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Resource CodeSystem/FHIR Server from package hl7.fhir.us.davinci-crd#current (125 ms)

Package hl7.fhir.us.davinci-crd
Type CodeSystem
Id Id
FHIR Version R4
Source http://hl7.org/fhir/us/davinci-crd/https://build.fhir.org/ig/HL7/davinci-crd/CodeSystem-temp.html
Url http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp
Version 2.1.0
Status active
Date 2024-12-05T21:04:42+00:00
Name CRDTempCodes
Title CRD Temporary Codes
Experimental False
Realm us
Authority hl7
Description Codes temporarily defined as part of the CRD implementation guide. These will eventually migrate into an officially maintained terminology (likely either SNOMED CT or HL7's UTG code systems).
Content complete

Resources that use this resource

ConceptMap
HL7Location-CRDTemp HL7 Location code to CMS location code
http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation CRD Coverage Information Additional Documentation Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/CMSMappableLocationCodes CMS Mappable Location Codes
http://hl7.org/fhir/us/davinci-crd/ValueSet/DocReason CRD Coverage Information Documentation Reason Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/afterCompletionCode CRD After Completion Code Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/cardType CRD Card Types Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/cdsHookType CDS Hook Types Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/cmslocationcodes CMS Location Codes Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons CRD Coverage Assertion Reasons
http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetail CRD Coverage Detail Codes Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo CRD Coverage Information Covered Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail CRD Coverage Information Prior Authorization Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/informationNeeded CRD Information Needed Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/metricDataSource CRD Metric Data Source Value Set
http://hl7.org/fhir/us/davinci-crd/ValueSet/metricTokenUse CRD Metric Token Use
http://hl7.org/fhir/us/davinci-crd/ValueSet/taskReason CRD Task Reason Codes Value Set

Resources that this resource uses

No resources found



Narrative

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

Generated Narrative: CodeSystem temp

Properties

This code system defines the following properties for its concepts

NameCodeURIType
Not Selectableabstracthttp://hl7.org/fhir/concept-properties#notSelectableboolean

Concepts

This case-sensitive code system http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp defines the following codes in a Is-A hierarchy:

