Resource ValueSet/FHIR Server from package hl7.fhir.us.davinci-crd#current (62 ms)
Resources that use this resource
Resources that this resource uses
| CodeSystem |
temp  | CRD Temporary Codes |
Narrative
Note: links and images are rebased to the (stated) source
- Include these codes as defined in
http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp| Code | Display | Definition |
| allowed-quantity | Maximum quantity | Indicates limitations on the number of services/products allowed (possibly per time period). Value should be a Quantity |
| allowed-period | Maximum allowed period | Indicates the maximum period of time that can be covered in a single order. Value should be a Period |
| in-network-copay | Copay for in-network | Indicates a percentage co-pay to expect if delivered in-network. Value should be a Quantity. |
| out-network-copay | Copay for out-of-network | Indicates a percentage co-pay to expect if delivered out-of-network. Value should be a Quantity. |
| auth-out-network-only | Authorization out-of-network only | Authorization is only necessary if out-of-network. Value should be a boolean. |
| concurrent-review | Concurrent review | Additional payer-defined documentation will be required prior to claim payment. Value should be a boolean. |
| appropriate-use-needed | Appropriate use | Payer-defined appropriate use process must be invoked to determine coverage. Value should be a boolean. |
Source
{
"resourceType" : "ValueSet",
"id" : "coverageDetail",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet coverageDetail</b></p><a name=\"coverageDetail\"> </a><a name=\"hccoverageDetail\"> </a><a name=\"coverageDetail-en-US\"> </a><ul><li>Include these codes as defined in <a href=\"CodeSystem-temp.html\"><code>http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-temp.html#temp-allowed-quantity\">allowed-quantity</a></td><td style=\"color: #cccccc\">Maximum quantity</td><td>Indicates limitations on the number of services/products allowed (possibly per time period). Value should be a Quantity</td></tr><tr><td><a href=\"CodeSystem-temp.html#temp-allowed-period\">allowed-period</a></td><td style=\"color: #cccccc\">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></tr><tr><td><a href=\"CodeSystem-temp.html#temp-in-network-copay\">in-network-copay</a></td><td style=\"color: #cccccc\">Copay for in-network</td><td>Indicates a percentage co-pay to expect if delivered in-network. Value should be a Quantity.</td></tr><tr><td><a href=\"CodeSystem-temp.html#temp-out-network-copay\">out-network-copay</a></td><td style=\"color: #cccccc\">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></tr><tr><td><a href=\"CodeSystem-temp.html#temp-auth-out-network-only\">auth-out-network-only</a></td><td style=\"color: #cccccc\">Authorization out-of-network only</td><td>Authorization is only necessary if out-of-network. Value should be a boolean.</td></tr><tr><td><a href=\"CodeSystem-temp.html#temp-concurrent-review\">concurrent-review</a></td><td style=\"color: #cccccc\">Concurrent review</td><td>Additional payer-defined documentation will be required prior to claim payment. Value should be a boolean.</td></tr><tr><td><a href=\"CodeSystem-temp.html#temp-appropriate-use-needed\">appropriate-use-needed</a></td><td style=\"color: #cccccc\">Appropriate use</td><td>Payer-defined appropriate use process must be invoked to determine coverage. Value should be a boolean.</td></tr></table></li></ul></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "fm"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 2,
"_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/ValueSet/coverageDetail",
"version" : "2.1.0-preview",
"name" : "CRDCoverageDetailCodes",
"title" : "CRD Coverage Detail Codes Value Set",
"status" : "active",
"experimental" : false,
"date" : "2024-09-12T03:57:38+00:00",
"publisher" : "HL7 International / Financial Management",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/fm"
}
]
}
],
"description" : "Codes for name-value-pair details on a coverage assertion",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"compose" : {
"include" : [
{
"system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
"concept" : [
{
"code" : "allowed-quantity"
},
{
"code" : "allowed-period"
},
{
"code" : "in-network-copay"
},
{
"code" : "out-network-copay"
},
{
"code" : "auth-out-network-only"
},
{
"code" : "concurrent-review"
},
{
"code" : "appropriate-use-needed"
}
]
}
]
}
}
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