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  1. FHIR Specification Feedback
  2. FHIR-41172

use of "clinical" vs "dtr-clin" in CRD value sets, move of code system

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Da Vinci CRD (FHIR)
    • 1.1.0-ballot [deprecated]
    • Financial Mgmt
    • CRD Temporary Codes
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      The codes were moved to align with HL7 terminology policy.  The intention is that eventually these codes will migrate to an 'official' code system once there is sufficient implementation experience to be sure that no breaking changes will be needed.

      The following 'cardType' codes will be removed because they are now all handled by the generic "coverageInformation" card and there is no longer any expectation of control of what subset of information would be returned in coverageInformation (either you get all of it or you get none of it): coverage, documentation, auth-req, unsolicited-determ, preempt-determination, dtr-clin, dtr-admin

      A new 'coverage-info' code will be added with name "coverage information" and definition "Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection"

       

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      The codes were moved to align with HL7 terminology policy.  The intention is that eventually these codes will migrate to an 'official' code system once there is sufficient implementation experience to be sure that no breaking changes will be needed. The following 'cardType' codes will be removed because they are now all handled by the generic "coverageInformation" card and there is no longer any expectation of control of what subset of information would be returned in coverageInformation (either you get all of it or you get none of it): coverage , documentation , auth-req , unsolicited-determ , preempt-determination , dtr-clin , dtr-admin A new 'coverage-info' code will be added with name "coverage information" and definition "Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection"  
    • Bob Dieterle / Andy Stechischin : 8-0-1
    • Correction
    • Non-compatible
    • Yes

    Description

      During CRD ballot rec, the CRD code systems migrated from http://hl7.org/fhir/us/davinci-crd/2022May/CodeSystem-coverageGuidance.html (and some other places) to http://build.fhir.org/ig/HL7/davinci-crd/CodeSystem-temp.html .

       

      First I wanted to ask the question of why they moved and confirm this is intended before updating my implementation.

       

      Second, when all the values are in the same code system it becomes apparent that they are a bit inconsistent- in card types, DTR is represented as "dtr-clin" or "dtr-admin", but in guidance it's represented as "clinical" or "admin". I think it would be good to be consistent and update http://build.fhir.org/ig/HL7/davinci-crd/ValueSet-coverageGuidance.html to use "dtr-clin" and "dtr-admin".

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            Unassigned Unassigned
            kjohnsen Kyle Johnsen
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              Updated:
              Resolved: