bonnie_bundler 2.0.3 → 2.1.0
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- checksums.yaml +4 -4
- data/Gemfile +1 -1
- data/Gemfile.lock +6 -6
- data/bonnie-bundler.gemspec +1 -1
- data/lib/bonnie_bundler.rb +1 -0
- data/lib/measures/loading/cql_loader.rb +25 -12
- data/lib/measures/loading/exceptions.rb +0 -2
- data/lib/measures/loading/value_set_loader.rb +77 -97
- data/lib/util/vsac_api.rb +274 -0
- data/test/fixtures/PVC2_v5_4_Unused_Support_Libraries.zip +0 -0
- data/test/fixtures/vcr_cassettes/valid_vsac_response_pvc_unused_libraries.yml +4286 -0
- data/test/fixtures/vcr_cassettes/vs_loading_500_response.yml +633 -0
- data/test/fixtures/vcr_cassettes/vs_loading_empty_concept_list.yml +174 -0
- data/test/fixtures/vcr_cassettes/vs_loading_meausre_defined_no_backup_profile.yml +1237 -0
- data/test/fixtures/vcr_cassettes/vs_loading_release.yml +17035 -0
- data/test/fixtures/vcr_cassettes/vsac_auth_bad_credentials.yml +57 -0
- data/test/fixtures/vcr_cassettes/vsac_auth_bad_ticket.yml +57 -0
- data/test/fixtures/vcr_cassettes/vsac_auth_good_credentials.yml +57 -0
- data/test/fixtures/vcr_cassettes/vsac_auth_good_credentials_and_simple_call.yml +177 -0
- data/test/fixtures/vcr_cassettes/vsac_util_get_profiles.yml +74 -0
- data/test/fixtures/vcr_cassettes/vsac_util_get_program_details_CMS_Hybrid.yml +57 -0
- data/test/fixtures/vcr_cassettes/vsac_util_get_program_details_CMS_eCQM.yml +64 -0
- data/test/fixtures/vcr_cassettes/vsac_util_get_program_details_HL7_C-CDA.yml +58 -0
- data/test/fixtures/vcr_cassettes/vsac_util_get_program_details_invalid.yml +53 -0
- data/test/fixtures/vcr_cassettes/vsac_util_get_programs.yml +64 -0
- data/test/fixtures/vcr_cassettes/vsac_vs_include_draft_no_profile.yml +57 -0
- data/test/fixtures/vcr_cassettes/vsac_vs_include_draft_with_profile.yml +177 -0
- data/test/fixtures/vcr_cassettes/vsac_vs_no_options.yml +177 -0
- data/test/fixtures/vcr_cassettes/vsac_vs_not_found.yml +164 -0
- data/test/fixtures/vcr_cassettes/vsac_vs_release.yml +4802 -0
- data/test/fixtures/vcr_cassettes/vsac_vs_version.yml +370 -0
- data/test/test_helper.rb +9 -4
- data/test/unit/cql_loader_test.rb +42 -15
- data/test/unit/load_mat_export_test.rb +10 -13
- data/test/unit/measure_complexity_test.rb +1 -1
- data/test/unit/measure_diff_test.rb +4 -4
- data/test/unit/storing_mat_export_package_test.rb +1 -1
- data/test/unit/value_set_loading_test.rb +58 -16
- data/test/unit/vsac_api_auth_test.rb +129 -0
- data/test/unit/vsac_api_test.rb +77 -0
- data/test/unit/vsac_api_util_test.rb +139 -0
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<ns0:Concept code="59400" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care"/>
|
338
|
+
<ns0:Concept code="59510" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Routine obstetric care including antepartum care, cesarean delivery, and postpartum care"/>
|
339
|
+
<ns0:Concept code="59610" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery"/>
|
340
|
+
<ns0:Concept code="59618" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery"/>
|
341
|
+
<ns0:Concept code="63547008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMEDCT" codeSystemVersion="2018-03" displayName="Caloric vestibular test with recording (procedure)"/>
|
342
|
+
<ns0:Concept code="66902005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMEDCT" codeSystemVersion="2018-03" displayName="Ophthalmic examination and evaluation, follow-up (procedure)"/>
|
343
|
+
<ns0:Concept code="78318003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMEDCT" codeSystemVersion="2018-03" displayName="History and physical examination, annual for health maintenance (procedure)"/>
|
344
|
+
<ns0:Concept code="83607001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMEDCT" codeSystemVersion="2018-03" displayName="Gynecologic examination (procedure)"/>
|
345
|
+
<ns0:Concept code="8411005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMEDCT" codeSystemVersion="2018-03" displayName="Interactive individual medical psychotherapy (regime/therapy)"/>
|
346
|
+
<ns0:Concept code="86013001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMEDCT" codeSystemVersion="2018-03" displayName="Periodic reevaluation and management of healthy individual (procedure)"/>
|
347
|
+
<ns0:Concept code="90526000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMEDCT" codeSystemVersion="2018-03" displayName="Initial evaluation and management of healthy individual (procedure)"/>
|
348
|
+
<ns0:Concept code="90791" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Psychiatric diagnostic evaluation"/>
|
349
|
+
<ns0:Concept code="90792" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Psychiatric diagnostic evaluation with medical services"/>
|
350
|
+
<ns0:Concept code="90832" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Psychotherapy, 30 minutes with patient"/>
|
351
|
+
<ns0:Concept code="90834" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Psychotherapy, 45 minutes with patient"/>
|
352
|
+
<ns0:Concept code="90837" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Psychotherapy, 60 minutes with patient"/>
|
353
|
+
<ns0:Concept code="90839" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Psychotherapy for crisis; first 60 minutes"/>
|
354
|
+
<ns0:Concept code="91573000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMEDCT" codeSystemVersion="2018-03" displayName="Tympanometry testing (procedure)"/>
|
355
|
+
<ns0:Concept code="92002" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient"/>
|
356
|
+
<ns0:Concept code="92004" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits"/>
|
357
|
+
