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

: Claim Medical Product or Service Value Set - XML Representation

Page standards status: Trial-use

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="USClaimMedicalProductOrServiceCodes"/>
  <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>Include all codes defined in <a href="http://terminology.hl7.org/5.3.0/CodeSystem-CPT.html"><code>http://www.ama-assn.org/go/cpt</code></a></li><li>Include all codes defined in <code>http://ada.org/cdt</code></li><li>Include all codes defined in <code>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</code></li><li>Include all codes defined in <a href="http://terminology.hl7.org/5.3.0/CodeSystem-HIPPS.html"><code>https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ProspMedicareFeeSvcPmtGen/HIPPSCodes</code></a></li><li>Include these codes as defined in <a href="http://terminology.hl7.org/5.3.0/CodeSystem-data-absent-reason.html"><code>http://terminology.hl7.org/CodeSystem/data-absent-reason</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="http://terminology.hl7.org/5.3.0/CodeSystem-data-absent-reason.html#data-absent-reason-not-applicable">not-applicable</a></td><td>Not Applicable</td><td>There is no proper value for this element (e.g. last menstrual period for a male).</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/USClaimMedicalProductOrServiceCodes"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.40.4.48.36"/>
  </identifier>
  <version value="2.0.0-ballot"/>
  <name value="USClaimMedicalProductOrServiceCodes"/>
  <title value="Claim Medical Product or Service 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="CPT - HCPCS - HIPPS - CDT codes to report medical procedures and services under public and private health insurance programs"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Current Procedural Terminology (CPT) is copyright 2020 American Medical Association. All rights reserved."/>
  <compose>
    <include>
      <system value="http://www.ama-assn.org/go/cpt"/>
    </include>
    <include>
      <system value="http://ada.org/cdt"/>
    </include>
    <include>
      <system
              value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
    </include>
    <include>
      <system
              value="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ProspMedicareFeeSvcPmtGen/HIPPSCodes"/>
    </include>
    <include>
      <system
              value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/>
      <concept>
        <code value="not-applicable"/>
        <display value="Not Applicable"/>
      </concept>
    </include>
  </compose>
</ValueSet>