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. For a full list of available versions, see the Directory of published versions

Downloads

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Downloadable Copy of Entire Specification

A downloadable version of this IG is available so it can be hosted locally:

• Downloadable Copy(compressed folder)

Examples

All the examples that are used in this Implementation Guide available for download:

• JSON(compressed folder)
• XML(compressed folder)

Definitions

• JSON Definitions (zip)
• XML Definitions (zip)
• Turtle Definitions (zip)

IG/package dependencies

The following dependencies are used in production of this guide:

Globals table

There are no Global profiles defined

Cross version analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (hl7.fhir.us.davinci-pdex.r4) and R4B (hl7.fhir.us.davinci-pdex.r4b) are available.

IP Statements

This publication includes IP covered under the following statements.

• All X12 products are subject to this IP policy, including published and draft works.X12 is the only organization authorized to grant permission for use of X12 products. Users of all X12 products should make sure that they understand the permissible uses, as well as the limitations on such usage, as outlined below.Additional IP information can be found here Send an email to ip@x12.org to request permission to reproduce X12 IP. Include your name, organization, title, address, city, state, zip, email, a detailed description of the Submitted Artifact, including the underlying or cited X12 Product, and a detailed description of the intended audience and planned distribution method for the Artifact.Additional information on X12 licensing program can be found here To purchase code list subscriptions call (425) 562-2245 or email admin@wpc-edi.com.
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  • X12 Claim Adjustment Reason Codes: PdexPriorAuthorization and X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes
• All X12 work products are copyrighted. Any use of any X12 work product must be compliant with US Copyright laws and X12 Intellectual Property policies.Please see https://x12.org/products/licensing-program
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  • X12 Service Type Codes: ExplanationOfBenefit/PDexPriorAuth1, PdexPriorAuthorization and PriorAuthServiceTypeCodes
• CMS maintains HIPPS. There are no known constraints on the use of HIPPS.
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  • Health Insurance Prospective Payment System (HIPPS): ExplanationOfBenefit/PDexPriorAuth1, PDexPAInstitutionalProcedureCodes, PDexPAInstitutionalProcedureCodesVS and PdexPriorAuthorization
• Copyright HL7. Licensed under creative commons public domain
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  • identifierType: Bundle/1000000-1, Bundle/1000000-2... Show 4 more, Bundle/1000000-3, Patient/1, Patient/1-2 and Patient/100
• HL7 Inc.
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  • Claim Type Codes: ExplanationOfBenefit/PDexPriorAuth1
• ISO Maintains the copyright on the country codes, and controls it's use carefully. For futher details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
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  • ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: AssociatedServers, BundleTypeVS... Show 86 more, ContactPointAvailableTime, CredentialStatusCS, DaVinciPayerDataExchange, DispenseRefill, DynamicRegistration, EndpointAccessControlMechanism, EndpointAccessControlMechanismCS, EndpointAccessControlMechanismVS, EndpointConnectionTypeCS, EndpointConnectionTypeVS, EndpointConnectionTypeVersion, EndpointConnectionTypeVersionCS, EndpointConnectionTypeVersionVS, EndpointFhirMimeTypeCS, EndpointFhirMimeTypeVS, EndpointHieSpecificConnectionTypeCS, EndpointPayloadTypeCS, EndpointPayloadTypeVS, EndpointRank, EndpointUsecase, ExplanationOfBenefit_Identifier, ExplanationOfBenefit_Patient, ExplanationOfBenefit_ServiceDate, ExplanationOfBenefit_Type, ExplanationOfBenefit_Use, FDANationalDrugCode, FhirIg, IdentifierStatus, IdentifierStatusVS, IdentifierTypeCS, LevelOfServiceCode, MtlsBundle, MtlsEndpoint, MtlsObjectCodeCS, MtlsObjectType, MtlsOrganization, MtlsSignedObject, NdhAssociatedServersTypeCS, NdhAssociatedServersTypeVS, NdhFhirEndpointUseCaseCS, NdhFhirEndpointUseCaseVS, NdhSecureExchangeArtifactsCS, NdhSecureExchangeArtifactsVS, NdhVerificationStatusCS, NdhVerificationStatusVS, OrgTypeCS, OrgTypeVS, PDexAdjudication, PDexAdjudicationCS, PDexAdjudicationCategoryDiscriminator, PDexAdjudicationDiscriminator, PDexIdentifierType, PDexPAInstitutionalProcedureCodes, PDexPAInstitutionalProcedureCodesVS, PDexPayerAdjudicationStatus, PDexPayerBenefitPaymentStatus, PDexProviderExportModeVS, PDexSupportingInfoType, PdexDevice, PdexMedicationDispense, PdexMedicationDispensePatient, PdexMedicationDispenseStatus, PdexPriorAuthorization, PdexProviderExportModeCS, PdexServerCapabilityStatement, PriorAuthServiceTypeCodes, PriorAuthorizationAmounts, PriorAuthorizationUtilization, PriorAuthorizationValueCodes, Provenance, ProvenanceAgentRoleType, ProvenanceAgentType, ProvenancePayerDataSource, ProvenancePayerSourceFormat, ProvenanceSourceFrom, ReviewAction, ReviewActionCode, SecureExchangeArtifacts, TrustFramework, TrustFrameworkTypeCS, TrustFrameworkTypeVS, TrustProfileCS, TrustProfileVS, VerificationStatus, X12278ReviewDecisionReasonCode and X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes
• These codes are excerpted from ASTM Standard, E1762-95(2013) - Standard Guide for Electronic Authentication of Health Care Information, Copyright by ASTM International, 100 Barr Harbor Drive, West Conshohocken, PA 19428. Copies of this standard are available through the ASTM Web Site at www.astm.org.
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  • Signature Type Codes: Bundle/example-mtls-endpoint-bundle
• This CodeSystem is not copyrighted.
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  • PDex Adjudication Codes: PDexAdjudication, PDexAdjudicationCategoryDiscriminator and PdexPriorAuthorization
  • PDex Adjudication Discriminator: PdexPriorAuthorization
  • PDex Payer Adjudication Status: PDexPayerBenefitPaymentStatus
  • PDex Supporting Info Type: PDexSupportingInfoType
• This is an example set based on ASTM Standard, E1762-95 (2013) HL7 RoleClass OID 2.16.840.1.113883.5.110, HL7 Role Code 2.16.840.1.113883.5.111, HL7 ParticipationType OID: 2.16.840.1.113883.5.90, HL7 ParticipationFunction codes at OID: 2.16.840.1.113883.5.88, and HL7 Security and Privacy Domain Analysis Model roles classes.
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  • Contract Signer Type Codes: Bundle/1000000-1, Bundle/1000000-2, Bundle/1000000-3 and Provenance/1000017
• This is an example set.
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  • Adjudication Value Codes: ExplanationOfBenefit/PDexPriorAuth1, PDexAdjudication and PdexPriorAuthorization
  • Example Diagnosis Type Codes: ExplanationOfBenefit/PDexPriorAuth1
  • Example Related Claim Relationship Codes: ExplanationOfBenefit/PDexPriorAuth1
  • Funds Reservation Codes: ExplanationOfBenefit/PDexPriorAuth1
  • Process Priority Codes: ExplanationOfBenefit/PDexPriorAuth1 and PdexPriorAuthorization
• This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
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  • LOINC: DocumentReference/123456
• This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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  • SNOMED Clinical Terms® (SNOMED CT®): Bundle/1000000-1, Bundle/1000000-2... Show 7 more, Bundle/1000000-3, Bundle/3000003, Device/543210, Encounter/6, Encounter/7, Encounter/8 and PdexDevice

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