<ns0:Concept code="92012" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient"/>
|
358
|
+
<ns0:Concept code="92014" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits"/>
|
359
|
+
<ns0:Concept code="92507" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual"/>
|
360
|
+
<ns0:Concept code="92508" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals"/>
|
361
|
+
<ns0:Concept code="92526" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Treatment of swallowing dysfunction and/or oral function for feeding"/>
|
362
|
+
<ns0:Concept code="92537" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)"/>
|
363
|
+
<ns0:Concept code="92538" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)"/>
|
364
|
+
<ns0:Concept code="92540" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording"/>
|
365
|
+
<ns0:Concept code="92541" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording"/>
|
366
|
+
<ns0:Concept code="92542" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Positional nystagmus test, minimum of 4 positions, with recording"/>
|
367
|
+
<ns0:Concept code="92544" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording"/>
|
368
|
+
<ns0:Concept code="92545" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Oscillating tracking test, with recording"/>
|
369
|
+
<ns0:Concept code="92547" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Use of vertical electrodes (List separately in addition to code for primary procedure)"/>
|
370
|
+
<ns0:Concept code="92548" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Computerized dynamic posturography"/>
|
371
|
+
<ns0:Concept code="92550" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Tympanometry and reflex threshold measurements"/>
|
372
|
+
<ns0:Concept code="92557" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)"/>
|
373
|
+
<ns0:Concept code="92567" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Tympanometry (impedance testing)"/>
|
374
|
+
<ns0:Concept code="92568" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Acoustic reflex testing, threshold"/>
|
375
|
+
<ns0:Concept code="92570" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing"/>
|
376
|
+
<ns0:Concept code="92585" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive"/>
|
377
|
+
<ns0:Concept code="92588" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report"/>
|
378
|
+
<ns0:Concept code="92626" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Evaluation of auditory rehabilitation status; first hour"/>
|
379
|
+
<ns0:Concept code="96116" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities), per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpreting test results and preparing the report"/>
|
380
|
+
<ns0:Concept code="96150" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; initial assessment"/>
|
381
|
+
<ns0:Concept code="96151" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Health and behavior assessment (eg, health-focused clinical interview, behavioral observations, psychophysiological monitoring, health-oriented questionnaires), each 15 minutes face-to-face with the patient; re-assessment"/>
|
382
|
+
<ns0:Concept code="96152" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Health and behavior intervention, each 15 minutes, face-to-face; individual"/>
|
383
|
+
<ns0:Concept code="97127" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing and sequencing tasks), direct (one-on-one) patient contact"/>
|
384
|
+
<ns0:Concept code="97161" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family."/>
|
385
|
+
<ns0:Concept code="97162" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family."/>
|
386
|
+
<ns0:Concept code="97163" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family."/>
|
387
|
+
<ns0:Concept code="97164" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family."/>
|
388
|
+
<ns0:Concept code="97165" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; An assessment(s) that identifies 1-3 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of low complexity, which includes an analysis of the occupational profile, analysis of data from problem-focused assessment(s), and consideration of a limited number of treatment options. Patient presents with no comorbidities that affect occupational performance. Modification of tasks or assistance (eg, physical or verbal) with assessment(s) is not necessary to enable completion of evaluation component. Typically, 30 minutes are spent face-to-face with the patient and/or family."/>
|
389
|
+
<ns0:Concept code="97166" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Occupational therapy evaluation, moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 3-5 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of moderate analytic complexity, which includes an analysis of the occupational profile, analysis of data from detailed assessment(s), and consideration of several treatment options. Patient may present with comorbidities that affect occupational performance. Minimal to moderate modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. Typically, 45 minutes are spent face-to-face with the patient and/or family."/>
|
390
|
+
<ns0:Concept code="97167" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Occupational therapy evaluation, high complexity, requiring these components: An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 5 or more performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of high analytic complexity, which includes an analysis of the patient profile, analysis of data from comprehensive assessment(s), and consideration of multiple treatment options. Patient presents with comorbidities that affect occupational performance. Significant modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. Typically, 60 minutes are spent face-to-face with the patient and/or family."/>
