Da Vinci Payer Data Exchange
2.1.0 - STU2 United States of America flag

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

: PDex Supporting Info Type - JSON Representation

Page standards status: Trial-use

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{
  "resourceType" : "CodeSystem",
  "id" : "PDexSupportingInfoType",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This case-insensitive code system <code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoType</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">admissionperiod<a name=\"PDexSupportingInfoType-admissionperiod\"> </a></td><td>Admission Period</td><td>Dates corresponding with the admission and discharge of the beneficiary to a facility</td></tr><tr><td style=\"white-space:nowrap\">pointoforigin<a name=\"PDexSupportingInfoType-pointoforigin\"> </a></td><td>Point Of Origin</td><td>UB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility.</td></tr><tr><td style=\"white-space:nowrap\">admtype<a name=\"PDexSupportingInfoType-admtype\"> </a></td><td>Admission Type</td><td>UB-04 Priority of the admission (FL-14) indicates, for example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled.</td></tr><tr><td style=\"white-space:nowrap\">billingnetworkcontractingstatus<a name=\"PDexSupportingInfoType-billingnetworkcontractingstatus\"> </a></td><td>Billing Network Contracting Status</td><td>Indicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission.</td></tr><tr><td style=\"white-space:nowrap\">brandgenericindicator<a name=\"PDexSupportingInfoType-brandgenericindicator\"> </a></td><td>Brand Generic Indicator</td><td>NCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug.</td></tr><tr><td style=\"white-space:nowrap\">clmrecvddate<a name=\"PDexSupportingInfoType-clmrecvddate\"> </a></td><td>Claim Received Date</td><td>Date the claim was received by the payer.</td></tr><tr><td style=\"white-space:nowrap\">compoundcode<a name=\"PDexSupportingInfoType-compoundcode\"> </a></td><td>Compound Code</td><td>NCPDP code indicating whether or not the prescription is a compound.</td></tr><tr><td style=\"white-space:nowrap\">dawcode<a name=\"PDexSupportingInfoType-dawcode\"> </a></td><td>DAW (Dispense As Written) Code</td><td>NCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.</td></tr><tr><td style=\"white-space:nowrap\">dayssupply<a name=\"PDexSupportingInfoType-dayssupply\"> </a></td><td>Days Supply</td><td>NCPDP value indicating the Number of days supply of medication dispensed by the pharmacy.</td></tr><tr><td style=\"white-space:nowrap\">discharge-status<a name=\"PDexSupportingInfoType-discharge-status\"> </a></td><td>Discharge Status</td><td>UB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay.</td></tr><tr><td style=\"white-space:nowrap\">drg<a name=\"PDexSupportingInfoType-drg\"> </a></td><td>DRG</td><td>DRG (Diagnosis Related Group), including the code system, the DRG version and the code value</td></tr><tr><td style=\"white-space:nowrap\">performingnetworkcontractingstatus<a name=\"PDexSupportingInfoType-performingnetworkcontractingstatus\"> </a></td><td>Performing Network Contracting Status</td><td>Indicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission.</td></tr><tr><td style=\"white-space:nowrap\">refillnum<a name=\"PDexSupportingInfoType-refillnum\"> </a></td><td>Refill Number</td><td>NCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)</td></tr><tr><td style=\"white-space:nowrap\">rxorigincode<a name=\"PDexSupportingInfoType-rxorigincode\"> </a></td><td>Rx Origin Code</td><td>NCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy.</td></tr><tr><td style=\"white-space:nowrap\">servicefacility<a name=\"PDexSupportingInfoType-servicefacility\"> </a></td><td>Service Facility</td><td>The facility where the service occurred.  Examples include hospitals, nursing homes, laboratories or homeless shelters.</td></tr><tr><td style=\"white-space:nowrap\">typeofbill<a name=\"PDexSupportingInfoType-typeofbill\"> </a></td><td>Type of Bill</td><td>UB-04 Type of Bill (FL-04) provides specific information for payer purposes.</td></tr><tr><td style=\"white-space:nowrap\">medicalrecordnumber<a name=\"PDexSupportingInfoType-medicalrecordnumber\"> </a></td><td>Medical Record Number</td><td>Patient Medical Record Number associated with the specific claim.</td></tr><tr><td style=\"white-space:nowrap\">patientaccountnumber<a name=\"PDexSupportingInfoType-patientaccountnumber\"> </a></td><td>Patient Account Number</td><td>Patient Account Number associated with the specific claim.</td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoType",
  "version" : "2.1.0",
  "name" : "PDexSupportingInfoType",
  "title" : "PDex Supporting Info Type",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-05-10T16:45:39+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fm@lists.HL7.org"
        }
      ]
    },
    {
      "name" : "Mark Scrimshire (mark.scrimshire@onyxhealth.io)",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:mark.scrimshire@onyxhealth.io"
        }
      ]
    },
    {
      "name" : "HL7 International - Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description" : "Claim Information Category - Used as the discriminator for supportingInfo",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "copyright" : "This CodeSystem is not copyrighted.",
  "caseSensitive" : false,
  "content" : "complete",
  "count" : 18,
  "concept" : [
    {
      "code" : "admissionperiod",
      "display" : "Admission Period",
      "definition" : "Dates corresponding with the admission and discharge of the beneficiary to a facility"
    },
    {
      "code" : "pointoforigin",
      "display" : "Point Of Origin",
      "definition" : "UB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility."
    },
    {
      "code" : "admtype",
      "display" : "Admission Type",
      "definition" : "UB-04 Priority of the admission (FL-14) indicates, for example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled."
    },
    {
      "code" : "billingnetworkcontractingstatus",
      "display" : "Billing Network Contracting Status",
      "definition" : "Indicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission."
    },
    {
      "code" : "brandgenericindicator",
      "display" : "Brand Generic Indicator",
      "definition" : "NCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug."
    },
    {
      "code" : "clmrecvddate",
      "display" : "Claim Received Date",
      "definition" : "Date the claim was received by the payer."
    },
    {
      "code" : "compoundcode",
      "display" : "Compound Code",
      "definition" : "NCPDP code indicating whether or not the prescription is a compound."
    },
    {
      "code" : "dawcode",
      "display" : "DAW (Dispense As Written) Code",
      "definition" : "NCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication."
    },
    {
      "code" : "dayssupply",
      "display" : "Days Supply",
      "definition" : "NCPDP value indicating the Number of days supply of medication dispensed by the pharmacy."
    },
    {
      "code" : "discharge-status",
      "display" : "Discharge Status",
      "definition" : "UB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay."
    },
    {
      "code" : "drg",
      "display" : "DRG",
      "definition" : "DRG (Diagnosis Related Group), including the code system, the DRG version and the code value"
    },
    {
      "code" : "performingnetworkcontractingstatus",
      "display" : "Performing Network Contracting Status",
      "definition" : "Indicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission."
    },
    {
      "code" : "refillnum",
      "display" : "Refill Number",
      "definition" : "NCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)"
    },
    {
      "code" : "rxorigincode",
      "display" : "Rx Origin Code",
      "definition" : "NCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy."
    },
    {
      "code" : "servicefacility",
      "display" : "Service Facility",
      "definition" : "The facility where the service occurred.  Examples include hospitals, nursing homes, laboratories or homeless shelters."
    },
    {
      "code" : "typeofbill",
      "display" : "Type of Bill",
      "definition" : "UB-04 Type of Bill (FL-04) provides specific information for payer purposes."
    },
    {
      "code" : "medicalrecordnumber",
      "display" : "Medical Record Number",
      "definition" : "Patient Medical Record Number associated with the specific claim."
    },
    {
      "code" : "patientaccountnumber",
      "display" : "Patient Account Number",
      "definition" : "Patient Account Number associated with the specific claim."
    }
  ]
}