Da Vinci Clinical Data Exchange (CDex)
1.0.0 - STU R1 US

This page is part of the Da Vinci Clinical Documentation Exchange (v1.0.0: STU1) 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

: CDex Temporary Code System - JSON Representation

Draft as of 2021-10-26

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{
  "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\">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\">prior-authorization<a name=\"cdex-temp-prior-authorization\"> </a></td><td>Prior Authorization</td><td>Request for data from payers as part of a prior authorization requests from EHR systems. If authorization is required and documentation is necessary to substantiate the need for the service, the specific documentation is requested. The documentation may take the form of attestations by the provider, diagnoses, results of specific diagnostic tests, prior treatment that has been tried and failed, specific studies that need to be performed and other specific documentation such as progress notes or discharge summaries.</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\">claim<a name=\"cdex-temp-claim\"> </a></td><td>Claim</td><td>A provider issued list of professional services and products which have been provided to a patient which is sent to an insurer for reimbursement.</td></tr></table></div>"
  },
  "url" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
  "version" : "1.0.0",
  "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" : "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" : "prior-authorization",
      "display" : "Prior Authorization",
      "definition" : "Request for data from payers as part of a prior authorization requests from EHR systems. If authorization is required and documentation is necessary to substantiate the need for the service, the specific documentation is requested. The documentation may take the form of attestations by the provider, diagnoses, results of specific diagnostic tests, prior treatment that has been tried and failed, specific studies that need to be performed and other specific documentation such as progress notes or discharge summaries."
    },
    {
      "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" : "claim",
      "display" : "Claim",
      "definition" : "A provider issued list of professional services and products which have been provided to a patient which is sent to an insurer for reimbursement."
    }
  ]
}