|
391
|
+
<ns0:Concept code="97168" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Re-evaluation of occupational therapy established plan of care, requiring these components: An assessment of changes in patient functional or medical status with revised plan of care; An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals; and A revised plan of care. A formal reevaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required. Typically, 30 minutes are spent face-to-face with the patient and/or family."/>
|
392
|
+
<ns0:Concept code="97802" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes"/>
|
393
|
+
<ns0:Concept code="97803" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes"/>
|
394
|
+
<ns0:Concept code="97804" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes"/>
|
395
|
+
<ns0:Concept code="98960" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient"/>
|
396
|
+
<ns0:Concept code="98961" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients"/>
|
397
|
+
<ns0:Concept code="98962" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients"/>
|
398
|
+
<ns0:Concept code="99024" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure"/>
|
399
|
+
<ns0:Concept code="99201" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused 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, 10 minutes are spent face-to-face with the patient and/or family."/>
|
400
|
+
<ns0:Concept code="99202" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient 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; 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 to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family."/>
|
401
|
+
<ns0:Concept code="99203" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed 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 moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family."/>
|
402
|
+
<ns0:Concept code="99204" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive 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 of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family."/>
|
403
|
+
<ns0:Concept code="99205" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; 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 presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family."/>
|
404
|
+
<ns0:Concept code="99212" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused 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, 10 minutes are spent face-to-face with the patient and/or family."/>
|
405
|
+
<ns0:Concept code="99213" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and 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, 15 minutes are spent face-to-face with the patient and/or family."/>
|
406
|
+
<ns0:Concept code="99214" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed 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 of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family."/>
|
407
|
+
<ns0:Concept code="99215" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; 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 presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family."/>
|
408
|
+
<ns0:Concept code="99221" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or 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 problem(s) requiring admission are of low severity. Typically, 30 minutes are spent at the bedside and on the patient's hospital floor or unit."/>
|
409
|
+
<ns0:Concept code="99222" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial hospital care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit."/>
|
410
|
+
<ns0:Concept code="99223" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial hospital care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit."/>
|
411
|
+
<ns0:Concept code="99236" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date, 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 presenting problem(s) requiring admission are of high severity. Typically, 55 minutes are spent at the bedside and on the patient's hospital floor or unit."/>
|
412
|
+
<ns0:Concept code="99281" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Emergency department visit for the evaluation and management of a 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 self limited or minor."/>
|
413
|
+
<ns0:Concept code="99282" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Emergency department visit for the evaluation and management of a 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 low to moderate severity."/>
|
414
|
+
<ns0:Concept code="99283" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused 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 severity."/>
|
415
|
+
<ns0:Concept code="99284" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Emergency department visit for the evaluation and management of a 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 high severity, and require urgent evaluation by the physician, or other qualified health care professionals but do not pose an immediate significant threat to life or physiologic function."/>
|
416
|
+
<ns0:Concept code="99285" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: 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 presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function."/>
|
417
|
+
