Da Vinci - Coverage Requirements Discovery
2.1.0 - STU 2.1 United States of America flag

This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.1.0: STU 2.1) 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

ValueSet: CRD Coverage Assertion Reasons

Official URL: http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons Version: 2.1.0
Standards status: Trial-use Maturity Level: 1 Computable Name: CRDCoverageAssertionReasons
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.48.10

Reasons for a coverage assertion in the coverage-information extension

References

Logical Definition (CLD)

Generated Narrative: ValueSet coverageAssertionReasons

  • Include these codes as defined in http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp
    CodeDisplayDefinition
    gold-cardGold cardOrdering Practitioner has been granted 'gold card' status with this payer/coverage type.
    detail-codeDetail codeThe ordered code is at too high a level of granularity to make decisions about coverage/pa/etc. Can only be present if something is 'conditional'

 

Expansion

Generated Narrative: ValueSet

Expansion based on codesystem CRD Temporary Codes v2.1.0 (CodeSystem)

This value set contains 2 concepts

CodeSystemDisplayDefinition
  gold-cardhttp://hl7.org/fhir/us/davinci-crd/CodeSystem/tempGold card

Ordering Practitioner has been granted 'gold card' status with this payer/coverage type.

  detail-codehttp://hl7.org/fhir/us/davinci-crd/CodeSystem/tempDetail code

The ordered code is at too high a level of granularity to make decisions about coverage/pa/etc. Can only be present if something is 'conditional'

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