LvlCodeDisplayDefinitionNot Selectable
1prior-auth-include Include in prior authorizationInclude information in prior authorization
1initial-claim-include Include in initial claimInclude information in initial claim submission
1all-claims-include Include in all claimsInclude information in all claim submissions
1reason-prior-auth Prior authorizationTask action is needed for prior authorization
1after-completion-action After-completion actionA task input indicating an action that should be taken after a QuestionnaireResponse has been completed on a specified Questionnaire. (Multiple completion actions can be specified.)
1gold-card Gold cardOrdering Practitioner has been granted 'gold card' status with this payer/coverage type.
1detail-code Detail codeThe ordered code is at too high a level of granularity to make decisions about coverage/pa/etc. Can only be present if something is 'conditional'
1allowed-quantity Maximum quantityIndicates limitations on the number of services/products allowed (possibly per time period). Value should be a Quantity
1allowed-period Maximum allowed periodIndicates the maximum period of time that can be covered in a single order. Value should be a Period
1in-network-copay Copay for in-networkIndicates a percentage co-pay to expect if delivered in-network. Value should be a Quantity.
1out-network-copay Copay for out-of-networkIndicates a percentage co-pay to expect if delivered out-of-network. Value should be a Quantity.
1auth-out-network-only Authorization out-of-network onlyAuthorization is only necessary if out-of-network. Value should be a boolean.
1concurrent-review Concurrent reviewAdditional payer-defined documentation will be required prior to claim payment. Value should be a boolean.
1appropriate-use-needed Appropriate usePayer-defined appropriate use process must be invoked to determine coverage. Value should be a boolean.
1policy-link Policy LinkA URL pointing to the specific portion of a payer policy, coverage agreement or similar authoritative document that provides a portion of the basis for the decision documented in the coverage-information. Value should be a url.
1instructions InstructionsInformation to display to the user that gives guidance about what steps to take in achieving the recommended actions identified by this coverage-information (e.g. special instructions about requesting authorization, details about information needed, details about data retention, etc.). Value should be a string.
2  instructions-clinical Clinical instructionsInstructions specifically intended for the use of clinical (rather than administrative staff)
2  instructions-admin Administrative InstructionsInstructions specifically intended for the use of administrative (rather than clinical staff)
1conditional ConditionalThere is the potential for information requirements from a participant type not listed. However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.)
1covered CoveredRegular coverage applies
1not-covered Not coveredNo coverage or possibility of coverage for this service)
1clinical Clinical DocumentationDetails most likely to originate from a clinician are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by clinician. Indicates that the CRD client should expose the need to launch DTR to clinical users.
1admin Administrative DocumentationAdministrative details not likely to require clinical expertise are needed to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by back-end staff. Indicates that while the CRD client might expose the ability to launch DTR as an option for clinical users, it should be clear that clinical input is not necessary and deferring the use of DTR to back-end staff is perfectly appropriate. Some CRD clients might be configured (based on provider preference) to not even show clinicians the option to launch.
1both Administrative & clinical docBoth clinical and administrative details are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. Equivalent to the union of #admin and #clinical.
1patient Administrative & clinical docDetails most likely to originate from the patient or their personal representative (e.g. parent, spouse, etc.) are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. For example, information about household composition, accessibility considerations, etc. This should be used when the data needs to come from the patient themselves, rather than a clinician's assessment of the patient
1no-auth No Prior AuthorizationThe ordered service does not require prior authorization
1auth-needed Prior Authorization NeededThe ordered service will require prior authorization
2  performpa Performer Prior AuthorizationPrior authorization is needed for the service, however such prior authoriation must be initiated by the performing (rather than ordering) provider.
1satisfied Authorization SatisfiedWhile prior authorization would typically be needed, the conditions evaluated by prior authorization have already been evaluated and therefore prior authorization can be bypassed
1performer Performer NeededInformation about who (specifically, or at least performer type and affiliation) is necessary to make a determination of coverage and/or prior auth expectations
1location Location NeededInformation about where (specific clinic/site or organization) is necessary to make a determination of coverage and/or prior auth expectations
1timeframe Timeframe NeededInformation about when the service will be performed that is more granular than the order effective period is necessary to make a determination of coverage and/or prior auth expectations
1contract-window New Contract WindowThe target performance time for the event falls outside the contract window for the patient's current coverage. Information will not be available until a contract is in place covering the service time period
1used Authorization Token UsedAn authorization token was used by the payer to access additional information from the provider system as part of the CDS Hook call
2  rejected Authorization Token RejectedThe payer attempted to use an authorization token to access additional information from the provider system as part of the CDS Hook call, however the access request failed. (This is not used if the request succeeded but returned no records.)
1not-used Authorization Token Not UsedThe payer did not attempt to use an authorization token to access additional information from the provider system as part of the CDS Hook call
1provider-src Provider-sourcedThe metric information was captured from the provider system's perspective
1payer-src Payer-sourcedThe metric information was captured from the payer system's perspective
1_cardType Card Type (abstract)A collector for different profiles on CDS Hooks cardtrue
2  coverage-info Coverage InformationInformation related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection
3    unsolicited-determ Unsolicited DeterminationAn unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request
2  claim ClaimInformation about what steps need to be taken to submit a claim for the service
2  insurance InsuranceAllows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)
2  limits LimitsMessages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general
2  network NetworkProviding information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)
2  appropriate-use Appropriate UseGuidance on whether appropriate-use documentation is needed
2  cost CostWhat is the anticipated cost to the patient based on their coverage
2  therapy-alternatives-opt Optional Therapy AlternativesAre there alternative therapies that have better coverage and/or are lower-cost for the patient
2  therapy-alternatives-req Required Therapy AlternativesAre there alternative therapies that must be tried first prior to coverage being available for the proposed therapy
2  clinical-reminder Clinical ReminderReminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)
2  duplicate-therapy Duplicate TherapyNotice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system
2  contraindication ContraindicationNotice that the proposed intervention may be contraindicated based on information the payer has in their record that the provider doesn't have in theirs
2  guideline GuidelineIndication that there is a guideline available for the proposed therapy (with an option to view)
2  off-guideline Off GuidelineNotice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline
1_HookType CDS Hook Type (abstract)A collector for the different types of CDS Hookstrue
2  appointment-book Appointment Book
2  encounter-start Encounter Start
2  encounter-discharge Encounter Discharge
2  order-dispatch" Order Dispatch
2  order-select Order Select
2  order-sign Order Sign
1_docReason Additional Information PurposesA collector for codes representing different reasons for capturing additional informationtrue
2  withpa Include in prior authorizationThe information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) a prior authorization for the associated request resource(s).
2  withclaim Include with claimThe information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) the insurance claim for the services ordered by the associated request resource(s).
2  withorder Include with orderThe information in this QuestionnaireResponse should be packaged into a Bundle and submitted along with (or referenced as supporting information to) the associated request resource(s) when transmitting the order to the fulfilling system.
2  retain-doc Medical necessityThe information in this QuestionnaireResponse should be retained within the EHR as supporting evidence of the medical necessity of the associated request resource(s).
1_cmsLocation CMS Location codesA collector for CMS location codes
2  1 Pharmacy **A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients.
2  2 Telehealth Provided Other than in Patient's HomeThe location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.
2  3 SchoolA facility whose primary purpose is education.
2  4 Homeless ShelterA facility or location whose primary purpose is to provide temporary housing to homeless individuals (e.g., emergency shelters, individual or family shelters).
2  5 Indian Health ServiceA facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to American Indians and Alaska Natives who do not require hospitalization. (Effective January 1, 2003)
2  6 Indian Health ServiceA facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services rendered by, or under the supervision of, physicians to American Indians and Alaska Natives admitted as inpatients or outpatients.
2  7 Tribal 638A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members who do not require hospitalization. (Effective January 1, 2003)
2  8 Tribal 638A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members admitted as inpatients or outpatients.
2  9 Correctional FacilityA prison, jail, reformatory, work farm, detention center, or any other similar facility maintained by either Federal, State or local authorities for the purpose of confinement or rehabilitation of adult or juvenile criminal offenders.
2  10 Telehealth Provided in Patient's HomeThe location where health services and health related services are provided or received, through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
2  11 OfficeLocation, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.
2  12 HomeLocation, other than a hospital or other facility, where the patient receives care in a private residence.
2  13 Assisted Living FacilityCongregate residential facility with self-contained living units providing assessment of each resident's needs and on-site support 24 hours a day, 7 days a week, with the capacity to deliver or arrange for services including some health care and other services.
2  14 Group Home *A residence, with shared living areas, where clients receive supervision and other services such as social and/or behavioral services, custodial service, and minimal services (e.g., medication administration).
2  15 Mobile UnitA facility/unit that moves from place-to-place equipped to provide preventive, screening, diagnostic, and/or treatment services.
2  16 Temporary LodgingA short term accommodation such as a hotel, camp ground, hostel, cruise ship or resort where the patient receives care, and which is not identified by any other POS code.
2  17 Walk-in Retail Health ClinicA walk-in health clinic, other than an office, urgent care facility, pharmacy or independent clinic and not described by any other Place of Service code, that is located within a retail operation and provides, on an ambulatory basis, preventive and primary care services. (This code is available for use immediately with a final effective date of May 1, 2010)
2  18 Place of Employment-A location, not described by any other POS code, owned or operated by a public or private entity where the patient is employed, and where a health professional provides on-going or episodic occupational medical, therapeutic or rehabilitative services to the individual. (This code is available for use effective January 1, 2013 but no later than May 1, 2013)
2  19 Off Campus-Outpatient HospitalA portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Effective January 1, 2016)
2  20 Urgent Care FacilityLocation, distinct from a hospital emergency room, an office, or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention.
2  21 Inpatient HospitalA facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervision of physicians to patients admitted for a variety of medical conditions.
2  22 On Campus-Outpatient HospitalA portion of a hospital's main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Description change effective January 1, 2016)
2  23 Emergency Room - HospitalA portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.
2  24 Ambulatory Surgical CenterA freestanding facility, other than a physician's office, where surgical and diagnostic services are provided on an ambulatory basis.
2  25 Birthing CenterA facility, other than a hospital's maternity facilities or a physician's office, which provides a setting for labor, delivery, and immediate post-partum care as well as immediate care of new born infants.
2  26 Military Treatment FacilityA medical facility operated by one or more of the Uniformed Services. Military Treatment Facility (MTF) also refers to certain former U.S. Public Health Service (USPHS) facilities now designated as Uniformed Service Treatment Facilities (USTF).
2  27 Outreach Site/ StreetA non-permanent location on the street or found environment, not described by any other POS code, where health professionals provide preventive, screening, diagnostic, and/or treatment services to unsheltered homeless individuals.
2  31 Skilled Nursing FacilityA facility which primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital.
2  32 Nursing FacilityA facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care services above the level of custodial care to other than individuals with intellectual disabilities.
2  33 Custodial Care FacilityA facility which provides room, board and other personal assistance services, generally on a long-term basis, and which does not include a medical component.
2  34 HospiceA facility, other than a patient's home, in which palliative and supportive care for terminally ill patients and their families are provided.
2  41 Ambulance - LandA land vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.
2  42 Ambulance - Air or WaterAn air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.
2  49 Independent ClinicA location, not part of a hospital and not described by any other Place of Service code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only.
2  50 Federally Qualified Health CenterA facility located in a medically underserved area that provides Medicare beneficiaries preventive primary medical care under the general direction of a physician.
2  51 Inpatient Psychiatric FacilityA facility that provides inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour basis, by or under the supervision of a physician.
2  52 Psychiatric Facility-Partial HospitalizationA facility for the diagnosis and treatment of mental illness that provides a planned therapeutic program for patients who do not require full time hospitalization, but who need broader programs than are possible from outpatient visits to a hospital-based or hospital-affiliated facility.
2  53 Community Mental Health CenterA facility that provides the following services: outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically ill, and residents of the CMHC's mental health services area who have been discharged from inpatient treatment at a mental health facility; 24 hour a day emergency care services; day treatment, other partial hospitalization services, or psychosocial rehabilitation services; screening for patients being considered for admission to State mental health facilities to determine the appropriateness of such admission; and consultation and education services.
2  54 Intermediate Care Facility/ Individuals with Intellectual DisabilitiesA facility which primarily provides health-related care and services above the level of custodial care to individuals but does not provide the level of care or treatment available in a hospital or SNF.
2  55 Residential Substance Abuse Treatment FacilityA facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board.
2  56 Psychiatric Residential Treatment CenterA facility or distinct part of a facility for psychiatric care which provides a total 24-hour therapeutically planned and professionally staffed group living and learning environment.
2  57 Non-residential Substance Abuse Treatment FacilityA location which provides treatment for substance (alcohol and drug) abuse on an ambulatory basis.  Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, and psychological testing.
2  58 Non-residential Opioid Treatment FacilityA location that provides treatment for opioid use disorder on an ambulatory basis. Services include methadone and other forms of Medication Assisted Treatment (MAT). (Effective January 1, 2020)
2  60 Mass Immunization CenterA location where providers administer pneumococcal pneumonia and influenza virus vaccinations and submit these services as electronic media claims, paper claims, or using the roster billing method. This generally takes place in a mass immunization setting, such as, a public health center, pharmacy, or mall but may include a physician office setting.
2  61 Comprehensive Inpatient Rehabilitation FacilityA facility that provides comprehensive rehabilitation services under the supervision of a physician to inpatients with physical disabilities. Services include physical therapy, occupational therapy, speech pathology, social or psychological services, and orthotics and prosthetics services.
2  62 Comprehensive Outpatient Rehabilitation FacilityA facility that provides comprehensive rehabilitation services under the supervision of a physician to outpatients with physical disabilities. Services include physical therapy, occupational therapy, and speech pathology services.
2  65 End-Stage Renal Disease Treatment FacilityA facility other than a hospital, which provides dialysis treatment, maintenance, and/or training to patients or caregivers on an ambulatory or home-care basis.
2  71 Public Health ClinicA facility maintained by either State or local health departments that provides ambulatory primary medical care under the general direction of a physician.
2  72 Rural Health ClinicA certified facility which is located in a rural medically underserved area that provides ambulatory primary medical care under the general direction of a physician.
2  81 Independent LaboratoryA laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a physician's office.
2  99 Other Place of ServiceOther place of service not identified above.

