PAS Claim item.productorservice ValueSet does not allow for NDC

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    • Type: Change Request
    • Resolution: Persuasive with Modification
    • Priority: Medium
    • US Da Vinci PAS (FHIR)
    • 1.0.0 [deprecated]
    • Financial Mgmt
    • PAS Claim
      PAS Claim Inquiry
      PAS Claim Inquiry Response
      PAS Claim Response
    • (many)
    • 9.64.1
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      #1 - Add NDC codes to the value set.

      #2 - the code system returned will tell us whether it is HC or CPT

      #3 - no need for DRG in this value set

      #4 - will need to add "not applicable" code to the value set as the productOrService element is 1..1 on the base Claim resource.  (Note that this won't be needed when the base resource is changed.)

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      #1 - Add NDC codes to the value set. #2 - the code system returned will tell us whether it is HC or CPT #3 - no need for DRG in this value set #4 - will need to add "not applicable" code to the value set as the productOrService element is 1..1 on the base Claim resource.  (Note that this won't be needed when the base resource is changed.)
    • Andy Stechishin / Mark Scrimshire: 13-0-0
    • Correction
    • Non-substantive

      The SV1-1 and SV2-1 allows for HCPCS/CPT AND NDC in the 5-4-2 format. The item.productorservice is bound to the x12 278 Requested Service Type.

      X12 278 Requested Service Type is: X12 Service Type Codes/CPT/HCPCS/ICD9/ICD10

      http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType

      #1:  No NDC codes allowed, need to add the Code Set to this Code System

      #2:  on response SVC101-01 & SV2102-01 allow HC/CPT back. There is no way to tell if HC or CPT from the 278. So, how are we gonna fix/update/deal in the future? Right now, we will ignore the URL for the Code System. Need to determine resolution for future version and add new Jira Ticket to cover, but needs to be discussed in context of this ticket.

      #3:  We’re missing MS-DRG. CARIN created one:  http://build.fhir.org/ig/HL7/carin-bb/CodeSystem-CMSMSDRG.html.  

      #4:  FOR PAS Claim Inquiry. Need to create a value set that allows for all of the codes in the X12278RequestedServiceType AND a null value of "not applicable" or 'not allowed'. In the prior authorization request the product or service is not required. The inquiry can be limited to other elements, such as Provider and Date or Provider and Service Type or Patient and dates.

      Question:  Do we need to add the STATE DRGs to this request also? New Jira ticket for CARIN4BB.

            Assignee:
            Jean Duteau
            Reporter:
            Mary Kay McDaniel
            Watchers:
            1 Start watching this issue

              Created:
              Updated:
              Resolved: