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valuesets-EXM124_FHIR3-7.2.000-bundle.json
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valuesets-EXM124_FHIR3-7.2.000-bundle.json
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{
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"title": "Payer",
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{
"system": "http://www.phdsc.org/standards/pdfs/SourceofPaymentTypologyVersion6FINALSeptember2015.pdf",
"version": "8.0",
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"code": "1",
"display": "MEDICARE"
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{
"code": "11",
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{
"code": "111",
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{
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{
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{
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{
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{
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{
"code": "122",
"display": "Medicare Drug Benefit"
},
{
"code": "123",
"display": "Medicare Medical Savings Account (MSA)"
},
{
"code": "129",
"display": "Medicare Non-managed Care Other"
},
{
"code": "13",
"display": "Medicare Hospice"
},
{
"code": "14",
"display": "Dual Eligibility Medicare/Medicaid Organization"
},
{
"code": "19",
"display": "Medicare Other"
},
{
"code": "191",
"display": "Medicare Pharmacy Benefit Manager"
},
{
"code": "2",
"display": "MEDICAID"
},
{
"code": "21",
"display": "Medicaid (Managed Care)"
},
{
"code": "211",
"display": "Medicaid HMO"
},
{
"code": "212",
"display": "Medicaid PPO"
},
{
"code": "213",
"display": "Medicaid PCCM (Primary Care Case Management)"
},
{
"code": "219",
"display": "Medicaid Managed Care Other"
},
{
"code": "22",
"display": "Medicaid (Non-managed Care Plan)"
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{
"code": "23",
"display": "Medicaid/SCHIP"
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{
"code": "25",
"display": "Medicaid - Out of State"
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{
"code": "26",
"display": "Medicaid -- Long Term Care"
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{
"code": "29",
"display": "Medicaid Other"
},
{
"code": "291",
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{
"code": "299",
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{
"code": "3",
"display": "OTHER GOVERNMENT (Federal/State/Local) (excluding Department of Corrections)"
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{
"code": "31",
"display": "Department of Defense"
},
{
"code": "311",
"display": "TRICARE (CHAMPUS)"
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{
"code": "3111",
"display": "TRICARE Prime--HMO"
},
{
"code": "3112",
"display": "TRICARE Extra--PPO"
},
{
"code": "3113",
"display": "TRICARE Standard - Fee For Service"
},
{
"code": "3114",
"display": "TRICARE For Life--Medicare Supplement"
},
{
"code": "3115",
"display": "TRICARE Reserve Select"
},
{
"code": "3116",
"display": "Uniformed Services Family Health Plan (USFHP) -- HMO"
},
{
"code": "3119",
"display": "Department of Defense - (other)"
},
{
"code": "312",
"display": "Military Treatment Facility"
},
{
"code": "3121",
"display": "Enrolled Prime--HMO"
},
{
"code": "3122",
"display": "Non-enrolled Space Available"
},
{
"code": "3123",
"display": "TRICARE For Life (TFL)"
},
{
"code": "313",
"display": "Dental --Stand Alone"
},
{
"code": "32",
"display": "Department of Veterans Affairs"
},
{
"code": "321",
"display": "Veteran care--Care provided to Veterans"
},
{
"code": "3211",
"display": "Direct Care--Care provided in VA facilities"
},
{
"code": "3212",
"display": "Indirect Care--Care provided outside VA facilities"
},
{
"code": "32121",
"display": "Fee Basis"
},
{
"code": "32122",
"display": "Foreign Fee/Foreign Medical Program (FMP)"
},
{
"code": "32123",
"display": "Contract Nursing Home/Community Nursing Home"
},
{
"code": "32124",
"display": "State Veterans Home"
},
{
"code": "32125",
"display": "Sharing Agreements"
},
{
"code": "32126",
"display": "Other Federal Agency"
},
{
"code": "32127",
"display": "Dental Care"
},
{
"code": "32128",
"display": "Vision Care"
},
{
"code": "322",
"display": "Non-veteran care"
},
{
"code": "3221",
"display": "Civilian Health and Medical Program for the VA (CHAMPVA)"
},
{
"code": "3222",
"display": "Spina Bifida Health Care Program (SB)"
},
{
"code": "3223",
"display": "Children of Women Vietnam Veterans (CWVV)"
},
{
"code": "3229",
"display": "Other non-veteran care"
},
{
