FHIR IG Statistics: ValueSet/coverageDetail
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. |
| 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. |
| policy-link | Policy Link | 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. |
| instructions | Instructions | 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. (Category may vary.) |
Source
{
"resourceType": "ValueSet",
"id": "coverageDetail",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"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/ValueSet/coverageDetail",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.4.642.40.18.48.12"
}
],
"version": "2.2.0-cibuild",
"name": "CRDCoverageDetailCodes",
"title": "CRD Coverage Detail Codes Value Set",
"status": "active",
"experimental": false,
"date": "2025-07-20T15:31:59+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": "concurrent-review"
},
{
"code": "appropriate-use-needed"
},
{
"code": "policy-link"
},
{
"code": "instructions"
}
]
}
]
}
}
FHIR