<ns0:Concept code="99304" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or 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 problem(s) requiring admission are of low severity. Typically, 25 minutes are spent at the bedside and on the patient's facility floor or unit."/>
|
418
|
+
<ns0:Concept code="99305" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial nursing facility care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of moderate severity. Typically, 35 minutes are spent at the bedside and on the patient's facility floor or unit."/>
|
419
|
+
<ns0:Concept code="99306" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial nursing facility care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of high severity. Typically, 45 minutes are spent at the bedside and on the patient's facility floor or unit."/>
|
420
|
+
<ns0:Concept code="99307" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Subsequent nursing facility care, per day, for the evaluation and management of a 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 patient is stable, recovering, or improving. Typically, 10 minutes are spent at the bedside and on the patient's facility floor or unit."/>
|
421
|
+
<ns0:Concept code="99308" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Subsequent nursing facility care, per day, for the evaluation and management of a 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 patient is responding inadequately to therapy or has developed a minor complication. Typically, 15 minutes are spent at the bedside and on the patient's facility floor or unit."/>
|
422
|
+
<ns0:Concept code="99309" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Subsequent nursing facility care, per day, for the evaluation and management of a 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 patient has developed a significant complication or a significant new problem. Typically, 25 minutes are spent at the bedside and on the patient's facility floor or unit."/>
|
423
|
+
<ns0:Concept code="99310" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; 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. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 35 minutes are spent at the bedside and on the patient's facility floor or unit."/>
|
424
|
+
<ns0:Concept code="99315" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Nursing facility discharge day management; 30 minutes or less"/>
|
425
|
+
<ns0:Concept code="99316" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Nursing facility discharge day management; more than 30 minutes"/>
|
426
|
+
<ns0:Concept code="99318" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Evaluation and management of a patient involving an annual nursing facility assessment, which requires these 3 key components: A detailed interval history; A comprehensive examination; and Medical decision making that is of low to 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 patient is stable, recovering, or improving. Typically, 30 minutes are spent at the bedside and on the patient's facility floor or unit."/>
|
427
|
+
<ns0:Concept code="99324" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 with the patient and/or family or caregiver."/>
|
428
|
+
<ns0:Concept code="99325" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 with the patient and/or family or caregiver."/>
|
429
|
+
<ns0:Concept code="99326" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 with the patient and/or family or caregiver."/>
|
430
|
+
<ns0:Concept code="99327" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 with the patient and/or family or caregiver."/>
|
431
|
+
<ns0:Concept code="99328" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 with the patient and/or family or caregiver."/>
|
432
|
+
<ns0:Concept code="99334" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 with the patient and/or family or caregiver."/>
|
433
|
+
<ns0:Concept code="99335" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 with the patient and/or family or caregiver."/>
|
434
|
+
<ns0:Concept code="99336" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 of moderate to high severity. Typically, 40 minutes are spent with the patient and/or family or caregiver."/>
|
435
|
+
<ns0:Concept code="99337" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Domiciliary or rest 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 with the patient and/or family or caregiver."/>
|
436
|
+
<ns0:Concept code="99339" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Individual physician supervision of a patient (patient not present) in home, domiciliary or rest home (eg, assisted living facility) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 15-29 minutes"/>
|
437
|
+
<ns0:Concept code="99340" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Individual physician supervision of a patient (patient not present) in home, domiciliary or rest home (eg, assisted living facility) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 30 minutes or more"/>
|
438
|
+
<ns0:Concept code="99341" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
439
|
+
<ns0:Concept code="99342" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
440
|
+
<ns0:Concept code="99343" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
441
|
+
<ns0:Concept code="99344" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
442
|
+
<ns0:Concept code="99345" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
443
|
+
<ns0:Concept code="99347" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
444
|
+
<ns0:Concept code="99348" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
445
|
+
