Release 4 Snapshot 3: Connectathon 32 Base

This page is part of the Snapshot #3 for FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). The current version which supercedes this version is 5.0.0 R5 , released to support Connectathon 32 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Using Codes Code Systems Value Sets Concept Maps Identifier Systems 4.4.1.316 Value Set http://hl7.org/fhir/ValueSet/supplement-type

Example Claim/MED-00050 (XML)

Source Resource XML / JSON
Orders and Observations Financial Management Work Group   Maturity Level : 1 N/A Draft Use Context Standards Status : Any This is a value set defined by the FHIR project. Summary Defining URL: http://hl7.org/fhir/ValueSet/supplement-type Version: 4.0.1 Name: SupplementTypeCodes Title: Supplement Type Codes Definition: SupplementType : Codes for nutritional supplements to be provided to the patient. This value set is composed of SNOMED CT (US Extension) Concepts from SCTID 470581016 (Enteral+supplement feeds hierarchy (product)) and is provided as a suggestive example. Committee: Informative Orders and Observations Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson Work Group OID: 2.16.840.1.113883.4.642.3.390 (for OID based terminology systems) Copyright: This resource includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyright of the International Health Terminology Standards Development Organisation (IHTSDO). Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org
This value set is used in the following places: Resource: NutritionOrder.supplement.type (CodeableConcept / Example ) 4.4.1.316.1 Content Logical Definition This value set includes codes from the following code systems:
  • Include these codes as defined in http://snomed.info/sct Code Display 442901000124106 Adult clear liquid supplement 443031000124106 Adult critical care formula 443051000124104 Adult diabetes specialty formula 442911000124109 Adult elemental formula 443021000124108 Adult hepatic specialty formula 442971000124100 Adult high energy formula 442981000124102 Adult hydrolyzed protein formula 442991000124104 Adult high protein formula 443011000124100 Adult high protein high fiber formula 442961000124107 Adult low carbohydrate formula 442951000124105 Adult pulmonary specialty formula 442941000124108 Adult renal specialty formula 442921000124101 Adult standard formula 442931000124103 Adult soy protein isolate formula 444331000124106 Diabetic meal replacement bar 443361000124100 Pediatric Formula 443391000124108 Pediatric clear liquid supplement 443401000124105 Pediatric elemental formula 443491000124103 Pediatric high energy formula 443501000124106 Pediatric high energy formula with increased fiber 443421000124100 Pediatric hydrolyzed protein formula 443471000124104 Pediatric increased fiber formula 444431000124104 Pediatric reduced energy formula 443451000124109 Pediatric standard formula 444321000124108 Standard pudding oral supplement 441561000124106 Standard enteral formula with fiber 443461000124106 Standard Formula 441531000124102 Standard Enteral Formula 443561000124107 Soy based formula 443481000124101 Renal Formula 441571000124104 High energy enteral formula with fiber 441591000124103 Diabetic enteral formula with fiber 441601000124106 Diabetic high calorie high protein enteral formula with fiber 443351000124102 Increased fiber formula 443771000124106 Hydrolyzed protein formula 441671000124100 Narrative Hydrolyzed peptide-based high protein enteral formula
    • 443111000124101
  • XML High protein formula
    • 443431000124102
  • JSON High Energy Formula
    • 443411000124108
  • TTL Elemental Formula 444361000124102

Raw XML Electrolyte replacement supplement 444401000124107 ( canonical form Frozen electrolyte replacement supplement 444381000124107 + also see XML Format Specification )

Liquid electrolyte replacement supplement 444371000124109 Jump past Narrative Powdered electrolyte replacement supplement 443441000124107

Simple US Medical Surgery Claim (id = "MED-00050") 


<?xml version="1.0" encoding="UTF-8"?>

<Claim xmlns="http://hl7.org/fhir">
  <id value="MED-00050"/> 


  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of a CMS 1500 Claim</div> 
  </text> 


