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 CRD (FHIR)
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current
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Financial Mgmt
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Coverage Information
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Bob Dieterle / Andy Stechischin : 8-0-1
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Enhancement
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Non-compatible
Description
separate coverageinfo into multiple elements as described below
add new value to reason
add new ID for satisfied PA
| Element | Value Set | Card | MS | |||
| Covered | no | yes | conditional | 1..1 | MS | |
| PA | no | yes | satisfied | performing | 0..1 | MS |
| Doc | no | clinical | admin | both | 0..1 | MS |
| Perform | no | yes | 0..1 | MS | ||
| Detailcode | add to reason | |||||
| Unique ID | for order | |||||
| Unique ID | for Determination PA not required | |||||
| performing | Must be requested by the performing provider | |||||
| Perform | requires perfroming provider, location, and/or date | |||||
| Yes only allowed if Covered is conditional | ||||||
| Detailcode | need detail code to make determination | |||||
| Yes only allowed if Covered is conditional | ||||||
| Add to reason value set | ||||||
| Need invariants (partial list) | ||||||
| if Covered = no, PA = no | ||||||
| if Covered = yes, Perform = no | ||||||
| if PA = satisfied, Doc = no | ||||||
| if PA = satisfied, Perform = no |