Source

{
  "resourceType" : "CodeSystem",
  "id" : "temp",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem temp</b></p><a name=\"temp\"> </a><a name=\"hctemp\"> </a><a name=\"temp-en-US\"> </a><p><b>Properties</b></p><p><b>This code system defines the following properties for its concepts</b></p><table class=\"grid\"><tr><td><b>Name</b></td><td><b>Code</b></td><td><b>URI</b></td><td><b>Type</b></td></tr><tr><td>Not Selectable</td><td>abstract</td><td>http://hl7.org/fhir/concept-properties#notSelectable</td><td>boolean</td></tr></table><p><b>Concepts</b></p><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp</code> defines the following codes in a Is-A hierarchy:</p><table class=\"codes\"><tr><td><b>Lvl</b></td><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td><td><b>Not Selectable</b></td></tr><tr><td>1</td><td style=\"white-space:nowrap\">prior-auth-include<a name=\"temp-prior-auth-include\"> </a></td><td>Include in prior authorization</td><td>Include information in prior authorization</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">initial-claim-include<a name=\"temp-initial-claim-include\"> </a></td><td>Include in initial claim</td><td>Include information in initial claim submission</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">all-claims-include<a name=\"temp-all-claims-include\"> </a></td><td>Include in all claims</td><td>Include information in all claim submissions</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">reason-prior-auth<a name=\"temp-reason-prior-auth\"> </a></td><td>Prior authorization</td><td>Task action is needed for prior authorization</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">after-completion-action<a name=\"temp-after-completion-action\"> </a></td><td>After-completion action</td><td>A task input indicating an action that should be taken after a QuestionnaireResponse has been completed on a specified Questionnaire. (Multiple completion actions can be specified.)</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">gold-card<a name=\"temp-gold-card\"> </a></td><td>Gold card</td><td>Ordering Practitioner has been granted 'gold card' status with this payer/coverage type.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">detail-code<a name=\"temp-detail-code\"> </a></td><td>Detail code</td><td>The ordered code is at too high a level of granularity to make decisions about coverage/pa/etc. Can only be present if something is 'conditional'</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">allowed-quantity<a name=\"temp-allowed-quantity\"> </a></td><td>Maximum quantity</td><td>Indicates limitations on the number of services/products allowed (possibly per time period). Value should be a Quantity</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">allowed-period<a name=\"temp-allowed-period\"> </a></td><td>Maximum allowed period</td><td>Indicates the maximum period of time that can be covered in a single order. Value should be a Period</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">in-network-copay<a name=\"temp-in-network-copay\"> </a></td><td>Copay for in-network</td><td>Indicates a percentage co-pay to expect if delivered in-network. Value should be a Quantity.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">out-network-copay<a name=\"temp-out-network-copay\"> </a></td><td>Copay for out-of-network</td><td>Indicates a percentage co-pay to expect if delivered out-of-network. Value should be a Quantity.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">auth-out-network-only<a name=\"temp-auth-out-network-only\"> </a></td><td>Authorization out-of-network only</td><td>Authorization is only necessary if out-of-network. Value should be a boolean.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">concurrent-review<a name=\"temp-concurrent-review\"> </a></td><td>Concurrent review</td><td>Additional payer-defined documentation will be required prior to claim payment. Value should be a boolean.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">appropriate-use-needed<a name=\"temp-appropriate-use-needed\"> </a></td><td>Appropriate use</td><td>Payer-defined appropriate use process must be invoked to determine coverage. Value should be a boolean.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">policy-link<a name=\"temp-policy-link\"> </a></td><td>Policy Link</td><td>A URL pointing to the specific portion of a payer policy, coverage agreement or similar authoritative document that provides a portion of the basis for the decision documented in the coverage-information. Value should be a url.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">instructions<a name=\"temp-instructions\"> </a></td><td>Instructions</td><td>Information to display to the user that gives guidance about what steps to take in achieving the recommended actions identified by this coverage-information (e.g. special instructions about requesting authorization, details about information needed, details about data retention, etc.). Value should be a string.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��instructions-clinical<a name=\"temp-instructions-clinical\"> </a></td><td>Clinical instructions</td><td>Instructions specifically intended for the use of clinical (rather than administrative staff)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��instructions-admin<a name=\"temp-instructions-admin\"> </a></td><td>Administrative Instructions</td><td>Instructions specifically intended for the use of administrative (rather than clinical staff)</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">conditional<a name=\"temp-conditional\"> </a></td><td>Conditional</td><td>There is the potential for information requirements from a participant type not listed. However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.)</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">covered<a name=\"temp-covered\"> </a></td><td>Covered</td><td>Regular coverage applies</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">not-covered<a name=\"temp-not-covered\"> </a></td><td>Not covered</td><td>No coverage or possibility of coverage for this service)</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">clinical<a name=\"temp-clinical\"> </a></td><td>Clinical Documentation</td><td>Details most likely to originate from a clinician are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by clinician. Indicates that the CRD client should expose the need to launch DTR to clinical users.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">admin<a name=\"temp-admin\"> </a></td><td>Administrative Documentation</td><td>Administrative details not likely to require clinical expertise are needed to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by back-end staff. Indicates that while the CRD client might expose the ability to launch DTR as an option for clinical users, it should be clear that clinical input is not necessary and deferring the use of DTR to back-end staff is perfectly appropriate. Some CRD clients might be configured (based on provider preference) to not even show clinicians the option to launch.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">both<a name=\"temp-both\"> </a></td><td>Administrative &amp; clinical doc</td><td>Both clinical and administrative details are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. Equivalent to the union of #admin and #clinical.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">patient<a name=\"temp-patient\"> </a></td><td>Administrative &amp; clinical doc</td><td>Details most likely to originate from the patient or their personal representative (e.g. parent, spouse, etc.) are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. For example, information about household composition, accessibility considerations, etc. This should be used when the data needs to come from the patient themselves, rather than a clinician's assessment of the patient</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">no-auth<a name=\"temp-no-auth\"> </a></td><td>No Prior Authorization</td><td>The ordered service does not require prior authorization</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">auth-needed<a name=\"temp-auth-needed\"> </a></td><td>Prior Authorization Needed</td><td>The ordered service will require prior authorization</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��performpa<a name=\"temp-performpa\"> </a></td><td>Performer Prior Authorization</td><td>Prior authorization is needed for the service, however such prior authoriation must be initiated by the performing (rather than ordering) provider.</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">satisfied<a name=\"temp-satisfied\"> </a></td><td>Authorization Satisfied</td><td>While prior authorization would typically be needed, the conditions evaluated by prior authorization have already been evaluated and therefore prior authorization can be bypassed</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">performer<a name=\"temp-performer\"> </a></td><td>Performer Needed</td><td>Information about who (specifically, or at least performer type and affiliation) is necessary to make a determination of coverage and/or prior auth expectations</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">location<a name=\"temp-location\"> </a></td><td>Location Needed</td><td>Information about where (specific clinic/site or organization) is necessary to make a determination of coverage and/or prior auth expectations</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">timeframe<a name=\"temp-timeframe\"> </a></td><td>Timeframe Needed</td><td>Information about when the service will be performed that is more granular than the order effective period is necessary to make a determination of coverage and/or prior auth expectations</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">contract-window<a name=\"temp-contract-window\"> </a></td><td>New Contract Window</td><td>The target performance time for the event falls outside the contract window for the patient's current coverage. Information will not be available until a contract is in place covering the service time period</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">used<a name=\"temp-used\"> </a></td><td>Authorization Token Used</td><td>An authorization token was used by the payer to access additional information from the provider system as part of the CDS Hook call</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��rejected<a name=\"temp-rejected\"> </a></td><td>Authorization Token Rejected</td><td>The payer attempted to use an authorization token to access additional information from the provider system as part of the CDS Hook call, however the access request failed. (This is not used if the request succeeded but returned no records.)