Level
Lvl
|
Code
|
Display
|
Definition
|
|
1
|
(_ActAccommodationReason)
_ActAccommodationReason
|
ActAccommodationReason
|
Identifies
the
reason
the
patient
is
assigned
to
this
accommodation
type
|
|
2
|
ACCREQNA
ACCREQNA
|
Accommodation
Requested
Not
Available
|
Accommodation
requested
is
not
available.
|
|
2
|
FLRCNV
FLRCNV
|
Floor
Convenience
|
Accommodation
is
assigned
for
floor
convenience.
|
|
2
|
MEDNEC
MEDNEC
|
Medical
Necessity
|
Required
for
medical
reasons(s).
|
|
2
|
PAT
PAT
|
Patient
request
|
The
Patient
requested
the
action
|
|
1
|
(_ActCoverageReason)
_ActCoverageReason
|
ActCoverageReason
|
Description:Codes
used
to
specify
reasons
or
criteria
relating
to
coverage
provided
under
a
policy
or
program.
May
be
used
to
convey
reasons
pertaining
to
coverage
contractual
provisions,
including
criteria
for
eligibility,
coverage
limitations,
coverage
maximums,
or
financial
participation
required
of
covered
parties.
|
|
2
|
(_EligibilityActReasonCode)
_EligibilityActReasonCode
|
EligibilityActReasonCode
|
Identifies
the
reason
or
rational
for
why
a
person
is
eligibile
for
benefits
under
an
insurance
policy
or
progam.
Examples:
A
person
is
a
claimant
under
an
automobile
insurance
policy
are
client
deceased
&
adopted
client
has
been
given
a
new
policy
identifier.
A
new
employee
is
eligible
for
health
insurance
as
an
employment
benefit.
A
person
meets
a
government
program
eligibility
criteria
for
financial,
age
or
health
status.
|
|
3
|
(_ActIneligibilityReason)
_ActIneligibilityReason
|
ActIneligibilityReason
|
Identifies
the
reason
or
rational
for
why
a
person
is
not
eligibile
for
benefits
under
an
insurance
policy.
Examples
are
client
deceased
&
adopted
client
has
been
given
a
new
policy
identifier.
|
|
4
|
COVSUS
COVSUS
|
coverage
suspended
|
When
a
client
has
no
contact
with
the
health
system
for
an
extended
period,
coverage
is
suspended.
Client
will
be
reinstated
to
original
start
date
upon
proof
of
identification,
residency
etc.
Example:
Coverage
may
be
suspended
during
a
strike
situation,
when
employer
benefits
for
employees
are
not
covered
(i.e.
not
in
effect).
|
|
4
|
DECSD
DECSD
|
deceased
|
Client
deceased.
|
|
4
|
REGERR
REGERR
|
registered
in
error
|
Client
was
registered
in
error.
|
|
3
|
(_CoverageEligibilityReason)
_CoverageEligibilityReason
|
CoverageEligibilityReason
|
Definition:
Identifies
the
reason
or
rational
for
why
a
person
is
eligibile
for
benefits
under
an
insurance
policy
or
progam.
Examples:
A
person
is
a
claimant
under
an
automobile
insurance
policy
are
client
deceased
&
adopted
client
has
been
given
a
new
policy
identifier.
A
new
employee
is
eligible
for
health
insurance
as
an
employment
benefit.
A
person
meets
a
government
program
eligibility
criteria
for
financial,
age
or
health
status.
|
|
4
|
AGE
AGE
|
age
eligibility
|
A
person
becomes
eligible
for
a
program
based
on
age.
Example:
In
the
U.S.,
a
person
who
is
65
years
of
age
or
older
is
eligible
for
Medicare.
|
|
4
|
CRIME
CRIME
|
crime
victim
|
A
person
becomes
eligible
for
insurance
or
a
program
because
of
crime
related
health
condition
or
injury.
Example:
A
person
is
a
claimant
under
the
U.S.
Crime
Victims
Compensation
program.
|
|
4
|
DIS
DIS
|
disability
|
A
person
becomes
a
claimant
under
a
disability
income
insurance
policy
or
a
disability
rehabilitation
program
because
of
a
health
condition
or
injury
which
limits
the
person's
ability
to
earn
an
income
or
function
without
institutionalization.
|
|
4
|
EMPLOY
EMPLOY
|
employment
benefit
|
A
person
becomes
eligible
for
insurance
provided
as
an
employment
benefit
based
on
employment
status.
|
|
4
|
FINAN
FINAN
|
financial
eligibility
|
A
person
becomes
eligible
for
a
program
based
on
financial
criteria.
Example:
A
person
whose
family
income
is
below
a
financial
threshold
for
eligibility
for
Medicaid
or
SCHIP.
|
|
4
|
HEALTH
HEALTH
|
health
status
|
A
person
becomes
eligible
for
a
program
because
of
a
qualifying
health
condition
or
injury.
Examples:
A
person
is
determined
to
have
a
qualifying
health
conditions
include
pregnancy,
HIV/AIDs,
tuberculosis,
end
stage
renal
disease,
breast
or
cervical
cancer,
or
other
condition
requiring
specialized
health
services,
hospice,
institutional
or
community
based
care
provided
under
a
program
|
|
4
|
MULTI
MULTI
|
multiple
criteria
eligibility
|
A
person
becomes
eligible
for
a
program
based
on
more
than
one
criterion.
Examples:
In
the
U.S.,
a
child
whose
familiy
income
meets
Medicaid
financial
thresholds
and
whose
age
is
less
than
18
is
eligible
for
the
Early
and
Periodic
Screening,
Diagnostic,
and
Treatment
program
(EPSDT).
A
person
whose
family
income
meets
Medicaid
financial
thresholds
and
whose
age
is
65
years
or
older
is
eligible
for
Medicaid
and
Medicare,
and
are
referred
to
as
dual
eligibles.
|
|
4
|
PNC
PNC
|
property
and
casualty
condition
|
A
person
becomes
a
claimant
under
a
property
and
casualty
insurance
policy
because
of
a
related
health
condition
or
injury
resulting
from
a
circumstance
covered
under
the
terms
of
the
policy.
Example:
A
person
is
a
claimant
under
a
homeowners
insurance
policy
because
of
an
injury
sustained
on
the
policyholderaTMs
premises.
|
|
4
|
STATUTORY
STATUTORY
|
statutory
eligibility
|
A
person
becomes
eligible
for
a
program
based
on
statutory
criteria.
Examples:
A
person
is
a
member
of
an
indigenous
group,
a
veteran
of
military
service,
or
in
the
U.S.,
a
recipient
of
adoption
assistance
and
foster
care
under
Title
IV-E
of
the
Social
Security.
|
|
4
|
VEHIC
VEHIC
|
motor
vehicle
accident
victim
|
A
person
becomes
a
claimant
under
a
motor
vehicle
accident
insurance
because
of
a
motor
vehicle
accident
related
health
condition
or
injury.
|
|
4
|
WORK
WORK
|
work
related
|
A
person
becomes
eligible
for
insurance
or
a
program
because
of
a
work
related
health
condition
or
injury.
