CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.0.0 - STU 2 US

This page is part of the CARIN Blue Button Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: C4BB Supporting Info Type Code System - XML Representation

Active as of 2022-11-28

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<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 <code>http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType</code> 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">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">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">refillsauthorized<a name="C4BBSupportingInfoType-refillsauthorized"> </a></td><td>Refills Authorized</td><td>NCPDP value indicating the number of refills authorized by the subscriber (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><tr><td style="white-space:nowrap">orthodontics<a name="C4BBSupportingInfoType-orthodontics"> </a></td><td>Orthodontics</td><td>Orthodontics treatment indicator.</td></tr><tr><td style="white-space:nowrap">prosthesis<a name="C4BBSupportingInfoType-prosthesis"> </a></td><td>Prosthesis</td><td>Prosthesis replacement indicator.</td></tr><tr><td style="white-space:nowrap">additionalbodysite<a name="C4BBSupportingInfoType-additionalbodysite"> </a></td><td>Additional Body Site</td><td>Additional tooth number or oral cavity. Additional body sites are specific to line item and have to be linked by ExplanationOfBenefit.item.informationSequence.</td></tr><tr><td style="white-space:nowrap">missingtoothnumber<a name="C4BBSupportingInfoType-missingtoothnumber"> </a></td><td>Missing Tooth Number</td><td>Missing tooth number.</td></tr><tr><td style="white-space:nowrap">patientweight<a name="C4BBSupportingInfoType-patientweight"> </a></td><td>Patient Weight</td><td>Patient weight (for transportation services)</td></tr><tr><td style="white-space:nowrap">ambulancetransportreason<a name="C4BBSupportingInfoType-ambulancetransportreason"> </a></td><td>Ambulance Transport Reason</td><td>Reason ambulance transport was needed (for transportation services)</td></tr><tr><td style="white-space:nowrap">transportationdistance<a name="C4BBSupportingInfoType-transportationdistance"> </a></td><td>Transportation Distance</td><td>Distance traveled (for transportation services)</td></tr><tr><td style="white-space:nowrap">roudtrippurpose<a name="C4BBSupportingInfoType-roudtrippurpose"> </a></td><td>Round Trip Purpose</td><td>Reason for round trip (for transportation services)</td></tr><tr><td style="white-space:nowrap">stretcherpurpose<a name="C4BBSupportingInfoType-stretcherpurpose"> </a></td><td>Stretcher Purpose</td><td>Purpose of using a stretcher (for transportation services)</td></tr><tr><td style="white-space:nowrap">pickuplocation<a name="C4BBSupportingInfoType-pickuplocation"> </a></td><td>Pick-up Location</td><td>Patient pick-up Location (for transportation services)</td></tr><tr><td style="white-space:nowrap">dropofflocation<a name="C4BBSupportingInfoType-dropofflocation"> </a></td><td>Drop-off Location</td><td>Patient drop-off location (for transportation services)</td></tr></table></div>
  </text>
  <url
       value="http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType"/>
  <version value="2.0.0"/>
  <name value="C4BBSupportingInfoType"/>
  <title value="C4BB Supporting Info Type Code System"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2022-11-28T15:16:46+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"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fm@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               value="Claim Information Category - Used as the discriminator for supportingInfo.

This is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <copyright value="This CodeSystem is not copyrighted."/>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="28"/>
  <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="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="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="refillsauthorized"/>
    <display value="Refills Authorized"/>
    <definition
                value="NCPDP value indicating the number of refills authorized by the subscriber (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>
  <concept>
    <code value="orthodontics"/>
    <display value="Orthodontics"/>
    <definition value="Orthodontics treatment indicator."/>
  </concept>
  <concept>
    <code value="prosthesis"/>
    <display value="Prosthesis"/>
    <definition value="Prosthesis replacement indicator."/>
  </concept>
  <concept>
    <code value="additionalbodysite"/>
    <display value="Additional Body Site"/>
    <definition
                value="Additional tooth number or oral cavity. Additional body sites are specific to line item and have to be linked by ExplanationOfBenefit.item.informationSequence."/>
  </concept>
  <concept>
    <code value="missingtoothnumber"/>
    <display value="Missing Tooth Number"/>
    <definition value="Missing tooth number."/>
  </concept>
  <concept>
    <code value="patientweight"/>
    <display value="Patient Weight"/>
    <definition value="Patient weight (for transportation services)"/>
  </concept>
  <concept>
    <code value="ambulancetransportreason"/>
    <display value="Ambulance Transport Reason"/>
    <definition
                value="Reason ambulance transport was needed (for transportation services)"/>
  </concept>
  <concept>
    <code value="transportationdistance"/>
    <display value="Transportation Distance"/>
    <definition value="Distance traveled (for transportation services)"/>
  </concept>
  <concept>
    <code value="roudtrippurpose"/>
    <display value="Round Trip Purpose"/>
    <definition value="Reason for round trip (for transportation services)"/>
  </concept>
  <concept>
    <code value="stretcherpurpose"/>
    <display value="Stretcher Purpose"/>
    <definition
                value="Purpose of using a stretcher (for transportation services)"/>
  </concept>
  <concept>
    <code value="pickuplocation"/>
    <display value="Pick-up Location"/>
    <definition
                value="Patient pick-up Location (for transportation services)"/>
  </concept>
  <concept>
    <code value="dropofflocation"/>
    <display value="Drop-off Location"/>
    <definition
                value="Patient drop-off location (for transportation services)"/>
  </concept>
</CodeSystem>