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  1. FHIR Specification Feedback
  2. FHIR-26709

Add values to Related Claim Relationship Codes

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    Details

    • Type: Change Request
    • Status: Published (View Workflow)
    • Priority: Highest
    • Resolution: Persuasive with Modification
    • Specification:
      US CARIN Blue Button (FHIR)
    • Raised in Version:
      0.1
    • Work Group:
      Financial Mgmt
    • Related Page(s):
      (NA)
    • Related Section(s):
      4.4.1.167
    • Grouping:
    • Resolution Description:
      Hide

      Delete CARIN-BB Value Set and Code System as required.  

      Instead of adding values to the HL7 Value Set and Code System, define the following Value Set and Code System:

      Define Value Set:

       

      Defining URL: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBRelatedClaimRelationshipCodes
      Name: C4BBRelatedClaimRelationshipCodes
      Title: C4BB Related Claim Relationship Codes
      Definition: Identifies if the current claim represents a claim that has been adjusted and was given a prior claim number or if the current claim has been adjusted; i.e., replaced by or merged to another claim number.
      Copyright: This Value Set is not copyrighted. 
      Logical Definition: This value set includes codes from the following code systems:
      ·       Include the value prior from http://terminology.hl7.org/CodeSystem/ex-relatedclaimrelationship
      ·       Include all codes defined in http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBRelatedClaimRelationshipCodes
      Expansion: This value set contains 2 concepts
      Code Display Definition
      prior Prior Claim A prior claim instance for the same intended suite of services.
      replacedby Replaced by claim The current claim has been adjusted; i.e., replaced by or merged to another claim number.

       

      Bind with binding strength Required to the data element related.relationship in all profiles

       

      Define Code System: 

       

      Defining URL: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBRelatedClaimRelationshipCodes
      Name: C4BBRelatedClaimRelationshipCodes
      Title: C4BB Related Claim Relationship Codes
      Definition: Identifies if the current claim represents a claim that has been adjusted and was given a prior claim number or if the current claim has been adjusted; i.e., replaced by or merged to another claim number.
      Copyright: This Code System is not copyrighted.  
      Content:
      Code Display Definition
      replacedby Replaced by claim number The current claim has been adjusted; i.e., replaced by or merged to another claim number.
      Show
      Delete CARIN-BB Value Set and Code System as required.   Instead of adding values to the HL7 Value Set and Code System, define the following Value Set and Code System: Define Value Set:   Defining URL: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBRelatedClaimRelationshipCodes Name: C4BBRelatedClaimRelationshipCodes Title: C4BB Related Claim Relationship Codes Definition: Identifies if the current claim represents a claim that has been adjusted and was given a prior claim number or if the current claim has been adjusted; i.e., replaced by or merged to another claim number. Copyright: This Value Set is not copyrighted.  Logical Definition: This value set includes codes from the following code systems: ·       Include the value prior from http://terminology.hl7.org/CodeSystem/ex-relatedclaimrelationship ·       Include all codes defined in http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBRelatedClaimRelationshipCodes Expansion: This value set contains 2 concepts Code Display Definition prior Prior Claim A prior claim instance for the same intended suite of services. replacedby Replaced by claim The current claim has been adjusted; i.e., replaced by or merged to another claim number.   Bind with binding strength Required to the data element related.relationship in all profiles   Define Code System:    Defining URL: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBRelatedClaimRelationshipCodes Name: C4BBRelatedClaimRelationshipCodes Title: C4BB Related Claim Relationship Codes Definition: Identifies if the current claim represents a claim that has been adjusted and was given a prior claim number or if the current claim has been adjusted; i.e., replaced by or merged to another claim number. Copyright: This Code System is not copyrighted.   Content: Code Display Definition replacedby Replaced by claim number The current claim has been adjusted; i.e., replaced by or merged to another claim number.
    • Resolution Vote:
      Pat Taylor/Mark Roberts: 24-0-2
    • Change Category:
      Enhancement
    • Change Impact:
      Non-substantive

      Description

      Delete Value Set: http://hl7.org/fhir/us/carin/ValueSet/carin-bb-relatedclaimrelationship

      Delete Code System:  http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-relatedclaimrelationship

      To map EOB.related, the Common Payer Consumer Data Set defines Prior claim number and Replaced or Merged claim number.

      Update https://www.hl7.org/fhir/valueset-related-claim-relationship.html

      Existing Wording:

      Current values are the values: prior | associated.

      Proposed Wording:

      Add the value: 'replaced by or merged’

       

      Bind to the following EOB profiles:  Inpatient Facility, Outpatient Facility, Professional and Non-Clinician and Pharmacy

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              Assignee:
              Unassigned Unassigned
              Reporter:
              taylorpatriciab Patricia Taylor
              Request in-person:
              Patricia Taylor
              Watchers:
              2 Start watching this issue

                Dates

                Created:
                Updated:
                Resolved:
                Vote Date: