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  1. FHIR Specification Feedback
  2. FHIR-29789

Update US Core Procedure with latest mappings from CPCDS and CARIN Blue Button

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Da Vinci PDex (FHIR)
    • 0.1 [deprecated]
    • Financial Mgmt
    • US Core Procedure
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      Updates applied to CPCDS Mapping table for Procedure:

      1. a)  Procedure Code Modifiers:  These accompany procedure codes to clarify, for example, right knee vs left knee.  They’re available in  ExplanationOfBenefit.item.modifiers.  Data element name is Procedure Code Modifier - CPT / HCPCS, Map ID is 41
      2. b)  Dates of service:  ExplanationOfBenefit.item.serviced.servicedPeriod or ExplanationOfBenefit.item.serviced.servicedDate.  Data element names are Service (from) date and Service to date; MapIDs are 90, 119
      3. c)  A Place of Service is coded for professional claims; it may be of value:  ExplanationOfBenefit.item.location. locationCodeableConcept.  Data element name is Place of service code; MapID is 46
      4. d)  A Service Facility is coded for professional claims; it may be of value:  ExplanationOfBenefit.item.supportingInfo.location. locationCodeableConcept.  Map ID is 97, 170, 176, data element names are Service Facility NPI (if available), Name and Address

       

       

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      Updates applied to CPCDS Mapping table for Procedure: a)  Procedure Code Modifiers:  These accompany procedure codes to clarify, for example, right knee vs left knee.  They’re available in  ExplanationOfBenefit.item.modifiers.  Data element name is Procedure Code Modifier - CPT / HCPCS, Map ID is 41 b)  Dates of service:  ExplanationOfBenefit.item.serviced.servicedPeriod or ExplanationOfBenefit.item.serviced.servicedDate.  Data element names are Service (from) date and Service to date; MapIDs are 90, 119 c)  A Place of Service is coded for professional claims; it may be of value:  ExplanationOfBenefit.item.location. locationCodeableConcept.  Data element name is Place of service code; MapID is 46 d)  A Service Facility is coded for professional claims; it may be of value:  ExplanationOfBenefit.item.supportingInfo.location. locationCodeableConcept.  Map ID is 97, 170, 176, data element names are Service Facility NPI (if available), Name and Address    
    • Bob Dieterle / Chris Johnson: 12-0-1
    • Clarification
    • Non-substantive
    • Yes
    • 1.0.0

    Description

      Update US Core Procedure with latest mappings from CPCDS and CARIN Blue Button

      Procedure Code:  The table below refers to the ICD Procedures.  These are only used for Inpatient Facility claims.  What is missing are the CPT / HCPCS codes.  They’re available in

      ExplanationOfBenefit.item.productOrService.  Data element name is Procedure Code - CPT / HCPCS, Map ID is 40.

      1. a)  Procedure Code Modifiers:  These accompany procedure codes to clarify, for example, right knee vs left knee.  They’re available in  ExplanationOfBenefit.item.modifiers.  Data element name is Procedure Code Modifier - CPT / HCPCS, Map ID is 41
      2. b)  Dates of service:  ExplanationOfBenefit.item.serviced.servicedPeriod or ExplanationOfBenefit.item.serviced.servicedDate.  Data element names are Service (from) date and Service to date; MapIDs are 90, 119
      3. c)  A Place of Service is coded for professional claims; it may be of value:  ExplanationOfBenefit.item.location. locationCodeableConcept.  Data element name is Place of service code; MapID is 46
      4. d)  A Service Facility is coded for professional claims; it may be of value:  ExplanationOfBenefit.item.supportingInfo.location. locationCodeableConcept.  Map ID is 97, 170, 176, data element names are Service Facility NPI (if available), Name and Address

       

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