Proprietary Codes

• Overview
• Infrastructure
• Scheduling
• List of Code Sets

Overview

Cerner’s implementation of the HL7^® DSTU2 FHIR^® standard allows Millennium proprietary code values to be used in addition to standard value set codes on a limited basis. This allows developers to read and write data with clients’ proprietary codes, eliminating the need to map proprietary codes to standard codes. This is particularly beneficial for concepts that are highly customized by clients such as appointment and document types.

Millennium groups repetitive textual information into code sets. The code set stores a numeric code value that represents a textual or character display. Code sets are consistent across all clients. But the values in a code set vary between clients and are only guaranteed unique within a specific EHR system, which is the reason for the EHR source id (or tenant) qualifier in the system URL.

The following are true for all Millennium proprietary codes:

• The system value uses the following format: https://fhir.cerner.com/<EHR source id>/codeSet/<code set>
• The code value is the numeric code value as a string
• The display value is the code value display
• The userSelected value is set to true
• On inbound requests (POST, PUT, PATCH), proprietary codes and standard codes may not be set in the same coding array. If they are, the create or update request will fail with a 422 Unprocessable Entity response.

Example outbound CodeableConcept displaying both standard and proprietary codes:

{
  "type": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "394581000",
        "display": "Community medicine",
        "userSelected": false
      },
      {
        "system": "https://fhir.cerner.com/<EHR source id>/codeSet/14249",
        "code": "21265426",
        "display": "Same Day",
        "userSelected": true
      }
    ]
  }
}

Infrastructure

DocumentReference

The DocumentReference Resource supports proprietary codes for:

• DocumentReference.type codes are maintained in Code Set 72 Event Code

Scheduling

Appointment

The Appointment Resource supports proprietary codes for:

• Appointment.type codes are maintained in Code Set 14249 Scheduling Appointment Synonyms or Types

Slot

The Slot Resource supports proprietary codes for:

• Slot.type codes are maintained in Code Set 14249 Scheduling Appointment Synonyms or Types

List of Code Sets

Code Set 72 Event Code

This code set is extremely large, very client customized, and maintains all clinical events such as various clinical documents or note types and clinical observations such as laboratory results and vital signs.

{
  "system": "https://fhir.cerner.com/<EHR source id>/codeSet/72,
  "code": "2820587",
  "display": "Discharge Note-Nursing",
  "userSelected": true
}

Code Set 14249 Scheduling Appointment Synonyms or Types

This code set is highly customized by clients and may include appointment types such as Office Visit, Office Visit - New, or Office Visit - Follow Up.

{
  "system": "https://fhir.cerner.com/<EHR source id>/codeSet/14249,
  "code": "5038369",
  "display": "Office Visit - Return",
  "userSelected": true
}