CDS Hooks Card Types

{
  "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.",
  "date" : "2025-10-16T00:00:00+00:00",
  "publisher" : "Health Level Seven International",
  "content" : "complete",
  "property" : [ {
    "description" : "The concept identified is a child of the concept",
    "type" : "code",
    "code" : "child",
    "uri" : "http://hl7.org/fhir/concept-properties#child"
  }, {
    "description" : "The concept identified is a parent of the concept",
    "type" : "code",
    "code" : "parent",
    "uri" : "http://hl7.org/fhir/concept-properties#parent"
  } ],
  "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",
  "experimental" : false,
  "resourceType" : "CodeSystem",
  "title" : "CDS Hooks Card Types",
  "extension" : [ {
    "valueCode" : "fm",
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"
  }, {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 1
  }, {
    "extension" : [ {
      "valueString" : "concept",
      "url" : "path"
    }, {
      "url" : "count",
      "valueInteger" : 14
    } ],
    "url" : "http://health-samurai.io/extensions/excised-data"
  }, {
    "url" : "http://health-samurai.io/extensions/source",
    "valueCode" : "db"
  } ],
  "status" : "active",
  "language" : "en",
  "hierarchyMeaning" : "is-a",
  "id" : "cdshooks-card-type",
  "url" : "http://terminology.hl7.org/CodeSystem/cdshooks-card-type",
  "identifier" : [ {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.5.176"
  } ],
  "caseSensitive" : true,
  "version" : "1.0.0",
  "contact" : [ {
    "telecom" : [ {
      "system" : "url",
      "value" : "http://hl7.org"
    }, {
      "system" : "email",
      "value" : "hq@HL7.org"
    } ]
  } ],
  "text" : {
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem cdshooks-card-type</b></p><a name=\"cdshooks-card-type\"> </a><a name=\"hccdshooks-card-type\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p></div><p>This case-sensitive code system <code>http://terminology.hl7.org/CodeSystem/cdshooks-card-type</code> defines the following codes in a Is-A hierarchy:</p><table class=\"codes\"><tr><td><b>Lvl</b></td><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>1</td><td style=\"white-space:nowrap\">coverage-info<a name=\"cdshooks-card-type-coverage-info\"> </a></td><td>Coverage Information</td><td>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</td></tr><tr><td>2</td><td style=\"white-space:nowrap\">  unsolicited-determ<a name=\"cdshooks-card-type-unsolicited-determ\"> </a></td><td>Unsolicited Determination</td><td>An unsolicited approval of the service as having prior authorization requirements met without a formal submission of a prior authorization request</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">claim<a name=\"cdshooks-card-type-claim\"> </a></td><td>Claim</td><td>Information about what steps need to be taken to submit a claim for the service</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">insurance<a name=\"cdshooks-card-type-insurance\"> </a></td><td>Insurance</td><td>Allows a provider to update the patient's coverage information with additional details from the payer (e.g. expiry date, coverage extensions)</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">limits<a name=\"cdshooks-card-type-limits\"> </a></td><td>Limits</td><td>Messages warning about the patient approaching or exceeding their limits for a particular type of coverage or expiry date for coverage in general</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">network<a name=\"cdshooks-card-type-network\"> </a></td><td>Network</td><td>Providing information about in-network providers that could deliver the order (or in-network alternatives for an order directed out-of-network)</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">appropriate-use<a name=\"cdshooks-card-type-appropriate-use\"> </a></td><td>Appropriate Use</td><td>Guidance on whether appropriate-use documentation is needed</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">cost<a name=\"cdshooks-card-type-cost\"> </a></td><td>Cost</td><td>What is the anticipated cost to the patient based on their coverage</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">therapy-alternatives-opt<a name=\"cdshooks-card-type-therapy-alternatives-opt\"> </a></td><td>Optional Therapy Alternatives</td><td>Are there alternative therapies that have better coverage and/or are lower-cost for the patient</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">therapy-alternatives-req<a name=\"cdshooks-card-type-therapy-alternatives-req\"> </a></td><td>Required Therapy Alternatives</td><td>Are there alternative therapies that must be tried first prior to coverage being available for the proposed therapy</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">clinical-reminder<a name=\"cdshooks-card-type-clinical-reminder\"> </a></td><td>Clinical Reminder</td><td>Reminders that a patient is due for certain screening or other therapy (based on payer recorded date of last intervention)</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">duplicate-therapy<a name=\"cdshooks-card-type-duplicate-therapy\"> </a></td><td>Duplicate Therapy</td><td>Notice that the proposed intervention has already recently occurred with a different provider when that information isn't already available in the provider system</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">contraindication<a name=\"cdshooks-card-type-contraindication\"> </a></td><td>Contraindication</td><td>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</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">guideline<a name=\"cdshooks-card-type-guideline\"> </a></td><td>Guideline</td><td>Indication that there is a guideline available for the proposed therapy (with an option to view)</td></tr><tr><td>1</td><td style=\"white-space:nowrap\">off-guideline<a name=\"cdshooks-card-type-off-guideline\"> </a></td><td>Off Guideline</td><td>Notice that the proposed therapy may be contrary to best-practice guidelines, typically with an option to view the relevant guideline</td></tr></table></div>",
    "status" : "generated"
  }
}