Da Vinci - Coverage Requirements Discovery
2.2.0 - STU 2.2
Da Vinci - Coverage Requirements Discovery
2.2.0 - STU 2.2
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 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
| Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo | Version: 2.2.0 | ||||
| Standards status: Trial-use Active as of 2026-03-04 | Maturity Level: 1 | Computable Name: CRDCoveredInfo | |||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.13 | |||||
Codes defining whether the ordered/requested service is covered under patient's plan
References
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes version 📦2.2.0| Code | Display | Definition |
| not-covered | Not covered | No coverage or possibility of coverage for this service |
| covered | Covered | Regular coverage applies. Coverage is still subject to normal plan limits, deductibles, and other considerations meaning there is no guarantee of payment. This response does NOT replace any need for a pre-determination, if required. |
| conditional | Conditional | There is the potential for information requirements from a participant type not listed. However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.) |
| indeterminate | Indeterminate | Indicates that, due to technical issues on the part of the client and/or server, consent restrictions by the patient, or similar atypical limitations or constraints, the payer is unable to evaluate coverage requirements |
Expansion performed internally based on codesystem Coverage Information Codes v2.2.0 (CodeSystem)
This value set contains 4 concepts
| System | Code | Display (en) | Definition | JSON | XML |
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | not-covered | Not covered | No coverage or possibility of coverage for this service | ||
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | covered | Covered | Regular coverage applies. Coverage is still subject to normal plan limits, deductibles, and other considerations meaning there is no guarantee of payment. This response does NOT replace any need for a pre-determination, if required. | ||
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | conditional | Conditional | There is the potential for information requirements from a participant type not listed. However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.) | ||
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | indeterminate | Indeterminate | Indicates that, due to technical issues on the part of the client and/or server, consent restrictions by the patient, or similar atypical limitations or constraints, the payer is unable to evaluate coverage requirements |
IG © 2019+ HL7 International / Financial Management.
Package hl7.fhir.us.davinci-crd#2.2.0 based on FHIR 4.0.1.
Generated
2026-03-04
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