</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">not-used<a name=\"temp-not-used\"> </a></td><td>Authorization Token Not Used</td><td>The payer did not attempt to use an authorization token to access additional information from the provider system as part of the CDS Hook call</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">provider-src<a name=\"temp-provider-src\"> </a></td><td>Provider-sourced</td><td>The metric information was captured from the provider system's perspective</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">payer-src<a name=\"temp-payer-src\"> </a></td><td>Payer-sourced</td><td>The metric information was captured from the payer system's perspective</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">_cardType<a name=\"temp-_cardType\"> </a></td><td>Card Type (abstract)</td><td>A collector for different profiles on CDS Hooks card</td><td>true</td></tr><tr><td>2</td><td style=\"white-space:nowrap\">��coverage-info<a name=\"temp-coverage-info\"> </a></td><td>Coverage Information</td><td>Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection</td><td/></tr><tr><td>3</td><td style=\"white-space:nowrap\">����unsolicited-determ<a name=\"temp-unsolicited-determ\"> </a></td><td>Unsolicited Determination</td><td>An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��claim<a name=\"temp-claim\"> </a></td><td>Claim</td><td>Information about what steps need to be taken to submit a claim for the service</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��insurance<a name=\"temp-insurance\"> </a></td><td>Insurance</td><td>Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��limits<a name=\"temp-limits\"> </a></td><td>Limits</td><td>Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��network<a name=\"temp-network\"> </a></td><td>Network</td><td>Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��appropriate-use<a name=\"temp-appropriate-use\"> </a></td><td>Appropriate Use</td><td>Guidance on whether appropriate-use documentation is needed</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��cost<a name=\"temp-cost\"> </a></td><td>Cost</td><td>What is the anticipated cost to the patient based on their coverage</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��therapy-alternatives-opt<a name=\"temp-therapy-alternatives-opt\"> </a></td><td>Optional Therapy Alternatives</td><td>Are there alternative therapies that have better coverage and/or are lower-cost for the patient</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��therapy-alternatives-req<a name=\"temp-therapy-alternatives-req\"> </a></td><td>Required Therapy Alternatives</td><td>Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��clinical-reminder<a name=\"temp-clinical-reminder\"> </a></td><td>Clinical Reminder</td><td>Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��duplicate-therapy<a name=\"temp-duplicate-therapy\"> </a></td><td>Duplicate Therapy</td><td>Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��contraindication<a name=\"temp-contraindication\"> </a></td><td>Contraindication</td><td>Notice that the proposed intervention may be contraindicated based on information the payer has in their record that the provider doesn't have in theirs</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��guideline<a name=\"temp-guideline\"> </a></td><td>Guideline</td><td>Indication that there is a guideline available for the proposed therapy (with an option to view)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��off-guideline<a name=\"temp-off-guideline\"> </a></td><td>Off Guideline</td><td>Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">_HookType<a name=\"temp-_HookType\"> </a></td><td>CDS Hook Type (abstract)</td><td>A collector for the different types of CDS Hooks</td><td>true</td></tr><tr><td>2</td><td style=\"white-space:nowrap\">��appointment-book<a name=\"temp-appointment-book\"> </a></td><td>Appointment Book</td><td/><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��encounter-start<a name=\"temp-encounter-start\"> </a></td><td>Encounter Start</td><td/><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��encounter-discharge<a name=\"temp-encounter-discharge\"> </a></td><td>Encounter Discharge</td><td/><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��order-dispatch&quot;<a name=\"temp-order-dispatch.34\"> </a></td><td>Order Dispatch</td><td/><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��order-select<a name=\"temp-order-select\"> </a></td><td>Order Select</td><td/><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��order-sign<a name=\"temp-order-sign\"> </a></td><td>Order Sign</td><td/><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">_docReason<a name=\"temp-_docReason\"> </a></td><td>Additional Information Purposes</td><td>A collector for codes representing different reasons for capturing additional information</td><td>true</td></tr><tr><td>2</td><td style=\"white-space:nowrap\">��withpa<a name=\"temp-withpa\"> </a></td><td>Include in prior authorization</td><td>The information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) a prior authorization for the associated request resource(s).</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��withclaim<a name=\"temp-withclaim\"> </a></td><td>Include with claim</td><td>The information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) the insurance claim for the services ordered by the associated request resource(s).</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��withorder<a name=\"temp-withorder\"> </a></td><td>Include with order</td><td>The information in this QuestionnaireResponse should be packaged into a Bundle and submitted along with (or referenced as supporting information to) the associated request resource(s) when transmitting the order to the fulfilling system.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��retain-doc<a name=\"temp-retain-doc\"> </a></td><td>Medical necessity</td><td>The information in this QuestionnaireResponse should be retained within the EHR as supporting evidence of the medical necessity of the associated request resource(s).</td><td/></tr><tr><td>1</td><td style=\"white-space:nowrap\">_cmsLocation<a name=\"temp-_cmsLocation\"> </a></td><td>CMS Location codes</td><td>A collector for CMS location codes</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��1<a name=\"temp-1\"> </a></td><td>Pharmacy **</td><td>A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��2<a name=\"temp-2\"> </a></td><td>Telehealth Provided Other than in Patient's Home</td><td>The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��3<a name=\"temp-3\"> </a></td><td>School</td><td>A facility whose primary purpose is education.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��4<a name=\"temp-4\"> </a></td><td>Homeless Shelter</td><td>A facility or location whose primary purpose is to provide temporary housing to homeless individuals (e.g., emergency shelters, individual or family shelters).</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��5<a name=\"temp-5\"> </a></td><td>Indian Health Service</td><td>A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to American Indians and Alaska Natives who do not require hospitalization. (Effective January 1, 2003)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��6<a name=\"temp-6\"> </a></td><td>Indian Health Service</td><td>A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services rendered by, or under the supervision of, physicians to American Indians and Alaska Natives admitted as inpatients or outpatients.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��7<a name=\"temp-7\"> </a></td><td>Tribal 638</td><td>A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members who do not require hospitalization. (Effective January 1, 2003)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��8<a name=\"temp-8\"> </a></td><td>Tribal 638</td><td>A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members admitted as inpatients or outpatients.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��9<a name=\"temp-9\"> </a></td><td>Correctional Facility</td><td>A prison, jail, reformatory, work farm, detention center, or any other similar facility maintained by either Federal, State or local authorities for the purpose of confinement or rehabilitation of adult or juvenile criminal offenders.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��10<a name=\"temp-10\"> </a></td><td>Telehealth Provided in Patient's Home</td><td>The location where health services and health related services are provided or received, through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��11<a name=\"temp-11\"> </a></td><td>Office</td><td>Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��12<a name=\"temp-12\"> </a></td><td>Home</td><td>Location, other than a hospital or other facility, where the patient receives care in a private residence.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��13<a name=\"temp-13\"> </a></td><td>Assisted Living Facility</td><td>Congregate residential facility with self-contained living units providing assessment of each resident's needs and on-site support 24 hours a day, 7 days a week, with the capacity to deliver or arrange for services including some health care and other services.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��14<a name=\"temp-14\"> </a></td><td>Group Home *</td><td>A residence, with shared living areas, where clients receive supervision and other services such as social and/or behavioral services, custodial service, and minimal services (e.g., medication administration).</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��15<a name=\"temp-15\"> </a></td><td>Mobile Unit</td><td>A facility/unit that moves from place-to-place equipped to provide preventive, screening, diagnostic, and/or treatment services.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��16<a name=\"temp-16\"> </a></td><td>Temporary Lodging</td><td>A short term accommodation such as a hotel, camp ground, hostel, cruise ship or resort where the patient receives care, and which is not identified by any other POS code.