CRDCoverageInformation

Coverage Information

activeDa Vinci CRD2.2.19 contexts

Captures assertions from a payer about the coverage rules for a service - in particular, whether it is covered and/or requires prior authorization.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
ID
ext-coverage-information
Name
CRDCoverageInformation

Context (9)

This extension can be used on the following elements:

elementAppointment
elementCommunicationRequest
elementEncounter
elementDeviceRequest
elementMedicationRequest
elementNutritionOrder
elementQuestionnaireResponse
elementServiceRequest
elementVisionPrescription
PathCard.TypeFlagsDescription
Extension
CoverageInfo
extension
:coverage1..1
S
Reference to Coverage
extension
url
fixed: coverage
value[x]
Reference
:covered1..1
S
covered | not-covered | conditional | indeterminate
extension
url
fixed: covered
value[x]
code
required
:pa-needed0..1
S
no-auth | auth-needed | satisfied | performpa | conditional | indeterminate
extension
url
fixed: pa-needed
value[x]
code
required
:doc-needed0..*
S
clinical | admin | patient | conditional | indeterminate
extension
url
fixed: doc-needed
value[x]
code
required
:doc-purpose0..*
S
withpa | withclaim | withorder | retain-doc | OTH
extension
url
fixed: doc-purpose
value[x]
code
required
:info-needed0..*
S
performer | location | timeframe | contract-window | detail-code | OTH
extension
url
fixed: info-needed
value[x]
code
required
:billingCode0..*
S
Billing code
extension
url
fixed: billingCode
value[x]
Coding
example
:reason0..*
S
Reason for assertion
extension
url
fixed: reason
value[x]
CodeableConcept
extensible
:detail0..*
S
detail for assertion
extension
:category1..1
Type of detail
extension
url
fixed: category
value[x]
code
required
:code1..1
Name of name-value pair
extension
url
fixed: code
value[x]
CodeableConcept
extensible
:value1..1
Value of name-value pair
extension
url
fixed: value
value[x]
booleanstringurlPeriodQuantity
:qualification0..1
Additional info about detail
extension
url
fixed: qualification
value[x]
string
url
fixed: detail
value[x]
:dependency0..*
S
Resources that impact this assertion
extension
url
fixed: dependency
value[x]
Reference
:questionnaire0..*
S
Questionnaire to complete
extension
url
fixed: questionnaire
value[x]
canonical
:date1..1
S
Assertion date
extension
url
fixed: date
value[x]
date
:coverage-assertion-id1..1
S
Coverage assertion trace number
extension
url
fixed: coverage-assertion-id
value[x]
string
:satisfied-pa-id0..1
S
Satisfied prior auth number
extension
url
fixed: satisfied-pa-id
value[x]
string
:contact0..*
S
Contact information
extension
url
fixed: contact
value[x]
ContactDetail
:expiry-date0..1
S
Expiration date
extension
url
fixed: expiry-date
value[x]
date
url
fixed: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
value[x]