  <contained> 
    <Patient> 
      <id value="patient-1"/> 
      <name> 
        <use value="official"/> 
        <family value="Ashcraft"/> 
        <given value="Alvina"/> 
      </name> 
      <gender value="female"/> 
      <birthDate value="1954-06-11"/> 
      <address> 
        <use value="home"/> 
        <line value="123 Main Street"/> 
        <city value="Portland"/> 
        <state value="OR"/> 
        <postalCode value="97125"/> 
        <country value="USA"/> 
      </address> 
    </Patient> 
  </contained> 


  <contained> 
    <Coverage> 
      <id value="coverage-1"/> 


      <identifier> 
        <system value="http://benefitsinc.com/certificate"/> 
        <value value="10138556"/> 
      </identifier> 


      <status value="active"/> 


      <kind value="insurance"/> 

      
      <type> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/> 
          <code value="HIP"/> 
          <display value="health insurance plan policy"/> 
        </coding> 
      </type> 


      <subscriber> 
        <reference value="#patient-1"/> 
      </subscriber> 


      <beneficiary> 
        <reference value="#patient-1"/> 
      </beneficiary> 


      <relationship> 
        <coding> 
          <code value="self"/> 
        </coding> 
      </relationship> 


      <period> 
        <start value="2015-01-01T00:00:00-07:00"/> 
        <end value="2016-01-01T00:00:00-07:00"/> 
      </period> 


      <insurer> 
        <identifier> 
          <system value="http://www.bindb.com/bin"/> 
          <value value="123456"/>   
        </identifier> 
        <display value="Humana Inc."/> 
      </insurer> 


      <class> 
        <type> 
          <coding> 
            <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/> 
            <code value="group"/> 
          </coding> 
        </type> 
        <value> 
          <value value="80902206"/> 
        </value> 
      </class> 


    </Coverage> 
  </contained> 


  <identifier> 
    <system value="http://CedarArmsMedicalCenter.com/claim"/> 
    <value value="MED-00050"/> 
  </identifier> 


  <status value="active"/> 


  <type> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/> 
      <code value="institutional"/> 
    </coding> 
  </type> 


  <subType> 
    <coding> 
      <system value="https://www.cms.gov/codes/billtype"/> 
      <code value="831"/> 
      <display value="Hospital Outpatient Surgery performed in an Ambulatory ​Surgical Center"/> 
    </coding> 
  </subType> 


  <use value="claim"/> 


  <patient> 
    <reference value="#patient-1"/> 
  </patient> 


  <created value="2015-10-16T00:00:00-07:00"/> 


  <insurer> 
    <identifier> 
      <system value="http://www.bindb.com/bin"/> 
      <value value="123456"/> 
    </identifier> 
    <display value="Humana Inc."/> 
  </insurer> 


  <provider> 
    <reference value="Organization/1"/> 
  </provider> 


  <priority> 
    <coding> 
      <code value="normal"/> 
    </coding> 
  </priority> 


  <payee> 
    <type> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/payeetype"/> 
        <code value="provider"/> 
      </coding> 
    </type> 
    <party> 
      <reference value="Organization/1"/> 
    </party> 
  </payee> 


  <careTeam> 
    <sequence value="1"/> 
    <provider> 
      <reference value="Practitioner/example"/> 
    </provider> 
  </careTeam> 


  <supportingInfo> 
    <sequence value="1"/> 
    <category> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/claiminformationcategory"/> 
        <code value="hospitalized"/> 
      </coding> 
    </category> 
    <timingPeriod> 
      <start value="2015-10-01T00:00:00-07:00"/> 
      <end value="2015-10-05T00:00:00-07:00"/> 
    </timingPeriod> 
  </supportingInfo> 


  <supportingInfo> 
    <sequence value="2"/> 
    <category> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/claiminformationcategory"/> 
        <code value="discharge"/> 
      </coding> 
    </category> 
    <code> 
      <coding> 
        <system value="https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/d

        ownloads/SE0801.pdf"/> 
        <code value="01"/> 
        <display value="Discharge to Home or Self Care"/> 
      </coding> 
    </code> 
  </supportingInfo> 


