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 Detail Categories Value Set

Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetailCategories Version: 2.2.0-ballot
Standards status: Trial-use Active as of 2025-10-30 Maturity Level: 1 Computable Name: CRDCoverageDetailCategories
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.23

Codes that define the type of coverage information detail being provided

References

Logical Definition (CLD)

  • Include these codes as defined in http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes version 📦2.2.0-ballot
    CodeDisplayDefinition
    cat-limitationCoverage LimitationThe statement being made about coverage or authorization that are being constrained in scope in some way. I.e. It is not safe to interpret the statements of 'this is covered' or 'this does not require prior auth' without looking at this detail.
    cat-decisionalDecision ConsiderationsThe statement does not qualify the coverage statement, however it does provide information that may be relevant to the patient & caregiver decision of whether a therapy is appropriate/reasonable.
    cat-otherOther DetailsThe statement does not limit the coverage statement being made and is unlikely to influence a decision to proceed with care. For example, instructions on how to submit a claim, reference to to policy, etc.

 

Expansion

Expansion performed internally based on codesystem Coverage Information Codes v2.2.0-ballot (CodeSystem)

This value set contains 3 concepts

SystemCodeDisplay (en)JSONXML
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  cat-limitationCoverage Limitation
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  cat-decisionalDecision Considerations
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  cat-otherOther Details

Description of the above table(s).