Da Vinci Payer Data Exchange
2.1.0-ballot - STU2 Ballot United States of America flag

This page is part of the Da Vinci Payer Data Exchange (v2.1.0-ballot: STU2.1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

: Provenance Payer Data Source Format - XML Representation

Page standards status: Trial-use

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="ProvenancePayerDataSource"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem ProvenancePayerDataSource</b></p><a name="ProvenancePayerDataSource"> </a><a name="hcProvenancePayerDataSource"> </a><a name="ProvenancePayerDataSource-en-US"> </a><p>This case-insensitive code system <code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource</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">hl7v2other<a name="ProvenancePayerDataSource-hl7v2other"> </a></td><td>HL7 v2</td><td>HL7 v2 Message</td></tr><tr><td style="white-space:nowrap">hl7v2oru<a name="ProvenancePayerDataSource-hl7v2oru"> </a></td><td>HL7 v2 ORU</td><td>HL7 v2 Structured Observation Report(ORU) message</td></tr><tr><td style="white-space:nowrap">hl7v2adt<a name="ProvenancePayerDataSource-hl7v2adt"> </a></td><td>HL7 v2 ADT</td><td>HL7 v2 Admit, Discharge Transfer (ADT) message</td></tr><tr><td style="white-space:nowrap">hl7v2r01<a name="ProvenancePayerDataSource-hl7v2r01"> </a></td><td>HL7 v2 R01</td><td>HL7 v2 Observation (R01) message</td></tr><tr><td style="white-space:nowrap">hl7v2rsp<a name="ProvenancePayerDataSource-hl7v2rsp"> </a></td><td>HL7 v2 RSP</td><td>HL7 V2 Immunization Record Response</td></tr><tr><td style="white-space:nowrap">hl7v2orm<a name="ProvenancePayerDataSource-hl7v2orm"> </a></td><td>HL7 v2 ORM</td><td>HL7 v2 Orders</td></tr><tr><td style="white-space:nowrap">hl7v2mdm<a name="ProvenancePayerDataSource-hl7v2mdm"> </a></td><td>HL7 v2 MDM</td><td>Medical Document Management</td></tr><tr><td style="white-space:nowrap">hl7v2vxu<a name="ProvenancePayerDataSource-hl7v2vxu"> </a></td><td>HL7 v2 VXU</td><td>HL7 V2 Immunization Transaction</td></tr><tr><td style="white-space:nowrap">hl7v3<a name="ProvenancePayerDataSource-hl7v3"> </a></td><td>HL7 v3</td><td>HL7 v3 Message</td></tr><tr><td style="white-space:nowrap">hl7ccda<a name="ProvenancePayerDataSource-hl7ccda"> </a></td><td>HL7 C-CDA</td><td>HL7 Consolidated-Clinical Document Architecture</td></tr><tr><td style="white-space:nowrap">hl7cda<a name="ProvenancePayerDataSource-hl7cda"> </a></td><td>HL7 CDA</td><td>HL7 CDA documents that are not C-CDA</td></tr><tr><td style="white-space:nowrap">hl7cdaqrda<a name="ProvenancePayerDataSource-hl7cdaqrda"> </a></td><td>HL7 CDA QRDA</td><td>HL7 Quality Reporting Document</td></tr><tr><td style="white-space:nowrap">hl7fhirdstu2<a name="ProvenancePayerDataSource-hl7fhirdstu2"> </a></td><td>FHIR DSTU2</td><td>HL7 FHIR DSTU2</td></tr><tr><td style="white-space:nowrap">hl7fhirdstu3<a name="ProvenancePayerDataSource-hl7fhirdstu3"> </a></td><td>FHIR STU3</td><td>HL7 FHIR STU3</td></tr><tr><td style="white-space:nowrap">hl7fhirr4<a name="ProvenancePayerDataSource-hl7fhirr4"> </a></td><td>FHIR R4</td><td>HL7 FHIR R4</td></tr><tr><td style="white-space:nowrap">x12837<a name="ProvenancePayerDataSource-x12837"> </a></td><td>837 claim</td><td>X12 837 Claim</td></tr><tr><td style="white-space:nowrap">x12278<a name="ProvenancePayerDataSource-x12278"> </a></td><td>278</td><td>X12 Prior Authorization</td></tr><tr><td style="white-space:nowrap">x12275<a name="ProvenancePayerDataSource-x12275"> </a></td><td>275</td><td>X12 Attachment</td></tr><tr><td style="white-space:nowrap">x12other<a name="ProvenancePayerDataSource-x12other"> </a></td><td>X12</td><td>X12 non-specific transaction</td></tr><tr><td style="white-space:nowrap">script<a name="ProvenancePayerDataSource-script"> </a></td><td>NCPDP SCRIPT</td><td>National Council for Prescription Drug Programs (NCPDP) SCRIPT message (eRx)</td></tr><tr><td style="white-space:nowrap">ncpdp<a name="ProvenancePayerDataSource-ncpdp"> </a></td><td>NCPDP Telecommunication</td><td>NCPDP Telecommunication transaction (pharmacy claims)</td></tr><tr><td style="white-space:nowrap">capture<a name="ProvenancePayerDataSource-capture"> </a></td><td>Direct Capture</td><td>Direct Capture, such as into a payers case management system</td></tr><tr><td style="white-space:nowrap">customtx<a name="ProvenancePayerDataSource-customtx"> </a></td><td>Trading Partner Format</td><td>Trading Partner Proprietary format</td></tr><tr><td style="white-space:nowrap">image<a name="ProvenancePayerDataSource-image"> </a></td><td>Image</td><td>Fax or scanned document</td></tr><tr><td style="white-space:nowrap">unstructured<a name="ProvenancePayerDataSource-unstructured"> </a></td><td>Unstructured Document</td><td>PDF, text and other unstructured document</td></tr><tr><td style="white-space:nowrap">other<a name="ProvenancePayerDataSource-other"> </a></td><td>Other</td><td>Any other document format not specifically defined</td></tr></table></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-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource"/>
