JohnMoehrke SLS ValueSets Implementation Guide
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JohnMoehrke SLS ValueSets Implementation Guide, published by John Moehrke. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/JohnMoehrke/SLSValueSets/ and changes regularly. See the Directory of published versions

: Gender-Affirming Care Codes (Health Net California) - TTL Representation

Active as of 2024-01-01

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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/ValueSet/AB352GenderAffirmingCareHealthNet> a fhir:ValueSet ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "AB352GenderAffirmingCareHealthNet"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://SHIFT-Task-Force.github.io/sls-ri/StructureDefinition/SlsValueSet" ;
       fhir:index 0 ;
       fhir:link <http://SHIFT-Task-Force.github.io/sls-ri/StructureDefinition/SlsValueSet>
     ]
  ] ;
  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: ValueSet AB352GenderAffirmingCareHealthNet</b></p><a name=\"AB352GenderAffirmingCareHealthNet\"> </a><a name=\"hcAB352GenderAffirmingCareHealthNet\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/SHIFT-Task-Force/sls-ri-ig/StructureDefinition-SlsValueSet.html\">SLS ValueSet Profile</a></p></div><ul><li>Include these codes as defined in <a href=\"http://tx.fhir.org/r4\"><code>http://www.ama-assn.org/go/cpt</code></a><span title=\"Version is not explicitly stated. No matching Code System found\"> version Not Stated (use latest from terminology server)</span><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td>11960</td><td style=\"color: #cccccc\">Insertion of tissue expander(s) for other than breast, including subsequent expansion</td></tr><tr><td>11950</td><td style=\"color: #cccccc\">Subcutaneous injection of filling material (eg, collagen); 1 cc or less</td></tr><tr><td>11951</td><td style=\"color: #cccccc\">Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc</td></tr><tr><td>11952</td><td style=\"color: #cccccc\">Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc</td></tr><tr><td>11954</td><td style=\"color: #cccccc\">Subcutaneous injection of filling material (eg, collagen); over 10.0 cc</td></tr><tr><td>11970</td><td style=\"color: #cccccc\">Replacement of tissue expander with permanent implant</td></tr><tr><td>14000</td><td style=\"color: #cccccc\">Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less</td></tr><tr><td>14001</td><td style=\"color: #cccccc\">Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm</td></tr><tr><td>14040</td><td style=\"color: #cccccc\">Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less</td></tr><tr><td>14041</td><td style=\"color: #cccccc\">Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm</td></tr><tr><td>15100</td><td style=\"color: #cccccc\">Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)</td></tr><tr><td>15101</td><td style=\"color: #cccccc\">Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)</td></tr><tr><td>15120</td><td style=\"color: #cccccc\">Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)</td></tr><tr><td>15121</td><td style=\"color: #cccccc\">Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)</td></tr><tr><td>15200</td><td style=\"color: #cccccc\">Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less</td></tr><tr><td>15570</td><td style=\"color: #cccccc\">Formation of direct or tubed pedicle, with or without transfer; trunk</td></tr><tr><td>15574</td><td style=\"color: #cccccc\">Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet</td></tr><tr><td>15600</td><td style=\"color: #cccccc\">Delay of flap or sectioning of flap (division and inset); at trunk</td></tr><tr><td>15620</td><td style=\"color: #cccccc\">Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet</td></tr><tr><td>15757</td><td style=\"color: #cccccc\">Free skin flap with microvascular anastomosis</td></tr><tr><td>15758</td><td style=\"color: #cccccc\">Free fascial flap with microvascular anastomosis</td></tr><tr><td>15775</td><td style=\"color: #cccccc\">Punch graft for hair transplant; 1 to 15 punch grafts</td></tr><tr><td>15776</td><td style=\"color: #cccccc\">Punch graft for hair transplant; more than 15 punch grafts</td></tr><tr><td>15780</td><td style=\"color: #cccccc\">Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)</td></tr><tr><td>15781</td><td style=\"color: #cccccc\">Dermabrasion; segmental, face</td></tr><tr><td>15782</td><td style=\"color: #cccccc\">Dermabrasion; regional, other than face</td></tr><tr><td>15783</td><td style=\"color: #cccccc\">Dermabrasion; superficial, any site (eg, tattoo removal)</td></tr><tr><td>15786</td><td style=\"color: #cccccc\">Abrasion; single lesion (eg, keratosis, scar)</td></tr><tr><td>15787</td><td style=\"color: #cccccc\">Abrasion; each additional 4 lesions or less (List separately in addition to code for primary procedure)</td></tr><tr><td>15788</td><td style=\"color: #cccccc\">Chemical peel, facial; epidermal</td></tr><tr><td>15789</td><td style=\"color: #cccccc\">Chemical peel, facial; dermal</td></tr><tr><td>15792</td><td style=\"color: #cccccc\">Chemical peel, nonfacial; epidermal</td></tr><tr><td>15793</td><td style=\"color: #cccccc\">Chemical peel, nonfacial; dermal</td></tr><tr><td>15820</td><td style=\"color: #cccccc\">Blepharoplasty, lower eyelid;</td></tr><tr><td>15821</td><td style=\"color: #cccccc\">Blepharoplasty, lower eyelid; with extensive herniated fat pad</td></tr><tr><td>15822</td><td style=\"color: #cccccc\">Blepharoplasty, upper eyelid;</td></tr><tr><td>15823</td><td style=\"color: #cccccc\">Blepharoplasty, upper eyelid; with excessive skin weighting down lid</td></tr><tr><td>15824</td><td style=\"color: #cccccc\">Rhytidectomy; forehead</td></tr><tr><td>15825</td><td style=\"color: #cccccc\">Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap)</td></tr><tr><td>15826</td><td style=\"color: #cccccc\">Rhytidectomy; glabellar frown lines</td></tr><tr><td>15828</td><td style=\"color: #cccccc\">Rhytidectomy; cheek, chin, and neck</td></tr><tr><td>15829</td><td style=\"color: #cccccc\">Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap</td></tr><tr><td>15830</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy</td></tr><tr><td>15832</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh</td></tr><tr><td>15833</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg</td></tr><tr><td>15834</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip</td></tr><tr><td>15835</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock</td></tr><tr><td>15836</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm</td></tr><tr><td>15837</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand</td></tr><tr><td>15838</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad</td></tr><tr><td>15839</td><td style=\"color: #cccccc\">Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area</td></tr><tr><td>15876</td><td style=\"color: #cccccc\">Suction assisted lipectomy; head and neck</td></tr><tr><td>15877</td><td style=\"color: #cccccc\">Suction assisted lipectomy; trunk</td></tr><tr><td>15878</td><td style=\"color: #cccccc\">Suction assisted lipectomy; upper extremity</td></tr><tr><td>15879</td><td style=\"color: #cccccc\">Suction assisted lipectomy; lower extremity</td></tr><tr><td>17380</td><td style=\"color: #cccccc\">Electrolysis epilation, each 30 minutes</td></tr><tr><td>19300</td><td style=\"color: #cccccc\">Mastectomy for gynecomastia</td></tr><tr><td>19301</td><td style=\"color: #cccccc\">Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);</td></tr><tr><td>19303</td><td style=\"color: #cccccc\">Mastectomy, simple, complete</td></tr><tr><td>19316</td><td style=\"color: #cccccc\">Mastopexy</td></tr><tr><td>19318</td><td style=\"color: #cccccc\">Breast reduction</td></tr><tr><td>19325</td><td style=\"color: #cccccc\">Breast augmentation with implant</td></tr><tr><td>19350</td><td style=\"color: #cccccc\">Nipple/areola reconstruction</td></tr><tr><td>21120</td><td style=\"color: #cccccc\">Genioplasty; augmentation (autograft, allograft, prosthetic material)</td></tr><tr><td>21121</td><td style=\"color: #cccccc\">Genioplasty; sliding osteotomy, single piece</td></tr><tr><td>21122</td><td style=\"color: #cccccc\">Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)</td></tr><tr><td>21123</td><td style=\"color: #cccccc\">Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)</td></tr><tr><td>21125</td><td style=\"color: #cccccc\">Augmentation, mandibular body or angle; prosthetic material</td></tr><tr><td>21127</td><td style=\"color: #cccccc\">Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)</td></tr><tr><td>21208</td><td style=\"color: #cccccc\">Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)</td></tr><tr><td>21209</td><td