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��17<a name=\"temp-17\"> </a></td><td>Walk-in Retail Health Clinic</td><td>A walk-in health clinic, other than an office, urgent care facility, pharmacy or independent clinic and not described by any other Place of Service code, that is located within a retail operation and provides, on an ambulatory basis, preventive and primary care services. (This code is available for use immediately with a final effective date of May 1, 2010)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��18<a name=\"temp-18\"> </a></td><td>Place of Employment-</td><td>A location, not described by any other POS code, owned or operated by a public or private entity where the patient is employed, and where a health professional provides on-going or episodic occupational medical, therapeutic or rehabilitative services to the individual. (This code is available for use effective January 1, 2013 but no later than May 1, 2013)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��19<a name=\"temp-19\"> </a></td><td>Off Campus-Outpatient Hospital</td><td>A portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Effective January 1, 2016)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��20<a name=\"temp-20\"> </a></td><td>Urgent Care Facility</td><td>Location, distinct from a hospital emergency room, an office, or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��21<a name=\"temp-21\"> </a></td><td>Inpatient Hospital</td><td>A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervision of physicians to patients admitted for a variety of medical conditions.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��22<a name=\"temp-22\"> </a></td><td>On Campus-Outpatient Hospital</td><td>A portion of a hospital's main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Description change effective January 1, 2016)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��23<a name=\"temp-23\"> </a></td><td>Emergency Room - Hospital</td><td>A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��24<a name=\"temp-24\"> </a></td><td>Ambulatory Surgical Center</td><td>A freestanding facility, other than a physician's office, where surgical and diagnostic services are provided on an ambulatory basis.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��25<a name=\"temp-25\"> </a></td><td>Birthing Center</td><td>A facility, other than a hospital's maternity facilities or a physician's office, which provides a setting for labor, delivery, and immediate post-partum care as well as immediate care of new born infants.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��26<a name=\"temp-26\"> </a></td><td>Military Treatment Facility</td><td>A medical facility operated by one or more of the Uniformed Services. Military Treatment Facility (MTF) also refers to certain former U.S. Public Health Service (USPHS) facilities now designated as Uniformed Service Treatment Facilities (USTF).</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��27<a name=\"temp-27\"> </a></td><td>Outreach Site/ Street</td><td>A non-permanent location on the street or found environment, not described by any other POS code, where health professionals provide preventive, screening, diagnostic, and/or treatment services to unsheltered homeless individuals.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��31<a name=\"temp-31\"> </a></td><td>Skilled Nursing Facility</td><td>A facility which primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��32<a name=\"temp-32\"> </a></td><td>Nursing Facility</td><td>A facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care services above the level of custodial care to other than individuals with intellectual disabilities.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��33<a name=\"temp-33\"> </a></td><td>Custodial Care Facility</td><td>A facility which provides room, board and other personal assistance services, generally on a long-term basis, and which does not include a medical component.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��34<a name=\"temp-34\"> </a></td><td>Hospice</td><td>A facility, other than a patient's home, in which palliative and supportive care for terminally ill patients and their families are provided.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��41<a name=\"temp-41\"> </a></td><td>Ambulance - Land</td><td>A land vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��42<a name=\"temp-42\"> </a></td><td>Ambulance - Air or Water</td><td>An air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��49<a name=\"temp-49\"> </a></td><td>Independent Clinic</td><td>A location, not part of a hospital and not described by any other Place of Service code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��50<a name=\"temp-50\"> </a></td><td>Federally Qualified Health Center</td><td>A facility located in a medically underserved area that provides Medicare beneficiaries preventive primary medical care under the general direction of a physician.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��51<a name=\"temp-51\"> </a></td><td>Inpatient Psychiatric Facility</td><td>A facility that provides inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour basis, by or under the supervision of a physician.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��52<a name=\"temp-52\"> </a></td><td>Psychiatric Facility-Partial Hospitalization</td><td>A facility for the diagnosis and treatment of mental illness that provides a planned therapeutic program for patients who do not require full time hospitalization, but who need broader programs than are possible from outpatient visits to a hospital-based or hospital-affiliated facility.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��53<a name=\"temp-53\"> </a></td><td>Community Mental Health Center</td><td>A facility that provides the following services: outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically ill, and residents of the CMHC's mental health services area who have been discharged from inpatient treatment at a mental health facility; 24 hour a day emergency care services; day treatment, other partial hospitalization services, or psychosocial rehabilitation services; screening for patients being considered for admission to State mental health facilities to determine the appropriateness of such admission; and consultation and education services.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��54<a name=\"temp-54\"> </a></td><td>Intermediate Care Facility/ Individuals with Intellectual Disabilities</td><td>A facility which primarily provides health-related care and services above the level of custodial care to individuals but does not provide the level of care or treatment available in a hospital or SNF.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��55<a name=\"temp-55\"> </a></td><td>Residential Substance Abuse Treatment Facility</td><td>A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��56<a name=\"temp-56\"> </a></td><td>Psychiatric Residential Treatment Center</td><td>A facility or distinct part of a facility for psychiatric care which provides a total 24-hour therapeutically planned and professionally staffed group living and learning environment.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��57<a name=\"temp-57\"> </a></td><td>Non-residential Substance Abuse Treatment Facility</td><td>A location which provides treatment for substance (alcohol and drug) abuse on an ambulatory basis.� Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, and psychological testing.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��58<a name=\"temp-58\"> </a></td><td>Non-residential Opioid Treatment Facility</td><td>A location that provides treatment for opioid use disorder on an ambulatory basis. Services include methadone and other forms of Medication Assisted Treatment (MAT). (Effective January 1, 2020)</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��60<a name=\"temp-60\"> </a></td><td>Mass Immunization Center</td><td>A location where providers administer pneumococcal pneumonia and influenza virus vaccinations and submit these services as electronic media claims, paper claims, or using the roster billing method. This generally takes place in a mass immunization setting, such as, a public health center, pharmacy, or mall but may include a physician office setting.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��61<a name=\"temp-61\"> </a></td><td>Comprehensive Inpatient Rehabilitation Facility</td><td>A facility that provides comprehensive rehabilitation services under the supervision of a physician to inpatients with physical disabilities. Services include physical therapy, occupational therapy, speech pathology, social or psychological services, and orthotics and prosthetics services.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��62<a name=\"temp-62\"> </a></td><td>Comprehensive Outpatient Rehabilitation Facility</td><td>A facility that provides comprehensive rehabilitation services under the supervision of a physician to outpatients with physical disabilities. Services include physical therapy, occupational therapy, and speech pathology services.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��65<a name=\"temp-65\"> </a></td><td>End-Stage Renal Disease Treatment Facility</td><td>A facility other than a hospital, which provides dialysis treatment, maintenance, and/or training to patients or caregivers on an ambulatory or home-care basis.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��71<a name=\"temp-71\"> </a></td><td>Public Health Clinic</td><td>A facility maintained by either State or local health departments that provides ambulatory primary medical care under the general direction of a physician.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��72<a name=\"temp-72\"> </a></td><td>Rural Health Clinic</td><td>A certified facility which is located in a rural medically underserved area that provides ambulatory primary medical care under the general direction of a physician.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��81<a name=\"temp-81\"> </a></td><td>Independent Laboratory</td><td>A laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a physician's office.</td><td/></tr><tr><td>2</td><td style=\"white-space:nowrap\">��99<a name=\"temp-99\"> </a></td><td>Other Place of Service</td><td>Other place of service not identified above.</td><td/></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 3,
      "_valueInteger" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.18.16.1"
    }
  ],
  "version" : "2.1.0",
  "name" : "CRDTempCodes",
  "title" : "CRD Temporary Codes",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-12-05T21:04:42+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description" : "Codes temporarily defined as part of the CRD implementation guide. These will eventually migrate into an officially maintained terminology (likely either SNOMED CT or HL7's UTG code systems).",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "caseSensitive" : true,
  "hierarchyMeaning" : "is-a",
  "content" : "complete",
