Patient Cost Transparency Implementation Guide
0.1.0 - STU 1 Ballot

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v0.1.0: STU 1 Draft) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

ValueSet: PCT Coverage Copay Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set

Summary

Defining URL:http://hl7.org/fhir/us/davinci-pct/ValueSet/pct-coverage-copay-codes
Version:0.1.0
Name:PCTCoverageCopayTypeVS
Title:PCT Coverage Copay Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
Status:Active as of 12/4/21 9:54 PM
Definition:

Codes for the classification of insurance coverage copay types for patient. This is an extension of the CoverageCopayTypeCodes value set

Publisher:HL7 International - Financial Management Work Group
Copyright:

This Valueset is not copyrighted.

Source Resource:XML / JSON / Turtle

References

Logical Definition (CLD)

This value set includes codes based on the following rules:

 

Expansion

This value set contains 12 concepts

CodeSystemDisplayDefinition
gpvisithttp://terminology.hl7.org/CodeSystem/coverage-copay-typeGP Office VisitAn office visit for a general practitioner of a discipline.
spvisithttp://terminology.hl7.org/CodeSystem/coverage-copay-typeSpecialist Office VisitAn office visit for a specialist practitioner of a discipline
emergencyhttp://terminology.hl7.org/CodeSystem/coverage-copay-typeEmergencyAn episode in an emergency department.
inpthosphttp://terminology.hl7.org/CodeSystem/coverage-copay-typeInpatient HospitalAn episode of an Inpatient hospital stay.
televisithttp://terminology.hl7.org/CodeSystem/coverage-copay-typeTele-visitA visit held where the patient is remote relative to the practitioner, e.g. by phone, computer or video conference.
urgentcarehttp://terminology.hl7.org/CodeSystem/coverage-copay-typeUrgent CareA visit to an urgent care facility - typically a community care clinic.
copaypcthttp://terminology.hl7.org/CodeSystem/coverage-copay-typeCopay PercentageA standard percentage applied to all classes or service or product not otherwise specified.
copayhttp://terminology.hl7.org/CodeSystem/coverage-copay-typeCopay AmountA standard fixed currency amount applied to all classes or service or product not otherwise specified.
deductiblehttp://terminology.hl7.org/CodeSystem/coverage-copay-typeDeductibleThe accumulated amount of patient payment before the coverage begins to pay for services.
maxoutofpockethttp://terminology.hl7.org/CodeSystem/coverage-copay-typeMaximum out of pocketThe maximum amout of payment for services which a patient, or family, is expected to incur - typically annually.
pharmacy-deductiblehttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCoverageCopayTypeCSPharmacy-DeductibleThe accumulated amount of patient payment before the coverage begins to pay for medicines.
pharmacy-maxoutofpockethttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCoverageCopayTypeCSPharmacy-Maximum Out Of PocketThe maximum amout of payment for medicines which a patient, or family, is expected to incur - typically annually.

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
Source 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