This page is part of the Da Vinci Clinical Documentation Exchange (v2.0.0-ballot: STU2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions
Draft as of 2021-10-26 |
{
"resourceType" : "CodeSystem",
"id" : "cdex-temp",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp 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\">claims-processing<a name=\"cdex-temp-claims-processing\"> </a></td><td>Claim Processing</td><td>Request for data necessary from payers to support claims for services.</td></tr><tr><td style=\"white-space:nowrap\">preauth-processing<a name=\"cdex-temp-preauth-processing\"> </a></td><td>Pre-authorization Processing</td><td>Request for data necessary from payers to support pre-authorization for services.</td></tr><tr><td style=\"white-space:nowrap\">risk-adjustment<a name=\"cdex-temp-risk-adjustment\"> </a></td><td>Risk Adjustment</td><td>Request for data from payers to calculate differences in beneficiary-level risk factors that can affect quality outcomes or medical costs, regardless of the care provided.</td></tr><tr><td style=\"white-space:nowrap\">quality-metrics<a name=\"cdex-temp-quality-metrics\"> </a></td><td>Quality Metrics</td><td>Request for data used for aggregation, calculation and analysis, and ultimately reporting of quality measures.</td></tr><tr><td style=\"white-space:nowrap\">referral<a name=\"cdex-temp-referral\"> </a></td><td>Referral</td><td>Request for additional clinical information from referring provider to support performing the requested service.</td></tr><tr><td style=\"white-space:nowrap\">social-care<a name=\"cdex-temp-social-care\"> </a></td><td>Social Care</td><td>Request for data from payers to support the non-medical social needs of individuals, especially the elderly, vulnerable or with special needs.</td></tr><tr><td style=\"white-space:nowrap\">authorization-other<a name=\"cdex-temp-authorization-other\"> </a></td><td>Other Authorization</td><td>Request for data from payers for other authorization request not otherwise specified.</td></tr><tr><td style=\"white-space:nowrap\">care-coordination<a name=\"cdex-temp-care-coordination\"> </a></td><td>Care Coordination</td><td>Request for data from payers to create a complete clinical record for each of their members to improve care coordination and provide optimum medical care.</td></tr><tr><td style=\"white-space:nowrap\">documentation-general<a name=\"cdex-temp-documentation-general\"> </a></td><td>General Documentation</td><td>Request for data used from payers or providers for general documentation.</td></tr><tr><td style=\"white-space:nowrap\">orders<a name=\"cdex-temp-orders\"> </a></td><td>Orders</td><td>Request for additional clinical information from referring provider to support orders.</td></tr><tr><td style=\"white-space:nowrap\">patient-status<a name=\"cdex-temp-patient-status\"> </a></td><td>Patient Status</td><td>Requests for patient health record information from payers to support their payer member records.</td></tr><tr><td style=\"white-space:nowrap\">signature<a name=\"cdex-temp-signature\"> </a></td><td>Signature</td><td>Request for signatures from payers or providers on requested data.</td></tr><tr><td style=\"white-space:nowrap\">care-planning<a name=\"cdex-temp-care-planning\"> </a></td><td>Care Planning</td><td>Request for data from payers or providers to determine how to deliver care for a particular patient, group or community.</td></tr><tr><td style=\"white-space:nowrap\">social-risk<a name=\"cdex-temp-social-risk\"> </a></td><td>Social Risk</td><td>Request for data from payers or other providers to assess of social risk, establishing coded health concerns/problems, creating patient driven goals, managing interventions, and measuring outcomes.</td></tr><tr><td style=\"white-space:nowrap\">operations-nos<a name=\"cdex-temp-operations-nos\"> </a></td><td>Operations Not Otherwise Specified</td><td>[Healthcare Operations as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html) and isn't defined further to ascertain a more detailed Purpose of Use concept.</td></tr><tr><td style=\"white-space:nowrap\">payment-nos<a name=\"cdex-temp-payment-nos\"> </a></td><td>Payment Not Otherwise Specified</td><td>[Healthcare Payment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html) and isn't defined further to ascertain a more detailed Purpose of Use concept.</td></tr><tr><td style=\"white-space:nowrap\">purpose-of-use<a name=\"cdex-temp-purpose-of-use\"> </a></td><td>Purpose Of Use</td><td>Purpose of use for the requested data.</td></tr><tr><td style=\"white-space:nowrap\">signature-flag<a name=\"cdex-temp-signature-flag\"> </a></td><td>Signature Flag</td><td>Flag to indicate whether the requested data requires a signature.</td></tr><tr><td style=\"white-space:nowrap\">tracking-id<a name=\"cdex-temp-tracking-id\"> </a></td><td>Tracking Id</td><td>A business identifier that ties requested attachments back to the claim or prior-authorization (referred to as the “re-association tracking control numbers”).</td></tr><tr><td style=\"white-space:nowrap\">multiple-submits-flag<a name=\"cdex-temp-multiple-submits-flag\"> </a></td><td>Multiple Submits Flag</td><td>Flag to indicate whether the requested data can be submitted in multiple transactions. If true the data can be submitted in separate transactions. if false *all* the data should be submitted in a single transaction.</td></tr><tr><td style=\"white-space:nowrap\">payer-url<a name=\"cdex-temp-payer-url\"> </a></td><td>Payer URL</td><td>$submit-attachment operation endpoint where the requested data can be submitted</td></tr><tr><td style=\"white-space:nowrap\">service-date<a name=\"cdex-temp-service-date\"> </a></td><td>Service Date</td><td>Date of service or starting date of the service for the claim or prior authorization.</td></tr><tr><td style=\"white-space:nowrap\">attachment-request<a name=\"cdex-temp-attachment-request\"> </a></td><td>Attachment Request</td><td>A Task by a Payer requesting attachments for a claim or prior-authorization from the Provider. The Provider is expected to submit the attachments using the $submit-attachment operation to the endpoint provided in the "payer-url" input parameter.</td></tr></table></div>"
},
"url" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"version" : "2.0.0-ballot",
"name" : "CDexTempCodes",
"title" : "CDex Temporary Code System",
"status" : "draft",
"date" : "2021-10-26T18:38:56-07:00",
"publisher" : "HL7 International - Patient Care Work Group",
"contact" : [
{
"name" : "HL7 International - Patient Care Work Group",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/patientcare"
},
{
"system" : "email",
"value" : "patientcare@lists.HL7.org"
}
]
}
],
"description" : "Codes temporarily defined as part of the CDex implementation guide. These will eventually migrate into an officially maintained terminology (likely HL7's [UTG](https://terminology.hl7.org/codesystems.html) code systems).",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"copyright" : "Used by permission of HL7 International all rights reserved Creative Commons License",
"caseSensitive" : true,
"content" : "complete",
"concept" : [
{
"code" : "claims-processing",
"display" : "Claim Processing",
"definition" : "Request for data necessary from payers to support claims for services."
