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data-model.md

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Blue Button API FHIR Data Model

This document contains (some) details on the Blue Button API's FHIR data model.

Coding Systems

The following Coding systems can be found in API responses:

  • Industry standards:
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/betos.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/drg_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/hcfaspcl.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/rev_cntr.txt
    • https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/index.html
    • urn:std:iso:4217
    • https://www.accessdata.fda.gov/scripts/cder/ndc
    • http://hl7.org/fhir/sid/us-npi
    • http://hl7.org/fhir/sid/icd-10
    • http://hl7.org/fhir/sid/icd-9-cm
  • Standard FHIR:
    • http://hl7.org/fhir/v3/ActCode
    • http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode
    • http://hl7.org/fhir/benefit-category
    • http://hl7.org/fhir/claimcareteamrole
    • http://hl7.org/fhir/ex-claimtype
  • Systems specific to Medicare billing forms and/or the CCW itself:
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/race.txt
    • CMS Adjudications
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/type_adm.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/freq_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/clm_id.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/clm_type.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/coin_day.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/hcthgbtp.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/hha_rfrl.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/lupaind.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/mcopdsw.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/rev_cntr_ndc_qty_qlfr_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/stus_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/ptntstus.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/astnt_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/plcsrvc.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/clm_poa_ind_sw1.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/prcngind.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/asgmntcd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/ric_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/brnd_gnrc_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/typcsrvcb.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/dspnsng_stus_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/adjstmt_dltn_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/ctstrphc_cvrg_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/drug_cvrg_stus_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/daw_prod_slctn_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/nstd_frmt_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/ptnt_rsdnc_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/rx_orgn_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/prcng_excptn_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/submsn_clr_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/src_adms.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/pmtdnlcd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/typesrvc.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/revdedcd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/esrd_ind.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/fac_type.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/ded_sw.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/crec.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/orec.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/ms_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/pmtindsw.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/nopay_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/lclty_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/prcng_st.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/prtcptg.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/prvstate.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/prv_type.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/provzip.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/query_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/phrmcy_srvc_type_cd.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/sup_type.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/mtus_ind.txt
    • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/prpay_cd.txt

Identifiers

The following Identifier systems can be found in API responses:

  • https://bluebutton.cms.gov/developer/docs/reference/some-thing
    • temporary placeholder for claim type link
  • http://bluebutton.cms.hhs.gov/identifier#bene_id
  • CCW.BENE_ID
  • http://bluebutton.cms.hhs.gov/identifier#hicnHash
  • http://bluebutton.cms.hhs.gov/identifier#claimGroup
    • Debatably, this could instead be categorized as CCW-specific.
  • CCW.PDE_ID
  • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/carr_num.txt
  • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/carr_line_clia_lab_num.txt
  • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/ccltrnum.txt
  • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/plan_pbp_rec_num.txt
  • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/plan_cntrct_rec_id.txt
  • https://www.ccwdata.org/cs/groups/public/documents/datadictionary/provider.txt
  • CCW.RX_SRVC_RFRNC_NUM