<ns0:Concept code="99349" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
446
|
+
<ns0:Concept code="99350" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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."/>
|
447
|
+
<ns0:Concept code="99385" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial comprehensive preventive medicine evaluation 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, new patient; 18-39 years"/>
|
448
|
+
<ns0:Concept code="99386" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial comprehensive preventive medicine evaluation 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, new patient; 40-64 years"/>
|
449
|
+
<ns0:Concept code="99387" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Initial comprehensive preventive medicine evaluation 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, new patient; 65 years and older"/>
|
450
|
+
<ns0:Concept code="99395" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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"/>
|
451
|
+
<ns0:Concept code="99396" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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"/>
|
452
|
+
<ns0:Concept code="99397" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="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"/>
|
453
|
+
<ns0:Concept code="99495" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Transitional Care Management Services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge Medical decision making of at least moderate complexity during the service period Face-to-face visit, within 14 calendar days of discharge"/>
|
454
|
+
<ns0:Concept code="99496" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT" codeSystemVersion="2018" displayName="Transitional Care Management Services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge Medical decision making of high complexity during the service period Face-to-face visit, within 7 calendar days of discharge"/>
|
455
|
+
<ns0:Concept code="G0101" codeSystem="2.16.840.1.113883.6.285" codeSystemName="HCPCS" codeSystemVersion="2018" displayName="Cervical or vaginal cancer screening; pelvic and clinical breast examination"/>
|
456
|
+
<ns0:Concept code="G0108" codeSystem="2.16.840.1.113883.6.285" codeSystemName="HCPCS" codeSystemVersion="2018" displayName="Diabetes outpatient self-management training services, individual, per 30 minutes"/>
|
457
|
+
<ns0:Concept code="G0270" codeSystem="2.16.840.1.113883.6.285" codeSystemName="HCPCS" codeSystemVersion="2018" displayName="Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes"/>
|
458
|
+
<ns0:Concept code="G0402" codeSystem="2.16.840.1.113883.6.285" codeSystemName="HCPCS" codeSystemVersion="2018" displayName="Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment"/>
|
459
|
+
<ns0:Concept code="G0438" codeSystem="2.16.840.1.113883.6.285" codeSystemName="HCPCS" codeSystemVersion="2018" displayName="Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit"/>
|
460
|
+
<ns0:Concept code="G0439" codeSystem="2.16.840.1.113883.6.285" codeSystemName="HCPCS" codeSystemVersion="2018" displayName="Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit"/>
|
461
|
+
</ns0:ConceptList>
|
462
|
+
<ns0:Source>Quality Insights of Pennsylvania</ns0:Source>
|
463
|
+
<ns0:Purpose>(Clinical Focus: This set of values contains encounters where a medication list would be reviewed, updated, or transcribed as a current medication list.),(Data Element Scope: ),(Inclusion Criteria: Included are specific encounters from multiple specialty physicians, primary care physicians, as well as therapist and nutritionists; this value set also includes assessments and tasks that would prompt documentation of current medications.),(Exclusion Criteria: )</ns0:Purpose>
|
464
|
+
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<ns0:Concept code="14" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Dual Eligibility Medicare/Medicaid Organization"/>
|
1076
|
+
<ns0:Concept code="19" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicare Other"/>
|
1077
|
+
<ns0:Concept code="191" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicare Pharmacy Benefit Manager"/>
|
1078
|
+
<ns0:Concept code="2" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="MEDICAID"/>
|
1079
|
+
<ns0:Concept code="21" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid (Managed Care)"/>
|
1080
|
+
<ns0:Concept code="211" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid HMO"/>
|
1081
|
+
<ns0:Concept code="212" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid PPO"/>
|
1082
|
+
<ns0:Concept code="213" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid PCCM (Primary Care Case Management)"/>
|
1083
|
+
<ns0:Concept code="219" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid Managed Care Other"/>
|
1084
|
+
<ns0:Concept code="22" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid (Non-managed Care Plan)"/>
|
1085
|
+
<ns0:Concept code="23" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid/SCHIP"/>
|
1086
|
+
<ns0:Concept code="24" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid Applicant"/>
|
1087
|
+
<ns0:Concept code="25" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid - Out of State"/>
|
1088
|
+
<ns0:Concept code="26" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid -- Long Term Care"/>
|
1089
|
+
<ns0:Concept code="29" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid Other"/>
|
1090
|
+
<ns0:Concept code="291" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid Pharmacy Benefit Manager"/>
|
1091
|
+
<ns0:Concept code="299" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicaid - Dental"/>