  <diagnosis> 
    <sequence value="1"/> 
    <diagnosisCodeableConcept> 
      <coding> 
        <system value="http://hl7.org/fhir/sid/icd-10-cm"/> 
        <code value="M96.1"/> 
        <display value="Postlaminectomy syndrome, not elsewhere classified"/> 
      </coding> 
    </diagnosisCodeableConcept> 
  </diagnosis> 


  <diagnosis> 
    <sequence value="2"/> 
    <diagnosisCodeableConcept> 
      <coding> 
        <system value="http://hl7.org/fhir/sid/icd-10-cm"/> 
        <code value="G89.4"/> 
        <display value="Chronic pain syndrome"/> 
      </coding> 
    </diagnosisCodeableConcept> 
  </diagnosis> 


  <diagnosis> 
    <sequence value="3"/> 
    <diagnosisCodeableConcept> 
      <coding> 
        <system value="http://hl7.org/fhir/sid/icd-10-cm"/> 
        <code value="M53.88"/> 
        <display value="Other specified dorsopathies, sacral and sacrococcygeal region"/> 
      </coding> 
    </diagnosisCodeableConcept> 
  </diagnosis> 


  <diagnosis> 
    <sequence value="4"/> 
    <diagnosisCodeableConcept> 
      <coding> 
        <system value="http://hl7.org/fhir/sid/icd-10-cm"/> 
        <code value="M47.816"/> 
        <display value="Spondylosis without myelopathy or radiculopathy, lumbar region"/> 
      </coding> 
    </diagnosisCodeableConcept> 
  </diagnosis> 


  <insurance> 
    <sequence value="1"/> 
    <focal value="true"/> 
    <identifier> 
      <system value="http://CedarArmsMedicalCenter.com/claim"/> 
      <value value="MED-00050"/> 
    </identifier>     <coverage> 
      <reference value="#coverage-1"/> 
    </coverage> 
  </insurance> 


  <item> 
    <sequence value="1"/> 
    <careTeamSequence value="1"/> 
    <diagnosisSequence value="2"/> 
    <diagnosisSequence value="4"/> 
    <informationSequence value="1"/> 
    <productOrService> 
      <coding> 
        <system value="http://www.ama-assn.org/go/cpt"/> 
        <code value="62264"/> 
        <display value="Surgical Procedures on the Spine and Spinal Cord"/> 
      </coding> 
    </productOrService> 
    <servicedDate value="2015-10-13"/> 
    <locationCodeableConcept> 
      <coding> 
        <system value="https://www.cms.gov/medicare/coding/place-of-service-codes/place_of_service_code_set.html"/> 
        <code value="24"/> 
        <display value="Ambulatory Surgical Center"/> 
      </coding> 
    </locationCodeableConcept> 
    <unitPrice> 
      <value value="12500.00"/> 
      <currency value="USD"/>  
    </unitPrice>  


    <net> 
      <value value="12500.00"/> 
      <currency value="USD"/>  
    </net>  
  </item> 


  <total> 
    <value value="12500.00"/> 
    <currency value="USD"/>  
  </total>  




</

Claim


>

Clear
liquid
supplement
442651000124102



Adult
formula

  See the full registry of value sets defined as part of FHIR. Explanation of the columns that may appear on this page: Lvl A few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used Usage note: every effort has been made to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information Source The source of the definition of the code (when the value set draws in codes defined elsewhere) Code The code (used as the code in the resource instance). If the code is in italics, this indicates ensure that the code is examples are correct and useful, but they are not selectable ('Abstract') Display The display (used in the display element of a Coding ). If there is no display, implementers should not simply display the code, but map the concept into their application Definition An explanation of the meaning normative part of the concept Comments Additional notes about how to use the code specification.