Inpatient

{
  "description" : "This value set created for the purpose of identifying an inpatient stay for use in MSSP ACO readmission or preventable admission measures. Please note that use of this value set is not limited to MSSP ACO measures.",
  "compose" : {
    "exclude" : [ ],
    "include" : [ {
      "system" : "http://www.ama-assn.org/go/cpt",
      "extension" : [ {
        "extension" : [ {
          "valueString" : "concept",
          "url" : "path"
        }, {
          "url" : "count",
          "valueInteger" : 33
        } ],
        "url" : "http://health-samurai.io/extensions/excised-data"
      } ]
    } ]
  },
  "date" : "2019-10-24T01:00:18-04:00",
  "meta" : {
    "versionId" : "6",
    "lastUpdated" : "2023-12-21T17:43:03.000-05:00",
    "profile" : [ "http://hl7.org/fhir/StructureDefinition/shareablevalueset", "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-valueset-cqfm", "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-valueset-cqfm" ]
  },
  "publisher" : "Change Healthcare Steward",
  "jurisdiction" : [ {
    "coding" : [ {
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    } ]
  } ],
  "purpose" : "(Clinical Focus: This value set created for the purpose of identifying an inpatient stay for use in MSSP ACO readmission or preventable admission measures.  Includes acute and nonacute inpatient stays.),(Data Element Scope: ClaimProcedure, ClaimItem.service, ClaimItem.revenue, Encounter.hospitalization, Procedure),(Inclusion Criteria: Inpatient stay via procedure or revenue billing codes.  Includes acute and nonacute inpatient stays.),(Exclusion Criteria: n/a)",
  "name" : "Inpatient",
  "experimental" : false,
  "resourceType" : "ValueSet",
  "expansion" : {
    "contains" : [ {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99221",
      "display" : "Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99222",
      "display" : "Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99223",
      "display" : "Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99231",
      "display" : "Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99232",
      "display" : "Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99233",
      "display" : "Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99238",
      "display" : "Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99239",
      "display" : "Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99252",
      "display" : "Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99253",
      "display" : "Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99254",
      "display" : "Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99255",
      "display" : "Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99291",
      "display" : "Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99304",
      "display" : "Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99305",
      "display" : "Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99306",
      "display" : "Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99307",
      "display" : "Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99308",
      "display" : "Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99309",
      "display" : "Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99310",
      "display" : "Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99315",
      "display" : "Nursing facility discharge management; 30 minutes or less total time on the date of the encounter",
      "version" : "2024"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99316",
      "display" : "Nursing facility discharge management; more than 30 minutes total time on the date of the encounter",
      "version" : "2024"
    } ],
    "total" : 22,
    "identifier" : "urn:uuid:d6445255-5488-428e-b490-df015295ff72",
    "timestamp" : "2024-06-14T12:54:13-04:00"
  },
  "title" : "Inpatient",
  "extension" : [ {
    "valueString" : "Change Healthcare Author",
    "url" : "http://hl7.org/fhir/StructureDefinition/valueset-author"
  }, {
    "valueDate" : "2024-06-03",
    "url" : "http://hl7.org/fhir/StructureDefinition/resource-lastReviewDate"
  }, {
    "valueDate" : "2019-10-24",
    "url" : "http://hl7.org/fhir/StructureDefinition/valueset-effectiveDate"
  }, {
    "url" : "http://health-samurai.io/extensions/source",
    "valueCode" : "db"
  } ],
  "status" : "retired",
  "id" : "2.16.840.1.113762.1.4.1182.286",
  "url" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1182.286",
  "identifier" : [ {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113762.1.4.1182.286"
  } ],
  "version" : "20191024"
}