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 Information Needed Value Set

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

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
    performerPerformer NeededInformation about who (specifically, or at least performer type and affiliation) is necessary to make a determination of coverage and/or prior auth expectations
    locationLocation NeededInformation about where (specific clinic/site or organization) is necessary to make a determination of coverage and/or prior auth expectations
    timeframeTimeframe NeededInformation 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-windowNew Contract WindowThe 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-codeDetail codeThe 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'
  • 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 6 concepts

SystemCodeDisplay (en)JSONXML
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  performerPerformer Needed
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  locationLocation Needed
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  timeframeTimeframe Needed
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  contract-windowNew Contract Window
http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes  detail-codeDetail code
http://terminology.hl7.org/CodeSystem/v3-NullFlavor  OTHother

Description of the above table(s).