/coverage type. |  |
`http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp` | no-member-found | Member not found | The CRD server was unable to find a matching member, so no coverage information can be provided |  |
`http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp` | no-active-coverage | Coverage not active | The referenced insurance coverage for the member is not active, so no coverage information can be provided |  |
`http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp` | auth-out-network | Authorization needed out-of-network | Authorization is necessary if out-of-network. |  |

Description of the above table(s).