Example:
A
person
is
a
claimant
under
the
U.S.
Black
Lung
Program.
|
|
1
|
(_ActInformationManagementReason)
_ActInformationManagementReason
|
ActInformationManagementReason
|
Description:The
rationale
or
purpose
for
an
act
relating
to
information
management,
such
as
archiving
information
for
the
purpose
of
complying
with
an
enterprise
data
retention
policy.
|
|
2
|
(_ActHealthInformationManagementReason)
_ActHealthInformationManagementReason
|
ActHealthInformationManagementReason
|
Description:The
rationale
or
purpose
for
an
act
relating
to
health
information
management,
such
as
archiving
information
for
the
purpose
of
complying
with
an
organization
policy
or
jurisdictional
law
relating
to
data
retention.
|
|
3
|
(_ActConsentInformationAccessOverrideReason)
_ActConsentInformationAccessOverrideReason
|
ActConsentInformationAccessOverrideReason
|
To
perform
one
or
more
operations
on
information
to
which
the
patient
has
not
consented
as
deemed
necessary
by
authorized
entities
for
providing
care
in
the
best
interest
of
the
patient;
providing
immediately
needed
health
care
for
an
emergent
condition;
or
for
protecting
public
or
third
party
safety.
Usage
Notes:
Used
to
convey
the
reason
that
a
provider
or
other
entity
may
or
has
accessed
personal
healthcare
information.
Typically,
this
involves
overriding
the
subject's
consent
directives.
|
|
4
|
OVRER
OVRER
|
emergency
treatment
override
|
To
perform
one
or
more
operations
on
information
to
which
the
patient
has
not
consented
by
authorized
entities
for
treating
a
condition
which
poses
an
immediate
threat
to
the
patient's
health
and
which
requires
immediate
medical
intervention.
Usage
Notes:
The
patient
is
unable
to
provide
consent,
but
the
provider
determines
they
have
an
urgent
healthcare
related
reason
to
access
the
record.
|
|
4
|
OVRPJ
OVRPJ
|
professional
judgment
override
|
To
perform
one
or
more
operations
on
information
to
which
the
patient
declined
to
consent
for
providing
health
care.
Usage
Notes:
The
patient,
while
able
to
give
consent,
has
not.
However
the
provider
believes
it
is
in
the
patient's
interest
to
access
the
record
without
patient
consent.
|
|
4
|
OVRPS
OVRPS
|
public
safety
override
|
To
perform
one
or
more
operations
on
information
to
which
the
patient
has
not
consented
for
public
safety
reasons.
Usage
Notes:
The
patient,
while
able
to
give
consent,
has
not.
However,
the
provider
believes
that
access
to
masked
patient
information
is
justified
because
of
concerns
related
to
public
safety.
|
|
4
|
OVRTPS
OVRTPS
|
third
party
safety
override
|
To
perform
one
or
more
operations
on
information
to
which
the
patient
has
not
consented
for
third
party
safety.
Usage
Notes:
The
patient,
while
able
to
give
consent,
has
not.
However,
the
provider
believes
that
access
to
masked
patient
information
is
justified
because
of
concerns
related
to
the
health
and
safety
of
one
or
more
third
parties.
|
|
3
|
PurposeOfUse
PurposeOfUse
|
purpose
of
use
|
Reason
for
performing
one
or
more
operations
on
information,
which
may
be
permitted
by
source
system's
security
policy
in
accordance
with
one
or
more
privacy
policies
and
consent
directives.
Usage
Notes:
The
rationale
or
purpose
for
an
act
relating
to
the
management
of
personal
health
information,
such
as
collecting
personal
health
information
for
research
or
public
health
purposes.
|
|
4
|
HMARKT
HMARKT
|
healthcare
marketing
|
To
perform
one
or
more
operations
on
information
for
marketing
services
and
products
related
to
health
care.
|
|
4
|
HOPERAT
HOPERAT
|
healthcare
operations
|
To
perform
one
or
more
operations
on
information
used
for
conducting
administrative
and
contractual
activities
related
to
the
provision
of
health
care.
|
|
5
|
DONAT
DONAT
|
donation
|
To
perform
one
or
more
operations
on
information
used
for
cadaveric
organ,
eye
or
tissue
donation.
|
|
5
|
FRAUD
FRAUD
|
fraud
|
To
perform
one
or
more
operations
on
information
used
for
fraud
detection
and
prevention
processes.
|
|
5
|
GOV
GOV
|
government
|
To
perform
one
or
more
operations
on
information
used
within
government
processes.
|
|
5
|
HACCRED
HACCRED
|
health
accreditation
|
To
perform
one
or
more
operations
on
information
for
conducting
activities
related
to
meeting
accreditation
criteria.
|
|
5
|
HCOMPL
HCOMPL
|
health
compliance
|
To
perform
one
or
more
operations
on
information
used
for
conducting
activities
required
to
meet
a
mandate.
|
|
5
|
HDECD
HDECD
|
decedent
|
To
perform
one
or
more
operations
on
information
used
for
handling
deceased
patient
matters.
|
|
5
|
HDIRECT
HDIRECT
|
directory
|
To
perform
one
or
more
operation
operations
on
information
used
to
manage
a
patient
directory.
Examples:
facility
enterprise
payer
health
information
exchange
patient
directory
|
|
5
|
HLEGAL
HLEGAL
|
legal
|
To
perform
one
or
more
operations
on
information
for
conducting
activities
required
by
legal
proceeding.
|
|
5
|
HOUTCOMS
HOUTCOMS
|
health
outcome
measure
|
To
perform
one
or
more
operations
on
information
used
for
assessing
results
and
comparative
effectiveness
achieved
by
health
care
practices
and
interventions.
|
|
5
|
HPRGRP
HPRGRP
|
health
program
reporting
|
To
perform
one
or
more
operations
on
information
used
for
conducting
activities
to
meet
program
accounting
requirements.
|
|
5
|
HQUALIMP
HQUALIMP
|
health
quality
improvement
|
To
perform
one
or
more
operations
on
information
used
for
conducting
administrative
activities
to
improve
health
care
quality.
|
|
5
|
HSYSADMIN
HSYSADMIN
|
health
system
administration
|
To
perform
one
or
more
operations
on
information
to
administer
the
electronic
systems
used
for
the
delivery
of
health
care.
|
|
5
|
MEMADMIN
MEMADMIN
|
member
administration
|
To
perform
one
or
more
operations
on
information
to
administer
health
care
coverage
to
an
enrollee
under
a
policy
or
program.
|
|
5
|
PATADMIN
PATADMIN
|
patient
administration
|
To
perform
one
or
more
operations
on
information
used
for
operational
activities
conducted
to
administer
the
delivery
of
health
care
to
a
patient.
