SHIFT SLS ValueSets Implementation Guide
0.1.0 - ci-build

SHIFT SLS ValueSets Implementation Guide, published by SHIFT-Task-Force. 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/SHIFT-Task-Force/SLS-ValueSets/ and changes regularly. See the Directory of published versions

## Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

### Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

AB352 Segmentation Tags | ValueSet of security labels used to segment AB352-sensitive health information in meta.security.
Abortion-Related Health Topics (Health Net California) | Health Net explains and references 500073-Abortion-DX-Code-List.pdf file primarily within its Provider Library and through Provider Bulletins related to legislative compliance. The specific explanation is found in the context of Assembly Bill (AB) 352, which mandates the segregation and protection of sensitive health data. Where the Explanation is Located: Provider Bulletin 24-351 (New Laws Help Safeguard Privacy): Health Net (and its affiliate Wellcare) issued this bulletin to explain the requirements of AB 352. The bulletin explicitly identifies abortion and abortion-related services as "Sensitive Services" that must be: Segregated from the rest of the patient's medical record. Excluded from automatic sharing with the California Data Exchange Framework (DxF). Protected from out-of-state subpoenas or investigations. Reference: Wellcare/Health Net Bulletin 24-351 Health Net Provider Library - `Pregnancy Termination` Section: The website hosts a dedicated page for pregnancy termination benefits. It explains that to comply with California laws (specifically SB 245 for cost-sharing and AB 352 for privacy), providers must use specific diagnosis codes. The 500073 PDF serves as the technical master list for these required codes. Reference: Pregnancy Termination - Health Net Provider Library The PDF Itself: The document title, `ICD-10-CM Codes for Abortion-Related Services,` is the direct label Health Net uses on its search results and directory pages to explain what the file contains. It lists codes ranging from O00 (Ectopic pregnancy) to Z33.2 (Encounter for elective termination). How Health Net Directs Providers to Use This File: According to the site's AB 352 guidance, Health Net recommends that IT and Billing departments download this PDF and use the listed codes to create firewalls in EHR systems. If a patient's record contains any code found in 500073-Abortion-DX-Code-List.pdf, the system should automatically: Block that data from being sent to out-of-state entities. Prevent the data from being discovered in automated health information exchanges. Direct Link to the Document: 500073-Abortion-DX-Code-List.pdf Note: This list may not be all-inclusive and is subject to change.
Contraception-Related Health Topics | Clinical concepts related to contraception drawn from LOINC, SNOMED CT, and ICD-10-CM. Intended for segmentation of sensitive reproductive health information under AB352. This ValueSet does not include code recommendations from Health Net California. Health Net California does not have a single source document for contraception-related codes similar to their abortion-related code list. Instead, Health Net references multiple sources, including the DHCS Family PACT Code List, within various policy documents. Health Net Bulletin 24-351: New Laws Help Safeguard Privacy (View Link) Health Net Medi-Cal Provider Manual (Chapter 4): Sensitive Services section (Link to Manuals) Family PACT Policies: Health Net adopts the DHCS Family PACT Code List as their baseline for identifying what constitutes a contraceptive service.
Gender-Affirming Care Codes (Health Net California) | CPT and ICD-10-CM codes referenced in Health Net California's clinical policy 'HNCA.CP.MP.496 - Gender Affirming Procedures'. Intended for segmentation of gender-affirming care under AB352. Health Net Bulletin 24-351 Health Net's bulletin 24-351 explicitly tells providers that services defined in policies like HNCA.CP.MP.496 must be: Blocked from automatic sharing with the California Data Exchange Framework (DxF). Omitted from responses to out-of-state subpoenas or investigations. Flagged within the EHR to prevent unauthorized access by users outside of California. Where to Find and Download HNCA.CP.MP.496.pdf Health Net maintains this policy in several locations within their provider libraries: Direct PDF Link: HNCA.CP.MP.496 - Gender Affirming Procedures 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.`
Synthea Codes for attention_deficit_disorder | A ValueSet containing all clinical codes found in the sensitive Synthea module: attention_deficit_disorder.
Synthea Codes for cerebral_palsy | A ValueSet containing all clinical codes found in the sensitive Synthea module: cerebral_palsy.
Synthea Codes for cystic_fibrosis | A ValueSet containing all clinical codes found in the sensitive Synthea module: cystic_fibrosis. v3-ActCode#GDIS
Synthea Codes for dementia | A ValueSet containing all clinical codes found in the sensitive Synthea module: dementia. v3-ActCode#COGN
