# text.div
Generated Narrative: CodeSystem cdshooks-card-type

Language: en

This case-sensitive code system http://terminology.hl7.org/CodeSystem/cdshooks-card-type defines the following codes in a Is-A hierarchy:

Lvl | Code | Display | Definition
1 | coverage-info | Coverage Information | Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection
2 | unsolicited-determ | Unsolicited Determination | An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request
1 | claim | Claim | Information about what steps need to be taken to submit a claim for the service
1 | insurance | Insurance | Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)
1 | limits | Limits | Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general
1 | network | Network | Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)
1 | appropriate-use | Appropriate Use | Guidance on whether appropriate-use documentation is needed
1 | cost | Cost | What is the anticipated cost to the patient based on their coverage
1 | therapy-alternatives-opt | Optional Therapy Alternatives | Are there alternative therapies that have better coverage and/or are lower-cost for the patient
1 | therapy-alternatives-req | Required Therapy Alternatives | Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy
1 | clinical-reminder | Clinical Reminder | Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)
1 | duplicate-therapy | Duplicate Therapy | Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system
1 | contraindication | Contraindication | Notice that the proposed intervention may be contraindicated based on information the payer has in their record that the provider doesn't have in theirs
1 | guideline | Guideline | Indication that there is a guideline available for the proposed therapy (with an option to view)
1 | off-guideline | Off Guideline | Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline

# description
Codes defining types of cards that can potentially be returned by a decision support service.  The initial set of codes is biased towards those related to insurance coverage, but all types of response types are acceptable in the code system.

# 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
Information related to the patient's coverage, including whether a service is covered, requires prior authorization, is approved without seeking prior authorization, and/or requires additional documentation or data collection

# concept[].concept[].definition
An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request

# concept[].definition
Information about what steps need to be taken to submit a claim for the service

# concept[].definition
Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)

# concept[].definition
Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general

# concept[].definition
Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)

# concept[].definition
Guidance on whether appropriate-use documentation is needed

# concept[].definition
What is the anticipated cost to the patient based on their coverage

# concept[].definition
Are there alternative therapies that have better coverage and/or are lower-cost for the patient

# concept[].definition
Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy

# concept[].definition
Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)

# concept[].definition
Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system

# concept[].definition
Notice that the proposed intervention may be contraindicated based on information the payer has in their record that the provider doesn't have in theirs

# concept[].definition
Indication that there is a guideline available for the proposed therapy (with an option to view)

# concept[].definition
Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline