Da Vinci Clinical Data Exchange (CDex)
1.1.0 - STU1.1 US

This page is part of the Da Vinci Clinical Documentation Exchange (v1.1.0: STU1.1) 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

: CDex Temporary Code System - XML Representation

Draft as of 2021-10-26

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="cdex-temp"/>
  <text>
    <status value="generated"/>
    <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 &quot;payer-url&quot; input parameter.</td></tr></table></div>
  </text>
  <url value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
  <version value="1.1.0"/>
  <name value="CDexTempCodes"/>
  <title value="CDex Temporary Code System"/>
  <status value="draft"/>
  <date value="2021-10-26T18:38:56-07:00"/>
  <publisher value="HL7 International - Patient Care Work Group"/>
  <contact>
    <name value="HL7 International - Patient Care Work Group"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/patientcare"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="patientcare@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               value="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 value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Used by permission of HL7 International all rights reserved Creative Commons License"/>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <concept>
    <code value="claims-processing"/>
    <display value="Claim Processing"/>
    <definition
                value="Request for data necessary from payers to support claims for services."/>
  </concept>
  <concept>
    <code value="preauth-processing"/>
    <display value="Pre-authorization Processing"/>
    <definition
                value="Request for data necessary from payers to support pre-authorization for services."/>
  </concept>
  <concept>
    <code value="risk-adjustment"/>
    <display value="Risk Adjustment"/>
    <definition
                value="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."/>
  </concept>
  <concept>
    <code value="quality-metrics"/>
    <display value="Quality Metrics"/>
    <definition
                value="Request for data used for aggregation, calculation and analysis, and ultimately reporting of quality measures."/>
  </concept>
  <concept>
    <code value="referral"/>
    <display value="Referral"/>
    <definition
                value="Request for additional clinical information from referring provider to support performing the requested service."/>
  </concept>
  <concept>
    <code value="social-care"/>
    <display value="Social Care"/>
    <definition
                value="Request for data from payers to support the non-medical social needs of individuals, especially the elderly, vulnerable or with special needs."/>
  </concept>
  <concept>
    <code value="authorization-other"/>
    <display value="Other Authorization"/>
    <definition
                value="Request for data from payers for other authorization request not otherwise specified."/>
  </concept>
  <concept>
    <code value="care-coordination"/>
    <display value="Care Coordination"/>
    <definition
                value="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."/>
  </concept>
  <concept>
    <code value="documentation-general"/>
    <display value="General Documentation"/>
    <definition
                value="Request for data used from payers or providers for general documentation."/>
  </concept>
  <concept>
    <code value="orders"/>
    <display value="Orders"/>
    <definition
                value="Request for additional clinical information from referring provider to support orders."/>
  </concept>
  <concept>
    <code value="patient-status"/>
    <display value="Patient Status"/>
    <definition
                value="Requests for patient health record information from payers to support their payer member records."/>
  </concept>
  <concept>
    <code value="signature"/>
    <display value="Signature"/>
    <definition
                value="Request for signatures from payers or providers on requested data."/>
  </concept>
  <concept>
    <code value="care-planning"/>
    <display value="Care Planning"/>
    <definition
                value="Request for data from payers or providers to determine how to deliver care for a particular patient, group or community."/>
  </concept>
  <concept>
    <code value="social-risk"/>
    <display value="Social Risk"/>
    <definition
                value="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."/>
  </concept>
  <concept>
    <code value="operations-nos"/>
    <display value="Operations Not Otherwise Specified"/>
    <definition
                value="[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."/>
  </concept>
  <concept>
    <code value="payment-nos"/>
    <display value="Payment Not Otherwise Specified"/>
    <definition
                value="[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."/>
  </concept>
  <concept>
    <code value="purpose-of-use"/>
    <display value="Purpose Of Use"/>
    <definition value="Purpose of use for the requested data."/>
  </concept>
  <concept>
    <code value="signature-flag"/>
    <display value="Signature Flag"/>
    <definition
                value="Flag to indicate whether the requested data requires a signature."/>
  </concept>
  <concept>
    <code value="tracking-id"/>
    <display value="Tracking Id"/>
    <definition
                value="A business identifier that ties requested attachments back to the claim or prior-authorization (referred to as the “re-association tracking control numbers”)."/>
  </concept>
  <concept>
    <code value="multiple-submits-flag"/>
    <display value="Multiple Submits Flag"/>
    <definition
                value="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."/>
  </concept>
  <concept>
    <code value="payer-url"/>
    <display value="Payer URL"/>
    <definition
                value="$submit-attachment operation endpoint where the requested data can be submitted"/>
  </concept>
  <concept>
    <code value="service-date"/>
    <display value="Service Date"/>
    <definition
                value="Date of service or starting date of the service for the claim or prior authorization."/>
  </concept>
  <concept>
    <code value="attachment-request"/>
    <display value="Attachment Request"/>
    <definition
                value="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 &quot;payer-url&quot; input parameter."/>
  </concept>
</CodeSystem>