This page is part of the CARIN Blue Button Implementation Guide (v1.1.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
<CodeSystem xmlns="http://hl7.org/fhir">
<id value="C4BBSupportingInfoType"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p>This code system http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">admissionperiod<a name="C4BBSupportingInfoType-admissionperiod"> </a></td><td>Admission Period</td><td>Dates corresponding with the admission and discharge of the beneficiary to a facility</td></tr><tr><td style="white-space:nowrap">pointoforigin<a name="C4BBSupportingInfoType-pointoforigin"> </a></td><td>Point Of Origin</td><td>UB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility.</td></tr><tr><td style="white-space:nowrap">admtype<a name="C4BBSupportingInfoType-admtype"> </a></td><td>Admission Type</td><td>UB-04 Priority of the admission (FL-14) indicates, for example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled.</td></tr><tr><td style="white-space:nowrap">billingnetworkcontractingstatus<a name="C4BBSupportingInfoType-billingnetworkcontractingstatus"> </a></td><td>Billing Network Contracting Status</td><td>Indicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission.</td></tr><tr><td style="white-space:nowrap">brandgenericindicator<a name="C4BBSupportingInfoType-brandgenericindicator"> </a></td><td>Brand Generic Indicator</td><td>NCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug.</td></tr><tr><td style="white-space:nowrap">clmrecvddate<a name="C4BBSupportingInfoType-clmrecvddate"> </a></td><td>Claim Received Date</td><td>Date the claim was received by the payer.</td></tr><tr><td style="white-space:nowrap">compoundcode<a name="C4BBSupportingInfoType-compoundcode"> </a></td><td>Compound Code</td><td>NCPDP code indicating whether or not the prescription is a compound.</td></tr><tr><td style="white-space:nowrap">dawcode<a name="C4BBSupportingInfoType-dawcode"> </a></td><td>DAW (Dispense As Written) Code</td><td>NCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.</td></tr><tr><td style="white-space:nowrap">dayssupply<a name="C4BBSupportingInfoType-dayssupply"> </a></td><td>Days Supply</td><td>NCPDP value indicating the Number of days supply of medication dispensed by the pharmacy.</td></tr><tr><td style="white-space:nowrap">discharge-status<a name="C4BBSupportingInfoType-discharge-status"> </a></td><td>Discharge Status</td><td>UB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay.</td></tr><tr><td style="white-space:nowrap">drg<a name="C4BBSupportingInfoType-drg"> </a></td><td>DRG</td><td>DRG (Diagnosis Related Group), including the code system, the DRG version and the code value</td></tr><tr><td style="white-space:nowrap">performingnetworkcontractingstatus<a name="C4BBSupportingInfoType-performingnetworkcontractingstatus"> </a></td><td>Performing Network Contracting Status</td><td>Indicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission.</td></tr><tr><td style="white-space:nowrap">refillnum<a name="C4BBSupportingInfoType-refillnum"> </a></td><td>Refill Number</td><td>NCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)</td></tr><tr><td style="white-space:nowrap">rxorigincode<a name="C4BBSupportingInfoType-rxorigincode"> </a></td><td>Rx Origin Code</td><td>NCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy.</td></tr><tr><td style="white-space:nowrap">servicefacility<a name="C4BBSupportingInfoType-servicefacility"> </a></td><td>Service Facility</td><td>The facility where the service occurred. Examples include hospitals, nursing homes, laboratories or homeless shelters.</td></tr><tr><td style="white-space:nowrap">typeofbill<a name="C4BBSupportingInfoType-typeofbill"> </a></td><td>Type of Bill</td><td>UB-04 Type of Bill (FL-04) provides specific information for payer purposes.</td></tr><tr><td style="white-space:nowrap">medicalrecordnumber<a name="C4BBSupportingInfoType-medicalrecordnumber"> </a></td><td>Medical Record Number</td><td>Patient Medical Record Number associated with the specific claim.</td></tr><tr><td style="white-space:nowrap">patientaccountnumber<a name="C4BBSupportingInfoType-patientaccountnumber"> </a></td><td>Patient Account Number</td><td>Patient Account Number associated with the specific claim.</td></tr></table></div>