style=\"color: #cccccc\">Osteoplasty, facial bones; reduction</td></tr><tr><td>21210</td><td style=\"color: #cccccc\">Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)</td></tr><tr><td>21270</td><td style=\"color: #cccccc\">Malar augmentation, prosthetic material</td></tr><tr><td>30400</td><td style=\"color: #cccccc\">Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip</td></tr><tr><td>30410</td><td style=\"color: #cccccc\">Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip</td></tr><tr><td>30420</td><td style=\"color: #cccccc\">Rhinoplasty, primary; including major septal repair</td></tr><tr><td>30430</td><td style=\"color: #cccccc\">Rhinoplasty, secondary; minor revision (small amount of nasal tip work)</td></tr><tr><td>30435</td><td style=\"color: #cccccc\">Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)</td></tr><tr><td>30450</td><td style=\"color: #cccccc\">Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)</td></tr><tr><td>31580</td><td style=\"color: #cccccc\">Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion</td></tr><tr><td>31587</td><td style=\"color: #cccccc\">Laryngoplasty, cricoid split, without graft placement</td></tr><tr><td>31599</td><td style=\"color: #cccccc\">Unlisted procedure, larynx</td></tr><tr><td>31899</td><td style=\"color: #cccccc\">Unlisted procedure, trachea, bronchi</td></tr><tr><td>44145</td><td style=\"color: #cccccc\">Colectomy, partial; with coloproctostomy (low pelvic anastomosis)</td></tr><tr><td>53400</td><td style=\"color: #cccccc\">Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type)</td></tr><tr><td>53405</td><td style=\"color: #cccccc\">Urethroplasty; second stage (formation of urethra), including urinary diversion</td></tr><tr><td>53410</td><td style=\"color: #cccccc\">Urethroplasty, 1-stage reconstruction of male anterior urethra</td></tr><tr><td>53415</td><td style=\"color: #cccccc\">Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra</td></tr><tr><td>53420</td><td style=\"color: #cccccc\">Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage</td></tr><tr><td>53425</td><td style=\"color: #cccccc\">Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage</td></tr><tr><td>53430</td><td style=\"color: #cccccc\">Urethroplasty, reconstruction of female urethra</td></tr><tr><td>53460</td><td style=\"color: #cccccc\">Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure)</td></tr><tr><td>54125</td><td style=\"color: #cccccc\">Amputation of penis; complete</td></tr><tr><td>54340</td><td style=\"color: #cccccc\">Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple</td></tr><tr><td>54400</td><td style=\"color: #cccccc\">Insertion of penile prosthesis; non-inflatable (semi-rigid)</td></tr><tr><td>54401</td><td style=\"color: #cccccc\">Insertion of penile prosthesis; inflatable (self-contained)</td></tr><tr><td>54405</td><td style=\"color: #cccccc\">Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir</td></tr><tr><td>54406</td><td style=\"color: #cccccc\">Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis</td></tr><tr><td>54408</td><td style=\"color: #cccccc\">Repair of component(s) of a multi-component, inflatable penile prosthesis</td></tr><tr><td>54410</td><td style=\"color: #cccccc\">Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session</td></tr><tr><td>54411</td><td style=\"color: #cccccc\">Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue</td></tr><tr><td>54415</td><td style=\"color: #cccccc\">Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis</td></tr><tr><td>54416</td><td style=\"color: #cccccc\">Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session</td></tr><tr><td>54417</td><td style=\"color: #cccccc\">Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue</td></tr><tr><td>54520</td><td style=\"color: #cccccc\">Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach</td></tr><tr><td>54660</td><td style=\"color: #cccccc\">Insertion of testicular prosthesis (separate procedure)</td></tr><tr><td>54690</td><td style=\"color: #cccccc\">Laparoscopy, surgical; orchiectomy</td></tr><tr><td>55175</td><td style=\"color: #cccccc\">Scrotoplasty; simple</td></tr><tr><td>55180</td><td style=\"color: #cccccc\">Scrotoplasty; complicated</td></tr><tr><td>55970</td><td style=\"color: #cccccc\">Intersex surgery; male to female</td></tr><tr><td>55980</td><td style=\"color: #cccccc\">Intersex surgery; female to