Da Vinci - Coverage Requirements Discovery
2.2.0-ballot - STU 2.2 Ballot
Da Vinci - Coverage Requirements Discovery
2.2.0-ballot - STU 2.2 Ballot
This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.2.0-ballot: STU 2.2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 2.1.0. For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/cardType | Version: 2.2.0-ballot | |||
| Standards status: Trial-use | Maturity Level: 4 | Computable Name: CRDCardType | ||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.6 | ||||
List of card types defined by the CRD spec
References
As mentioned in the ballot introduction, this value set uses codes slated to be moved from the temporary code system to a more permanent URL.
http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp where concept descends from _cardType
Expansion performed internally based on codesystem CRD Temporary Codes v2.2.0-ballot (CodeSystem)
This value set contains 15 concepts
| Level | Code | System | Display (en-US) | Definition |
| 1 | coverage-info | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Coverage Information | Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection |
| 2 | unsolicited-determ | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Unsolicited Determination | An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request |
| 1 | claim | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Claim | Information about what steps need to be taken to submit a claim for the service |
| 1 | insurance | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Insurance | Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions) |
| 1 | limits | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Limits | Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general |
| 1 | network | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Network | Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network) |
| 1 | appropriate-use | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Appropriate Use | Guidance on whether appropriate-use documentation is needed |
| 1 | cost | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Cost | What is the anticipated cost to the patient based on their coverage |
| 1 | therapy-alternatives-opt | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Optional Therapy Alternatives | Are there alternative therapies that have better coverage and/or are lower-cost for the patient |
| 1 | therapy-alternatives-req | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Required Therapy Alternatives | Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy |
| 1 | clinical-reminder | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Clinical Reminder | Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention) |
| 1 | duplicate-therapy | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Duplicate Therapy | Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system |
| 1 | contraindication | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Contraindication | Notice that the proposed intervention may be contraindicated based on information the payer has in their record that the provider doesn't have in theirs |
| 1 | guideline | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Guideline | Indication that there is a guideline available for the proposed therapy (with an option to view) |
| 1 | off-guideline | http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp | Off Guideline | Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline |
Explanation of the columns that may appear on this page:
| Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies |
| System | The source of the definition of the code (when the value set draws in codes defined elsewhere) |
| Code | The code (used as the code in the resource instance) |
| Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application |
| Definition | An explanation of the meaning of the concept |
| Comments | Additional notes about how to use the code |
IG © 2019+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-crd#2.2.0-ballot based on FHIR 4.0.1. Generated 2025-08-06
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