|
|
5
|
PATSFTY
PATSFTY
|
patient
safety
|
To
perform
one
or
more
operations
on
information
in
processes
related
to
ensuring
the
safety
of
health
care.
|
|
5
|
PERFMSR
PERFMSR
|
performance
measure
|
To
perform
one
or
more
operations
on
information
used
for
monitoring
performance
of
recommended
health
care
practices
and
interventions.
|
|
5
|
RECORDMGT
RECORDMGT
|
records
management
|
To
perform
one
or
more
operations
on
information
used
within
the
health
records
management
process.
|
|
5
|
TRAIN
TRAIN
|
training
|
To
perform
one
or
more
operations
on
information
used
in
training
and
education.
|
|
4
|
HPAYMT
HPAYMT
|
healthcare
payment
|
To
perform
one
or
more
operations
on
information
for
conducting
financial
or
contractual
activities
related
to
payment
for
provision
of
health
care.
|
|
5
|
CLMATTCH
CLMATTCH
|
claim
attachment
|
To
perform
one
or
more
operations
on
information
for
provision
of
additional
clinical
evidence
in
support
of
a
request
for
coverage
or
payment
for
health
services.
|
|
5
|
COVAUTH
COVAUTH
|
coverage
authorization
|
To
perform
one
or
more
operations
on
information
for
conducting
prior
authorization
or
predetermination
of
coverage
for
services.
|
|
5
|
COVERAGE
COVERAGE
|
coverage
under
policy
or
program
|
To
perform
one
or
more
operations
on
information
for
conducting
activities
related
to
coverage
under
a
program
or
policy.
|
|
6
|
ELIGDTRM
ELIGDTRM
|
eligibility
determination
|
To
perform
one
or
more
operations
on
information
used
for
conducting
eligibility
determination
for
coverage
in
a
program
or
policy.
May
entail
review
of
financial
status
or
disability
assessment.
|
|
6
|
ELIGVER
ELIGVER
|
eligibility
verification
|
To
perform
one
or
more
operations
on
information
used
for
conducting
eligibility
verification
of
coverage
in
a
program
or
policy.
May
entail
provider
contacting
coverage
source
(e.g.,
(e.g.
government
health
program
such
as
workers
compensation
or
health
plan)
for
confirmation
of
enrollment,
eligibility
for
specific
services,
and
any
applicable
copays.
|
|
6
|
ENROLLM
ENROLLM
|
enrollment
|
To
perform
one
or
more
operations
on
information
used
for
enrolling
a
covered
party
in
a
program
or
policy.
May
entail
recording
of
covered
party's
and
any
dependent's
demographic
information
and
benefit
choices.
|
|
5
|
REMITADV
REMITADV
|
remittance
advice
|
To
perform
one
or
more
operations
on
information
about
the
amount
remitted
for
a
health
care
claim.
|
|
4
|
HRESCH
HRESCH
|
healthcare
research
|
To
perform
one
or
more
operations
on
information
for
conducting
scientific
investigations
to
obtain
health
care
knowledge.
|
|
5
|
CLINTRCH
CLINTRCH
|
clinical
trial
research
|
To
perform
one
or
more
operations
on
information
for
conducting
scientific
investigations
in
accordance
with
clinical
trial
protocols
to
obtain
health
care
knowledge.
|
|
4
|
PATRQT
PATRQT
|
patient
requested
|
To
perform
one
or
more
operations
on
information
in
response
to
a
patient's
request.
|
|
5
|
FAMRQT
FAMRQT
|
family
requested
|
To
perform
one
or
more
operations
on
information
in
response
to
a
request
by
a
family
member
authorized
by
the
patient.
|
|
5
|
PWATRNY
PWATRNY
|
power
of
attorney
|
To
perform
one
or
more
operations
on
information
in
response
to
a
request
by
a
person
appointed
as
the
patient's
legal
representative.
|
|
5
|
SUPNWK
SUPNWK
|
support
network
|
To
perform
one
or
more
operations
on
information
in
response
to
a
request
by
a
person
authorized
by
the
patient.
|
|
4
|
PUBHLTH
PUBHLTH
|
public
health
|
To
perform
one
or
more
operations
on
information
for
conducting
public
health
activities,
such
as
the
reporting
of
notifiable
conditions.
|
|
5
|
DISASTER
DISASTER
|
disaster
|
To
perform
one
or
more
operations
on
information
used
for
provision
of
immediately
needed
health
care
to
a
population
of
living
subjects
located
in
a
disaster
zone.
|
|
5
|
THREAT
THREAT
|
threat
|
To
perform
one
or
more
operations
on
information
used
to
prevent
injury
or
disease
to
living
subjects
who
may
be
the
target
of
violence.
|
|
4
|
TREAT
TREAT
|
treatment
|
To
perform
one
or
more
operations
on
information
for
provision
of
health
care.
|
|
5
|
CAREMGT
CAREMGT
|
Care
Management
|
To
perform
one
or
more
operations
on
information
for
provision
of
health
care
coordination.
|
|
5
|
CLINTRL
CLINTRL
|
clinical
trial
|
To
perform
health
care
as
part
of
the
clinical
trial
protocol.
|
|
5
|
ETREAT
ETREAT
|
Emergency
Treatment
|
To
perform
one
or
more
operations
on
information
for
provision
of
immediately
needed
health
care
for
an
emergent
condition.
|
|
5
|
POPHLTH
POPHLTH
|
population
health
|
To
perform
one
or
more
operations
on
information
for
provision
of
health
care
to
a
population
of
living
subjects,
e.g.,
e.g.
needle
exchange
program.
|
|
2
|
(_ActInformationPrivacyReason)
_ActInformationPrivacyReason
|
ActInformationPrivacyReason
|
Description:The
rationale
or
purpose
for
an
act
relating
to
the
management
of
personal
information,
such
as
disclosing
personal
tax
information
for
the
purpose
of
complying
with
a
court
order.
|
|
3
|
MARKT
MARKT
|
marketing
|
Description:
|
|
3
|
OPERAT
OPERAT
|
operations
|
Description:Administrative
and
contractual
processes
required
to
support
an
activity,
product,
or
service
|
|
4
|
LEGAL
LEGAL
|
subpoena
|
Definition:To
provide
information
as
a
result
of
a
subpoena.
