Blue Button 2.0

Line Primary Payer Code (if not Medicare)

@prefix fhir: <https://bluebutton.cms.gov/assets/ig/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:CodeSystem;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "line-bene-prmry-pyr-cd"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Line Primary Payer Code (if not Medicare)</h2><div><p>The code specifying a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's medical bills relating to the line item service on the non-institutional claim. The presence of a primary payer code indicates that some other payer besides Medicare covered at least some portion of the charges. Source: https://bluebutton.cms.gov/resources/variables/line<em>bene</em>prmry<em>pyr</em>cd</p>\n</div><p>This code system https://bluebutton.cms.gov/assets/ig/CodeSystem-line-bene-prmry-pyr-cd defines the following codes:</p><table class=\"codes\"><tr><td><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>A<a name=\"line-bene-prmry-pyr-cd-A\"> </a></td><td>Working aged bene/spouse with employer group health plan (EGHP)</td><td>Working aged bene/spouse with employer group health plan (EGHP)</td></tr><tr><td>B<a name=\"line-bene-prmry-pyr-cd-B\"> </a></td><td>End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan</td><td>End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan</td></tr><tr><td>C<a name=\"line-bene-prmry-pyr-cd-C\"> </a></td><td>Conditional payment by Medicare; future reimbursement expected</td><td>Conditional payment by Medicare; future reimbursement expected</td></tr><tr><td>D<a name=\"line-bene-prmry-pyr-cd-D\"> </a></td><td>Automobile no-fault</td><td>Automobile no-fault</td></tr><tr><td>E<a name=\"line-bene-prmry-pyr-cd-E\"> </a></td><td>Workers' compensation</td><td>Workers' compensation</td></tr><tr><td>F<a name=\"line-bene-prmry-pyr-cd-F\"> </a></td><td>Public Health Service or other federal agency (other than Dept. of Veterans Affairs)</td><td>Public Health Service or other federal agency (other than Dept. of Veterans Affairs)</td></tr><tr><td>G<a name=\"line-bene-prmry-pyr-cd-G\"> </a></td><td>Working disabled bene (under age 65 with LGHP)</td><td>Working disabled bene (under age 65 with LGHP)</td></tr><tr><td>H<a name=\"line-bene-prmry-pyr-cd-H\"> </a></td><td>Black Lung</td><td>Black Lung</td></tr><tr><td>I<a name=\"line-bene-prmry-pyr-cd-I\"> </a></td><td>Dept. of Veterans Affairs</td><td>Dept. of Veterans Affairs</td></tr><tr><td>L<a name=\"line-bene-prmry-pyr-cd-L\"> </a></td><td>Any liability insurance</td><td>Any liability insurance</td></tr><tr><td>M<a name=\"line-bene-prmry-pyr-cd-M\"> </a></td><td>Override code: EGHP services involved</td><td>Override code: EGHP services involved</td></tr><tr><td>N<a name=\"line-bene-prmry-pyr-cd-N\"> </a></td><td>Override code: non-EGHP services involved</td><td>Override code: non-EGHP services involved</td></tr><tr><td>W<a name=\"line-bene-prmry-pyr-cd-W\"> </a></td><td>Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Null/missing= Medicare is primary payer</td><td>Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Null/missing= Medicare is primary payer</td></tr></table></div>"
  ];
  fhir:CodeSystem.url [ fhir:value "https://bluebutton.cms.gov/assets/ig/CodeSystem-line-bene-prmry-pyr-cd"];
  fhir:CodeSystem.identifier [
     fhir:Identifier.value [ fhir:value "https://bluebutton.cms.gov/assets/ig/CodeSystem-line-bene-prmry-pyr-cd.html" ]
  ];
  fhir:CodeSystem.version [ fhir:value "1.1.1"];
  fhir:CodeSystem.name [ fhir:value "Line Primary Payer Code (if not Medicare)"];
  fhir:CodeSystem.title [ fhir:value "Line Primary Payer Code (if not Medicare)"];
  fhir:CodeSystem.status [ fhir:value "active"];
  fhir:CodeSystem.date [ fhir:value "2018-11-27T15:56:35+00:00"^^xsd:dateTime];
  fhir:CodeSystem.publisher [ fhir:value "CMS Blue Button 2.0 Team"];
  fhir:CodeSystem.description [ fhir:value "The code specifying a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's medical bills relating to the line item service on the non-institutional claim. The presence of a primary payer code indicates that some other payer besides Medicare covered at least some portion of the charges. Source: https://bluebutton.cms.gov/resources/variables/line_bene_prmry_pyr_cd"];
