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 Information Covered Value Set - TTL Representation

Page standards status: Trial-use Maturity Level: 1

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ValueSet ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "coverageInfo"] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet coverageInfo</b></p><a name=\"coverageInfo\"> </a><a name=\"hccoverageInfo\"> </a><a name=\"coverageInfo-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-not-covered\">not-covered</a></td><td style=\"color: #cccccc\">Not covered</td><td>No coverage or possibility of coverage for this service)</td></tr><tr><td><a href=\"CodeSystem-temp.html#temp-covered\">covered</a></td><td style=\"color: #cccccc\">Covered</td><td>Regular coverage applies</td></tr><tr><td><a href=\"CodeSystem-temp.html#temp-conditional\">conditional</a></td><td style=\"color: #cccccc\">Conditional</td><td>There is the potential for information requirements from a participant type not listed.  However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.)</td></tr></table></li></ul></div>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1"^^xsd:integer ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
fhir:value [ fhir:v "fm" ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ;
fhir:value [
fhir:v "trial-use" ;
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
fhir:v "http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd>         ]       ] )     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageInfo"^^xsd:anyURI] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.40.18.48.13" ]
  ] ) ; # 
  fhir:version [ fhir:v "2.1.0"] ; # 
  fhir:name [ fhir:v "CRDCoveredInfo"] ; # 
  fhir:title [ fhir:v "CRD Coverage Information Covered Value Set"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v "false"^^xsd:boolean] ; # 
  fhir:date [ fhir:v "2024-12-11T19:24:00+00:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; # 
  fhir:contact ( [
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "Codes defining whether the ordered/requested service is covered under patient's plan"] ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US" ]     ] )
  ] ) ; # 
  fhir:compose [
    ( fhir:include [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp"^^xsd:anyURI ] ;
      ( fhir:concept [
fhir:code [ fhir:v "not-covered" ]       ] [
fhir:code [ fhir:v "covered" ]       ] [
fhir:code [ fhir:v "conditional" ]       ] )     ] )
  ] . #