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 - 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">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>
  </text>
  <url value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
  <version value="1.0.0"/>
  <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="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="prior-authorization"/>
    <display value="Prior Authorization"/>
    <definition
                value="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."/>
  </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="claim"/>
    <display value="Claim"/>
    <definition
                value="A provider issued list of professional services and products which have been provided to a patient which is sent to an insurer for reimbursement."/>
  </concept>
</CodeSystem>