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Type:
Change Request
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Resolution: Persuasive with Modification
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Priority:
Highest
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US CARIN Blue Button (FHIR)
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0.1 [deprecated]
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Financial Mgmt
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(NA)
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4.4.1.182
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Mark Roberts/Mark Schrimshire: 20-0-2
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Correction
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Compatible, substantive
Definitions of the Claim Type codes do not align with industry claims submissions standards.
Replace the definitions of the following codes in Code System http://terminology.hl7.org/CodeSystem/claim-type with the following:
– institutional: Claims submitted by clinics, hospitals, skilled nursing facilities, and other institutional providers
– professional: Claims submitted by physicians, suppliers, and other non-institutional providers
– pharmacy: Claims submitted by retail pharmacies
The updates do not change the meaning of the codes but add clarity to their content.
2) Bind EOB.type of CARINBBExplanationOfBenefit profile to ValueSet "http://hl7.org/fhir/ValueSet/claim-type" with binding strength required
3) Set EOB.type of "Inpatient Facility" and "Outpatient Facility" profiles to the fixed code "institutional", "Pharmacy" profile to the fixed code "pharmacy" and "Professional and Non-Clinician" profile to the fixed codes "professional"
4) Delete CARIN Blue Button Claim Type Value Set
5) Delete CARIN Blue Button Claim Type Code System
- is voted on by
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BALLOT-12238 Negative - Lenel James : 2020-Feb-BLUEBUTTON R1 STU
- Balloted
- relates to
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FHIR-26777 Page 17: The existing type codes should be used with an extension or subtype to indicate inpatient or outpatient if needed
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- Published
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FHIR-26706 The Terminology Section of the IG requires a major overhaul, renaming the Value Sets and Code Systems and updating links
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- Published
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