Stream: CARIN IG for Blue Button®
Topic: ExplanationOfBenefit.procedure
Melanie Davies (Aug 25 2020 at 16:25):
Hello, I'm looking at the IG for the ExplanationOfBenefit resource and there is a procedure BackboneElement and also item.productOrService. The former specifies ICD-10, the latter CPT and HCPCS. Other than the difference in coding systems, I'm having trouble differentiating these in a meaningful way. How are each of these fields intended to be used/what do they represent?
Michele Mottini (Aug 25 2020 at 16:49):
procedure is the what has been done clinically - eg hip replacement surgery - item is the list of what has been claimed for it - eg the details of all consumables and services used in the surgery
Melanie Davies (Aug 25 2020 at 17:33):
Thank you for such a quick response @Michele Mottini ! That is very helpful and clear.
John Achoukian (Sep 23 2020 at 21:12):
For resource ExplanationOfBenefit.procedure.procedure[x]
The code or reference to a Procedure resource which identifies the clinical intervention performed.
Are only ICD-10 Procedure Codes allowable?
Last updated: Apr 12 2022 at 19:14 UTC
