This page is part of the Da Vinci Clinical Documentation Exchange (v2.1.0-snapshot: QA Preview) 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
Page standards status: Trial-use | Maturity Level: 1 |
{
"resourceType" : "CodeSystem",
"id" : "cdex-temp",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem cdex-temp</b></p><a name=\"cdex-temp\"> </a><a name=\"hccdex-temp\"> </a><a name=\"cdex-temp-en-US\"> </a><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp</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\">claims-processing<a name=\"cdex-temp-claims-processing\"> </a></td><td>Claim Processing</td><td><div><p>Request for data necessary from payers to support claims for services.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">preauth-processing<a name=\"cdex-temp-preauth-processing\"> </a></td><td>Pre-authorization Processing</td><td><div><p>Request for data necessary from payers to support pre-authorization for services.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">risk-adjustment<a name=\"cdex-temp-risk-adjustment\"> </a></td><td>Risk Adjustment</td><td><div><p>Request for data from payers to calculate differences in beneficiary-level risk factors that can affect quality outcomes or medical costs, regardless of the care provided.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">quality-metrics<a name=\"cdex-temp-quality-metrics\"> </a></td><td>Quality Metrics</td><td><div><p>Request for data used for aggregation, calculation and analysis, and ultimately reporting of quality measures.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">referral<a name=\"cdex-temp-referral\"> </a></td><td>Referral</td><td><div><p>Request for additional clinical information from referring provider to support performing the requested service.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">social-care<a name=\"cdex-temp-social-care\"> </a></td><td>Social Care</td><td><div><p>Request for data from payers to support the non-medical social needs of individuals, especially the elderly, vulnerable or with special needs.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">authorization-other<a name=\"cdex-temp-authorization-other\"> </a></td><td>Other Authorization</td><td><div><p>Request for data from payers for other authorization request not otherwise specified.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">care-coordination<a name=\"cdex-temp-care-coordination\"> </a></td><td>Care Coordination</td><td><div><p>Request for data from payers to create a complete clinical record for each of their members to improve care coordination and provide optimum medical care.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">documentation-general<a name=\"cdex-temp-documentation-general\"> </a></td><td>General Documentation</td><td><div><p>Request for data used from payers or providers for general documentation.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">orders<a name=\"cdex-temp-orders\"> </a></td><td>Orders</td><td><div><p>Request for additional clinical information from referring provider to support orders.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">patient-status<a name=\"cdex-temp-patient-status\"> </a></td><td>Patient Status</td><td><div><p>Requests for patient health record information from payers to support their payer member records.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">signature<a name=\"cdex-temp-signature\"> </a></td><td>Signature</td><td><div><p>Request for signatures from payers or providers on requested data.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">care-planning<a name=\"cdex-temp-care-planning\"> </a></td><td>Care Planning</td><td><div><p>Request for data from payers or providers to determine how to deliver care for a particular patient, group or community.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">social-risk<a name=\"cdex-temp-social-risk\"> </a></td><td>Social Risk</td><td><div><p>Request for data from payers or other providers to assess of social risk, establishing coded health concerns/problems, creating patient driven goals, managing interventions, and measuring outcomes.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">operations-noe<a name=\"cdex-temp-operations-noe\"> </a></td><td>Operations Not Otherwise Enumerated</td><td><div><p>Existing concepts do not define a more detailed <a href=\"https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html\">Healthcare Operations as defined by HIPAA</a>. Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">payment-noe<a name=\"cdex-temp-payment-noe\"> </a></td><td>Payment Not Otherwise Enumerated</td><td><div><p>[Existing concepts do not define a more detailed <a href=\"https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html\">Payment as defined by HIPAA</a>. Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">treatment-noe<a name=\"cdex-temp-treatment-noe\"> </a></td><td>Treatment Not Otherwise Enumerated</td><td><div><p>Existing concepts do not define a more detailed <a href=\"https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html\">Treatment as defined by HIPAA</a>. Therefore, implicit in using this code is that an implementer must supply an additional, alternate code.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">purpose-of-use<a name=\"cdex-temp-purpose-of-use\"> </a></td><td>Purpose Of Use</td><td><div><p>Purpose of use for the requested data.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">signature-flag<a name=\"cdex-temp-signature-flag\"> </a></td><td>Signature Flag</td><td><div><p>Flag to indicate whether the requested data requires a signature.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">tracking-id<a name=\"cdex-temp-tracking-id\"> </a></td><td>Tracking Id</td><td><div><p>A business identifier that ties requested attachments back to the claim or prior-authorization (referred to as the “re-association tracking control numbers”).</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">multiple-submits-flag<a name=\"cdex-temp-multiple-submits-flag\"> </a></td><td>Multiple Submits Flag</td><td><div><p>Flag to indicate whether the requested data can be submitted in multiple transactions. If true the data can be submitted in separate transactions. if false <em>all</em> the data should be submitted in a single transaction.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">service-date<a name=\"cdex-temp-service-date\"> </a></td><td>Service Date</td><td><div><p>Date of service or starting date of the service for the claim or prior authorization.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">data-request-code<a name=\"cdex-temp-data-request-code\"> </a></td><td>Data Request Code</td><td><div><p>A Task requesting data using a code.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">data-request-query<a name=\"cdex-temp-data-request-query\"> </a></td><td>Data Request Query</td><td><div><p>A Task requesting data using FHIR query syntax.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\">data-request-questionnaire<a name=\"cdex-temp-data-request-questionnaire\"> </a></td><td>Data Request Questionnaire</td><td><div><p>A Task requesting data using a data request questionnaire (<a href=\"http://hl7.org/fhir/questionnaire.html\">FHIR Questionnaire</a>).</p>\n</div></td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "trial-use"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 1
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "claims"
}
],
"url" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"identifier" : [
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.40.21.16.1"
}
],
"version" : "2.1.0-snapshot",
"name" : "CDexTempCodes",
"title" : "CDex Temporary Code System",
"status" : "active",
"experimental" : false,
"date" : "2022-12-23",
"publisher" : "HL7 International / Payer/Provider Information Exchange Work Group",
"contact" : [
{
"name" : "HL7 International / Payer/Provider Information Exchange Work Group",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/claims"
},
{
"system" : "email",
"value" : "pie@lists.hl7.org"
}
]
}
],
"description" : "Codes temporarily defined as part of the CDex implementation guide. These will eventually migrate into an officially maintained terminology (likely HL7's [UTG](https://terminology.hl7.org/codesystems.html) code systems).",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"copyright" : "Used by permission of HL7 International all rights reserved Creative Commons License",
"caseSensitive" : true,
"content" : "complete",
"concept" : [
{
"code" : "claims-processing",
"display" : "Claim Processing",
"definition" : "Request for data necessary from payers to support claims for services."
},
{
"code" : "preauth-processing",
"display" : "Pre-authorization Processing",
"definition" : "Request for data necessary from payers to support pre-authorization for services."
},
{
"code" : "risk-adjustment",
"display" : "Risk Adjustment",
"definition" : "Request for data from payers to calculate differences in beneficiary-level risk factors that can affect quality outcomes or medical costs, regardless of the care provided."
},
{
"code" : "quality-metrics",
"display" : "Quality Metrics",
"definition" : "Request for data used for aggregation, calculation and analysis, and ultimately reporting of quality measures."
},
{
"code" : "referral",
"display" : "Referral",
"definition" : "Request for additional clinical information from referring provider to support performing the requested service."
},
{
"code" : "social-care",
"display" : "Social Care",
"definition" : "Request for data from payers to support the non-medical social needs of individuals, especially the elderly, vulnerable or with special needs."
},
{
"code" : "authorization-other",
"display" : "Other Authorization",
"definition" : "Request for data from payers for other authorization request not otherwise specified."
},
{
"code" : "care-coordination",
"display" : "Care Coordination",
"definition" : "Request for data from payers to create a complete clinical record for each of their members to improve care coordination and provide optimum medical care."
},
{
"code" : "documentation-general",
"display" : "General Documentation",
"definition" : "Request for data used from payers or providers for general documentation."
},
{
"code" : "orders",
"display" : "Orders",
"definition" : "Request for additional clinical information from referring provider to support orders."
},
{
"code" : "patient-status",
"display" : "Patient Status",
"definition" : "Requests for patient health record information from payers to support their payer member records."
},
{
"code" : "signature",
"display" : "Signature",
"definition" : "Request for signatures from payers or providers on requested data."
},
{
"code" : "care-planning",
"display" : "Care Planning",
"definition" : "Request for data from payers or providers to determine how to deliver care for a particular patient, group or community."
},
{
"code" : "social-risk",
"display" : "Social Risk",
"definition" : "Request for data from payers or other providers to assess of social risk, establishing coded health concerns/problems, creating patient driven goals, managing interventions, and measuring outcomes."
},
{
"code" : "operations-noe",
"display" : "Operations Not Otherwise Enumerated",
"definition" : "Existing concepts do not define a more detailed [Healthcare Operations as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code."
},
{
"code" : "payment-noe",
"display" : "Payment Not Otherwise Enumerated",
"definition" : "[Existing concepts do not define a more detailed [Payment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code."
},
{
"code" : "treatment-noe",
"display" : "Treatment Not Otherwise Enumerated",
"definition" : "Existing concepts do not define a more detailed [Treatment as defined by HIPAA](https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/disclosures-treatment-payment-health-care-operations/index.html). Therefore, implicit in using this code is that an implementer must supply an additional, alternate code."
},
{
"code" : "purpose-of-use",
"display" : "Purpose Of Use",
"definition" : "Purpose of use for the requested data."
},
{
"code" : "signature-flag",
"display" : "Signature Flag",
"definition" : "Flag to indicate whether the requested data requires a signature."
},
{
"code" : "tracking-id",
"display" : "Tracking Id",
"definition" : "A business identifier that ties requested attachments back to the claim or prior-authorization (referred to as the “re-association tracking control numbers”)."
},
{
"code" : "multiple-submits-flag",
"display" : "Multiple Submits Flag",
"definition" : "Flag to indicate whether the requested data can be submitted in multiple transactions. If true the data can be submitted in separate transactions. if false *all* the data should be submitted in a single transaction."
},
{
"code" : "service-date",
"display" : "Service Date",
"definition" : "Date of service or starting date of the service for the claim or prior authorization."
},
{
"code" : "data-request-code",
"display" : "Data Request Code",
"definition" : "A Task requesting data using a code."
},
{
"code" : "data-request-query",
"display" : "Data Request Query",
"definition" : "A Task requesting data using FHIR query syntax."
},
{
"code" : "data-request-questionnaire",
"display" : "Data Request Questionnaire",
"definition" : "A Task requesting data using a data request questionnaire ([FHIR Questionnaire](http://hl7.org/fhir/questionnaire.html))."
}
]
}