Da Vinci Payer Data Exchange
2.0.0-ballot - ballot US

This page is part of the Da Vinci Payer Data Exchange (v2.0.0-ballot: STU2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

ValueSet: PDex SupportingInfo Type

Official URL: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexSupportingInfoType Version: 2.0.0-ballot
Active as of 2022-02-18 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

This value set contains 18 concepts

Expansion based on PDex Supporting Info Type v2.0.0-ballot (CodeSystem)

All codes in this table are from the system http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoType

CodeDisplayDefinition
admissionperiodAdmission PeriodDates corresponding with the admission and discharge of the beneficiary to a facility
pointoforiginPoint Of OriginUB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility.
admtypeAdmission 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.
billingnetworkcontractingstatusBilling Network Contracting StatusIndicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission.
brandgenericindicatorBrand Generic IndicatorNCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug.
clmrecvddateClaim Received DateDate the claim was received by the payer.
compoundcodeCompound CodeNCPDP code indicating whether or not the prescription is a compound.
dawcodeDAW (Dispense As Written) CodeNCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.
dayssupplyDays SupplyNCPDP value indicating the Number of days supply of medication dispensed by the pharmacy.
discharge-statusDischarge StatusUB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay.
drgDRGDRG (Diagnosis Related Group), including the code system, the DRG version and the code value
performingnetworkcontractingstatusPerforming Network Contracting StatusIndicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission.
refillnumRefill NumberNCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)
rxorigincodeRx Origin CodeNCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy.
servicefacilityService FacilityThe facility where the service occurred. Examples include hospitals, nursing homes, laboratories or homeless shelters.
typeofbillType of BillUB-04 Type of Bill (FL-04) provides specific information for payer purposes.
medicalrecordnumberMedical Record NumberPatient Medical Record Number associated with the specific claim.
patientaccountnumberPatient 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