"code": "33",
"display": "Indian Health Service or Tribe"
},
{
"code": "331",
"display": "Indian Health Service -- Regular"
},
{
"code": "332",
"display": "Indian Health Service -- Contract"
},
{
"code": "333",
"display": "Indian Health Service - Managed Care"
},
{
"code": "334",
"display": "Indian Tribe - Sponsored Coverage"
},
{
"code": "34",
"display": "HRSA Program"
},
{
"code": "341",
"display": "Title V (MCH Block Grant)"
},
{
"code": "342",
"display": "Migrant Health Program"
},
{
"code": "343",
"display": "Ryan White Act"
},
{
"code": "349",
"display": "Other"
},
{
"code": "35",
"display": "Black Lung"
},
{
"code": "36",
"display": "State Government"
},
{
"code": "361",
"display": "State SCHIP program (codes for individual states)"
},
{
"code": "362",
"display": "Specific state programs (list/ local code)"
},
{
"code": "369",
"display": "State, not otherwise specified (other state)"
},
{
"code": "37",
"display": "Local Government"
},
{
"code": "371",
"display": "Local - Managed care"
},
{
"code": "3711",
"display": "HMO"
},
{
"code": "3712",
"display": "PPO"
},
{
"code": "3713",
"display": "POS"
},
{
"code": "372",
"display": "FFS/Indemnity"
},
{
"code": "379",
"display": "Local, not otherwise specified (other local, county)"
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{
"code": "38",
"display": "Other Government (Federal, State, Local not specified)"
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{
"code": "381",
"display": "Federal, State, Local not specified managed care"
},
{
"code": "3811",
"display": "Federal, State, Local not specified - HMO"
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{
"code": "3812",
"display": "Federal, State, Local not specified - PPO"
},
{
"code": "3813",
"display": "Federal, State, Local not specified - POS"
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{
"code": "3819",
"display": "Federal, State, Local not specified - not specified managed care"
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{
"code": "382",
"display": "Federal, State, Local not specified - FFS"
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{
"code": "389",
"display": "Federal, State, Local not specified - Other"
},
{
"code": "39",
"display": "Other Federal"
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{
"code": "391",
"display": "Federal Employee Health Plan - Use when known"
},
{
"code": "4",
"display": "DEPARTMENTS OF CORRECTIONS"
},
{
"code": "41",
"display": "Corrections Federal"
},
{
"code": "42",
"display": "Corrections State"
},
{
"code": "43",
"display": "Corrections Local"
},
{
"code": "44",
"display": "Corrections Unknown Level"
},
{
"code": "5",
"display": "PRIVATE HEALTH INSURANCE"
},
{
"code": "51",
"display": "Managed Care (Private)"
},
{
"code": "511",
"display": "Commercial Managed Care - HMO"
},
{
"code": "512",
"display": "Commercial Managed Care - PPO"
},
{
"code": "513",
"display": "Commercial Managed Care - POS"
},
{
"code": "514",
"display": "Exclusive Provider Organization"
},
{
"code": "515",
"display": "Gatekeeper PPO (GPPO)"
},
{
"code": "516",
"display": "Commercial Managed Care - Pharmacy Benefit Manager"
},
{
"code": "517",
"display": "Commercial Managed Care - Dental"
},
{
"code": "519",
"display": "Managed Care, Other (non HMO)"
},
{
"code": "52",
"display": "Private Health Insurance - Indemnity"
},
{
"code": "521",
"display": "Commercial Indemnity"
},
{
"code": "522",
"display": "Self-insured (ERISA) Administrative Services Only (ASO) plan"
},
{
"code": "523",
"display": "Medicare supplemental policy (as second payer)"
},
{
"code": "524",
"display": "Indemnity Insurance - Dental"
},
{
"code": "529",
"display": "Private health insurance--other commercial Indemnity"
},
{
"code": "53",
"display": "Managed Care (private) or private health insurance (indemnity), not otherwise specified"
},
{
"code": "54",
"display": "Organized Delivery System"
},
{
"code": "55",
"display": "Small Employer Purchasing Group"
},
{
"code": "56",
"display": "Specialized Stand Alone Plan"
},
{
"code": "561",
"display": "Dental"
},
{
"code": "562",
"display": "Vision"
},
{
"code": "59",
"display": "Other Private Insurance"
},
{
"code": "6",
"display": "BLUE CROSS/BLUE SHIELD"
},
{
"code": "61",
"display": "BC Managed Care"
},
{
"code": "611",
"display": "BC Managed Care -- HMO"
},
{
"code": "612",
"display": "BC Managed Care -- PPO"
},
{
"code": "613",
"display": "BC Managed Care -- POS"
},
{
"code": "614",
"display": "BC Managed Care - Dental"
},
{
"code": "619",
"display": "BC Managed Care -- Other"
},
{
"code": "62",
"display": "BC Insurance Indemnity"
},
