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  Agenda Outline

Recap

                                                                                                                                                            



Dental and Vision Update

  • Dental mapping will be ready for review during the 9/24 call

Examples Update

  • We will incorporate all the great work done on Examples at the Connectathon into the IG

Status of CARIN BB WG Ballot Reconciliation

                                                                                       

  • On Monday's call we reviewed tickets in Block-Vote-3a, 3c, and most of 3f
  • Today we reviewed two of the three remaining tickets in 3f
    • FHIR-27013 - Define CARIN BB Care Team Role Value Sets

      • We will hold pending confirmation by David Riddle and Gail Kocher

    • FHIR-28482 - Define a Value Set to be used as the discriminator for supportingInfo
    • Proposed Disposition:

      • Define Value Set:

         

        Defining URL:http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBSupportingInfoType
        Name:C4BBSupportingInfoType
        Title:C4BB Supporting Info Type
        Definition:Used as the discriminator for the types of supporting information
        Copyright:This Value Set is not copyrighted. 
        Logical Definition:This value set includes all codes from the following code systems:
        ·       Include all codes defined in http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType



        This Value Set is a discriminator for supportingInfo slices.  Binding to a data element is not required. 

        Define Code System: 

         

        Defining URL:http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBSupportingInfoType
        Name:C4BBSupportingInfoType
        Title:C4BB Supporting Info Type
        Definition:Used as the discriminator for the types of supporting information
        Copyright:This Code System is not copyrighted.  
        Content:
        CodeDisplayDefinition
        admissionperiodAdmission PeriodDates corresponding with the admission and discharge of the beneficiary to a facility
        pointoforiginPoint Of OriginUB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility.
        admtypeAdmission TypeUB-04 Priority of the admission (FL-14) indicates, for example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled.
        billingnetworkcontractingstatusBilling Network Contracting StatusIndicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission.
        brandgenericcodeBrand Generic CodeNCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug.
        clmrecvddateClaim Received DateDate the claim was received by the payer.
        compoundcodeCompound CodeNCPDP code indicating whether or not the prescription is a compound. 
        dawcodeDAW (Dispense As Written) CodeNCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.
        dayssupplyDays SupplyNCPDP value indicating the Number of days supply of medication dispensed by the pharmacy.
        discharge-statusDischarge StatusUB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay.
        drgDRGDRG (Diagnosis Related Group), including the code system, the DRG version and the code value
        performingnetworkcontractingstatusPerforming Network Contracting StatusIndicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission.
        refillnumRefill NumberNCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)
        rxorigincodeRx Origin CodeNCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy.
        servicefacilityService FacilityThe facility where the service occurred.  Examples include hospitals, nursing homes, laboratories or homeless shelters. 
        typeofbillType Of BillUB-04 Type of Bill (FL-04) provides specific information for payer purposes.


  • FHIR-28532 - Define a Code System to discriminate the slicing in the item.adjudication and adjudication fields
    • Proposed Disposition

      • Define Code System:  

        Defining URL:http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator
        Name:C4BBAdjudicationDiscriminator
        Title:C4BB Adjudication Discriminator
        Definition:Used as the discriminator for the data elements in adjudication and item.adjudication
        Copyright:This Code System is not copyrighted.  
        Content:
        CodeDisplayDefinition
        allowedunitsallowed unitsdefines the adjudication slice to define allowed units
        inoutnetworkin or out networkdefines the adjudication and item.adjudication slice to indicate whether a claim was adjudicatd in or out of network
        denialreasondenial reasondefines the adjudication slice to identify the denial reason


        A value set is not required to constrain the value of adjudication.category and item.adjudication in the abstract profile as it unnecessarily would over constrain its use. 

  • Remaining tickets

    • 8 tickets remain to be reviewed and we will look to have these ready for review next week.

    •