  "count" : 118,
  "property" : [
    {
      "code" : "abstract",
      "uri" : "http://hl7.org/fhir/concept-properties#notSelectable",
      "type" : "boolean"
    }
  ],
  "concept" : [
    {
      "code" : "prior-auth-include",
      "display" : "Include in prior authorization",
      "definition" : "Include information in prior authorization"
    },
    {
      "code" : "initial-claim-include",
      "display" : "Include in initial claim",
      "definition" : "Include information in initial claim submission"
    },
    {
      "code" : "all-claims-include",
      "display" : "Include in all claims",
      "definition" : "Include information in all claim submissions"
    },
    {
      "code" : "reason-prior-auth",
      "display" : "Prior authorization",
      "definition" : "Task action is needed for prior authorization"
    },
    {
      "code" : "after-completion-action",
      "display" : "After-completion action",
      "definition" : "A task input indicating an action that should be taken after a QuestionnaireResponse has been completed on a specified Questionnaire. (Multiple completion actions can be specified.)"
    },
    {
      "code" : "gold-card",
      "display" : "Gold card",
      "definition" : "Ordering Practitioner has been granted 'gold card' status with this payer/coverage type."
    },
    {
      "code" : "detail-code",
      "display" : "Detail code",
      "definition" : "The ordered code is at too high a level of granularity to make decisions about coverage/pa/etc. Can only be present if something is 'conditional'"
    },
    {
      "code" : "allowed-quantity",
      "display" : "Maximum quantity",
      "definition" : "Indicates limitations on the number of services/products allowed (possibly per time period). Value should be a Quantity"
    },
    {
      "code" : "allowed-period",
      "display" : "Maximum allowed period",
      "definition" : "Indicates the maximum period of time that can be covered in a single order. Value should be a Period"
    },
    {
      "code" : "in-network-copay",
      "display" : "Copay for in-network",
      "definition" : "Indicates a percentage co-pay to expect if delivered in-network. Value should be a Quantity."
    },
    {
      "code" : "out-network-copay",
      "display" : "Copay for out-of-network",
      "definition" : "Indicates a percentage co-pay to expect if delivered out-of-network. Value should be a Quantity."
    },
    {
      "code" : "auth-out-network-only",
      "display" : "Authorization out-of-network only",
      "definition" : "Authorization is only necessary if out-of-network. Value should be a boolean."
    },
    {
      "code" : "concurrent-review",
      "display" : "Concurrent review",
      "definition" : "Additional payer-defined documentation will be required prior to claim payment. Value should be a boolean."
    },
    {
      "code" : "appropriate-use-needed",
      "display" : "Appropriate use",
      "definition" : "Payer-defined appropriate use process must be invoked to determine coverage. Value should be a boolean."
    },
    {
      "code" : "policy-link",
      "display" : "Policy Link",
      "definition" : "A URL pointing to the specific portion of a payer policy, coverage agreement or similar authoritative document that provides a portion of the basis for the decision documented in the coverage-information. Value should be a url."
    },
    {
      "code" : "instructions",
      "display" : "Instructions",
      "definition" : "Information to display to the user that gives guidance about what steps to take in achieving the recommended actions identified by this coverage-information (e.g. special instructions about requesting authorization, details about information needed, details about data retention, etc.). Value should be a string.",
      "concept" : [
        {
          "code" : "instructions-clinical",
          "display" : "Clinical instructions",
          "definition" : "Instructions specifically intended for the use of clinical (rather than administrative staff)"
        },
        {
          "code" : "instructions-admin",
          "display" : "Administrative Instructions",
          "definition" : "Instructions specifically intended for the use of administrative (rather than clinical staff)"
        }
      ]
    },
    {
      "code" : "conditional",
      "display" : "Conditional",
      "definition" : "There is the potential for information requirements from a participant type not listed. However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.)"
    },
    {
      "code" : "covered",
      "display" : "Covered",
      "definition" : "Regular coverage applies"
    },
    {
      "code" : "not-covered",
      "display" : "Not covered",
      "definition" : "No coverage or possibility of coverage for this service)"
    },
    {
      "code" : "clinical",
      "display" : "Clinical Documentation",
      "definition" : "Details most likely to originate from a clinician are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by clinician. Indicates that the CRD client should expose the need to launch DTR to clinical users."
    },
    {
      "code" : "admin",
      "display" : "Administrative Documentation",
      "definition" : "Administrative details not likely to require clinical expertise are needed to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by back-end staff. Indicates that while the CRD client might expose the ability to launch DTR as an option for clinical users, it should be clear that clinical input is not necessary and deferring the use of DTR to back-end staff is perfectly appropriate. Some CRD clients might be configured (based on provider preference) to not even show clinicians the option to launch."
    },
    {
      "code" : "both",
      "display" : "Administrative & clinical doc",
      "definition" : "Both clinical and administrative details are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. Equivalent to the union of #admin and #clinical."
    },
    {
      "code" : "patient",
      "display" : "Administrative & clinical doc",
      "definition" : "Details most likely to originate from the patient or their personal representative (e.g. parent, spouse, etc.) are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. For example, information about household composition, accessibility considerations, etc. This should be used when the data needs to come from the patient themselves, rather than a clinician's assessment of the patient"
    },
    {
      "code" : "no-auth",
      "display" : "No Prior Authorization",
      "definition" : "The ordered service does not require prior authorization"
    },
    {
      "code" : "auth-needed",
      "display" : "Prior Authorization Needed",
      "definition" : "The ordered service will require prior authorization",
      "concept" : [
        {
          "code" : "performpa",
          "display" : "Performer Prior Authorization",
          "definition" : "Prior authorization is needed for the service, however such prior authoriation must be initiated by the performing (rather than ordering) provider."
        }
      ]
    },
    {
      "code" : "satisfied",
      "display" : "Authorization Satisfied",
      "definition" : "While prior authorization would typically be needed, the conditions evaluated by prior authorization have already been evaluated and therefore prior authorization can be bypassed"
    },
    {
      "code" : "performer",
      "display" : "Performer Needed",
      "definition" : "Information about who (specifically, or at least performer type and affiliation) is necessary to make a determination of coverage and/or prior auth expectations"
    },
    {
      "code" : "location",
      "display" : "Location Needed",
      "definition" : "Information about where (specific clinic/site or organization) is necessary to make a determination of coverage and/or prior auth expectations"
    },
    {
      "code" : "timeframe",
      "display" : "Timeframe Needed",
      "definition" : "Information about when the service will be performed that is more granular than the order effective period is necessary to make a determination of coverage and/or prior auth expectations"
    },
    {
      "code" : "contract-window",
      "display" : "New Contract Window",
      "definition" : "The target performance time for the event falls outside the contract window for the patient's current coverage. Information will not be available until a contract is in place covering the service time period"
    },
    {
      "code" : "used",
      "display" : "Authorization Token Used",
      "definition" : "An authorization token was used by the payer to access additional information from the provider system as part of the CDS Hook call",
      "concept" : [
        {
          "code" : "rejected",
          "display" : "Authorization Token Rejected",
          "definition" : "The payer attempted to use an authorization token to access additional information from the provider system as part of the CDS Hook call, however the access request failed. (This is not used if the request succeeded but returned no records.)"
        }
      ]
    },
    {
      "code" : "not-used",
      "display" : "Authorization Token Not Used",
      "definition" : "The payer did not attempt to use an authorization token to access additional information from the provider system as part of the CDS Hook call"
    },
    {
      "code" : "provider-src",
      "display" : "Provider-sourced",
      "definition" : "The metric information was captured from the provider system's perspective"
    },
    {
      "code" : "payer-src",
      "display" : "Payer-sourced",
      "definition" : "The metric information was captured from the payer system's perspective"
    },
    {
      "code" : "_cardType",
      "display" : "Card Type (abstract)",
      "definition" : "A collector for different profiles on CDS Hooks card",
      "property" : [
        {
          "code" : "abstract",
          "valueBoolean" : true
        }
      ],
      "concept" : [
        {
          "code" : "coverage-info",
          "display" : "Coverage Information",
          "definition" : "Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection",
          "concept" : [
            {
              "code" : "unsolicited-determ",
              "display" : "Unsolicited Determination",
              "definition" : "An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request"
            }
          ]
        },
        {
          "code" : "claim",
          "display" : "Claim",
          "definition" : "Information about what steps need to be taken to submit a claim for the service"
