Patient Cost Transparency Implementation Guide
2.0.2 - STU 2 United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

: PCT AEOB Process Note Code System

Page standards status: Trial-use Maturity Level: 2

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/PCTAEOBProcessNoteCS> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "PCTAEOBProcessNoteCS"] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem PCTAEOBProcessNoteCS</b></p><a name=\"PCTAEOBProcessNoteCS\"> </a><a name=\"hcPCTAEOBProcessNoteCS\"> </a><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAEOBProcessNoteCS</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\">disclaimer<a name=\"PCTAEOBProcessNoteCS-disclaimer\"> </a></td><td>Disclaimer</td><td>Indicates a disclaimer type of process note</td></tr><tr><td style=\"white-space:nowrap\">adjudication-note<a name=\"PCTAEOBProcessNoteCS-adjudication-note\"> </a></td><td>Adjudication Note</td><td>Indicates an adjudication note type of process note</td></tr><tr><td style=\"white-space:nowrap\">conditional<a name=\"PCTAEOBProcessNoteCS-conditional\"> </a></td><td>Conditional</td><td>Indicates a conditional type of note which supplements information that is already included in the required Medical Management or Prior Authorization information.  A process note that includes information about conditional factors of the estimate not captured in the originating GFE submission of  the advanced explanation of benefit.</td></tr><tr><td style=\"white-space:nowrap\">other<a name=\"PCTAEOBProcessNoteCS-other\"> </a></td><td>Other</td><td>Indicates other type of AEOB process note</td></tr></table></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ] ;
     fhir:Extension.valueCode [ fhir:value "fm" ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm" ] ;
     fhir:Extension.valueInteger [
       fhir:value "2"^^xsd:integer ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ;
         fhir:Extension.valueCanonical [
           fhir:value "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct" ;
           fhir:link <http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct>
         ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status" ] ;
     fhir:Extension.valueCode [
       fhir:value "trial-use" ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ;
         fhir:Extension.valueCanonical [
           fhir:value "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct" ;
           fhir:link <http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct>
         ]
       ]
     ]
  ] ;
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAEOBProcessNoteCS"] ;
  fhir:CodeSystem.identifier [
     fhir:index -1 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.40.4.16.1" ]
  ] ;
  fhir:CodeSystem.version [ fhir:value "2.0.2"] ;
  fhir:CodeSystem.name [ fhir:value "PCTAEOBProcessNoteCS"] ;
  fhir:CodeSystem.title [ fhir:value "PCT AEOB Process Note Code System"] ;
  fhir:CodeSystem.status [ fhir:value "active"] ;
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-11-09T22:17:29+00:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "HL7 International / Financial Management"] ;
  fhir:CodeSystem.contact [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "HL7 International / Financial Management" ] ;
     fhir:ContactDetail.telecom [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/fm" ]
     ], [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "fmlists@lists.hl7.org" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "Defining codes for process notes.  This CodeSystem is currently defined by this IG, but is anticipated to be temporary. The concepts within are expected to be moved in a future version to a more central terminology specification such as THO, which will result in a code system url change and possibly modified codes and definitions."] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "US" ]
     ]
  ] ;
  fhir:CodeSystem.copyright [ fhir:value "This CodeSystem is not copyrighted."] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "4"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "disclaimer" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Disclaimer" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates a disclaimer type of process note" ]
  ], [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "adjudication-note" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Adjudication Note" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates an adjudication note type of process note" ]
  ], [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "conditional" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Conditional" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates a conditional type of note which supplements information that is already included in the required Medical Management or Prior Authorization information.  A process note that includes information about conditional factors of the estimate not captured in the originating GFE submission of  the advanced explanation of benefit." ]
  ], [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "other" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Other" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Indicates other type of AEOB process note" ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/PCTAEOBProcessNoteCS.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/PCTAEOBProcessNoteCS.ttl> .