|
|
4
|
ACCRED
ACCRED
|
accreditation
|
Description:Operational
activities
conducted
for
the
purposes
of
meeting
of
criteria
defined
by
an
accrediting
entity
for
an
activity,
product,
or
service
|
|
4
|
COMPL
COMPL
|
compliance
|
Description:Operational
activities
required
to
meet
a
mandate
related
to
an
activity,
product,
or
service
|
|
4
|
ENADMIN
ENADMIN
|
entity
administration
|
Description:Operational
activities
conducted
to
administer
information
relating
to
entities
involves
with
an
activity,
product,
or
service
|
|
4
|
OUTCOMS
OUTCOMS
|
outcome
measure
|
Description:Operational
activities
conducted
for
the
purposes
of
assessing
the
results
of
an
activity,
product,
or
service
|
|
4
|
PRGRPT
PRGRPT
|
program
reporting
|
Description:Operational
activities
conducted
to
meet
program
accounting
requirements
related
to
an
activity,
product,
or
service
|
|
4
|
QUALIMP
QUALIMP
|
quality
improvement
|
Description:Operational
activities
conducted
for
the
purposes
of
improving
the
quality
of
an
activity,
product,
or
service
|
|
4
|
SYSADMN
SYSADMN
|
system
administration
|
Description:Operational
activities
conducted
to
administer
the
electronic
systems
used
for
an
activity,
product,
or
service
|
|
3
|
PAYMT
PAYMT
|
payment
|
Description:Administrative,
financial,
and
contractual
processes
related
to
payment
for
an
activity,
product,
or
service
|
|
3
|
RESCH
RESCH
|
research
|
Description:Investigative
activities
conducted
for
the
purposes
of
obtaining
knowledge
|
|
3
|
SRVC
SRVC
|
service
|
Description:Provision
of
a
service,
product,
or
capability
to
an
individual
or
organization
|
|
1
|
_ActInvalidReason
|
ActInvalidReason
|
Description:
Types
of
reasons
why
a
substance
is
invalid
for
use.
|
|
2
|
ADVSTORAGE
ADVSTORAGE
|
adverse
storage
condition
|
Description:
Storage
conditions
caused
the
substance
to
be
ineffective.
|
|
3
|
COLDCHNBRK
COLDCHNBRK
|
cold
chain
break
|
Description:
Cold
chain
was
not
maintained
for
the
substance.
|
|
2
|
EXPLOT
EXPLOT
|
expired
lot
|
Description:
The
lot
from
which
the
substance
was
drawn
was
expired.
|
|
2
|
OUTSIDESCHED
OUTSIDESCHED
|
administered
outside
recommended
schedule
or
practice
|
The
substance
was
administered
outside
of
the
recommended
schedule
or
practice.
|
|
2
|
PRODRECALL
PRODRECALL
|
product
recall
|
Description:
The
substance
was
recalled
by
the
manufacturer.
|
|
1
|
(_ActInvoiceCancelReason)
_ActInvoiceCancelReason
|
ActInvoiceCancelReason
|
Domain
specifies
the
codes
used
to
describe
reasons
why
a
Provider
is
cancelling
an
Invoice
or
Invoice
Grouping.
|
|
2
|
INCCOVPTY
INCCOVPTY
|
incorrect
covered
party
as
patient
|
The
covered
party
(patient)
specified
with
the
Invoice
is
not
correct.
|
|
2
|
INCINVOICE
INCINVOICE
|
incorrect
billing
|
The
billing
information,
specified
in
the
Invoice
Elements,
is
not
correct.
This
could
include
incorrect
costing
for
items
included
in
the
Invoice.
|
|
2
|
INCPOLICY
INCPOLICY
|
incorrect
policy
|
The
policy
specified
with
the
Invoice
is
not
correct.
For
example,
it
may
belong
to
another
Adjudicator
or
Covered
Party.
|
|
2
|
INCPROV
INCPROV
|
incorrect
provider
|
The
provider
specified
with
the
Invoice
is
not
correct.
|
|
1
|
(_ActNoImmunizationReason)
_ActNoImmunizationReason
|
ActNoImmunizationReason
|
A
coded
description
of
the
reason
for
why
a
patient
did
not
receive
a
scheduled
immunization.
(important
for
public
health
strategy
|
|
2
|
IMMUNE
IMMUNE
|
immunity
|
Definition:Testing
has
shown
that
the
patient
already
has
immunity
to
the
agent
targeted
by
the
immunization.
|
|
2
|
MEDPREC
MEDPREC
|
medical
precaution
|
Definition:The
patient
currently
has
a
medical
condition
for
which
the
vaccine
is
contraindicated
or
for
which
precaution
is
warranted.
|
|
2
|
OSTOCK
OSTOCK
|
product
out
of
stock
|
Definition:There
was
no
supply
of
the
product
on
hand
to
perform
the
service.
|
|
2
|
PATOBJ
PATOBJ
|
patient
objection
|
Definition:The
patient
or
their
guardian
objects
to
receiving
the
vaccine.
|
|
2
|
PHILISOP
PHILISOP
|
philosophical
objection
|
Definition:The
patient
or
their
guardian
objects
to
receiving
the
vaccine
because
of
philosophical
beliefs.
|
|
2
|
RELIG
RELIG
|
religious
objection
|
Definition:The
patient
or
their
guardian
objects
to
receiving
the
vaccine
on
religious
grounds.
|
|
2
|
VACEFF
VACEFF
|
vaccine
efficacy
concerns
|
Definition:The
intended
vaccine
has
expired
or
is
otherwise
believed
to
no
longer
be
effective.
Example:Due
to
temperature
exposure.
|
|
2
|
VACSAF
VACSAF
|
vaccine
safety
concerns
|
Definition:The
patient
or
their
guardian
objects
to
receiving
the
vaccine
because
of
concerns
over
its
safety.
|
|
1
|
(_ActSupplyFulfillmentRefusalReason)
_ActSupplyFulfillmentRefusalReason
|
ActSupplyFulfillmentRefusalReason
|
Indicates
why
a
fulfiller
refused
to
fulfill
a
supply
order,
and
considered
it
important
to
notify
other
providers
of
their
decision.
E.g.
decision;
e.g.
"Suspect
fraud",
"Possible
abuse",
"Contraindicated".
(used
when
capturing
'refusal
to
fill'
annotations)
|
|
2
|
FRR01
FRR01
|
order
stopped
|
Definition:The
order
has
been
stopped
by
the
prescriber
but
this
fact
has
not
necessarily
captured
electronically.
Example:A
verbal
stop,
a
fax,
etc.
|
|
2
|
FRR02
FRR02
|
stale-dated
order
|
Definition:Order
has
not
been
fulfilled
within
a
reasonable
amount
of
time,
and
may
not
be
current.
|
|
2
|
FRR03
FRR03
|
incomplete
data
|
Definition:Data
needed
to
safely
act
on
the
order
which
was
expected
to
become
available
independent
of
the
order
is
not
yet
available
Example:Lab
results,
diagnostic
imaging,
etc.
|
|
2
|
FRR04
FRR04
|
product
unavailable
|
Definition:Product
not
available
or
manufactured.
Cannot
supply.
|
|
2
|
FRR05
FRR05
|
ethical/religious
|
Definition:The
dispenser
has
ethical,
religious
or
moral
objections
to
fulfilling
the
order/dispensing
the
product.
|
|
2
|
FRR06
FRR06
|
unable
to
provide
care
|
Definition:Fulfiller
not
able
to
provide
appropriate
care
associated
with
fulfilling
the
order.
