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23cca1f9ba
devsofttech_hms_ci4/ABDM_FHIR/definitions.json/CodeSystem-ndhm-claim-exclusion.json
DevSoftTech Server 23cca1f9ba feat(abdm): proper FHIR bundles for lab reports and IPD discharge 
- FhirR4Builder: rewrite buildLabReportBundle() with DiagnosticReportLab
  profile, structured Observation valueQuantity/valueString, reference
  ranges, interpretation codes, Binary+DocumentReference for HTML report,
  Encounter resource, HFR-based bundle identifier system

- FhirR4Builder: rewrite buildDischargeSummaryBundle() with optional
  Practitioner/Organization params, structured ABDM sections (chief
  complaints 422843007, medical history 1003642006, investigations
  721981007, procedures 1003640003, medications 721912009, follow-up
  736271009), HFR-based bundle identifier system

- AbdmGateway: shareIpdDischargeBundle() now builds a real
  DischargeSummaryRecord FHIR bundle and posts via pushRecord()
  (POST /v3/records/push) instead of the stale shareIpdDischargeBundle()

- AbdmGateway: shareDiagnosisReportBundle() now builds a real
  DiagnosticReportRecord FHIR bundle and posts via pushRecord()
  instead of the stale shareDiagnosisReportBundle()

- AbdmGateway: add getHospitalProfileForFhir() and mapLabTypeToTitle()
  helpers; fix pre-existing undefined \ bug in
  getActiveConsentRecord()

- Add ABDM_FHIR reference package, AbdmBridgeLog controller/view,
  bridge record migration, debug scripts and misc UI/settings updates
2026-05-23 04:41:59 +05:30

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{"resourceType":"CodeSystem","id":"ndhm-claim-exclusion","text":{"status":"generated","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem ndhm-claim-exclusion</b></p><a name=\"ndhm-claim-exclusion\"> </a><a name=\"hcndhm-claim-exclusion\"> </a><a name=\"ndhm-claim-exclusion-hi-IN\"> </a><p>This case-sensitive code system <code>https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td style=\"white-space:nowrap\">Excl01<a name=\"ndhm-claim-exclusion-Excl01\"> </a></td><td>Pre-Existing Diseases</td></tr><tr><td style=\"white-space:nowrap\">Excl02<a name=\"ndhm-claim-exclusion-Excl02\"> </a></td><td>Specified disease/procedure waiting period</td></tr><tr><td style=\"white-space:nowrap\">Excl03<a name=\"ndhm-claim-exclusion-Excl03\"> </a></td><td>30-day waiting period</td></tr><tr><td style=\"white-space:nowrap\">Excl04<a name=\"ndhm-claim-exclusion-Excl04\"> </a></td><td>Investigation Evaluation</td></tr><tr><td style=\"white-space:nowrap\">Excl05<a name=\"ndhm-claim-exclusion-Excl05\"> </a></td><td>Rest Cure,Rehabilitation and Respite Care</td></tr><tr><td style=\"white-space:nowrap\">Excl06<a name=\"ndhm-claim-exclusion-Excl06\"> </a></td><td>Obesity/Weight Control</td></tr><tr><td style=\"white-space:nowrap\">Excl07<a name=\"ndhm-claim-exclusion-Excl07\"> </a></td><td>Change-of-Gender treatments</td></tr><tr><td style=\"white-space:nowrap\">Excl08<a name=\"ndhm-claim-exclusion-Excl08\"> </a></td><td>Cosmetic or plastic Surgery</td></tr><tr><td style=\"white-space:nowrap\">Excl09<a name=\"ndhm-claim-exclusion-Excl09\"> </a></td><td>Hazardous or Adventure sports</td></tr><tr><td style=\"white-space:nowrap\">Excl10<a name=\"ndhm-claim-exclusion-Excl10\"> </a></td><td>Breach of law</td></tr><tr><td style=\"white-space:nowrap\">Excl11<a name=\"ndhm-claim-exclusion-Excl11\"> </a></td><td>Excluded Providers</td></tr><tr><td style=\"white-space:nowrap\">Excl12<a name=\"ndhm-claim-exclusion-Excl12\"> </a></td><td>Rehabilitation</td></tr><tr><td style=\"white-space:nowrap\">Excl13<a name=\"ndhm-claim-exclusion-Excl13\"> </a></td><td>Hydrotherapy</td></tr><tr><td style=\"white-space:nowrap\">Excl14<a name=\"ndhm-claim-exclusion-Excl14\"> </a></td><td>Non-prescription</td></tr><tr><td style=\"white-space:nowrap\">Excl15<a name=\"ndhm-claim-exclusion-Excl15\"> </a></td><td>Refractive Error</td></tr><tr><td style=\"white-space:nowrap\">Excl16<a name=\"ndhm-claim-exclusion-Excl16\"> </a></td><td>Unproven Treatments</td></tr><tr><td style=\"white-space:nowrap\">Excl17<a name=\"ndhm-claim-exclusion-Excl17\"> </a></td><td>Sterility and Infertility</td></tr><tr><td style=\"white-space:nowrap\">Excl18<a name=\"ndhm-claim-exclusion-Excl18\"> </a></td><td>Maternity Expenses</td></tr><tr><td style=\"white-space:nowrap\">IIB13<a name=\"ndhm-claim-exclusion-IIB13\"> </a></td><td>Fraudulent Claim</td></tr><tr><td style=\"white-space:nowrap\">IIB14<a name=\"ndhm-claim-exclusion-IIB14\"> </a></td><td>Sum insured exhausted</td></tr><tr><td style=\"white-space:nowrap\">IIB15<a name=\"ndhm-claim-exclusion-IIB15\"> </a></td><td>Withdrawal by the Insured</td></tr><tr><td style=\"white-space:nowrap\">IIB16<a name=\"ndhm-claim-exclusion-IIB16\"> </a></td><td>Suppression of Material Information</td></tr><tr><td style=\"white-space:nowrap\">IIB17<a name=\"ndhm-claim-exclusion-IIB17\"> </a></td><td>Waiting Period beyond 30 days</td></tr><tr><td style=\"white-space:nowrap\">IIB20<a name=\"ndhm-claim-exclusion-IIB20\"> </a></td><td>Not covered under the Terms and Conditions of the contract</td></tr></table></div>"},"url":"https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion","version":"6.5.0","name":"ClaimExclusion","title":"Claim Exclusion","status":"draft","experimental":false,"date":"2023-07-05","publisher":"National Resource Center for EHR Standards","contact":[{"name":"National Resource Center for EHR Standards","telecom":[{"system":"url","value":"https://nrces.in/"}]}],"description":"This CodeSystem comprises codes that describes excluded coverage within a health insurance product.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"IN","display":"India"}]}],"caseSensitive":true,"content":"complete","count":24,"concept":[{"code":"Excl01","display":"Pre-Existing Diseases"},{"code":"Excl02","display":"Specified disease/procedure waiting period"},{"code":"Excl03","display":"30-day waiting period"},{"code":"Excl04","display":"Investigation Evaluation"},{"code":"Excl05","display":"Rest Cure,Rehabilitation and Respite Care"},{"code":"Excl06","display":"Obesity/Weight Control"},{"code":"Excl07","display":"Change-of-Gender treatments"},{"code":"Excl08","display":"Cosmetic or plastic Surgery"},{"code":"Excl09","display":"Hazardous or Adventure sports"},{"code":"Excl10","display":"Breach of law"},{"code":"Excl11","display":"Excluded Providers"},{"code":"Excl12","display":"Rehabilitation"},{"code":"Excl13","display":"Hydrotherapy"},{"code":"Excl14","display":"Non-prescription"},{"code":"Excl15","display":"Refractive Error"},{"code":"Excl16","display":"Unproven Treatments"},{"code":"Excl17","display":"Sterility and Infertility"},{"code":"Excl18","display":"Maternity Expenses"},{"code":"IIB13","display":"Fraudulent Claim"},{"code":"IIB14","display":"Sum insured exhausted"},{"code":"IIB15","display":"Withdrawal by the Insured"},{"code":"IIB16","display":"Suppression of Material Information"},{"code":"IIB17","display":"Waiting Period beyond 30 days"},{"code":"IIB20","display":"Not covered under the Terms and Conditions of the contract"}]}
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