Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot

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

## ValueSet: PAS LOINC Attachment Codes Value Set

Official URL: http://hl7.org/fhir/us/davinci-pas/ValueSet/pas-loinc-attachment-codes | Version: 2.2.0-ballot
Standards status: Trial-use | Maturity Level: 3 | Computable Name: PASLOINCAttachmentCodesValueSet
Other Identifiers: http://loinc.org#Logical Observation Identifier Names and Codes (LOINC)#valid-hl7-attachment-requests, OID:1.3.6.1.4.1.12009.10.2.6
Copyright/Legal: This material contains content from LOINC (http://loinc.org). LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.

This value set includes LOINC terms that can be sent by a payer as part of an HL7 attachment request for additional information. It has been curated by the HL7 Payer/Provider Information Exchange (PIE) Work Group. More information about using LOINC in HIPAA attachments and the source of this value set can be found at LOINC Attahments.

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

### Logical Definition (CLD)

- Include these codes as defined in `http://loinc.org`

  Code | Display
  11526-1 | Pathology study
  11488-4 | Consult note
  80792-5 | Pulmonary Diagnostic study note
  47420-5 | Functional status assessment note
  34117-2 | History and physical note
  74156-1 | Oncology Plan of care and summary note
  18776-5 | Plan of care note
  80785-9 | Radiation oncology Plan of care note
  11506-3 | Progress note
  11504-8 | Surgical operation note
  18842-5 | Discharge summary
  34133-9 | Summary of episode note
  18761-7 | Transfer summary note
  80565-5 | Medication administration record
  28570-0 | Procedure note
  57133-1 | Referral note
  52027-0 | Abortion consent Document
  52028-8 | Hysterectomy consent Document
  52029-6 | Sterilization consent Document
  53245-7 | Driver license
  57828-6 | Prescription list
  18682-5 | Ambulance records
  52063-5 | Prescription for durable medical equipment (DME)
  52062-7 | Transcutaneous electrical neural stimulation (TENS) attachment
  52073-4 | Vision services attachment
  52070-0 | Workers compensation attachment
  80405-4 | Provider Certification [Type]
  53242-4 | Charge ticket or encounter form
  52042-9 | Continuous positive airway pressure (CPAP) attachment
  52040-3 | Dental X-rays and other images (not DICOM)
  18748-4 | Diagnostic imaging study
  53243-2 | Advanced beneficiary notice
  53247-3 | Eligibility acknowledgement
  52071-8 | Employee assistance program attachment
  67796-3 | EMS patient care report - version 3 Document NEMSIS
  77601-3 | Enhanced note
  52043-7 | Enteral nutrition attachment
  11514-7 | Chiropractic Episode of care medical records
  11521-2 | Occupational therapy Episode of care medical records
  11515-4 | Physical therapy Episode of care medical records
  11516-2 | Physician Episode of care medical records
  11517-0 | Podiatry Episode of care medical records
  11518-8 | Psychology Episode of care medical records
  11519-6 | Social service Episode of care medical records
  11520-4 | Speech therapy Episode of care medical records
  52030-4 | Explanation of benefits
  52031-2 | Explanation of benefits to subscriber
  52044-5 | External infusion pump attachment
  103567-4 | FHIR previous cancer therapy medical record
  52064-3 | Worker's compensation first report of injury attachment
  52045-2 | Gait trainers attachment
  52033-8 | General correspondence attachment
  11485-0 | Anesthesia records
  52035-3 | Home health claims
  52036-1 | Home health prior authorization
  52046-0 | Hospital beds attachment
  52032-0 | Appeal denial letter
  52047-8 | Immunosuppressive drug attachment
  77600-5 | Interval note
  94093-2 | Itemized bill
  15508-5 | Labor and delivery records
  11502-2 | Laboratory report
  52048-6 | Lymphedema pump attachment
  52049-4 | Manual wheelchair attachment
  11503-0 | Medical records
  28011-5 | Emergency department Medical records
  94118-7 | Medical records in response to authorization denial
  52037-9 | Member ID card copy
  52065-0 | Automobile liability attachment
  52050-2 | Motorized wheelchair attachment
  76641-0 | Neurology study
  52072-6 | Non-emergency transportation attachment
  53246-5 | Non-medical services attachment
  52066-8 | Notice of Discharge Medicare Appeal Rights (NODMAR) form
  53244-0 | Notice of privacy practices receipt
  52051-0 | Orthotic/Prosthetic attachment
  52052-8 | Osteogenesis stimulator attachment
  52053-6 | Oxygen attachment
  52054-4 | Parenteral nutrition attachment
  52067-6 | Past filing limit justification
  52034-6 | Payer letter
  28629-4 | Perimetry study
  74030-8 | Periodontal service attachment
  28633-6 | Polysomnography (sleep) study
  52055-1 | Power operated vehicle attachment
  57073-9 | Prenatal records
  52041-1 | Blood glucose monitor attachment
  52068-4 | Property and casualty state mandated forms
  52075-9 | Purchase invoice
  18823-5 | Alcohol and/or substance abuse service attachment
  18824-3 | Cardiac service attachment
  18825-0 | Medical social services attachment
  18826-8 | Occupational therapy service attachment
  19002-5 | Physical therapy service attachment
  18594-2 | Psychiatric service attachment
  52184-9 | Pulmonary therapy service attachment
  19003-3 | Respiratory therapy service attachment
  29206-0 | Speech therapy service attachment
  52056-9 | Repair of durable medical equipment attachment
  52057-7 | Seat lift mechanism attachment
  52058-5 | Seating system attachment
  52039-5 | Skilled Nursing Facility (SNF) record
  101657-5 | Special investigation unit (SIU) medical record request Document
  52059-3 | Speech generating device attachment
  52060-1 | Standers/standing frame attachment
  52038-7 | Subscriber Information including retroactive and presumptive eligibility
  52061-9 | Support surface attachment
  52069-2 | Tax ID number - IRS form W9
  103595-5 | Certificate of Medical Necessity
  103596-3 | Durable medical equipment proof of delivery receipt
  103597-1 | Pain management form or template
  46212-7 | Pre operative photo
  52459-5 | CMS certification number (CCN) Provider

