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 Total Value Set - XML Representation

Page standards status: Trial-use

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="PCTTotal"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This value set includes codes based on the following rules:</p><ul><li>Import all the codes that are contained in <a href="ValueSet-PCTAdjudication.html">PCT Adjudication Value Set</a></li><li>Include these codes as defined in <a href="CodeSystem-PCTNetworkStatusCS.html"><code>http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS</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-PCTNetworkStatusCS.html#PCTNetworkStatusCS-innetwork">innetwork</a></td><td>In Network</td><td>Indicates an in network status in relation to a patient's coverage</td></tr><tr><td><a href="CodeSystem-PCTNetworkStatusCS.html#PCTNetworkStatusCS-outofnetwork">outofnetwork</a></td><td>Out Of Network</td><td>Indicates a not in network status in relation to a patient's coverage</td></tr><tr><td><a href="CodeSystem-PCTNetworkStatusCS.html#PCTNetworkStatusCS-negotiated">negotiated</a></td><td>Negotiated Service or Product</td><td>Indicates a special negotiated status in relation to a patient's coverage</td></tr></table></li></ul></div>
  </text>
  <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-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"/>
      </extension>
    </valueCode>
  </extension>
  <url value="http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTTotal"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.40.4.48.34"/>
  </identifier>
  <version value="2.0.0-ballot"/>
  <name value="PCTTotal"/>
  <title value="PCT Total Value Set"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-04-08T16:53:34+00:00"/>
  <publisher value="HL7 International / Financial Management"/>
  <contact>
    <name value="HL7 International / Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fmlists@lists.hl7.org"/>
    </telecom>
  </contact>
  <description
               value="Describes the various amount fields used when payers receive and adjudicate a claim.  It includes the values 
defined in http://terminology.hl7.org/CodeSystem/adjudication, as well as those defined in the Network Status."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <copyright value="This Valueset is not copyrighted."/>
  <compose>
    <include>
      <valueSet
                value="http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTAdjudication"/>
    </include>
    <include>
      <system
              value="http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS"/>
      <concept>
        <code value="innetwork"/>
        <display value="In Network"/>
      </concept>
      <concept>
        <code value="outofnetwork"/>
        <display value="Out Of Network"/>
      </concept>
      <concept>
        <code value="negotiated"/>
        <display value="Negotiated Service or Product"/>
      </concept>
    </include>
  </compose>
</ValueSet>