Da Vinci Payer Data Exchange
2.1.0 - STU 2.1 United States of America flag

This page is part of the Da Vinci Payer Data Exchange (v2.1.0: STU2.1) 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

ValueSet: PDex SupportingInfo Type (Experimental)

Official URL: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexSupportingInfoType Version: 2.1.0
Standards status: Informative Computable Name: PDexSupportingInfoType

Copyright/Legal: This Valueset is not copyrighted.

Used as the discriminator for the types of supporting information for the PDEX Prior Authorization. Based on the CARIN IG for Blue Button� Implementation Guide.

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

 

Expansion

Expansion performed internally based on codesystem PDex Supporting Info Type v2.1.0 (CodeSystem)

This value set contains 18 concepts

CodeSystemDisplay (en-US)Definition
  admissionperiodhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSAdmission PeriodDates corresponding with the admission and discharge of the beneficiary to a facility
  pointoforiginhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSPoint Of OriginUB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility.
  admtypehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSAdmission TypeUB-04 Priority of the admission (FL-14) indicates, for example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled.
  billingnetworkcontractingstatushttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSBilling Network Contracting StatusIndicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission.
  brandgenericindicatorhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSBrand Generic IndicatorNCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug.
  clmrecvddatehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSClaim Received DateDate the claim was received by the payer.
  compoundcodehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSCompound CodeNCPDP code indicating whether or not the prescription is a compound.
  dawcodehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSDAW (Dispense As Written) CodeNCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.
  dayssupplyhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSDays SupplyNCPDP value indicating the Number of days supply of medication dispensed by the pharmacy.
  discharge-statushttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSDischarge StatusUB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay.
  drghttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSDRGDRG (Diagnosis Related Group), including the code system, the DRG version and the code value
  performingnetworkcontractingstatushttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSPerforming Network Contracting StatusIndicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission.
  refillnumhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSRefill NumberNCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)
  rxorigincodehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSRx Origin CodeNCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy.
  servicefacilityhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSService FacilityThe facility where the service occurred. Examples include hospitals, nursing homes, laboratories or homeless shelters.
  typeofbillhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSType of BillUB-04 Type of Bill (FL-04) provides specific information for payer purposes.
  medicalrecordnumberhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSMedical Record NumberPatient Medical Record Number associated with the specific claim.
  patientaccountnumberhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCSPatient Account NumberPatient Account Number associated with the specific claim.

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