### Expansion

Expansion from tx.fhir.org based on Loinc v2.80

This value set contains 113 concepts

Code | System | Display (en-US)
11526-1 | http://loinc.org | Pathology study
11488-4 | http://loinc.org | Consult note
80792-5 | http://loinc.org | Pulmonary Diagnostic study note
47420-5 | http://loinc.org | Functional status assessment note
34117-2 | http://loinc.org | History and physical note
74156-1 | http://loinc.org | Oncology Plan of care and summary note
18776-5 | http://loinc.org | Plan of care note
80785-9 | http://loinc.org | Radiation oncology Plan of care note
11506-3 | http://loinc.org | Progress note
11504-8 | http://loinc.org | Surgical operation note
18842-5 | http://loinc.org | Discharge summary
34133-9 | http://loinc.org | Summary of episode note
18761-7 | http://loinc.org | Transfer summary note
80565-5 | http://loinc.org | Medication administration record
28570-0 | http://loinc.org | Procedure note
57133-1 | http://loinc.org | Referral note
52027-0 | http://loinc.org | Abortion consent Document
52028-8 | http://loinc.org | Hysterectomy consent Document
52029-6 | http://loinc.org | Sterilization consent Document
53245-7 | http://loinc.org | Driver license
57828-6 | http://loinc.org | Prescription list
18682-5 | http://loinc.org | Ambulance records
52063-5 | http://loinc.org | Prescription for durable medical equipment (DME)
52062-7 | http://loinc.org | Transcutaneous electrical neural stimulation (TENS) attachment
52073-4 | http://loinc.org | Vision services attachment
52070-0 | http://loinc.org | Workers compensation attachment
80405-4 | http://loinc.org | Provider Certification [Type]
53242-4 | http://loinc.org | Charge ticket or encounter form
52042-9 | http://loinc.org | Continuous positive airway pressure (CPAP) attachment
52040-3 | http://loinc.org | Dental X-rays and other images (not DICOM)
18748-4 | http://loinc.org | Diagnostic imaging study
53243-2 | http://loinc.org | Advanced beneficiary notice
53247-3 | http://loinc.org | Eligibility acknowledgement
52071-8 | http://loinc.org | Employee assistance program attachment
67796-3 | http://loinc.org | EMS patient care report - version 3 Document NEMSIS
77601-3 | http://loinc.org | Enhanced note
52043-7 | http://loinc.org | Enteral nutrition attachment
11514-7 | http://loinc.org | Chiropractic Episode of care medical records
11521-2 | http://loinc.org | Occupational therapy Episode of care medical records
11515-4 | http://loinc.org | Physical therapy Episode of care medical records
11516-2 | http://loinc.org | Physician Episode of care medical records
11517-0 | http://loinc.org | Podiatry Episode of care medical records
11518-8 | http://loinc.org | Psychology Episode of care medical records
11519-6 | http://loinc.org | Social service Episode of care medical records
11520-4 | http://loinc.org | Speech therapy Episode of care medical records
52030-4 | http://loinc.org | Explanation of benefits
52031-2 | http://loinc.org | Explanation of benefits to subscriber
52044-5 | http://loinc.org | External infusion pump attachment
103567-4 | http://loinc.org | Previous cancer therapy (narrative)
52064-3 | http://loinc.org | Worker's compensation first report of injury attachment
52045-2 | http://loinc.org | Gait trainers attachment
52033-8 | http://loinc.org | General correspondence attachment
11485-0 | http://loinc.org | Anesthesia records
52035-3 | http://loinc.org | Home health claims
52036-1 | http://loinc.org | Home health prior authorization
52046-0 | http://loinc.org | Hospital beds attachment
52032-0 | http://loinc.org | Appeal denial letter
52047-8 | http://loinc.org | Immunosuppressive drug attachment
77600-5 | http://loinc.org | Interval note
94093-2 | http://loinc.org | Itemized bill