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean];
  fhir:CodeSystem.valueSet [ fhir:value "https://bluebutton.cms.gov/assets/ig/ValueSet-line-bene-prmry-pyr-cd"];
  fhir:CodeSystem.hierarchyMeaning [ fhir:value "is-a"];
  fhir:CodeSystem.content [ fhir:value "complete"];
  fhir:CodeSystem.concept [
     fhir:index 0;
     fhir:CodeSystem.concept.code [ fhir:value "A" ];
     fhir:CodeSystem.concept.display [ fhir:value "Working aged bene/spouse with employer group health plan (EGHP)" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Working aged bene/spouse with employer group health plan (EGHP)" ]
  ], [
     fhir:index 1;
     fhir:CodeSystem.concept.code [ fhir:value "B" ];
     fhir:CodeSystem.concept.display [ fhir:value "End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan" ];
     fhir:CodeSystem.concept.definition [ fhir:value "End stage renal disease (ESRD) beneficiary in the 18 month coordination period with an employer group health plan" ]
  ], [
     fhir:index 2;
     fhir:CodeSystem.concept.code [ fhir:value "C" ];
     fhir:CodeSystem.concept.display [ fhir:value "Conditional payment by Medicare; future reimbursement expected" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Conditional payment by Medicare; future reimbursement expected" ]
  ], [
     fhir:index 3;
     fhir:CodeSystem.concept.code [ fhir:value "D" ];
     fhir:CodeSystem.concept.display [ fhir:value "Automobile no-fault" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Automobile no-fault" ]
  ], [
     fhir:index 4;
     fhir:CodeSystem.concept.code [ fhir:value "E" ];
     fhir:CodeSystem.concept.display [ fhir:value "Workers' compensation" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Workers' compensation" ]
  ], [
     fhir:index 5;
     fhir:CodeSystem.concept.code [ fhir:value "F" ];
     fhir:CodeSystem.concept.display [ fhir:value "Public Health Service or other federal agency (other than Dept. of Veterans Affairs)" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Public Health Service or other federal agency (other than Dept. of Veterans Affairs)" ]
  ], [
     fhir:index 6;
     fhir:CodeSystem.concept.code [ fhir:value "G" ];
     fhir:CodeSystem.concept.display [ fhir:value "Working disabled bene (under age 65 with LGHP)" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Working disabled bene (under age 65 with LGHP)" ]
  ], [
     fhir:index 7;
     fhir:CodeSystem.concept.code [ fhir:value "H" ];
     fhir:CodeSystem.concept.display [ fhir:value "Black Lung" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Black Lung" ]
  ], [
     fhir:index 8;
     fhir:CodeSystem.concept.code [ fhir:value "I" ];
     fhir:CodeSystem.concept.display [ fhir:value "Dept. of Veterans Affairs" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Dept. of Veterans Affairs" ]
  ], [
     fhir:index 9;
     fhir:CodeSystem.concept.code [ fhir:value "L" ];
     fhir:CodeSystem.concept.display [ fhir:value "Any liability insurance" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Any liability insurance" ]
  ], [
     fhir:index 10;
     fhir:CodeSystem.concept.code [ fhir:value "M" ];
     fhir:CodeSystem.concept.display [ fhir:value "Override code: EGHP services involved" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Override code: EGHP services involved" ]
  ], [
     fhir:index 11;
     fhir:CodeSystem.concept.code [ fhir:value "N" ];
     fhir:CodeSystem.concept.display [ fhir:value "Override code: non-EGHP services involved" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Override code: non-EGHP services involved" ]
  ], [
     fhir:index 12;
     fhir:CodeSystem.concept.code [ fhir:value "W" ];
     fhir:CodeSystem.concept.display [ fhir:value "Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Null/missing= Medicare is primary payer" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Null/missing= Medicare is primary payer" ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.