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

## : CRD Information Needed Value Set

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

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    {
      "resourceType" : "ValueSet",
      "id" : "informationNeeded",
      "language" : "en",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet informationNeeded</b></p><a name=\"informationNeeded\"> </a><a name=\"hcinformationNeeded\"> </a><p>This value set includes codes based on the following rules:</p><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;2.2.0-snapshot</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-performer\">performer</a></td><td style=\"color: #cccccc\">Performer Needed</td><td>Information about who (specifically, or at least performer type and affiliation) is necessary to make a determination of coverage and/or prior auth expectations</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-location\">location</a></td><td style=\"color: #cccccc\">Location Needed</td><td>Information about where (specific clinic/site or organization) is necessary to make a determination of coverage and/or prior auth expectations</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-timeframe\">timeframe</a></td><td style=\"color: #cccccc\">Timeframe Needed</td><td>Information about when the service will be performed that is more granular than the order effective period is necessary to make a determination of coverage and/or prior auth expectations</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-contract-window\">contract-window</a></td><td style=\"color: #cccccc\">New Contract Window</td><td>The target performance time for the event falls outside the contract window for the patient's current coverage.  Information will not be available until a contract is in place covering the service time period</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-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><li>Include these codes as defined in <a href=\"http://terminology.hl7.org/7.0.1/CodeSystem-v3-NullFlavor.html\"><code>http://terminology.hl7.org/CodeSystem/v3-NullFlavor</code></a><span title=\"Version is explicitly stated to be 3.0.0\"> version &#x1F4CD;3.0.0</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=\"http://terminology.hl7.org/7.0.1/CodeSystem-v3-NullFlavor.html#v3-NullFlavor-OTH\">OTH</a></td><td style=\"color: #cccccc\">other</td><td>**Description:**The actual value is not a member of the set of permitted data values in the constrained value domain of a variable. (e.g., concept not provided by required code system).<br/><br/>**Usage Notes**: This flavor and its specializations are most commonly used with the CD datatype and its flavors. However, it may apply to \\*any\\* datatype where the constraints of the type are tighter than can be conveyed. For example, a PQ that is for a true measured amount whose units are not supported in UCUM, a need to convey a REAL when the type has been constrained to INT, etc.<br/><br/>With coded datatypes, this null flavor may only be used if the vocabulary binding has a coding strength of CNE. By definition, all local codes and original text are part of the value set if the coding strength is CWE.</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/informationNeeded",
      "identifier" : [
        {
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:oid:2.16.840.1.113883.4.642.40.18.48.16"
        }
      ],
      "version" : "2.2.0-snapshot",
      "name" : "CRDInformationNeeded",
      "title" : "CRD Information Needed Value Set",
      "status" : "active",
      "experimental" : false,
      "date" : "2026-02-19T15:54:35+00:00",
      "publisher" : "HL7 International / Financial Management",
      "contact" : [
        {
          "telecom" : [
            {
              "system" : "url",
              "value" : "http://www.hl7.org/Special/committees/fm"
            }
          ]
        }
      ],
      "description" : "Codes defining whether information about the performer, location, and/or performance date is needed to determine coverage information",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "US"
            }
          ]
        }
      ],
      "compose" : {
        "include" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes",
            "concept" : [
              {
                "code" : "performer"
              },
              {
                "code" : "location"
              },
              {
                "code" : "timeframe"
              },
              {
                "code" : "contract-window"
              },
              {
                "code" : "detail-code"
              }
            ]
          },
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
            "version" : "3.0.0",
            "concept" : [
              {
                "code" : "OTH"
              }
            ]
          }
        ]
      }
    }