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Resource ValueSet/FHIR Server from package hl7.fhir.us.davinci-cdex#current (31 ms)

Package hl7.fhir.us.davinci-cdex
Type ValueSet
Id Id
FHIR Version R4
Source http://hl7.org/fhir/us/davinci-cdex/https://build.fhir.org/ig/HL7/davinci-ecdx/ValueSet-cdex-POU.html
Url http://hl7.org/fhir/us/davinci-cdex/ValueSet/cdex-POU
Version 2.1.0-preview
Status active
Date 2022-10-24
Name CDexPOUCodes
Title CDex Purpose of Use Value Set
Experimental False
Realm us
Authority hl7
Description The set of purpose of use codes for the requested data (the output of the task). This code set is composed of [FHIR core Purpose of Use security labels](http://hl7.org/fhir/security-labels.html#core) and additional codes defined by this Guide.
Copyright Used by permission of HL7 International all rights reserved Creative Commons License

Resources that use this resource

StructureDefinition
cdex-task-attachment-request CDex Task Attachment Request Profile
cdex-task-data-request CDex Task Data Request Profile
http://hl7.org/fhir/us/davinci-atr/ValueSet/davinci-group-characteristic DaVinci Group Characteristic

Resources that this resource uses

CodeSystem
http://terminology.hl7.org/CodeSystem/v3-ActReason ActReason
cdex-temp CDex Temporary Code System


Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ValueSet cdex-POU

This value set includes codes based on the following rules:

  • Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActReason
    CodeDisplayDefinition
    COVERAGEcoverage under policy or programTo perform one or more operations on information for conducting activities related to coverage under a program or policy.
    CLMATTCHclaim attachmentTo perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services.
    COVAUTHcoverage authorizationTo perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.
    HQUALIMPhealth quality improvementTo perform one or more operations on information used for conducting administrative activities to improve health care quality.
    HDMhealthcare delivery managementTo perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual's benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.

    *Usage Note:* Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking.

    *Map:* Maps to ISO 14265 Classification Term "Administration of care for an individual subject of care" described as "To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care."

    However, this classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.
    COCcoordination of careTo perform one or more actions on information in order to organize the provision and case management of an individual's healthcare, including: Monitoring a person's goals, needs, and preferences; acting as the communication link between two or more participants concerned with a person's health and wellness; organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person; and ensuring safe, appropriate, non-duplicative, and effective integrated care.

    *Usage Note:* Use when describing these functions: 1. Monitoring a person's goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care.

    The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment.

    For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare.

    *Map:* Maps to ISO 14265 Classification Terms: "Support of care activities within the provider organisation for an individual subject of care" described as "To inform persons or processes enabling others to provide health care services to the subject of care." "Subject of Care Uses" described as "To inform the subject of care in support of his or her own interests."
    TREATtreatmentTo perform one or more operations on information for provision of health care.
  • Include these codes as defined in http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp
    CodeDisplayDefinition
    care-planningCare PlanningRequest for data from payers or providers to determine how to deliver care for a particular patient, group or community.
    social-riskSocial RiskRequest for data from payers or other providers to assess of social risk, establishing coded health concerns/problems, creating patient driven goals, managing interventions, and measuring outcomes.
    payment-noePayment Not Otherwise Enumerated[Existing concepts do not define a more detailed [Payment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.
    operations-noeOperations Not Otherwise EnumeratedExisting concepts do not define a more detailed [Healthcare Operations as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.
    treatment-noeTreatment Not Otherwise EnumeratedExisting concepts do not define a more detailed [Treatment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.