{
"code": "621",
"display": "BC Indemnity"
},
{
"code": "622",
"display": "BC Self-insured (ERISA) Administrative Services Only (ASO)Plan"
},
{
"code": "623",
"display": "BC Medicare Supplemental Plan"
},
{
"code": "629",
"display": "BC Indemnity - Dental"
},
{
"code": "7",
"display": "MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)"
},
{
"code": "71",
"display": "HMO"
},
{
"code": "72",
"display": "PPO"
},
{
"code": "73",
"display": "POS"
},
{
"code": "79",
"display": "Other Managed Care"
},
{
"code": "8",
"display": "NO PAYMENT from an Organization/Agency/Program/Private Payer Listed"
},
{
"code": "81",
"display": "Self-pay (Includes applicants for insurance and Medicaid applicants)"
},
{
"code": "82",
"display": "No Charge"
},
{
"code": "821",
"display": "Charity"
},
{
"code": "822",
"display": "Professional Courtesy"
},
{
"code": "823",
"display": "Research/Clinical Trial"
},
{
"code": "83",
"display": "Refusal to Pay/Bad Debt"
},
{
"code": "84",
"display": "Hill Burton Free Care"
},
{
"code": "85",
"display": "Research/Donor"
},
{
"code": "89",
"display": "No Payment, Other"
},
{
"code": "9",
"display": "MISCELLANEOUS/OTHER"
},
{
"code": "91",
"display": "Foreign National"
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{
"code": "92",
"display": "Other (Non-government)"
},
{
"code": "93",
"display": "Disability Insurance"
},
{
"code": "94",
"display": "Long-term Care Insurance"
},
{
"code": "95",
"display": "Worker's Compensation"
},
{
"code": "951",
"display": "Worker's Comp HMO"
},
{
"code": "953",
"display": "Worker's Comp Fee-for-Service"
},
{
"code": "954",
"display": "Worker's Comp Other Managed Care"
},
{
"code": "959",
"display": "Worker's Comp, Other unspecified"
},
{
"code": "96",
"display": "Auto Insurance (includes no fault)"
},
{
"code": "97",
"display": "Legal Liability / Liability Insurance"
},
{
"code": "98",
"display": "Other specified but not otherwise classifiable (includes Hospice - Unspecified plan)"
},
{
"code": "99",
"display": "No Typology Code available for payment source"
},
{
"code": "9999",
"display": "Unavailable / No Payer Specified / Blank"
}
]
}
]
}
},
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"system": "urn:ietf:rfc:3986",
"value": "2.16.840.1.113883.3.464.1003.101.12.1025"
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"version": "20170504",
"name": "PreventiveCareServices-EstablishedOfficeVisit,18andUp",
"title": "Preventive Care Services - Established Office Visit, 18 and Up",
"status": "active",
"publisher": "NLM",
"compose": {
"include": [
{
"system": "http://www.ama-assn.org/go/cpt",
"version": "2018",
"concept": [
{
"code": "99395",
"display": "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years"
},
{
"code": "99396",
"display": "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years"
},
{
"code": "99397",
"display": "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older"
}
]
}
]
}
},
"request": {
"method": "PUT",
"url": "ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
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"resourceType": "ValueSet",
"id": "2.16.840.1.113883.3.560.100.2",
"url": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.560.100.2",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "2.16.840.1.113883.3.560.100.2"
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"version": "20160331",
"name": "Female",
"title": "Female",
"status": "active",
"publisher": "NLM",
"compose": {
"include": [
{
"system": "http://hl7.org/fhir/v3/AdministrativeGender",
"version": "HL7V3.0_2017-07",
"concept": [
{
"code": "F",
"display": "Female"
}
]
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}
},
"request": {
"method": "PUT",
"url": "ValueSet/2.16.840.1.113883.3.560.100.2"
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{
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"id": "2.16.840.1.113883.3.464.1003.101.12.1016",
"url": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016",
"identifier": [
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"system": "urn:ietf:rfc:3986",
"value": "2.16.840.1.113883.3.464.1003.101.12.1016"
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"version": "20180310",
"name": "HomeHealthcareServices",
"title": "Home Healthcare Services",
"status": "active",
"publisher": "NLM",
"compose": {
"include": [
{
"system": "http://www.ama-assn.org/go/cpt",
"version": "2018",
"concept": [
{
"code": "99341",
"display": "Home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low severity. Typically, 20 minutes are spent face-to-face with the patient and/or family."
