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 Advance Explanation of Benefit Type Value Set - JSON Representation

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{
  "resourceType" : "ValueSet",
  "id" : "PCTAEOBTypeVS",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This value set includes codes based on the following rules:</p><ul><li>Include these codes as defined in <a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claim-type.html\"><code>http://terminology.hl7.org/CodeSystem/claim-type</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-claim-type.html#claim-type-institutional\">institutional</a></td><td style=\"color: #cccccc\">Institutional</td><td>Hospital, clinic and typically inpatient claims.</td></tr><tr><td><a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claim-type.html#claim-type-professional\">professional</a></td><td style=\"color: #cccccc\">Professional</td><td>Typically, outpatient claims from Physician, Psychological, Chiropractor, Physiotherapy, Speech Pathology, rehabilitative, consulting.</td></tr></table></li><li>Include all codes defined in <a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claim-type.html\"><code>http://terminology.hl7.org/CodeSystem/claim-type</code></a></li></ul></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/ValueSet/PCTAEOBTypeVS",
  "version" : "1.1.0",
  "name" : "PCTAEOBTypeVS",
  "title" : "PCT Advance Explanation of Benefit Type Value Set",
  "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" : "Codes to specify the type of AEOB",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "compose" : {
    "include" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "concept" : [
          {
            "code" : "institutional"
          },
          {
            "code" : "professional"
          }
        ]
      },
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type"
      }
    ]
  }
}