        },
        {
          "code" : "insurance",
          "display" : "Insurance",
          "definition" : "Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)"
        },
        {
          "code" : "limits",
          "display" : "Limits",
          "definition" : "Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general"
        },
        {
          "code" : "network",
          "display" : "Network",
          "definition" : "Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)"
        },
        {
          "code" : "appropriate-use",
          "display" : "Appropriate Use",
          "definition" : "Guidance on whether appropriate-use documentation is needed"
        },
        {
          "code" : "cost",
          "display" : "Cost",
          "definition" : "What is the anticipated cost to the patient based on their coverage"
        },
        {
          "code" : "therapy-alternatives-opt",
          "display" : "Optional Therapy Alternatives",
          "definition" : "Are there alternative therapies that have better coverage and/or are lower-cost for the patient"
        },
        {
          "code" : "therapy-alternatives-req",
          "display" : "Required Therapy Alternatives",
          "definition" : "Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy"
        },
        {
          "code" : "clinical-reminder",
          "display" : "Clinical Reminder",
          "definition" : "Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)"
        },
        {
          "code" : "duplicate-therapy",
          "display" : "Duplicate Therapy",
          "definition" : "Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system"
        },
        {
          "code" : "contraindication",
          "display" : "Contraindication",
          "definition" : "Notice that the proposed intervention may be contraindicated based on information the payer has in their record that the provider doesn't have in theirs"
        },
        {
          "code" : "guideline",
          "display" : "Guideline",
          "definition" : "Indication that there is a guideline available for the proposed therapy (with an option to view)"
        },
        {
          "code" : "off-guideline",
          "display" : "Off Guideline",
          "definition" : "Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline"
        }
      ]
    },
    {
      "code" : "_HookType",
      "display" : "CDS Hook Type (abstract)",
      "definition" : "A collector for the different types of CDS Hooks",
      "property" : [
        {
          "code" : "abstract",
          "valueBoolean" : true
        }
      ],
      "concept" : [
        {
          "code" : "appointment-book",
          "display" : "Appointment Book"
        },
        {
          "code" : "encounter-start",
          "display" : "Encounter Start"
        },
        {
          "code" : "encounter-discharge",
          "display" : "Encounter Discharge"
        },
        {
          "code" : "order-dispatch\"",
          "display" : "Order Dispatch"
        },
        {
          "code" : "order-select",
          "display" : "Order Select"
        },
        {
          "code" : "order-sign",
          "display" : "Order Sign"
        }
      ]
    },
    {
      "code" : "_docReason",
      "display" : "Additional Information Purposes",
      "definition" : "A collector for codes representing different reasons for capturing additional information",
      "property" : [
        {
          "code" : "abstract",
          "valueBoolean" : true
        }
      ],
      "concept" : [
        {
          "code" : "withpa",
          "display" : "Include in prior authorization",
          "definition" : "The information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) a prior authorization for the associated request resource(s)."
        },
        {
          "code" : "withclaim",
          "display" : "Include with claim",
          "definition" : "The information in this QuestionnaireResponse should be packaged into a Bundle and submitted as part of (or in association with) the insurance claim for the services ordered by the associated request resource(s)."
        },
        {
          "code" : "withorder",
          "display" : "Include with order",
          "definition" : "The information in this QuestionnaireResponse should be packaged into a Bundle and submitted along with (or referenced as supporting information to) the associated request resource(s) when transmitting the order to the fulfilling system."
        },
        {
          "code" : "retain-doc",
          "display" : "Medical necessity",
          "definition" : "The information in this QuestionnaireResponse should be retained within the EHR as supporting evidence of the medical necessity of the associated request resource(s)."
        }
      ]
    },
    {
      "code" : "_cmsLocation",
      "display" : "CMS Location codes",
      "definition" : "A collector for CMS location codes",
      "concept" : [
        {
          "code" : "1",
          "display" : "Pharmacy **",
          "definition" : "A facility or location where drugs and other medically related items and services are sold, dispensed, or otherwise provided directly to patients."
        },
        {
          "code" : "2",
          "display" : "Telehealth Provided Other than in Patient's Home",
          "definition" : "The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology."
        },
        {
          "code" : "3",
          "display" : "School",
          "definition" : "A facility whose primary purpose is education."
        },
        {
          "code" : "4",
          "display" : "Homeless Shelter",
          "definition" : "A facility or location whose primary purpose is to provide temporary housing to homeless individuals (e.g., emergency shelters, individual or family shelters)."
        },
        {
          "code" : "5",
          "display" : "Indian Health Service",
          "definition" : "A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to American Indians and Alaska Natives who do not require hospitalization. (Effective January 1, 2003)"
        },
        {
          "code" : "6",
          "display" : "Indian Health Service",
          "definition" : "A facility or location, owned and operated by the Indian Health Service, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services rendered by, or under the supervision of, physicians to American Indians and Alaska Natives admitted as inpatients or outpatients."
        },
        {
          "code" : "7",
          "display" : "Tribal 638",
          "definition" : "A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members who do not require hospitalization. (Effective January 1, 2003)"
        },
        {
          "code" : "8",
          "display" : "Tribal 638",
          "definition" : "A facility or location owned and operated by a federally recognized American Indian or Alaska Native tribe or tribal organization under a 638 agreement, which provides diagnostic, therapeutic (surgical and non-surgical), and rehabilitation services to tribal members admitted as inpatients or outpatients."
        },
        {
          "code" : "9",
          "display" : "Correctional Facility",
          "definition" : "A prison, jail, reformatory, work farm, detention center, or any other similar facility maintained by either Federal, State or local authorities for the purpose of confinement or rehabilitation of adult or juvenile criminal offenders."
        },
        {
          "code" : "10",
          "display" : "Telehealth Provided in Patient's Home",
          "definition" : "The location where health services and health related services are provided or received, through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology."
        },
        {
          "code" : "11",
          "display" : "Office",
          "definition" : "Location, other than a hospital, skilled nursing facility (SNF), military treatment facility, community health center, State or local public health clinic, or intermediate care facility (ICF), where the health professional routinely provides health examinations, diagnosis, and treatment of illness or injury on an ambulatory basis."
        },
        {
          "code" : "12",
          "display" : "Home",
          "definition" : "Location, other than a hospital or other facility, where the patient receives care in a private residence."
        },
        {
          "code" : "13",
          "display" : "Assisted Living Facility",
          "definition" : "Congregate residential facility with self-contained living units providing assessment of each resident's needs and on-site support 24 hours a day, 7 days a week, with the capacity to deliver or arrange for services including some health care and other services."
        },
        {
          "code" : "14",
          "display" : "Group Home *",
          "definition" : "A residence, with shared living areas, where clients receive supervision and other services such as social and/or behavioral services, custodial service, and minimal services (e.g., medication administration)."
        },
        {
          "code" : "15",
          "display" : "Mobile Unit",
          "definition" : "A facility/unit that moves from place-to-place equipped to provide preventive, screening, diagnostic, and/or treatment services."
        },
        {
          "code" : "16",
          "display" : "Temporary Lodging",
          "definition" : "A short term accommodation such as a hotel, camp ground, hostel, cruise ship or resort where the patient receives care, and which is not identified by any other POS code."
        },
        {
          "code" : "17",
          "display" : "Walk-in Retail Health Clinic",
          "definition" : "A walk-in health clinic, other than an office, urgent care facility, pharmacy or independent clinic and not described by any other Place of Service code, that is located within a retail operation and provides, on an ambulatory basis, preventive and primary care services. (This code is available for use immediately with a final effective date of May 1, 2010)"
        },
        {
          "code" : "18",
          "display" : "Place of Employment-",
          "definition" : "A location, not described by any other POS code, owned or operated by a public or private entity where the patient is employed, and where a health professional provides on-going or episodic occupational medical, therapeutic or rehabilitative services to the individual. (This code is available for use effective January 1, 2013 but no later than May 1, 2013)"