male</td></tr><tr><td>56625</td><td style=\"color: #cccccc\">Vulvectomy simple; complete</td></tr><tr><td>56800</td><td style=\"color: #cccccc\">Plastic repair of introitus</td></tr><tr><td>56805</td><td style=\"color: #cccccc\">Clitoroplasty for intersex state</td></tr><tr><td>56810</td><td style=\"color: #cccccc\">Perineoplasty, repair of perineum, nonobstetrical (separate procedure)</td></tr><tr><td>57106</td><td style=\"color: #cccccc\">Vaginectomy, partial removal of vaginal wall;</td></tr><tr><td>57107</td><td style=\"color: #cccccc\">Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)</td></tr><tr><td>57110</td><td style=\"color: #cccccc\">Vaginectomy, complete removal of vaginal wall;</td></tr><tr><td>57111</td><td style=\"color: #cccccc\">Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)</td></tr><tr><td>57291</td><td style=\"color: #cccccc\">Construction of artificial vagina; without graft</td></tr><tr><td>57292</td><td style=\"color: #cccccc\">Construction of artificial vagina; with graft</td></tr><tr><td>57295</td><td style=\"color: #cccccc\">Revision (including removal) of prosthetic vaginal graft; vaginal approach</td></tr><tr><td>57296</td><td style=\"color: #cccccc\">Revision (including removal) of prosthetic vaginal graft; open abdominal approach</td></tr><tr><td>57335</td><td style=\"color: #cccccc\">Vaginoplasty for intersex state</td></tr><tr><td>57426</td><td style=\"color: #cccccc\">Revision (including removal) of prosthetic vaginal graft, laparoscopic approach</td></tr><tr><td>58150</td><td style=\"color: #cccccc\">Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);</td></tr><tr><td>58180</td><td style=\"color: #cccccc\">Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)</td></tr><tr><td>58260</td><td style=\"color: #cccccc\">Vaginal hysterectomy, for uterus 250 g or less;</td></tr><tr><td>58262</td><td style=\"color: #cccccc\">Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)</td></tr><tr><td>58263</td><td style=\"color: #cccccc\">Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele</td></tr><tr><td>58267</td><td style=\"color: #cccccc\">Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control</td></tr><tr><td>58270</td><td style=\"color: #cccccc\">Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele</td></tr><tr><td>58275</td><td style=\"color: #cccccc\">Vaginal hysterectomy, with total or partial vaginectomy;</td></tr><tr><td>58280</td><td style=\"color: #cccccc\">Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele</td></tr><tr><td>58285</td><td style=\"color: #cccccc\">Vaginal hysterectomy, radical (Schauta type operation)</td></tr></table></li></ul></div>"
  ] ;
  fhir:ValueSet.url [ fhir:value "http://johnmoehrke.github.io/SLSValueSets/ValueSet/AB352GenderAffirmingCareHealthNet"] ;
  fhir:ValueSet.identifier [
     fhir:index 0 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:1.3.6.1.4.1.66281.18.48.3" ]
  ] ;
  fhir:ValueSet.version [ fhir:value "0.1.0"] ;
  fhir:ValueSet.name [ fhir:value "AB352GenderAffirmingCareHealthNet"] ;
  fhir:ValueSet.title [ fhir:value "Gender-Affirming Care Codes (Health Net California)"] ;
  fhir:ValueSet.status [ fhir:value "active"] ;
  fhir:ValueSet.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:ValueSet.date [ fhir:value "2024-01-01T00:00:00Z"^^xsd:dateTime] ;
  fhir:ValueSet.publisher [ fhir:value "John Moehrke"] ;
  fhir:ValueSet.contact [
     fhir:index 0 ;
     fhir:ContactDetail.name [ fhir:value "John Moehrke" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "http://johnmoehrke.github.io" ]
     ]
  ], [
     fhir:index 1 ;
     fhir:ContactDetail.name [ fhir:value "John Moehrke (himself)" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "JohnMoehrke@gmail.com" ]
     ]
  ] ;
  fhir:ValueSet.description [ fhir:value "CPT and ICD-10-CM codes referenced in Health Net California's clinical policy\n'HNCA.CP.MP.496 - Gender Affirming Procedures'. Intended for segmentation of\ngender-affirming care under AB352.\n\n**Health Net Bulletin 24-351**\n\nHealth Net's [bulletin 24-351](https://providerlibrary.healthnetcalifornia.com/) explicitly tells providers that services defined in policies like HNCA.CP.MP.496 must be:\n\n- **Blocked from automatic sharing** with the California Data Exchange Framework (DxF).\n- **Omitted from responses** to out-of-state subpoenas or investigations.\n- **Flagged within the EHR** to prevent unauthorized access by users outside of California.\n\n**Where to Find and Download HNCA.CP.MP.496.pdf** Health Net maintains this policy in several locations within their provider libraries:\n\n- **Direct PDF Link:** [HNCA.CP.MP.496 - Gender Affirming Procedures](https://providerlibrary.healthnetcalifornia.com/content/dam/centene/healthnet/pdfs/providerlibrary/HNCA.CP.MP.496.pdf)\n- **The Provider Library Archive:** You can find this by navigating to Health Net Provider Library > Resources > Clinical Policies and searching for `Gender Affirming Procedures` or the code `496.`"] ;
