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
{
"resourceType" : "CodeSystem",
"id" : "C4BBSupportingInfoType",
"text" : {
"status" : "generated",
"div" : "<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>"
},
"url" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType",
"version" : "1.1.0",
"name" : "C4BBSupportingInfoType",
"title" : "C4BB Supporting Info Type",
"status" : "active",
"date" : "2021-07-02T17:53:32+00:00",
"publisher" : "HL7 Financial Management Working Group",
"contact" : [
{
"name" : "HL7 Financial Management Working Group",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/fm/index.cfm"
},
{
"system" : "email",
"value" : "fm@lists.HL7.org"
}
]
}
],
"description" : "Claim Information Category - Used as the discriminator for supportingInfo",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"copyright" : "This CodeSystem is not copyrighted.",
"content" : "complete",
"count" : 18,
"concept" : [
{
"code" : "admissionperiod",
"display" : "Admission Period",
"definition" : "Dates corresponding with the admission and discharge of the beneficiary to a facility"
},
{
"code" : "pointoforigin",
"display" : "Point Of Origin",
"definition" : "UB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility."
},
{
"code" : "admtype",
"display" : "Admission Type",
"definition" : "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."
},
{
"code" : "billingnetworkcontractingstatus",
"display" : "Billing Network Contracting Status",
"definition" : "Indicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission."
},
{
"code" : "brandgenericindicator",
"display" : "Brand Generic Indicator",
"definition" : "NCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug."
},
{
"code" : "clmrecvddate",
"display" : "Claim Received Date",
"definition" : "Date the claim was received by the payer."
},
{
"code" : "compoundcode",
"display" : "Compound Code",
"definition" : "NCPDP code indicating whether or not the prescription is a compound."
},
{
"code" : "dawcode",
"display" : "DAW (Dispense As Written) Code",
"definition" : "NCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication."
},
{
"code" : "dayssupply",
"display" : "Days Supply",
"definition" : "NCPDP value indicating the Number of days supply of medication dispensed by the pharmacy."
},
{
"code" : "discharge-status",
"display" : "Discharge Status",
"definition" : "UB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay."
},
{
"code" : "drg",
"display" : "DRG",
"definition" : "DRG (Diagnosis Related Group), including the code system, the DRG version and the code value"
},
{
"code" : "performingnetworkcontractingstatus",
"display" : "Performing Network Contracting Status",
"definition" : "Indicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission."
},
{
"code" : "refillnum",
"display" : "Refill Number",
"definition" : "NCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)"
},
{
"code" : "rxorigincode",
"display" : "Rx Origin Code",
"definition" : "NCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy."
},
{
"code" : "servicefacility",
"display" : "Service Facility",
"definition" : "The facility where the service occurred. Examples include hospitals, nursing homes, laboratories or homeless shelters."
},
{
"code" : "typeofbill",
"display" : "Type of Bill",
"definition" : "UB-04 Type of Bill (FL-04) provides specific information for payer purposes."
},
{
"code" : "medicalrecordnumber",
"display" : "Medical Record Number",
"definition" : "Patient Medical Record Number associated with the specific claim."
},
{
"code" : "patientaccountnumber",
"display" : "Patient Account Number",
"definition" : "Patient Account Number associated with the specific claim."
}
]
}