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This page is part of the Da Vinci Payer Data Exchange (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Provenance Payer Data Source Format - JSON Representation

Active as of 2024-01-06

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{
  "resourceType" : "CodeSystem",
  "id" : "ProvenancePayerDataSource",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><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>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource",
  "version" : "2.0.0",
  "name" : "ProvenancePayerDataSource",
  "title" : "Provenance Payer Data Source Format",
  "status" : "active",
  "experimental" : true,
  "date" : "2024-01-06T03:07:01+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" : "fm@lists.HL7.org"
        }
      ]
    },
    {
      "name" : "Mark Scrimshire (mark.scrimshire@onyxhealth.io)",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:mark.scrimshire@onyxhealth.io"
        }
      ]
    },
    {
      "name" : "HL7 International - Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description" : "CodeSystem for source formats that identify what non-FHIR source was used to create FHIR record(s)",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "caseSensitive" : false,
  "content" : "complete",
  "count" : 26,
  "concept" : [
    {
      "code" : "hl7v2other",
      "display" : "HL7 v2",
      "definition" : "HL7 v2 Message"
    },
    {
      "code" : "hl7v2oru",
      "display" : "HL7 v2 ORU",
      "definition" : "HL7 v2 Structured Observation Report(ORU) message"
    },
    {
      "code" : "hl7v2adt",
      "display" : "HL7 v2 ADT",
      "definition" : "HL7 v2 Admit, Discharge Transfer (ADT) message"
    },
    {
      "code" : "hl7v2r01",
      "display" : "HL7 v2 R01",
      "definition" : "HL7 v2 Observation (R01) message"
    },
    {
      "code" : "hl7v2rsp",
      "display" : "HL7 v2 RSP",
      "definition" : "HL7 V2 Immunization Record Response"
    },
    {
      "code" : "hl7v2orm",
      "display" : "HL7 v2 ORM",
      "definition" : "HL7 v2 Orders"
    },
    {
      "code" : "hl7v2mdm",
      "display" : "HL7 v2 MDM",
      "definition" : "Medical Document Management"
    },
    {
      "code" : "hl7v2vxu",
      "display" : "HL7 v2 VXU",
      "definition" : "HL7 V2 Immunization Transaction"
    },
    {
      "code" : "hl7v3",
      "display" : "HL7 v3",
      "definition" : "HL7 v3 Message"
    },
    {
      "code" : "hl7ccda",
      "display" : "HL7 C-CDA",
      "definition" : "HL7 Consolidated-Clinical Document Architecture"
    },
    {
      "code" : "hl7cda",
      "display" : "HL7 CDA",
      "definition" : "HL7 CDA documents that are not C-CDA"
    },
    {
      "code" : "hl7cdaqrda",
      "display" : "HL7 CDA QRDA",
      "definition" : "HL7 Quality Reporting Document"
    },
    {
      "code" : "hl7fhirdstu2",
      "display" : "FHIR DSTU2",
      "definition" : "HL7 FHIR DSTU2"
    },
    {
      "code" : "hl7fhirdstu3",
      "display" : "FHIR STU3",
      "definition" : "HL7 FHIR STU3"
    },
    {
      "code" : "hl7fhirr4",
      "display" : "FHIR R4",
      "definition" : "HL7 FHIR R4"
    },
    {
      "code" : "x12837",
      "display" : "837 claim",
      "definition" : "X12 837 Claim"
    },
    {
      "code" : "x12278",
      "display" : "278",
      "definition" : "X12 Prior Authorization"
    },
    {
      "code" : "x12275",
      "display" : "275",
      "definition" : "X12 Attachment"
    },
    {
      "code" : "x12other",
      "display" : "X12",
      "definition" : "X12 non-specific transaction"
    },
    {
      "code" : "script",
      "display" : "NCPDP SCRIPT",
      "definition" : "National Council for Prescription Drug Programs (NCPDP) SCRIPT message (eRx)"
    },
    {
      "code" : "ncpdp",
      "display" : "NCPDP Telecommunication",
      "definition" : "NCPDP Telecommunication transaction (pharmacy claims)"
    },
    {
      "code" : "capture",
      "display" : "Direct Capture",
      "definition" : "Direct Capture, such as into a payers case management system"
    },
    {
      "code" : "customtx",
      "display" : "Trading Partner Format",
      "definition" : "Trading Partner Proprietary format"
    },
    {
      "code" : "image",
      "display" : "Image",
      "definition" : "Fax or scanned document"
    },
    {
      "code" : "unstructured",
      "display" : "Unstructured Document",
      "definition" : "PDF, text and other unstructured document"
    },
    {
      "code" : "other",
      "display" : "Other",
      "definition" : "Any other document format not specifically defined"
    }
  ]
}