Da Vinci - Coverage Requirements Discovery
2.2.0-snapshot - STU 2.2 Peer Review 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-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: Deprecated CRD Coverage Detail Codes Value Set

Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetail Version: 2.2.0-snapshot
Standards status: Deprecated Retired as of 2025-12-12 Maturity Level: 4 Computable Name: CRDCoverageDetailCodes
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.12

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.

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

  • Include these codes as defined in http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp version 📦2.2.0-snapshot
    CodeDisplayDefinition
    allowed-quantityMaximum quantityIndicates limitations on the number of services/products allowed (possibly per time period). Value should be a Quantity
    allowed-periodMaximum allowed periodIndicates the maximum period of time that can be covered in a single order. Value should be a Period
    in-network-copayCopay for in-networkIndicates a percentage co-pay to expect if delivered in-network. Value should be a Quantity.
    out-network-copayCopay for out-of-networkIndicates a percentage co-pay to expect if delivered out-of-network. Value should be a Quantity.
    concurrent-reviewConcurrent reviewAdditional payer-defined documentation will be required prior to claim payment. Value should be a boolean.
    appropriate-use-neededAppropriate usePayer-defined appropriate use process must be invoked to determine coverage. Value should be a boolean.
    policy-linkPolicy LinkA 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.
    instructionsInstructionsInformation 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.)

 

Expansion

Expansions are not generated for retired value sets

Description of the above table(s).