Da Vinci - Coverage Requirements Discovery
2.2.0-ballot -
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
| Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded | Version: 2.2.0-ballot | |||
| Standards status: Trial-use Active as of 2025-10-30 | Maturity Level: 1 | Computable Name: CRDInformationNeeded | ||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.16 | ||||
Codes defining whether information about the performer, location, and/or performance date is needed to determine coverage information
References
This value set includes codes based on the following rules:
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes version 📦2.2.0-ballot| Code | Display | Definition |
| performer | Performer Needed | Information about who (specifically, or at least performer type and affiliation) is necessary to make a determination of coverage and/or prior auth expectations |
| location | Location Needed | Information about where (specific clinic/site or organization) is necessary to make a determination of coverage and/or prior auth expectations |
| timeframe | Timeframe Needed | 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 |
| contract-window | New Contract Window | 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 |
| detail-code | Detail code | 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' |
http://terminology.hl7.org/CodeSystem/v3-NullFlavor version 📦3.0.0
| Code | Display | Definition |
| 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 performed internally based on:
This value set contains 6 concepts
| System | Code | Display (en) | JSON | XML |
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | performer | Performer Needed | ||
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | location | Location Needed | ||
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | timeframe | Timeframe Needed | ||
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | contract-window | New Contract Window | ||
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes | detail-code | Detail code | ||
http://terminology.hl7.org/CodeSystem/v3-NullFlavor | OTH | other |