Synthea Codes for opioid_addiction | A ValueSet containing all clinical codes found in the sensitive Synthea module: opioid_addiction. v3-ActCode#OPIOIDUD
Synthea Codes for pregnancy | A ValueSet containing all clinical codes found in the sensitive Synthea module: pregnancy. v3-ActCode#PREGNANT
Synthea Codes for self_harm | A ValueSet containing all clinical codes found in the sensitive Synthea module: self_harm. v3-ActCode#SDV
Synthea Codes for spina_bifida | A ValueSet containing all clinical codes found in the sensitive Synthea module: spina_bifida. v3-ActCode#GDIS
Synthea Cognitive Disability Codes | A comprehensive ValueSet encompassing codes from all Synthea modules related to cognitive and neurological disabilities. v3-ActCode#COGN
Synthea Genetic Disability Codes | A comprehensive ValueSet encompassing codes from all Synthea modules related to genetic diseases. v3-ActCode#GDIS
Synthea Mental and Behavioral Health Codes | A comprehensive ValueSet encompassing codes from all Synthea modules related to mental health conditions, including ADD, PTSD, and self-harm events. v3-ActCode#BH
Synthea Reproductive Health Codes | A comprehensive ValueSet encompassing codes from all Synthea modules related to reproductive health, including pregnancy, contraception, and sexual activity. v3-ActCode#SEX
Synthea Substance Abuse Codes | A comprehensive ValueSet encompassing codes from all Synthea modules related to Opioid Addiction, OUD treatment, and chronic pain prescribing. v3-ActCode#SUD
ValueSet - Example Behavioral Health Codes | Example set of codes representing behavioral health conditions requiring special privacy protections Identified as: v3-ActCode#BH
ValueSet - Example Hallucinogen Codes | Example set of codes representing hallucinogen abuse requiring special privacy protections Identified as: local#hallucinogen and local#bh_substances/SUD
ValueSet - Example Opioid Codes | Example set of codes representing opioid abuse requiring special privacy protections. Identified as: local#opioid
ValueSet - Example Sensitive Kind Codes | Example set of codes representing kinds of sensitive information requiring special privacy protections
ValueSet - Example Sexuality and Reproductive Health Codes | Example set of codes representing sexuality and reproductive health requiring special privacy protections Identified as: v3-ActCode#SEX
ValueSet - Example Substance Use Codes | Example set of codes representing substance use requiring special privacy protections. Inclusive of medications, conditions, and observations; as no matter where these codes show up they would indicate the sensitivity kind SUD. Identified as: SUD
clinical codes that indicate ETH | codes that when found in data would indicate the data is likely ETH related ETH - substance abuse information sensitivity (alcohol or drug-abuse information) SAMHSA C2S Alcohol Use Disorders ValueSet 2.16.840.1.113762.1.4.1142.1 // SNOMEDCD ValueSet 2.16.840.1.113762.1.4.1142.2 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.3 // RXNORM ValueSet 2.16.840.1.113762.1.4.1142.4 // ICD10CD ValueSet 2.16.840.1.113762.1.4.1142.5 // LOINC SAMHSA C2S Amphetamine Use Disorders ValueSet 2.16.840.1.113762.1.4.1142.10 // RXNORM ValueSet 2.16.840.1.113762.1.4.1142.11 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.6 // HCPCS ValueSet 2.16.840.1.113762.1.4.1142.7 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.8 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.9 // LOINC SAMHSA C2S Cannabis Use Disorders ValueSet 2.16.840.1.113762.1.4.1142.12 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.13 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.14 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.15 // SNOMED-CT SAMHSA C2S Cocaine Use Disorder ValueSet 2.16.840.1.113762.1.4.1142.16 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.17 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.18 // SNOMED-CT SAMHSA C2S Hallucinogens ValueSet 2.16.840.1.113762.1.4.1142.19 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.20 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.21 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.22 // SNOMED-CT SAMHSA C2S Inhalants ValueSet 2.16.840.1.113762.1.4.1142.28 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.29 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.30 // SNOMED-CT SAMHSA C2S Opioids ValueSet 2.16.840.1.113762.1.4.1142.38 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.39 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.40 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.41 // RXNORM ValueSet 2.16.840.1.113762.1.4.1142.42 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.59 // CPT SAMHSA C2S Other Psychoactive Substance Use Disorder ValueSet 2.16.840.1.113762.1.4.1142.43 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.44 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.45 // ICD10CM SAMHSA C2S Sedative Hypnotic, or anxiolytic related disorders ValueSet 2.16.840.1.113762.1.4.1142.46 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.47 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.48 // ICD9CM SAMHSA C2S Substance use Information Sensitivity ValueSet 2.16.840.1.113762.1.4.1142.55 // HCPCS ValueSet 2.16.840.1.113762.1.4.1142.56 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.57 // RXNORM SAMHSA Test C2S Alcohol Use Disorders ValueSet 2.16.840.1.113762.1.4.1142.65 // SNOMED-CT
