Patient Cost Transparency Implementation Guide
2.0.0 - STU 2 United States of America flag

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v2.0.0: STU 2) 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

ValueSet: PCT Payer Benefit Payment Status

Official URL: http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTPayerBenefitPaymentStatusVS Version: 2.0.0
Standards status: Trial-use Maturity Level: 2 Computable Name: PCTPayerBenefitPaymentStatusVS
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.48.28

Indicates the in network or out of network payment status of the claim or line item.

References

Changes since version 1.1.0:

  • The logical definition of the value set has changed

    • Logical Definition (CLD)

    This value set includes codes based on the following rules:

     

    Expansion

    Expansion performed internally based on codesystem PCT Network Status v2.0.0 (CodeSystem)

    This value set contains 4 concepts

    CodeSystemDisplayDefinition
      innetworkhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCSIn NetworkIndicates an in network status in relation to a patient's coverage
      outofnetworkhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCSOut Of NetworkIndicates a not in network status in relation to a patient's coverage
      negotiatedhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCSNegotiated Service or ProductIndicates a special negotiated status in relation to a patient's coverage
      otherhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCSOtherIndicates other network status or when a network does not apply

    Explanation of the columns that may appear on this page:

    Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
    System The source of the definition of the code (when the value set draws in codes defined elsewhere)
    Code The code (used as the code in the resource instance)
    Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
    Definition An explanation of the meaning of the concept
    Comments Additional notes about how to use the code