Da Vinci - Coverage Requirements Discovery
2.0.1 - STU 2 United States of America flag

This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.0.1: STU 2.0) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: CRD Coverage Information Additional Documentation Value Set - XML Representation

Page standards status: Trial-use Maturity Level: 1

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="AdditionalDocumentation"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><ul><li>Include these codes as defined in <a href="CodeSystem-temp.html"><code>http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href="CodeSystem-temp.html#temp-clinical">clinical</a></td><td style="color: #cccccc">Clinical Documentation</td><td>Details most likely to originate from a clinician are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by clinician.  Indicates that the CRD client should expose the need to launch DTR to clinical users.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-admin">admin</a></td><td style="color: #cccccc">Administrative Documentation</td><td>Administrative details not likely to require clinical expertise are needed to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by back-end staff.  Indicates that while the CRD client might expose the ability to launch DTR as an option for clinical users, it should be clear that clinical input is not necessary and deferring the use of DTR to back-end staff is perfectly appropriate.  Some CRD clients might be configured (based on provider preference) to not even show clinicians the option to launch.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-both">both</a></td><td style="color: #cccccc">Administrative &amp; clinical doc</td><td>Both clinical and administrative details are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability.  Equivalent to the union of #admin and #clinical.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-conditional">conditional</a></td><td style="color: #cccccc">Conditional</td><td>Decision cannot be made without more information (more detailed code, service rendering information, etc.)</td></tr></table></li></ul></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-crd/ValueSet/AdditionalDocumentation"/>
  <version value="2.0.1"/>
  <name value="CRDAdditionalDoc"/>
  <title value="CRD Coverage Information Additional Documentation Value Set"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-01-08T19:15:34+00:00"/>
  <publisher value="HL7 International / Financial Management"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
  </contact>
  <description
               value="Codes defining whether additional documentation needs to be captured"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <compose>
    <include>
      <system value="http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp"/>
      <concept>
        <code value="clinical"/>
      </concept>
      <concept>
        <code value="admin"/>
      </concept>
      <concept>
        <code value="both"/>
      </concept>
      <concept>
        <code value="conditional"/>
      </concept>
    </include>
  </compose>
</ValueSet>