Details
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Change Request
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Resolution: Persuasive with Modification
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Medium
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US Da Vinci DTR (FHIR)
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1.1.0-ballot [deprecated]
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Clinical Decision Support
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Use Cases and Overview
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Bob Dieterle / Isaac Vetter : 11-0-0
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Clarification
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Non-substantive
Description
From the coverageGuidance value set, one can see that it is possible for the coverage determination itself to not be completed without further information, including potentially a DTR questionnaire:
Code | Display | Definition |
not-covered | Not covered | no coverage or possibility of coverage for this service) |
covered | Covered | regular coverage applies |
prior-auth | Prior authorization | coverage is possible with prior authorization |
clinical | Clinical | clinical details are required to determine coverage/prior auth applicability - e.g. via DTR by clinician |
admin | Admin | administrative details are required to determine coverage/prior auth applicability - e.g. via DTR by clinician |
This is a separate use of DTR than prior auth. This variant of the DTR workflow needs to be called out in the DTR spec's Use Cases.
Attachments
Issue Links
- is voted on by
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BALLOT-32427 Negative - Christopher Schaut : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33244 Negative - Daniel Rutz : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33266 Negative - Thanos Tsiolis : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33288 Negative - Chris Courville : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33332 Negative - Daniel Zhang : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33354 Negative - Michael Clifton : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33376 Negative - David Sundaram-Stukel : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33398 Negative - Isaac Vetter : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33420 Negative - Amit Popat : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33442 Negative - Cooper Thompson : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33464 Negative - Danielle Friend : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33486 Negative - Vassil Peytchev : 2022-May-FHIR IG DTR R2 STU
- Withdrawn
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BALLOT-33310 Negative - Peter DeVault : 2022-May-FHIR IG DTR R2 STU
- Balloted
- mentioned in
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