|
1092
|
+
<ns0:Concept code="3" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="OTHER GOVERNMENT (Federal/State/Local) (excluding Department of Corrections)"/>
|
1093
|
+
<ns0:Concept code="31" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Department of Defense"/>
|
1094
|
+
<ns0:Concept code="311" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="TRICARE (CHAMPUS)"/>
|
1095
|
+
<ns0:Concept code="3111" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="TRICARE Prime--HMO"/>
|
1096
|
+
<ns0:Concept code="3112" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="TRICARE Extra--PPO"/>
|
1097
|
+
<ns0:Concept code="3113" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="TRICARE Standard - Fee For Service"/>
|
1098
|
+
<ns0:Concept code="3114" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="TRICARE For Life--Medicare Supplement"/>
|
1099
|
+
<ns0:Concept code="3115" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="TRICARE Reserve Select"/>
|
1100
|
+
<ns0:Concept code="3116" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Uniformed Services Family Health Plan (USFHP) -- HMO"/>
|
1101
|
+
<ns0:Concept code="3119" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Department of Defense - (other)"/>
|
1102
|
+
<ns0:Concept code="312" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Military Treatment Facility"/>
|
1103
|
+
<ns0:Concept code="3121" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Enrolled Prime--HMO"/>
|
1104
|
+
<ns0:Concept code="3122" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Non-enrolled Space Available"/>
|
1105
|
+
<ns0:Concept code="3123" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="TRICARE For Life (TFL)"/>
|
1106
|
+
<ns0:Concept code="313" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Dental --Stand Alone"/>
|
1107
|
+
<ns0:Concept code="32" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Department of Veterans Affairs"/>
|
1108
|
+
<ns0:Concept code="321" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Veteran care--Care provided to Veterans"/>
|
1109
|
+
<ns0:Concept code="3211" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Direct Care--Care provided in VA facilities"/>
|
1110
|
+
<ns0:Concept code="3212" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Indirect Care--Care provided outside VA facilities"/>
|
1111
|
+
<ns0:Concept code="32121" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Fee Basis"/>
|
1112
|
+
<ns0:Concept code="32122" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Foreign Fee/Foreign Medical Program (FMP)"/>
|
1113
|
+
<ns0:Concept code="32123" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Contract Nursing Home/Community Nursing Home"/>
|
1114
|
+
<ns0:Concept code="32124" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="State Veterans Home"/>
|
1115
|
+
<ns0:Concept code="32125" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Sharing Agreements"/>
|
1116
|
+
<ns0:Concept code="32126" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other Federal Agency"/>
|
1117
|
+
<ns0:Concept code="32127" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Dental Care"/>
|
1118
|
+
<ns0:Concept code="32128" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Vision Care"/>
|
1119
|
+
<ns0:Concept code="322" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Non-veteran care"/>
|
1120
|
+
<ns0:Concept code="3221" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Civilian Health and Medical Program for the VA (CHAMPVA)"/>
|
1121
|
+
<ns0:Concept code="3222" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Spina Bifida Health Care Program (SB)"/>
|
1122
|
+
<ns0:Concept code="3223" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Children of Women Vietnam Veterans (CWVV)"/>
|
1123
|
+
<ns0:Concept code="3229" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other non-veteran care"/>
|
1124
|
+
<ns0:Concept code="33" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Indian Health Service or Tribe"/>
|
1125
|
+
<ns0:Concept code="331" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Indian Health Service -- Regular"/>
|
1126
|
+
<ns0:Concept code="332" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Indian Health Service -- Contract"/>
|
1127
|
+
<ns0:Concept code="333" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Indian Health Service - Managed Care"/>
|
1128
|
+
<ns0:Concept code="334" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Indian Tribe - Sponsored Coverage"/>
|
1129
|
+
<ns0:Concept code="34" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="HRSA Program"/>
|
1130
|
+
<ns0:Concept code="341" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Title V (MCH Block Grant)"/>
|
1131
|
+
<ns0:Concept code="342" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Migrant Health Program"/>
|
1132
|
+
<ns0:Concept code="343" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Ryan White Act"/>
|
1133
|
+
<ns0:Concept code="349" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other"/>
|
1134
|
+
<ns0:Concept code="35" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Black Lung"/>
|
1135
|
+
<ns0:Concept code="36" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="State Government"/>
|
1136
|
+
<ns0:Concept code="361" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="State SCHIP program (codes for individual states)"/>
|
1137
|
+
<ns0:Concept code="362" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Specific state programs (list/ local code)"/>
|
1138
|
+