Example:Therapy
requires
ongoing
monitoring
by
fulfiller
and
fulfiller
will
be
ending
practice,
leaving
town,
unable
to
schedule
necessary
time,
etc.
|
|
1
|
(_ClinicalResearchEventReason)
_ClinicalResearchEventReason
|
ClinicalResearchEventReason
|
Definition:Specifies
the
reason
that
an
event
occurred
in
a
clinical
research
study.
|
|
2
|
RET
RET
|
retest
|
Definition:The
event
occurred
so
that
a
test
or
observation
performed
at
a
prior
event
could
be
performed
again
due
to
conditions
set
forth
in
the
protocol.
|
|
2
|
SCH
SCH
|
scheduled
|
Definition:The
event
occurred
due
to
it
being
scheduled
in
the
research
protocol.
|
|
2
|
TRM
TRM
|
termination
|
Definition:The
event
occurred
in
order
to
terminate
the
subject's
participation
in
the
study.
|
|
2
|
UNS
UNS
|
unscheduled
|
Definition:The
event
that
occurred
was
initiated
by
a
study
participant
(e.g.
the
subject
or
the
investigator),
and
did
not
occur
for
protocol
reasons.
|
|
1
|
(_ClinicalResearchObservationReason)
_ClinicalResearchObservationReason
|
ClinicalResearchObservationReason
|
Definition:SSpecifies
the
reason
that
a
test
was
performed
or
observation
collected
in
a
clinical
research
study.
Note:This
set
of
codes
are
not
strictly
reasons,
but
are
used
in
the
currently
Normative
standard.
Future
revisions
of
the
specification
will
model
these
as
ActRelationships
and
thes
codes
may
subsequently
be
retired.
Thus,
these
codes
should
not
be
used
for
new
specifications.
|
|
2
|
NPT
NPT
|
non-protocol
|
Definition:The
observation
or
test
was
neither
defined
or
scheduled
in
the
study
protocol.
|
|
2
|
PPT
PPT
|
per
protocol
|
Definition:The
observation
or
test
occurred
due
to
it
being
defined
in
the
research
protocol,
and
during
an
activity
or
event
that
was
scheduled
in
the
protocol.
|
|
2
|
UPT
UPT
|
per
definition
|
:The
:The
observation
or
test
occurred
as
defined
in
the
research
protocol,
but
at
a
point
in
time
not
specified
in
the
study
protocol.
|
|
1
|
(_CombinedPharmacyOrderSuspendReasonCode)
_CombinedPharmacyOrderSuspendReasonCode
|
CombinedPharmacyOrderSuspendReasonCode
|
Description:Indicates
why
the
prescription
should
be
suspended.
|
|
2
|
ALTCHOICE
ALTCHOICE
|
try
another
treatment
first
|
Description:This
therapy
has
been
ordered
as
a
backup
to
a
preferred
therapy.
This
order
will
be
released
when
and
if
the
preferred
therapy
is
unsuccessful.
|
|
2
|
CLARIF
CLARIF
|
prescription
requires
clarification
|
Description:Clarification
is
required
before
the
order
can
be
acted
upon.
|
|
2
|
DRUGHIGH
DRUGHIGH
|
drug
level
too
high
|
Description:The
current
level
of
the
medication
in
the
patient's
system
is
too
high.
The
medication
is
suspended
to
allow
the
level
to
subside
to
a
safer
level.
|
|
2
|
HOSPADM
HOSPADM
|
admission
to
hospital
|
Description:The
patient
has
been
admitted
to
a
care
facility
and
their
community
medications
are
suspended
until
hospital
discharge.
|
|
2
|
LABINT
LABINT
|
lab
interference
issues
|
Description:The
therapy
would
interfere
with
a
planned
lab
test
and
the
therapy
is
being
withdrawn
until
the
test
is
completed.
|
|
2
|
NON-AVAIL
NON-AVAIL
|
patient
not-available
|
Description:Patient
not
available
for
a
period
of
time
due
to
a
scheduled
therapy,
leave
of
absence
or
other
reason.
|
|
2
|
PREG
PREG
|
parent
is
pregnant/breast
feeding
|
Description:The
patient
is
pregnant
or
breast
feeding.
The
therapy
will
be
resumed
when
the
pregnancy
is
complete
and
the
patient
is
no
longer
breastfeeding.
|
|
2
|
SALG
SALG
|
allergy
|
Description:The
patient
is
believed
to
be
allergic
to
a
substance
that
is
part
of
the
therapy
and
the
therapy
is
being
temporarily
withdrawn
to
confirm.
|
|
2
|
SDDI
SDDI
|
drug
interacts
with
another
drug
|
Description:The
drug
interacts
with
a
short-term
treatment
that
is
more
urgently
required.
This
order
will
be
resumed
when
the
short-term
treatment
is
complete.
|
|
2
|
SDUPTHER
SDUPTHER
|
duplicate
therapy
|
Description:Another
short-term
co-occurring
therapy
fulfills
the
same
purpose
as
this
therapy.
This
therapy
will
be
resumed
when
the
co-occuring
therapy
is
complete.
|
|
2
|
SINTOL
SINTOL
|
suspected
intolerance
|
Description:The
patient
is
believed
to
have
an
intolerance
to
a
substance
that
is
part
of
the
therapy
and
the
therapy
is
being
temporarily
withdrawn
to
confirm.
|
|
2
|
SURG
SURG
|
patient
scheduled
for
surgery
|
Description:The
drug
is
contraindicated
for
patients
receiving
surgery
and
the
patient
is
scheduled
to
be
admitted
for
surgery
in
the
near
future.
The
drug
will
be
resumed
when
the
patient
has
sufficiently
recovered
from
the
surgery.
|
|
2
|
WASHOUT
WASHOUT
|
waiting
for
old
drug
to
wash
out
|
Description:The
patient
was
previously
receiving
a
medication
contraindicated
with
the
current
medication.
The
current
medication
will
remain
on
hold
until
the
prior
medication
has
been
cleansed
from
their
system.
|
|
1
|
_ControlActNullificationReasonCode
|
ControlActNullificationReasonCode
|
Description:Identifies
reasons
for
nullifying
(retracting)
a
particular
control
act.
|
|
2
|
ALTD
ALTD
|
altered
decision
|
Description:The
decision
on
which
the
recorded
information
was
based
was
changed
before
the
decision
had
an
effect.