        },
        {
          "code" : "19",
          "display" : "Off Campus-Outpatient Hospital",
          "definition" : "A portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Effective January 1, 2016)"
        },
        {
          "code" : "20",
          "display" : "Urgent Care Facility",
          "definition" : "Location, distinct from a hospital emergency room, an office, or a clinic, whose purpose is to diagnose and treat illness or injury for unscheduled, ambulatory patients seeking immediate medical attention."
        },
        {
          "code" : "21",
          "display" : "Inpatient Hospital",
          "definition" : "A facility, other than psychiatric, which primarily provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services by, or under, the supervision of physicians to patients admitted for a variety of medical conditions."
        },
        {
          "code" : "22",
          "display" : "On Campus-Outpatient Hospital",
          "definition" : "A portion of a hospital's main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Description change effective January 1, 2016)"
        },
        {
          "code" : "23",
          "display" : "Emergency Room - Hospital",
          "definition" : "A portion of a hospital where emergency diagnosis and treatment of illness or injury is provided."
        },
        {
          "code" : "24",
          "display" : "Ambulatory Surgical Center",
          "definition" : "A freestanding facility, other than a physician's office, where surgical and diagnostic services are provided on an ambulatory basis."
        },
        {
          "code" : "25",
          "display" : "Birthing Center",
          "definition" : "A facility, other than a hospital's maternity facilities or a physician's office, which provides a setting for labor, delivery, and immediate post-partum care as well as immediate care of new born infants."
        },
        {
          "code" : "26",
          "display" : "Military Treatment Facility",
          "definition" : "A medical facility operated by one or more of the Uniformed Services. Military Treatment Facility (MTF) also refers to certain former U.S. Public Health Service (USPHS) facilities now designated as Uniformed Service Treatment Facilities (USTF)."
        },
        {
          "code" : "27",
          "display" : "Outreach Site/ Street",
          "definition" : "A non-permanent location on the street or found environment, not described by any other POS code, where health professionals provide preventive, screening, diagnostic, and/or treatment services to unsheltered homeless individuals."
        },
        {
          "code" : "31",
          "display" : "Skilled Nursing Facility",
          "definition" : "A facility which primarily provides inpatient skilled nursing care and related services to patients who require medical, nursing, or rehabilitative services but does not provide the level of care or treatment available in a hospital."
        },
        {
          "code" : "32",
          "display" : "Nursing Facility",
          "definition" : "A facility which primarily provides to residents skilled nursing care and related services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care services above the level of custodial care to other than individuals with intellectual disabilities."
        },
        {
          "code" : "33",
          "display" : "Custodial Care Facility",
          "definition" : "A facility which provides room, board and other personal assistance services, generally on a long-term basis, and which does not include a medical component."
        },
        {
          "code" : "34",
          "display" : "Hospice",
          "definition" : "A facility, other than a patient's home, in which palliative and supportive care for terminally ill patients and their families are provided."
        },
        {
          "code" : "41",
          "display" : "Ambulance - Land",
          "definition" : "A land vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured."
        },
        {
          "code" : "42",
          "display" : "Ambulance - Air or Water",
          "definition" : "An air or water vehicle specifically designed, equipped and staffed for lifesaving and transporting the sick or injured."
        },
        {
          "code" : "49",
          "display" : "Independent Clinic",
          "definition" : "A location, not part of a hospital and not described by any other Place of Service code, that is organized and operated to provide preventive, diagnostic, therapeutic, rehabilitative, or palliative services to outpatients only."
        },
        {
          "code" : "50",
          "display" : "Federally Qualified Health Center",
          "definition" : "A facility located in a medically underserved area that provides Medicare beneficiaries preventive primary medical care under the general direction of a physician."
        },
        {
          "code" : "51",
          "display" : "Inpatient Psychiatric Facility",
          "definition" : "A facility that provides inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour basis, by or under the supervision of a physician."
        },
        {
          "code" : "52",
          "display" : "Psychiatric Facility-Partial Hospitalization",
          "definition" : "A facility for the diagnosis and treatment of mental illness that provides a planned therapeutic program for patients who do not require full time hospitalization, but who need broader programs than are possible from outpatient visits to a hospital-based or hospital-affiliated facility."
        },
        {
          "code" : "53",
          "display" : "Community Mental Health Center",
          "definition" : "A facility that provides the following services: outpatient services, including specialized outpatient services for children, the elderly, individuals who are chronically ill, and residents of the CMHC's mental health services area who have been discharged from inpatient treatment at a mental health facility; 24 hour a day emergency care services; day treatment, other partial hospitalization services, or psychosocial rehabilitation services; screening for patients being considered for admission to State mental health facilities to determine the appropriateness of such admission; and consultation and education services."
        },
        {
          "code" : "54",
          "display" : "Intermediate Care Facility/ Individuals with Intellectual Disabilities",
          "definition" : "A facility which primarily provides health-related care and services above the level of custodial care to individuals but does not provide the level of care or treatment available in a hospital or SNF."
        },
        {
          "code" : "55",
          "display" : "Residential Substance Abuse Treatment Facility",
          "definition" : "A facility which provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board."
        },
        {
          "code" : "56",
          "display" : "Psychiatric Residential Treatment Center",
          "definition" : "A facility or distinct part of a facility for psychiatric care which provides a total 24-hour therapeutically planned and professionally staffed group living and learning environment."
        },
        {
          "code" : "57",
          "display" : "Non-residential Substance Abuse Treatment Facility",
          "definition" : "A location which provides treatment for substance (alcohol and drug) abuse on an ambulatory basis.� Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, and psychological testing."
        },
        {
          "code" : "58",
          "display" : "Non-residential Opioid Treatment Facility",
          "definition" : "A location that provides treatment for opioid use disorder on an ambulatory basis. Services include methadone and other forms of Medication Assisted Treatment (MAT). (Effective January 1, 2020)"
        },
        {
          "code" : "60",
          "display" : "Mass Immunization Center",
          "definition" : "A location where providers administer pneumococcal pneumonia and influenza virus vaccinations and submit these services as electronic media claims, paper claims, or using the roster billing method. This generally takes place in a mass immunization setting, such as, a public health center, pharmacy, or mall but may include a physician office setting."
        },
        {
          "code" : "61",
          "display" : "Comprehensive Inpatient Rehabilitation Facility",
          "definition" : "A facility that provides comprehensive rehabilitation services under the supervision of a physician to inpatients with physical disabilities. Services include physical therapy, occupational therapy, speech pathology, social or psychological services, and orthotics and prosthetics services."
        },
        {
          "code" : "62",
          "display" : "Comprehensive Outpatient Rehabilitation Facility",
          "definition" : "A facility that provides comprehensive rehabilitation services under the supervision of a physician to outpatients with physical disabilities. Services include physical therapy, occupational therapy, and speech pathology services."
        },
        {
          "code" : "65",
          "display" : "End-Stage Renal Disease Treatment Facility",
          "definition" : "A facility other than a hospital, which provides dialysis treatment, maintenance, and/or training to patients or caregivers on an ambulatory or home-care basis."
        },
        {
          "code" : "71",
          "display" : "Public Health Clinic",
          "definition" : "A facility maintained by either State or local health departments that provides ambulatory primary medical care under the general direction of a physician."
        },
        {
          "code" : "72",
          "display" : "Rural Health Clinic",
          "definition" : "A certified facility which is located in a rural medically underserved area that provides ambulatory primary medical care under the general direction of a physician."
        },
        {
          "code" : "81",
          "display" : "Independent Laboratory",
          "definition" : "A laboratory certified to perform diagnostic and/or clinical tests independent of an institution or a physician's office."
        },
        {
          "code" : "99",
          "display" : "Other Place of Service",
          "definition" : "Other place of service not identified above."
        }
      ]
    }
  ]
}

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