15508-5 | http://loinc.org | Labor and delivery records
11502-2 | http://loinc.org | Laboratory report
52048-6 | http://loinc.org | Lymphedema pump attachment
52049-4 | http://loinc.org | Manual wheelchair attachment
11503-0 | http://loinc.org | Medical records
28011-5 | http://loinc.org | Emergency department Medical records
94118-7 | http://loinc.org | Medical records in response to authorization denial
52037-9 | http://loinc.org | Member ID card copy
52065-0 | http://loinc.org | Automobile liability attachment
52050-2 | http://loinc.org | Motorized wheelchair attachment
76641-0 | http://loinc.org | Neurology study
52072-6 | http://loinc.org | Non-emergency transportation attachment
53246-5 | http://loinc.org | Non-medical services attachment
52066-8 | http://loinc.org | Notice of Discharge Medicare Appeal Rights (NODMAR) form
53244-0 | http://loinc.org | Notice of privacy practices receipt
52051-0 | http://loinc.org | Orthotic/Prosthetic attachment
52052-8 | http://loinc.org | Osteogenesis stimulator attachment
52053-6 | http://loinc.org | Oxygen attachment
52054-4 | http://loinc.org | Parenteral nutrition attachment
52067-6 | http://loinc.org | Past filing limit justification
52034-6 | http://loinc.org | Payer letter
28629-4 | http://loinc.org | Perimetry study
74030-8 | http://loinc.org | Periodontal service attachment
28633-6 | http://loinc.org | Polysomnography (sleep) study
52055-1 | http://loinc.org | Power operated vehicle attachment
57073-9 | http://loinc.org | Prenatal records
52041-1 | http://loinc.org | Blood glucose monitor attachment
52068-4 | http://loinc.org | Property and casualty state mandated forms
52075-9 | http://loinc.org | Purchase invoice
18823-5 | http://loinc.org | Alcohol and/or substance abuse service attachment
18824-3 | http://loinc.org | Cardiac service attachment
18825-0 | http://loinc.org | Medical social services attachment
18826-8 | http://loinc.org | Occupational therapy service attachment
19002-5 | http://loinc.org | Physical therapy service attachment
18594-2 | http://loinc.org | Psychiatric service attachment
52184-9 | http://loinc.org | Pulmonary therapy service attachment
19003-3 | http://loinc.org | Respiratory therapy service attachment
29206-0 | http://loinc.org | Speech therapy service attachment
52056-9 | http://loinc.org | Repair of durable medical equipment attachment
52057-7 | http://loinc.org | Seat lift mechanism attachment
52058-5 | http://loinc.org | Seating system attachment
52039-5 | http://loinc.org | Skilled Nursing Facility (SNF) record
101657-5 | http://loinc.org | Special investigation unit (SIU) medical record request Document
52059-3 | http://loinc.org | Speech generating device attachment
52060-1 | http://loinc.org | Standers/standing frame attachment
52038-7 | http://loinc.org | Subscriber Information including retroactive and presumptive eligibility
52061-9 | http://loinc.org | Support surface attachment
52069-2 | http://loinc.org | Tax ID number - IRS form W9
103595-5 | http://loinc.org | Certificate of Medical Necessity
103596-3 | http://loinc.org | Durable medical equipment proof of delivery receipt
103597-1 | http://loinc.org | Pain management form or template
46212-7 | http://loinc.org | Pre operative photo
52459-5 | http://loinc.org | CMS certification number (CCN) Provider

Explanation of the columns that may appear on this page:

Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System | The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code | The code (used as the code in the resource instance)
Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition | An explanation of the meaning of the concept
Comments | Additional notes about how to use the code