Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2.1 United States of America flag

Da Vinci Prior Authorization Support (PAS) FHIR IG, 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-pas/ and changes regularly. See the Directory of published versions

: X12 278 Requested Service Type - JSON Representation

Page standards status: Trial-use Maturity Level: 3

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{
  "resourceType" : "ValueSet",
  "id" : "X12278RequestedServiceType",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet X12278RequestedServiceType</b></p><a name=\"X12278RequestedServiceType\"> </a><a name=\"hcX12278RequestedServiceType\"> </a><a name=\"X12278RequestedServiceType-en-US\"> </a><p>This value set includes codes based on the following rules:</p><ul><li>Include these codes as defined in <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-data-absent-reason.html\"><code>http://terminology.hl7.org/CodeSystem/data-absent-reason</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-data-absent-reason.html#data-absent-reason-not-applicable\">not-applicable</a></td><td style=\"color: #cccccc\">Not Applicable</td><td>There is no proper value for this element (e.g. last menstrual period for a male).</td></tr></table></li><li>Include all codes defined in <code>https://codesystem.x12.org/005010/1365</code></li><li>Include all codes defined in <a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-CPT.html\"><code>http://www.ama-assn.org/go/cpt</code></a></li><li>Include all codes defined in <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-hcpcs-Level-II.html\"><code>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</code></a></li><li>Include all codes defined in <a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-icd9cm.html\"><code>http://terminology.hl7.org/CodeSystem/icd9cm</code></a></li><li>Include all codes defined in <a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-icd10PCS.html\"><code>http://www.cms.gov/Medicare/Coding/ICD10</code></a></li><li>Include all codes defined in <a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-v3-ndc.html\"><code>http://hl7.org/fhir/sid/ndc</code></a></li></ul></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 3,
      "_valueInteger" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"
          }
        ]
      }
    },
    {
      "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-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.24.48.18"
    }
  ],
  "version" : "2.1.0",
  "name" : "X12278RequestedServiceType",
  "title" : "X12 278 Requested Service Type",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-12-20T19:33:39+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fmlists@lists.hl7.org"
        }
      ]
    },
    {
      "name" : "Jean Duteau",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:jean@duteaudesign.com"
        }
      ]
    },
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description" : "This set of codes identifies what service is being requested.  For queries, if the query is not searching for a specific service type, the not-applicable data absent reason code can be used.  It is a combination of X12 Service Type codes, CPT (HCPCS I) and HCPCS II procedure code modifiers, ICD-9 Procedure codes, ICD-10 Procedure codes, and NDC Drug codes.  NOTE: HCPCS Level 1 Codes are the CPT codes so either code system could be used to send the codes.  When receiving the codes from an X12 system, the system returned will be HCPCS even if it was initially sent as a CPT code.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "copyright" : "Current Procedural Terminology (CPT) is copyright 2020 American Medical Association. All rights reserved.\nX12 codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.",
  "compose" : {
    "include" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/data-absent-reason",
        "concept" : [
          {
            "code" : "not-applicable"
          }
        ]
      },
      {
        "system" : "https://codesystem.x12.org/005010/1365"
      },
      {
        "system" : "http://www.ama-assn.org/go/cpt"
      },
      {
        "system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"
      },
      {
        "system" : "http://terminology.hl7.org/CodeSystem/icd9cm"
      },
      {
        "system" : "http://www.cms.gov/Medicare/Coding/ICD10"
      },
      {
        "system" : "http://hl7.org/fhir/sid/ndc"
      }
    ]
  }
}