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

: CRD Coverage Assertion Reasons - XML Representation

Page standards status: Trial-use Maturity Level: 1

Raw xml | Download


<ValueSet xmlns="http://hl7.org/fhir">
  <id value="coverageAssertionReasons"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet coverageAssertionReasons</b></p><a name="coverageAssertionReasons"> </a><a name="hccoverageAssertionReasons"> </a><a name="coverageAssertionReasons-en-US"> </a><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-gold-card">gold-card</a></td><td style="color: #cccccc">Gold card</td><td>Ordering Practitioner has been granted 'gold card' status with this payer/coverage type.</td></tr><tr><td><a href="CodeSystem-temp.html#temp-detail-code">detail-code</a></td><td style="color: #cccccc">Detail code</td><td>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'</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/coverageAssertionReasons"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.40.18.48.10"/>
  </identifier>
  <version value="2.1.0"/>
  <name value="CRDCoverageAssertionReasons"/>
  <title value="CRD Coverage Assertion Reasons"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-12-11T19:24:00+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="Reasons for a coverage assertion in the coverage-information extension"/>
  <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="gold-card"/>
      </concept>
      <concept>
        <code value="detail-code"/>
      </concept>
    </include>
  </compose>
</ValueSet>