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

CodeSystem: PDex Supporting Info Type

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

Copyright/Legal: This CodeSystem is not copyrighted.

Claim Information Category - Used as the discriminator for supportingInfo

This Code system is referenced in the content logical definition of the following value sets:

This code system http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoType defines the following codes:

CodeDisplayDefinition
admissionperiod Admission PeriodDates corresponding with the admission and discharge of the beneficiary to a facility
pointoforigin Point Of OriginUB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility.
admtype Admission 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.
billingnetworkcontractingstatus Billing Network Contracting StatusIndicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission.
brandgenericindicator Brand Generic IndicatorNCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug.
clmrecvddate Claim Received DateDate the claim was received by the payer.
compoundcode Compound CodeNCPDP code indicating whether or not the prescription is a compound.
dawcode DAW (Dispense As Written) CodeNCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.
dayssupply Days SupplyNCPDP value indicating the Number of days supply of medication dispensed by the pharmacy.
discharge-status Discharge StatusUB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay.
drg DRGDRG (Diagnosis Related Group), including the code system, the DRG version and the code value
performingnetworkcontractingstatus Performing Network Contracting StatusIndicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission.
refillnum Refill NumberNCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)
rxorigincode Rx Origin CodeNCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy.
servicefacility Service FacilityThe facility where the service occurred. Examples include hospitals, nursing homes, laboratories or homeless shelters.
typeofbill Type of BillUB-04 Type of Bill (FL-04) provides specific information for payer purposes.
medicalrecordnumber Medical Record NumberPatient Medical Record Number associated with the specific claim.
patientaccountnumber Patient Account NumberPatient Account Number associated with the specific claim.