{
  "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.",
  "_filename": "CodeSystem-cdshooks-card-type.json",
  "package_name": "hl7.terminology.r4",
  "date": "2025-10-16T00:00:00+00:00",
  "publisher": "Health Level Seven International",
  "content": "complete",
  "name": "CDSHooksCardType",
  "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",
  "type": null,
  "experimental": "false",
  "resourceType": "CodeSystem",
  "title": "CDS Hooks Card Types",
  "package_version": "7.0.0",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "fm"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger": 1
  } ],
  "status": "active",
  "hierarchyMeaning": "is-a",
  "id": "f9b4db28-8f7d-4600-b333-181ebfea4d40",
  "kind": null,
  "url": "http://terminology.hl7.org/CodeSystem/cdshooks-card-type",
  "identifier": [ {
    "value": "urn:oid:2.16.840.1.113883.5.176",
    "system": "urn:ietf:rfc:3986"
  } ],
  "concept": [ {
    "code": "coverage-info",
    "concept": [ {
      "code": "unsolicited-determ",
      "display": "Unsolicited Determination",
      "definition": "An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request"
    } ],
    "display": "Coverage Information",
    "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"
  }, {
    "code": "claim",
    "display": "Claim",
    "definition": "Information about what steps need to be taken to submit a claim for the service"
  }, {
    "code": "insurance",
    "display": "Insurance",
    "definition": "Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)"
  }, {
    "code": "limits",
    "display": "Limits",
    "definition": "Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general"
  }, {
    "code": "network",
    "display": "Network",
    "definition": "Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)"
  }, {
    "code": "appropriate-use",
    "display": "Appropriate Use",
    "definition": "Guidance on whether appropriate-use documentation is needed"
  }, {
    "code": "cost",
    "display": "Cost",
    "definition": "What is the anticipated cost to the patient based on their coverage"
  }, {
    "code": "therapy-alternatives-opt",
    "display": "Optional Therapy Alternatives",
    "definition": "Are there alternative therapies that have better coverage and/or are lower-cost for the patient"
  }, {
    "code": "therapy-alternatives-req",
    "display": "Required Therapy Alternatives",
    "definition": "Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy"
  }, {
    "code": "clinical-reminder",
    "display": "Clinical Reminder",
    "definition": "Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)"
  }, {
    "code": "duplicate-therapy",
    "display": "Duplicate Therapy",
    "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"
  }, {
    "code": "contraindication",
    "display": "Contraindication",
    "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"
  }, {
    "code": "guideline",
    "display": "Guideline",
    "definition": "Indication that there is a guideline available for the proposed therapy (with an option to view)"
  }, {
    "code": "off-guideline",
    "display": "Off Guideline",
    "definition": "Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline"
  } ],
  "caseSensitive": true,
  "version": "1.0.0",
  "contact": [ {
    "telecom": [ {
      "value": "http://hl7.org",
      "system": "url"
    }, {
      "value": "hq@HL7.org",
      "system": "email"
    } ]
  } ]
}