Example:Aborted
prescription
before
patient
left
office,
released
prescription
before
suspend
took
effect.
|
|
2
|
EIE
EIE
|
entered
in
error
|
Description:The
information
was
recorded
incorrectly
or
was
recorded
in
the
wrong
record.
|
|
2
|
NORECMTCH
NORECMTCH
|
no
record
match
|
Description:
There
is
no
match
for
the
record
in
the
database.
|
|
1
|
(_ControlActNullificationRefusalReasonType)
_ControlActNullificationRefusalReasonType
|
ControlActNullificationRefusalReasonType
|
Description:
Reasons
to
refuse
a
transaction
to
be
undone.
|
|
2
|
INRQSTATE
INRQSTATE
|
in
requested
state
|
The
record
is
already
in
the
requested
state.
|
|
2
|
NOMATCH
NOMATCH
|
no
match
|
Description:
There
is
no
match.
|
3
NORECMTCH
|
3
|
NOPRODMTCH
NOPRODMTCH
|
no
product
match
|
Description:
There
is
no
match
for
the
product
in
the
master
file
repository.
|
|
3
|
NOSERMTCH
NOSERMTCH
|
no
service
match
|
Description:
There
is
no
match
for
the
service
in
the
master
file
repository.
|
|
3
|
NOVERMTCH
NOVERMTCH
|
no
version
match
|
Description:
There
is
no
match
for
the
record
and
version.
|
|
2
|
NOPERM
NOPERM
|
no
permission
|
Description:
There
is
no
permission.
|
|
3
|
NOUSERPERM
NOUSERPERM
|
no
user
permission
|
Definition:The
user
does
not
have
permission
|
|
3
|
NOAGNTPERM
NOAGNTPERM
|
no
agent
permission
|
Description:
The
agent
does
not
have
permission.
|
|
3
|
NOUSRPERM
|
no
user
permission
|
Description:
The
user
does
not
have
permission.
|
|
2
|
WRNGVER
WRNGVER
|
wrong
version
|
Description:
The
record
and
version
requested
to
update
is
not
the
current
version.
|
|
1
|
(_ControlActReason)
_ControlActReason
|
ControlActReason
|
Identifies
why
a
specific
query,
request,
or
other
trigger
event
occurred.
|
|
2
|
(_MedicationOrderAbortReasonCode)
_MedicationOrderAbortReasonCode
|
medication
order
abort
reason
|
Description:Indicates
the
reason
the
medication
order
should
be
aborted.
|
|
3
|
DISCONT
DISCONT
|
product
discontinued
|
Description:The
medication
is
no
longer
being
manufactured
or
is
otherwise
no
longer
available.
|
|
3
|
INEFFECT
INEFFECT
|
ineffective
|
Description:The
therapy
has
been
found
to
not
have
the
desired
therapeutic
benefit
on
the
patient.
|
|
3
|
MONIT
MONIT
|
response
to
monitoring
|
Description:Monitoring
the
patient
while
taking
the
medication,
the
decision
has
been
made
that
the
therapy
is
no
longer
appropriate.
|
|
3
|
NOREQ
NOREQ
|
no
longer
required
for
treatment
|
Description:The
underlying
condition
has
been
resolved
or
has
evolved
such
that
a
different
treatment
is
no
longer
needed.
|
|
3
|
NOTCOVER
NOTCOVER
|
not
covered
|
Description:The
product
does
not
have
(or
no
longer
has)
coverage
under
the
patientaTMs
insurance
policy.
|
|
3
|
PREFUS
PREFUS
|
patient
refuse
|
Description:The
patient
refused
to
take
the
product.
|
|
3
|
RECALL
RECALL
|
product
recalled
|
Description:The
manufacturer
or
other
agency
has
requested
that
stocks
of
a
medication
be
removed
from
circulation.
|
|
3
|
REPLACE
REPLACE
|
change
in
order
|
Description:Item
in
current
order
is
no
longer
in
use
as
requested
and
a
new
one
has/will
be
created
to
replace
it.
|
|
4
|
DOSECHG
DOSECHG
|
change
in
medication/dose
|
Description:The
medication
is
being
re-prescribed
at
a
different
dosage.
|
|
3
|
REPLACEFIX
REPLACEFIX
|
error
in
order
|
Description:Current
order
was
issued
with
incorrect
data
and
a
new
order
has/will
be
created
to
replace
it.
|
|
3
|
UNABLE
UNABLE
|
unable
to
use
|
Description:<The
patient
is
not
(or
is
no
longer)
able
to
use
the
medication
in
a
manner
prescribed.
Example:CanaTMt
swallow.
|
|
2
|
(_MedicationOrderReleaseReasonCode)
_MedicationOrderReleaseReasonCode
|
medication
order
release
reason
|
Definition:A
collection
of
concepts
that
indicate
why
the
prescription
should
be
released
from
suspended
state.
|
|
3
|
HOLDDONE
HOLDDONE
|
suspend
reason
no
longer
applies
|
Definition:The
original
reason
for
suspending
the
medication
has
ended.
|
|
3
|
HOLDINAP
HOLDINAP
|
suspend
reason
inappropriate
|
Definition:
|
|
2
|
(_ModifyPrescriptionReasonType)
_ModifyPrescriptionReasonType
|
ModifyPrescriptionReasonType
|
Types
of
reason
why
a
prescription
is
being
changed.
|
|
3
|
ADMINERROR
ADMINERROR
|
administrative
error
in
order
|
Order
was
created
with
incorrect
data
and
is
changed
to
reflect
the
intended
accuracy
of
the
order.
|
|
3
|
CLINMOD
CLINMOD
|
clinical
modification
|
Order
is
changed
based
on
a
clinical
reason.
|
|
2
|
_PharmacySupplyEventAbortReason
_PharmacySupplyEventAbortReason
|
PharmacySupplyEventAbortReason
|
Definition:Identifies
why
the
dispense
event
was
not
completed.
|
|
3
|
CONTRA
CONTRA
|
contraindication
|
Definition:Contraindication
identified
|
|
3
|
FOABORT
FOABORT
|
order
aborted
|
Definition:Order
to
be
fulfilled
was
aborted
|
|
3
|
FOSUSP
FOSUSP
|
order
suspended
|
Definition:Order
to
be
fulfilled
was
suspended
|
|
3
|
NOPICK
NOPICK
|
not
picked
up
|
Definition:Patient
did
not
come
to
get
medication
|
|
3
|
PATDEC
PATDEC
|
patient
changed
mind
|
Definition:Patient
changed
their
mind
regarding
obtaining
medication
|
|
3
|
QUANTCHG
QUANTCHG
|
change
supply
quantity
|
Definition:Patient
requested
a
revised
quantity
of
medication
|
|
2
|
(_PharmacySupplyEventStockReasonCode)
_PharmacySupplyEventStockReasonCode
|
pharmacy
supply
event
stock
reason
|
Definition:A
collection
of
concepts
that
indicates
the
reason
for
a
"bulk
supply"
of
medication.
|
|
3
|
FLRSTCK
FLRSTCK
|
floor
stock
|
Definition:The
bulk
supply
is
issued
to
replenish
a
ward
for
local
dispensing.
