Order Catalog Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Lab billing code and rule for vitamin D - JSON Representation

Raw json | Download

{
  "resourceType" : "ChargeItemDefinition",
  "id" : "example-lab-billing-vitamind-focus",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/uv/order-catalog/StructureDefinition/LabChargeItemDefinition"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "additional",
    "div" : "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\">\n            <p><b>Billing details for Vitamin D testing:</b></p>\n            <p>Billing code and conditions for Vitamin D testing</p>\n            <p>Coverage for this test is limited to the following situations:</p>\n            <ul>\n                <li>Suspicion of rickets</li>\n                <li>Suspicion of osteomalacia</li>\n                <li>Outpatient follow-up of adult kidney transplant recipients beyond three months after transplantation</li>\n                <li>Before and after bariatric surgery</li>\n                <li>Assessment and management of elderly patients prone to repeated falls</li>\n                <li>Compliance with Summary of Product Characteristics (SPC) of medications requiring test 1139</li>\n            </ul>\n        </div>"
  },
  "url" : "http://hl7.org/fhir/uv/order-catalog/ChargeItemDefinition/example-lab-billing-vitamind-focus",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.55.14.1"
    }
  ],
  "version" : "1.0.0",
  "title" : "Vitamin D Testing",
  "status" : "active",
  "date" : "2019-10-18",
  "publisher" : "HL7 International / Orders and Observations",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/orders"
        }
      ]
    }
  ],
  "description" : "Detailed billing properties for a 25-(OH)-Vitamin D (D2 + D3) assay.\\nThis test is billable if at least one of the targeted clinical contexts is declared by the prescriber in the test request as the value of the relevant clinical element \"reason for the test\".",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "41345002",
            "display" : "Rickets"
          }
        ],
        "text" : "Suspicion of rickets"
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "4598005",
            "display" : "Osteomalacia"
          }
        ],
        "text" : "Suspicion of osteomalacia"
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "737295003",
            "display" : "Transplanted kidney present"
          }
        ],
        "text" : "Outpatient follow-up of adult kidney transplant recipients beyond three months after transplantation"
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "707206008",
            "display" : "Assessment for bariatric surgery"
          }
        ],
        "text" : "Before and after bariatric surgery"
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "443731004",
            "display" : "Assessment using Falls Risk Assessment Scale for the Elderly"
          }
        ],
        "text" : "Assessment and management of elderly patients prone to repeated falls"
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "33633005",
            "display" : "Prescription of drug"
          }
        ],
        "text" : "Compliance with Summary of Product Characteristics (SPC) of medications requiring test 1139"
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001"
        }
      ]
    }
  ],
  "code" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/uv/order-catalog/CodeSystem/example-cpt",
        "code" : "CPTvitd",
        "display" : "25-(OH)-Vitamin D (D2 + D3) assay"
      }
    ]
  },
  "propertyGroup" : [
    {
      "priceComponent" : [
        {
          "type" : "base",
          "code" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/uv/order-catalog/CodeSystem/example-cpt",
                "code" : "B"
              }
            ]
          },
          "factor" : 35
        }
      ]
    }
  ]
}