  fhir:ValueSet.useContext [
     fhir:index 0 ;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ] ;
       fhir:Coding.code [ fhir:value "focus" ]
     ] ;
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "http://johnmoehrke.github.io/SLSValueSets/CodeSystem/AB352HealthSensitivityCs" ] ;
         fhir:Coding.code [ fhir:value "GENDER_AFFIRMING_CARE" ]
       ]
     ]
  ] ;
  fhir:ValueSet.jurisdiction [
     fhir:index 0 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "http://unstats.un.org/unsd/methods/m49/m49.htm" ] ;
       fhir:Coding.code [ fhir:value "001" ]
     ]
  ] ;
  fhir:ValueSet.compose [
     fhir:ValueSet.compose.inactive [ fhir:value "true"^^xsd:boolean ] ;
     fhir:ValueSet.compose.include [
       fhir:index 0 ;
       fhir:ValueSet.compose.include.system [ fhir:value "http://www.ama-assn.org/go/cpt" ] ;
       fhir:ValueSet.compose.include.concept [
         fhir:index 0 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "11960" ]
       ], [
         fhir:index 1 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "11950" ]
       ], [
         fhir:index 2 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "11951" ]
       ], [
         fhir:index 3 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "11952" ]
       ], [
         fhir:index 4 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "11954" ]
       ], [
         fhir:index 5 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "11970" ]
       ], [
         fhir:index 6 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "14000" ]
       ], [
         fhir:index 7 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "14001" ]
       ], [
         fhir:index 8 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "14040" ]
       ], [
         fhir:index 9 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "14041" ]
       ], [
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         fhir:index 14 ;
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         fhir:index 15 ;
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         fhir:index 16 ;
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         fhir:index 17 ;
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         fhir:index 18 ;
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         fhir:index 21 ;
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         fhir:index 22 ;
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         fhir:index 23 ;
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         fhir:index 24 ;
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         fhir:index 25 ;
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         fhir:index 26 ;
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         fhir:index 27 ;
         fhir:ValueSet.compose.include.concept.code [ fhir:value "15786" ]
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         fhir:index 28 ;
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         fhir:index 29 ;
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         fhir:index 30 ;
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         fhir:index 31 ;
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         fhir:index 32 ;
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         fhir:index 34 ;
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         fhir:index 36 ;
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       ], [
         fhir:index 134 ;
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       ]
     ]
  ] .

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

<http://hl7.org/fhir/ValueSet/AB352GenderAffirmingCareHealthNet.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/ValueSet/AB352GenderAffirmingCareHealthNet.ttl> .