This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v1.1.0: STU 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

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

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{
  "resourceType" : "CodeSystem",
  "id" : "PCTSubjectToMedicalMgmtReasonCS",
  "text" : {
    "status" : "generated",
    "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>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSubjectToMedicalMgmtReasonCS",
  "version" : "1.1.0",
  "name" : "PCTSubjectToMedicalMgmtReasonCS",
  "title" : "PCT Subject-To-Medical-Management Reason Code System",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-01-03T18:32:02+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fmlists@lists.hl7.org"
        }
      ]
    }
  ],
  "description" : "Defining codes for the classification of subject-to-medical-management reason types",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "copyright" : "This CodeSystem is not copyrighted.",
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 4,
  "concept" : [
    {
      "code" : "concurrent-review",
      "display" : "Concurrent Review",
      "definition" : "Concurrent Review"
    },
    {
      "code" : "prior-auth",
      "display" : "Prior Authorization",
      "definition" : "Prior Authorization"
    },
    {
      "code" : "step-therapy",
      "display" : "Step Therapy",
      "definition" : "Step Therapy"
    },
    {
      "code" : "fail-first",
      "display" : "Fail-First",
      "definition" : "Fail-First"
    }
  ]
}