},
{
"code": "99342",
"display": "Home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family."
},
{
"code": "99343",
"display": "Home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family."
},
{
"code": "99344",
"display": "Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family."
},
{
"code": "99345",
"display": "Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician attention. Typically, 75 minutes are spent face-to-face with the patient and/or family."
},
{
"code": "99347",
"display": "Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family."
},
{
"code": "99348",
"display": "Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent face-to-face with the patient and/or family."
},
{
"code": "99349",
"display": "Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family."
},
{
"code": "99350",
"display": "Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 60 minutes are spent face-to-face with the patient and/or family."
}
]
},
{
"system": "http://snomed.info/sct",
"version": "2018-03",
"concept": [
{
"code": "185460008",
"display": "Home visit request by patient (procedure)"
},
{
"code": "185462000",
"display": "Home visit request by relative (procedure)"
},
{
"code": "185466002",
"display": "Home visit for urgent condition (procedure)"
},
{
"code": "185467006",
"display": "Home visit for acute condition (procedure)"
},
{
"code": "185468001",
"display": "Home visit for chronic condition (procedure)"
},
{
"code": "185470005",
"display": "Home visit elderly assessment (procedure)"
},
{
"code": "225929007",
"display": "Joint home visit (procedure)"
},
{
"code": "315205008",
"display": "Bank holiday home visit (procedure)"
},
{
"code": "439708006",
"display": "Home visit (procedure)"
},
{
"code": "698704008",
"display": "Home visit for rheumatology service (procedure)"
},
{
"code": "704126008",
"display": "Home visit for anticoagulant drug monitoring (procedure)"
}
]
}
]
}
},
"request": {
"method": "PUT",
"url": "ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
}
},
{
"resource": {
"resourceType": "ValueSet",
"id": "2.16.840.1.113883.3.464.1003.198.12.1014",
"url": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014",
"identifier": [
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"system": "urn:ietf:rfc:3986",
"value": "2.16.840.1.113883.3.464.1003.198.12.1014"
}
],
"version": "20170504",
"name": "HysterectomywithNoResidualCervix",
"title": "Hysterectomy with No Residual Cervix",
"status": "active",
"publisher": "NLM",
"compose": {
"include": [
{
"system": "http://www.ama-assn.org/go/cpt",
"version": "1998",
"concept": [
{
"code": "56308",
"display": "Laparoscopy, surgical; with vaginal hysterectomy with or without removal of tube(s), with or without removal of ovary(s) (laparoscopic assisted vaginal hysterectomy)"
}
]
},
{
"system": "http://www.ama-assn.org/go/cpt",
"version": "2018",
"concept": [
{
"code": "51925",
"display": "Closure of vesicouterine fistula; with hysterectomy"
},
{
"code": "57540",
"display": "Excision of cervical stump, abdominal approach"
},
{
"code": "57545",
"display": "Excision of cervical stump, abdominal approach; with pelvic floor repair"
},
{
"code": "57550",
"display": "Excision of cervical stump, vaginal approach"
},
{
"code": "57555",
"display": "Excision of cervical stump, vaginal approach; with anterior and/or posterior repair"
},
{
"code": "57556",
"display": "Excision of cervical stump, vaginal approach; with repair of enterocele"
},
{
"code": "58150",
"display": "Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)"
},
{
"code": "58152",
"display": "Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch)"
},
{
"code": "58200",
"display": "Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)"
},
{
"code": "58210",
"display": "Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)"
},
{
"code": "58240",
"display": "Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof"
},
{
"code": "58260",
"display": "Vaginal hysterectomy, for uterus 250 g or less"
},
{
"code": "58262",
"display": "Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)"
},
{
"code": "58263",
"display": "Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele"
},
{
"code": "58267",
"display": "Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control"
},
{
"code": "58270",
"display": "Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele"
},
{
"code": "58275",
"display": "Vaginal hysterectomy, with total or partial vaginectomy"
},
{
"code": "58280",
"display": "Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele"
},
{
"code": "58285",
"display": "Vaginal hysterectomy, radical (Schauta type operation)"
},
{
"code": "58290",
"display": "Vaginal hysterectomy, for uterus greater than 250 g"
},
{
"code": "58291",
"display": "Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)"
},
{