</text>
<url value="http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType"/>
<version value="1.1.0"/>
<name value="C4BBSupportingInfoType"/>
<title value="C4BB Supporting Info Type"/>
<status value="active"/>
<date value="2021-07-02T17:53:32+00:00"/>
<publisher value="HL7 Financial Management Working Group"/>
<contact>
<name value="HL7 Financial Management Working Group"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/fm/index.cfm"/>
</telecom>
<telecom>
<system value="email"/>
<value value="fm@lists.HL7.org"/>
</telecom>
</contact>
<description
value="Claim Information Category - Used as the discriminator for supportingInfo"/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<copyright value="This CodeSystem is not copyrighted."/>
<content value="complete"/>
<count value="18"/>
<concept>
<code value="admissionperiod"/>
<display value="Admission Period"/>
<definition
value="Dates corresponding with the admission and discharge of the beneficiary to a facility"/>
</concept>
<concept>
<code value="pointoforigin"/>
<display value="Point Of Origin"/>
<definition
value="UB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility."/>
</concept>
<concept>
<code value="admtype"/>
<display value="Admission Type"/>
<definition
value="UB-04 Priority of the admission (FL-14) indicates, for example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled."/>
</concept>
<concept>
<code value="billingnetworkcontractingstatus"/>
<display value="Billing Network Contracting Status"/>
<definition
value="Indicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission."/>
</concept>
<concept>
<code value="brandgenericindicator"/>
<display value="Brand Generic Indicator"/>
<definition
value="NCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug."/>
</concept>
<concept>
<code value="clmrecvddate"/>
<display value="Claim Received Date"/>
<definition value="Date the claim was received by the payer."/>
</concept>
<concept>
<code value="compoundcode"/>
<display value="Compound Code"/>
<definition
value="NCPDP code indicating whether or not the prescription is a compound."/>
</concept>
<concept>
<code value="dawcode"/>
<display value="DAW (Dispense As Written) Code"/>
<definition
value="NCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication."/>
</concept>
<concept>
<code value="dayssupply"/>
<display value="Days Supply"/>
<definition
value="NCPDP value indicating the Number of days supply of medication dispensed by the pharmacy."/>
</concept>
<concept>
<code value="discharge-status"/>
<display value="Discharge Status"/>
<definition
value="UB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay."/>
</concept>
<concept>
<code value="drg"/>
<display value="DRG"/>
<definition
value="DRG (Diagnosis Related Group), including the code system, the DRG version and the code value"/>
</concept>
<concept>
<code value="performingnetworkcontractingstatus"/>
<display value="Performing Network Contracting Status"/>
<definition
value="Indicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission."/>
</concept>
<concept>
<code value="refillnum"/>
<display value="Refill Number"/>
<definition
value="NCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)"/>
</concept>
<concept>
<code value="rxorigincode"/>
<display value="Rx Origin Code"/>
<definition
value="NCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy."/>
</concept>
<concept>
<code value="servicefacility"/>
<display value="Service Facility"/>
<definition
value="The facility where the service occurred. Examples include hospitals, nursing homes, laboratories or homeless shelters."/>
</concept>
<concept>
<code value="typeofbill"/>
<display value="Type of Bill"/>
<definition
value="UB-04 Type of Bill (FL-04) provides specific information for payer purposes."/>
</concept>
<concept>
<code value="medicalrecordnumber"/>
<display value="Medical Record Number"/>
<definition
value="Patient Medical Record Number associated with the specific claim."/>
</concept>
<concept>
<code value="patientaccountnumber"/>
<display value="Patient Account Number"/>
<definition
value="Patient Account Number associated with the specific claim."/>
</concept>
</CodeSystem>