},
{
"code" : "preauth-processing",
"display" : "Pre-authorization Processing",
"definition" : "Request for data necessary from payers to support pre-authorization for services."
},
{
"code" : "risk-adjustment",
"display" : "Risk Adjustment",
"definition" : "Request for data from payers to calculate differences in beneficiary-level risk factors that can affect quality outcomes or medical costs, regardless of the care provided."
},
{
"code" : "quality-metrics",
"display" : "Quality Metrics",
"definition" : "Request for data used for aggregation, calculation and analysis, and ultimately reporting of quality measures."
},
{
"code" : "referral",
"display" : "Referral",
"definition" : "Request for additional clinical information from referring provider to support performing the requested service."
},
{
"code" : "social-care",
"display" : "Social Care",
"definition" : "Request for data from payers to support the non-medical social needs of individuals, especially the elderly, vulnerable or with special needs."
},
{
"code" : "authorization-other",
"display" : "Other Authorization",
"definition" : "Request for data from payers for other authorization request not otherwise specified."
},
{
"code" : "care-coordination",
"display" : "Care Coordination",
"definition" : "Request for data from payers to create a complete clinical record for each of their members to improve care coordination and provide optimum medical care."
},
{
"code" : "documentation-general",
"display" : "General Documentation",
"definition" : "Request for data used from payers or providers for general documentation."
},
{
"code" : "orders",
"display" : "Orders",
"definition" : "Request for additional clinical information from referring provider to support orders."
},
{
"code" : "patient-status",
"display" : "Patient Status",
"definition" : "Requests for patient health record information from payers to support their payer member records."
},
{
"code" : "signature",
"display" : "Signature",
"definition" : "Request for signatures from payers or providers on requested data."
},
{
"code" : "care-planning",
"display" : "Care Planning",
"definition" : "Request for data from payers or providers to determine how to deliver care for a particular patient, group or community."
},
{
"code" : "social-risk",
"display" : "Social Risk",
"definition" : "Request for data from payers or other providers to assess of social risk, establishing coded health concerns/problems, creating patient driven goals, managing interventions, and measuring outcomes."
},
{
"code" : "operations-nos",
"display" : "Operations Not Otherwise Specified",
"definition" : "[Healthcare Operations as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html) and isn't defined further to ascertain a more detailed Purpose of Use concept."
},
{
"code" : "payment-nos",
"display" : "Payment Not Otherwise Specified",
"definition" : "[Healthcare Payment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html) and isn't defined further to ascertain a more detailed Purpose of Use concept."
},
{
"code" : "purpose-of-use",
"display" : "Purpose Of Use",
"definition" : "Purpose of use for the requested data."
},
{
"code" : "signature-flag",
"display" : "Signature Flag",
"definition" : "Flag to indicate whether the requested data requires a signature."
},
{
"code" : "tracking-id",
"display" : "Tracking Id",
"definition" : "A business identifier that ties requested attachments back to the claim or prior-authorization (referred to as the “re-association tracking control numbers”)."
},
{
"code" : "multiple-submits-flag",
"display" : "Multiple Submits Flag",
"definition" : "Flag to indicate whether the requested data can be submitted in multiple transactions. If true the data can be submitted in separate transactions. if false *all* the data should be submitted in a single transaction."
},
{
"code" : "payer-url",
"display" : "Payer URL",
"definition" : "$submit-attachment operation endpoint where the requested data can be submitted"
},
{
"code" : "service-date",
"display" : "Service Date",
"definition" : "Date of service or starting date of the service for the claim or prior authorization."
},
{
"code" : "attachment-request",
"display" : "Attachment Request",
"definition" : "A Task by a Payer requesting attachments for a claim or prior-authorization from the Provider. The Provider is expected to submit the attachments using the $submit-attachment operation to the endpoint provided in the \"payer-url\" input parameter."
}
]
}