# text.div
Generated Narrative: CodeSystem crd-coverage-detail

Properties

This code system defines the following properties for its concepts

Name | Code | URI | Type
Not Selectable | abstract | http://hl7.org/fhir/concept-properties#notSelectable | boolean

Concepts

This case-sensitive code system http://terminology.hl7.org/CodeSystem/crd-coverage-detail defines the following codes in a Is-A hierarchy:

Lvl | Code | Display | Definition | Not Selectable
1 | _limitation | Limitation details | Identifies detail codes that define limitations of coverage. (Category should be 'cat-limitation') | true
2 | allowed-quantity | Maximum quantity | Indicates limitations on the number of services/products allowed (possibly per time period). Value should be a Quantity |
2 | allowed-period | Maximum allowed period | Indicates the maximum period of time that can be covered in a single order. Value should be a Period |
1 | _decisional | Decisional details | Identifies detail codes that may impact patient and clinician decision making (Category should be 'cat-decisional') | true
2 | in-network-copay | Copay for in-network | Indicates a percentage co-pay to expect if delivered in-network. Value should be a Quantity. |
2 | out-network-copay | Copay for out-of-network | Indicates a percentage co-pay to expect if delivered out-of-network. Value should be a Quantity. |
2 | concurrent-review | Concurrent review | Additional payer-defined documentation will be required prior to claim payment. Value should be a boolean. |
2 | appropriate-use-needed | Appropriate use | Payer-defined appropriate use process must be invoked to determine coverage. Value should be a boolean. |
1 | _other | Other details | Identifies detail codes that are generally not relevant to clinicians/patients (Category should be 'cat-other') | true
2 | policy-link | Policy Link | A URL pointing to the specific portion of a payer policy, coverage agreement or similar authoritative document that provides a portion of the basis for the decision documented in the coverage-information. Value should be a url. |
1 | instructions | Instructions | Information to display to the user that gives guidance about what steps to take in achieving the recommended actions identified by this coverage-information (e.g. special instructions about requesting authorization, details about information needed, details about data retention, etc.). Value should be a string. (Category may vary.) |

# description
Codes that describe additional details related to a coverage information assertion.  These live in THO rather than the CRD specification to support adding additional concepts without putting out a new CRD release.

# copyright
This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license

# concept[].definition
Identifies detail codes that define limitations of coverage.  (Category should be 'cat-limitation')

# concept[].concept[].definition
Indicates limitations on the number of services/products allowed (possibly per time period).  Value should be a Quantity

# concept[].concept[].definition
Indicates the maximum period of time that can be covered in a single order.  Value should be a Period

# concept[].definition
Identifies detail codes that may impact patient and clinician decision making  (Category should be 'cat-decisional')

# concept[].concept[].definition
Indicates a percentage co-pay to expect if delivered in-network.  Value should be a Quantity.

# concept[].concept[].definition
Indicates a percentage co-pay to expect if delivered out-of-network.  Value should be a Quantity.

# concept[].concept[].definition
Additional payer-defined documentation will be required prior to claim payment.  Value should be a boolean.

# concept[].concept[].definition
Payer-defined appropriate use process must be invoked to determine coverage.  Value should be a boolean.

# concept[].definition
Identifies detail codes that are generally not relevant to clinicians/patients  (Category should be 'cat-other')

# concept[].concept[].definition
A URL pointing to the specific portion of a payer policy, coverage agreement or similar authoritative document that provides a portion of the basis for the decision documented in the coverage-information.  Value should be a url.

# concept[].definition
Information to display to the user that gives guidance about what steps to take in achieving the recommended actions identified by this coverage-information (e.g. special instructions about requesting authorization, details about information needed, details about data retention, etc.).  Value should be a string.  (Category may vary.)