Da Vinci Payer Data Exchange
2.1.1 - STU2 Ballot 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 2.1.1 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 Adjudication Category Discriminator - XML Representation

Page standards status: Informative

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="PDexAdjudicationCategoryDiscriminator"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet PDexAdjudicationCategoryDiscriminator</b></p><a name="PDexAdjudicationCategoryDiscriminator"> </a><a name="hcPDexAdjudicationCategoryDiscriminator"> </a><a name="PDexAdjudicationCategoryDiscriminator-en-US"> </a><p>This value set includes codes based on the following rules:</p><ul><li>Import all the codes that are contained in <a href="ValueSet-PDexAdjudication.html">PDex Adjudication</a></li><li>Import all the codes that are contained in <a href="ValueSet-PDexPayerBenefitPaymentStatus.html">PDex Payer Benefit Payment Status</a></li><li>Include all codes defined in <a href="CodeSystem-PDexAdjudicationCS.html"><code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS</code></a></li><li>Include all codes defined in <a href="CodeSystem-PDexAdjudicationDiscriminator.html"><code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationDiscriminator</code></a></li></ul></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="informative">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudicationCategoryDiscriminator"/>
  <version value="2.1.1"/>
  <name value="PDexAdjudicationCategoryDiscriminator"/>
  <title value="PDex Adjudication Category Discriminator"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2024-11-20T18:18:31+00:00"/>
  <publisher value="HL7 International / Financial Management"/>
  <contact>
    <name value="HL7 International / Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fm@lists.HL7.org"/>
    </telecom>
  </contact>
  <contact>
    <name value="Mark Scrimshire (mark.scrimshire@onyxhealth.io)"/>
    <telecom>
      <system value="email"/>
      <value value="mailto:mark.scrimshire@onyxhealth.io"/>
    </telecom>
  </contact>
  <contact>
    <name value="HL7 International - Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
  </contact>
  <description
               value="Used as the discriminator for adjudication.category and item.adjudication.category for the PDex Prior Authorization."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <copyright value="This Valueset is not copyrighted."/>
  <compose>
    <include>
      <valueSet
                value="http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudication"/>
    </include>
    <include>
      <valueSet
                value="http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexPayerBenefitPaymentStatus"/>
    </include>
    <include>
      <system
              value="http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationCS"/>
    </include>
    <include>
      <system
              value="http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationDiscriminator"/>
    </include>
  </compose>
</ValueSet>