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 2.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

US Core Procedure

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The US Core 3.1.1 Procedure or US Core 6.1.0 Procedure SHALL be used to record a member's health events. ^§pdex-39

The essential fields (Must Support or Cardinality greater than 0..*) to be provided in the US Core 3.1.1 Procedure or US Core 6.1.0 Procedure are:

Table Definition

Health Plan Mapping Assistance

A collaboration of Health Plan experts has performed an evaluation of claims information and developed a mapping of data for Members to the US Core Procedure profile. This is shown below as an assistance to implementers:

Table Definition

Note: Procedure records SHOULD only be created from ExplanationOfBenefit or CPCDS resources for items that are clinical procedures. ^§pdex-40 Medications, facility charges and supplies SHOULD NOT be created as procedure records. ^§pdex-41

Example Procedure Resource

An example mapping of a Procedure resource for a medical implant is presented below:

{
  "resourceType" : "Procedure",
  "id" : "defib-implant",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">
Generated Narrative with Details
id: defib-implant
meta: 
identifier: urn:uuid:b2a737f2-2fdb-49c1-b097-dac173d07aff
status: completed
code: Insertion or replacement of permanent implantable defibrillator system with transvenous lead(s), single or dual chamber <span style=\"background: LightGoldenRodYellow\">(Details : {http://www.ama-assn.org/go/cpt code '33249' = '33249)</span>
subject: <a href=\"Patient-example.html\">Generated Summary: id: example; Medical Record Number = 1032702 (USUAL); active; Amy V. Shaw ; ph: 555-555-5555(HOME), amy.shaw@example.com; gender: female; birthDate: Feb 20, 2007</a>
performed: Mar 26, 2019, 7:55:26 PM --> Mar 26, 2019, 8:25:26 PM
Performers
<table class=\"grid\">-Actor*<a href=\"Practitioner-practitioner-1.html\">Generated Summary: id: practitioner-1; 9941339108, 25456; Ronald Bone </a></table>
FocalDevices
<table class=\"grid\">-Manipulated*<a href=\"Device-udi-2.html\">Generated Summary: id: udi-2; status: active; manufacturer: ACME Biomedical; expirationDate: Jan 1, 2022, 12:00:00 AM; lotNumber: M320; serialNumber: AC221; modelNumber: 1.0; <span title=\"Codes: {http://snomed.info/sct 19257004}\">Implant</span></a></table></div>"
  },
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:uuid:b2a737f2-2fdb-49c1-b097-dac173d07aff"
    }
  ],
  "status" : "completed",
  "code" : {
    "coding" : [
      {
        "system" : "http://www.ama-assn.org/go/cpt",
        "code" : "33249"
      }
    ],
    "text" : "Insertion or replacement of permanent implantable defibrillator system with transvenous lead(s), single or dual chamber"
  },
  "subject" : {
    "reference" : "Patient/example"
  },
  "performedPeriod" : {
    "start" : "2019-03-26T12:55:26-07:00",
    "end" : "2019-03-26T13:25:26-07:00"
  },
  "performer" : [
    {
      "actor" : {
        "reference" : "Practitioner/practitioner-1"
      }
    }
  ],
  "focalDevice" : [
    {
      "manipulated" : {
        "reference" : "Device/udi-2"
      }
    }
  ]
}

Refer to the US Core Additional examples of the US Core 3.1.1 or US Core 6.1.0 Implementation Guide for further examples of completed Procedure Profiles.

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