Da Vinci - Coverage Requirements Discovery
2.2.0-ballot - United States of America flag

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-ballot 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 Information Documentation Reason Value Set

Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason Version: 2.2.0-ballot
Standards status: Trial-use Active as of 2025-10-30 Maturity Level: 1 Computable Name: CRDDocReason
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.3

List of reasons for additional documentation

References

Logical Definition (CLD)

This value set includes codes based on the following rules:

  • Include these codes as defined in http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes version 📦2.2.0-ballot
    CodeDisplayDefinition
    withpaInclude in prior authorizationThe information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) a prior authorization for the associated request resource(s).
    withclaimInclude with claimThe information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) the insurance claim for the services ordered by the associated request resource(s).
    withorderInclude with orderThe information in this QuestionnaireResponse should be packaged into a Bundle and submitted along with (or referenced as supporting information to) the associated request resource(s) when transmitting the order to the fulfilling system.
    retain-docMedical necessityThe information in this QuestionnaireResponse should be retained within the EHR as supporting evidence of the medical necessity of the associated request resource(s).
  • Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-NullFlavor version 📦3.0.0
    CodeDisplayDefinition
    OTH other **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).

    **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.

    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.

 

Expansion

This value set contains 5 concepts

SystemCodeDisplay (en)JSONXML
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  withpaInclude in prior authorization
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  withclaimInclude with claim
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  withorderInclude with order
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  retain-docMedical necessity
http://terminology.hl7.org/CodeSystem/v3-NullFlavor  OTHother

Description of the above table(s).