(Includes
both
mobile
and
fixed-location
ward
stocks.)
|
|
3
|
LTC
LTC
|
long
term
care
use
|
Definition:The
bulk
supply
will
be
administered
within
a
long
term
care
facility.
|
|
3
|
OFFICE
OFFICE
|
office
use
|
Definition:The
bulk
supply
is
intended
for
general
clinician
office
use.
|
|
3
|
PHARM
PHARM
|
pharmacy
transfer
|
Definition:The
bulk
supply
is
being
transferred
to
another
dispensing
facility
to.
Example:Alleviate
a
temporary
shortage.
|
|
3
|
PROG
PROG
|
program
use
|
Definition:The
bulk
supply
is
intended
for
dispensing
according
to
a
specific
program.
Example:Mass
immunization.
|
|
2
|
(_PharmacySupplyRequestRenewalRefusalReasonCode)
_PharmacySupplyRequestRenewalRefusalReasonCode
|
pharmacy
supply
request
renewal
refusal
reason
|
Definition:A
collection
of
concepts
that
identifies
why
a
renewal
prescription
has
been
refused.
|
3
DISCONT
|
3
|
ALREADYRX
ALREADYRX
|
new
prescription
exists
|
Definition:Patient
has
already
been
given
a
new
(renewal)
prescription.
|
|
3
|
FAMPHYS
FAMPHYS
|
family
physician
must
authorize
further
fills
|
Definition:Request
for
further
authorization
must
be
done
through
patient's
family
physician.
|
|
3
|
MODIFY
MODIFY
|
modified
prescription
exists
|
Definition:Therapy
has
been
changed
and
new
prescription
issued
|
|
3
|
NEEDAPMT
NEEDAPMT
|
patient
must
make
appointment
|
Definition:Patient
must
see
prescriber
prior
to
further
fills.
|
|
3
|
NOTAVAIL
NOTAVAIL
|
prescriber
not
available
|
Definition:Original
prescriber
is
no
longer
available
to
prescribe
and
no
other
prescriber
has
taken
responsibility
for
the
patient.
|
|
3
|
NOTPAT
NOTPAT
|
patient
no
longer
in
this
practice
|
Definition:Patient
no
longer
or
has
never
been
under
this
prescribers
care.
|
|
3
|
ONHOLD
ONHOLD
|
medication
on
hold
|
Definition:This
medication
is
on
hold.
|
|
3
|
PRNA
PRNA
|
product
not
available
|
Description:This
product
is
not
available
or
manufactured.
|
|
3
|
STOPMED
STOPMED
|
prescriber
stopped
medication
for
patient
|
Renewing
or
original
prescriber
informed
patient
to
stop
using
the
medication.
|
|
3
|
TOOEARLY
TOOEARLY
|
too
early
|
Definition:The
patient
should
have
medication
remaining.
|
|
2
|
(_SupplyOrderAbortReasonCode)
_SupplyOrderAbortReasonCode
|
supply
order
abort
reason
|
Definition:A
collection
of
concepts
that
indicates
why
the
prescription
should
no
longer
be
allowed
to
be
dispensed
(but
can
still
administer
what
is
already
being
dispensed).
|
|
3
|
IMPROV
IMPROV
|
condition
improved
|
Definition:The
patient's
medical
condition
has
nearly
abated.
|
|
3
|
INTOL
INTOL
|
intolerance
|
Description:The
patient
has
an
intolerance
to
the
medication.
|
|
3
|
NEWSTR
NEWSTR
|
new
strength
|
Definition:The
current
medication
will
be
replaced
by
a
new
strength
of
the
same
medication.
|
|
3
|
NEWTHER
NEWTHER
|
new
therapy
|
Definition:A
new
therapy
will
be
commenced
when
current
supply
exhausted.
|
|
1
|
(_GenericUpdateReasonCode)
_GenericUpdateReasonCode
|
GenericUpdateReasonCode
|
Description:Identifies
why
a
change
is
being
made
to
a
record.
|
|
2
|
CHGDATA
CHGDATA
|
information
change
|
Description:Information
has
changed
since
the
record
was
created.
|
|
2
|
FIXDATA
FIXDATA
|
error
correction
|
Description:Previously
recorded
information
was
erroneous
and
is
being
corrected.
|
|
2
|
MDATA
MDATA
|
merge
data
|
Information
is
combined
into
the
record.
|
|
2
|
NEWDATA
NEWDATA
|
new
information
|
Description:New
information
has
become
available
to
supplement
the
record.
|
|
2
|
UMDATA
UMDATA
|
unmerge
data
|
Information
is
separated
from
the
record.
|
|
1
|
(_PatientProfileQueryReasonCode)
_PatientProfileQueryReasonCode
|
patient
profile
query
reason
|
Definition:A
collection
of
concepts
identifying
why
the
patient's
profile
is
being
queried.
|
|
2
|
ADMREV
ADMREV
|
administrative
review
|
Definition:
To
evaluate
for
service
authorization,
payment,
reporting,
or
performance/outcome
measures.
|
2
LEGAL
|
2
|
PATCAR
PATCAR
|
patient
care
|
Definition:To
obtain
records
as
part
of
patient
care.
|
|
2
|
PATREQ
PATREQ
|
patient
request
query
|
Definition:Patient
requests
information
from
their
profile.
|
|
2
|
PRCREV
PRCREV
|
practice
review
|
Definition:To
evaluate
the
provider's
current
practice
for
professional-improvement
reasons.
|
|
2
|
REGUL
REGUL
|
regulatory
review
|
Description:Review
for
the
purpose
of
regulatory
compliance.
|
|
2
|
RSRCH
RSRCH
|
research
|
Definition:To
provide
research
data,
as
authorized
by
the
patient.
|
|
2
|
VALIDATION
VALIDATION
|
validation
review
|
Description:To
validate
the
patient's
record.
Example:Merging
or
unmerging
records.
|
|
1
|
_PharmacySupplyRequestFulfillerRevisionRefusalReasonCode
|
PharmacySupplyRequestFulfillerRevisionRefusalReasonCode
|
Definition:Indicates
why
the
request
to
transfer
a
prescription
from
one
dispensing
facility
to
another
has
been
refused.
|
|
2
|
LOCKED
LOCKED
|
locked
|
Definition:The
prescription
may
not
be
reassigned
from
the
original
pharmacy.
|
2
NOUSERPERM
|
2
|
UNKWNTARGET
UNKWNTARGET
|
unknown
target
|
Definition:The
target
facility
does
not
recognize
the
dispensing
facility.
|
|
1
|
(_RefusalReasonCode)
_RefusalReasonCode
|
RefusalReasonCode
|
Description:
Identifies
why
a
request
to
add
(or
activate)
a
record
is
being
refused.
