Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot US

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v2.0.0-ballot: STU 2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

: PCT Subject-To-Medical-Management Reason Code System - TTL Representation

Page standards status: Trial-use

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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:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "PCTSubjectToMedicalMgmtReasonCS"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSubjectToMedicalMgmtReasonCS</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">concurrent-review<a name=\"PCTSubjectToMedicalMgmtReasonCS-concurrent-review\"> </a></td><td>Concurrent Review</td><td>Concurrent Review</td></tr><tr><td style=\"white-space:nowrap\">prior-auth<a name=\"PCTSubjectToMedicalMgmtReasonCS-prior-auth\"> </a></td><td>Prior Authorization</td><td>Prior Authorization</td></tr><tr><td style=\"white-space:nowrap\">step-therapy<a name=\"PCTSubjectToMedicalMgmtReasonCS-step-therapy\"> </a></td><td>Step Therapy</td><td>Step Therapy</td></tr><tr><td style=\"white-space:nowrap\">fail-first<a name=\"PCTSubjectToMedicalMgmtReasonCS-fail-first\"> </a></td><td>Fail-First</td><td>Fail-First</td></tr></table></div>"
  ] ; # 
  fhir:extension ( [
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-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct>         ]       ] )     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSubjectToMedicalMgmtReasonCS"^^xsd:anyURI] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.40.4.16.16" ]
  ] ) ; # 
  fhir:version [ fhir:v "2.0.0-ballot"] ; # 
  fhir:name [ fhir:v "PCTSubjectToMedicalMgmtReasonCS"] ; # 
  fhir:title [ fhir:v "PCT Subject-To-Medical-Management Reason Code System"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v "false"^^xsd:boolean] ; # 
  fhir:date [ fhir:v "2024-04-08T16:53:34+00:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; # 
  fhir:contact ( [
fhir:name [ fhir:v "HL7 International / Financial Management" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ]     ] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "fmlists@lists.hl7.org" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "Defining codes for the classification of subject-to-medical-management reason types. This CodeSystem is currently defined by this IG, but is anticipated to be temporary. The concepts within are expected to be moved in a future version to a more central terminology specification such as THO, which will result in a code system url change and possibly modified codes and definitions."] ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US" ]     ] )
  ] ) ; # 
  fhir:copyright [ fhir:v "This CodeSystem is not copyrighted."] ; # 
  fhir:caseSensitive [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:content [ fhir:v "complete"] ; # 
  fhir:count [ fhir:v "4"^^xsd:nonNegativeInteger] ; # 
  fhir:concept ( [
fhir:code [ fhir:v "concurrent-review" ] ;
fhir:display [ fhir:v "Concurrent Review" ] ;
fhir:definition [ fhir:v "Concurrent Review" ]
  ] [
fhir:code [ fhir:v "prior-auth" ] ;
fhir:display [ fhir:v "Prior Authorization" ] ;
fhir:definition [ fhir:v "Prior Authorization" ]
  ] [
fhir:code [ fhir:v "step-therapy" ] ;
fhir:display [ fhir:v "Step Therapy" ] ;
fhir:definition [ fhir:v "Step Therapy" ]
  ] [
fhir:code [ fhir:v "fail-first" ] ;
fhir:display [ fhir:v "Fail-First" ] ;
fhir:definition [ fhir:v "Fail-First" ]
  ] ) . #