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Packagehl7.fhir.us.davinci-crd
Resource TypeValueSet
IdValueSet-coverageInfo.json
FHIR VersionR4
Sourcehttps://build.fhir.org/ig/HL7/davinci-crd/ValueSet-coverageInfo.html
URLhttp://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo
Version2.2.0-snapshot
Statusactive
Date2026-01-30T22:02:38+00:00
NameCRDCoveredInfo
TitleCRD Coverage Information Covered Value Set
Realmus
Authorityhl7
DescriptionCodes defining whether the ordered/requested service is covered under patient's plan

Resources that use this resource

StructureDefinition
CRDMetricDataCRD Metric Data
ext-coverage-informationCoverage Information
DTRMetricDataDTR Metric Data

Resources that this resource uses

CodeSystem
coverage-information-codesCoverage Information Codes

Narrative

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

Generated Narrative: ValueSet coverageInfo

  • Include these codes as defined in http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes version 📦2.2.0-snapshot
    CodeDisplayDefinition
    not-coveredNot coveredNo coverage or possibility of coverage for this service
    coveredCoveredRegular coverage applies. Coverage is still subject to normal plan limits, deductibles, and other considerations meaning there is no guarantee of payment. This response does NOT replace any need for a pre-determination, if required.
    conditionalConditionalThere 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.)

Source1

{
  "resourceType": "ValueSet",
  "id": "coverageInfo",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 1
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    },
    {
      "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/coverageInfo",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.18.48.13"
    }
  ],
  "version": "2.2.0-snapshot",
  "name": "CRDCoveredInfo",
  "title": "CRD Coverage Information Covered Value Set",
  "status": "active",
  "experimental": false,
  "date": "2026-01-30T22:02:38+00:00",
  "publisher": "HL7 International / Financial Management",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description": "Codes defining whether the ordered/requested service is covered under patient's plan",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "compose": {
    "include": [
      {
        "system": "http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes",
        "concept": [
          {
            "code": "not-covered"
          },
          {
            "code": "covered"
          },
          {
            "code": "conditional"
          }
        ]
      }
    ]
  }
}