Examples
include
the
receiving
system
not
able
to
match
the
identifier
and
find
that
record
in
the
receiving
system,
having
no
permission,
or
a
detected
issue
exists
which
precludes
the
requested
action.
|
2
NOMATCH
2
NOPERM
|
1
|
(_SchedulingActReason)
_SchedulingActReason
|
SchedulingActReason
|
Reasons
for
cancelling
or
rescheduling
an
Appointment
|
2
PAT
|
2
|
BLK
BLK
|
Unexpected
Block
(of
Schedule)
|
The
time
slots
previously
allocated
are
now
blocked
and
no
longer
available
for
booking
Appointments
|
|
2
|
DEC
DEC
|
Patient
Deceased
|
The
Patient
is
deceased
|
|
2
|
FIN
FIN
|
No
Financial
Backing
|
Patient
unable
to
pay
and
not
covered
by
insurance
|
|
2
|
MED
MED
|
Medical
Status
Altered
|
The
medical
condition
of
the
Patient
has
changed
|
|
2
|
MTG
MTG
|
In
an
outside
meeting
|
The
Physician
is
in
a
meeting.
For
example,
he/she
may
request
administrative
time
to
talk
to
family
after
appointment
|
|
2
|
PHY
PHY
|
Physician
request
|
The
Physician
requested
the
action
|
|
1
|
_StatusRevisionRefusalReasonCode
|
StatusRevisionRefusalReasonCode
|
Indicates
why
the
act
revision
(status
update)
is
being
refused.
2
NORECMTCH
2
INRQSTATE
|
2
NOUSERPERM
|
2
|
FILLED
FILLED
|
fully
filled
|
Ordered
quantity
has
already
been
completely
fulfilled.
|
|
1
|
_SubstanceAdministrationPermissionRefusalReasonCode
|
SubstanceAdministrationPermissionRefusalReasonCode
|
Definition:Indicates
why
the
requested
authorization
to
prescribe
or
dispense
a
medication
has
been
refused.
|
2
NOUSERPERM
|
2
|
PATINELIG
PATINELIG
|
patient
not
eligible
|
Definition:Patient
not
eligible
for
drug
|
|
2
|
PROTUNMET
PROTUNMET
|
protocol
not
met
|
Definition:Patient
does
not
meet
required
protocol
|
|
2
|
PROVUNAUTH
PROVUNAUTH
|
provider
not
authorized
|
Definition:Provider
is
not
authorized
to
prescribe
or
dispense
|
|
1
|
(_SubstanceAdminSubstitutionNotAllowedReason)
_SubstanceAdminSubstitutionNotAllowedReason
|
SubstanceAdminSubstitutionNotAllowedReason
|
Reasons
why
substitution
of
a
substance
administration
request
is
not
permitted.
|
2
PAT
|
2
|
ALGINT
ALGINT
|
allergy
intolerance
|
Definition:
Patient
has
had
a
prior
allergic
intolerance
response
to
alternate
product
or
one
of
its
components.
|
|
2
|
COMPCON
COMPCON
|
compliance
concern
|
Definition:
Patient
has
compliance
issues
with
medication
such
as
differing
appearance,
flavor,
size,
shape
or
consistency.
|
|
2
|
THERCHAR
THERCHAR
|
therapeutic
characteristics
|
The
prescribed
product
has
specific
clinical
release
or
other
therapeutic
characteristics
not
shared
by
other
substitutable
medications.
|
|
2
|
TRIAL
TRIAL
|
clinical
trial
drug
|
Definition:
The
specific
manufactured
drug
is
part
of
a
clinical
trial.
|
|
1
|
(_SubstanceAdminSubstitutionReason)
_SubstanceAdminSubstitutionReason
|
SubstanceAdminSubstitutionReason
|
SubstanceAdminSubstitutionReason
|
|
2
|
CT
CT
|
continuing
therapy
|
Indicates
that
the
decision
to
substitute
or
to
not
substitute
was
driven
by
a
desire
to
maintain
consistency
with
a
pre-existing
therapy.
I.e.
The
performer
provided
the
same
item/service
as
had
been
previously
provided
rather
than
providing
exactly
what
was
ordered,
or
rather
than
substituting
with
a
lower-cost
equivalent.
|
|
2
|
FP
FP
|
formulary
policy
|
Indicates
that
the
decision
to
substitute
or
to
not
substitute
was
driven
by
a
policy
expressed
within
the
formulary.
|
|
2
|
OS
OS
|
out
of
stock
|
In
the
case
of
'substitution',
indicates
that
the
substitution
occurred
because
the
ordered
item
was
not
in
stock.
In
the
case
of
'no
substitution',
indicates
that
a
cheaper
equivalent
was
not
substituted
because
it
was
not
in
stock.
|
|
2
|
RR
RR
|
regulatory
requirement
|
Indicates
that
the
decision
to
substitute
or
to
not
substitute
was
driven
by
a
jurisdictional
regulatory
requirement
mandating
or
prohibiting
substitution.
|
|
1
|
(_TransferActReason)
_TransferActReason
|
TransferActReason
|
The
explanation
for
why
a
patient
is
moved
from
one
location
to
another
within
the
organization
|
|
2
|
ER
ER
|
Error
|
Moved
to
an
error
in
placing
the
patient
in
the
original
location.
|
|
2
|
RQ
RQ
|
Request
|
Moved
at
the
request
of
the
patient.
|
|
1
|
_ActBillableServiceReason
|
ActBillableServiceReason
|
Definition:
This
domain
is
used
to
document
reasons
for
providing
a
billable
service;
the
billable
services
may
include
both
clinical
services
and
social
services.
|
|
2
|
_ActBillableClinicalServiceReason
|
ActBillableClinicalServiceReason
|
Reason
for
Clinical
Service
being
performed.
This
domain
excludes
reasons
specified
by
diagnosed
conditions.
Examples
of
values
from
this
domain
include
duplicate
therapy
and
fraudulent
prescription.
|
|
1
|
BONUS
| | |
|
1
|
CHD
|
Children
only
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
only
to
children
|
|
1
|
DEP
|
Dependents
only
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
only
to
a
subscriber's
dependents.
|
|
1
|
ECH
|
Employee
and
children
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
to
an
employee
and
his
or
her
children.
|
|
1
|
EDU
| | |
|
1
|
EMP
|
Employee
only
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
only
to
an
employee.
|
|
1
|
ESP
|
Employee
and
spouse
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
to
an
employee
and
his
or
her
spouse.
|
|
1
|
FAM
|
Family
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
to
a
subscriber's
family.
|
|
1
|
IND
|
Individual
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
to
an
individual.
|
|
1
|
INVOICE
| | |
|
1
|
PROA
| | |
|
1
|
RECOV
| | |
|
1
|
RETRO
| | |
|
1
|
SPC
|
Spouse
and
children
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
to
a
subscriber's
spouse
and
children
|
|
1
|
SPO
|
Spouse
only
|
Description:The
level
of
coverage
under
the
policy
or
program
is
available
only
to
a
subscribers
spouse
|
|
1
|
TRAN
| | |