  <version value="2.1.0-ballot"/>
  <name value="ProvenancePayerDataSource"/>
  <title value="Provenance Payer Data Source Format"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-08-14T20:04:35+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="fm@lists.HL7.org"/>
    </telecom>
  </contact>
  <contact>
    <name value="Mark Scrimshire (mark.scrimshire@onyxhealth.io)"/>
    <telecom>
      <system value="email"/>
      <value value="mailto:mark.scrimshire@onyxhealth.io"/>
    </telecom>
  </contact>
  <contact>
    <name value="HL7 International - Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
  </contact>
  <description
               value="CodeSystem for source formats that identify what non-FHIR source was used to create FHIR record(s)"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Used by permission of HL7 International, all rights reserved Creative Commons License"/>
  <caseSensitive value="false"/>
  <content value="complete"/>
  <count value="26"/>
  <concept>
    <code value="hl7v2other"/>
    <display value="HL7 v2"/>
    <definition value="HL7 v2 Message"/>
  </concept>
  <concept>
    <code value="hl7v2oru"/>
    <display value="HL7 v2 ORU"/>
    <definition value="HL7 v2 Structured Observation Report(ORU) message"/>
  </concept>
  <concept>
    <code value="hl7v2adt"/>
    <display value="HL7 v2 ADT"/>
    <definition value="HL7 v2 Admit, Discharge Transfer (ADT) message"/>
  </concept>
  <concept>
    <code value="hl7v2r01"/>
    <display value="HL7 v2 R01"/>
    <definition value="HL7 v2 Observation (R01) message"/>
  </concept>
  <concept>
    <code value="hl7v2rsp"/>
    <display value="HL7 v2 RSP"/>
    <definition value="HL7 V2 Immunization Record Response"/>
  </concept>
  <concept>
    <code value="hl7v2orm"/>
    <display value="HL7 v2 ORM"/>
    <definition value="HL7 v2 Orders"/>
  </concept>
  <concept>
    <code value="hl7v2mdm"/>
    <display value="HL7 v2 MDM"/>
    <definition value="Medical Document Management"/>
  </concept>
  <concept>
    <code value="hl7v2vxu"/>
    <display value="HL7 v2 VXU"/>
    <definition value="HL7 V2 Immunization Transaction"/>
  </concept>
  <concept>
    <code value="hl7v3"/>
    <display value="HL7 v3"/>
    <definition value="HL7 v3 Message"/>
  </concept>
  <concept>
    <code value="hl7ccda"/>
    <display value="HL7 C-CDA"/>
    <definition value="HL7 Consolidated-Clinical Document Architecture"/>
  </concept>
  <concept>
    <code value="hl7cda"/>
    <display value="HL7 CDA"/>
    <definition value="HL7 CDA documents that are not C-CDA"/>
  </concept>
  <concept>
    <code value="hl7cdaqrda"/>
    <display value="HL7 CDA QRDA"/>
    <definition value="HL7 Quality Reporting Document"/>
  </concept>
  <concept>
    <code value="hl7fhirdstu2"/>
    <display value="FHIR DSTU2"/>
    <definition value="HL7 FHIR DSTU2"/>
  </concept>
  <concept>
    <code value="hl7fhirdstu3"/>
    <display value="FHIR STU3"/>
    <definition value="HL7 FHIR STU3"/>
  </concept>
  <concept>
    <code value="hl7fhirr4"/>
    <display value="FHIR R4"/>
    <definition value="HL7 FHIR R4"/>
  </concept>
  <concept>
    <code value="x12837"/>
    <display value="837 claim"/>
    <definition value="X12 837 Claim"/>
  </concept>
  <concept>
    <code value="x12278"/>
    <display value="278"/>
    <definition value="X12 Prior Authorization"/>
  </concept>
  <concept>
    <code value="x12275"/>
    <display value="275"/>
    <definition value="X12 Attachment"/>
  </concept>
  <concept>
    <code value="x12other"/>
    <display value="X12"/>
    <definition value="X12 non-specific transaction"/>
  </concept>
  <concept>
    <code value="script"/>
    <display value="NCPDP SCRIPT"/>
    <definition
                value="National Council for Prescription Drug Programs (NCPDP) SCRIPT message (eRx)"/>
  </concept>
  <concept>
    <code value="ncpdp"/>
    <display value="NCPDP Telecommunication"/>
    <definition
                value="NCPDP Telecommunication transaction (pharmacy claims)"/>
  </concept>
  <concept>
    <code value="capture"/>
    <display value="Direct Capture"/>
    <definition
                value="Direct Capture, such as into a payers case management system"/>
  </concept>
  <concept>
    <code value="customtx"/>
    <display value="Trading Partner Format"/>
    <definition value="Trading Partner Proprietary format"/>
  </concept>
  <concept>
    <code value="image"/>
    <display value="Image"/>
    <definition value="Fax or scanned document"/>
  </concept>
  <concept>
    <code value="unstructured"/>
    <display value="Unstructured Document"/>
    <definition value="PDF, text and other unstructured document"/>
  </concept>
  <concept>
    <code value="other"/>
    <display value="Other"/>
    <definition value="Any other document format not specifically defined"/>
  </concept>
</CodeSystem>