Source

{
  "resourceType" : "ValueSet",
  "id" : "cdex-POU",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet cdex-POU</b></p><a name=\"cdex-POU\"> </a><a name=\"hccdex-POU\"> </a><a name=\"hccdex-POU-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-v3-ActReason.html\"><code>http://terminology.hl7.org/CodeSystem/v3-ActReason</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-v3-ActReason.html#v3-ActReason-COVERAGE\">COVERAGE</a></td><td style=\"color: #cccccc\">coverage under policy or program</td><td>To perform one or more operations on information for conducting activities related to coverage under a program or policy.</td></tr><tr><td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html#v3-ActReason-CLMATTCH\">CLMATTCH</a></td><td style=\"color: #cccccc\">claim attachment</td><td>To perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services.</td></tr><tr><td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html#v3-ActReason-COVAUTH\">COVAUTH</a></td><td style=\"color: #cccccc\">coverage authorization</td><td>To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.</td></tr><tr><td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html#v3-ActReason-HQUALIMP\">HQUALIMP</a></td><td style=\"color: #cccccc\">health quality improvement</td><td>To perform one or more operations on information used for conducting administrative activities to improve health care quality.</td></tr><tr><td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html#v3-ActReason-HDM\">HDM</a></td><td style=\"color: #cccccc\">healthcare delivery management</td><td>To perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual's benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.<br/><br/>*Usage Note:* Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking.<br/><br/>*Map:* Maps to ISO 14265 Classification Term &quot;Administration of care for an individual subject of care&quot; described as &quot;To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care.&quot;<br/><br/>However, this classification term is described as activities, i.e., &quot;to inform persons&quot; or &quot;to inform processes&quot; rather than the rationale for performing actions/operations on information related to the activity.</td></tr><tr><td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html#v3-ActReason-COC\">COC</a></td><td style=\"color: #cccccc\">coordination of care</td><td>To perform one or more actions on information in order to organize the provision and case management of an individual's healthcare, including: Monitoring a person's goals, needs, and preferences; acting as the communication link between two or more participants concerned with a person's health and wellness; organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person; and ensuring safe, appropriate, non-duplicative, and effective integrated care.<br/><br/>*Usage Note:* Use when describing these functions: 1. Monitoring a person's goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care.<br/><br/>The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment.<br/><br/>For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare.<br/><br/>*Map:* Maps to ISO 14265 Classification Terms: &quot;Support of care activities within the provider organisation for an individual subject of care&quot; described as &quot;To inform persons or processes enabling others to provide health care services to the subject of care.&quot; &quot;Subject of Care Uses&quot; described as &quot;To inform the subject of care in support of his or her own interests.&quot;</td></tr><tr><td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html#v3-ActReason-TREAT\">TREAT</a></td><td style=\"color: #cccccc\">treatment</td><td>To perform one or more operations on information for provision of health care.</td></tr></table></li><li>Include these codes as defined in <a href=\"CodeSystem-cdex-temp.html\"><code>http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp</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=\"CodeSystem-cdex-temp.html#cdex-temp-care-planning\">care-planning</a></td><td style=\"color: #cccccc\">Care Planning</td><td>Request for data from payers or providers to determine how to deliver care for a particular patient, group or community.</td></tr><tr><td><a href=\"CodeSystem-cdex-temp.html#cdex-temp-social-risk\">social-risk</a></td><td style=\"color: #cccccc\">Social Risk</td><td>Request for data from payers or other providers to assess of social risk, establishing coded health concerns/problems, creating patient driven goals, managing interventions, and measuring outcomes.</td></tr><tr><td><a href=\"CodeSystem-cdex-temp.html#cdex-temp-payment-noe\">payment-noe</a></td><td style=\"color: #cccccc\">Payment Not Otherwise Enumerated</td><td>[Existing concepts do not define a more detailed [Payment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.</td></tr><tr><td><a href=\"CodeSystem-cdex-temp.html#cdex-temp-operations-noe\">operations-noe</a></td><td style=\"color: #cccccc\">Operations Not Otherwise Enumerated</td><td>Existing concepts do not define a more detailed [Healthcare Operations as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.</td></tr><tr><td><a href=\"CodeSystem-cdex-temp.html#cdex-temp-treatment-noe\">treatment-noe</a></td><td style=\"color: #cccccc\">Treatment Not Otherwise Enumerated</td><td>Existing concepts do not define a more detailed [Treatment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.</td></tr></table></li></ul></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 1
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "claims"
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-cdex/ValueSet/cdex-POU",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.21.48.1"
    }
  ],
  "version" : "2.1.0-preview",
  "name" : "CDexPOUCodes",
  "title" : "CDex Purpose of Use Value Set",
  "status" : "active",
  "experimental" : false,
  "date" : "2022-10-24",
  "publisher" : "HL7 International / Payer/Provider Information Exchange Work Group",
  "contact" : [
    {
      "name" : "HL7 International / Payer/Provider Information Exchange Work Group",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/claims"
        },
        {
          "system" : "email",
          "value" : "pie@lists.hl7.org"
        }
      ]
    }
  ],
  "description" : "The set of purpose of use codes for the requested data (the output of the task). This code set is composed of [FHIR core Purpose of Use security labels](http://hl7.org/fhir/security-labels.html#core) and additional codes defined by this Guide.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "copyright" : "Used by permission of HL7 International all rights reserved Creative Commons License",
  "compose" : {
    "include" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "concept" : [
          {
            "code" : "COVERAGE"
          },
          {
            "code" : "CLMATTCH"
          },
          {
            "code" : "COVAUTH"
          },
          {
            "code" : "HQUALIMP"
          },
          {
            "code" : "HDM"
          },
          {
            "code" : "COC"
          },
          {
            "code" : "TREAT"
          }
        ]
      },
      {
        "system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
        "concept" : [
          {
            "code" : "care-planning"
          },
          {
            "code" : "social-risk"
          },
          {
            "code" : "payment-noe"
          },
          {
            "code" : "operations-noe"
          },
          {
            "code" : "treatment-noe"
          }
        ]
      }
    ]
  }
}

XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.