clinical codes that indicate ETH | codes that when found in data would indicate the data is likely ETH related ETH - substance abuse information sensitivity (alcohol or drug-abuse information) These valueSets are `not maintained`, the codes in these valueSets are inactive/retired. However they don't show in some distributions of vsac such as the HL7 package.
clinical codes that indicate ETHUD | codes that when found in data would indicate the data is likely ETHUD related ETHUD - alcohol abuse information sensitivity (alcohol abuse information) SAMHSA C2S Alcohol Use Disorders ValueSet 2.16.840.1.113762.1.4.1142.1 // SNOMEDCD ValueSet 2.16.840.1.113762.1.4.1142.2 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.3 // RXNORM ValueSet 2.16.840.1.113762.1.4.1142.4 // ICD10CD ValueSet 2.16.840.1.113762.1.4.1142.5 // LOINC SAMHSA Test C2S Alcohol Use Disorders ValueSet 2.16.840.1.113762.1.4.1142.65 // SNOMED-CT
clinical codes that indicate HIV | HIV/AIDS information SAMHSA C2S HIV/AIDS Information ValueSet 2.16.840.1.113762.1.4.1142.23 // HCPCS ValueSet 2.16.840.1.113762.1.4.1142.24 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.25 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.26 // RXNORM ValueSet 2.16.840.1.113762.1.4.1142.27 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.60 // CPT SAMHSA Test C2S HIV/AIDS Information Sensitivity ValueSet 2.16.840.1.113762.1.4.1142.67 // SNOMEDCD
clinical codes that indicate OPIOIDUD | codes that when found in data would indicate the data is likely OPIOIDUD related OPIOIDUD - Opioid substance abuse information sensitivity (drug-abuse information) SAMHSA C2S Amphetamine Use Disorders ValueSet 2.16.840.1.113762.1.4.1142.10 // RXNORM ValueSet 2.16.840.1.113762.1.4.1142.11 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.6 // HCPCS ValueSet 2.16.840.1.113762.1.4.1142.7 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.8 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.9 // LOINC SAMHSA C2S Cannabis Use Disorders ValueSet 2.16.840.1.113762.1.4.1142.12 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.13 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.14 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.15 // SNOMED-CT SAMHSA C2S Cocaine Use Disorder ValueSet 2.16.840.1.113762.1.4.1142.16 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.17 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.18 // SNOMED-CT SAMHSA C2S Hallucinogens ValueSet 2.16.840.1.113762.1.4.1142.19 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.20 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.21 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.22 // SNOMED-CT SAMHSA C2S Inhalants ValueSet 2.16.840.1.113762.1.4.1142.28 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.29 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.30 // SNOMED-CT SAMHSA C2S Opioids ValueSet 2.16.840.1.113762.1.4.1142.38 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.39 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.40 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.41 // RXNORM ValueSet 2.16.840.1.113762.1.4.1142.42 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.59 // CPT SAMHSA C2S Other Psychoactive Substance Use Disorder ValueSet 2.16.840.1.113762.1.4.1142.43 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.44 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.45 // ICD10CM SAMHSA C2S Sedative Hypnotic, or anxiolytic related disorders ValueSet 2.16.840.1.113762.1.4.1142.46 // SNOMED-CT ValueSet 2.16.840.1.113762.1.4.1142.47 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.48 // ICD9CM SAMHSA C2S Substance use Information Sensitivity ValueSet 2.16.840.1.113762.1.4.1142.55 // HCPCS ValueSet 2.16.840.1.113762.1.4.1142.56 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.57 // RXNORM
clinical codes that indicate PSY | codes that when found in data would indicate the data is likely PSY related PSY - psychiatry disorder information sensitivity ??should this include MH (Mental Health), PSYTHPN (psychotherapy note), and SUD (substance use)?? SAMHSA C2S Mental Health Disorders ValueSet 2.16.840.1.113762.1.4.1142.32 // ICD10CM ValueSet 2.16.840.1.113762.1.4.1142.33 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.34 // LOINC ValueSet 2.16.840.1.113762.1.4.1142.35 // RXNORM ValueSet 2.16.840.1.113762.1.4.1142.36 // SNOMED-CT
clinical codes that indicate SDV | SDV - Sexual assault, abuse or domestic violence ??should this also include SEX (sexuality and reproductive health information sensitivity), PREGNANT (pregnancy), STD (sexually transmitted disease)? The SAMHSA valuesets seem to be labeled as if they are only about sexuality and reproductive health, but do include sexual abuse and sexually transmitted disease. SAMHSA C2S Sexuality and reproductive health information sensitivity ValueSet 2.16.840.1.113762.1.4.1142.49 // ICD9CM ValueSet 2.16.840.1.113762.1.4.1142.50 // RXNORM

### Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

CodeSystem - Local Sensitive Kind Codes | Local CodeSystem for Sensitive Kind Codes used in meta.security labels
Health Information Sensitivity Categories | Code system defining sensitivity categories for health information segmentation under California AB352. Note did not use HL7 v2-ActCodes as two of the three categories are not represented there, and the GENDER code may be more broad than GENDER_AFFIRMING_CARE as intended here.

### Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

AB352 Organizational Privacy Consent - Allow All | A FHIR Consent instance that is an explicit consent for AB 352 protected data, with provisions that reflect Patient allowing all access. permit TPO
AB352 Organizational Privacy Consent - breath | A FHIR Consent instance that is an explicit consent for AB 352 protected data, with provisions that reflect the statutory requirements, with auto-filter bypassed for in-state recipients. Breath first - not possible with R6 consent structure, but shown here for clarity. permit TPO deny sensitive data [for TPO] permit in-state sensitive data [for TPO]
AB352 Organizational Privacy Consent - depth | A FHIR Consent instance that is an explicit consent for AB 352 protected data, with provisions that reflect the statutory requirements, with auto-filter bypassed for in-state recipients. permit TPO deny sensitive data [for TPO] permit in-state [sensitive data for TPO]
AB352 Organizational Privacy Consent - four deep | A FHIR Consent instance that is an explicit consent for AB 352 protected data, with provisions that reflect the statutory requirements, with auto-filter bypassed for in-state recipients, and exception for data from 2014. permit TPO for All data deny AB352sensitive data [for TPO] (essentially for out-of-state) permit in-state AB352 sensitive data [for TPO] (in-state, auto-filter bypassed) deny in-state AB352 sensitive data from 2014
AB352 ValueSet Bundle | A FHIR Bundle containing all ValueSets related to AB352 sensitive topics.
Bundle - Example Sensitive Kind Codes | Example Bundle containing ValueSets representing kinds of sensitive information requiring special privacy protections
Bundle of all SAMHSA sensitive ValueSets | A bundle containing all of the SAMHSA sensitive ValueSets defined in this file.
California Location | Location resource representing California for use in Consent provisions.
Synthea Sensitive Value Sets Bundle | A FHIR Bundle containing all Synthea sensitive ValueSets.