<ns0:Concept code="369" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="State, not otherwise specified (other state)"/>
|
1139
|
+
<ns0:Concept code="37" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Local Government"/>
|
1140
|
+
<ns0:Concept code="371" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Local - Managed care"/>
|
1141
|
+
<ns0:Concept code="3711" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="HMO"/>
|
1142
|
+
<ns0:Concept code="3712" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="PPO"/>
|
1143
|
+
<ns0:Concept code="3713" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="POS"/>
|
1144
|
+
<ns0:Concept code="372" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="FFS/Indemnity"/>
|
1145
|
+
<ns0:Concept code="379" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Local, not otherwise specified (other local, county)"/>
|
1146
|
+
<ns0:Concept code="38" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other Government (Federal, State, Local not specified)"/>
|
1147
|
+
<ns0:Concept code="381" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Federal, State, Local not specified managed care"/>
|
1148
|
+
<ns0:Concept code="3811" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Federal, State, Local not specified - HMO"/>
|
1149
|
+
<ns0:Concept code="3812" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Federal, State, Local not specified - PPO"/>
|
1150
|
+
<ns0:Concept code="3813" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Federal, State, Local not specified - POS"/>
|
1151
|
+
<ns0:Concept code="3819" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Federal, State, Local not specified - not specified managed care"/>
|
1152
|
+
<ns0:Concept code="382" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Federal, State, Local not specified - FFS"/>
|
1153
|
+
<ns0:Concept code="389" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Federal, State, Local not specified - Other"/>
|
1154
|
+
<ns0:Concept code="39" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other Federal"/>
|
1155
|
+
<ns0:Concept code="391" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Federal Employee Health Plan"/>
|
1156
|
+
<ns0:Concept code="4" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="DEPARTMENTS OF CORRECTIONS"/>
|
1157
|
+
<ns0:Concept code="41" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Corrections Federal"/>
|
1158
|
+
<ns0:Concept code="42" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Corrections State"/>
|
1159
|
+
<ns0:Concept code="43" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Corrections Local"/>
|
1160
|
+
<ns0:Concept code="44" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Corrections Unknown Level"/>
|
1161
|
+
<ns0:Concept code="5" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="PRIVATE HEALTH INSURANCE"/>
|
1162
|
+
<ns0:Concept code="51" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Managed Care (Private)"/>
|
1163
|
+
<ns0:Concept code="511" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Commercial Managed Care - HMO"/>
|
1164
|
+
<ns0:Concept code="512" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Commercial Managed Care - PPO"/>
|
1165
|
+
<ns0:Concept code="513" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Commercial Managed Care - POS"/>
|
1166
|
+
<ns0:Concept code="514" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Exclusive Provider Organization"/>
|
1167
|
+
<ns0:Concept code="515" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Gatekeeper PPO (GPPO)"/>
|
1168
|
+
<ns0:Concept code="516" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Commercial Managed Care - Pharmacy Benefit Manager"/>
|
1169
|
+
<ns0:Concept code="517" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Commercial Managed Care - Dental"/>
|
1170
|
+
<ns0:Concept code="519" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Managed Care, Other (non HMO)"/>
|
1171
|
+
<ns0:Concept code="52" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Private Health Insurance - Indemnity"/>
|
1172
|
+
<ns0:Concept code="521" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Commercial Indemnity"/>
|
1173
|
+
<ns0:Concept code="522" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Self-insured (ERISA) Administrative Services Only (ASO) plan"/>
|
1174
|
+
<ns0:Concept code="523" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Medicare supplemental policy (as second payer)"/>
|
1175
|
+
<ns0:Concept code="524" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Indemnity Insurance - Dental"/>
|
1176
|
+
<ns0:Concept code="529" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Private health insurance--other commercial Indemnity"/>
|
1177
|
+
<ns0:Concept code="53" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Managed Care (private) or private health insurance (indemnity), not otherwise specified"/>
|
1178
|
+
<ns0:Concept code="54" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Organized Delivery System"/>
|
1179
|
+
<ns0:Concept code="55" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Small Employer Purchasing Group"/>
|
1180
|
+
<ns0:Concept code="56" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Specialized Stand Alone Plan"/>
|
1181
|
+
<ns0:Concept code="561" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Dental"/>
|
1182
|
+
<ns0:Concept code="562" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Vision"/>
|
1183
|
+
<ns0:Concept code="59" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other Private Insurance"/>
|
1184
|
+
<ns0:Concept code="6" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BLUE CROSS/BLUE SHIELD"/>
