FHIR IG Statistics: ValueSet/coverageDetailCategories
Resources that use this resource
Resources that this resource uses
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/coverage-information-codes| Code | Display | Definition |
| cat-limitation | Coverage Limitation | The statement being made about coverage or authorization that are being constrained in scope in some way. I.e. It is not safe to interpret the statements of 'this is covered' or 'this does not require prior auth' without looking at this detail. |
| cat-decisional | Decision Considerations | The statement does not qualify the coverage statement, however it does provide information that may be relevant to the patient & caregiver decision of whether a therapy is appropriate/reasonable. |
| cat-other | Other Details | The statement does not limit the coverage statement being made and is unlikely to influence a decision to proceed with care. For example, instructions on how to submit a claim, reference to to policy, etc. |
Source
{
"resourceType": "ValueSet",
"id": "coverageDetailCategories",
"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/coverageDetailCategories",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.4.642.40.18.48.23"
}
],
"version": "2.2.0-ballot",
"name": "CRDCoverageDetailCategories",
"title": "CRD Coverage Detail Categories",
"status": "active",
"experimental": false,
"date": "2025-07-22T17:00:27+00:00",
"publisher": "HL7 International / Financial Management",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/fm"
}
]
}
],
"description": "Codes that define the type of coverage information detail being provided",
"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": "cat-limitation"
},
{
"code": "cat-decisional"
},
{
"code": "cat-other"
}
]
}
]
}
}
FHIR