• Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Da Vinci CRD (FHIR)
    • 1.1.0 [deprecated]
    • Financial Mgmt
    • Coverage Information
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      Make these changes

      Make these changes
    • Bob Dieterle / Rachael Foerster : 10-0-0
    • Enhancement
    • Compatible, substantive
    • Yes


      Addresses part of FHIR-42697.

      In some cases, orders may be issued well in advance of a performance date (e.g. as part of a sequence of orders where some happen sooner and others happen after the initial therapy is complete).  In some situations, the performance timeline may be outside the contractual window of the coverage the patient currently has, and therefore assertions around coverage, prior authorization, etc. will not be possible.

      We need to do two things:

      1. Add a new code to the Coverage Information info-needed value set  called "new-contract-window" with the definition "The target performance time for the event falls outside the contract window for the patient's current coverage.  Information will not be available until a contract is in place covering the service time period."
      2. On the Deviations page, add to the existing sentence "This IG adopts the newer wording, meaning that the order-sign hook can be triggered both on newly created orders, as well as when orders are updated (changing status, changing time-frame, etc.)." this additional sentence: "The hook can also be re-triggered if there is a key change to the context, most typically the establishment of new or renewed coverage relevant to the order."




            Unassigned Unassigned
            lloyd Lloyd McKenzie
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