Da Vinci Prior Authorization Support (PAS) FHIR IG
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This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.0.1: STU 2) 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

: X12 278 Requested Service Type - XML Representation

Page standards status: Trial-use Maturity Level: 3

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="X12278RequestedServiceType"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This value set includes codes based on the following rules:</p><ul><li>Include these codes as defined in <a href="http://terminology.hl7.org/5.0.0/CodeSystem-data-absent-reason.html"><code>http://terminology.hl7.org/CodeSystem/data-absent-reason</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href="http://terminology.hl7.org/5.0.0/CodeSystem-data-absent-reason.html#data-absent-reason-not-applicable">not-applicable</a></td><td style="color: #cccccc">Not Applicable</td><td>There is no proper value for this element (e.g. last menstrual period for a male).</td></tr></table></li><li>Include all codes defined in <code>https://codesystem.x12.org/005010/1365</code></li><li>Include all codes defined in <a href="http://terminology.hl7.org/5.0.0/CodeSystem-CPT.html"><code>http://www.ama-assn.org/go/cpt</code></a></li><li>Include all codes defined in <code>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</code></li><li>Include all codes defined in <a href="http://terminology.hl7.org/5.0.0/CodeSystem-icd9cm.html"><code>http://terminology.hl7.org/CodeSystem/icd9cm</code></a></li><li>Include all codes defined in <a href="http://terminology.hl7.org/5.0.0/CodeSystem-icd10PCS.html"><code>http://www.cms.gov/Medicare/Coding/ICD10</code></a></li><li>Include all codes defined in <a href="http://terminology.hl7.org/5.0.0/CodeSystem-v3-ndc.html"><code>http://hl7.org/fhir/sid/ndc</code></a></li></ul></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="3">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"/>
      </extension>
    </valueInteger>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType"/>
  <version value="2.0.1"/>
  <name value="X12278RequestedServiceType"/>
  <title value="X12 278 Requested Service Type"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2023-12-01T20:58:53+00:00"/>
  <publisher value="HL7 International / Financial Management"/>
  <contact>
    <name value="HL7 International / Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/Special/committees/fm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fmlists@lists.hl7.org"/>
    </telecom>
  </contact>
  <contact>
    <name value="Jean Duteau"/>
    <telecom>
      <system value="email"/>
      <value value="mailto:jean@duteaudesign.com"/>
    </telecom>
  </contact>
  <contact>
    <name value="HL7 International / Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
  </contact>
  <description
               value="This set of codes identifies what service is being requested.  It is a combination of X12 Service Type codes, CPT (HCPCS I) and HCPCS II procedure code modifiers, ICD-9 Procedure codes, ICD-10 Procedure codes, and NDC Drug codes.  NOTE: HCPCS Level 1 Codes are the CPT codes so either code system could be used to send the codes.  When receiving the codes from an X12 system, the system returned will be HCPCS even if it was initially sent as a CPT code."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Current Procedural Terminology (CPT) is copyright 2020 American Medical Association. All rights reserved.
X12 codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions."/>
  <compose>
    <include>
      <system
              value="http://terminology.hl7.org/CodeSystem/data-absent-reason"/>
      <concept>
        <code value="not-applicable"/>
      </concept>
    </include>
    <include>
      <system value="https://codesystem.x12.org/005010/1365"/>
    </include>
    <include>
      <system value="http://www.ama-assn.org/go/cpt"/>
    </include>
    <include>
      <system
              value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
    </include>
    <include>
      <system value="http://terminology.hl7.org/CodeSystem/icd9cm"/>
    </include>
    <include>
      <system value="http://www.cms.gov/Medicare/Coding/ICD10"/>
    </include>
    <include>
      <system value="http://hl7.org/fhir/sid/ndc"/>
    </include>
  </compose>
</ValueSet>