Da Vinci - Coverage Requirements Discovery
2.2.0-ballot - STU 2.2 Ballot United States of America flag

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

ValueSet: CRD Coverage Detail Categories Value Set

Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetailCategories Version: 2.2.0-ballot
Standards status: Trial-use Maturity Level: 1 Computable Name: CRDCoverageDetailCategories
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.23

Codes that define the type of coverage information detail being provided

References

Logical Definition (CLD)

  • Include these codes as defined in http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes
    CodeDisplayDefinition
    cat-limitationCoverage LimitationThe statement being made about coverage or authorization that are being constrained in scope in some way. I.e. It is not safe to interpret the statements of 'this is covered' or 'this does not require prior auth' without looking at this detail.
    cat-decisionalDecision ConsiderationsThe statement does not qualify the coverage statement, however it does provide information that may be relevant to the patient & caregiver decision of whether a therapy is appropriate/reasonable.
    cat-otherOther DetailsThe statement does not limit the coverage statement being made and is unlikely to influence a decision to proceed with care. For example, instructions on how to submit a claim, reference to to policy, etc.

 

Expansion

Expansion performed internally based on codesystem Coverage Information Codes v2.2.0-ballot (CodeSystem)

This value set contains 3 concepts

CodeSystemDisplay (en-US)Definition
  cat-limitationhttp://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codesCoverage LimitationThe statement being made about coverage or authorization that are being constrained in scope in some way. I.e. It is not safe to interpret the statements of 'this is covered' or 'this does not require prior auth' without looking at this detail.
  cat-decisionalhttp://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codesDecision ConsiderationsThe statement does not qualify the coverage statement, however it does provide information that may be relevant to the patient & caregiver decision of whether a therapy is appropriate/reasonable.
  cat-otherhttp://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codesOther DetailsThe statement does not limit the coverage statement being made and is unlikely to influence a decision to proceed with care. For example, instructions on how to submit a claim, reference to to policy, etc.

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