|
1185
|
+
<ns0:Concept code="61" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Managed Care"/>
|
1186
|
+
<ns0:Concept code="611" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Managed Care -- HMO"/>
|
1187
|
+
<ns0:Concept code="612" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Managed Care -- PPO"/>
|
1188
|
+
<ns0:Concept code="613" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Managed Care -- POS"/>
|
1189
|
+
<ns0:Concept code="614" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Managed Care - Dental"/>
|
1190
|
+
<ns0:Concept code="619" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Managed Care -- Other"/>
|
1191
|
+
<ns0:Concept code="62" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Insurance Indemnity"/>
|
1192
|
+
<ns0:Concept code="621" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Indemnity"/>
|
1193
|
+
<ns0:Concept code="622" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Self-insured (ERISA) Administrative Services Only (ASO)Plan"/>
|
1194
|
+
<ns0:Concept code="623" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Medicare Supplemental Plan"/>
|
1195
|
+
<ns0:Concept code="629" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="BC Indemnity - Dental"/>
|
1196
|
+
<ns0:Concept code="7" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)"/>
|
1197
|
+
<ns0:Concept code="71" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="HMO"/>
|
1198
|
+
<ns0:Concept code="72" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="PPO"/>
|
1199
|
+
<ns0:Concept code="73" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="POS"/>
|
1200
|
+
<ns0:Concept code="79" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other Managed Care"/>
|
1201
|
+
<ns0:Concept code="8" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="NO PAYMENT from an Organization/Agency/Program/Private Payer Listed"/>
|
1202
|
+
<ns0:Concept code="81" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Self-pay"/>
|
1203
|
+
<ns0:Concept code="82" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="No Charge"/>
|
1204
|
+
<ns0:Concept code="821" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Charity"/>
|
1205
|
+
<ns0:Concept code="822" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Professional Courtesy"/>
|
1206
|
+
<ns0:Concept code="823" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Research/Clinical Trial"/>
|
1207
|
+
<ns0:Concept code="83" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Refusal to Pay/Bad Debt"/>
|
1208
|
+
<ns0:Concept code="84" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Hill Burton Free Care"/>
|
1209
|
+
<ns0:Concept code="85" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Research/Donor"/>
|
1210
|
+
<ns0:Concept code="89" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="No Payment, Other"/>
|
1211
|
+
<ns0:Concept code="9" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="MISCELLANEOUS/OTHER"/>
|
1212
|
+
<ns0:Concept code="91" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Foreign National"/>
|
1213
|
+
<ns0:Concept code="92" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other (Non-government)"/>
|
1214
|
+
<ns0:Concept code="93" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Disability Insurance"/>
|
1215
|
+
<ns0:Concept code="94" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Long-term Care Insurance"/>
|
1216
|
+
<ns0:Concept code="95" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Worker's Compensation"/>
|
1217
|
+
<ns0:Concept code="951" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Worker's Comp HMO"/>
|
1218
|
+
<ns0:Concept code="953" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Worker's Comp Fee-for-Service"/>
|
1219
|
+
<ns0:Concept code="954" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Worker's Comp Other Managed Care"/>
|
1220
|
+
<ns0:Concept code="959" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Worker's Comp, Other unspecified"/>
|
1221
|
+
<ns0:Concept code="96" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Auto Insurance (includes no fault)"/>
|
1222
|
+
<ns0:Concept code="97" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Legal Liability / Liability Insurance"/>
|
1223
|
+
<ns0:Concept code="98" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Other specified but not otherwise classifiable (includes Hospice - Unspecified plan)"/>
|
1224
|
+
<ns0:Concept code="99" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="No Typology Code available for payment source"/>
|
1225
|
+
<ns0:Concept code="9999" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="SOP" codeSystemVersion="7.0" displayName="Unavailable / No Payer Specified / Blank"/>
|
1226
|
+
</ns0:ConceptList>
|
1227
|
+
<ns0:Source>HL7 Terminology</ns0:Source>
|
1228
|
+
<ns0:Purpose>(Clinical Focus: Categories of types of health care payor entities as defined by the US Public Health Data Consortium SOP code system),(Data Element Scope: @code in CCDA r2.1 template Planned Coverage [act: identifier urn:oid:2.16.840.1.113883.10.20.22.4.129 (open)] DYNAMIC),(Inclusion Criteria: All codes in the code system),(Exclusion Criteria: none)</ns0:Purpose>
|
1229
|
+
<ns0:Type>Extensional</ns0:Type>
|
1230
|
+
<ns0:Binding>Dynamic</ns0:Binding>
|
1231
|
+
<ns0:Status>Active</ns0:Status>
|
1232
|
+
<ns0:RevisionDate>2018-02-27</ns0:RevisionDate>
|
1233
|
+
</ns0:DescribedValueSet>
|
1234
|
+
</ns0:RetrieveMultipleValueSetsResponse>
|
1235
|
+
http_version:
|
1236
|
+
recorded_at: Mon, 02 Apr 2018 13:16:59 GMT
|
1237
|
+
recorded_with: VCR 3.0.3
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