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Packagehl7.terminology
Resource TypeCodeSystem
IdCodeSystem-cdshooks-card-type.json
FHIR VersionR5
Sourcehttps://build.fhir.org/ig/HL7/UTG/CodeSystem-cdshooks-card-type.html
URLhttp://terminology.hl7.org/CodeSystem/cdshooks-card-type
Version1.0.0
Statusactive
Date2025-10-16T00:00:00+00:00
NameCDSHooksCardType
TitleCDS Hooks Card Types
Realmuv
Authorityhl7
DescriptionCodes defining types of cards that can potentially be returned by a decision support service. The initial set of codes is biased towards those related to insurance coverage, but all types of response types are acceptable in the code system.
CopyrightThis material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license
Contentcomplete

Resources that use this resource

ValueSet
cardTypeCRD Response Types Value Set

Resources that this resource uses

No resources found


Narrative

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

Generated Narrative: CodeSystem cdshooks-card-type

This case-sensitive code system http://terminology.hl7.org/CodeSystem/cdshooks-card-type defines the following codes in a Is-A hierarchy:

LvlCodeDisplayDefinition
1coverage-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
2  unsolicited-determ Unsolicited DeterminationAn unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request
1claim ClaimInformation about what steps need to be taken to submit a claim for the service
1insurance InsuranceAllows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)
1limits LimitsMessages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general
1network NetworkProviding information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)
1appropriate-use Appropriate UseGuidance on whether appropriate-use documentation is needed
1cost CostWhat is the anticipated cost to the patient based on their coverage
1therapy-alternatives-opt Optional Therapy AlternativesAre there alternative therapies that have better coverage and/or are lower-cost for the patient
1therapy-alternatives-req Required Therapy AlternativesAre there alternative therapies that must be tried first prior to coverage being available for the proposed therapy
1clinical-reminder Clinical ReminderReminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)
1duplicate-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
1contraindication 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
1guideline GuidelineIndication that there is a guideline available for the proposed therapy (with an option to view)
1off-guideline Off GuidelineNotice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline

Source1

{
  "resourceType": "CodeSystem",
  "id": "cdshooks-card-type",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 1
    }
  ],
  "url": "http://terminology.hl7.org/CodeSystem/cdshooks-card-type",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.5.176"
    }
  ],
  "version": "1.0.0",
  "name": "CDSHooksCardType",
  "title": "CDS Hooks Card Types",
  "status": "active",
  "experimental": false,
  "date": "2025-10-16T00:00:00+00:00",
  "publisher": "Health Level Seven International",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://hl7.org"
        },
        {
          "system": "email",
          "value": "hq@HL7.org"
        }
      ]
    }
  ],
  "description": "Codes defining types of cards that can potentially be returned by a decision support service.  The initial set of codes is biased towards those related to insurance coverage, but all types of response types are acceptable in the code system.",
  "copyright": "This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license",
  "caseSensitive": true,
  "hierarchyMeaning": "is-a",
  "content": "complete",
  "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"
    }
  ]
}